GOPers Join ‘Read-the-Bill Movement’ to Slow Health Care Debate

Thursday, July 30, 2009 at 4:15 pm
Collin Hanna (YouTube: Fox News)

Colin Hanna (YouTube: letfreedomringusa)

In early July, settled in at one of Grover Norquist’s conservative movement breakfast meetings, Colin Hanna and Peter Roff had a brainstorm. Hanna, who commutes to Washington from the Wilmington, Delaware offices of his organization Let Freedom Ring, speculated that Americans were concerned about Congress considering a health care bill that not every member had read. Roff, a senior fellow at the libertarian Institute for Liberty, suggested that there was a way to take advantage of this. Members of Congress could be put to the test: No vote on health care unless they’d read the entire bill.

Image by: Matt Mahurin

Image by: Matt Mahurin

“The credit for the actual idea, I want to give to Peter,” Hanna told TWI on Wednesday. “From there we refined the language and we came up with our respective pledges for members of Congress.”

The respective pledges–a “Pledge to Read” from Hanna’s group, which is racking up signatures, and a “Truth in Voting Initiative” –have been smash hits. Ninety-eight Republicans in the House and Senate have signed onto Hanna’s pledge, which demands that members read any health care bill “personally, in its entirety” and make sure it’s available on the Internet for 72 hours before a vote. More importantly, they have changed the tone of the health care debate as members prepare to head home for a five-week recess during which liberal and conservative pressure groups will fight to lock up or break up support for a far-reaching reform bill.

On Tuesday, 180 members of the House Democratic conference met for two hours to listen to a read-through of the current version of the party’s health care legislation; after the meeting, Rep. C.A. “Dutch” Ruppersberger (D-Md.) told reporters that “no one’s going to say we haven’t read the bill.” On Wednesday, Barack Obama told a town hall in North Carolina that a month-long delay on a health care vote might be a good thing, because it would give members “time to read” the bill.

All of this represents a small but important messaging success for conservative opponents of current Democratic health proposals. And it’s the latest example of how an Obama campaign promise, of more transparency in government, has been turned against the administration and congressional Democrats.

“Democrats remember that they lost control of the health care debate in 1993 and 1994 when people read the bill and reacted to what they were reading,” said Michael Franc, vice president of government relations at the Heritage Foundation. “People hear about a crazy proposal and they ask themselves: if this one proposal that sounds kind of crazy is in there, what else is in there? The details are seen as a real danger for proponents of this bill. They wanted to do this in a hurry, working off talking points and executive summaries.”

According to Republicans in Congress, the groundwork for this campaign and this argument was laid years ago. In 2006 and 2007, Republican opponents of immigration reform legislation picked apart the bill sponsored by Sen. Ted Kennedy (D-Mass.) and Sen. John McCain (R-Ariz.) and highlighted portions such as Z-visa limits and scholarships for the children of naturalized citizens to drive up conservative outrage and the debate dragged on. In December 2007, Sen. Jim DeMint (R-S.C.) roasted Democrats for claiming that there had been ample time to read an omnibus spending bill because it had been posted online, without much fanfare, for two days. And this year, Republicans have repeatedly, theatrically waved around the thick bills they were voting against to argue that Congress was rubber-stamping junk, waste, and earmarks.

The short-lived outrage over the bonuses paid out to employees by the bailed-out American Investment Group was not enough to help Republicans win a special election for a House seat in upstate New York, but party strategists have not forgotten how it flummoxed Democrats or how it introduced the question of what Democrats such as Sen. Christopher Dodd (D-Conn.) knew when they voted for the economic stimulus package. “I think we’ve reached a tipping point,” suggested Hanna.

“We’ve had too many huge pushes by Washington to ram through these enormous bills in short periods of time,” explained DeMint’s spokesman Wesley Denton. “Members go home and their constituents know more than they do about these bills. That’s why the ‘read the bill’ movement is registering. Between the amnesty, the bailouts, and the stimulus, politicians showed that they didn’t understand what they had voted for.”

It’s a simple message that comes with the trappings of a good-government reform idea. Americans for Prosperity, a conservative group that has been helping organize anti-spending “tea parties” and anti-health care reform rallies, has prepped for the upcoming recess with a softer message; a TV ad telling voters to ask their members of Congress whether or not they’ve read the bill. The news of Democrats girding themselves for those questions with a special health care cram session was treated as a small victory by AFP. “It shows that our message is getting through,” said Amy Menefee, a spokeswoman for the group.

Obama’s guarded comments about the value of reading the bill hinted at the politics at work; demanding more transparency is a more subtle and powerful way of pressuring Congress into delaying or killing a health care vote than cries of “socialism” or a mounting “government takeover.”

“I don’t see anything mischievous or Machiavellian about this,” said Mickey Edwards, a former Republican congressman who is now vice president of the non-partisan Aspen Institute, and who has been critical of Republicans in opposition. “Passing bills without reading them has been a problem for decades. When I was a congressman and this came up at town halls–someone asking me about some obscure provision in a bill I’d supported–I used to defend myself by admitting, well, I didn’t read that part.”

While Republicans have not-so-quietly cheered delays in the health care bill mark-up process, seeing a prolonged debate during the recess as the best chance of tabling the most expansive version of reform, they’re careful not to present the “read the bill” campaign that way. “Just because you want to slow the process down doesn’t mean want to you want to kill something, necessarily,” said Matthew Specht, a spokesman for Rep. Jeff Flake (R-Ariz.).

At the same time, Republicans were cheered by Obama’s comments on Wednesday. One GOP staffer told TWI that after the president suggested that he would “go line by line” through the health care bill with any senator or representative who asked, staffers joked about heading up to the White House, carrying take-out pizza, taking up him up on his offer.

“Was that a sincere offer to go through the bill line by line?” laughed Hanna. “I hope he’s reserved plenty of time. There are a lot of people who’d take him up on that.”

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Comment posted July 30, 2009 @ 8:42 pm

I share the opinion that only a strong public option will be capable of getting the premium inflation under control.

Comment posted July 30, 2009 @ 8:42 pm

I share the opinion that only a strong public option will be capable of getting the premium inflation under control.

Comment posted July 30, 2009 @ 8:43 pm

For more on Obamacare and the bureaucrats in charge, read the article titled “Are you willing to die for your government?” posted at

Comment posted July 30, 2009 @ 10:08 pm

“Are you willing to die for your government?”
Where were you in 2003?

Comment posted July 31, 2009 @ 1:36 am

Hunh! What a novel idea. A corps of “public servants” called upon to actually render the public service of reading a bill before enacting it into law.

Where the hell were the guys who came up with this brilliantly obvious notion when Dubbya was ramming that unreadably massive Gestapo fantasy USA PATRIOT Act down the nation's throat?

