Medicine

Conspiracy Theories

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Last week was a week for the conspiracy theories. First, we had Benghazi and the hearings which interviewed career State Department officers, most of whom probably vote for Democrats. The fact that they were ordered not to talk to Congressmen and denied any attempt at help when under attack, even from as close as Tripoli, invites speculation about motive. Peggy Noonan, a little unusually, hits this one out of the park.

Since it is behind a pay wall, I’ll quote a few bits.

What happened in Benghazi last Sept. 11 and 12 was terrible in every way. The genesis of the scandal? It looks to me like this:

The Obama White House sees every event as a political event. Really, every event, even an attack on a consulate and the killing of an ambassador.

Because of that, it could not tolerate the idea that the armed assault on the Benghazi consulate was a premeditated act of Islamist terrorism. That would carry a whole world of unhappy political implications, and demand certain actions. And the American presidential election was only eight weeks away. They wanted this problem to go away, or at least to bleed the meaning from it.

That sounds about right to me.

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Kids These Days

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At the age of 21, Danielle Fong cofounded LightSail Energy, a venture focused on energy storage via compressed air, with heat generated by the compression recovered for later use. Investors include Peter Thiel, Khosla Ventures, and Bill Gates. (GE and RWE of Germany are also developing a compressed-air-based energy storage technology that they call  ADELE…it will be interesting to see how these two alternative approaches play out.)

A New York University student has developed a new substance for wound closure, which may be able to replace bandages in many cases. Any comments, Michael K?

 

“Healthcare 2.0”

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This issue has to be handled carefully by reform proponents. Otherwise leftist pols, in tacit collaboration with tech lobbyists who want to be paid to create an automated version of the current system, with reduced costs based on fewer workers and worse (rationed) service, may frame the issue as NHS-style single-payer vs. greedy doctors. Therefore it’s important to argue that the right kinds of reforms might greatly improve the quality of medical care AND the patient’s experience, as well as reduce costs. Mead doesn’t quite make this case.

Currently one sees increased reliance (in the USA) on nurses and physician’s assistants to do things that physicians formerly did. This makes sense to some extent but there is a limit to the amount of skilled work that can be shifted away from physicians without degrading quality of care. The Obama model is to cut costs by overworking a smaller number of physicians while shifting as much work as possible to less-well-paid workers, making patients wait longer, reducing quality of care overall and expecting people to put up with it. The better alternative would lower costs and improve care by using technology to increase productivity.

The Obama model is hostile to the high-tech alternative because 1) the Obama people don’t have a clue about either economics or medicine and 2) high-tech reforms would contribute to decentralization and individual control of medicine, and Obamaism rejects decentralization and individual control on principle.

Queen to UK: Stay away from the NHS

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The Queen has fallen ill, gastroenteritis to be specific. She has been taken to King Edward VII hospital in London. This hospital bills itself as the leading private hospital in London.

Why is she not staying at an NHS hospital? Gastroenteritis is not particularly complicated or unusual and should be well within the capabilities of any decent hospital facility of the most rudimentary type.

The Queen of England’s main role is to provide an example, a symbol. She is doing so today with the choice of her hospital. But is anybody paying attention?

It’s a Matter of Trust

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As the old Billy Joel song goes; that is, a fair portion of a civil society is built on trust. Or at least a large portion of the citizens in that society not only trust each other, but they generally also trust the civil institutions, too. There is an assumption, albeit slightly frayed around some edges that our institutions are generally benign and have the well-being of the larger public at heart. We assume, or did in the past, that laws are passed for our benefit, that rules are instituted for the same reason, that our elected leaders did, or at least mostly made a convincing pretense of representing the interests of their constituents, and not those of lobbyists bearing large favors.

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