Thursday, September 30, 2010

The Lobbying Heats Up

The 9/27/2010 Denver Post reports that, "Christian Scientists push for health insurance that covers spiritual care".

This is a completely predictable development. When the government specifies what benefits shall (or shall not) be covered by insurance, special interest groups will lobby ferociously to have their particular pet benefit be part of the mandatory package.

The result is that ordinary people are forced to pay extra for "benefits" they may neither need nor want in order to satisfy those with the greatest political pull.

As I discussed a few months ago in the 3/24/2010 Denver Post, this turns medicine into a permanent political football.

Wednesday, September 29, 2010

Quick Links: IT Consequences, MLR

The 9/27/2010 Wall Street Journal health blog discusses how, "Computerized Order Entry System Has Unintended Consequences". Expect to see more of this as physicians are forced to adopt government-approved health IT systems.

Why should you care about MLR's ("medical loss ratios")? John R. Graham of PRI discusses why in, "ObamaCare Will Dramatically Reduce Choice in Private Insurance".

Tuesday, September 28, 2010

More Mammography Brouhaha

The question of the value of screening mammography is in the news again.

Here is one typical article from the 9/22/2010 New York Times, "Mammograms' Value in Cancer Fight at Issue".

The abstract of the original paper at the New England Journal of Medicine is here at, "Effect of Screening Mammography on Breast-Cancer Mortality in Norway".

Of the various commentary I've seen, one of the best has been from the 9/23/2010 Wall Street Journal Health Blog, "Study: Mammograms Save Lives — Just Not As Many As Expected".

As NEJM co-author Marvin Zelen notes in the WSJ piece:
Zelen says women need to weigh the benefits of screening (a lower chance of dying from breast cancer, at least in this age group) against possible risks. As an accompanying editorial notes, those include false alarms and unnecessary biopsies, as well as the "less frequent but more worrisome" problem of needlessly treating cancer found via mammogram that never would have amounted to anything if it went undetected. If you take the approach of "minimizing the maximum risk," as Zelen says, that suggests being screened.

But "we have to make decisions about our health on the basis of what's important to us," he says.
That last point deserves highlighting.

Patients must have the freedom to decide for themselves (in consultation with their doctors) whether they wish to undergo certain tests and procedures -- or if the risk aren't worth it (in their opinion). Those decisions are intensely personal and no government agency can or should make those decisions for us.

Hence, people should be left free to spend their own health care dollars according to their own best judgment for their benefit based on their priorities and values.

This precious freedom will evaporate as ObamaCare is implemented. Instead of patients and doctors making these decisions according to the patient's values, they will be made by central committees enforcing "practice guidelines" dictated from above to doctors working in government-sanctioned "Accountable Care Organizations" and "Medical Homes". These decisions will be based on the government's values, not the patients'.

Do Americans really want the government making these decisions for them?

Monday, September 27, 2010

Haynes on the Doctor-Patient Relationship

Dr. Beth Haynes of the Black Ribbon Project has a great post on how ObamaCare will destroy the doctor-patient relationship.

Nor is this some "unintended consequence". Instead, it is the explicitly desired goal of men like Donald Berwick.

Read the full text of, "ACA intentionally undermines the Doctor-Patient relationship".

Friday, September 24, 2010

Faith-Based Propaganda

The Obama Administration further entangled religion and politics in this latest attempt to salvage his deeply unpopular health care plan.

Sarah Kliff at Politico reports, "Obama seeks divine intervention on health care":
With nothing else working, President Barack Obama is asking religious leaders to help him sell the public on health care reform.

POLITICO listened in to an Oval Office conference call Tuesday, where Obama and top administration officials, beseeched thousands of faith-based and community organizations to preach the gospel on new insurance reforms, chiefly the Patients' Bill of Rights.

"Get out there and spread the word," Obama told leaders from across the religious spectrum on the conference call, organized by the Health and Human Services Center for Faith-Based and Community Partnerships.
(Read the full text of "Obama seeks divine intervention on health care". Link via David Catron.)

His appeal to faith is not surprising, especially given that fact-based analysis of the law increasingly shows that "Obamacare is even worse than critics thought" (Washington Examiner, 9/22/2010).

Two quick comments:

1) I support the principle of separation of church and state. Hence, I think it's inappropriate for politicians of either major political party to attempt to enlist any kind of official religious backing (or opposition) to government policies.

2) I am also a supporter of abortion rights.

