The Free Market versus Death Panels by Alpheus Madsen

545 thoughts on “The Free Market versus Death Panels by Alpheus Madsen”

1. The people dying from lack of health care in the United States…

   are partly vets who depended on the VA.

   And the people who denied them care still work for the VA.

   This is government run health care… and is somehow not death panels.

   1. OH DEAR! Yes…

      I can just see a campaign: FIX THE VA FIRST- then talk universal health care. 🙂

   2. Sad as the situation is, the VA exists for vets who can’t afford any other form of healthcare. CHAMPUS, TRICARE 9various iterations), US Family Health Plan were and are available to active duty members, retirees, and qualified family members (usually spouses and minor children). Even though my premium under the U.S.Famly Health Plan increased by over 25% (under the Obama Administration, of course), it’s still head and shoulders better care than most VA centers, and more affordable than any other health insurance and care system. All you were required to do was volunteer to get yourself killed supporting our country. Not many SJWs would that that risk even for that return; much less out of a sense of patriotic duty.

      1. I fail to see your point here. The plain fact is, the VA is a government-run healthcare system. It is horrendously broken. Yet the socialists want to make ALL healthcare run by the government.

         1. Like the VA or the Indian Health Service. Both of which should give even the most rabid socialist, single-payer fan pause.

            1. You assume that they can see the cause and effect. They see the effect but attribute it to the wrong cause.

            2. I recommend Sherman Alexies Absolutely True Diary of Full Part Time Federal Dependant Indian .

            3. Before the Affordable Care Act was passed I took part in several heated discussion with a friend. She sing the praises about Canada and Britain. I would tell her the stories of the NHS failures and Canada’s limitations.

               Exasperated she finally told me, “Well, you don’t know it will be like that, maybe we’ll get a system like the one in France.”

               I smiled and replied “The one thing that everyone in England can console themselves with when faced with the NHS — at least it isn’t the French system.”

               1. The sad fact about such government programs as the ACA is that they are like cake made for TV commercials: they look all promisingly moist and yummy but the actuality is a tasteless sponge iced with lard. The cake is a lie.

                  1. (See 3:14)

                     “They promise me Miracles, Magic, and Hope….

                     but somehow it always turns out to be soap.”

                     1. Um, only goes to 3:01. Maybe 2:14?

                        1. Oh I got 3:14 as:

                           ‘I keep buying things that I don’t understand…’

                           and yes, it continues:

                           ‘ ’cause they promise me miracles, magic & hope
                           but somehow it always turns out to be soap.’

                           1. Odd, I look for 3:14 and get “And as Moses lifted up the serpent in the wilderness, even so must the Son of man be lifted up:”

                        2. Given RES’s comment below, are we seeing the same video?

                           The video (at least the one I’m seeing) is Allan Sherman – Chim Chim Cheree. And it’s 3:50 long.

                           1. Never mind about RES’s comment, I just realized he was quoting a Bible Verse based on the time Ox mentioned. (Forehead slap)

                           2. I was tempted to say “pi minutes in” but timekeeping, for times under a day, is sexagesimal rather than decimal and the conversion could cause confusion.

      2. I’m going to keep harping a point, because know-nothings who say government run healthcare is awesome need my spite.

         I was in the Army for one year one month ten days. All that time was spent in training.

         I managed to thoroughly mess up my legs and received a service-connected medical discharge, rated at 10%

         My legs kept bothering me, but the VA said my leg damage rates 0%.

         The VA prescribed me to walk with a cane ‘as neccessary’, ten days before i turned 21. (24 years ago btw)

         But my legs aren’t disabling, even tho they have clearly gotten worse.

         To make things even more fun, other health care providers have spent two decades insisting that the VA is supposed to cover my legs.

         And yes, i have another not-me example (my dad) of wonderful VA health care that i can cite as well.

         1. I have seen what the VA did for/to my father-in-law, and I couldn’t help but wonder “What horrible things did our veterans do to deserve such ‘care’?”

            My first encounter with VA where I was more aware of such things (my grandpa died of pancreatic cancer in a VA hospital*, but I wasn’t aware enough of either politics or health care ate the time to make any sorts of judgements), I remember what my father-in-law had to do to get the drugs he needed for type-II diabetes and other things, just to get what he needed while visiting us in Albany, NY, because he accidentally left them at home. I also remember that the hospital itself was *very* reminiscent of hospitals in Great Britain.

            *I have since learned, years later, about a VA policy encouraged by the Clinton Administration where the VA would discourage vets from fighting “hopeless” prognoses, and I have wondered whether my grandpa could have lived for a few years longer had he fought the cancer….

            Would a few years of a living grandpa have helped my cousins stay on the straight-and-narrow? Or would he have merely been saddened by how his grandchildren have strayed? (And by “strayed”, I mean “eventually served time in prison” — although there’s a certain amount of religious straying involved as well…) I don’t know. For that matter, I don’t know whether my grandpa’s pancreatic cancer was truly a hopeless case or not — or if my grandpa would have chosen not to treat it, even if the VA was all-out to do so…

            But in any case, the VA had that nasty program, and now I live with the question of whether or not the VA had a role in hastening my grandpa’s death…

            1. Pancreatic cancer is pretty much a death sentence, I’m afraid. Even the type Steve Jobs had, in the single-digit survival version instead of the “put your affairs in order” style, killed him within a few years.

               1. That is my understanding, particularly in 1995, but learning about the Clinton policy can’t help but plant doubts in my mind.

      3. I know a fellow who could afford a knee replacement but let the VA do it. It’s not just for indigent vets.
         He’s a liberal and doesn’t believe there are any problems. He’s lucky that the VA hospitals around here aren’t among the hellholes.

         1. Meanwhile, they say doing mine is ‘not cost effective’. That would be the fate of everyone’s health care.

         2. I’m sure the VA is great for whom it helps, but the fact that there are a *lot* of people who could use VA benefits, but avoid it at all costs, and only resort to it because they are indigent, says something about VA care, and it’s not good.

            OTOH, my father-in-law was the type who accepted the government benefits because he “earned” it (I don’t mean to disparage his service by putting “earned” in quotations; I put “earned” in questions because I think he deserved better care) and I have often wondered if he could have done better — indeed, if the cancer that ultimately killed him could have been caught earlier — had he used private insurance (or heck, even just MediCare) instead…

   3. You should be aware that there is a strong uptick in VA firings for cause during this administration. Strangely there doesn’t seem to be much push behind press coverage of this fact so it’s not widely known.

      1. i am peripherally aware of that, but it won’t magically fix their entire ‘not cost effective’ scam. MY current (non-VA) doc is very concerned about the fact that my ‘average’ day has me in at least a 5 without pain meds, whereas the VA doesn’t want to lift a finger to find and treat the cause.

2. Food is my favorite example of the weaknesses of rationing by central economic control.

   We know the size of the population, so we can multiply that by daily calorie recommendation by days in a year to get the yearly calorie production quota, and everything will be fine?

   No.

   First, we don’t really know the population. I do not merely speak of measurement error in census, apparently forecasting population is extremely uncertain and prone to error. The speed at which a centralized bureaucracy can manage production demands forecasts far enough in advance that one can expect wrong forecasts. Underestimation would cause starvation, and overestimation would increase the rate of theft and adjusting production below what the forecasts call for. Assuming production targets were met.

   Our food supply depends on agriculture, and agriculture is itself a very uncertain process. Each crop has hundreds of decisions any one of which being majorly wrong can ruin the whole thing. The traditional strategy is farmers who are often effectively apprenticed for years, thereby loading the brain with records of past decisions. These vary crop to crop, and area to area, centralized decision making may be a guarantee of getting them wrong fairly often. (This may be a reason making it impossible to just have robots come out of the factory and start farming.)

   The combination of the two sets of challenges may mean that government management of the food supply will always cause starvation in the long run. Also, food justice and land reform are often just a horrible mistake.

   1. It seems to me that most modern land reform schemes have been implemented after land started to cease to be the primary determinant of wealth. The land reform movements of the 20th and late 19th centuries, be they government policy or merely the demands of an angry rural populace, came after the industrial revolution was in full swing. When the push is coming from the rural poor, has it really been a viable goal, or merely a group of people unwilling to face the economic reality that small scale farming, freeholding or tenant, had ceased to be viable? Especially given globalization and low levels of capitalization?

      1. The latter…but it goes beyond that. A lot of national leaders in the 20th Century thought that land conquests equaled national power. Which might have been true in the agrarian past, but was decidedly NOT true in the industrial present. Better to develop your own country than to try conquering someone else’s.

      2. While small scale farming may not be viable, medium scale is. However with inheritance laws the way they are, this is only true for a generation or so nowadays. Because when there is a 50% of value tax on land inherited, it is very difficult to keep a medium scale farm that is capable of making ends meet intact from one generation to the next. And splitting of chunks to sell in order to pay the taxes soon causes one to be reduced to too small a scale farming to be viable.

         1. Anyone with any serious land-holdings these days is incorporated.

   2. I saw this in a column t’other day and am sure the coders here will appreciate the sentiment and all will perceive the relevance:

      Can we trust the Census Bureau’s software?
      By John Crudele
      Dear John: In 2010, lacking work as a senior software engineer, I worked as a quality clerk for the Census Bureau.

      The main software package for running the census that year, called “PBOCS” internally, was so buggy that in the Denver office we were only allowed to run five PBOCS stations at one time.

      The software had so many problems that Census came up with workarounds in which we used bar-code scanners to get questionnaires into Excel spreadsheets.

      The system was not competently written or engineered for performance.

      I mention all this because you are covering the work on the 2020 Census. So I suggest you keep an eye on whether the 2020 software is built by the same group of clowns that built the software for the last census.
      M.B.

      Dear M.B.: The decennial census is crucial to the country. It determines the number of House members for each state. Also, the amount of money each state gets from the feds.

      And, since you’ve been reading my column from your home in Utah, you know that I have been on the case for years.

      Congress is now extremely worried that the census will not only be over budget, but also inaccurate. So it is devising shortcuts using modern technology that the Census Bureau hopes will solve some of the problems.

      But, as most people know, things seldom work properly when they are used for the first time. Remember the old warning: Never buy a car in its first model year.

      Thanks for the information. It’s people like you who are making the bureaucrats at Census a little more honest and responsible.

      1. The question is, of course, “Why?”
         And we should know the answer by now. A single-player system means lack of natural incentives for decision-makers. Which leads to sleepy going through motions to pretend something is sort of done, or some form of theft. Usually both.

   3. Latest example of this is Venezuela. Chaves nationalized the entire food supply chain and now folks are starving now that they cannot pay for importing the food every one needs.

      1. Mange-t-ils brioche…

   4. When it comes to food, if you don’t have a surplus, then you don’t have enough.

      1. Yes. I’d go further than that, and say that surpluses and cheaper supplies are probably better for most everything.

         1. There’s a local farm that has surpluses by design (they sell commercial-grade stuff and need overage to make sure that the stuff they sell meets standards.) What do they do with the extra? They have U-Pick days (at 30¢ a pound! 100 pound minimum) and have a charity that sends food to local food banks. So the surplus goes where it should—without intervention. The stuff that rots in the fields is the stuff that has problems from the start—volunteers pick everything that’s edible.

   5. And then there’s…WEATHER. The climate people say we’re all gonna DIEEEEEEEEE if we don’t do something/anything/what-they-want. Weather does affect the crop yields.

      1. I forgot to mention the Communist 5-Year Plans…all of which failed.

         1. Well you can’t blame them for all the bad weather they had.

      2. Yeah, when it gets warmer, crop yields usually go up, though you MAY need to change what you’re growing, depending on where you are in the growing zones.

      3. The “funny” thing is that the ones howling about the latter don’t want to “do something” in the line of flood control, water storage, etc– they’ll sometimes be OK with “erosion control,” but only when it does what they want to do anyways.

         1. The universal panacea is always complete governmental control of the economy. Maybe not always total control (so they say). It turns out that they want to be the ones in control. Maybe not themselves as the chief but one of the courtiers or nobility. Others say this because they have been thoroughly brainwashed into thinking that these are the best ways to do something.

            1. Belief in the effectiveness of people with advanced degrees making important decisions seems mostly to be held by people with advanced degrees.

               Only the highly educated can believe anything so foolish, as Orwell noted.

               1. And some number of those who can’t/won’t think for themselves, and so must trust the ones with advanced degrees.

                  One of the big things related to homeschooling (since our host wrote about it on PJMedia recently, and it connects) is getting parents to understand that you don’t need to have advanced degrees or lots of specialized knowledge to teach your kids.
                  It’s not just that there’s curricula out there to help. It’s that – generally speaking – it really isn’t rocket surgery. As a matter of fact, you’re probably better educated on any one topic than most teachers out there, since an education degree (again, generally) is almost entirely about how to deal with kids. You already are doing that, as a parent. And probably better than those folks who don’t live with your kid.
                  An awful lot of teachers never receive specific higher education on their subject matter. And up through high school level a parent can learn the subject matter in a just-in-time fashion, ahead of the student (with a good curriculum, they can learn with their student!).
                  The biggest keys to success as a homeschooler are whether you want to put in the work and whether you can teach them critical thinking. An advanced degree might actually be a hindrance to the latter.

                  1. If the schools were to require that the teachers understand the material they teach (which, arguably, is especially important in mathematics), then they *might* have a point that the teachers would be better off teaching the material than the parents.

                     That many people — both in and outside education — insist that we don’t need to know the material well in order to teach it, though, implies that parents are just as qualified to teach their children these things, because chances are, the parents know the material just as well (or perhaps even better!) than the teachers!

                     1. It is often less a matter of knowing the material than of knowing the student. A certifiable teacher might know the material better than I, might know “the art of imparting information” better than I, but assuredly does not know the Daughtorial Unit better than I.

                        1. This is very true. I would go so far as to add that if you’re going to teach a bunch of kids you don’t know, year after year, you had *better* understand the subject inside and out, so that you can find the right thing to teach at the right moment on your feet, or try multiple approaches, when a particular student is stuck on something.

                           It boggles my mind that a large number of educators will insist that the teachers don’t need to know the subjects they are teaching, yet will insist that parents can’t teach because they don’t have the proper certifications (which, among other things, ought to be a certification that you know the material you are trying to teach…)

                           1. I did a (very little) bit of tutoring. I learned an awful lot by having to explain things in different ways.

                              That showed itself a bit later when I ran into some bug and called on a coworker to assist. Said coworker also programmed, but not in the language I was using (Forth – so not a trivial transition or translation). More than once I used the line, “Let me explain this to you until I understand it.” There is a disturbing amount of truth in that line, as most often the problem would be found and sound of its discover was not “Eureka!” but “D’oh!” or “Duh!”

                           2. Thus is the basis of “Rubber Duck” or “Teddy Bear” code analysis. You explain what you are doing to the duck, or bear, or whatever, until you see where the problem lies.

                           3. AMEN! Ahem. Sorry. Didn’t mean to shout. The look on people’s faces when I explain that I can’t teach in a public school because I only have a graduate degree in a field and not a BA in Education…

                           4. My obsession with trying to figure out what each person means by the words they’re using when there’s an issue is probably a variation on the “find a different way to explain it.”

                              You’ve got to really think about it.

                           5. The “find a different way to explain it” method will unfortunately probably always be linked in my mind with Obama’s, “we just aren’t explaining the ACA right, that is why people still aren’t in favor of it.”

                  2. At the time our family engaged in homeschooling, a couple decades ago, the concept seemed to be that the goal was creation of autodidactic individuals: teaching the child (as was our practice with Daughtorial Unit) to teach herself. Thus it was less a matter of “imparting knowledge” and more one of directing efforts.

                     Instead of stifling a child’s natural curiosity, it is directed and focused. Given that the public schools are less interested in developing students’ minds than in conditioning conformity, homeschooling has several distinct advantages that make it much easier for the involved parent.

   6. Random thought: deodorant is also an interesting case study.

      Bernie Sanders is famous for wanting to have only one deodorant, voted on by the public, because having 22 different varieties is a waste.

      There are multiple problems with this, among them is this: I happen to use a cheap scent-free deodorant, because I’m afraid I may be allergic to scents — and my wife is *certainly* allergic to scents. What are the chances that my cheap scent-free deodorant is going to lose to the super-popular Good Ole’ “Migraine Aura Voice Killer Scent”? Very high.

      But it’s not just that: if the store I get my deodorant from is out of my favorite deodorant, I can decided to try out a different one in a pinch, or try going to a different store, or even ask the manager when they’re getting some more, and exercise some patience. If there’s only one deodorant, I don’t necessarily have these options.

      And the redundancy isn’t a bad thing, either: if a bomb is dropped on the factory that makes my favorite deodorant, or an earthquake and flood take out the warehouse, other deodorants can pick up the slack until everything is put back in order.

      When the likes of Bernie sees all these deodorants, they automatically think “waste”, when (1) hundreds of different tastes in deodorant are being satisfied by these 22 different types, (2) they ignore that redundancy helps make a system resilient in the face of disaster — and because we can’t completely eliminate chaos, we need resiliency, and (3) (I almost forgot this) having 22 varieties of deodorant is a side effect of someone every so often deciding “the current varieties don’t satisfy everyone, so why don’t I create a new one or two that someone, somewhere will like?” and push the varieties up, sometimes temporarily (because the new variety either dies out, or kills off another variety), sometimes permanently (because it meets a need that wasn’t addressed before, without affecting the others already in existence) — and this is how technology progresses!

      It’s yet another example of trying to sound compassionate and logical, when in reality they are the cruel ones. Heck, this is a demonstration of how so-called progressives are out-and-out against progress! (Excepting, of course, whatever progress gives them more power….)

      1. Twenty two varieties of deodorant are wasteful. Twenty variations on gender and sexuality are just letting people express themselves.

         1. Exactly. *eyeroll*

      2. What bugs me is that the “21 deodorants is wasteful” thing assumes the conclusion, and ignores all other information.

         For it to be wasteful, you would have to actually have them going to waste.

         Are we throwing away tons of deodorant?

         No?

         Then it’s not wasteful.

         1. It makes perfect sense if you remember that Bernie is a communist. In communist countries, you get at most one choice for stuff. (Often zero choices, actually.)

            1. A lot of things make sense if you accept nonsense as a starting point.

            2. One choice, and it is back-ordered.

               1. Because Bernie the highly educated doesn’t know that people like different scents and have different bio-chemistries. I use unscented Mitchum because of habit (when i was younger it was all that worked) and some people have immediate reactions to that. The cheapie stuff doesn’t work for me. Men don’t want womens scents and vice versa. Bernie is an idiot, in short.

         2. It’s wasteful because it would save time, work, and resources (chemicals used in producing multiple print plates for different labels, different shape containers require more machines to make them, etc).

            Who cares if having multiple choices leads to a higher quality of life? You’ve WASTED nearly a penny per container!

            Now to unknot my fingers, which were trying to rebel at typing that.

            1. But even that assumes that they actually WORK for everyone.

               If you cannot, reasonably, use it? It doesn’t work.

               1. Using deodorant at all is wasteful. Go au naturale to save Mother Earth!

                  Oh and only bathe bimonthly to help preserve our dwindling* water supplies.