Sean Hackbarth
Comment posted July 31, 2009 @ 6:56 pm

Senator Lindsey Graham and Senator John Barrasso told Greta Van Susteren they'd take up President Obama's offer to go through any health care bill line-by-line:…

Comment posted July 31, 2009 @ 9:08 pm

This is just a make work program. Who could find enough Republicans who know how to read and can read the bills aloud to the GOP contingents? It's so much easier and takes less time and effort to just shout Communism! Socialism! and Birth Certificate! and Black President! all the time. Kristol admitted as much in his interview with John Stuart. What a shame the allegedly liberal media has to wait for a comedian to actually ask the hard questions of our anointed wingnut intellectuals.

Comment posted July 31, 2009 @ 10:08 pm

I have been searching the net for a copy of the bill so I can read it — where is it!!!!! The liberal press only reports on what they want the public to hear. Everyone should read page 425 that refers to mandatory counseling for everyone on Social Security every five years to learn how to end their life sooner, ie. starvation and dehydration. Also, this bill will not provide medication for any age related diseases, i.e. age related macular degeneration or Alzheimer.

Comment posted August 1, 2009 @ 3:59 pm

Everyone should watch this Moyers interview of Wendell Potter – Excellent piece! ScottyG-dumbass, there are multiple bills at the moment due to House and Senate committees working in parallel. I heard it on the news in spite of the conspiracy to keep me in the dark. The “liberal” press is hiding nothing; but you know that. You can read all proposed legislation at Thomas – e.g.…. which I found in 30 seconds after reading your inane post. Since you are too fucking stupid to thwart the “liberal media propaganda complex”, how do you know what's on page 425 (of which bill?) and why do you make the rest of your false claims in your post? Are you trying to scare people or do you just take everything that Sean Hannity and Dick Morris say at face value?

Comment posted August 4, 2009 @ 10:38 am

LMAO! Hey, back away from Olbermans show for a minute and take a breath. Where is your liberal tolerance and compassion? Reread your post…according to your post (and defense of the liberal media), its safe to assume you are a liberal and are FULL of love for all people…where is it?

The biggest problem with liberals is they all THINK they need to THINK for me because they know better…sounds like you fit the mold well.

Comment posted August 4, 2009 @ 10:57 am

So actually reading the bill and understanding it is sabotage to the bill? How many pages is it? How much pork has been added?
Why don't the politicians go after the real culprit in health care…the pharmacutical companies and hospitals. My brother just got out of the hospital and we ask for an itemized fee list. They charged him $15 for each Tylenol pill. He was charged for a pap smear test. They added on additionl fees for x-rays and he had none taken. He is taking 2 heart medicines. He goes to Canada to get them. One is made by Phizer. He pays $1.72 for each pill. Here it is $32.11 each. Same size, color, shape and manufacturer. Phizer.
So if they can sell it to Canada and still make a small profit, why does our government allow them to gouge the public? They went after the oil companies when they made huge profits but nothing is being said about this. Why? Oh, wait…the pharmacutical companies are huge supporters of the Democratic Party. Imagine that.

Comment posted August 4, 2009 @ 11:07 am

Well, “actually reading the bill” is something so exceptionally rare for our “distinctly native American criminal class” – Congress – that any member of that body insisting on such consequentiality is ipso facto trying to “sabotage” the sort of massive, explicitly unconstitutional, budget-fucking, economically and practically impossible legislation that Barry and his fellow National Socialist Party stalwarts are trying so vigorously to ram up the nation's collective ass.

As for the pharmaceutical companies…. Ah, what a seductive target that might seem to the terminally stupid. Classic example of Bastiat's “That Which is Seen, and That Which is Not Seen,” isn't it? The bull keeps his eyes on the cape in the politician's left hand, and doesn't pay attention to that long, sharp, pointy thing in the right hand that's about to slide down into his chest and rip his heart out.

Moo for me, would you, please, Dragon?

Comment posted August 4, 2009 @ 12:17 pm

Terminally stupid. What was stupid about it? Insurance companies charge what they need to to cover the cost of the hospital and pharmacies charge. Lower the fees charged by the hospitals and pharmacies and then health insurance will go down accordingly.
If this is too simple for you, let me know.

Comment posted August 4, 2009 @ 12:51 pm

First, lizard-boy, because the relatively lower prices of branded (on-patent) pharmaceutical products in foreign markets like Canada and Mexico are artificially suppressed by government fiat. The governments of these countries threaten the manufacturers of such products with the violation of their international patents on these drugs if the pharma manufacturers refuse to sell these products in countries like Canada for a bare minimum over the cost required to produce and to transport them to market.

Y'see, one of the peculiarities in the FDA-regulated pharmaceuticals marketplace is that the manufacturers have to follow what are called current good manufacturing processes (cGMP) and report to that regulating authority every little detail of how their proprietary products are formulated, manufactured, packaged, and even transported. And this information becomes totally public in almost all cases. You can get it in voluminous detail off the FDA's Web portals.

This means that foreign company's like India' mega-thieving Dr. Redy can and do reproduce these proprietary compounds and strive to push them – legally or illegally – onto world markets, literally stealing the intellectual property of the originating pharma manufacturers.

Now, the costs associated with complying with the elaborate bodies of regulatory bullshit pressed upon drug manufacturers in these United States, Europe, and Japan (the most lucrative markets in the world, and where these manufacturers need to make profits in order to keep going as businesses) average about a billion dollars – that's “billion” with a “B” – per finished, approved medication.

And that doesn't count all the new chemical entities (NCEs) which go into the research and development process but never make it to finished, approved status. Or the approved drugs that have to be pulled off the market owing to intolerable adverse drug event (ADE) profiles developing in Phase IV – the post-FDA-approval marketing period, which goes on and on – obliging withdrawal.

In order to cut down these drug development costs (and the time required to get these drugs through the FDA's Office of New Drugs [OND] review process), I've seen it suggested – and this makes a helluva lot of sense – that the FDA give up obliging proofs of efficacy in Phase II and Phase III development and go back to securing reliable and robust proofs of safety only, which is what the FDA is legitimately supposed to do.

Efficacy (Kefauver be damned) is nothing with which any bureaucrat should be concerned. If the damned drug is going to be accepted as workable in a particular application, the manufacturer either undertakes research to confirm this, or prescribers won't write for the product. Any fraudulent claims of efficacy or safety – which practicing physicians invariably point out long before any ham-headed FDA bureaucrat ever does – get pursued per the government's brief to retaliate against theft of property by fraud.

Right now, the FDA is both less effective – by dint of “regulatory capture” – than it ought to be, and puts pharma manufacturers through literally billions of dollars' worth of absolutely useless testing and years of delay (efficacy testing takes a helluva lot more time than does safety testing) while patients suffer and die, and costs get pushed up to the point of agony.

That's one way in which you're terminally stupid, Dragon. You don't know a goddam thing you're trying to talk about.

There are other ways to chop down health care costs. Look for an example to:

…for some not quite elegantly expressed but very practicable solutions.

Comment posted August 4, 2009 @ 7:53 pm

Just how left do you swing? You proved my point that the pharmacitical companies are allowed to over charge in the States. We can not control what a doctor over seas does. I see what is going on and do not try to blame foreign natiions.
You talk about their need to make profits, what about the insurance companies needs to make profits? That is why the area I live in hate liberals, not democrats, liberals. They only show one side of a story, just like you.
Since you are so full of liberal shit, no amount of facts will ever get by the blinders you wear.