Hence, with respect to the Examiner OpEd, it is true that one serious problem with ObamaCare is that it compels people to pay for others' elective abortions against their will. But this is just an instance of the more fundamental problem -- namely that ObamaCare compels people to pay for all sorts of medical procedures (such as heart surgeries and colonoscopies) for others against their will.

Thursday, September 23, 2010

Hennenfent on Death Panels

Dr. Brad Hennenfent has updated his blog post, "The 'Death Panels' are Real and They Exist Now".

He notes that the stealth rationing occurs due to government policy and "crony capitalism" (i.e., insurance companies acting as proxies for the government).

The quote by Dr. Kevin Pezzi on the problems of the government-run VA hospital system is especially worth reading. Here's an excerpt:
Anyone who values their life, or the lives of loved ones, should fear any healthcare system controlled by the government because the government excels at creating massive bureaucracies, such as those in VA hospitals, in which employees who are not doctors can overrule physician orders. No President or Congressman would have the guts to personally tell a doctor what he can and cannot do, but the need of politicians to control us is so strong that they create cold and uncaring bureaucracies to do the dirty work for them.

Who is on the short end of the stick when politicians ration care? Patients, who pay for that rationing with more suffering and an increased risk of death. President Obama tried to dismiss the notion of government "death panels" by claiming that he would create no such bureaucracy. He doesn't need to do that to achieve his objectives because every government bureaucracy in which doctors can be overruled by people who don't know what they are doing is functionally a death panel even though it is never labeled as such.

Wednesday, September 22, 2010

Quick Links: Avastin, Taxes, Thuggery

The FDA has delayed its decision on whether or not to ration the cancer drug Avastin until after the November elections.

ObamaCare levies a new 3.8% tax on the sale of your home.

Brian Schwartz covers the upcoming state-level thuggery here in Colorado over some insurers' plans to stop offering certain types of plans due to costly government regulations.

Tuesday, September 21, 2010

FIRM's Facebook Page

I recently created a fan page on Facebook for FIRM. If you're a fan, please spread the word about free market medicine by hitting the "like" button!

Also, you can find FIRM on Twitter here: @WeStandFIRM.

Zawistowski On Free Market Health Reforms

The Fall 2010 issue of The Objective Standard features an article on free market health care reforms by Stella Daily Zawistowski, "A Prescription for America's Health Care Ills".

Her article:
Compares and contrasts the cost, quality, and accessibility of government-regulated, rights-violating medicine with that of free-market, rights-respecting medicine and finds, once again, that the moral is the practical.
The introduction is available to all.

Subscribers have access for the full text. Interested non-subscribers can purchase the PDF for $3.95.

Monday, September 20, 2010

Armstrong Interviews Cassell

Ari Armstrong attended the 9/12 Tea Party rally in Washington, DC, and interviewed several participants, including Dr. Jack Cassell.

Casell is the Florida urologist who made national headlines by posting a sign on his office door after ObamaCare had passed saying, "If you voted for Obama, seek urologic care elsewhere".

The short segment with Dr. Cassell starts at 0:29:

In particular, Cassell notes that ObamaCare makes it impossible for doctors to uphold their Hippocratic Oath to their patients. And it will lower the life expectancy of the American people. He also expects that it will be "defunded", then eventually repealed.

Let's hope he's right.

Saturday, September 18, 2010

Catron on Accountability

David Catron writes on "Accountability and Its Discontents".

He examines some of the leading theories by leftist pundits as to why America has turned so sharply against the current administration's policies:
...[A] variety of lesser liberal outlets have used their columns and posts to vent frustration with the electorate's inability to see that the current regime has been a success. Why, they ask, is the public not grateful for the "historic" health reform bill, the stimulus package and Wall Street reform? What, they demand to know, are the voters not getting?
Catron notes that they are blaming the voters -- for instance, blaming it on voters' seeming madness ("cognitive dissonance"), stupidity, or racism.

Of course, they seem to not even consider the possibility that the voters' concerns are justified -- that Americans don't want their freedoms infringed, that they don't want their hard-earned money spent on boondoggle make-work "stimulus" projects, and they don't want to support a system that punishes people who live responsibly, create values, and sustain the economy while rewarding those who live irresponsibly at others' expense.

And most critically, they don't want to be held accountable for the failures their policies have caused -- so they instead blame the voters for not "getting with the program".

Come November, we'll see another round of accountability as voters make their preferences known loud and clear.