                  *Somehow the people who believe in dwindling water supplies (apparently the water cycle is no longer taught in grade school?) also tend to be the same people who lament global warming and the melting of the polar ice caps. Somehow never coming to the logical conclusion that one problem solves the other.

                  1. What freaks me out is that they are also the people who think a gallon in January is the same as a gallon in July.

                  2. Ah, someone else read the description of the Saint ship from March Upcountry.

            2. Reminds me of the Foxtrot comic where Roger is dealing with an efficiency expert at work.

               EE: “This is a Number 2.5 pencil.”

               Roger: “I like Number 2.5 pencils.”

               EE: “You’re the only person in the office who uses Number 2.5 pencils. Efficiency dictates that all supplies should be bought in bulk. Your little pencil habit is costing the company pennies per year! …. Let’s pick this up later. Your boss is treating me to lunch at the Ritz in fifteen minutes.”

               1. wouldnt that be a 2B?

                  1. …or not 2B?

                     1. That is the question.

      3. Not to mention that different scents, if you use them, can smell bad or good depending on the individual’s chemical makeup. For example, I tried a citrus-scented deodorant once. Never again. It smelled rancid. I’m sure it would smell perfectly lovely on someone else, or they would never have put it into mass production.

      4. I seriously suspect that in the great Deodorant elimination the powers that be would cull scented products from the list of possibilities because there are so many people with allergies.

         In fact they would probably not even consult the general public in the matter of selection, but make one based on some matrix of their own devising. This would include the companies work practice ratings, including fair pay, and such very important items as the necessary diversity of employees in the work and supervisory force. There would also be the issue of greenness of the entire process, from the plant, to sourcing ingredients, to work practices, and so much more.

         Would it include the ease of use or efficacy of the product? Possibly. I can’t guarantee it would rank high on priorities.

         1. The government would establish a research team to analyse which of the various deodorants sufficed for the broadest array of human body chemistry, subject the finishers to careful and thorough evaluation of “correct” practices and then award the contract to the company paying the greatest kickback, whther directly or in the form of donations to favoured “charities” and be demonstrated willingness to fill their Directors’ Board with the “right” sort of people … primarily retired civil servants people who had previously demonstrated a commitment to give selflessly of their time and energy to advance the greater public good.

3. Free market, versus social allotment. Just check how many MRI devices are in the United States against Canada with “Healthcare”. As well, check out waiting lists for the same. That’s the best comparison I can think of currently and it goes to say a lot about which system is better.

   1. As a point on this… I live in a large rural county. And not only do we have two ERs in the county. Both have MRI devices. Enough that when I had pneumonia (and they weren’t sure if it was that, gall blader, or kidney stones or something else. They just wheeled me down there. We didn’t have to go to one of the two major cities in the state. There was no waiting (though admitedly this was around midnight, not a high demand hour.)

      1. Even if it had been a high demand time, say 1pm, there is a difference between waiting for the patient who came it at noon and the guy who made a 1pm appointment last week for a chronic shoulder issue and then getting to go (with the possibility that emergency need might reverse you and the shoulder guy) and waiting to make an appointment next week while chronic shoulder guy made his four months ago and thus much less ameniable to giving up his appointment today at 1pm (because you can’t reverse as 1:30, 2, 2:30, etc are all booked) so a critical patient can get in If he was asked to bump four months ago for a critical patient he is even less likely to do it again.

      2. My mother-in-law recently had a stroke. This put a lot of things in sharp contrast:

         First, one reason why the US has higher mortality than other industrial nations is that we have wide areas of travel, and thus high car accident rates (and air accident rates in Alaska). (Another is murder, but that’s a different issue…) Since my mother-in-law had to travel about half an hour or so just to get to a tiny town (Kanab, Utah) to get to the nearest hospital of some sort — and then travel one and a half hours to get to the nearest major hospital (in St. George, Utah) because it became clear that the doctor in Kanab wasn’t doing a good job of diagnosis — it occurred to me that traveling far distances for medical care, particularly emergency care, is going to take a toll on mortality rates too.

         Second, one of the complaints my brother-in-law had (and later, me, too, when I understood the situation better) was that the doctor in Kanab realized my mother-in-law was having a stroke, but didn’t order an MRI (which, when she got one in St. George, proved that she needed the exact opposite care of what was given to her in Kanab). My reaction was, “wait — does Kanab even have an MRI?” I looked it up, and sure enough, they have a mobile MRI. It’s not at all clear why the doctor didn’t order one, but it’s *very* clear he should have.

         In any case, in a “little” State that’s four times the size of Great Britain, yet has easily 1/50th the population (3m vs 68m)…and *little towns have MRIs*? That’s pretty amazing!

         1. Northern BC has one of the best rates for survival after being admitted for a heart attack.

            After all, when the hospital is 3 hours away, anyone going to die has already done so…

            1. Always, always, ALWAYS look at how the statistics are measured. The U.S. has a higher level of infant mortality than it should. This is often used against it in healthcare discussions. But when the individual parts are broken out, it turns out that the premature death rate is the part bringing the average down… and broken down even further, it comes down to two things: that we have an anomalously high rate of premature birth in certain subsections of the population (poverty + certain racial groups), and that we try to save babies younger than most other countries have the temerity to try. (A relative of my husband’s has twin daughters who were born shy of 22 weeks. Prior to those two, there *were* no survival statistics for twins born that early in her state.)

         2. I was recently in a discussion on this subject and offhandedly remarked as to how I’d heard that there were something like 100,000 deaths a year due to medical errors. My number was challenged so I did a bit of research and had to admit I was in error. My number was from a study done in 1999. A study by Johns Hopkins Medical Center done in 2016 now places the number at 251,000 making deaths by medical error the third leading cause of death in the United States.

            1. /em puts on his medical analyst hat. (I wear at least 3 different hats at the hospital I work in.)
               You are quite right. We have roughly between 100K and 250K deaths in healthcare each year due to mistakes made in care and treatment. The Centers for Medicare and Medicaid Services (CMS) currently has an emphasis on us looking at reducing 30 day mortality rates for Acute Myocardial Infarction, Heart Failure, COPD, Pneumonia. stroke, and CABG, as well as reducing the number of infections contracted while in a healthcare facility. Several health insurance companies also have programs designed to provide monetary incentives to our reducing readmissions, injuries, and deaths.

               Both CMS and the insurance companies motivations are financial; to reduce the amount of payments they have to make. At least this way they’re encouraging improvements in care and treatment, rather than exclusively reducing them by saying, “That’s it, we’re not paying any more for that.”

               1. Is this over and above the expected death rate of quite ill people?

                  1. We know what the expected death rate is for quite ill people (unflateringly referred to as “trainwrecks”); it’s not the same thing as a medical mistake.

                     We’re talking about when a woman comes into the Emergency Room, with clear symptoms of septicemia (blood infection), and gets sent back home for a “cold”; then is readmitted 2 days later with a horrible case of sepsis and dies the next day.

                     Or if you’re in to remove a cancerous kidney, and they remove the good one instead.

                     Or the anesthesiologist screws up, puts you under, and basically kills your brain.

                     That doesn’t include the myriad errors that don’t kill you, but may be anything from a temporary inconvenience to a permanent crippling injury.

                     1. > Or if you’re in to remove a cancerous kidney,
                        > and they remove the good one instead.

                        I got wheeled into an operating room and ordered to turn over on my stomach before they knocked me out. When I questioned this, much to their annoyance, they told me there was no way they could fix my hemorrhoids otherwise.

                        I sat up and pointed at my left leg, which was still laying in the bottom half of the cast they’d just sawed off in the hallway, bleeding from where they’d sawed into flesh, and also stinking pretty bad from blood and pus that had been there a couple of weeks already. It was evidently my fault for being in the wrong operating room. I got to wait out in the hall another hour or so before they wheeled me into another room, where the crew seemed to understand they were they for orthopedia surgery.

                        The anesthetist started playing with his bottles and I asked him what he was planning to use. Demerol. I sat up again, a bit shouty this time, since “NO DEMEROL” was written in three inch high letters on the chart cover. No, he hadn’t bothered to check for drug allergies before preparing to shoot my veins with poison.

                        Then, to cap it off, he asked “Well, what am I supposed to do then?”

                        The mind, she boggle…

                        The people who write their name and procedure on their chest with shoe polish? They’re not in the LEAST paranoid.

                        Then there was the bozo who cut on my wife. Yes, I understand she’s got so many scars it looks like I built her from a kit. That’s no excuse for a fourteen inch curved slash to get the the gall bladder they’d just precisely located on the MRI three hours before. It looked like she’d just encountered Jack the Ripper. I didn’t find his “I was in a hurry” excuse convincing. And then he did such a poor job of stiching her back together she had to go back under the knife to get the damage to her abdominal wall repaired after his incompetent stitching popped apart.

                        1. “Well, what am I supposed to do then?”

                           Wow — that’s right near the top of the list of questions best not asked.

                           1. Go to the unemployment office. YOU’RE FIRED!

                           2. I do believe the answer to that one is “Get me an anesthesiologist who knows what’s she’s doing.”

                              Also “anesthesiologist” is surprisingly hard to spell. *tilts head*

                           3. The British spelling saves typing…

                        2. I was in a hurry is a perfectly acceptable excuse for something like the impressive scar my dad has from having his spleen removed. It was already burst and he had passed out from blood loss. He had seven pints of blood in his abdomen when they cut him open, they didn’t have TIME for such niceties as MRIs and neat precise incisions. Blood was literally leaking out of him faster than they could pump it in.
                           A standard, planned and scheduled surgery is a far different circumstance, and the doctors time should be planned and scheduled so he doesn’t HAVE to hurry.

                           1. It varies greatly from doctor to doctor. There was one doctor we knew who stitched so neatly that the scar was seldom noticeable. Another, at the same medical center, left a lot to be desired. The scar from where he stitched up my father’s hand would make you wince. That was the same hand he peeled the skin off years later. The first doctor stitched up his hand from that one, and that corrected the horrible scar.

                           2. My wife’s first plastic surgeon was AMAZING. Barely noticeable scars from a major reconstruction surgery (in hindsight, we chose the wrong one to have done, but the execution of the reconstruction was masterful). Poor dear had to retire from surgery a couple of years later due to deteriorating eyesight.

                           3. Aye.. but yeah if it’s “cut or cadaver” then cut and don’t worry about the fiddly details. Scheduled? Schedule the fiddly in.

                              “You look terrible!” “Beats looking dead.”

                        3. There really should be a lot less tolerance for medical mistakes than there currently are. I believe it was Bill Whittle who pointed out that the medical profession can learn a lot from looking at FAA procedures — and he has pointed out more than once that FAA regulations are written in the blood of those who have gone and died before.

                           Indeed, I can’t help but think that death from an incorrect surgery or from the use of a medicine that is clearly marked as dangerous to the patient ought to result in manslaughter charges, perhaps in addition to wrongful death lawsuits.

                           What really galls me is knowing that the AMA is anti-gun, and tries to enlist and even draft doctors to participate in their anti-gun efforts, when they can save just as many lives by cutting back on medical errors by a third (back when it was 100,000/year) or somewhat more than a tenth (since it has apparently risen to 250,000/year).

                           1. Heh. I should have ended that comment with a notice to AMA: “Physician, heal thyself!”

                           2. It is entirely possible that the AMA is anti-gun under the impression that it is better to be inside the tent pissing out, that they are secure against intrusion into their affairs so long as they are seen to be standing shoulder to shoulder with their fellow travelers.

                           3. A relative was murdered by medical malpractice– an expensive drug, which MUST be used in 8 hours of being opened, and MUST be refrigerated, was used in 3 different surgeries.

                              Wed, Fri, and Mon.

                              He was Monday.

                              The doctor who did it had done it before– just the last 8 hadn’t actually died. They all became disabled, but they survived.

                              His defense? That the guy was “old” and “in bad shape.”

                              He was getting a knee replaced so he could hunt better.

                        4. When I was attending the Naval Academy, there was a case where a midshipman with a knee injury had the wrong knee operated on when he was in the USNA hospital for treatment. When he went in the second time for the operation, he had written, “Other knee, Doc” on the knee that did not need (and had already had, erroneously) the operation.

                           He was placed on report for disrespect to a senior officer.

                           You had to learn how to understand the Weapons division officer on my sub, because a Navy doctor had damaged his vocal cords during an operation on his throat.

                           I had a Navy dentist dig down to my jawbone looking for a tooth to extract, because he was using year-and-a-half-old X-rays that he’d swapped right-for-left.

               2. CABG! I recently had a CABG4 (Coronary Artery Bypass Graft–four of them), and am recovering well. So far, so good!

                  1. I had to force myself not to reply to the previous comment with, “Why are we treating cabbages?”

                     1. Because he was a grumpy German?

                     2. I believe it is because the cabbages are the ones writing the bureaucratic regulationa.

                        1. That sounds about right.

                        2. Oh no, vegetables are far more intelligent than bureaucrats or bureaucratic interns.

                           1. They do, however, have less will to power and less ambition.

                           2. Well, some vegetables maybe, but cabbages are pretty dense.

                           3. Are we talking green cabbages here, or are we also considering red cabbages, Savoy and Napa cabbages? Because I’ve always found red cabbages pretty congenial while Savoy and Napa tend to be relatively open.

                           4. Ah. I seldom consider any but green cabbages, as I have few recipes that call for the others.

                        3. Cole’s Law?

         3. Travel is definitely a component. When you see all the studies proclaiming that red or gun owning States are suicide havens and more successful, these are also the states where we have to get a bird to get you to a level 2 hospital, nevermind level 1 in under an hour. In addition, high risk behavior is more prevalent resulting in higher death while young. In addition you have measuring methodology differences that skew. The us pretty much maximizes it’s deaths in counting. Same with crime.

            I will admit I’m surprised at the MRI. Code stroke has always been CT including at level 1 trauma or stroke centers at least in my experience. Although apparently NIH recommends MRI now.

         4. Another reason for the numbers is that we count ALL deaths. Many collectivized medical systems don’t count the deaths of preemies (and don’t work that hard to save them). A death at .045 years pull the average down a lot more than a death at 68 years.

            1. Many collectivized medical systems don’t count the deaths of preemies…

               This is also why our infant mortality rate is higher than those socialized systems.

            2. In some places “preemie” can include forty weeks, plus one to four after leaving the womb.

      3. Midnight on Friday or Saturday can be a high demand hour, especially in the cities. Weekend overnights are the terror of Emergency Departments.

         1. I think it was a tuesday. To the best of my knowledge. Tuesday night is the most boring night on the planet. (Observation, not complaint.)

            1. “Dawn’s in trouble. Must be Tuesday.” — Buffy Summers, Once More With Feeling.

            2. When I worked there, Domino’s Pizza ran a special on Tuesday, two pizzas for $6.99 each (take out only, as I recall), because it was a slow day.

               9/11 was on a Tuesday because it’s a slow travel day, less people to corral (but enough people for the passengers on Flight 93 to force the plane off course).

         2. Bring in yer drunks if you’re in a safeish area

            If you’re in Chiraq you may be mopping a lot of blood.

            And for both you get your standard mix of 1s (critical), 2s (major) and 3s (minor) as well as the annoying 4+ (try a taxi next time).

      4. Referencing the number of hospitals: A few years ago, when my son was a passenger in a fairly serious accident, the fact that the ambulance that picked him up was on the opposite side of the accident from his friends (and couldn’t get around, the road being blocked by the semi that hit them), caused him to be taken to a different hospital than his friends. Even though they were in a highly rural area, there were two hospitals within 30 miles,of the accident, even though the one he was taken to was across the river in the next state.

         1. A few years ago, my girlfriend was in an accident on I-80 in Wyoming – someone in front of her had done a U-turn because they missed their exit, and she found that out when she changed lanes to pass a semi. She came out of it with a totaled rental car and a broken foot. Although the accident was closer to Cheyenne, and that’s the direction she was heading, she was taken to the hospital in Rawlins. Something to do with which county the accident occurred in, IIRC.

   2. Aw geeze, Pal, you left out the best part of that story: because operating costs limited use of those machines to twelve hours a day they were using the “downtime” to do scans on people’s pets for eight hours, with the earnings going to underwrite and additional four hours of human scans.

      Of course, the bureaucrats soon put a stop to that nonsense.

      1. The fun apocryphal stories of needing an MRI and going to vet cuz faster.

         1. Of course any story of such a silly thing as going to a vet for medical treatment is apocryphal!

            Should anything so crazy actually happen, they’d come down on the vet’s head like a ton of bricks– so of course any treatments are of animals only.

            Insert “bitch” joke here.

            1. You used to be able to buy penicillin and terramycin out of the refrigerator at the farm supply store.

               1. Still can here, and now of course you can order “fish antibiotics” without a prescription. You know common antibiotics like amoxicillin, cephalexin, metronizole, etc. They come in the common sizes (usually 250 or 500mg) capsules labeled for use in fish, since unlike dogs, cats, humans, or horses prescriptions aren’t required for such antibiotics for fish. I’m still trying to figure out how to shove a 500mg amoxicillin down my goldfish and get him to swallow.

                  Make ridiculous rules and people WILL find a way around them, it is just inconvenient and usually expensive. (said antibiotics are usually about half the price with a prescription, at least a veterinary one)

                  1. That’s good to know. I need to get some for my disaster kit. Ahem, for my fish. The fish are very ill. Might have something to do with being breaded and frozen, but they didn’t start calling them “wonder drugs” for nothing…

                     1. Some pet stores carry them, not sure about feed stores, but it is likely. But you can order them from practically any vet supply place like KV.

                        A shot of penicillin can be handy because it works fast and lasts a while, but needing to keep it refrigerated is rather unhandy in a disaster.

      2. I’ve heard it going the reverse in Canada: because it’s so difficult to get an MRI in Canada, people have resorted to going to the vet to get MRIs. Of course, bureaucrats put a stop to that, too.

         1. Isn’t it wonderful! We have a legal service, a willing seller, a willing buyer, and an agreed upon price — but it is deemed harmful to the public weal for the transaction to take place.

            We mustn’t risk diminishing public confidence in government competence by permitting exposure of government incompetence.

            1. The concept of “Two Tier” healthcare is treated with shear hatred by lovers of Canadian Healthcare. The whole thought of someone paying for better service then them is considered sacrilege, and any attempt at it should punish the ones attempting to do so. God forbid that someone that can afford better and timelier care decide to spend their own money for better health….

               1. the fun bit of course is that we have it, but celebrity and political connections are the key, not cash.

                  1. I read decades ago of an MP who couldn’t get better treatment for his mother in an NHS facility.

   3. I posted this on another blog discussion much earlier ant fits here.

      The cost of an MRI would go way down if we could just walk in and say- “Hey, my knees hurt. Take a picture, will you?” and then send the picture off to “Orthopedic Evaluations Are Us” for an initial consult and recommendation.

      1. I used to get an MRI or an X-ray at the hospital and take it to my doctor, who would stick the film up on the hanger or stick the disc into his computer and point stuff out to me.

         Now the picture has to go to a radiology specialist, who will “interpret” the images for only a few hundred dollars, and it only takes them a week to get around to it.

