Saturday, March 31, 2012

Arguing Over Who Gets The Goodies Under UK Rationing

Journalist Christine Odine raises the uncomfortable question about health rationing in the UK, "Why should fat people take precedence over the elderly in the NHS?"

When the government is in charge of health care, it will inevitably lead to arguments about who receives medical care and whose care is denied. Which means, those with the most political clout (or with politically popular diseases) will get their care at the head of the rationing line -- at the expense of those without such clout. If you have an unpopular disease, you're out of luck.

Let's hope we don't get to that point here in the US.

Friday, March 30, 2012

Quick Links: Armstrong, Incentives, Free Rider Myths, Opportunity

At the TOS blog, Ari Armstrong notes how, "Force Begets Force Under Health Mandates".

More performance measure FAIL: "Hospital pay incentives fail to help patients".

Avik Roy: "Myths of the 'Free Rider' Health Care Problem".

(Note: I don't necessarily support some of Roy's proposed alternatives to EMTALA unless they are part of a transition to total elimination of government interference in health care. Voluntary charity can and should be the method that the truly need receive emergency health care if they cannot otherwise afford it.)

Investor's Business Daily: "If The Court Dumps ObamaCare, Republicans Must Be Ready"

(I especially like how the article offers politically-realistic free-market reforms that would move our country's health system in the right direction.)

Thursday, March 29, 2012

Hsieh PJM OpEd: "ObamaCare's Other Infringements"

PJ Media has published my latest OpEd, "It's Not Just the Mandate: ObamaCare's Other Infringements".

Here is the opening:
ObamaCare supporters were hit with more bad news recently when the Congressional Budget Office announced that the health care law would cost nearly twice the original estimates: $1.76 trillion over ten years rather than $940 billion. Of course, such "unexpected" cost overruns are nothing new for government programs. When Medicare was passed in 1965, it was predicted to cost $12 billion by 1990. In reality, it cost a whopping $110 billion, almost 10 times more than predicted.

But the escalating economic costs of ObamaCare will pale in comparison to the escalating losses of freedom.

The infringement of personal freedom receiving the most attention lately has been the "individual mandate" requiring Americans to purchase health insurance. This issue is at the heart of the current legal challenge before the U.S. Supreme Court.

But ObamaCare imposes numerous other mandates and controls, including the following...
(Read the full text of "It's Not Just the Mandate: ObamaCare's Other Infringements".)

Post-SCOTUS Commentary: Wolf, Rhoads, Simberg, LA Times

As one might expect, there's been lots of analysis and commentary of the Supreme Court arguments over ObamaCare.

In general, pundits opining on how SCOTUS will rule on ObamaCare reminds me of the TV commentators discussing how an NFL referee might rule when his head is under the instant replay hood. It's an interesting way to fill air time. But no one but the ref really knows what the final decision will be.

That said, I did want to flag a few pieces that caught my eye:
Milton Wolf, "Obamacare's inescapable death march" (Washington Times, 3/28/2012)

(Note: I agree with Milton that ObamaCare will eventually fail, even if the Supreme Court doesn't overturn it. The big questions would be how long will it take, how hard will the politicians try to prop it up with even worse laws, and how many more people will they harm in the process.)

Jared Rhoads, "Two more encouraging things from the oral arguments on the individual mandate" (Center for Objective Health Policy, 3/28/2012)

Rand Simberg, "The White House/Media Cocoon on ObamaCare" (PJ Media, 3/28/2012)

Los Angeles Times, "Supreme Court appears poised to nullify entire healthcare law"
I'm sure there will be lots more commentary to follow!

Wednesday, March 28, 2012

SCOTUS Day 2

Here are some links and commentary on the Day 2 arguments at the Supreme Court, concerning the individual mandate.

WSJ, 3/27/2012: "Conservative Justices Challenge Government Over Health Law"

NYT, 3/27/2012: "Hard Questions From Justices Over Insurance Mandate"

Fox News, 3/27/2012: "Health care law endures tough questioning from swing justice at Supreme Court showdown"

Multiple websites have copies of the audio and transcript for those who are interested.

Tuesday, March 27, 2012

Quick Links: Mandatory Medicare, Medicaid and ERs, Picture

Quin Hillyer discusses the latest in Hall vs. Sebelius.