Whether the "progressives" learn from that reality-check will be up to them. But given their bizarre "blame-the-voters" mindset, I won't hold my breath waiting.

Friday, September 17, 2010

OECD on Canada

Canada's socialized health care system is in trouble. Yes, I know you're all surprised.

Here are more details from the 9/14/2010 National Post, "OECD Prescription".

(Via Monica Hughes.)

Thursday, September 16, 2010

Sissel Fights Back

Matt Sissel explains, "Health-care reform: Why I'm suing to get back my freedom" in the 9/13/2010 Christian Science Monitor.

Here's an excerpt:
I'm a healthy young man fresh out of art school. I'm starting a small business, based in Iowa City, as a fine artist specializing in realistic drawing and painting. I have limited means and struggle to achieve my modest dreams. Every penny counts in the service of my career goals, but the federal government is intent on slowing down my progress and the progress of every other productive man and woman in this country in its drive to socialize the American health care system.

As a business person, I intend to cover my own medical expenses, and I want the freedom and flexibility to do my own budgeting, including setting aside money for medical needs.

I don't want the federal government dictating my personal financial decisions.

It can't even run its own budget!
The closing is especially nice:
I proudly served our country in the Iowa Army National Guard as a combat medic, spending two years in Iraq and eventually being awarded the Bronze Star. I mention that experience in order to drive home this point: While I am proud to have served my state and my country as a volunteer, I object to being conscripted into a federal health-care program that is at odds with basic constitutional principles of individual rights and limited government.

I see my lawsuit as a battle for my liberty -- my freedom to live out my life to the fullest without costly, one-size-fits-all dictates from the government. I am fighting the command-and-control health-care plan in order to safeguard the health of our Constitution and the freedoms it protects for me and for all Americans.
Thank you, Mr. Sissel, for standing up for your rights!

Wednesday, September 15, 2010

Hsieh PJM OpEd: Get Ready For Your Health Care 'Re-Education'

The September 14, 2010 PajamasMedia has just published my latest OpEd, "Get Ready For Your Health Care 'Re-Education'".

My theme is that the government has started an Orwellian "re-education" program to get the public to embrace ObamaCare -- and Americans must respond by teaching our politicians a lesson this November.

One excerpt:
In effect, the government is saying: "Let's pretend we never said ObamaCare would lower costs -- even though that's how we sold it to the public." "Let's push patients into restrictive health plans -- and call it a 'medical home.'" "Let's label it 'misinformation' when insurers tell the truth about how our laws raise their costs -- and then punish them if they complain about it."

And as the problems of ObamaCare deepen, we can expect such "re-education" efforts to intensify.
(Read the full text of "Get Ready For Your Health Care 'Re-Education'".)

And thanks to Glenn Reynolds for the Instapundit link!

Tuesday, September 14, 2010

Thuggery Updates

Betsy McCaughey warns us, "Get set for big premium hikes". (NY Post, 9/13/2010).

Michael Barone notes, "Gangster Government Stifles Criticism of Obamacare". (RealClearPolitics, 9/13/2010).

The 9/13/2010 Wall Street Journal explains that "Sebelius Has a List". As they note:
What Ms. Sebelius really means is that the government will prohibit insurers from doing business if reality is not politically convenient for Democrats.
Sebelius' approach is the federal government's latest version of the old saying, "The beatings will continue until morale improves".

Monday, September 13, 2010

Wolf is Back!

Dr. Milton Wolf is back and he's blogging up a storm!

Here's his latest, "Presidenting is Hard"

Sarrionandia Reports From The UK

UK resident Roberto Sarrionandia reports on his experience with the British National Health Service (NHS) when he suffered bad burns.

Basically, his experience was a roller-coaster of excellent and terrible care. In many ways, it's like the government (public) schools -- maybe you'll get a good teacher for your children, and maybe you won't. But you don't really have a say in the matter and your future is essentially up to luck.

Read the full text of his post, "A Healthcare Anecdote".

Friday, September 10, 2010

Quick Links: Cost Curve, Primary Care

Hot Air notes that "ObamaCare bends the cost curve... upward". (Related article, "Health Outlays Still Seen Rising".)

The WSJ notes, "Access to Primary Care No Guarantee of Better Care". Hence, any central-planning approach to somehow increase the numbers of primary care doctors won't necessarily actually improve medical outcomes.