         Somehow the three pages of medical doubletalk always seem to resolve to “yep, it’s broken” or “damned if I can see anything here,” same as the doc used to tell me to my face…

4. Socailized medicine is awful, we have it up here in Canada as well. I have read that Canada has 35 million people and over five million of them don’t have a doctor or live near hospital even tho in theory we are all insured.

   Government purposely does not train enough doctors or nurses because it would be too expensive to pay them and treat people. Long waiting lists for simple procedures are common, getting your operation time bumped to new time because doctors decided someone else more important is also common.

   I know one old fella who has epilepsy and local hospital was doing tests on epileptic, so he went in to help researchers. Medical people induced seizure, turned away from my acquaintance for a moment and that’s when he flopped off his bed and broke his back in multiple spots. Hospital says it can’t fix his back so they offered him six, 30-minute physical therapy sessions and he had to pay himself if he wanted more because therapy is not part of socialized health care.

   Americans like suing people when they are incompetent but you can’t do that with government run health care because The State protects itself.

   1. Just about everyone in Canada seems to have at least one horror story about our healthcare system and still we defend it as one of things that makes us superior to the Americans.

      Sigh.

      1. And self righteously so, in fact, sometimes with near panic at the thought of any alternative.

         1. What seems to send a good many Canadians into a panic is the thought that if the US changes to their style of health care they will loose the ability to border jump. What seems to be the practice today is to take full advantage of Canadian socialized health care when it’s convenient, and when they encounter one of the infamous delays or inabilities to provide certain treatments they simply take a small vacation to the States and get care on demand.

            1. Look at the license plates of any medical clinic/hospital on the border. A LOT, if not a majority, of them are Canadian.

            2. Not to mention we’re all paying for their discounted meds (as well as for those of our hometown layabouts pace the Angry Pharmacist) If we go socialist, Canadians are screwed.

      2. Edmund Maximus was well remembered when he stood at the podium addressing Parliament and proclaimed, “I say to you all, I shall defend to the death my right to have my country hang me for no good reason!”

         Interestingly enough, he was shortly taken out and shot, rather than hanged, for having used $5 more than his allotted lifetime government healthcare fund.

      3. I’ve noticed a pattern. Something bad that happens in socialized medicine happens because humans aren’t perfect, diseases can’t always be cured, etc. When the same bad thing happens in America, however, it’s because we don’t have socialized medicine. It goes further: socialized medicine often has severe systemic problems that are often ignored, while American medicine (I *wish* I could call it free market medicine, but it’s not nearly as free market as people make it out to be) has systemic problems that are imagined — they only exist in the fevered minds of people imagining what happens because our system isn’t centrally controlled.

         1. Oh it has systemic problems. Every large system does. For instance reimbursement rates have driven MD into specialties vs generalization so your pcp may be a nurse practitioner because docs only for certain subgroups that need more expansive care. In addition they still spend more time on paperwork than on treatment. Plus they have to subsidize the govt care payers and the indigent. And one of the growing diseases is t2 diabetes. Expensive, easy to screw up, and significantly dietary. But you still gotta go to Ms Mabel who bottomed her sugar out again because she refused to eat.

         2. Socialized Medicine – a condition under which when you need healthcare, you’re subjected to forced intercourse from the government.

            1. Ya, but the government is a very prolific offender for that offense.

         3. There’s no “free market” involved in US medicine. Even a lone doctor who owns and runs his own practice, office management, and collections still has to deal with the pharmaceutical industry, the hospital industry, and a maze of Federal and state laws. And it’s all corrrupt and protectionist, all the way to the top. Even the prices for drugs and services are a lie; that procedure billed at $20,000 on your statement? What might have cost *you* $20K, your insurance company might have paid only $5K for. And your hospital’s prices might vary enormously depending on your financial situation or insurance coverage.

            Everybody wins big in the medical industry. Well, except for their vict… er, customers.

            1. I’ve seen blame on the situation blamed on greedy insurance companies, but this shell game is done in no small part due to MediCare, who gets to tell the doctor “We’ll only pay $X, the patient only pays $Y, and oh, lookie here, there’s a little gap between $X and $Y and how much you charged us! Sorry about that, but hey, we have to cut costs somehow!” and if doctors try to charge a bit more for MediCare patients to make sure they can profit from their services, any attempts to charge others less is deemed MediCare fraud. Insurance companies can see this and play the game too, but the poor little patients who don’t (or sometimes can’t) get insurance are screwed.

               1. A lot of the high prices are because insurance negotiates the prices down. It’s similar to the permanent discounts at some stores – the “original price” is outrageous, and the discount is just about right.
                  (This is only partly the result of any greed, and a lot the result of regulations surrounding employer-provided health ‘insurance’ – and now 0Care.)

5. The take-home quote from the PJ Media link is the ending: “Charlie’s parents expect Charlie to be removed from life support in the very near future. That’s the end of this story, and it establishes the precedent that doctors in the British National Health Service can override parents’ wishes.”

   Socialized medicine is two things. It is a lie, and it is a power grab.

   The lie is that medical care is a “right.” That people have a right to medical care. They don’t. Medical care is a SERVICE, provided by human beings. Those people, in a free nation, cannot be -forced- to provide care, any more than a burger flipper can be forced to flip burgers.

   The power grab is that -only- the government authorized apparatus is allowed to provide medical care. That is where Charlie Gard’s parents got trapped.

   In a free nation, Mom and Dad would seek the opinion of NHS doctors, then look elsewhere for more/better/different options, and fund those options whatever way they could. They got a better deal in the USA? Hop on a plane and go get it. Some NHS doctor doesn’t like it? Tough shit, its a free country and its their kid. The parents decide.

   But now, Britain is -not- a free country. Some NHS doctor gets to decide what happens to Charlie Gard, not his parents. Charlie’s care is expensive, so they decide to let him die. Logical, reasonable, medically sound, and exactly the way decisions get made in an un-free country.

   Canada had this conversation back in the 1970’s and lost. We are fortunate in being able to make a run for the border and get private hospital care in the USA, although that is changing. Obamacare, international problem.

   The thing people don’t understand is the insidious nature of socialized medicine. The government doesn’t benefit from the provision of care, the doctors do. The government only -PAYS- for it. From their perspective, patient care is a -COST-. If they save a million bucks by letting little Charlie die, that’s a good deal for them.

   If they can save a billion dollars (and they can!) by letting every old lady in every nursing home quietly die from the next cold they catch, sooner or later, that’s what they are going to do. All it takes is an economic downturn and a good propaganda campaign.

   The difference between EuroSocialism and National Socialism is the sales job. All else is identical.

   1. I’ve been making that argument for years.

      Canadian hospital response to funding shortages: close an OR to save money

      American response: Open another OR to increase revenue.

      I leave it to the reader to determine which method leads to better care.

   2. We are fortunate in being able to make a run for the border and get private hospital care in the USA, although that is changing. Obamacare, international problem.

      The rest of the developed world loves to lord over the US how much more civilized and compassionate their medical and welfare systems are.

      Yet they expect the US to provide the safety valve for their shortages and the lion’s share of the innovation in products from medicines to ear buds.

      Isn’t there some quote by Heinlein about those who make progress are rightfully despised by all right thinking people?

      1. Throughout history, poverty is the normal condition of man. Advances which permit this norm to be exceeded — here and there, now and then — are the work of an extremely small minority, frequently despised, often condemned, and almost always opposed by all right-thinking people. Whenever this tiny minority is kept from creating, or (as sometimes happens) is driven out of a society, the people then slip back into abject poverty.
         This is known as “bad luck”.
         From The Notebook of Lazarus Long in Time Enough For Love by Robert A. Heinlein.

         1. I was being a bit sarcastic…I assume regulars here are familiar with the quote.

            I have not been proven wrong 🙂

            1. That’s ok. I never tire of the quote, myself!

               1. Nor does the puppy-blending Professor, Glenn Reynolds.

               2. I knew that, but I never pass up a chance to quote my hero and mentor.

         2. Ayn Rand said that first, in The Fountainhead.

      2. I sometimes wonder what nations are the ones who develop most of the drugs, procedures, and testing methods used by modern medicine. I actually tried looking it up a few years ago, but so many of the major players are multinationals I gave up.

         1. There is a reason they are multinationals. The US is the big “free market” nation where they can make profits from new drugs and procedures, but the regs are so strict with so many hoops to jump through for testing in the US that it is often much easier to do final development and testing in other countries. When you KNOW it works, because you have used it on a few hundred patients in country X it is both an incentive to jump through all the hoops in the US, and a useful ploy to point out repeatedly, “it works, see we are already using it overseas. How many lives are you constraining by delaying our approval here?”

         2. Look at where the majority of the research campuses are and where the majority of new therapies and drugs enter the market.

            Even if the research is done in the UK or Japan (when I consulted with Pzifer they had them there and one in the US where I was) the drugs generally get introduced in the US first because they have pricing freedom.

      3. Speaking of innovation – take a look at Nobel prizes for medicine. Not the nationality of who won them – that kind of brains, talent and skill is nearly universal. Look at the fine print. At which institution the research was done, and in what country. G’wan. I dare you.

      4. We are also their protector, allowing them to spend a helluva lot less on their militaries then they would have if we had not become the world’s policeman. This has subsidized the socialist systems of Europe especially.

   3. Haven’t you heard? Children don’t belong to their parents.

      https://www.theguardian.com/commentisfree/2017/jul/24/charlie-gard-tragic-respect-courts

      Of course it’s The Guardian. Of course.

      1. Open question: what percentage of The Guardian’s staff and readers actually have children?

         1. Improperly phrase question. It should be: what percentage of The Guardian’s staff and readers actually are children?

            1. Are we judging by calendar or mental age?

      2. It’s The Guardian. I flush stuff better than that. Moo.

         1. It is not simply The Guardian; MSNBC host Melissa “Tampon Eardangles” Harris-Perry was advocating that view four years ago.

            

            From “a television spot featuring MSNBC host Melissa Harris-Perry promoting her weekend show on the network, Harris-Perry, looking off camera, says the U.S. never invested properly in public education. “We’ve always had kind of a private notion of children. Your kid is yours, and your responsibility,” she says. “We haven’t had a very collective notion of ‘These are our children.’ So part of it is we have to break through our kind of private idea that ‘kids belong to their parents’ or ‘kids belong to their families,’ and recognize that kids belong to whole communities.”
            thedailybeast[DOT]com/melissa-harris-perry-and-the-firestorm-over-collective-parenting

            1. Ox head hurt again.
               Attempting to think down to that level… bad idea.

               1. It’s because when children belong to people who have a good chance loving them, there’s also a good chance they’ll fight you if you try to do horrible things to them.

                  Is, however they belong to people who have a good chance of being pretty much indifferent to them, there’s is a good chance they won’t care, no matter what they do.

                  1. So.. not stupid. Out and out evil.

      3. I would be extremely hard put to remember the command to pray for my enemies vice attempting to break their cotton picking necks as they so rightfully deserve if I were to ever find my self in situation of Charlie Gard’s parents. I’m getting angry just thinking about it.

         1. When you pray for your enemies, pray that they grasp the enormity of the evil they’ve perpetrated and that they repent (= feel or express sincere regret or remorse about one’s wrongdoing or sin).

            1. “Love the enemy…”

               Sometimes your enemy needs tough love.

               1. It is a goodness versus kindness thing. Or, if you’re a bit of an old pen-and-paper + dice geek, a Lawful Stupid fallacy.

                  It ain’t all that “good” to be “kind.” See: SJW, any type. See, we’re h8r’s because we don’t… “love science” in the global warming sense of the phrase, or diversity because we want everyone to have a fair chance to succeed or fail on their own merits. There’s an essay on this out there in the weeds of the internet I’m sure some of y’all have heard of.

                  1. I am very tempted to be totally cool with this interpretation.

               2. Ayup. And sometimes they need to be shot down like a rabid dog. … lovingly.

                  1. If you hate your enemy it makes it more likely that you’ll make tactical or strategic error.

                     Like insisting that your Army take a non-strategic city on the Volga rather than bypassing it and continuing to your strategic objective of the Caucasus oil fields. Just because it’s named after your adversary…

                     1. Dude! It’s just sitting there, virtually undefended! We’ll go in, brush the defenders aside with contempt, shoot a few politicians to show we mean business, and we’ll have a nice forward base to continue our advance from. The plan always worked before!

                        The plan always *had* worked before…someone forgot to tell the defenders that, though.

                        The city had been the playground of the Tsars for half a millennium; it was called Tsaritsyn until the Soviet leaders started renaming cities to boost their vanity. Lenin had already taken St. Petersburg. Stalin took Tsaritsyn. Well, officially the inhabitants were so in awe of the great leader they did it themselves.

                        After “de-Stalinization” in the early 1960s the Soviets renamed the city again… but not back to its original name. Now it’s “Volgograd”, generic for a city on the Volga River.

                        Outside of Russia, hardly anyone has ever heard of Volgograd. And wouldn’t care anyway. It will always be Stalingrad, the city that *earned* its name in blood and destruction… and victory.

                        1. Heck, Russia is a big place, I bet there are a significant portion of Russians who have never heard of Volgograd. Stalingrad however earned its place in history.

                        2. You’re forgetting that part of the plan of the blitzkrieg was to bypass well defended spots, encircle them, and keep going. That part of the plan got ditched just because “Stalin” was in the name of the city.

                           On the other hand, never second guess when your enemy chooses to act stupidly.

                     2. Hate is foolish. Yes, it harms the people around you, but it destroys you first.

                        Weird that the left makes (or tries to make) it a crime rather than the any actual criminal actions it can inspire.

                        If they had the language of sin, they could actually deal with it.

                  2. Huh. I am remined of what Paul wrote about if you don’t provide for your family you ain’t worth the powder and shot it’d take to blow you up, or words to that effect.

                     Defenestration it is then.

         2. That’s probably a large part of the reasoning behind the gun bans over there that have now been followed up with, if not outright bans, at least propaganda campaigns against knives.

            1. They’re working hard on the knife ban thing. It makes it hard to cut broccoli though, so they’re going slower.

               1. Since I tend to invent things to solve problems such as that, I could suggest a solution, but I am afraid someone would use it as a stepping stone for such a ban.

               2. Kale is much easier to deal with. Arugula too. No knife necessary.

         3. I understand that it is illegal to light people on fire, but I frequently find myself struggling to understand why it is wrong.

            1. One should only initiate controlled burns; people on fire tend to run around and ignite valuable resources.

               1. This is why you install tires before lighting people on fire, tires help control the lightees movements.

               2. The show is part of the appeal.

            2. You’re just helping them stay warm for the rest of their life.

            3. And this is why vigilantism can get to be a thing. When you hear people saying “It’s always wrong to take the law into your own hands”, consider carefully whether they simply want to keep it in THEIR hands to benefit them.

               1. An example of the problem with abbreviating philosophical positions: It’s generallly a bad idea (for which, read “wrong”) to take ENFORCEMENT OF the law into your own hands IF AN EFFECTIVE, REASONABLY DISINTERESTED ALTERNATIVE ENFORCER EXISTS.

                  1. A note in support of this, citizen’s arrest exists.

                     1. Depends on your jurisdiction, there is no (statutory) provision for citizen’s arrest in Arizona.

                        1. Found it!

                           http://www.azleg.gov/FormatDocument.asp?inDoc=/ars/13/03884.htm

                           Note: Washington state has open carry, has for ages, but doing so is taking your life in your hands.

                           1. I was misinformed.

                           2. Or it changed.

                           3. Unfortunately, unlike the Arizona Rules of Civil Procedure, the ARS aren’t annotated with dates of inception and revision.

                           4. Has that bill been passed and signed by the legislature?

                           5. The website kind of really, really sucks, but that link is to Arizona Revised Statutes Title 13. Criminal Code § 13-3884.

                              So, active law.

                              Just spent ten minutes double-checking it wasn’t a stealth bill listing or anything.

                           6. Signed by the *governor. Duh

                           7. Yes it has. LOL

      4. The same outlet that had an opinion piece arguing for a 100% death-tax, although a few sentimental low-value items might be exempted and given to the heirs of the deceased.

         1. Foundations and trusts exempt of course. It’s philanthropy then. *spit*

            1. Anyone can start a trust; lots of gun owners do it so that they can pass down guns (especially ones needing special licenses).

               1. and hence why the ATF is restricting/changing how that works…

               2. Oh I know. Just referring to all the ‘charitable’ trusts and foundations that are vehicles to pass down wealth of those who want to make sure you should be stripped of everything when dead

         2. I know a guy who believes in that, but at least he’s consistent: he doesn’t believe HE should get his parents’ money and property after they die, either.

            1. I’m sure he said that because he was sure that no such law would ever be passed. However, I’d bet that if he were confronted with legislation that stood a high chance of passing, he’d be one of the first in line to explain why his inheritance was somehow special and deserving of exemption.

               In much the same way that it was easy for Congress to repeal Obamacare when Obama was in the White House to veto the bill.

               1. With this particular guy, I’m pretty sure that his actual reasoning was that he would never be in a position to need it badly enough to care. Especially after he got married. They were both decently-paid IT people who had no intention of having children.

            2. You’ll pry my mama’s books from my cold dead hands. Her mother read them to her, she read them to me, and I read them to my daughter, and when the time comes I hope she’ll read them to her child.

               If she doesn’t, it’ll be her decision, not some fool bureaucrat.

         3. Oh EFF that. I don’t want or expect to get anything when my mother dies (I’d love it if she came to the end of her run having spent all but a few dollars on needful and wonderful things, and she’s very carefully doing that), but the government doesn’t need to take a hand in that. It’s my job. (Quite literally; she’s put together a trust instead of a will and I’m the co-trustee. I’ve told her she needs to wait a couple of decades before she makes me use it—she’s in her 70s.)

   4. When we were dealing with the terminal diagnosis of our fourth child, we were allowed lots of options. They were explained carefully to us. Yes, doctors are influenced by their own biases so friends in a very similar situation were “pressured” in a different way than us but even they were allowed to do what they wished within the limits of the medical community’s ability to deliver here in the US.

      We were given the option to end the pregnancy immediately (standard abortion, administer drugs to cause death and then deliver), end the pregnancy soon but attempt to deliver the baby alive (even at a little over 20 weeks and spend time with it for as long as we wished – still technically an abortion but one that allowed the baby to try to live for a time outside the womb), carry as long as we wanted and then deliver with no heroic measures – just allow us time with the baby until it passed, and lastly, carry as long as we could and do heroic measures to extend the baby’s life for as long as we were willing to let it go.

      They gave us all those options and would have supported us in whichever decision we made. They gave us the pros and cons of each, for us and for the baby. When we made our choice, they allowed us the most freedom possible in everything we did with him.

      Another friend delivered a stillborn baby in China (expats doing work over there – they are now back here in the US). The baby was whisked away and nobody got to see it. The “comfort” measure given was “It was ugly. You wouldn’t want to remember it that way.” Somebody did take a photo for them of the baby. In no way was there anything physically wrong on the outside. They couldn’t risk a foreigner having the chance to show grief over the loss of a baby in the country that took so many babies from their parents on purpose.

