Light Posting Notice

Because of the holidays, I'll be taking a break from blogging until after the weekend. Happy Thanksgiving, everyone!

Repealing ObamaCare?

The generally-liberal Chicago Tribune says it's time to repeal ObamaCare.

Pro-ObamaCare New Republic article warns: "Think Obamacare Can't Be Repealed? It Happened Once in Australia".

David Catron reminds us of some relatively recent US history in, "Obamacare Repeal a Fantasy?"

BRI: Obama's Not To Blame (Not Entirely)

I liked how Benjamin Rush Institute blogger Charlotte Monte put it: "Obama's Not to Blame! Well…Not Entirely".

Our current president has created many problems for American health care. But he is merely extending policies that go back many years (and caused by both major political parties).

She also notes:

Our health insurance system bears improving, especially since it was created by bad government intervention. The answer is not more government, but less. There exist viable, reasoned and intelligent solutions. It’s up to Americans to demand them.

Amen to that.

(And I greatly appreciated the link to my recent Forbes piece, "The Only Obamacare Fix Is For Obama To Legalize Real Health Insurance"!)

TOS Commentary From Armstrong

BTW, Ari Armstrong has been posting good analyses of the health care issue at the TOS blog.

Some of his recent posts include:

"What’s Your Best Line Exposing the Evil of ObamaCare?" (11/18/2013)
"Obama’s Answer to How Health Insurers Will Adjust to His Whim: Somehow" (11/15/2013)
"ObamaCare Ads Tout Keg Mishaps and Promiscuous Sex; Ignore Rights Violations" (11/14/2013)

The blog also has lots of cultural and political commentary on other issues, so go check them out!

Hsieh Forbes OpEd: Legalize Real Health Insurance

Forbes has published my latest OpEd, "The Only Obamacare Fix Is For Obama To Legalize Real Health Insurance".

My basic theme is that we need to legalize real "catastrophic-only" insurance, free of government mandates.  More broadly, instead of debating which new government entitlements to create, we should be vigorously debating which freedoms to restore.

Here is the opening:

The President has proposed a one-year “fix” to deal with the political fallout from his broken promise (or lie), “If you like your insurance plan, you will keep it.” Now it’s, “If you like your plan, you can keep it until after the 2014 mid-term elections. Maybe.”

But the problems with ObamaCare go much deeper than cancelled insurance. As surprising as it sounds, most Americans never had real health insurance to begin with — and were not allowed to by law. And the only cure for our current health insurance mess is to legalize real health insurance...

I discuss the history of how we got into our current mess and some concrete free-market reforms that would move us in the right direction. These include:

1. Eliminate the tax disparity between employer-provided health insurance and individually-purchased health insurance.

2. Eliminate all mandated benefits. Insurers should be free to offer to willing consumers inexpensive policies covering only catastrophic accidents and illnesses.

3. Allow insurers to sell policies across state lines.

(For more details, read the full text of "The Only Obamacare Fix Is For Obama To Legalize Real Health Insurance".)

If you like these ideas, please feel free to circulate the column to friends, family members, etc.

You can also send your elected officials a quick e-mail. Please feel free to use and/or modify the template below:

Dear [Congressman or Senator]:

As the current problems of the Affordable Care Act are becoming more apparent to Americans, we need to consider genuine free-market reforms.

I like the ideas in this recent Forbes article, "The Only Obamacare Fix Is For Obama To Legalize Real Health Insurance", including the following:

1. Eliminate the tax disparity between employer-provided health insurance and individually-purchased health insurance. This would uncouple health insurance from employment and restore a level playing field to the individual insurance market. Individuals could then purchase policies that they kept even when they changed jobs (just as they already do with their car and homeowners insurance).
2. Eliminate all mandated benefits. Insurers should be free to offer to willing consumers inexpensive policies covering only catastrophic accidents and illnesses. Insurers would remain free to offer richer policies that covered varying levels of elective procedures (but cost correspondingly more). Customers could purchase whatever levels of coverage they wished from willing insurers based on their own individual needs and circumstances.
3. Allow insurers to sell policies across state lines. State mandates create 50 separate state markets rather than a single national market. A family insurance plan costing $3,000 in Wisconsin might cost $10,000 in New Jersey because of state regulatory barriers. Allowing interstate competition would quickly drive down prices and help many working families on a tight budget.

From: http://www.forbes.com/sites/paulhsieh/2013/11/17/the-only-obamacare-fix-is-for-obama-to-legalize-real-health-insurance/

I hope Congress can discuss and debate these ideas as a way to truly fix our health care system.

[Signed your name, address, etc.]