As of now, the federal courts have ruled that if someone wishes to opt out of Medicare, they must also give up all their Social Security benefits (which would place a heavy financial burden on many senior citizens). In other words, the courts have stated that because Medicare is an "entitlement" that one must accept those benefits (and corresponding restrictions). But the legal challenge against this rule has moved forward another step.

US News: "Medicaid Patients Go to ERs More Often".

As many have observed, Medicaid patients have "coverage", but have a difficult time getting access to actual medical care. Thus, they are still using ERs for primary care. This problem will only get worse as ObamaCare expands "coverage" by expanding Medicaid.

Avik Roy: "Here, in one graphic, is what’s wrong with American healthcare"

Monday, March 26, 2012

SCOTUS Rundowns

The 3 days of ObamaCare arguments before the US Supreme Court start today. Here are a few helpful links for those wanting to follow the action:

Doug Mataconis, "ObamaCare Goes Before The Supreme Court: A Preview".

Center for Objective Health Policy: "Guide to SCOTUS Review of Health Reform Law" (and PDF version).

Wall Street Journal: "Liberty and ObamaCare" (3/22/2012)

David Catron: "Supreme Court Primer: How the process works for oral arguments"



(Direct YouTube link.)

Saturday, March 24, 2012

WSJ: Is Concierge Health Care Worth It?

The 3/23/2012 Wall Street Journal has some helpful tips for those considering signing up for a "concierge" physician: "Is Paying for 'Concierge' Health Care Worth It?"

The article discusses some questions to ask including:
Is this right for me?
Will you take my insurance?
What happens if I get sick while I'm out of town, or while you're on vacation?
Do you make house calls?
How will you handle my medical records?
What if I change my mind or don't like the service?
(Read the full text of "Is Paying for 'Concierge' Health Care Worth It?")

Beware that some states (like Oregon) are trying to restrict this practice model, by requiring these doctors to register their practices with the state's insurance department on the grounds that they're accepting fees for the promise of future medical care.

(WSJ link via Dr. Art Fougner.)

Friday, March 23, 2012

McBride: Courts, ObamaCare, and Limited Government

Attorney Katelynn McBride of the Institute for Justice has nice OpEd in the 3/23/2012 Minnesota Public Radio News entitled, "Health care law shows why we need courts to guard against government overreach".

In her piece, she makes some key points about the courts and limited government:
It does not appear that the supporters of health care reform gave any serious consideration to the law's constitutionality, a question that is scheduled for three days of argument before the U.S. Supreme Court next week. The unseemly process by which the law was enacted, and the apparent failure to consider its profound constitutional concerns, are precisely why we need an engaged judiciary to review and, when necessary, check the power of the Legislature...

The Constitution was designed to prevent runaway government like we have today and to account for the fact that, as Thomas Jefferson warned, "The natural progress of things is for liberty to yield and government to gain ground." The Framers knew perfectly well that legislatures are not inclined to recognize limits on their own authority.

When they do not, it is the job of the courts to enforce the Constitution. Increasingly, however, courts are not doing that job. A study by the Institute for Justice last fall found that the Supreme Court struck down just two-thirds of 1 percent of federal laws enacted between 1954 and 2002...
(Read the full text of "Health care law shows why we need courts to guard against government overreach".)

We don't know how the US Supreme Court (SCOTUS) will decide after they hear arguments next week. But they do hold in their hands the future of 1/6th of the US economy -- and our essential freedoms.

For a nice flowchart on the upcoming SCOTUS arguments scheduled for March 26-28, 2012, please see this nice one-page infographic by the Center for Objective Health Policy (PDF or JPG).

Elder: ObamaCare Still a Disaster

In the 3/22/2012 TownHall.com, Larry Elder observes, "ObamaCare Still a Disaster -- No Matter How the Supreme Court Decides".

One excerpt:
...In addition to the excise tax on medical device manufacturers, ObamaCare imposes many more taxes, including the following: an individual mandate excise tax for adults who don't purchase "qualifying" health insurance; an employer mandate tax for those companies who don't offer health coverage; and a surtax on investment income -- making the rate as high as 43.4 percent on gross income from interest, annuities, royalties, net rents and passive income for families making more than $250,000.