6. Re: Chrilie Gard — …and I suspect that Charlie’s condition has likely deteriorated during the months that his parents fought the courts and the hospital for treatment, in their efforts to do everything they could to save their son…

   Sadly so…

   Charlie Gard case: Parents withdraw application to bring sick baby to US

   By Katherine LamPublished July 24, 2017
   Fox News

   With tears streaming down their faces, the parents of terminally ill baby Charlie Gard on Monday withdrew their application seeking to take the child to the United States for an experimental medical treatment, with the couple’s lawyer announcing “the window of opportunity has been lost.”

   Attorney Grant Armstrong said at London’s High Court it was too late for the 11-month-old child to receive treatment. Recent medical tests revealed Charlie has irreversible muscular damage.

   “It’s too late for Charlie,” Armstrong said. “The damage has been done.”

   Charlie’s parents, Chris Gard and Connie Yates, cried in the courtroom as the lawyer announced the news — their last bid to seek permission to take their child to the U.S. for treatment.

   “As Charlie’s devoted and loving parents we have decided that it’s no longer in Charlie’s best interests to pursue treatment and we will let our son go and be with the angels,” Yates said in court.

   The couple was expected to present new evidence in court on Monday, but they arrived in court to say the dragged out case has wasted “time. A whole lot of wasted time.”

   “Had Charlie been given the treatment sooner he would have had the potential to be a normal, healthy little boy,” Yates said, referencing the recent medical test that ultimately led to the couple’s decision to withdraw.

   “I only wanted to give him a chance at life,” Yates said. “We will always know in our hearts that we did the very best for Charlie and I hope that he is proud of us for fighting in his corner.”

   Armstrong said the appeal withdrawal is “worthy of a Greek tragedy” and the couple now wishes “to spend the maximum amount of time they have left with Charlie.” Private discussions will be held regarding when Charlie’s life support will be switched off.

   Charlie, who was born on Aug. 4, 2016, suffers from a rare genetic condition, Mitochondrial DNA depletion syndrome. He has brain damage and is unable to breathe on his own. Doctors at Great Ormond Street Hospital, where Charlie has been treated since last October, have been locked in a prolong court battle, claiming more treatment would only cause pain to the child. They have argued to switch off Charlie’s life support to allow him to die peacefully.

   But Charlie’s parents dispute the claim and have argued that their child should receive every possible treatment until his death.

   “There has never been any proof that he was and we still don’t think that he’s in pain or suffering to this day,” Yates said in court on Monday.

   “Having said that, we have decided to let our son go and that’s for one reason and one reason only. It is because the prospect of improvement is unfortunately now too low for Charlie,” she added.

   The hospital spokesperson also said earlier though their view on Charlie’s treatment has not changed, it was the parents’ right to hear evidence on the proposed experimental treatment. On Monday, the hospital released a statement saying it will be formulating “the best possible plan for [Charlie’s] end of life care.”

   “It is greatly hoped that in the days ahead, it will be possible to extend to his parents the same quality of care with which Charlie has been provided and to concentrate on the family as a whole,” the statement read.

   The hospital also said it will “give careful thought” and learn from “this bruisng court case,” but also hope others will “reflect” on what happened.

   The case grabbed international attention and received support from leaders such as Pope Francis and politicians.

   President Trump also tweeted his willingness earlier in the month to lend a hand – and in doing so exposed the debate over who should make life-and-death decisions for Charlie to a massive audience.

   “If we can help little #CharlieGard, as per our friends in the U.K. and the Pope, we would be delighted to do so,” Trump wrote.

   1. Chrilie?

      All I can plead is dumb morning fingers … I have now started the coffee brewing.

   2. Letting his condition deteriorate while stalling is a feature, not a bug. Dragging their feet allowed their decision to become more permanent and I suspect they knew this.

      1. Every single NHS stooge involved in this travesty needs,to be charged with willful murder.

         1. amen. Hey, can we bring a lawsuit against them, internationally, for crimes against humanity?

            1. Sorry, there is a “but we’re good leftists” exception for all crimes against humanity.

               1. There’s a wall for those, isn’t there? One built by the even better leftists.

                  1. If only leftists could realize there will always be better leftists

               2. If the Left doesn’t tone it down a bit and regain some semblance of connection to reality, I fear there may be a reaction sometime in the future that yields many a “good leftist.”

                  1. “Good leftists” as defined by a modern general Sheridan?

                     1. That was the direction my thoughts had wandered, yes.

                     2. Good leftists are similar to a sheep farmers opinion of good wolves.

                        1. The good wolves are the ones safely contained in the wolf exhibit in the Philadelphia Zoo. 😉

                           1. Philadelphia already has too many leftists to cage.

                           2. On behalf of my brothers and sisters of canis lupus, it is entirely unfair to compare wolves to leftists.

                              Wolves work for their suppers.

               3. If they can get a pass for genocide, what is one little boy? But, oh, I wish we could hang them with it, for the sake of all their other victims.

                  1. Likely, you can only hang them in literature — i.e. by making a meme of “baby-killing statists” (or some even more apropos title) that gets used synonymously with bureaucrats and courts in similar abusive actions of whatever kind. Make the memory of them a horror no-one forgets.

                     Obvious, but I haven’t seen it yet: “Humane. You keep using that word, but I don’t think it means what you think it means.”

            2. Speaking of, ask Tom Knighton for what I sent him lately – re: crimes against humanity by ‘good law-abiding’ leftists. It’ll be interesting reading. I’d have written about it myself, but I still can’t come up with a response that isn’t staring in gobsmacked disbelief, or swearing nonstop for an hour or three.

               1. Good, law-abiding leftists* cannot commit crimes against humanity because those who are neither them or oppressed masses unafflicted by false consciousness are not really humanity.

                  Further, because those “crimes” are committed for the greater good there is no “evil intent” and therefore no crime. See also: eggs/omelets.

                  *There’s an oxymoron for you!

         2. The belief that those bureaucrats responsible for this travesty will burn for eternity in Hell is one of the more compelling arguments for faith in a just and vengeful Deity.

         3. Am I allowed to say “woodchipper”? I’ve heard that less rope, and fewer bullets, go to waste that way…plus, it’s a gas engine, so at least they suffer by knowing that their deaths are contributing to Climate Change. It’s faster than the evil son’s of -deleted- deserve, but if we took the time to do it properly, we’d never be finished…

            Damn it. That poor little angel…*sound of teeth grinding…noisily* Where’s The Punisher when you need him? Although, truthfully, he would have been more helpful at the *start* of this whole horrific, despicable, tragic, murderous-rage and heart-rending-sorrow inducing case. Frack.

            1. Being a conservationist, myself, I prefer the re-usable method. It also givs you a chance to use all those soap and ballot boxes they had made otherwise useless.

      2. This was how the VA waiting lists worked. Move the patient off the waiting list onto a “sub-waiting list”, and then rotate them back onto the primary waiting list after a period of time had passed. Sure, a lot of your patients died because they kept getting swapped off of the primary waiting list before they could actually get any care. But your primary waiting list was short, which is what DC was paying attention to.

         1. When the NHS became embarrassed by reports of long waiting times in ERs they passed regulations mandating a [whatever] hour maximum time awaiting treatment at the ER. And they met those benchmarks … by holding patients in ambulances in the parking lots and not counting them as waiting until in the actual ER.

            That this meant a lot of ambulances were being used as expensive hospital cots was not important. That it effectively meant even longer wait times was equally irrelevant.

            1. Never mind that the reason the booboo busses are so expensive is because they are outfitted to take a good chunk of the ER onto the streets. Would rather not know how many people died because of insufficient resources because they were being held to make bureaucrats look less incompetent.

   3. I have two thoughts:

      1) The bureaucrats responsible for this decision should be happy that Mr. and Mrs. Gard, who no longer have anything to lose, are still (from all appearances) decent people and not inclined towards taking revenge on the people directly responsible for Charlie’s death, and

      2) Now you see why Britain has such strict regulations on owning weapons.

      1. Yes.

      2. I suspect that the idea that Mr. and Mrs. Gard might be willing to seek violent retribution has never even occurred to the doctors responsible for this. Otherwise, they would probably have pre-emptively had the Gards forced into a psychiatric ward somewhere “to help deal with the impending death of their son”.

         1. Perhaps if the Gards were Muslims…

      3. Right now, Charlie is still alive (even if for not much longer). I suspect they will be focused on spending as much time with him as they can before they lose him for good with no energy left for going after the ones who caused it.

   4. “””On Monday, the hospital released a statement saying it will be formulating “the best possible plan for [Charlie’s] end of life care.””””

      I seem to recall that the hospital wasn’t even willing to release Charlie to the parents — they wanted Charlie to die while in hospital care.

      At the beginning of this year, my wife lost a cousin to cancer. Shortly before she died, she was in the hospital, and her husband was working out home hospice arrangements — and the nurse said, at one point, “You need to hurry, because I don’t think she’s going to last much longer.” It’s an interesting contrast: one hospital doing everything it can to keep the parents from caring for their son as they see fit (not even allowing them to take him home), vs. the hospital doing everything they can to make sure that the family gets the care they desire…

      1. You know, it occurs to me…

         Given that the hospital had already announced that they weren’t going to release the infant, shouldn’t they ALREADY have this plan? Why are they only formulating it *now*?

         1. “Just in time” care, dontchano.

            1. Just-in-time planning – also known as “winging it”.

   5. I found myself having rather strong flashbacks to when I lost Damien to stillbirth, over this. My first reaction was to plead for a caesarean, in the hopes that we could save him, bring him back.

      Then I realized that by the time they could have, in any way, prepped me for surgery, he’d be brain dead and lost to us, even before the doctor started explaining the same thing.

      I still remember that poor young redheaded male nurse or doctor. I’d never seen anyone actually turn ashen before. I could see his freckles from across that large birthing room! I remember thinking, all bemused: “Oh, so that’s what ‘turn grey with shock’ looks like. Huh. It really does happen.” It’s like my brain was trying to run away from reality right then.

      I remember also Rhys and I sitting there, hugging each other, listening to someone else’s baby crying -rather angrily, we thought. The bubby paused for a moment, then screamed with such indignant rage that we both burst out laughing. We wondered what had provoked that. Maybe he’d gotten a vitamin shot, or a cannula put in. “That’s NOT WHAT I WANTED!”

      1. Your mention of a male nurse in the delivery room reminded me: The discrimination against males in some professions has gotten really bad over here:

         A couple of months ago, my wife and I were talking with a guy who is a pediatric nurse. He was telling us that for all the various kinds of work he has done in pediatrics, he has never been allowed to even be present for any births that happened on his shifts. Because he’s a man. I would have been skeptical, but the description he gave was just ludicrous enough to ring true (I can’t remember the specifics, but one of the incidents I think went something like, “the doctor’s a man, I don’t want any more men in here” or something of that nature). My wife blinked a couple of times and shook her head.

         1. There were only female nurses in the post-birth maternity ward I was in, but I remembered seeing both male and female nurses in the birthing and maternal care area, and I remember there being nurses and doctors of both sexes in the OR when I had Brandon c-sectioned out of me. This young fellow was one of the ones who ran in when my midwife hit the emergency button.

            I can sort of get why some women (or husbands) wouldn’t want another man there, but we’re more pragmatic. I don’t care about what’s between your legs, I want you there if you’re supposed to be there and you’re competent!

            1. This poor guy was kind of bent out of shape about it. He’s been a nurse for something like ten years, and one of the things he wanted to do was catch babies, but he’s never been allowed to do it.

               1. Yeah, I feel for him. I originally thought of going into medicine, but the costs are prohibitive. After a while though I got the impression that only the obstetrician is really allowed to do the baby catching. Or the dad. On the other hand, apparently one of the things taxi drivers in the US are taught (or so I hear) is how to help a woman in labor…

         2. That’s awful. One of the specialists in at the birth of my first son (deep aspiration due to fears of inhaled meconium) was male. I didn’t care as long as they didn’t make me use the giant mirror to watch myself giving birth. (That’s… an option. They ask if you want it, at least.)

            1. *bursts out laughing* I think Rhys and I weirded out the doctors BADLY when we said we wanted to be able to see them cut me open and get the baby out. Rhys because he has had as part of training emergency battlefield medic training and well, both of us being the massively curious nerdy things we were, wanted to see, because Scientific Curiosity, it’s knowledge observed! The doctors refused, saying it would be too disturbing, especially, they felt, for the husband. Rhys and I looked at each other, but managed to not laugh in their faces. Our relationship with that particular obstetrician was bad enough already.*

               The anesthesiologist later whispered into my ear that I could see a little bit of reflected image in the faceted mirror that helped increase the light’s brightness above the operating table, which was as good as I could get.

               *He’d deemed that I was taking up Valuable Hospital Resources Paid For By Taxpayers by taking up a bed for special monitoring – I was borderline pre-eclamptic and had been admitted because my blood pressure was too high. He felt that I should be able to come in just on regular checkups. When I snarled at him for having already lost a previous child to stillbirth, he was all ‘fine, you can come in DAILY for a bloodpressure check,’ making it very clear that he saw it as a useless waste of time. And yes, he made obvious he saw me as nothing more than a dole-bludger without being verbally racist about it.

               Guess who got readmitted on the first day of that blood pressure checkup because my blood pressure was almost twice of my previous admission? Oh, and the nurses in the womens’ and childrens’ clinic were pissed off that he’d kicked me out. Instead of having me in a comfortable, controllable environment where they could keep a close watch on my blood pressure, that doctor put me through unnecessary stress of having to move back and forth from home AND all the discharge bullshit, which was likely why I needed a caesarean then, instead of perhaps a week later (which is what they were hoping for.) My normal obstetrician was on his scheduled leave, as was my midwife. If they had been there, that would not have happened. As it is, we lost Brandon to SIDS later on, and I frequently wonder if that extra week in the womb would have made a difference.

               1. *hugs*

                  1. *hugs*

                     I wish I could’ve punched the doctor, but then I’d be in trouble for assault. *sigh*

               2. I know some people want to watch. I just remember my mother’s face as she watched, and she said how hard it was for me, and SHE’S the one who had five kids!

                  As for Brandon, they have seen some evidence that SIDS may involve a brainstem anomaly. If that’s the case, the extra week may not have made a difference. (I have a friend who lost a baby to SIDS as well and she keeps up on the literature.)

                  1. I used to try, just because medical curiosity, but life has been busy. I’d be interested in reading about that.

7. I am sadly reminded of a phrase from a bit ago now. It seems to all too aptly describe the results of bureaucracy as applied to healthcare (and likely much else, but here it is glaringly evident for those with open eyes). That phrase is “the banality of evil.” Each bureaucrat is, of course, “Just doing his job.”

   1. No. The job is frequently defined in terms of helpfulness, and the pettiness is never helpful. What the petty evil bureaucrats are doing is ‘obeying the rules’ which is quite often very different from doing their jobs.

      They are also, of course, being sphincters, and taking great – almost sexual – pleasure in clenching up.

      1. Note the quote marks. Truth and claim/defense differ. Is much like “just following orders.” Brain off, book followed, decency be damned – because that’s the easy no-thinking (thinking: hard work!) path.

         1. Honestly, I think that in many cases it is the simple, almost orgasmic pleasure some people get in saying “no” (or “fill out form z” or,whatever). That’s what moved me from wanting Gay couples to have ‘Civil Unions’ to supporting Gay Marriage; the realization that even when marriage was legal, there would have to be a decade worth of lawsuits over obvious crap like admission to hospitals during visiting hours, and that these would not be mostly homophobic jerks but simply jerks who get pleasure in tormenting ‘little people’. And if it was,’Civil Union’ instead of Marriage, then it would be TWO decades.

            I just wish the Politically Gay hadn’t been quite so quick to prove they were just as bad.

            1. Then I have been remarkably fortunate. While I’ve met a few zero-thought types, I’ve not encountered many power trippers in such roles. Or if I have, have managed to circumvent things by asking my questions in such a way that their “NO” was a release to go do what was needed rather than a denial. I claim no great skill in this, btw.

               Granted, much is apt to be more a function of a semi-rural area where “everyone knows everyone” and if someone screws everyone over all the time… well, karma happens.

   2. Interesting. We tend to want simplifications, where evil is completely recognizable as ugly and thoroughly repulsive. Often it is starts as doing what is considers as a great ‘good’.

      From Wiki on the NHS:

      The NHS was born out of a long-held British ideal that good healthcare should be available to all, regardless of wealth. At its launch by Bevan on 5 July 1948 it had at its heart three core principles: That it meet the needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay.

      Whenever the pursuit of said good leads to treating people as objects it becomes evil. Bureaucracies are impersonal by nature and therefore tend to treat the people they serve as things. The bigger they get the worse it becomes. And the people up and down the chain are just doing their job.

      1. This reminds me of a parable of Jesus, where he talked about two sons, both who were asked to do something by their father. The first son says “No, I won’t do it!” and then goes and does it anyway…while the second says “Sure, dad, no problem!” and then doesn’t do what was asked.

         Capitalism is the first son: it doesn’t promise to help — indeed, pretty much anything done is because of greed of some sort or another — but in the end, everyone’s needs are met, and all the promises of socialism ultimately get fulfilled.

         Socialism, on the other hand, is the second: it promises the world, but in the end, all they offer is a mockery of service, which is then called “compassion”.

      2. And, if they are not following the rules (compassion!), the whole thing turns, eventually, into nepotism/baksheesh.

         Bureaucracies always take something decent (law, compassion) and drive it to its failure point – and beyond.

      3. The original British system wasn’t entirely wacky.

         They had a whole country that had suffered varying degrees of malnourishment during the war. They had tens of thousand of troops coming back from overseas, not just the injured, but the ones bringing back various diseases. Nobody wanted to see a reply of the Great Influenza like happened after WWI.

         Getting a large number of the walking unhealthy back up and into production was a reasonable idea. Britain was *hurt* after the war, and wasn’t a beneficiary of all those sweet, sweet Marshall Plan dollars that were flooding into its former enemies. It needed a strong workforce, and it definitely didn’t need plague too.

         The National Health covered almost everything, and by modern standards, their costing was incredibly cheap. But the state of medicine in the mid-’40s was little different than in the 1800s. X-rays, vaccinations, sterilization, and opiates all dated back to then; their costs were modest and well-known. There was that new “penicillin” stuff that they were making by the drum, and the sulfa drugs that were a bit older, and that was pretty much the extent of “modern medicine” in 1947.

         The problem is, nobody wants 1947 medicine any more. Technology moved on, and much of the service end moved from hospitals and charities (mostly dating back to the days when hospitals were places you went to die, not to get better) to corporate entities expecting to turn a nice profit. I don’t object to profit, but modern hospital billing floats somewhere between “profiteering” and “fraud.”

         “Your problem is an excess of black bile, or perhaps a small imp living in your stomach. Take a dram of this tincture of frog every evening and drop back by next week.”

   3. Hm. Now I think to myself: “What would Schlock do?”

      Ah, I see now:
      http://www.schlockmercenary.com/2011-01-20
      (…and it is very tempting.)

8. The thing that annoys me about the Lefite opponents to the Market is that so many of them claim to want some kind of ‘let’s consult everybody’ mechanism to set goals and prices. And then they turn around and attack the only such mechanism that exists.