Comment posted August 4, 2009 @ 8:59 pm

GOPers are so dyslexic that they have been reading health care reform bills since the Truman administration and their lips are getting chapped. I can put a 1,000 page .pdf up on my big screen, settle into my LazYBoy with a pot of mojo and read it thoroughly at about 1 minute per page in two eight hour shifts. Any Senator or Rep. who doesn't have the discipline to do that
should be home with the kids.

Comment posted August 5, 2009 @ 12:12 am

Fine. You get your mojo-drinking ass elected to the Senate.

Hey, if Al Franken can do it…

Comment posted August 5, 2009 @ 12:32 am

Grow up, Evan. All stereotypes are false. I will fight for things that make society better for me and my family and friends even if it benefits those who are too ignorant to recognize it. You do not need to thank me. I will not, and no one should, accept nonsensical, irrational or just plain lazy commentary specifically made to trash something under the guise of “the man” trying to block your right to know the facts about it. If you can read and post here, you can educate yourself on health care issues.

From your post it is clear that you have nothing to add to the debate but simply want to trash “liberals” 'cause someone told you they think they're smarter than you are.

Show us you're smart, Evan. What are your views on health care reform? Have you viewed the Potter interview? Did you read the proposed linked legislation or the CBO analysis of it? Do you agree or disagree? Do you have alternative suggestions?

Don't get PO'd at me, show me you can think for yourself.

Comment posted August 5, 2009 @ 12:53 am

No, stereotypes are commonly quite robust, and very useful. That's why people develop them and employ them. Think of them as labor-saving measures, enabling the user to quickly categorize people whom they encounter or must otherwise consider, either as threats or opportunities for cordial engagement.

The relative unreliability of stereotypes must be constantly borne in mind, as with all other modalities of deductive reasoning, but stereotypes serve the average human being very well. Indeed, it is likely that we could not survive without them.

And why should you “fight to make society better”? Society is the amicable process of individual human beings – each with individual human rights – living and working together in harmony. If there is “fighting,” the basis upon which society operates is simply absent.

The key is to reduce whatever elements in our polity give rise to social disharmony – factors such as economically and otherwise intrusive civil government, by which people struggle for political power to coerce from their neighbors what cannot be gained by persuasion, evocation of sympathy, or trading value for value.

You know the old saying. “As long as it's voluntary.” That's society.

Government, on the other hand…. Well, that's not really society at all.

See Thomas Paine, Common Sense, 1776.

Comment posted August 5, 2009 @ 2:33 am


I don't trust them.

And why should I?

Comment posted August 5, 2009 @ 7:16 am

??? ??
hdd ??
???? ??

Comment posted August 7, 2009 @ 5:59 pm


Comment posted August 7, 2009 @ 8:51 pm

dragon: What need to make profits? Insurance companies don't even need to exist. And if you think there is any necessary correlation between a doctor and a pharm company, you are really out there. Our medical system is broken; it cannot be maintained in this form any more. The rest of the world is single-payer for all intents and purposes, for a simple reason: IT WORKS! American-style insurance is a relic of WWII and needs to be jettisoned before it strangles all of us. And seriously – hate liberals? Blinders? What kinda pasty alien sheep live where you are (that is what Faux does to you if you watch it… at all)? ALL political groups show their side primarily, and if you think that liberals are holding the torch on this one, I just don't know what to say. Fair and balanced much? I didn't think so…

Comment posted August 7, 2009 @ 9:07 pm

Okay, so you're the pharmaceutical companies' pimp. I get it. Still, even a pimp should be able to tell the truth, which means all the truth, not selective bits that support a preconceived notion of reality. I'm glad you can read the descriptions of the FDA's work and write them down, but sir, you are dodging the question and you know it. For years the FDA fasttracked drug approval and we all know where some of those medications led us. Now you want to argue that the FDA is responsible for the outrageous prices and profits at these companies, and not admit that simple, stupid human greed is responsible?
Clearly you have a marketplace fetish, which is unfortunate but understandable in our sensationalized, undereducated fatty-fat-fat country. I want to make my country great again, not pour another fifty gallons of HFCS down my throat. Aren't you the least bit aware of the place unfettered market faith has gotten us? Why don't you look around, maybe get away from the computer for a minute or two and meet your neighbors, if you dare. The market is not the answer to all, only to some of our problems.
Medicine is not a commodity. Cars are a commodity. You don't have to drive one. Hats. Watches. Brownshirts. These are not essential to life, and as such are safe in the hands of the marketplace. Medicine is NOT. If someone gets sick, they need care; they can't just opt out of it like not buying a new car. Unless you think that life is also a commodity, and that therefore these large multinationals should be allowed to continue trafficking in human lives, but I will give you enough credit to have avoided becoming quite that zealous.
I don't think you are stupid, nor do I think you “don't know a goddam thing you're trying to talk about”, but I do know that you think you are way cleverer than you are, sir. Stop this disingenuous blabber and accept the change that is coming. It'll make it easier for you, because it's coming regardless. The days of obscene immoral greed in the field of medicine will be ended soon.

Comment posted August 8, 2009 @ 8:23 am

Nah. The PhRMA people have looked upon me all my professional life (hell, beginning in med school) as somebody they can induce to jump through whatever hoops they like. In turn, I've screwed them as hard as I can for prescription drug samples and anything else I can get to benefit my patients, The samples drying up lately has been a real pain in the ass. Some of my patients depend completely on pharma samples for their maintenance medications.

Fortunately, I'm good with materia medica. There are always less costly (never say “cheaper”) options, and I'm Sicilians. We taught the Scotsmen how to squeeze pennies.

But knowing something about the drug development process. FDA-required efficacy studies don't contribute a goddamned thing to drug safety. They cost a ton (both in time and in money), and we can do without the friggin' things.

And, yeah, the PhRMA guys would like that. Their NCEs only have so much time on their patent lives, and the sooner they can get 'em on the market, the better.

As for what you conceive to be problems arising from “FDA fasttracked drug approval,” you obviously don't know jack about what those bureaucrats in Rockville do, do you?

The big problems associated with failures of safety monitoring lie mostly in regulatory capture. However complex and redundant the regulatory scrutiny might be, the incentive is always with the regulated industry participants to find ways around and behind and between the safeguards. This is why such safeguards are less effective as time passes.

The PhRMA guys are smart. They get good at weaselry. The FDA guys are…well, they're bureaucrats. The smart ones get sick and tired of the government institutional stupidity, and the manufacturers know what the best of these guys can do. The PhRMA people hire them, and by incorporating not only these ex-FDA guys' technological and scientific knowledge and their insight into what goes on in the FDA's OND, the PhRMA people get better at sliding through and around and past the FDA filters.

Government regulation is a losing battle. Always has been. The real advantage of government regulation – like 21 CFR – is that the costs of complying with those regulations (which are horrible) freeze competitors and potential competitors out of the established PhRMA guys' chunks of the market.