Given this, will we see the same private-sector investments in the health care field, as ObamaCare imposes ever more regulations designed at increasing "accessibility" and "controlling costs"?
Elder also discusses how ObamaCare won't control costs, either. And will create a "brain drain" similar to what has already happened under Great Britain's socialized system.

Read the full text of "ObamaCare Still a Disaster -- No Matter How the Supreme Court Decides".

Thursday, March 22, 2012

Wolf on ObamaCare After 2 Years

Dr. Milton Wolf gives a retrospective review of ObamaCare 2 years after its passage into law in the 3/21/2012 Washington Times, "Obamacare: It's a big, disastrous deal".

Some of the lies told about ObamaCare by its supporters include:
You can keep your own insurance
Taxes will not be raised
Premiums will go down
It will create jobs
For details of these broken promises and more, read the full text of Washington Times, "Obamacare: It's a big, disastrous deal".

There's a damned good reason that the Obama administration is not taking the opportunity to trumpet the 2-year anniversary -- because they know it's a huge political loser.

Let's make sure they remember this come November 2012.

Wednesday, March 21, 2012

CO Doctors Limiting Medicare Patients

The 2/28/2012 Boulder Daily Camera reported that, "Colorado docs often refuse or limit new Medicare patients".

From the article:
Colorado Public News called family, general practice and internal medicine physicians across the state, using the nation's official website that lists thousands of doctors the site claims treats patients on Medicare. Of 100 contacted, only 34 said they would readily accept a new patient.

Of the remainder, 40 said they would not add a new patient on traditional Medicare. Another 26 limit new clients, making decisions on a case-by-case basis, or placing patients on waiting lists of up to six months. That adds up to 66 -- or two-thirds -- refusing or limiting new patients...

Dr. Jonathan Zonca, of Ascent Family Medicine in Denver, is taking new Medicare patients. But he said he hesitated after figuring out that Medicare had paid half of what other insurance plans did, over three years.

"That's a real hard way to make money and pay our staff and pay our rent, especially in Denver -- it's pretty expensive rent," he said.

Medicare also pays more slowly than other insurance plans...
(Read the full text of "Colorado docs often refuse or limit new Medicare patients".)

Remember, Medicare is "single payer" government health care for the elderly. But Medicare doesn't pay enough to allow doctors to take good care of their patients. And the proposed "payment reforms" have been a failure.

Yet there are still many who want to expand this dysfunction government model to encompass all of American health care.

(Via Brian Schwartz.)

Tuesday, March 20, 2012

Quick Links: Amerling, Palmisano, IPAB, End of Private Insurance

Dr. Richard Amerling: "The Clouded Utopian Vision For Healthcare Ignores Reality".

Dr. Donald Palmisano: "Repeal IPAB Now".

D4PC Signs on to Coalition Letter Concerning Dangers of IPAB. You can read the letter here.

Sally Pipes: "The End of Private Health Insurance In America".

Whole Truth Commercial

The group AmericanDocs4Truth.org has produced a clever commercial, responding to the infamous "Granny" video promoted by the leftists. This is the 60-second short version:



Here is the 4:30 longer version:



For more information on some free-market reforms that would move America in the right direction, see this 12-point plan by Dr. Jane Hughes.

(Eventually, we should privatize all government health programs including Medicare and Medicaid and get the government completely out of health care, except for protecting individuals against force or fraud. Dr. Hughes' proposals would be an excellent start in this direction.)

Catron: Of Obamacare and Appeals to Supreme Beings

David Catron has a new American Spectator piece, "Of Obamacare and Appeals to Supreme Beings".

In his OpEd, Catron lays out the various spurious legal arguments being made by the Obama administration to support their health care plan. Let's hope the justices see past all the smoke and mirrors and uphold Americans' individual rights.

Monday, March 19, 2012

Quick Links: Employment, Awakening, Washington Medicaid

Michael Randall tells his personal experience of problems caused by government linking health insurance to employment.

(And I very much appreciated his citing my earlier PJM piece, "Free Market Lessons from Contraception Fight".)

Dr. Meg Edison of Docs4PatientCare has created a nice short video, "Awakening of the American Doctor":



Dr. Doug Perednia discusses, "Denying payment for unnecessary emergency room visits". In particular, he highlights the perverse thinking behind the new guidelines in Washington state:
So here's the actual logic underlying this new Washington Medicaid initiative:

* ER docs and hospitals are required by federal law to see and evaluate anyone who walks in – at their own expense if necessary.