   They want control. Never mind what they SAY they want; watch what their proposed solutions will actually create. They don’t want ‘affordable health care’ they want health care controled by pillocks like themselves.

   1. People like to say that care must be rationed, no matter what system we use, because we only have finite resources. But this isn’t so: free market capitalism, when running unencumbered, doesn’t ration at all. Doctors set their prices, and the patient says whether or not he can pay. If the patient can’t pay, he can resort to other methods — pleading with the doctor for reduced prices, seeking out second opinions (and lower prices) from other doctors, asking for help from charity, or even having the foresight to pay for insurance that will cover some of these costs — but in the end, it’s up to the patient to decide how much he can afford, and it’s up to the doctor to decide how much he can afford to provide the service. There is no “rationing” going on.

      Sure, it might have the effects of rationing — some people will be denied, because they can’t pay — but it’s up to the people involved to decide what’s worthwhile to do.

      But this is different from a bureaucrat watching over everything, and saying “You may do that!” or “You can’t do that!” based on perceived understandings of resources — and will thus sometimes deny services to someone who desperately needs them, or give someone resources who doesn’t really need them. (And this is giving the bureaucrat the benefit of the doubt — we’re ignoring the bureaucrats who sentence people to misery or death, just so they can pad their own pocketbook, or brag about how they’re saving money…)

      1. I’d argue that it’s a bit more convoluted than that.

         One of the storylines (for the city-state of Bastok) in the online game Final Fantasy XI includes an interesting parable. President Karst is the leader of the city-state of Bastok. His daughter is idealistic, and generally unhappy about the way some of the things work in Bastok, particularly with how money tends to grease wheels within the city, which is heavily focused on industry and commerce. Another character relates a bit of history to the daughter.

         Back when the city was quite a bit poorer, a big fire wiped out most of the homes in the city. Two competing plans were submitted to try and rebuild. The president endorsed a plan that collected donations to a fund that would be used to pay for the rebuilding. But after several months, not much work had been accomplished, and many people were still without homes. So the plan submitted by Karst (who wasn’t president yet) was tried. It promised the merchants in the area that if they donated to the fund, they would get priority on the rebuilding. The merchants did so, and enough money was received from the merchants that there was leftover money to spend on rebuilding the homes of the other residents. As a result, the work was rapidly completed.

         Free market hospital spending is kind of like that second choice. Some people have lots of money. Some don’t. The people that can pay more can get better healthcare because they’re able to spend more. But some of that excess spending ends up helping people at the lower rung, as well. Wealthy patients spend enough to justify the expense of purchasing an MRI, and the less well-off are able to enjoy the benefits of using it at a lower cost now that the “sunk expense” of the initial purchase is out of the way. Hospitals are able to deal with dead beat patients who get ER care and then flee without paying their bill because richer patients are able to make up the difference. I could go on, but I think you get the gist.

         Under socialized medicine, that MRI will never get purchased.

   2. Those actually driving the train, ya. Others just don’t want to have to pay for what they need (try and suggest that we do a per capita tax for health care. It’s the only fair way. They’ll say that only the amorphous rich should pay the brunt) and others think that it gives them compassion points… without having to volunteer at the hospital to help, get trained and hold a stranger’s hand as they die because there was nothing that could be done, or go spend a decade in schools, more as the hospital serf and then compete with Abdul who has 4 yrs training and the same degree as far as the hospital cares.

      It’s the second group that anger me more, I’ll admit. Just greed.

   3. Absolutely!

9. Sadly I don’t have enough in the tank today for my typical rant about markets clearing and the negative effects of government interference. Suffice it to say that the market will, when unencumbered, use price signals to allow players to adjust behavior and more efficiently allocate scarce resources. When the market is encumbered with perverse incentives or penalties you get mohair ranches.

   1. Aye.. price.. money.. are signals in economic feedback loops. Mess up the feedback and the results go… non-linear. If you are very very lucky, this only results in wild oscillation. More likely, something blows in a spectacular and horribly expensive way.

10. …keeping NHS costs down, and doing the greatest good for the greatest number of people. I don’t know how many cases like this occur in Great Britain…

    Anecdotes, but here goes:

    Years ago I met a couple who came from Great Britain at church. They had grown up with the NHS, I had not and was largely ignorant. I learned a great deal about its performance listening to them. Their parents had remained in Great Britain and as they aged their medical care became a frustrating cause for concern. For example, her mother needed an artificial hip repair and was put on the waiting list. Before she received that treatment she had aged out as a candidate.

    One friend works with a woman who emigrated from Great Britain when she married an American. The emigre is a two time survivor of cancer. She firmly believes that there is no way this would be the case if she had remained in Great Britain. She has been and continues to be one of the most vocal anti-Socialized Medicine people you will ever meet. This woman is presently trying to convince her widowed mum to leave England and come live with her.

    The Spouse regularly follows the news on the NHS and tells me about it, from staffing issues, to long waits to receive treatments, to lack of supplies and unsanitary conditions found in hospitals the reports continue to be pretty uniformly dismal.

    1. The UK has now developed the “fat and fags” movement, which advocates that if you smoke, or are above the approved weight range, the NHS will not pay for any form of health care for you other than dealing with immediately life-threatening emergencies. Seems when the taxpayers are on the hook for your medical care they look for reasons to deny or delay it. Now I haven’t heard that smokers will be exempt from the tobacco taxes that help fund the NHS.

       I haven’t heard that this has actually been enacted. But a few years ago I copy edited a British book on medical ethics that discussed proposals for it. Seemingly over half of British doctors in a poll expressed opinions in favor of it. . . .

       1. It should be noted that current medical science has determined that being “fat” has less to do with “moral” behaviours (sloth, gluttony) than with endocrinology factors and gut bacteria.

          Not that that matters.

          1. Yep. I know. After having younger son, nothing I do, nothing I try makes me lose weight. I win if I gain SLOWER.

             1. I’ve often talked about a 19th Century Weight Loss program that might just work for you. Before you jump at the opportunity, though, you might want to consider that it will be the last time you get to jump…

                (I devised the weight loss program because it seemed that the answer to *anything* health related in the 19th century seemed to be “amputate!”)

                1. I recall reading somewhere that Sears&Roebuck used to sell tapeworm pills for weight reduction.

             2. Sadly, a lot of the info on weight loss over the last few decades has been terribly misinformed.
                Do you have any “holistic” doctors around there? They might have some information that would help. (Note, I’m not saying to run to a witch doctor and do whatever he says; but a good holistic doctor might be able to take a different perspective.)

             3. Well, I actually have a diet program that I can guarantee will cause you to lose weight.
                Hike the Appalachian Trail. 10-20 pounds lost, bare minimum.

                1. Not enough. They’d be back within a day to a week. Not actually joking.

                   1. I know. Dad has the same issue. He’s up to about six miles a day to keep the energy level up and the pain down. Any less, and yep, back it comes. It tends to run along certain gene lines.

                      Hope I get it from Mom’s dad. He was in good shape in his nineties, despite eating everything bad (black coffee, bacon and eggs, biscuits and gravy every darn day. Cholesterol was *still* lower than mine is now).

                      1. I remember walking away from lunch with a guy in his eighties. Said lunch consisted of pancakes, eggs, and patty sausage. The pancakes and eggs were fried in sausage grease, then he put butter on the pancakes and poured the remaining sausage grease over them in lieu of syrup.
                         As we got in the truck my dad commented something to the effect, “makes you wonder how bad cholesterol really is for you, doesn’t it?”

                         Of course said guy was an old farmer who had worked manual labor every day of his life. Many things are good for you or at least not harmful if you actually burn off the energy they provide.

                         1. Quality protein, animal and fat and olive oil and a nice mix of veg plus loads of physical exercise work great.

                            Until you get sick + injured and then you’re lucky if you can just “gain slower”

                         2. Last I heard, they were unable to replicate studies showing a connection between dietary cholesterol and blood cholesterol.

                            It looks, to my non-expert eye, like they may have made the same mistake with cholesterol as they did with salt– removing it can help some people who are already in trouble.

                      2. I recall reading that the fellow who discovered (or ‘discovered’) cholesterol eventually said that he though things had been gotten wrong and that good and bad and ideas of levels and such were perhaps reversed.

                   2. Maybe you should take up cigars and booze? George Burns was never overweight, and lived to a ripe old age.

                      1. I’ll see your George Burns and raise you one Winston Churchill.

                         1. You have strange definition of overweight if you think Winston Churchill was never overweight.

                            1. He did drink and smoke cigars and live to a ripe old age.

                   3. Given the health issues you’ve made public, I suspect any healthy permanent weight loss for you is waiting on resolution of things that medicine has yet to learn how to resolve. (Basically, it sounds like some of your systems are pretty much out of whack and setting off the weight gain.)

                      1. Yeah, though we might hate the thyroid at least on the right track, knocks on wood.

                2. First, whatever else you do, find some hiking shoes that are supportive and fit you properly. Then pack nice cushy socks. If your feet give out on you it will be miserable and you won’t get very far.

                   1. Wool socks are pretty nice for the hike. Almost a shame to have to walk back down to where all the people are, though.

                      1. But that’s where the showers and the restaurants are.

                         1. So happens there’s a quite nice waterfall I know of, not far off the path. Spring fed. Cold as anything, but clean. Bring a bar of soap, and be happy and clean even out in the woolies. *grin*

                      2. Wool is a good choice, it insulates even when wet. But carry more than one pair, because dry feet are happier feet.

                         1. Ah, very much so! Always two more pairs than days on the hike I expect, because stuff happens. *grin*

                         2. One of the old “Willie and Joe” cartoons by Bill Mauldin has a caption that reads something like, “Joe, you saved my life yesterday, and I swore to pay you back. Here’s my last pair of clean, dry socks.”

                   2. Oh yes. I saw that happen more than once.

       2. Of course smokers aren’t exempted from tobacco taxes…those taxes are needed to pay for the required additional healthcare due to their smoking that we are denying them to save money.

       3. Some years ago I saw a comment from a Briton who was angry at the proposal to limit NHS care for smokers. He said it was the British government who started him smoking by putting cigarettes in his rations when he was in the military. And the government was happy to collect all the tobacco taxes from him over the decades. And after all that, they were saying they didn’t want to treat him because he was a smoker.

          I can see his point, there.

    2. An acquantance and former employer who died last year was a UK emigre who was opposed to socialized medicine. He had some outstanding medical bills. Another acquaintance (Canadian emigre) made remarks about this after his passing to the effect of ‘ bet he wishes he hadn’t opposed socialized healthcare ‘.

       Several people gave him attaboys.

       Someone else pointed out that NHS wouldn’t have covered it in the first place.

       And some people wonder why i hate the entertainment industry.

11. Years ago I told a friend that the value of human life was finite. He was shocked and horrified. Later in the discussion I pointed out that (a) there are organizations that will accept a donation of a hundred dollars or so and use it to feed a starving child overseas, and (b) he owned a huge flatscreen TV that had cost maybe a couple of thousand dollars; so therefore he valued his own entertainment over the lives of a dozen or two African children, which didn’t look “infinite” to me. He took this to be pointing out his hypocrisy, but not as a criticism of his values; I had meant it as pointing out that neither he nor almost anyone else actually lived by those values.

    There seems to be a disconnect in many people’s minds between “what has value” (in some moral sense) and what they actually act to gain and/or keep (as Ayn Rand put it). That doesn’t make sense to me. What you value is what you actually choose or pursue. And in terms of what we actually choose of pursue, no one values other people’s lives infinitely, and indeed no one values their own life infinitely—because we eat things that don’t maximize our expected lifespan, take avoidable risks, and in some cases take major risks to protect someone or something, or to accomplish something. A world of people who really did value their own lives infinitely would be very different.

    1. Saying that something is pricceless, implying being of infinite value, is in fact saying it is worthless. Or, slightly more commonly, of variable value determined by The Right People. This is how the same swine who place ‘infinite value’ on human life justify killing off inconvenient lives like little Charlie’s.

       Vermin, the lot of them.

       1. Beyond that, human life is demonstrably not of infinite value: actuaries routinely calculate and courts award wrongful death damages based entirely on the presumption that the value of a single human life can be calculated.

          1. Ask an assassin what the value of a human life is, and he will give you a price.

             1. Yes, but he isn’t constrained to acquire the life from a willing seller.

                1. Nor, for that matter, is the assassin contracting to sell a life; the assassin is selling a death. Death is much cheaper than life.

                   1. Correction:
                      Death is much cheaper than life, until the appellate courts butt in.

                      1. I recall a line from some odd short story (in one of $SISTAUR’s textbooks…) a fellow is selling “love” and dealing with a customer who did not realize it a temporary thing. There’s a line that he’s NOT selling sex as that is “the second cheapest thing in the world.” Asked what the cheapest was, he replies, “human life.” No, it was not a nice world that the story was set in.

    2. Well said.
       /like
       /share
       Oh wait, this isn’t FB.

    3. A compassionate conservative will take some portion of his wealth and donate it to such causes as he believes will do good in the world. He can take some comfort in that he has at least made an attempt to make the world a better place.
       A liberal lobbies the government to either collect taxes to spend on charity or pass laws to force citizens into practices they would otherwise not willingly do themselves. And the louder those thus afflicted complain the more the liberals bask in the glory of their part in forcing social justice upon the great unwashed.

       1. Amen

    4. I like to think I don’t want to die, but you’re right: if we were to limit our activities to those where we would never be at risk of dying, we wouldn’t get anything done. I drive about 10 miles just to get to work and back — and that 10 miles is enough to get me killed, if just one person (which may even be me!) makes a simple, small mistake…

       But getting to and from work is crucial for me to provide for my family and my own future…while the risk of death enables me to live, it’s a risk nonetheless…

       1. That’s why the sensible motto is “safety third.”

          1. What’s second?

             1. “Here, hold my beer!”

             2. Varies by the person.

    5. What you value is what you actually choose or pursue.

       That sounds a lot like “For where your treasure is, there your heart will be also.” Given that is a quote from The Book of All Hate according to leftists and believed by those cousin loving, beer drinking, gun clutching religious nutjobs who embrace The Book of All Hate it cannot be true.

       More and more I have come to believe the Left embodies another quote from that same book, “Woe unto them that call evil good, and good evil; that put darkness for light, and light for darkness; that put bitter for sweet, and sweet for bitter!”

       Leftism, doing more than all but one minister to bring me closer to my faith.

       1. Herb, I now have “Woe unto Them” and “Howl Ye” from Randall Thompson’s “Peacable Kingdom” playing in my head. Thaaaanks. https://www.youtube.com/watch?v=ukFnYsSTYS4

12. So Medicare alone is capable of bankrupting us, and it only pays 80% of the costs of healthcare for a minority of the population. And yet the economically illiterate simply bleat “Medicare for all!” as their preferred solution.

    The VA recently tried developing a network of private care providers to alleviate their abysmal wait times, but then couldn’t get reimbursements to those providers in a timely or complete fashion, so many of them dropped out of the network. And of course the VA serves an even smaller fraction than Medicare. But fear not citizen, your economically-and-policy-ignorant betters who are also Experts!™ claim that Single Payer will fix all.

    Empirical data do not matter to the Reality-based community which claims to cherish Science!™ and Facts!™ All we have to do is make the bottomless money pit deeper.

    1. And you are not permitted to opt out of MediCare. And if you are on MediCare and try to pay cash for a service, the doctor could be fined a large sum for accepting the payment and providing the service if he also takes MediCare.

       1. …if he also takes MediCare

          The gerontologist the family ultimately found for primary care physician for The In-Laws would not take MediCare. She objected to the restrictions to care options. This doctor made house calls, not something really allowed for with MediCare. She felt that being aware of the living situation was often relevant to providing better care and outcomes. We saw demonstrated.

          The Mother-In-Law was having increasing trouble getting up and down from a seated position. This lead to falls. She was frequently unable to get up on her own and all too often sustained some injury in the fall. That necessitated calls for the EMTs, trips to the ER, various scans and stitches. The doctor came by, looked at the furniture, particularly M-I-L’s preferred couch. She observed the M-I-L getting sitting and rising. She then suggested that what The M-I-L needed was higher seats to lessen the strain on her legs while transitioning. With the addition of a four inch firm foam riser under the seat cushions of that couch we saw a significant improvement.

          1. Amazing how much people can see by actually looking.

          2. And thereby saved loads of medical costs, too.
             Free Market for the win!

          3. TBH, this is at least another part of the increasing costs. Before the job diaspora and travel ease a not insignificant portion of the elderly had either someone else or family. 24 hr presence makes it a lot more likely that you will catch the small stuff. Today we just toss em into ESF’s or just leave them at home, maybe paying a visiting nurse to check every so often. The items I have seen from these two, well they are good at desensitizing you because otherwise you lose your mind.

       2. Yeah, I don’t think any of us have space to effectively even highlight the problems with Medicare.

          All of these economically illiterate a**holes (let’s be frank) shouting Medicare for All and All for Medicare, or Single Payer! are going to wonder what happened when their choices dry up and/or they have no means of redress when something goes wrong. They’re probably going to get what they wished for, nice and hard.

          1. I am sure they will move on to blame greedy doctors, nurse, drug companies, ect for not being willing to provide current amounts and standards of care for minimum wage.

             They will also blame all the people (not them, of course) who refused to go into medicine as there were better opportunities (as defined by money, prestige, time off, fulfillment, etc) in other fields.

             In the end socialists, even if they won’t admit it them themselves, desire others as their slaves. They just want the state to insulate them from the reality of their demands making them, in some ways, less moral than plantation slave owners of the old South who at least owned up to what they were doing.

             1. Current situation in my mom’s town. Waiting list for a family doctor is in the thousands (population of 30k). Currently there are more doctors retiring or preparing to retire and any new doctors get the retiring doctors patients. So if you move there and need a family doctor, you are SOL. Unless you have a car and drive to a city that has doctors with openings. Good luck with that as well.
                They were talking awhile ago about forcing new doctors to take practices in under served communities. It didn’t go over well with a lot of people and was eventually sidelined until things change or get worse.

                1. Used to be that it was almost impossible to get old doctors to retire. Turns out that the personality traits of those who became old doctors do not take kindly to the kinds of management practices and procedural requirements imposed by the new regime and thus they are turning their intellects to less annoying more rewarding pursuits.

                   1. I went to a doctor near our house, because I had a horrible ear infection and was about to fly. So we went first place that took walk ins. Family practice. I won’t be going back. First, ipads for all the initial information. Great, except they were so old/scratched/dirty that what it actually checked was hit or miss.
                      SECOND they don’t assume gender, so you have to check that you do/don’t do a daily breast exam and (separate line) testicular exam, no matter if you have them or not.
                      PFUI.

                      1. Some women do do daily testicular exams… of course they often get paid for doing so.

                      2. “Yes, the other doctor told me I have ovarian cancer last week, but now I’m representing as male, so there’s nothing to worry about…”

                         1. Ovaries, testicles … to-MAY-to, to-MAH-to.

                      3. I keep thinking about the germ vector that old/scratched/dirty I-pad must be.

                      4. I have since decided that the proper answer to the question of whether you do a daily testicular exam should have been, “of course not, I’m married!”