They love that. Regulations are never imposed for the benefit of the consumer. They're always inflicted on a market segment to preserve the “turf” of established actors in that segment, and to fuck the consumer.

Sure, greed in in there. It's in bloody everything people do to make a living. Greed is okay as long as the market is free and open to all comers.

Bring in government – to “pick winners” or force political purposes on what's supposed to be happy, greed-propelled self-interest – and you've got a truly fucked-up system racked with useless costs, all of which the end consumer – by definition; it's inescapable, damnit – must pay.

And you bet your constipated ass that “Medicine is not a commodity.”

What the fuck else could it be? Does it rain down from the heavens by the grace of God? Is it something you can gather at the beach?

It takes purposeful human effort to deliver medical care, to manufacture and dispense pharmaceuticals, to devise and test and install medical devices like pacemakers and artificial hips. That doesn't happen without the end consumer paying for it, in one way or another.

That's about as moral as things can get, ghost. If you think that you – the patient – have a right to medical care, to medicines, to an ambulance at door when you need one – then what you're saying is that the doctors and nurses and pharmacists and ambulance crews have no right to their own lives.

If you want care, and exercise your “right,” they cannot refuse you.

Guess what happens then, ghost? You try to exercise you're right, and the doctors, the nurses, the pharmacists, the ambulance crews – they tell you to go fuck yourself.

They say “No.”

And then, buddy, you are a ghost. And we're better off here on earth without you.

Comment posted August 8, 2009 @ 8:26 am

Sorry. Meant “Medicine is a commodity.”

Too much blood in the caffeine stream. On to the coffeemaker!

Comment posted August 8, 2009 @ 3:18 pm

Hmm how do I tell this guy that I drew the opposite conclusions in MY medical school training? You think that being part of the broken dylexic system with which we engage gives us some moral high ground? Or that endlessly invoking The Fountainhead makes one look stronger?
Medicine is not a commodity, though it is treated as one in this coutry. What else could it be? I'm sorry if you can't conceive of any other state of things, sir. Clearly, if it isn't a commodity then market-only arguments fall flat, and if those arguments are all one is armed with, then admitting this is the last step one could take. But logical, or even supported by most philosophic or economic analyses? No.
Perhaps you think that all the other industrialized countries, which to a state have gone the socialized route, are all peopled by idiots, or dumbed down by some weird Euro-gas? No, Tuci, you just think that, because you put in the time, effort and money for your degree and practice, just like we all did, that defending this system is somehow automatically justified. All that it really means is that you have abdicated your responsibility to your patients in favor of the devil you know. Understandable, perhaps, but not therefore true.
There are plenty of reforms that I know you will support, like capping malpractice awards (I agree) and limiting the decrease in Medicare reimbursement (which I bet you still accept, despite its pariah status as a government program), but to reject those reforms which may affect your income only reveals exactly how much you think greed is okay.
It has baffled me for the better part of twenty years how deeply many physicians buy into this myth, because of the payoff to them. We are the leaders of healing, and we won't even look at how utterly diseased the current delivery system is! Fortunately all physicians are not of this stripe, no matter how hard the bullies try to make us seem monolithic.
We won't make as much under single-payer, but we will finally be engaged with a moral system. Too high a degree of self-interest disqualifies people from decision-making in nearly all fields, for a very good reason; most people can't see past the end of their noses when it comes to their money. Insurers and the Pharm guys know this and exploit it mercilessly, because they know that we are supposed to hold the moral high ground in arguments about medical care. If they lost our support they would wither and die. Which they deserve.
Finally, if health care coverage was required, and HCPs were reimbursed by the government for their work, why on earth would they deny me care in such a catastrophic case as you outlined? Just to be big meanies? Or because they wanted to lose their jobs?

Comment posted August 8, 2009 @ 4:54 pm

Well, ghost, when you write about a “broken dylexic system with which we engage” – largely against our will, and almost always against our better judgement – the institution to which you need to apply that characterization is civil government.

Much as I would myself – personally and professionally – like to see my patients' medical care needs fulfilled automatically, with such care (and all attending goods) seen to “…droppeth as the gentle rain from heaven / Upon the place beneath,” there's the plain fact that in this universe, There Ain't No Such Thing As A Free Lunch.


Neither a Heinlein fan nor a Milton Friedman reader, are you?

Even if I didn't have a family to feed and a mortgage to pay (even at my age), and could practice caritas, without so much as a single worry about what the third-party payors will or won't reject this month, the other stuff my patients require has got to come from somewhere, and to drum that “other stuff” up, somebody has to be induced to act on their behalf.

The division of labor economy was created to enable people to come into society “out of the state of nature” and secure better quality of life through access to specialized services. Real wealth has never been gold or silver or stacks of Federal Reserve Notes counterfeited by cabals of banksters, or even material goods, but rather the services of skilled and diligent human beings, either applied to the creation and provision of goods or to the direct comfort and well-being of the individuals benefiting from that creative ability, skill, and diligence.

So how does one induce the providers of these services to acquire and refine those skills, exercise due diligence, exert their creative talents, and do the things that satisfy the demands of other people around them, meeting those folks' needs and desires?

Well, in Pericles' Athens and Cato's Rome, one commonly bought them, kept them in the basement, and brought them out as required. They were called “chattel slaves.”

Under other systems of economic organization, they might be kept in peonage, or as serfs. “We are the worms of the earth / Against the lions of might….” That sort of thing.

But with the development of voluntary exchange – facilitated by intermediate commodities serving the purposes of money – it became possible to trade for these valuable services, and that beat hell out of enslaving people and then swapping or buying and selling the people themselves.

Enabled folks to get their hair cut, for example, without having to keep a barber in the basement full-time.

Also induces people to acquire marketable skills, and (entirely out of their own self-interest) to make those skills available for people they'd never before met in their lives.

An element of harmony comes into human affairs, and all because of money, greed (self-interest), and a system whereby people can voluntarily come together, free of coercion of threats or screaming and running and killing and torture and all the other commonplace horrors of government in action.

It's called “the free market” (pejorative name: “capitalism”), and it works effectively precisely to the extent that it's kept “free” of government goons jumping in to extort actions for political purposes at odds with the economic purposes for which private people came into that marketplace in the first place.

Must run right now. Back later, I assure you.

But bear in mind that when government gets involved, what was once “free” (as in “voluntary”) becomes coerced (as in “forced at gunpoint”), and there is no better way to turn a functioning society into a condition of civil war.

Comment posted August 8, 2009 @ 6:15 pm

Good lord, but you are rich, sir.

Why do you insist on reframing the argument? I've never suggested that the free market, which is the arena in which capitalism (a descriptive, not a perjorative, word) functions, is in any way inherently bad or wrong or even suboptimal. I clearly stated, time and again, that medicine is essentially different from other services in that it is not an optional service. Because of that, no price ceiling will exist for medical charges on the free market, and this fact has led us to the situation in which we are stuck.