Hsieh PJM OpEd: Will Tomorrow’s Medical Innovations Be There When You Need Them?

PJ Media has just published my latest OpEd, "Will Tomorrow’s Medical Innovations Be There When You Need Them?"

My basic theme is that we must protect the freedoms necessary for the advancement of medical technology.

I start with a pair of vignettes:

How much has American medicine changed in the past 30 years?

Let’s turn the clock back to 1983. A middle-aged man, Dan, is crossing the street on a busy midday Monday. An inattentive driver runs a red light and plows into Dan at 45 mph, sending him flying across the pavement. Bystanders immediately call for help. An ambulance rushes Dan to the nearest hospital. In the ER, the doctors can’t stabilize his falling blood pressure. They prep him for emergency surgery. The trauma surgeon tries desperately to stop the internal bleeding from his badly fractured pelvis but is unsuccessful. Dan dies on the operating table.

The surgeon gives Dan’s wife the sad news: “I’m sorry, but your husband’s injuries were too severe. We did everything we could. But we weren’t able to save him.”

Fast forward to 2013. Dan’s now-grown son Don suffers the same accident. But within minutes of his arrival in the ER, he’s sent for a rapid trauma body CT scan that shows the extent of the pelvic fractures — and more importantly, shows two badly torn blood vessels that can’t be easily reached with surgery.

An interventional radiologist inserts a catheter into the femoral artery in Don’s right leg. Watching live on the fluoroscopy screen, the radiologist skillfully guides the catheter through the various twists and turns of the arterial system and positions it at the first of the two “bleeders.” From within the blood vessel, he injects specially designed “microcoils” into the torn artery and stops the bleeding. He then guides the catheter to the second bleeder and repeats the procedure. Don’s blood pressure recovers. The surgeons now have time to repair Don’s pelvic fractures and other internal injuries.

The surgeons give Don’s wife the good news: “Your husband’s injuries were pretty bad. But we were able to fix everything. He’ll still have to go through recovery and physical therapy. But he should be back to normal in six months”...

For more, read the full text of "Will Tomorrow’s Medical Innovations Be There When You Need Them?"

(The material for the opening vignettes was drawn from a pair of excellent talks presented last month at the 2013 annual meeting of the American Society of Emergency Radiology. )

Update #1: A great example of medical innovation coming from unexpected places was this 11/14/2013 New York Times article describing how an Argentinian car mechanic saw a Youtube video on how to extract a stuck cork from a wine bottle and realized it could also be used to help extract babies stuck in the birth canal.

His idea will be manufactured by Becton, Dickinson and Company and has already undergone initial successful safety testing in humans. It could save the lives of many babies in Third World countries and also reduce the need for Caesarean section in industralized countries.  (Via Gus Van Horn.)

Update #2: For those interested in the real-life technology used in the fictional scenario I discussed, here's a nice medical slideshow from UCLA interventional radiologist Dr. Justin McWilliams, "Life-saving Embolizations: Trauma and GI bleeding"

Life saving embolizations from pryce27

Hsieh LTE in WaPo on ObamaCare Enrollees

The Washington Post published my letter-to-the-editor (LTE) on how the White House counts ObamaCare enrollees:

An Obamacare and income tax accounting

So the White House counts as Obamacare enrollees “those who simply picked a plan and put it in their online shopping cart” but have not yet paid for it. Do I then get to count as having paid my taxes if I’ve filled out my 1040 form but haven’t mailed in my check?

Paul Hsieh, Sedalia, Colo.

(My letter was in response to their 11/11/2013 article, "HealthCare.gov tally: 40,000 are signed up".)

Charlotte Monte Report on "Physicians Summit 2013"

Charlotte Monte of the Benjamin Rush Institute reports on the successful "Physicians Summit 2013" earlier this month.

From her post:

On November 1 – 2, over 60 physicians from across the country, including three Benjamin Rush Institute medical students, attended the 2-day Physicians Summit 2013 in Dallas, TX. The purpose of the Summit was to give information — factual and inspirational — to physicians seeking a better way to practice medicine other than under the thumb of the Affordable Care Act (“Obamacare”).

Throughout the event, attendees were presented with first hand accounts how doctors from Oregon to Florida are making a better life for themselves and their patients by not succumbing to Obamacare. They presented variations on the Direct Pay, or “Concierge” medical model, with many survival tips and techniques.

Other speakers provided advice about online reputation protection, marketing, innovation, entrepreneurial- and business-oriented thinking, and investment advice. Sponsors included offshore asset and precious metal investment account managers, health and wellness products, practice transition services, and non-profit doctor organizations who work together for positive healthcare policy...