* If a Washington State Medicaid patient walks into the ER with a non-emergency and the doctors and hospitals see them as required by law, Medicaid will refuse to pay on premise that the provider are "abusing the system" and being lousy "stewards of care and safety and the public resources"

* Since the doctors and hospitals are abusing the system by simply being there and doing what the federal government has said they must, they should not even be allowed to try to bill the patient directly for the visit.

Friday, March 16, 2012

Quick Links: Ethics Corruption, White House, MA Costs, CA Shortages

Dr. Jeffrey Singer does a nice job discussing, "The Coming Medical Ethics Crisis". The subtitle: "How the government is putting the medical profession -- and your health -- at risk". (Via Brian Schwartz.)

Here is the White House PR strategy to defend ObamaCare in the coming weeks.

NPR and Kaiser Health News report that Massachusetts legislators still trying to figure out how to reduce rising health costs. Their solution: More government controls.

California legislators realizing that "coverage" doesn't equal actual care.

Losing Your Insurance

The Washington Times reports, "Health care reforms could cost 20m work coverage".

This is based on information from the Congressional Budget Office and the Joint Committee on Taxation. Basically, President Obama's claim that "you could keep your insurance if you like it" won't apply to millions of Americans.

At best, workers dumped from their current plans might be able to scramble for some sort of coverage on government-run exchanges. But those policies will be loaded with expensive mandates on terms dictated by government and/or special interest groups with "pull" to determine what's considered an "essential benefit". People will have to pay for services they might not otherwise choose in a genuine free market (such as in vitro fertilization services or alcoholism treatment).

Furthermore, to save money these "qualified" (i.e., government-approved) plans will likely have to omit coverage for various services the government has decided are unnecessary, such as screening mammograms below age 50 or PSA prostate tests for men. The latest addition to this list of "nonessential" benefits will likely be annual Pap smears for cervical cancer screening). Through these exchanges, the government -- not you and your doctor -- will determine what's "essential" and what's "nonessential" to your health.

Forcing people out of their current coverage and into government-run insurance allows the Left to pin the blame on the "free market", while essentially herding Americans into state-run medicine.

Don't let them get away with this slippery sleight-of-hand.

Thursday, March 15, 2012

The Myth of the Free-Market American Health Care System

At the Forbes blog, Avik Roy discusses "The Myth of the Free-Market American Health Care System".

His basic point is an important one that bears repeating: America does not currently have a free-market medical system. In particular, he notes:
In reality, per-capita state-sponsored health expenditures in the United States are the third-highest in the world, only below Norway and Luxembourg. And this is before our new health law kicks in...

The thing to remember in America is that we have single-payer health care for the elderly and for the poor: the two costliest groups. In addition, the relatively healthy middle class has heavily-subsidized private health insurance, in which few individuals have the freedom to choose the insurance plan they receive. Neither of these facts commend the American health-care system to devotees of the free market.
Avik Roy does praise statist elements in some other countries' health systems, such as Switzerland and Singapore -- which I disagree with. But those are topics for a separate day.

(Via Dr. Matthew Bowdish.)

Wednesday, March 14, 2012

Quick Links: UK Elders, IPAB, Costs

The 3/14/2012 Telegraph reports that in the UK National Health Service, "More than half care home residents denied basic care". (Via Kelly V.)

Dr. Jane Orient asks, "Is the payment board a death panel?" (Washington Times, 3/8/2012)

The Washington Examiner reports on the latest CBO report detailing how ObamaCare will cost far more than originally projected.

WOLF: Democrats Sneak Uncle Sam Into Your Bedroom

Dr. Milton Wolf has a new OpEd out in the 3/12/2012 Washington Times, "Democrats sneak Uncle Sam into your bedroom".

In particular, he highlights the hidden cronyism behind many mandates and entitlement progrms. Any mandate to provide "free" birth control helps Big Pharma just as a ban on incandescent light bulbs is a giant payoff to companies like GE that want people to buy their more expensive "green bulbs".

Wolf also notes:
There's another pattern here. Politicians are like drug dealers. Once you’re addicted to freebies, you suddenly realize the free lunch is not so free. Like the drug dealers, the politicians want your money, to be sure, but what they really covet is your submission. They love telling you what to do and they always claim it’s for your own good.
(Read the full text of "Democrats sneak Uncle Sam into your bedroom".)

