Health Care

Quote of the Day

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There is one aspect of the change in moral values brought about by the advance of collectivism which at the present time provides special food for thought. It is that the virtues which are held less and less in esteem and which consequently become rarer are precisely those on which the British people justly prided themselves and in which they were generally agreed to excel. The virtues possessed by Anglo-Saxons in a higher degree than most other people, excepting only a few of the smaller nations, like the Swiss and the Dutch, were independence and self-reliance, individual initiative and local responsibility, the successful reliance on voluntary activity, noninterference with one’s neighbor and tolerance of the different and queer, respect for custom and tradition, and a healthy suspicion of power and authority.

F.A. Hayek, The Road to Serfdom

The Self-Reflecting Mirror of Good Intentions

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“The most interesting, under-discussed, and potentially revolutionary aspect of the law is that it doesn’t pretend to have the answers. Instead, through a new Center for Medicare and Medicaid Innovation, it offers to free communities and local health systems from existing payment rules, and let them experiment with ways to deliver better care at lower costs. In large part, it entrusts the task of devising cost-saving health-care innovation to communities like Boise and Boston and Buffalo, rather than to the drug and device companies and the public and private insurers that have failed to do so. This is the way costs will come down—or not.” – Atul Gawande, The New Yorker (via Real Clear Politics)

Or not? Or not? Or not?

Wait a minute. Proponents of Health Care Reform insisted that a crisis existed in American medicine – a crisis of steadily increasing costs and the uninsured. Forget for a moment the pages and pages and pages of regulation: the essential steel-frame structure at the heart of the bill consists – it seems to me! – of committees that have yet to write the myriad of rules that will govern the future of health care in this country. Isn’t that the case? Am I getting it wrong? And if I am, it’s not like the authors of the legislation took care to write something a layperson like me could understand. Do even the authors know what is in it?

I respect the good Dr. Gawande very much, but I cannot understand how any physician or scientist – who ought to pride him or herself on evidence-based medicine – would sign off on something like this? It’s all supposition. It’s all promises. It’s all the self-reflecting mirror of good intentions.* There’s no there there. Not really. Not if you look beyond the gimmicks.

Hey, if I’m being unfair, or misunderstanding, drop a line in the comments box, okay?

* I used the above phrase in this comment at zenpundit on an entirely different subject. I’m pretty sure I made it up on the spot, but somehow, I always have a subterranean fear that I am plagiarizing someone a lot more clever than I am. Not sure what that is about, but now, thanks to my penchant for TMI, you all know that about me!

Update: I am not saying the uninsured or costs are not a serious problem. What I am arguing is that the very legislation intended to solve the problem of cost is a roll of the dice in that regard. Why do we need an oxymoronic government “department of innovation” anyway? Why not break down government-set barriers and allow the experimentation to take place in the absence of said barriers? Honestly, I couldn’t understand a bit of the logic behind that article.

Another Update: “Two Views On Health Care From The New Yorker,” Peter Suderman (Reason – Hit and Run)

Images, Analogies, and Cooties

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In a comment, Mishu linked to “The Lie of a Liberal Arts Education.” Jeff Goldstein, of Protein Wisdom, tells us after a political cartoon was posted at his site, an old teacher e-mailed him, requesting that his name be struck from the list of Goldstein’s teachers. That we are responsible for those who have studied under us would make neither my raft of old teachers very happy nor me about many of my students. (Jonathan’s need to fix my comma splices, for instance, must make one of them spin in his grave.)

I’d seen the comment (for the usual reason, groggy in the morning and late at night, I check out Instapundit). And I’d remembered it clearly, since it brought home the adolescent and enforced homogeneity of academic thinking but also because the cartoon was especially memorable, disturbing the way political cartoons can be. The visual and analogous are powerful weapons. The Muslims realize that – and we should, too. That doesn’t mean, of course, that we follow the actions of either the Jihadists or the average college faculty. When I went back later to show it to my husband, the cartoon was linked but no longer at the top of the page. It provokes, but it has a certain rightness. I found it and my husband was repelled. He felt it was in bad taste. His explanation for that gut reaction was not a defense of Obama nor of the content or the process of Healthcare legislation as would any sentient being, he sees those as pretty bad. Nor did he see it as racist indeed, worrying about that label would make any criticism difficult.

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To be clear….

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“To be clear: it is not sufficient for those of us in the opposition to await a reversal of political fortune months or years from now before we advance action on health care reform. Costs will continue their ascent as the debt burden squeezes life out of our economy. We are unapologetic advocates for the repeal of this costly misstep. But Republicans must also make the case for a reform agenda to take its place, and get to work on that effort now.” – Paul Ryan in the New York Times

Is that “to be clear” intended as a little dig at the rhetorical style, or stylings, of our President? Gentle jokes aside, this is a very good Op-Ed.

*Because there’s more to life than Health Care Bills, here is a link about the William Eggleston photo exhibit at the Art Institute of Chicago. The exhibit is running until May 23.

But the evidence is right there – right there! – in front of you.

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(paraphrasing a conversation)

Me: Hi, I’m calling about my AMA dues notice?
AMA representative: Yes?
Me: I’m not a member currently. I’d like to be removed from your mailing list, please. I don’t plan on becoming a member any time soon, so I don’t need the dues notices.
AMA representative: Okay.

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From the AMA website a couple of days before the vote: “Washington, D.C. After careful review and consideration, the American Medical Association (AMA) today announced its qualified support for the current health reform bill as a step toward providing coverage to all Americans and improving our nation’s health system.”

Also from the AMA website (where they have a counter “counting down” to the 21% Medicare Physician cuts with the admonition to “take action now”:)

“Resolving the problem now is the fiscally responsible course to take. Relying on past methods of postponing the immediate crisis will only increase the cost of a permanent repeal. Congress can no longer afford to kick the can down the road.”

Does anyone want to explain the above statement to me? Seriously, I’m trying to understand what the organization might mean with that statement about fiscal responsibility – as they ask members to call and complain about cuts to physician medicare payments. What was that about CBO scoring again? I’m a dunce at all of this, so I ask for help from the readership! It’s a real question….