I'm sure they had a marketplace (agora) to go with their slaves in your ancient pre-enlightened world. I'm equally sure that we still enslave vast swaths of humanity today, even with our lovely markets crashing all around us (again). Surely you don't mean you believe that the rest of the industrialized world is enslaved insofar as their medical systems are concerned (this is the third time I've explicitly raised this point – do you think the invisible hand works differently here in the US than elsewhere? or what?).

I've never suggested that anyone try to re-engineer society to force labor from anyone without adequate renumeration. That is the essence of communism (a political system) and communism has long been discredited. But adequate renumeration isn't the same as charging whatever the market will bear, because in the case of medicine, the market will bear any weight, at least until the whole shell game collapses. That is the disaster Obama is trying to avert; a damn sight better than averting his eyes.

Free means voluntary (in one sense), but even so, it doesn't follow that an unregulated market would be somehow freer. Good old greed has shown, time and again, that the more priveleged classes can and will use their power and influence to maintain their supremacy. Such an approach may be appropriate in an aristocracy, but it is NOT in a democracy. Thugs and mafias, in the service of this economic elite, would take over in the absence of regulation, and the idiots on Wall Street, who will never learn how to quit their fix by themselves anyway, would have complete freedom to jerk everyone around ad infinitum. That's your ideal system, eh?

BTW, I love Heinlein and am quite familiar with Friedman's views, but that doesn't mean I agree with either. Both belong to the positivist school anyway, so y'know, particular types of apples are still apples. It's just that, in my view, entirely too much emphasis is placed on faith in the US, whether it be faith in “free” markets, in God, in the invisible hand, in the pronouncements of the ecomonic elite. I am not exempting politicians from this charge, as they are owned body and soul by those same entities. But a public office is a far better vehicle to accomplish change than is the private sector, simply because we can vote the rascals out if they mess up.

Don't pretend like we consumers have anything like the power to affect a modern corporation; it's to shield themselves from precisely this possibility (of being forced to be responsible) that commercial enterprises incorporate in the first place. But then, you know all this, don't you?

Comment posted August 9, 2009 @ 12:01 am

Nah. Marx and Engels needed a pejorative word to excoriate that system of economic organization and function which, until then, had simply been called “the free market.” They came up with “capitalism.”

Innovations in the aggregation, allocation, and productive use of capital being perhaps the single greatest advance in the utilization of the factors of production (land, labor, and capital) in the first half of the 19th Century, the free market guys looked at the word “capitalism,” shrugged, and said (more or less) “Yeah, that's about right. Okay, we're capitalists.”

But the word was originated as a tool with which to fuck over the free-marketers. A pejorative. “Dirty-bad-awful-greedy-capitalists!

And: “Us socialists are on the side of the proletariat!” Et-yadda-yadda-”Big Brother!”-cetera. You know the bullshit, right?

It's not that I'm “reframing the argument,” ghost. I'm doing what you're supposed to do in cardiopulmonary resuscitation. The “ABC's.” While you're showing people how good you are with the pharmaceuticals, you can't ever forget that unless you keep the Airway open, that there's Breath moving in and out of the lungs, and that there is blood Circulating, all you're doing is medicating a corpse.

Your appreciation of the ABC's of a division of labor economy obviously sucks. I'm dragging you back to the basics.

You want to frame this discussion with a horrible stupidity – a patient-killing failure to keep your eyes on the ABC's – wanting it “clearly stated, time and again, that medicine is essentially different from other services in that it is not an optional service.

And that's just plain wrong. Remove “medicine” from that line and substitute “nutrition.”

Or “housing.”

Or “schooling for little children.”

Or “potable water.”

Or any of a long litany of things which are necessary for the sustenance of life, and which are therefore “not an optional service.”

The temptation among those of us in the medical profession is to see what we do – the services we provide – as essential to life, the most important single thing in life.

And it's not. Not really. Women were having babies for literally millions of years without the services of ACOG-certified obstetricians. In most of the world, they still do. Children were getting through truly horrible childhood diseases – on not – without the vaccines we consider essential today, and long before the specialty of pediatrics was more than a glimmer of greed in the eyes of American physicians who observed that wealthy parents could afford to spend a helluva lot more for little junior's doctoring than they were handing to the family GP.

(( Did you know that pediatrics – one of the poorest-paid specialties in the profession – started out as a “carriage trade” luxury specialty? ))

Gotta go for a bit. Take a look at what I've written right here. I'll be back to go into the rest of your post, 'cause it's worth discussing.

But remember the ABC's.

Comment posted August 9, 2009 @ 12:58 am

Back sooner than expected. Continuing from my post immediately below.

Now, right after that deadly stupidity (“medicine … is not an optional service“), you had continued:

Because of that, no price ceiling will exist for medical charges on the free market, and this fact has led us to the situation in which we are stuck.

Okay. The premise being false (for medical care is “an optional service,” particularly if your more urgent priorities going unaddressed are things like food to eat, water to drink, clothes on your back, a roof over your head, etc.), your “Because” is nonsense.

And there is always a “price ceiling” – monetary or otherwise – on every service.

Think of the story of the two cowboys out on the range. One unzips to void his bladder, and an unnoticed rattlesnake strikes, biting the man upon the distal phallus, just aft of the glans.

Shrieks and screams, both men terrified. “You set down,” says the other guy, helping the injured party apply a canteen-soaked bandanna to his injured member. “If ya move around or try to ride, that pizen'll spread and yuh'll die. I'll ride inta town 'n git help.”

The uninjured cowboy rides like the blazes, gets into town, and finds that the doc is twenty miles away attending a lady in her confinement. The town's pharmacist is available, and the cowboy tells him:

“Abe's got hisself snakebit by a rattler. Whut kin I do fer him?”

“Well,” says the druggist. “You gotta cut an 'X' where the bite is, 'n suck out the poison. You got that?”

The cowboy nods, runs out to his horse, and rides like hell back to poor old Abe.

“No doc?” gasps Abe. The cowboy shakes his head.

“So what's gonna happen t'me?”

The cowboy looks sorrowful.

“Yer gonna die.”

Now, the point of this story is that a “price ceiling” had been established, and the “cost” of poor old Abe's care was not going to be met.

Not all prices are monetary.

Medical services are a relative luxury. After other needs – more truly urgent needs – are met, people can begin concerning themselves with their medical problems.

Over the past couple of generations, Americans have been so truly wealthy – astonishingly wealthy, which is one of the reasons why the majority of Muslims on this planet (almost all of whom live in unspeakable poverty by our standards) hate the hell out of us “Great Satan” folks. We're arrant infidels who mock the words of the Prophet, who partake of unclean foods and drink intoxicating beverages, and those Arabic- and Farsi- and Urdu-speaking adherents to the True Faith have to watch their children die like flies while they themselves live in squalor and pain.

Really pisses 'em off. They go through a helluva lot of crap to get themselves right with God, and look forward to Paradise, and there's all them godless Nazrany dogs with running water and refrigerators and confidence that no matter what happens today, they've got a good chance to fix it and make tomorrow better.

Insh'Allah versus “God helps those who help themselves.”