Plus based on the Masschusetts experience, we can expect that primary care shortage will get worse and wait times will get longer once ObamaCare is implemented nationwide.

Thursday, September 9, 2010

It's All About The Control

Today's nanny-state story on nutrition and health comes from Iowa, "Big Brother in Iowa? School District Monitors Kids' Lunch Choices":
An Iowa school district's lunch program asks children as young as 5 years old to memorize a four-digit PIN code so it can monitor what they eat in the school cafeteria -- prompting some parents to claim it's an unhealthy case of "Big Brother."

The Ankeny Community School District is maintaining a database that records what the kids buy to eat and then checks their food choices against national nutrition guidelines.

The program is intended to provide the children with more food options while ensuring compliance with new and stricter state-mandated nutrition requirements. But some parents are worried that the program infringes on people's freedoms...
Just as the government wants to monitor doctors to see if they follow proper "guidelines", some people want to ensure all children eat according to government guidelines.

It's not about keeping people healthy, it's about controlling people.

Wednesday, September 8, 2010

Doctors Hiring Scribes for EMRs

Under ObamaCare, physicians' offices will be required to use government-approved electronic records. (The Department of Health and Human Services even specified what counts as "meaningful use" to prevent physician offices from just purchasing the equipment but not using it.)

But because the EMRs (electronic medical records) make physicians so inefficient, many doctors are responding as one would expect: "Doctors hiring scribes because of electronic medical records".

Here's an excerpt:
...[I]t's rather difficult to tend to the computer when you’re supposed to be tending to the patient. It's relatively easy to write with pen and paper while listening and explaining. It's far harder to keep two hands on a keyboard, a third hand on the mouse, one eye on the screen and another eye on the patient and his family.

And the fact that most EMRs and user interfaces are designed by computer geeks with no knowledge of clinical care or workflow certainly doesn't help matters. As soon as EMRs are deployed, physician productivity typically goes down by about 50%. It rarely gets back to where it was prior to installation.
(Read the full text of "Doctors hiring scribes because of electronic medical records".)

So rather than saving money, mandatory EHRs will increase costs, decrease physician productivity, and increase patient waits. This is another lose-lose for both patients and doctors under ObamaCare.

Tuesday, September 7, 2010

Ari Armstrong and Diana Hsieh on Personhood

[Ari Armstrong and Diana Hsieh have just released the following major policy paper on the Colorado "Personhood Amendment". This is a major contribution to the abortion and "personhood" debate and I hope FIRM readers will circulate this information to all interested friends and colleagues. -- PSH]


The Coalition for Secular Government is pleased to announce the release of its policy paper on the "personhood" movement by Ari Armstrong and Diana Hsieh (Ph.D): The 'Personhood' Movement Is Anti-Life: Why It Matters that Rights Begin at Birth, Not Conception (PDF or HTML).

The 'Personhood' Movement Is Anti-Life

Why It Matters that Rights Begin at Birth, Not Conception

by Ari Armstrong and Diana Hsieh, Ph.D.

A policy paper written for the Coalition for Secular Government (

Published on August 31, 2010

Formats: HTML or PDF


From the Introduction

Amendment 62, set to appear on Colorado's 2010 ballot, seeks to legally establish personhood from the moment of conception, granting a fertilized egg (or zygote) full legal rights in the state's constitution. Following in the footsteps of 2008's Amendment 48, Amendment 62 is the spearhead of a national campaign to outlaw abortion and other practices that could harm a zygote, embryo, or fetus.

If fully implemented, Amendment 62 would profoundly and adversely impact the lives of sexually-active couples, couples seeking children, pregnant women and their partners, doctors, and medical researchers. It would subject them to severe legal restrictions, police controls, and in many cases protracted court battles and criminal punishments.

Amendment 62 would outlaw abortion, even in cases of rape, incest, terminally deformed fetuses, and danger to the woman's health. It would prohibit doctors from performing abortions except perhaps in some cases to save the life of the woman, thereby endangering the lives and health of many women. In conjunction with existing statutes, Amendment 62 would subject women and their doctors to first-degree murder charges for willfully terminating a pregnancy, with the required punishment of life in prison or the death penalty.

The impact of Amendment 62 would extend far beyond abortion into the personal corners of every couple's reproductive life. It would outlaw many forms of birth control, including the pill, IUD, and "morning after" drugs. It would require criminal investigation of any miscarriages deemed suspicious. It would ban potentially life-saving embryonic stem-cell research and common fertility treatments.