                2. I live in Langley, my doc is in Burnaby (seen him once), and I can maybe get an appointment in 6 months.

                   1. VA? So glad I’m in TX then. usually not same day app’t but between a week and a month. Lots of dentists here. I’ve gotten any number of ads for dentists in the mail.
                      A lot of medical procedures are “day surgeries” and aren’t done in a hospital. Some of these places are better than the hospital.

                      1. Langley and Burnaby are towns in the vicinity of Vancouver, British Columbia. They’re located about 20 miles apart.

                      2. We have some of those “surgical centers” in here in Arkansas. Usually quite modest in size, sometimes in strip malls. My wife had carpal tunnel surgery and rotator cuff surgery at one.

                         So far, I like them. They operate on the “outpatient” system, so you go home the same day.

                         There are also quite a lot of “diagnostic centers” with MRI and CAT scan machines, which most local hospitals *don’t* have, for whatever reason. Modern diagnostic equipment has probably exceeded the capability of all but the largest practices, and the local hospitals seem to all be behind the curve compared to the strip mall outfits.

                         1. My wife had two or three of her plastic surgeries in one of the non-hospital surgical centers. I was pretty happy with them.

                            Around this area, most if not all of the hospitals have CAT scans and MRIs, but there are also diagnostic centers with them, as well as testing centers for X-Rays, blood tests, and I don’t know what else.

                            I’m still amazed that they can make headsets that can carry video and sound in the maw of an MRI.

                            1. I expect the local problem dates back decades, to when the equipment was very expensive even for a hospital. The smaller hospitals deferred purchasing MRIs and CAT scanners and just used ambulances to send patients to one of the two or three larger hospitals in Little Rock. So it got established as The Way Things Are Done.

                               Meanwhile, the hospitals in Little Rock decided not to upgrade or expand their equipment, leading to long waits for antiquated machinery. They’ve started sending patients 150 miles to hospitals in Memphis when the best equipment is needed.

                               Heck, the local “Regional Hospital” doesn’t even have an MD on site in the evenings; you wait two or three hours, then a nurse “evaluates” you, and then the send you to an ER in Little Rock… it took longer than it should have for us to realize how the system worked, and that just driving to Little Rock in the first place saved a great deal of time and expense. That wait and referral, without so much as a band-aid, usually cost between $500 to $1000 between deductibles and co-pay.

                               The equipment can’t be that expensive; there are several companies with “MRIs on a truck” that circulate all around the state. Which is fine, if you can wait until next week when they’re in your town…

                            2. The equipment can’t be that expensive; there are several companies with “MRIs on a truck” that circulate all around the state. Which is fine, if you can wait until next week when they’re in your town…

                               Which is probably making the hospitals look around and say, “We don’t need an MRI, now that those guys are available.”

                3. If socialized medicine is so awesome why do they need to force doctors to do anything? This perfectly perfect system should be able to pick the best of the best to be doctors even in the most rural errors.

                   1. Ahhh, the stories I have heard. Family had a doctor in Peterborough (smallish city), that left to return to the big city of Toronto because it was too far of a drive for his music conservatory lessons. Most new doctors are still enamored of the big city life and find small towns to stifling for their social lives.

             2. I am sure they will move on to blame greedy doctors, nurse, drug companies, ect for not being willing to provide current amounts and standards of care for minimum wage.
                And then the purges will begin. And when they kill off all the doctors……..

    2. Did you see the tantrum that the California Nurses union threw when a Democratic politician (of all people) turned down the proposed statewide universal healthcare because it wasn’t detailed? As in, it said California needed universal healthcare, put forth that it would cost an estimated 200% of the state budget, but didn’t have specifics as to how it would be implemented or paid for. They were attacking him as an opponent of their proposal and he was simply saying, A vague guideline is not enough for a law.

       (Mind you, he might be in favor of statewide universal healthcare in general, but give the guy the credit for being able to see when something is literally unworkable.)

       1. That reminds me of this timeless classic from the floor of the CA Assembly.

       2. Worse, iirc the California healthcare bill had already been passed by the other state legislative body.

          1. IIRC, it had been passed along from committee to the (?) Senate. Basically, it was “kewl. go ahead and do it, guys!”

             But I’m no longer a Californian, and have little interest in how they choose to self-immolate.

             1. yeah the ‘can you sigh this petition???” people at wal-mart don’t like me anymore….

                1. Sorry, I can not sign your petition as I am not fluent in American Sign Language. Would you like me to interpretatively dance your petition, instead?

                   1. no, that isnt it at all… petitions like that are how the ‘propositions’ in CA get started… i.e. citizens amending the Ca constitution with stupid bs like the plastic bag ban..

                      “Can you sign this petition to stop the gas tax hike?” (enacted by the CA Assembly, you see, cash for clunkers means people have more fuel efficient cars means CA is running horribly short on high speed train graft money err i mean gas tax money)

                      “I won’t be in this state when it goes into force, not my problem. If you don’t like it, you shouldn’t have voted for the people that enacted it.”

                      the shocked expression on their faces , totally worth it.

                      1. I regret being less than clear. My interpretive dance for such things generally involves lots of waving my two middle fingers in upraised position.

                         1. but i enjoy rubbing their noses in me escaping their statist one party rule bullshit

       3. Much easier to deal with one organization that you can bribe legally to get pay and benefits vs dozens of hospitals that taking money from your members checks and paying the negotiators is illegal with.

       4. The funny thing is, whether it be California, or Colorado, or even Vermont, when an actual “universal” health care proposal gets enough detail, the proposal gets shot down as way too expensive.

          I suspect that the same thing is going to happen with National “Universal” Health Care, even though ObamaCare was supposed to sabotage what was left of the free market so that it would supposedly become universal….

          1. The thing is, there was enough information on the California single-payer plan to make it pretty obvious that it was going to collapse the budget. The numbers were actually published. IIRC, $400 billion in costs. $200 was supposed to come from the Feds (who are apparently paying that much to the state right now for healthcare stuff). $100-$150 billion from employers who would no longer need to pay for their employees’ health plans (which is currently required under state law). That would leave another $50-$100 billion. IIRC, a method of paying for it had been suggested, though I don’t remember all of the details. A payroll tax and a sales tax hike (on top of the already super high sales tax we’re already paying here in Los Angeles County) were part of it, though.

             So yeah, people thought, in all seriousness, that it was actually doable this time.

             Note that the state budget right now is $188 billion.

             1. The proposed tax hike on certain businesses (making above $XK) was something along the lines of 3.X%. Not on profit; on gross receipts.

                Now grocery stores, for example, both fall above that line AND make a profit of a certain percentage less than that proposed tax. And the idiots proposing this tax didn’t see that there would be any secondary fallout (like, say, immediate rise in food prices) (poor hardest hit, and that isn’t even a joke).

                1. You don’t need to pass basic economics, or even be able to balance a checkbook, to get elected in CA.

13. The NHS is responsible for killing a lot of people, and will doubtless kill more in future, but they shouldn’t get primary credit for the death of Charlie Gard. That credit belongs to the British and EU laws that allowed the State rather than his parents control of Charlie’s fate.

    In a free country, his parents would long ago have said “Up yours” to the British doctors, and would have taken their baby – and their privately raised medical fund – to a doctor who was willing to treat Charlie.

    Britain is no longer a free country. Take note.

    1. Very few countries have ever been even within shouting distance of Free. American has come closest for longest, but even here it has been episodic and is vanishing fast.

       The idea that the Common Man deserves to be peft alone by his self-styled Betters is one of the most radical ever expressed, and subversive of every Social Norm.

       1. As I have said before if there is one idea that underlies Libertarian theory and much Conservative theory that I can no longer belief is that most people want to be free. Rush Limbaugh calls it that natural yearning of the human spirit to be free.

          I think most people fear freedom and want the “certainty” that comes with being unfree. For exhibit A I offer how many Americans want to happily surrender their patrimony to the state. For exhibit B I offer how few people behind the Iron Curtain tried to escape. During the Cold War we celebrated the daring and ingenuity of those who fled to the West. Perhaps we should have wondered why they were so few.

          1. This was one of the things that first ticked me off about the younger Bush. It’s a lie we were told in our youth, that everyone wanted to be free.

             Really? You mean like those North Vietnamese? *smdh*

             1. Or Californians…

                Like I keep saying, “freedom” is just an abstract term to many people, and now something they put any value in. They do what they’re told, the System doesn’t crush them (too much), life goes on.

             2. Read the ending of the last Nick van Rijn story in Poul Anderson’s Trader to the Stars.

                “Do you think that they yonder is free?!?” His hand chopped downward in scorn.

          2. For a lot, people want someone to guide 80% of what they do. The other 20% they may have their own desires but they don’t want to run any risks. So it is once again personal rewards and socialized costs.

             If you want to try and rewrite the Great American Novel go for it. But it’s not my responsibility to underwrite your choices.

          3. Um. Because a person can’t want something quite badly without being willing to risk having his family tortured to death if he tries to get it.

             Sheesh.

             1. That still doesn’t explain the smaller numbers. Also, families fled as a whole.

                There was also no striking back at the commissars to make them afraid as Solzhenitsyn pointed out.

                The simple fact is “head down and they won’t notice us” is much more common in human history than “stand up and be free”. Even now, in the US and a few other parts of the Anglosphere, there is more dedication to freedom and facing risk for freedom than most of human history. I think we universalize that mindset at our own peril.

                1. Happily, America has a number of institutions, such as F.I.R.E., the NRA and the Second Amendment Foundation, dedicated to helping defend our rights against encroachment.

                   Heck, even the ACLU will occasionally defend the rights of the unliberal, if only to maintain their facade of non-partisanship.

                   Judge Tells Marine to Choose Between 2A Rights And Fostering Grandson
                   On Monday, the Second Amendment Foundation (SAF) filed a lawsuit against Michigan’s Department of Health and Human Services (MDHHS) for impeding on foster and adoptive parents’ Second Amendment rights.

                   SAF filed the lawsuit on behalf of two couples: William and Jill Johnson and Brian and Naomi Mason.

                   The Johnsons were going to take custody of their grandson to keep him from going into foster care. When they went to pick up their grandson, William, a retired, disabled Marine with a Concealed Pistol License (CPL), was searched for a firearm. He was not carrying a firearm at the time. At that point, agency officials told the Johnsons that they would be required to provide all firearms’ serial numbers to the agency as part of a registry. When Johnson questioned agency workers, he was given a surprising response.

                   “If you want to care for your grandson you will have to give up some of your constitutional rights,” a MDHHS worker retorted.

                   When the Johnsons appeared before a Gogebic County Court judge, the judge reiterated the agency worker’s statement.

                   “We know we are violating numerous constitutional rights here, but if you do not comply, we will remove the boy from your home,” the judge said.

                   According to Alan Gottlieb, the Founder and Executive Vice President of the Second Amendment Foundation, the statements from agency workers and judges were outrageous.

                   “This amounts to coercion, with a child as their bartering chip. I cannot recall ever hearing anything so offensive and egregious, and we’ve handled cases like this in the past. Blatantly telling someone they must give up their civil rights in order to care for their own grandchild is simply beyond the pale,” Gottlieb said in a statement. “This is a case we simply must pursue,” Gottlieb said. “State agencies and the people who work in those agencies simply cannot be allowed to disregard someone’s civil rights.”

                   The lawsuit alleges MDHHS’ policy violates foster parents’ right to self-defense inside and outside of the home, which is protected under the Second Amendment.

                   1. Seems like Posner’s affliction is contagious.

                2. Fair enough. I do agree that the impulse to trade ones long term birthright (liberty) for a mess of short-term gratification pottage (security) is an ancient and universal human impulse.

                   Nonetheless, that criticism of the folks living in a police state for not being more willing to send their families to the gulag is grotesquely unfair. That any did so – and continue to do so – there’s a chap in Cuba who spent decades in a dark, concrete box just to be free in his own mind – is proof that the desire for liberty is real and powerful.

                   It’s not enough to assume that it’s enough, or that it won’t be in conflict with other strong desires or that human nature isn’t broken and that the greatest lights of human virtue and endeavour aren’t continually undermined by petty temptation.

                   Darkship Revenge is really good on this one.

                3. The cost of not trying: it’s a big “maybe.”

                   The cost of trying: anybody you leave WILL be horribly murdered, and you have a much bigger risk of that “maybe” happening.

                   If I remember right, the Norks go up to your grandparent’s sibling’s descendants.

    2. Very hard to have freedom when you don’t have the tools necessary to rebel against tyranny.

       1. From guns… to knives… to acid…
          So when they start regulating acids…
          How long before nothing is clean because what happens if you mix cleaners?

          1. Back to wells and outhouses because Lord knows the damage one can do with a three foot section of metal pipe. Plumbing is a gateway activity to deadly violence.
             Will note in passing that a major source of pestilence in London many years back was contaminated public wells. That, and a lack of proper disposal of sewage.

             1. No outhouses. Shovels will have been confiscated long before pipes. Welcome to the return of Medieval Europe, where people walk in the streets because walking on the sidewalk is likely to get a chamber pot emptied on your head.

                1. Fortunately those people walking the streets will be in no danger of being run down because efforts to limit GHG emissions will have banned private automobiles. In future all automobiles will be property of government for essential government purposes and of private companies willing to pay the usage fees.

                   1. Somewhere I have the start of a semi-steampunk story where Europe does just that after the Greens and hard-right take over.

          2. I think I saw something over at Instapundit the other day that noted that Great Britain is considering restricting the shipping of knives through the mail.

       2. I’ll have to dig out my copy of the US Army’s Special Forces & Guerrilla Operations Field Manual (I use it for research for my fiction writing, I swear!) but as I recall… well, let’s just say that ordinary household goods like, say, for instance, detergent or match heads, can be used in some, *ahem*, creative ways. Same with, say, petrol or, perhaps, whiskey.

          1. Sorry, my mistake, it was the Special Forced Handbook (ST31-180) that I was thinking of.

    3. There’s a line in a song (about 2 Irish immigrants to the US) in which this country is referred to as ‘the land where no man has to bow.’ It was never 100% true, of course, still, it was more true here than most places and was always a guiding star. I think there was always a set of people in America who have found that particular characteristic of ours to be very irritating.

       1. And they’re doing their damnedest to redefine that as a bug, not a feature.

14. C4c

15. Who is the customer? Is it the patient, or in this case the patient’s parents? Is it an insurance company of some sort? Is it the government? That is who the market will listen to and attempt to serve.

    Even when I had to have O’care compliant “insurance,” I was still paying out of pocket for everything because 1) my docs were not on the plan available and 2) I wanted to keep control. Now I’m in a mutual assurance pool. I will lose this when I turn 65, but I am the customer and I call the shots.

    One thing the NHS doesn’t brag about when they talk about how wonderfully death rates decreased with the creation of the NHS in Britain is that it was antibiotics, not the NHS, that saved so many lives. The creation of the NHS coincided with the ability to mass-produce penicillin.

    1. Have you looked into a Medi Share program? They are an exception to O Care coverage requirements, and are much cheaper. You pay for your care, in cash and whatever price you can negotiate for doing so, then you send in the bill and get reimbursed. The plans I’ve looked into recently are about $220/ month for 1 person and $400 – $500 family/ month. You can submit everything, or just the large stuff, as you choose.
       For the present I’m staying with my employer provided insurance because it is cheaper, but the difference isn’t much.

       1. This is similar to MediShare. It’s a little more than what you were quoted per month, and I opted not to get routine check-up coverage because the out-of-pocket is so low for me as it is. ($350 or so for two docs and labs)

    2. Yep. This is true in almost all countries with socialized medicine, and that’s why it stuck. They saw all the gains upfront.
       Here, all we’re seeing is the losses, and if they don’t stop this shit, we WILL revolt. All it takes is a couple of Charlie Gards here and they’ll be dangling from lampposts.

       1. At the time, when care consisted mostly of support and maybe simple drugs you could make some financial argument, but today between medmal, new testing, expectations, and the changes in populace that have resulted in increases in certain “lifestyle” diseases you either pay for nothing else or you draw the line that you are willing to do.

          And politicos lose votes if they do the latter out loud so it’s bureaucracy that just fails to schedule and gives cost conscious “guidelines”

          1. “And politicos lose votes if they do the latter out loud …”

             And that kiddies, is why we have the Administrative State and have seen our liberties increasingly eroded. Politicians bewail current conditions, pass loosely defined laws to address the problems and leave it to bureaucrats to fill in the details … then complain because the bureaucrats filled in the details in ways that produced results politicians didn’t want to take the heat for intend.

             Rinse, wash, repeat.

          2. the changes in populace that have resulted in increases in certain “lifestyle” diseases
             And so, yet again, socializing negative consequences leads to more of the bad behavior.

          3. As I wrote elsewhere, the problem with conservatism/libertarianism is that we have nothing with which to buy the votes of enough people to restore the republic.

             1. There’s a second problem: it’s difficult to find people who want to participate in government from among people who want nothing to do with government….

                I seem to recall that the Democrats were having trouble finding a new slogan for 2018. Apparently they didn’t even consider “I’m going to take away free stuff, dismantle cherished government institutions and regulations, and if you want a job, you should go out and find it yourself!”

                (Although from what I’ve heard, even that would be better than some of the stuff they’ve been coming up with…)

                1. it’s difficult to find people who want to participate in government from among people who want nothing to do with government
                   So very true.

       2. Oh, you must have seen my post on him.
          *Must*
          *stay*
          *in*
          *control*
          *of*
          *my*
          *temper*
          I really dislike U.S. Marshall interviews.

          1. I’d really love to read your rant.

    3. Oh, in older son’s education and the way things are arranged. We are discarding half of our trained doctors at the end of each class (they don’t get residencies, they can’t practice) at the same time we are importing third world doctors (trained at a much lower standard) by the plane full every year. Cheaper? Or are our betters looking for people compliant enough to accede to Charlie Gard kind of stuff?

       1. If we have a doctor shortage, and part of it is discarding perfectly acceptable GRADUATES, then the system is, to put it politely, messed up.

          1. Ya’ think?

             Yes.

             It is profoundly messed up.

          2. Yep. On PURPOSE there are only slots for half the graduates. PLUS because of the shortage, most of fourth year is spent interviewing for residency and residents are treated like crap. (They can’t complain.)
             This on top of PERFECTLY QUALIFIED people being turned away from medschool because there’s only so many slots for entrance, so that for instance older son filled one of 180 slots, with something like 4k applicants, all with perfect undergrad grades (it starts there) and many with MSs to increase their chances.
             At the same time we are importing THOUSANDS of doctors (mostly from the third world, including a lot from Arab countries and China) EVERY YEAR. Nothing against the people, but the training isn’t even close to the same. (Not even in England.) It’s far more abbreviated and less demanding.

             1. Yikes.

             2. If only we limited law schools the same way that we limit medical schools … or freed medical schools to adhere to the standards employed to establish law schools.

                1. Law schools ain’t doin’ so well ,lately. Read Instapundit on “higher education bubble, legal edition”.

                   1. Or look at the discussion about whether the California Bar Exam is ‘too hard’ because too few law school graduates actually pass.