Or just think of Victor Davis Hanson's The Western Way of War. Pretty much ever since Mars-la-Tour and Lepanto, West meets Wog, Wog dies.

But, like I said, Americans are rich. As a result of our wealth – the wealth in which you and I both grew up – we can individually and in groups choose to allocate resources to relative luxuries like medical services.

Our quality of life metrics include calculations about the “value-add” of better functionality, less pain, longer lives. But this is – and always has been – a luxury.

My grandparents – your great-grandparents – got along without that luxury, and this is something we forget. They commonly buried small children. Husbands buried wives dead in childbirth. Wives buried husbands run over by ploughhorses. They commonly died young, were crippled, blinded, covered in smallpox scars.

Why was carrying a cane such a fashon among gentlemen in the 19th Century and earleir? Because gentlemen could afford to ride horses, and falling from a horse not uncommonly permanently fucked up one's back and/or lower extremities. So many gentlemen had to use canes to get around that men who didn't need 'em felt left out. So they carried canes, too.

Damn. More later. Being historically illiterate – as most Americans are – really robs you of perspective, ghost. Keep in mind the thought that Americans of the past half-century have been incredibly wealthy, and therefore consider the luxury of medical care to be “not an optional service.”

And why that's bullshit.

Comment posted August 9, 2009 @ 12:03 pm

Alright, that's it.
I explained quite clearly, little boy, what the problems are with your analysis of the current state of affairs in medicine. I can't make you see them or admit them, nor (it appears) can I make you even address them, even on an open forum. So clearly you are too wedded to your dumb reductionist views to even listen. As someone with an apparent degree of intelligence, I'd hoped for an actual dialogue, but you seem to think that condescension and banal character references are a better way to go. Fine, pal.

You are part of the problem, and there's no escaping it. If you feel afraid, you should, because your theoretical defense of your lifestyle isn't going to save you. I'm certainly goddamn sick of trying to discuss this with you while you insult me, pal.

Historically ignorant? Find me an historian who thinks that all the world can be fit inside your dumb reductionist paradigm and I'll find you a professor without tenure. Unless he slithered in the backdoor at the Heritage Foundation.

Wealth doesn't obviate the need for medicine, pal. None of the other examples you gave (water, child care, school, housing, ad nauseum) are allowed to languish in your capitalist trough in any modern industrialized country, including ours. Of course your lying ass knows that, but so what? Make some stupid joke about how anyone who sees these problems differently from you (most of the world) is wrong…better yet, conjure up an historical anecdote with no basis in reality so you can feel smug again.

I told you my background, yet still you bore me by regaling stories you might wish were true, but are made up out of whole cloth. I'm used to this tactic by the right, don't worry.
Anyone else notice that tuci still won't say that all the other countries are wrong? Of course he won't, because they aren't, so he sticks his head in the sand and talks about cowboys. Good one pal.

Now you take to Muslim-bashing instead. Great answer dittohead. You don't have a clue beyond “they hate our freedom,” sadly putting you on an intellectual level even with GWB – that is IQ 50ish. Is someone ghostwriting all this for you? Muslims (as a group) don't hate us, but those who do do so for a variety of reasons, which is about the point where you get confused. Most of their reasons are bullshit, but some aren't, like the way that we commodify everything, regardless of its actual nature. They hate you pal, and they should.

It doesn't matter, really. Our country has become the last refuge of medical scoundrels, and when we are finished repairing the delivery system, you freaks on the right will be out of power forever. Which is what really scares you, isn't it? Too bad, pal; things might have been different if you'd had any strategy besides FEAR and THE MARKET IS ALWAYS RIGHT. Your “God” has failed, so remember, all of you whiners can move to Dubai. Where morons like you belong, choking on the sand as the oil runs out.

Hey, don't get snakebit, okay?

Comment posted August 9, 2009 @ 12:29 pm

BTW tuci:
Lest you think I'm closing off discussion on this, I'm not. But reviewing basic economics or medical technique as answers to my questions isn't engaging the issues, it's obfuscation. Analogies only work if they are apt. Yours aren't.

An ideal world where capitalism could perfectly play out would be great, as would a socialist utopia. Neither of these has ever transpired, because perfection is impossible for us mortals. Every advanced society on earth strives to balance these approaches (and others) to make life fairer for their people. Nature is red in tooth and claw, but human society doesn't have to mirror that, any more than survival of the fittest works as a socially applicable concept.

When all you give me are American examples to explain why we should do things in a certain way here in America, you're loading the dice. I really wish you righties would learn to take all the data into account, not just the data you agree with. Of course you neglect to purposefully, but I keep hoping that maybe, just maybe, your desire for “truthiness” is linked to an actual desire for truth, somewhere.

Seems more likely that you just wanna preserve the status quo, which is unfortunate, because that is being upended as we speak. Adapt or perish – dems the breaks. A prerequisite for wich is learning to think outside the little box your mind is stuck in, and you ain't gonna learn that from Glenn Beck or Flush. Or Milton Friedman.

Comment posted August 10, 2009 @ 4:48 am

Okay. Now on to “your ancient pre-enlightened world” (yours, too).

That pre-industrial condition of the West – and the West is really all that counts; since the Renaissance, the rest of the planet just drags along behind us – was about as “enlightened” as anyplace on Earth had ever gotten. Even classical Hellas and republican/imperial Rome with all the slaves in the basement. Consider the size of Rome – just the city – during the Empire, and think of nothing else but what it took to feed, water, fuel, and drain off the sewage from a city with a population number a million or more.

In the absence of even 19th Century technology.

These guys were “enlightened” as all hell. And yet their economy depended on chattel slavery. Major suckage. Better ways awaited, but what they required – for everybody's good, not just the rich, not just the slaves – was the crotchety, nasty, greedy notion of individual rights.

Self-interest, figured out so that people could fulfill their own needs and satisfy their own desires – within reasonable and almost universally accepted limits – without slaughter, slavery, or conquest.

The results of systems enabling and protecting self-interest have always been increases in aggregate and individual wealth, with better distribution of the wealth that did not involve any sort of government “master” forcibly “spreading the wealth around.”

When people can keep more of the wealth they produce, they produce more.

Now, the recent (really only over the past half-century) efforts in “the rest of the industrialized world” to subordinate medical care entirely to political ends has been almost entirely parasitic upon the for-profit sectors of various economies all over the planet. Innovations in medical technology (except, perhaps in those areas of epidemiology and trauma management touching upon military operations) are not chiefly or even significantly generated by government agents.

To the extent that advances in disease management have been enjoyed by the citizens of these other countries, their benefit has been largely the result of a “free ride” upon those producers working to the tune of greedy self-interest in the prospect of profit.

Darn. Again, must sign off for a bit. More debridement of your necrotic notions will follow.

Comment posted August 10, 2009 @ 4:57 am

Oh, I want better than the status quo. One difference between you and I is that I've done the work necessary to understand the status quo, and how it developed. You haven't.

Before addressing a pathology, you must appreciate its etiology, and you must especially understand how the normal “physiology” functions. You don't.