She also reports that, "Plans are already underway for The Physicians Summit 2014, with more speakers, more sponsors and supporters." 

You can get more information about this and other events at the BRI Blog.

Balko on Forced Medical Procedures and the Drug War

This is a very eye-opening piece from Radley Balko: "Anal Probes And The Drug War: A Look At The Ethical And Legal Issues".

From the opening:

Last week, news wires, blogs and pundits lit up with the horrifying story of David Eckert, a New Mexico man who last January was subjected to a series of invasive and degrading drug search procedures after a traffic stop. The procedures, which included x-rays, digital anal penetration, enemas and a colonoscopy, were all performed without Eckert's consent.

[...other examples...]

These incidents raise troubling questions about how the criminal justice system and medical establishment could allow for such extreme and invasive measures based on such little suspicion for nonviolent drug offenses...

Read the full text for more thorough discussion of the relevant legal and medical ethics issues.

(BTW, Diana and I got to hear him speak in Denver on his book, Rise of the Warrior Cop: The Militarization of America's Police Forces.  If you get to hear him speak in person, it's worth going to.)

Chicago Tribune Speaks Out Against ObamaCare

I was pleasantly surprised to read this editorial from the liberal Chicago Tribune speaking out against ObamaCare and supporting free-market reforms.

From their piece, "Truth, consequences and Obamacare":

An essential first step: Accept that government doesn't know what's best for everyone. That people can decide what coverage they need and can afford. A strong marketplace offers choices for every wallet. Obamacare's rules curtail those choices. Why, for instance, should only people under age 30 be eligible to purchase lower-cost "catastrophic" insurance? Pinching Americans' coverage choices is one big reason this law doesn't work.

I wish they had spoken out sooner.  But it's a good start.

The FDA Prepares to Ban Trans-Fat

Michelle Minton of CEI has a new OpEd, "FDA Trans-Fat Ban Sets Stage to Target Sugar, Salt, and More".

In particular, she notes:

The de facto ban on trans-fat’s GRAS [Generally Recognized As Safe] status signals a sea change in the agency’s approach to food-safety regulation. Historically, the FDA has banned only additives and products that could be acutely dangerous to public health. FDA attempts to limit other ingredients, such as salt and sugar, have met public backlash, but it’s unlikely many will step up to defend trans-fats, considering the scientific evidence that seems to link its long-term consumption with a slightly increased risk of cardiovascular disease.

Since almost any food can become dangerous if consumed in excess over an extended period, this move would set a precedent for the FDA to go after other food ingredients. Unsurprisingly, self-styled “public health” advocates — always at the forefront of nanny state regulatory efforts -- are elated at this prospect...

It may indeed be that new scientific evidence show these fats are bad for people. 

But I posted the following comment below on Facebook and wanted to repost it here:

If the only thing the FDA did was say, "We think Food A is healthier for you than Food B", then it wouldn't be too big of a deal. Various private advocacy groups (biased and impartial) do that all the time -- and I can take or leave their advice. And in that case, the FDA would also be superfluous in a world where other people and organizations (some with much better credibility) would already be weighing in with their opinions.

But when the FDA also has the regulatory power to push some foods onto the market (and drive others off), then that's a different story entirely.

I'm fine with private people and organizations making arguments along the lines of, "Science now shows that some of our ideas from 20 years ago are wrong." One recent example has been the rise of "barefoot running" or the "minimalist shoes" as an alternative to the heavily padded traditional running shoes that gained popularity in the 1970s/1980s. There's interesting work showing those minimal shoes may have genuine long-term orthopedic benefits.

People can study the research for themselves and make their own decisions about what kind of running shoe to purchase (relying on any experts they deem reliable.)

But I would have objected to the FDA (or any similar government agency) promoting old-style running shoes in the 1980s and I would be similarly opposed to a government agency attempting to now tilt the playing field towards the popular new minimalist running shoes.

For agencies like the FDA, it's not just about the science. It's about someone's vision of what the science means for how you should live.

Armstrong On Finding A Concierge Doctor

Ari Armstrong describes how, "Prior to Concierge Medicine, My Access to Health Care Was Inferior to that of My Cat".

From his post:

Although I loved my previous doctor, I had a difficult time scheduling a timely appointment with her. When I last called, I was told I’d have to wait three months to schedule a routine physical. Such delays are not unusual; many Americans—including many of my friends—are having trouble getting in to see a doctor in a timely manner (although for serious emergencies Americans almost always receive fast and excellent care).

Contrast my physical exam with that of my cat. When I called my veterinarian’s office last month, I was able to schedule my cat’s routine exam within days, and she received top-notch care, complete with detailed blood analysis. Why is it, I thought, that my cat has better access to health care than I have?...