More people are waking up.

Tuesday, March 13, 2012

Should You Trust Practice Guidelines?

A big part of ObamaCare projected savings is based on physicians adhering to "practice guidelines", using so-called "evidence based medicine". These sound good in theory -- after all, what doctor wants to be against "evidence"?

But how solidly grounded are these guidelines?

A 2009 article from The Journal of the American Medical Association (JAMA) sounds a cautionary note, "Scientific Evidence Underlying the ACC/AHA Clinical Practice Guidelines".

The article opens:
Clinical practice guidelines are systematically developed statements to assist practitioners with decisions about appropriate health care for specific patients' circumstances.​ Guidelines are often assumed to be the epitome of evidence-based medicine. Yet, guideline recommendations imply not only an evaluation of the evidence but also a value judgment based on personal or organizational preferences regarding the various risks and benefits of a medical intervention for a population.
But after going through cardiology practice guidelines issued from 1984 to September 2008, they conclude:
Recommendations issued in current ACC/AHA clinical practice guidelines are largely developed from lower levels of evidence or expert opinion. The proportion of recommendations for which there is no conclusive evidence is also growing.
In particular, many guidelines are just expert "opinion", which may be subject to classic problems of bias, group-think, or conflict-of-interest:
The presence of a large proportion of recommendations with no supporting data from randomized clinical trials requires careful judgment by guideline authors. In such circumstances, the potential for authors' conflicts of interest, real or perceived, may be important. Recommendations based only on expert opinion may be prone to conflicts of interest because, just as clinical trialists have conflicts of interests, expert clinicians are also those who are likely to receive honoraria, speakers bureau, consulting fees, or research support from industry.
Government officials are pushing doctors to follow published guidelines as if they were some sort of "gold standard", yet many of them are lead not gold. (JAMA link via Dr. Art Fougner.)

Dr. Richard Amerling and co-authors make a similar point in their 2008 article, "Guidelines have done more harm than good":
Practice guidelines have proliferated in medicine but their impact on actual practice and outcomes is difficult, if not impossible, to quantify. Though guidelines are based largely on observational data and expert opinion, it is widely believed that adherence to them leads to improved outcomes. Data to support this belief simply does not exist. If guidelines are universally ignored, their impact on treatment and outcomes is minimal.

The incorporation of guidelines into treatment protocols and performance measures, as is now common practice in nephrology, increases greatly the likelihood that guidelines will influence practice and hence, outcomes. Practice patterns set up this way may be resistant to change, should new evidence emerge that contradicts certain recommendations.

Even if guidelines are entirely appropriate, a 'one-size-fits-all' approach is likely to benefit some, but not all. Certain patients may be harmed by adherence to specific guidelines. Guidelines certainly do not encourage clinicians to consider and treat each patient as an individual. They are unlikely to stimulate original research. They are created by a process that is artificial, laborious and cumbersome. This all but guarantees many guidelines are obsolete by the time they are published. Guidelines are produced with industry support and recommendations often have a major impact on sales of industry products.
See also his related 2011 AAPS talk:



Under ObamaCare, government will attempt to enforce standardized medical practice amongst physicians through various financial carrots and sticks, such as government-sanctioned "Accountable Care Organizations".

Dr. Donald Berwick (President Obama's former head of Medicare) has explicitly said as much on multiple occasions. For example:
The primary function of regulation in health care, especially as it affects the quality of medical care, is to constrain decentralized, individualized decision making.
And this:
I would place a commitment to excellence—standardization to the best-known method—above clinician autonomy as a rule for care.
In other words, he and his allies want government to dictate how physicians can practice, because they think they know what's best for you as a patient. They wish to be able to override the judgment of your personal physician who actually knows your medical history, your symptoms, your drug allergies, and your individual preferences.

There's mounting evidence that federal nutrition guidelines have made Americans less healthy, rather than more healthy.

Should we trust the government to do any better in foisting centralized clinical practice guidelines on American physicians?

Monday, March 12, 2012

Texas Doctors Opting Out of Medicare

The 3/9/2012 Houston Chronicle reports, "More Texas doctors opting out of Medicare". Only a few states track this particular statistic, but I suspect this reflects a nationwide trend.