What you would like to secure, in the ways you wish to implement, inexorably involves a derangement of fundamental “homeostatic” mechanisms in the market economy, and is therefore fraught with the inescapable promise of adverse effects – “unintended consequences” – which you, as a responsible professional in the healing arts, seek to impose without thought for absolutely certain morbidity and mortality.

This is malpractitionate.

You want what you want, and you're willing to leap in with scalpel flailing without adequate understanding of either the putative disease process or the outcomes your actions will inflict upon your patients.

Again, this is malpractitionate.

The prerequisite for responsible conduct as a physician is an understanding of what works and what does not.

You seek to act without that understanding, and this is the height of malignant quackery.

You got that, colleague?

Comment posted August 10, 2009 @ 5:07 am

Oh, I'll merrily bash any religion. Religious belief gets in the way of honest, skeptical inquiry. When you find yourself doing things on the basis of what you believe, colleague, you stop being a physician and start being a faith healer.

Or a witch-doctor. Take your pick.

The Islamic faith – intruding as it does into every aspect of life among the true believers in Islam, including civil law, finance (the employment of capital), human rights, the sciences, and so forth – is one of the most debilitating of the widely-held religious belief systems on the planet, and the relationship between the Islamic cultures and those of the West are exemplary of the practical handicaps imposed upon the faithful in their interactions with peoples who allow the scientific method to function and take advantage of the fruits thereof.

And the Muslims do resent the hell out of the infidels' quality of life. They try to come up with all sorts of excuses – “The Nazrany dogs plunder the faithful! They lead our women into sin, and seduce our young and impressionable ones!” – but the truth of the matter is that Islam just kicks the shit out of wealth production, to some significant extent by making almost impossible the sort of “society of trust” that prevails in the nations of the West.

Bashing Muslims consists merely in observing what they do to themselves, and making no effort to evade acknowledgement of their failures.

Comment posted August 10, 2009 @ 7:02 am

Politicians always do things for political reasons. Any time politicians intervene with the machinery of civil government in areas of society outside the very limited (and highly restricted) purview of constitutional and therefore lawful action, they take perverse incentives with them.

Perverse incentives yield pernicious actions, and result in bad outcomes. Medical care is not a political football to be punted around by politicians trying to suck up votes.

Comment posted August 10, 2009 @ 11:14 am

In response to batousghot, I'm pulling a long quotation from the free online sample chapters of the recent book The Last Centurion by John Ringo. This is properly attributed, and there is no violation of copyright in this use of this material. See Web link to the cited chapter (“Daddy is Under the Roses“).

Study done in 2004 by the CDC. The way that good science works is that the scientist looks at something and says “What if?” He then develops a statement from that (a hypothesis) then tries to disprove his hypothesis. “The sky is yellow.” He first defines yellow. He then tests to see if the sky is yellow. If it turns out that the sky is actually blue, his hypothesis gets disproved. But he still publishes the paper and comes up with another hypothesis. Say that the world is really round. If he cannot disprove his hypothesis, it then and only then becomes a theory. This is Science 101. Man-induced global warming was an hypothesis that had been repeatedly disproven. Anthropogenic (man-caused) global warming proponents weren't scientists, they were religious zealots.

Anyway, the CDC liked “universal healthcare.” It was a government health program and government health programs were good. They were a government health program so any government health program had to be good.

Hypothesis: “Universal health care will increase the lifespan and general health of a population over free-market health care.”

Conclusion: “Fuck, we were not only wrong we were really wrong!”

How could that possibly be? Seriously. Universal healthcare is, well, universal healthcare! Everybody gets the same quality of treatment, young and old, rich and poor! Nobody is turned away! It's perfect communism! With doctors!

Yeah, everybody gets the same quality of treatment: Bad.

Look, if you're between the ages of 7 and 50, in reasonably good overall condition, don't have fucked up genetics and don't really lose the lottery, you generally don't really need a doctor. People between the ages of 7 and 50 rarely realize how bad socialist medicine is. Because they don't have to depend on doctors.

Try getting a hip replacement in a country with socialized medicine. Or a gall bladder operation. Hell, try getting drugs that improve a heart condition without surgery. And even though you can't, you also can't get surgery. Not in any sort of real time. Go rushing into a socialized medicine hospital with a clogged artery. You're going to get a stent if you're lucky. And get put on a waiting list for a bypass. For various political reasons, drugs that in free-market economies are the first line of defense just aren't available.

In the U.S. the standard time to wait for a gall bladder operation was two weeks. In the UK it was nine months. In the U.S., if you needed a bypass you'd be out of the surgery less than fourteen hours after emergency admission. In the UK it was emergency admission, minimal support therapy, months wait. Some 35% of persons waiting for a bypass operation died before they got one.

They found an interesting statistical anomaly as well. Death rates amongst the elderly climbed sharply as the end of the fiscal year approached.

Doctors in socialized medicine programs worked for the same pay whether they fixed people or not. But they had quotas for operations. As the end of the fiscal year approached, most of them had filled their quotas and went on actual or virtual vacation.

And people died.

Average population age in most of the socialized medicine countries were only starting to climb to the levels where death rates due to poor medical care were going to be noticeable. But the truncation of ages was clear. As were quality of life indicators.

Persons in free-market medical environments lived longer, healthier, less pain-filled lives. Despite the evil doctors and HMOs and pharmaceutical companies? No, because of the evil doctors and HMOs and pharmaceutical companies. All three groups had a vested interest in keeping patients alive as long as possible. The longer they lived, the more money the “evil” guys made.

The U.S. had been repeatedly castigated for the cost of healthcare and especially pharmaceuticals. Also for over-prescription of the newest and most costly.


In Europe there was no pressure to use pharmaceuticals. With costs capped by the government, there was no incentive for the pharmaceutical companies. Modern pharmaceuticals are enormously expensive to field. The first problem is the cost of development. Many of them are derived from natural substances, but it takes relentless searching to find a new natural substance. Cancer drugs were derived from rare South African pansies, new antibiotics were derived from fungus found on a stone in a Japanese temple. Then they had to be tested to find out if any benefits could be derived.

Here's the numbers:

Animal (screening) in rats—about 1–2 years, cost about $500k/year, in monkeys—about 2–5 years, cost $2 million a year. Phase I in humans is strictly toxicology: 2 years, $10–20 million a year. If it doesn't kill anybody, then move to Phase II testing for effectiveness: up to 10 years, cost $100+ million/year. If statistics suggest a beneficial effect, then on to Phase III to determine effective dosage, side effects, other benefits and “off-label” uses: 5–10 years at another. $100+ million a year. A (large) Pharma company will start with 10,000 compounds in screening, take about 200 into animal testing, then possibly get ten into Phase I to maybe get one into Phase II. In the last 10–20 years, about 95% of Alzheimer's disease drugs that got to Phase II on the basis of rodent testing were sent back because they had no effect in humans—hence the necessity for the added expense of monkey testing . . .