                      There has been several years recently where the number of jobs available for those that graduate and pass the bar has been less than the number that pass.

                   2. The point is that, unlike medical schools, there is a free market for lawyers. If we were to restrict professional schools for one of those two professions, which do you imagine most people would choose?

                      Heck, accredit both sets of schools based upon having a sufficient percentage of graduates pass the requisite boards and let the market sort it out. Right now accreditation is largely an exercise in restraint of trade by enforcement of caps based on essentially irrelevant criteria.

                2. I think Jerry Pournelle put it best in several of his Byte columns:

                   “The US government has programs where it pays farmers not to grow food; it needs one to pay lawyers not to practice law.”

                   1. Well, some of them get elected to legislatures.

                   2. I understand it has one: student loans (to new-made lawyers that can’t find work.)

             3. Residency is also something that concerns me — where we put doctors through 80-hour work-weeks, and (if I recall correctly) some 24-hour shifts. What’s the point of putting our future doctors through sleep-deprivation, in a field where mistakes can literally be life-or-death?

                1. And I have often wondered why someone can’t, with a minimum of training, become apprentice doctors? (Beyond the careful control of who can become a doctor, of course, so that the supply of doctors can be artificially limited.)

                   (And now that I think of it, it takes a lot of money to go through med school — to go into debt, only to be driven out, without a degree, and thus without the means to pay off the massive debt — is a special class of cruelty in itself…)

                2. Per the physician in the family (who was a primary care physician, not specialist), the reason is so you learn 1) what diseases and conditions look like as time passes and they progress or improve and 2) to get used to working when you are exhausted. Because when you get called in at 0200 for an emergency, you need to know how YOU respond and what you need to do to make yourself functional.

                   1. Yes. to an extent. But the other extent is this sh*t continuing for years, because residents are $15 an hour. As with a lot of other things it’s “a good idea that has gotten more than a bit crazy.”

                      1. And of course that makes the dismissing of half the pool of candidates even more ridiculous.

             4. I have watched with some interest the development of the position of Nurse Practitioner, a fully qualified nurse with a great deal of additional training which allows them to perform many physician’s procedures and prescribe many drugs. Intended to take much of the strain off the constant doctor shortage particularly in rural areas with extremely scattered population.
                Huge pushback from the AMA and the medical profession in general.
                Their claim of course is quality of care. How they can say that with a straight face when medical error is the third leading cause of death in the US is beyond me.

                1. For quite a number of years my primary care came from an independent duty corpsman. He could- and did – prescribe antibiotics and painkillers and whatever else one could need for common illnesses and injuries. And was trained to know when he didn’t have the knowledge to treat and send me on to a doctor. A few times we had to medevac people in the North Atlantic to get them the care they needed. I’m extremely happy it was never me.

                   90% of what I see a doctor for I don’t need a doctor for except rules and regulations. If I could walk into into a pharmacy whenever I wanted and order up a selection of blood tests from a menu, and have them draw the blood and send it off, I could monitor my vitals more often and closely then the current every 6 month check by the doctor. And for less money. And if I were concerned that something was wrong, I could make a doctor’s appointment. And just think, the lab test results themselves could recommend seeing a doctor for treatment if numbers were out of whack.

                   1. THIS.

                   2. And that could be effectively anonymous, right?
                      As anonymous as something that contains your DNA can be.

                   3. The other day we went to the state fair with my mother and a friend of hers (that she’s known for decades; I was one of the kids attending his wedding). He’d had nurses’ training, and HE was the one who noticed that a particular combo of blood numbers on his wife’s tests was a red flag for leukemia. The doctors didn’t notice since both numbers were in tolerance levels. (Her leukemia is a type called “chronic” instead of “acute” and is apparently watched for danger signs. The things you learn…)

                2. Quality of care my @$$.

                   I saw the same doctor (pediatrician) three times. Each time, he said I was just constipated. Fourth time, he was out of the office so the nurse practitioner saw me. She took one look and told my Mom to get me to the ER right away. Four hours later I was in the OR getting my appendix removed. It had already perforated and actually ruptured when they set it in the little bowl after they removed it.

                   The nurse practitioner, and the rest of the nurses at that practice, never let that doctor how badly he’d messed up. He wound up being booted from that practice some time later. Something about not being good with kids, and allegedly repeatedly misdiagnosing conditions didn’t help his cause either.

                   1. Assembly line medicine can make similar mistakes. Story on that. When I was a company commander in Great Mistakes I was making room checks during mandatory study hours, and in one room a young man was in his rack. His roommates helpfully explained “He went to sick call this morning. He’s got stomach flu like everyone else.” Told him to stand up. Now I’m not a trained medical professional at all, but I took a look and said “He hasn’t got stomach flu. Take him down to the quarterdeck. ” He needed help just to stand upright. Informed the other CC’s in the building I was headed to the hospital. Got to the ER, told them “He hasn’t got stomach flu. Find out what’s wrong with him.” 15 minutes later a doctor came out and told me, “We’re prepping him for surgery. His appendix is coming out.” Early stages of appendicitis apparently resemble a lot of other things. Like stomach flu.

                      Difference between morning and evening? Morning he was one of a 100 or more young sailors at sick call with similar symptoms. Evening he had a CPO telling the corpsmen- “Find out what’s wrong with him.” If I was concerned- they were concerned.

                      1. Early stages of appendicitis almost everything apparently resemble a lot of other things. Like stomach flu.
                         Better, I think.

                      2. Been there, done that , got the appendectomy scar.
                         The early stages of appendicitis do manifest as something else. It took a few days of growing pain and discomfort until I was feeling ill enough to not eat, and some localized pain, for my parents to take me to the doctor. A quick exam put me in the operating room just a couple of hours later.

                   2. My mother (as a military dependent) kept going to the Air Force doctor complaining of various symptoms for months, only to be told, “It’s in your head” or “It’s generic female troubles.” It wasn’t until her cancer had metastasized to her liver, causing jaundice, that they bothered to actually do enough investigation to find out what was going on. By then, of course, it was inoperable.

                      1. Be fair. I was diagnosed with “menopause” at 37. Civilian gynecologists. Four of them. I finally had an hysterectomy at 53. STILL NOT MENOPAUSAL. What was actually wrong with me? My autoimmune was attacking my thyroid. Finally treated for a year and a half now, but not stabilized as to dosage yet.

                      2. Yeah. I haven’t had the war with my doctors yet—just the email back-and-forth of “you’re experiencing life changes.” If they don’t order blood tests when I go in, I will go to war. (When several different people say you need depression screenings, and you say you’re just always exhausted, and depression screenings basically come back with “you’re exhausted”, mayyyyybe you should do a blood test to screen out the usual suspects before advocating behavioral therapy. Just a thought.)

                3. “How they can say that with a straight face … ”

                   Oh, the things they can say with a straight face!

             5. Yes, the AMA does it deliberately to keep physician compensation high by removing marketplace incentives.

                1. Then there’s the proposition that the AMA did some time back, which was to ‘do a cultural genuflect’ toward FGM by doing a ‘ceremonial nick.’

                   Of course, there are plenty of doctors who will do it anyway, even in the US. Full FGM too, usually doctors who came from that ‘culture…’

                   *snarling expletives, need to walk away to cool off*

                   1. “need to walk away to cool off”

                      Really chafed your chaps, eh?

                      1. Mostly because I recognise the proposition as being no different from how they snuck in abortion as being socially acceptable – ‘It’s safer, it’ll be in a medically monitored environment, it’ll be safer for everyone around (let’s not mention the one getting cut / getting aborted.)

                         https://shadow.affsdiary.com/2017/07/21/moral-and-informed-choices/

                         1. Well, I’m not sure I’m happy about male circumcision either. But that’s still pretty widespread in the U.S., although changing glacially slowly.

                            1. I don’t like circumcision for men as babies; and frankly I didn’t do that to my sons. In the Philippines, it’s a male cultural rite of passage done at, or just before puberty, which is still common enough that there are huge local-government sponsored ‘circumcision events’ where it can be done. Choosing to have it done as an infant does happen, but not as much, I don’t think.

                               Personally, I wouldn’t have my son circumcised at any age. There’s quite a bit of personal squick there, admittedly. I understand some of the hygienic reasons, but I’m also aware that it’s perfectly possible to keep that part well cleaned if proper teaching happens (which is, to my mind, one of those things a father should be teaching to his son.)

                               I was able to wriggle out of the cultural reasoning by citing that it wasn’t something that was in his father’s culture as an excuse. ^.^

                            2. Sometimes circumcision is a medically necessary procedure. When the foreskin closes up and you can’t pee, it’s a painful experience. If it goes on too long, well…

                            3. Oh yeah. I know it’s medically necessary for some. Like abortion is needed for ectopic pregnancies / pregnancies where the placenta has grown over the cervix/weird anomalous medical reason and there really ARE women who need vulva trims. They’re not included in this at all (sorry if I gave that impression.)

                            4. A large difference between removing a bit of mostly pointless skin and actually damaging or removing a functioning “organ”.

                            5. Being a circumcised male I know I have never missed my foreskin. On the other hand I do believe it should be up to the parents whether it is done or not, on the principle that doctors should not do procedures on their own initiative* without permission from either the patient or family if the patient is not capable of making decisions at the time.

                               *With the exception of lifesaving procedures in trauma type situations, etc.

                2. Yes, the AMA does it deliberately to keep physician compensation high by removing marketplace incentives.

                   If that were true, they wouldn’t be importing thousands of doctors from overseas every year.

                   1. That’s how it originally started. They can’t control everything. They HAD to allow the government to bring in foreign trained physicians or they’d have lost all control when the shortages reached saturation levels of dissatisfaction with American citizens. and we terminated them as a controlling organization. (Too bad it didn’t happen.) And Americans do have a preference for seeing doctors who aren’t foreigners.

16. Given the wholesale corruption of the Democrat Party, does anyone think access to socialized medicine would NOT rely on how much you had paid in bribes?

    1. I think it would not depend on bribery. I think political compliance would also be important.

       1. THIS. Both.

          1. Crazy talk! Anyone who believed this would believe that our government could weaponize the IRS or the FBI. After all, as Heinlein pointed out, they call themselves civil servants.

       2. Political compliance is a form of bribery.

          1. Technically I think political compliance is a form of extortion.

             1. Fair point.

       3. There are already examples of this in the UK with the NHS. Specifically, I remember an anti-abortion activist being denied care at a local hospital because of all the letters he sent them about abortion (admittedly with graphic images but the point remains).

          Then again, we’re only talking about healthcare for deplorables not important rights like cakes for gay weddings.

          1. “… important rights like cakes for gay weddings.”

             I have this sudden urge to see a film (or skit, I admit to being more peculiar than particular) featuring a cake fight at a gay wedding.

          2. Would anyone care to bet against the idea that one reason for the abysmal performance of the VA is because the Deep State doesn’t want veterans surviving to participate in a revolt?

             1. Conspiracy thread is upstairs….

                1. What makes you think it requires a conspiracy? Just a pool of government workers who are the products of a K-12 and college education which says soldiers are a bunch of mindless killer myrmidons who are victims of trauma and brainwashing.

             2. m not attributing it to malice, because incompetence and stupidity are just as likely.

                1. Don’t forget lazy.

                   “Not my job” covers a lot.

                   There’s also the aftereffects of prior fixes. (I spent half an hour on the phone today, when it probably would’ve been ten minutes, but the phone system would re-dial the front desk ever 5 minutes I was on hold. And the medical system is so slow it takes at LEAST two minutes to print something up when you find it, and finding a nurse is another two minutes, and at least a minute to read the dang chart…. the poor office manager had to call me an hour later to verify that yes, they’d properly cleared the charge for the automatic service that I didn’t accept, but that’s automatically listed in their charges because IT’S RECOMMENDED! At least they never asked about guns.)

             3. Even five years ago I’d have called that paranoid. Times have changed.

                Yesterday on Instapundit I commented about a Russia story, “The Democrat Party became the John Birch Society so slowly I hardly noticed.” I then realized for a lot of people I’d have to explain that.

                Then I thought about the one John Bircher I’ve met and realized 35 years ago when I met him I thought he was paranoid. Now I wish I’d listened to him more to sift out the sane from the insane.

                1. But have you heard of the association of folks who insist upon Betula paneling for their restrooms? The Birch John Society.

                2. One of the reasons I grew to detest the Clinton Administration was that they made the Birchers credible. If for no other reason I opposed Hillary’s candidacy because of her reliance upon Sid “Grassy Knoll” Blumenthal.

17. Central control doesn’t work. Free market isn’t perfect but works best, Nothing is perfect.

    1. Socialism is alway perfect the next time it is tried.

       1. Just quoted that on my facebook page. Makes perfect sense.

    2. To paraphrase Churchill (or Franklin? someone, anyway):
       Free Market is the worst form of economics on earth – aside from all the others that have been tried.

18. c4c 😉

    1. c4c2

       …To read later. Have to work. Screaming not productive.

19. Forgot to click the ‘notify me’ box 😦

20. I have always suspected that Shaw imagined himself on the panel, and never imagined himself standing before the panel, trying to justify his own existence…and being found wanting…

    For a long time I thought the true failure in socialism or at least those who support it is they failed to understand human nature, specifically the virtue of laziness and how socialism allows that virtue to be a vice.

    In recent years I have conclude the true failure of socialists is they do not understand their own blindness. Just as those who cheered gov’t power being unmoored during Obama are now upset “not the people it was met for are getting it” under Trump the little Shaws among us (at least Shaw added something of lasting value in his plays which most socialists can’t even claim about the children they raise) fail to even imagine is the idea they will not be on the panel.

    They can’t conceive of a world where the panel is made up of retired Marines, wounded cops, fire fighters, and farms, rough people without sophisticated tastes and very, very practical mindsets. The kind of people that will find them wanting more often than now.

    However, reality is such that in the end such people do wind up forming such panels…Napoleon replaced the radicals of the Revolution and built a world more hazardous to them than the monarchies that proceeded him (and surrounded him).

    For that reason some days I want the socialists to get what they want.

    Good and hard.

    1. It did not surprise me to hear that the guy at work who was aghast at the idea of doing away with Karl Marx loved group projects in school – he could do very little and still get by as others did the work.

       Aw crap, now I have an idea for an evil time-traveler story about someone finding those who love group projects… and “forcefully applying selection pressure against them.” But is this traveler evil… or merely desperate?

    2. Embrace the power of “AND”.
       They really do fail to understand human nature, too. Even their own.

21. Lewis Washkansky, recipient of the first heart transplant, lived eighteen days past the operation. Obviously the procedure was not worth doing, was a waste of money and caused the recipient unnecessary pain. It ought not have been permitted, by the standards employed at the NHS. No “radical” treatments should be permitted, by their standards.

    I am reminded by a comment heard on NPR during the Hillarycare debate, that the most “cost effective” treatment for any medical condition is to end the patient’s suffering. Mass produce the Endit™ pills and they would be cheaper than the cost of removing a splinter (which, let us remember, can get infected, fester, induce gangrene and cause loss of limb or even life.)

    1. I do know at least one professor of medical ethics has written about how he introduces the “cost effective=death” comment into his class early on, because he wants his students to think about what they’re saying when they talk about cost effectiveness. (That professor is at least using it as a teaching tool rather than condoning it; I can’t say the same for everyone who talks about it.)

       1. Eventually every illness is a broken leg. And every person is a horse.
          And none (or almost none) are racing studs or such…. so…

          So that free market might have evils. They are, at least, the lesser evils.

    2. Isn’t it remarkable how concerned socialists become for the budget after they’ve seized control? They wreck the markets and blame “capitalism”, decrying the “suffering” it creates, when all they really want is the power to decide who dies and when.

       Life is precious to them when they’re not in charge, of infinite value (unless it hasn’t yet passed through the birth canal, mind you), until they’ve got the pursestrings.

       1. Reminds me of the New York subway system. It started out in private hands, but New York passed a law that forbade the company from raising ticket prices, and so eventually it became unprofitable for the company to run…and the City purchased the system.

          The City itself has adjusted ticket prices upwards quite a few times since then, and have had difficulty finding money to maintain the railways…

          1. The contract and franchise the subway companies signed that allowed them to construct and operate the subways limited fares to five cents for the duration of the initial contract period (25 years, IIRC). It also required the companies to pay portions of certain profits, but also required the city of New York to subsidize the companies for certain losses. It was tied to the fact that the major portions of lines were expected to be money-losers for years following construction; the city required their construction in order to encourage the population to spread out, decreasing density in the core. In effect the city’s refusal to permit fare increases also increasing the city’s own costs – but kept quiet the folks who’d be angry at fare increases.

22. You’re not the first person to make the case for the moral dimension of the free market.

    In the middle ages, nobody would have thought it moral or acceptible to starve slaves or serfs. Even kings did not claim this power in Western Civilization. But minor bureaucrats claim it now, over people who are supposed to be free.

    And to do this, those same bureaucrats claim a monopoly over who may provide medical aid or who may pay for it, and exclude everyone else from helping.

    I plan to write this in to the story I am writing.

23. Caution: before reading the appended article please prepare your shocked face for use.

    Healthcare CEO pay has grown under Obamacare, outpacing national average
    by Emily Jashinsky
    In the years since Democrats passed the Affordable Care Act into law, the CEOs of 70 of the largest healthcare companies have raked in a cumulative $9.8 billion in earnings, according to a new report.

    The survey, released Monday by Axios, found that these CEOs’ earnings “have grown faster than most Americans’ during that time.”

    “The ACA has not hurt the health care industry,” Axios’ Bob Herman reported. “Stock prices have boomed, and CEOs took home nearly 11% more money on average every year since 2010 — far outstripping the wage growth of nearly all Americans.”

    The survey also analyzed how CEOs stock earnings, which generate a major chunk of their total compensation, “don’t give them incentives to control health care spending,” erecting a critical obstacle to industry reform.

    “A gigantic portion of what CEOs make comes in the form of vested stock, and those incentives drive their decision-making,” Herman wrote. “The analysis shows that since the ACA was passed, health care executives routinely took measures to inflate stock prices — such as repurchasing shares or issuing dividends to shareholders — that led to higher take-home pay.”

    “Stock-heavy pay,” Herman continued, “also drives CEOs to do the exact opposite of their buzzword-laden goals of creating a ‘patient-centered’ health system that focuses on ‘value.'”

    Axios found that CEOs are less focused on taking actions that would benefit the system than actions that would boost stock prices, such as selling more prescription drugs, performing more procedures and tests, creating new medical therapies that may not add value to someone’s life, and raising prices above inflation.

    1. This is my shocked face. There are many other shocked faces like it. This shocked face is my shocked face.

       1. You want to get to know and love your shocked face. Someday, it may save your life.

    2. Stocks are a complication right now regardless of industry. Very much a case of “maximize before next shareholder meeting” rather than increase the intrinsic value of the business. So instead of keeping and advancing your experienced personnel you make it insufferable and replace em with new kids that have no pension, minimal health costs and low wages. Meanwhile employees cannot gain experience but merely bounce around companies learning the new environment for 6 mos to a year before even worth salary.

       Admittedly I have no idea how to fix. Returning to the idea of stock dividends vs just stock price is one idea.