As for why conscientious physicians might wish to opt out, Dr. Kathleen Brown explains in her recent essay, "Exiting the Game".

Note: The federal government makes it difficult for patients and doctors to opt out of Medicare. If a patient wants to opt out of Medicare and seek their own private arrangements with willing physicians, they may lose their Social Security benefits -- something many seniors can't easily afford.

Conversely, if a doctor wishes to completely opt out of Medicare, then they basically have to give up all Medicare reimbursements for 2 years. So effectively, they have to be willing to sever relations with all their Medicare patients, even if they just want to work out a non-Medicare arrangement with one patient for one particular operation or treatment.

(There is a way in which doctors can sometimes take Medicare and other times not, but to do so they have to agree to accept less than the Medicare rates, which is already pretty low. Interested readers can find details at, "Medicare Participation Options for Physicians".)

More broadly, the government has a deliberate policy of making it difficult for patients and doctors to engage in private contracts outside of Medicare. Attorney Kent Brown covers this in, "The Freedom to Spend Your Own Money on Medical Care: A Common Casualty of Universal Coverage".

Friday, March 9, 2012

Hsieh PJM OpEd: Free Market Lessons from Contraception Fight

PJMedia has published my latest piece, "Free Market Lessons from Contraception Fight".

I discuss how the controversy over contraception coverage has made apparent three lessons about America’s current health care system and why we need free-market health care reforms:
1) Health insurance should be uncoupled from employment.
2) Mandated benefits will become political footballs.
3) We must fight for freedom as a principle.
For more details on each of these three points, read the full piece.

Thursday, March 8, 2012

Wednesday, March 7, 2012

The Hidden Costs of Cost Control

In her 2/29/2012 Atlantic blog, Megan McArdle discusses, "What Cutting Health Care Costs Looks Like".

Basically, stricter cost control measures by hospitals shifts some of the work onto unpaid family members as patients are discharged far earlier than they would have in the old days.

McArdle cites her own mother as an example, recently released from the hospital after undergoing treatment for a ruptured appendix:
Thankfully, my mother is basically healthy -- except that she requires someone to hook up her IV antibiotics twice a day, and because she can't drive or move around much yet, she really needs someone nearby most of the time. It's been no problem for us -- my editors have been incredibly understanding, and I've spent many hours working from her hospital room on my laptop. But how many other people have this flexibility?

This, mind you, is for a relatively benign condition. In my extended family, I've seen elderly patients with terminal cancer sent home to die with families who hadn't any ability to cope with a patient that sick. The poorer and less educated you are, the more likely this is to happen, because you don't have the knowledge -- or the social capital -- to work the system and get a few extra days...

One way to think about it is that we made a policy choice to save money by turning family and friends into parahealth professionals. In my case, I think that's the right choice: I'm happy to take care of my mother, and I understand the cost pressures that made this desirable.

The problem is, most people didn't participate in that choice. There was no public debate over whether we should send elderly patients home in terminal condition to families with no training as health workers. We just said "let's cut hospital costs!" and everyone said "Yay!" and then some folks in a back room decided that this was the way to do it...
(Read the full text of "What Cutting Health Care Costs Looks Like".)

So when we talk about "cost shifting", we should keep in mind some of the invisible cost-shifting created by government policies that induce hospitals to discharge patients quickly -- and sometimes arguably too quickly.

(Via Instapundit.)

Tuesday, March 6, 2012

Surprise! Electronic Medical Records Increase Costs

The 3/5/2012 New York Times reports, "Digital Records May Not Cut Health Costs, Study Cautions".

From the article:
The promise of cost savings has been a major justification for billions of dollars in federal spending to encourage doctors to embrace digital health records.

But research published Monday in the journal Health Affairs found that doctors using computers to track tests, like X-rays and magnetic resonance imaging, ordered far more tests than doctors relying on paper records.
(Read the full text of Digital Records May Not Cut Health Costs, Study Cautions".)

Of course, electronic medical records (EMRs) can be of enormous benefit to doctors and patients, when freely chosen by physicians in response to their actual on-the-ground needs. But when EMRs are imposed by government mandate, we shouldn't be surprised if they don't have the predicted benefits.

However, EMRs will allow the government to more easily monitor physician practice patterns.