Amendment 62 rests on the absurd premise that a newly fertilized zygote is a full human person with an absolute right to biological life-support from a woman--regardless of her wishes and whatever the cost to her. The biological facts of pregnancy, in conjunction with an objective theory of rights, support a different view, namely that personhood and rights begin at birth. Colorado law should reflect those facts, not the Bible verses so often quoted (and creatively interpreted) by advocates of Amendment 62 and other "personhood" measures.

About the Authors

Ari Armstrong publishes Free Colorado and co-authors a column for Western Colorado's Grand Junction Free Press. He is the author of Values of Harry Potter: Lessons for Muggles, a book exploring the heroic fight for life-promoting values in the Potter novels.

Diana Hsieh founded the Coalition for Secular Government in 2008. She earned her doctorate in philosophy from the University of Colorado, Boulder. She is currently working on a book on Ayn Rand's novel Atlas Shrugged, based on her series of podcasts at More of her work can be found at

Read The 'Personhood' Movement Is Anti-Life: Why It Matters that Rights Begin at Birth, Not Conception (PDF or HTML).

Saturday, September 4, 2010

Schwartz on Amendment 63

Brian Schwartz has an OpEd in the September 4, 2010 Colorado Springs Gazette, "Opposition to Amendment 63 both flawed and deceptive".

In particular, he debunks the following fallacy:
Edie Sonn of the Colorado Medical Society says Amendment 63 “will lead to higher health care costs for insured individuals and businesses as they are forced to absorb the costs of the uninsured.” This cost-shifting argument is both wrong and deceptive. Mandatory insurance will increase costs and impose much larger cost shifts.
(Read the full text of "Opposition to Amendment 63 both flawed and deceptive" for his detailed analysis.)

I also left the following comment on the editorial webpage:
Although I am a member of the Colorado Medical Society, I have to disagree with them when they declare that Amendment 63 will raise costs. Instead, it will lower costs and protect individual freedoms. It's the right thing for Colorado, and I hope the voters take advantage of this opportunity to defend both their pocketbooks and their freedoms.

Friday, September 3, 2010

Desperate Measures

Because of costs imposed by burdensome regulations, drug companies often do not pursue research into treatments that could benefit patients.

Dr. Stephane Huberty learned this the hard way when he was diagnosed with myasthenia gravis.

The September 2, 2010 Wall Street Journal describes the measures Dr. Huberty had to take (including injecting himself with an unapproved treatment he helped develop) in its article, "Desperate for a Treatment, One Physician Heals Himself".

(Via Dr. AA.)

Thursday, September 2, 2010

Quick Links: Scherz and Amerling

Dr. Hal Scherz of Docs4PatientCare has piece in the September 1, 2010 Wall Street Journal entitled "Dear Patients: Vote to Repeal ObamaCare".

One critical passage:
In making doctors answerable in the federal bureaucracy this bill effectively makes them government employees and means that you and your doctor are no longer in charge of your health care decisions. This new law politicizes medicine and in my opinion destroys the sanctity of the doctor-patient relationship that makes the American health care system the best in the world...
(Read the full text of "Dear Patients: Vote to Repeal ObamaCare".)

Dr. Richard Amerling of AAPS warns of "Enslavement by Health Insurance".

He likens our current system of tax-preferred employer-based health insurance to working in an oppressive "company store":
During World War II, the government imposed wage and price controls. In an effort to attract and retain workers, companies offered health insurance in lieu of wages. These benefits were not taxable for either the employer or employee. When the war ended and controls lifted (everywhere except in New York City, where rent controls persist to this day), the tax subsidy for employer-sponsored health insurance was retained. This explains why the majority of working Americans buy health insurance at work, at the "company store." This accident of history underlies much of what has gone wrong with health care in America...
(Read the full text of "Enslavement by Health Insurance".)

Wednesday, September 1, 2010

University of Colorado Clinics Turn Away Medicare/Medicaid

The August 27, 2010 Denver Post reports that "Two University Hospital clinics balk at government insurance".

Specifically, they are turning away patients covered by Medicare and Medicaid -- because they lose money on each one. These patients all have theoretical "coverage", but that's not the same as getting actual medical care.

Medicare and Medicaid are the government-run "universal coverage" programs for the elderly and the indigent, respectively. We can expect to hear about more such problems as the entire country moves towards a system of government "coverage".

(Via @MatthewBowdish.)