It was a hideously expensive process. Again, Do. The. Math. Easily a billion dollars invested in one drug. The reason that a new pharmaceutical was so expensive was not just the cost of developing that pharmaceutical but the brutal necessity of so many thousands and millions of failures that that one new shining hope bore upon its back. Billions of dollars lost when “miracle” drugs failed at one step or another. And all that money only being recouped by those limited shining hopes that made it through the process.

But the results were worth every penny. New drugs that cut the need for bypasses; one of the most lucrative surgeries of the 1980s had been almost eliminated in the U.S. …. Stroke reducing medicines, anti-cancer medicines, cancer prophylactics and, of course, Viagra, every old man's fantasy made real.

In Europe, in contrast, it was considered cheaper to just operate. Much more unpleasant for the patient but the doctors filled their quotas and the government wasn't forced to pay for the development of pharmaceuticals. Which was why most of the modern wonder drugs were coming out of America or from European businesses that were making most of their nut selling them in America.

Doctors in socialized medicine countries, and their bosses and the heads of departments, had no vested interest in keeping old people or the chronically sick alive. The doctors might have a personal desire to help people, otherwise they wouldn't have become doctors. But they had no actual benefit and if you've ever dealt with a bunch of crotchety old people you can see some of the actual detraction.

For doctors, hospitals and pharmaceutical companies in the U.S., those crotchety old people spelled money, money, money! So they researched and they worked and they studied ways to extend the time they could continue to suck the money out of them.

In the case of governments of socialized medicine countries, the primary users of the services, see: “crotchety old people,” were their worst nightmares. The patients worked their whole lives, contributed to the economies of the countries and now expected to be paid back. Heavily. Socialized medicine wasn't the only benefit they expected. They retired early with pensions that nearly equalled their salaries when working. And they paid little or no taxes. And as any health insurance actuary will tell you, they consumed 90+% of the health budget. Mostly in their last six months of life. And what was the point of that?

It would be unfair to say that the politicians just wanted to see them all go away and that cutting off access to vital health services thus killed two birds with one stone. Save money and quietly kill off the primary users.

Or would it? Health care spending as adjusted for inflation had dropped steadily in socialized medicine countries in Europe even as the need had increased. All access to medicine was rationed. And in the Netherlands people who were “beyond help” were denied access to healthcare on a regular basis and even “medically terminated,” put to death, against the wishes of their care-givers. Not only old people but children with chronic health care problems. “Terminal” cancer? Which sometimes was treatable or even erasable in the U.S.? In the Netherlands, they just turned up the morphine drip until you quietly passed into the Long Dark.

A corollary effect was on the members of the health profession. A doctor in Britain who worked ninety hours a week got paid exactly the same as a doctor who worked forty hours per week. (Often they worked less.) And it was rare that there were any changes for quality. World-renowned surgeons in Germany and France made only a fraction more than less competent doctors.

In the U.S., on the other hand, they could write their ticket.

The brain drain was not severe [in 2004] but it was telling. More and more top-flight doctors had left to find greener pastures. For that matter, doctors in less developed countries had flooded into the U.S., where they might not make a fortune but they got paid in more than chickens and hummus. They filled the corner “Minor Emergency Centers” as well as being the front line general practicioners, a field most American born doctors disdained as the most plebian of medical fields.

This was what the good doctors at the CDC learned when they set out to prove that American healthcare, with its dependence on the free-market, doctor/patient choice, HMOs and pharmaceutical companies was far inferior to the enlightened healthcare of “socialized medicine” countries.

They discovered the irrefutable truth that when you put the same sort of people that run the Post Office in charge of your healthcare you get Postal Workers for health care providers. And more people die in less necessary ways.

(( source:… ))

The attention of batousghost is directed to the robust estimates of costs associated with pharmaceuticals development, and is reminded that supporting information is all to hellangone over the place by way of PubMed (National Library of Medicine).

If he likes, I'll hold his hand through a search and show him how to use this resource, either with a Web browser or a reference manager.


Comment posted August 13, 2009 @ 11:09 am

A good article on the virtues of “read the bill” was published on August 2, 2009. I quote a few paragraphs:

I don't know how long reading a bill today would take. Let's do a little calculation. Assuming charitably that the typeface these things are printed in is about the same size as the average paperback book, and that they're printed only on one side of a page (of course I could easily be wrong about that, too), a 1000-page bill would consist of 500,000 words—over six times the length of the average Star Trek novel. At a professional annnouncer's speed of 100 words a minute (and not the guys who spew the “fine print” at the end of medicine and insurance commercials), it would take 5000 minutes, or 83 hours to read.

Eighty-three hours in which our lives, liberties, and property are safe — at least from whatever hasn't been mentioned in the bill being read. We might sweeten the pot a little by hiring professionals with beautiful voices to do the reading, people like James Earl Jones, Helen Mirren, Anthony Stewart Head, Queen Latifah, Morgan Freeman, Angelina Jolie, Lawrence Fishburn, Amber Benson, Gabriel Byrne, Ellen Degeneres, Will Smith, Judy Densch, Wilford Brimley — well, you get the idea.

One hundred sixty-six hours if we got Antonio Banderas, Jennifer Lopez, Ricky Martin, Salma Hayeck, Enrique Iglesias, Hector Elizando, or the immortal Charo to do the reading, politically correctly en espanol.

Don't forget American Sign Language.

One of the nation's leading douchebags, Congressman John Conyers (C-MI),is whimpering already that it won't do any good for he and his accomplices to read a 1000-page bill if they don't have at least two lawyers to explain what it means to them. Aside from the fact that most of these putrescently festering boils on our collective glutea maximi are lawyers, what in the hated name of Alexander Hamilton are they doing passing laws they need a lawyer to interpret when it is an established principle that ignorance of the law is no excuse for its violation?

– L. Neil Smith, “And Charo, Too”

(( Source:… ))

Comment posted September 5, 2009 @ 6:55 am

I want to read the bill, every word of it. I am a Fairview RN and am part of the solution to the “Health Care Crisis” Listen to me and you may learn something.

Comment posted September 5, 2009 @ 7:14 am

Good for you. This isn't a speed reading test. What is your comprehension of the words you just read? Don't answer, I already know.
Stay home with your kids and teach them how to read the ABC's really fast.
I am an RN who is actually making a difference in how healthcare $ are being spent. Until you can claim the same, please shut up or do something to make a real contribution.
Seeeee Ya…

Comment posted September 5, 2009 @ 4:48 pm

Oooo. Touchy GOPer. You know all about my reading comprehension? How about my big white butt? Tell me about it.

My kids are both grad students – one math, one engineering. Nothing more I can teach them.

You sound like an RN with an attitude. You sign checks? Keep your hands off my catheter.

Maybe Nurse Kratchett? I sincerely hope never to “Seeee Ya”

Comment posted September 9, 2009 @ 6:57 am

I recently came across your blog and have been reading along. I thought I would leave my first comment. I don't know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.


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Pingback posted May 20, 2010 @ 3:06 pm

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Pingback posted May 21, 2010 @ 8:11 am

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Pingback posted May 21, 2010 @ 11:18 pm

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Pingback posted May 23, 2010 @ 4:00 am

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