I predict that the rising costs related to EMRs will thus be used as a pretext by the government to further limit what tests and treatments physicians can order for their patients. This means government bureaucrats will be increasingly decide what tests and treatments patients can receive, potentially overriding the physicians who are actually responsible for that patient's care.

But just don't call it rationing.

Quick Links: Death Spiral, E-Smoking, Canadian Drugs

Investor's Business Daily: "ObamaCare Is Designed To End Private Insurers" (3/2/2012)

Ryan Krause: "Bureaucrats Demand You Stop Smoking... and Stop Not Smoking, Too"

Globe and Mail: US FDA interferes with Canadian patients' drug supply. Note that, "Health Canada completed its own inspection later that month, and found no issues with the company’s Canadian products." (2/19/2012)

(Here's a copy of the FDA warning letter to Novartis, the parent company of Sandoz Canada.)

Monday, March 5, 2012

SCOTUS ObamaCare Flowchart

Jared Rhoads of the Center for Objective Health Policy has created a nice infographic for anyone planning to follow the Supreme Court hearings on Obamacare later this month.

Rhoads explains: "At the core is a flow chart that shows what the key questions are and how they interrelate. On the margins I give an indication of some of the arguments that we'll probably hear, along with some other useful tidbits."

Here is the link to the infographic.

Here's a downloadable PDF suitable for printing, distributing as flyers, etc.

Thanks, Jared!

Frezza: The Nanny State and Your Waistline

In the 3/5/2012 RealClearMarkets, Bill Frezza discusses the latest nanny-state obsession with citizens' waistlines: "Too Fat? Too Thin? Progressive Policies Can Fix That!"

From his OpEd:
The logic behind government efforts to control Americans' mass body index is as impeccable as it is insidious. If health care is a "right" to be paid for by the taxpayer, and "access" to this right is being jeopardized by the runaway costs associated with a "disease" called obesity, then the food that you stuff in your face is no longer a personal preference but a critical matter of fiscal necessity.

Sugar is the latest demon, since it appears that years of government advice on the consumption of saturated fats has turned out to be wrong. A broad-based campaign is underway, spearheaded by zealots like Professor Robert Lustig of the University of California, to get the federal Food and Drug Administration to regulate sugar as it does other "addictive poisons"...

At the other end of the scale, "scientists" are urging government action to ban skinny models to curb anorexia, a self-induced malady that affects far too many young women with self-esteem problems. Apparently, the fashion industry's penchant for thinness, which you might think would be hailed by obesity warriors, is a public menace that needs to be controlled. First Amendment be dammed, we have a crisis here and we cannot let corporate greed trump public safety!
(Read the full text of "Too Fat? Too Thin? Progressive Policies Can Fix That!")

As Robert Heinlein once said: "The human race divides politically into those who want people to be controlled and those who have no such desire."

Unfortunately, the first group is in charge -- until we muster up the gumption to kick them out of office.

Related OpEds:
Milton Wolf, "Is This Still America?", Washington Times, 2/27/2012.

Paul Hsieh, "Universal healthcare and the waistline police", Christian Science Monitor, 1/7/2009.

Friday, March 2, 2012

Supreme Court Must Strike Down All of Obamacare

In the 2/24/2012 Washington Times, Phil Kerpen explains why, "Supreme Court must strike down all of Obamacare".

If only the individual mandate is struck down, the other provisions of ObamaCare (including requirements that insurance companies take all comers regardless of pre-existing conditions yet only charge them the same as healthy applicants) would destroy private insurance in the US. Of course, for some leftists, this would be a feature not a bug.

But if we don't want this country to back into a government-run "single payer" system by default, we need to scrap the entirety of ObamaCare. And we need to let our elected officials know where we stand.

Thursday, March 1, 2012

Quick Links: Exiting, Privacy, IJ, Sudafed

Dr. Kathleen M. Brown discusses how doctors can practice good medicine by "Exiting the Game".

Linda Gorman and Amy Oliver critique a proposed Colorado medical database: "Bill would compromise patients' medical privacy".

The Institute for Justice asks, "Does the ObamaCare individual mandate make contracts unenforceable?"

Paul Crowley satirically tweets: "US crackdown on crystal meth means Sudafed is hard to buy. But meth is easy to buy; here's how to make Sudafed from it."

Direct link to article (PDF): "A Simple and Convenient Synthesis of Pseudoephedrine From N-Methylamphetamine".