Thankfully, my story has a happy ending: I found a “concierge” family practice in my area, similar to that of Dr. Josh Umbehr (whom I interviewed for the Fall issue of TOS). The practice accepts no insurance, provides many tests at cost, and charges a relatively low monthly fee (which my wife and I pay from our Health Savings Account). I was able to schedule my physical within days, and my new doctor was able to spend a full, unhurried hour with me.

For more details, read the full text of "Prior to Concierge Medicine, My Access to Health Care Was Inferior to that of My Cat".

John Hunt: Assume The Physician

Reader book plug from pediatrician Dr. John Hunt: His novel, Assume The Physician.

Roy On American Life Expectancy

Avik Roy discusses, "The Myth of Americans' Poor Life Expectancy".

A couple of excerpts:

If you really want to measure health outcomes, the best way to do it is at the point of medical intervention. If you have a heart attack, how long do you live in the U.S. vs. another country? If you’re diagnosed with breast cancer? In 2008, a group of investigators conducted a worldwide study of cancer survival rates, called CONCORD. They looked at 5-year survival rates for breast cancer, colon and rectal cancer, and prostate cancer. I compiled their data for the U.S., Canada, Australia, Japan, and western Europe. Guess who came out number one?

And:

Another point worth making is that people die for other reasons than health. For example, people die because of car accidents and violent crime. A few years back, Robert Ohsfeldt of Texas A&M and John Schneider of the University of Iowa asked the obvious question: what happens if you remove deaths from fatal injuries from the life expectancy tables?

Click through to read the answers.

Dr. Craig Wax' Letter To The President

Family physician Dr. Craig Wax has posted his letter to the President.

There are a lot of doctors in America who share his concerns.

Catron Update on Contraception Mandate

David Catron has an update on the latest court ruling here in American Spectator: "Whither Obamacare's Contraception Mandate Now?"

Here's the opening:

Last Friday, capping off a week filled with disturbing revelations of bureaucratic incompetence and presidential mendacity concerning Obamacare, the D.C. Circuit Court of Appeals struck down the “reform” law’s notorious contraception mandate. On behalf of the majority, Judge Janice Rogers Brown wrote that the mandate would force the plaintiffs in Gilardi v. HHS to choose between bankruptcy and violating their religious beliefs: “They can either abide by the sacred tenets of their faith, pay a penalty of over $14 million and cripple the companies they have spent a lifetime building, or they become complicit in a grave moral wrong.”

This, the court ruled, violates the constitutional rights of plaintiffs Francis and Philip Gilardi. The Gilardi brothers own Freshway Foods as well as Freshway logistics and provide health insurance for their 400 employees through a third-party administrator. They also oppose contraception, sterilization, and abortion. Thus, Freshway’s employee health plan excludes coverage of products and services related to those practices. Believing that the contraception mandate violates their rights under the Religious Freedom Restoration Act (RFRA) and the Free Exercise clause of the First Amendment, the Gilardis filed a lawsuit against the government last January...

This looks like it will be headed to the US Supreme Court. Read the full text for more.

Morning Snark: Hsieh PJM OpEd "Obamacare and the Wages of Spin"

PJ Media has posted my snarky piece, "Obamacare and the Wages of Spin".

The basic theme: Don't piss on my back and tell me it's raining.

Here is the opening:

Many years ago, the writer Ayn Rand noticed a curious kind of backpedalling from the political Left. First, they’d claim that socialism would provide enough shoes for the whole world. But when economic reality caught up with them, and they failed to deliver on their promises, they’d turn around and claim that going barefoot was superior to wearing shoes. In modern parlance, those broken promises weren’t a bug, but a feature!

In the past few weeks, we’ve seen precisely this pattern coming from defenders of ObamaCare. For example...

Read the full text at: "Obamacare and the Wages of Spin".

(And thanks to Jawaid Bazyar for flagging the Ayn Rand quote I used in the opening.)

PJ Media on Math and Security

Two noteworthy pieces on PJ Media.

From Charlie Martin: "Obamacare vs. Arithmetic".

(I agree with most of his proposals, although I don't think we should have a mandate on purchasing even "catastrophic-only" insurance plans.)

From Rick Moran: "Worrisome Security Breach at Healthcare.gov".

(If a private health care organization had similar data security breaches, the government would be on them like a ton of bricks.)

Catron Reviews Sebelius Testimony

David Catron gives a big thumbs-down to HHS Secretary Sebelius' recent testimony before Congress: "Sebelius Enters the Eighth Circle of Obamacare".