       1. Well, the first step is for the government to quit treating dividends as something to tax twice as normal income (to the corp and then to the shareholder) while capital gains are taxed once and then in a favored manner. If the tax treatments are roughly equal I suspect most people would prefer cash in pocket.

          Not to mention that Enron like shenanigans are harder if shareholders want dividends and not capital gains. You can fool the market long enough for people to cash out gains but when you are writing quarterly checks you have to be able to cover them with cash.

          1. Traditionally, stocks that primarily measured their value by regularly paid dividends were known as “widows and orphans” stocks because they were a primary investment for trusts and other such prophylactics against loss of the primary family earner.

             Any who oppose such preferential treatment of dividends as you describe clearly want widows and orphans to starve.

             1. I’m not even asking for preferential treatment although I’d like to see dividends be a pre-tax expense to corporations…let he who can spend the money be the one whose income it is counted towards.

       2. Oh, I can fix that. All stock owners are jointly and severably liable for all activities performed by employees during their work hours, during the time frame stocks are owned.

          Would fix any number of problems. Starting by making employees with a history of non-screwing-up valuable.

          1. And then nobody not already rich is able to invest for retirement

             1. Rich people would invest where such was the law, they can afford to put their money in safer places.

                1. …wouldN”T invest…

          2. And seriously discourage the investment in stocks.

             1. Nah, it’d take a few years to sort out, but you’d get some sort of market in stockholder insurance, you’d get companies with very different attitudes towards following rules and towards lobbying for more rules, and you’d get smaller companies overall. You’d also get it written into every CEO, President, CFO, manager, etc, contract, that part of their compensation would be in stocks and they would be required to hold them their entire tenure in their position. You’d get a lot less stock speculation, I’m sure, but people would still find ways to hold stocks if they found company ownership valuable. It would just put all companies back to an evener playing field, the same place the small business is, which would be good for competition. If you’ve ever had a small business, the banks want you to use your home as collateral for a business loan, so if something goes wrong, you’re personally screwed. Be good for big businesses to face the same consequences. It’d also be good to deperson them, and with the owners facing the consequences of the businesses’ activities, it’d make it pretty clear that corporations aren’t people.

                Or do you really think no one came up with ways to invest before limited liability corporations were invented?

                1. “Or do you really think no one came up with ways to invest before limited liability corporations were invented?”

                   No, they simply made do with less effective means, usually by involving nobles and the church who were shielded from liability in other ways. Let’s not encourage feudalism any more than the Left is already.

    3. Are we talking about insurance company CEOs? Or CEOs of care delivery companies, such as hospitals? Because I can readily explain why both would rise under Obama; with it clear that every decision is going to be second guessed by the State, and that the State is actively trying to bankrupt the whole market, it becomes necessary to pay high salaries to get anyone tomsit in the hot seat.

       1. I think it is delivery companies. It might be noted that many of those delivery providers have grown more dominant in their home markets, often achieving monopoly status. In my county the main hospital has not only bought the other hospitals in the area it has bought many care providers (or, at least, it provides billing services for them) so that it hardly matters where you go; if it isn’t urgent care (and maybe even then) it is the One that in the darkness binds them.

24. A friend of a friend of Little Brother’s is in surgery today for an antibiotic resistant infection. LB and I keep saying we need to write a story about the rise in antibiotic resistance, but we haven’t the time, and the news keeps getting ahead of our proto-plot.
    I expect if the various socialized medical systems don’t crash soon, it’ll be the old STDs, new mutant multi-antibiotic resistant strains, that bring them down.

25. Something to keep in mind in any discussion of healthcare reforms in America. When the CBO repports that some 22 million Americans will be without insurance coverage under any reform, three quarters of those are because they will willfully decline coverage. The remainder are attributable to loss of Medicaid coverage.

    When discussing Medicaid coverage, four facts matter:

    1. Almost the entirety of increased Obamacare coverage is due to people being put on Medicaid.

    2. Medicaid patients are frequently refused service by medical providers because reimbursement rates do not adequately cover costs of treatment (in most cases, where treatment is prvided, the difference is billed to private insurance, raising the costs of insurance coverage.)

    3. Medicaid cverage has been demonstrated to provide no better results than being uninsured:

    The Oregon Experiment — Effects of Medicaid on Clinical Outcomes
    BACKGROUND
    Despite the imminent expansion of Medicaid coverage for low-income adults, the effects of expanding coverage are unclear. The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate these effects.

    CONCLUSIONS
    This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.
    NEJM

    4. Because of the nature of its funding, states have no incentives to reduce Medicaid coverage nor make it more efficient, therefore its portion of the Federal budget is growing uncontrollably.

    1. Another thing I am skeptical about with these numbers, is whether they are taking into account the middle-class people who have lost their ability to pay for insurance, and those who can still pay, but only just barely, because they are now paying through the nose, both due to rocketing insurance premiums and expanding deductibles — both of which ObamaCare was supposed to reverse.

       I *really* wish we had a natural mechanism in law where, if the purpose of the law isn’t achieved, then it’s null and void. ObamaCare would be scratched immediately, and it would save some poor schmuck from jail time if they transport lobster in cardboard because they are unfamiliar with the need for lobster merchants to ship lobster in plastic for environmental and hygienic reasons that don’t apply to individuals taking lobster home. (And, for that matter, to save the merchants themselves, when it is demonstrably proven that the law doesn’t even work as it was intended!)

       1. rocketing insurance premiums and expanding deductibles — both of which ObamaCare was supposed to reverse
          That’s because of your ridiculous insistence on “legalities” and “constitutions” and such! If you had just let us subsidize, using whatever money was laying around, and to heck with the law, we wouldn’t be in this position!
          /prog

    2. *raises paw* I’m “not insured” because my type of coverage is non-compliant. But I still have an insurance-like coverage.

    3. Just one data point from here out west: Publicly available enrollment reporting indicates that more than 30% of the population of Los Angeles County are enrolled in one or the other of the state-blessed Medicaid (in CA, Medicaid is called MediCal) HMOs.

       Basically one third of the entire population of LA County is enrolled in the system that was intended as a last ditch safety net for people too poor to have any other coverage.

       And that fraction keeps increasing year over year.

       It won’t be Medicare for all – it will be Medicaid.

       1. oh, they know it, the single payer proposal for CA banked on it- literally, it was going to take everyone’s insurance premium money and give them MediCal (Medicaid)- so, universally crappy health care.

26. One way the government muddies the medical waters is by defining insurance pools — those grouped together for actuarial accounting of projected medical costs. Surprisingly, these pools are typically not defined by physiological similarity, such as gender & age & ethnicity. They are defined by geographical consanguinity — you are presumed to be blood relation to everybody else in your community.

    In many states this community is defined as the entire population of the state, as if somebody living in Virginia’s Blue Ridge has more in common with Tidewater residents than with neighboring Kentuckians, Tarheels or Tennesseans, even as those neighbors may utilize the same medical providers.

    Reimbursement rates for Medicare are typically determined by geographical regiion, a definition that is as subject to political hanky-panky as gerrymandering of voting districts (probably more, as there is less oversight.) Thus Medicare payments for Milwaukee were once (may still be) tied to those in Chicago as a payoff benefit to Milwaukee medical union (from Nurses to janitors) members even though costs of living and other relevant factors are dissimilar.

    One reason church-based insurance works is that it groups people of very similar risk profiles, there being a reduced likelihood of drug abuse, out-of-wedlock childbirth and other risk rising behaviours. It all depends, as you notice, on how you define the community insurance pool. Start telling vegan marathonists that they can get a lower insurance rate and pretty soon you have free market advocates.

27. Interesting article I found via Isegoria, about the Communist takeover of Portugal. There are some very interesting parallels between how that happened and what’s going on here in the US, when you look at the slow-motion capture of the academic and government by the Left…

    http://www.socialmatter.net/2017/06/29/how-communists-overthrew-salazars-regime-in-portugal/

28. WHOLLY unrelated …

    US Navy ship fires warning shots at Iranian vessel
    DUBAI, United Arab Emirates — A US Navy patrol boat fired warning shots Tuesday near an Iranian vessel that came close to it during a tense encounter in the Persian Gulf, an American defense official said.

    The incident involving the USS Thunderbolt, a Cyclone-class patrol ship based in Bahrain as part of the US Navy’s 5th Fleet, is the latest confrontation between Iranian vessels and American warships.

    The Thunderbolt was taking part in an exercise with American and other coalition vessels when the Iranian patrol boat approached it, the official said. The Iranian ship did not respond to radio calls, flares and sirens as it came within 150 yards (137 meters) of the Thunderbolt, forcing the US sailors aboard to fire the warning shots, the official said.

    The Iranian boat went “dead in the water” after the shots and the vessels all left the area without further incident, the official said.
    [SNIP]
    Iranian forces view the American presence in the Gulf as a provocation by itself. They in turn have accused the US Navy of unprofessional behavior, especially in the Strait of Hormuz, the mouth of the Persian Gulf through which a third of all oil trade by sea passes.

29. If you keep messing with bull you’ll have to deal with the horns.

30. While socialized medicine’s hard fought battle to murder a little boy is disturbing, it brings to mind Terri Shiavo, who died of thirst in a hospital. That implies that perhaps the problem is one of the declining value of human life in the West rather than a strictly socialized or free market medicine debate. If Western culture valued human life, a board of socialists wouldn’t have condemned a little boy to death. Nor would judges and medical staff have condemned a woman to die in a manner that we wouldn’t use to execute the worst convicted serial killer.

    The irony is that it’s exactly this sort of non-existent compassion that advocates of socialized medicine believe is an incentive for government health care. Yet if the value of human life is in decline, there is no reason to expect that the government would look at anything other than expense.

    Free market gives some freedom from this in that a service will be provided if some are willing to pay for it, yet the declining value of human life affects this, too, in that it lessens altruistic motivations. That’s why my father doesn’t agree to resuscitate orders: he doesn’t know the ones making that decision enough to trust them.

    The bottom line is as the value of human life declines, we’re up @#$% creek. Socialized medicine just gets us farther up it quicker, but both is still @#$% creek.

    I don’t think it’s a coincidence that the declining value of human life follows the declining influence of religion in the West. Deist Benjamin Franklin supported religion basically on these grounds. He once wrote to Thomas Paine that if men were so terrible with religion, what would they be without it?

    I think we’re starting to see the answer to Franklin’s question.

    1. Schiavo was different. Her husband had control of her. yes, he was the wrong person, but there it was.

       1. Yet with Shiavo there were doctors and nurses willing to let a fellow human being do without food and water until she died of thirst.

          Before anyone brings it up, yes, I know of cases where the organs start to shut down and a person feels neither hunger or thirst. I’ve seen that happen with an individual in our family. I also know that when a person is brain dead there is no hope, as happened with the wife of a friend. The thing is Shiavo didn’t fit neatly into these categories. From reports, including some nurses, Shiavo was capable of some very limited response to stimulus, such as sucking the moisture out of a rag, hinting that she felt things such as thirst even though she no longer had cognitive ability.

          Yes, her husband legally had the right to pull the plug – but it wasn’t his hand on the wires. Someone besides him had to agree to do such a thing, and that implies some very disturbing things.

          1. Speaking of brain death diagnoses …

             Neurologist backs family’s fight to revoke teen’s death certificate
             A Northern California family fighting to have their daughter’s death certificate revoked has won the backing of a retired neurosurgeon who is a longtime critic of how brain death is classified.

             Jahi McMath was declared brain dead after a 2013 tonsillectomy went awry. McMath’s mother, Nailah Winkfield, previously acknowledged that her daughter suffered severe and irreparable brain damage, but said her Christian beliefs compel to her to continue fighting to keep the teen on life support.

             In court documents filed last month, Dr. Alan Shewmon, a professor emeritus of pediatrics and neurology at UCLA, said videos of the teen taken between 2014 and 2016 prove that McMath is alive, and that her condition is improving.A Northern California family fighting to have their daughter’s death certificate revoked has won the backing of a retired neurosurgeon who is a longtime critic of how brain death is classified.

             Jahi McMath was declared brain dead after a 2013 tonsillectomy went awry. McMath’s mother, Nailah Winkfield, previously acknowledged that her daughter suffered severe and irreparable brain damage, but said her Christian beliefs compel to her to continue fighting to keep the teen on life support.

             In court documents filed last month, Dr. Alan Shewmon, a professor emeritus of pediatrics and neurology at UCLA, said videos of the teen taken between 2014 and 2016 prove that McMath is alive, and that her condition is improving.

             “Jahi’s subsequent course defied all predictions of what must happen to dead bodies maintained indefinitely on ventilators,” Dr. Shewmon said in his filing. “Jahi McMath is a living, severely disabled young lady, who currently fulfills neither the standard diagnostic guidelines for brain death nor California’s statutory definition of death.”
             [END EXCERPT]

             1. The guy who writes the “human exceptionalism” blog over at NRO was one of those who thought the girl was brain-dead, but from memory he was uncomfortable with how possessive the hospital was about the girl escaping.

                Given that she is still alive, he reversed his prior belief that she was brain dead. (Short version, if she were genuinely brain dead, the machines wouldn’t be able to keep her going on even an even keel for very long. She’d shut down, machines or no.)

    2. I’m beginning to think the value of yours or anyone else’s life is directly dependent on how hard you’re willing to fight for it.

       “I’m sorry Mr. Smith, but your life has been rated as a 1 and you are no longer entitled to healthcare or government rations.”

       “But how am I supposed to eat? What happens if I get sick?”

       “I’m sorry sir; but you are no longer our problem. Government regulation stipulates that no one is eligible for healthcare unless they have a rating of 3 or higher. If you had even two people willing to fight for your life with you, you’d qualify.”

       1. “So.. you are murdering me. That means I have nothing lose.” *BANG*
          Or *STAB* or *SPALSH* or even *CRACK* “Now you have a zero, enjoy.”

          1. Reminds me of one of Larry Niven’s short stories about the organ banks.

             1. Yeah, though I could see it becoming more, “Now everyone in the Public Sector is a ZERO.” And any and all attempts to reset that… get reset.

       2. I’ve said for years that ultimately the only “rights” you have are the ones you are willing to kill those trying to take them away.

    3. I may be so bad at the religion thing that it doesn’t count. Certainly, I understand that there are taxonomic reasons to doubt the classification that I identify as. I’ve enough monster in me that long ago I looked down the path of no religion, saw where it would lead me, and attempted to turn away. I’m no great prize now, but I could be worse.

31. And this discussion has (unless I overlooked it) neglected the American teenager (15-year old or so) who was made a ward of the Commonwealth of Massachusetts while visiting that state as a patient in a hospital there because the hospital staff disagreed with her parents over her course of treatment.

    1. Here on this blog today, I believe that’s the first mention of it. But I’ve seen it pop up elsewhere in discussions of the sad story of Charlie Gard.

    2. If I remember the case correctly the “course of treatment” the parents were advocating was woo infested, and pretty much guaranteed to turn a treatable cancer into an almost certain death sentence.

       1. Actually (and I had to read the link), it was the hospital doctors in Massachusetts who diagnosed a psychological problem where none existed.

       2. Different case. If it’s the one I think it is, the parents got second (and possibly third) opinions that disagreed with that of the state hospital. So the state hospital used the fact that it was an arm of the government to seize the kid. Or in other words, there’s ample evidence to suggest that the state misdiagnosed the kid, and then seized her when the parents decided that the evidence didn’t support the hospital’s diagnosis.

          1. IIRC, she had some kind of nasty congenital issue, the hospital in Boston diagnosed her as psych and held her untreated for her physical issue for 16 months

    3. Which one. Every few years you see one of these. The ones that are popularized tend to be the faith healing and (reasonable man) obvious neglect. Sad thing is I expect that in time the ‘credential knows best’ mindset will mean that even someone of sound mind cannot refuse what someone with the proper letters after their name says. Even if they are wearing an I heart Kevorkian button.

       But I do remember one where it was a disagreement between docs and family. Family had gotten second opinion and that doc had changed treatment to suit the second opinion. But first docs disliked and called it abuse (IIRC it was a case of treatments were opposites and if wrong could be fatal).

       And in the meantime we can’t house the hefty percentage of homeless that have significant mental disorders or substance abuse because that would be restricting their freedom to piss in doorways.

       1. This one: https://townhall.com/columnists/michellemalkin/2017/06/28/the-brutal-battle-against-medical-kidnappers-n2347599

32. Why is is food cheap and medical care expensive? Because medical care is hard.

    Barefoot illiterate medieval peasants could grow enough food to live on, and even have some left over (to support craftsmen, priests, nobles). Barefoot illiterate “doctors” are generally useless.

    Yes, bacterial infections are relatively easy to treat – once someone has spent many million $ inventing antibiotics. Diabetes is controllable, once someone invented insulin – which still isn’t cheap.

    Any kind of invasive surgery requires great skill, expensive equipment, and elaborate protections against contamination – unless a 20% fatality rate is acceptable.

    Cancer treatment requires either exotic chemicals, costly radioisotopes, or fancy equipment such as the “gamma knife”.

    The U.S. could reduce its expenditures on food by about 80% IMO. If Americans were willing to give up meat more than once a week, and live mainly on potatoes otherwise.

    But I doubt we could reduce health care expenditures very much without dying a lot.

    1. Why is is food cheap and medical care expensive? Because medical care is hard.

       Gods, I don’t know where to start on this one.

       Agriculture is hard, too. Maybe a different kind of hard, but just because you can walk into a store anywhere in North America, Europe, or Japan and find plenty to eat doesn’t mean that farming is easy. Those medieval peasants weren’t guaranteed that they’d actually grow enough to feed themselves, or have a surplus for those city bound artisans. Non-political famines were still a thing until barely a hundred years ago.

       Knowing what and when to plant, how deep, what seed treatments, if any to use, how to help birth a calf or a foal, sheering sheep with out injuring them and risking predators smelling blood. These and thousands of other skills you have to have to make farming a viable endeavor.

       1. In 1900 about 50 percent of the US population were farmers; now it’s about three percent. And the other day I paid less that $2 for a gallon of milk (at Sam’s Club) for a gallon of milk for the first time in a long time. American farmers are very efficient; to an extent because they are supported by lots and lots of technology—agrochemicals (fertilizer, grow regulators, pesticides, etc.) farm equipment and so forth. NB: I do not farm, and I have not participated materially in farming in many years (1992?) although I live in a rural area and a few of my relatives farm. In other words, I’m not an expert, nor have I ever played an expert on TV; for ten years or so I was involved in the grunt work on my uncle’s farm.

          1. 1900 statistic is what I remember from high school, I think.

          2. And the other day I paid less that $2 for a gallon of milk (at Sam’s Club) for a gallon of milk for the first time in a long time.

             Really? At the local Kroger, I’ve paid as little as $0.99 for a gallon of milk, with my loyalty card, recently, and $1.69 has been the normal price for over a year. Down from a high of, I think, $3.49 a few years ago.

             Now, this is the store brand, but I really don’t know of any difference between that and the name brands.

             1. The lowest I’ve seen in several years was 2/$5 at Braums over the winter, during their icecream slack season. Otherwise it runs $3.50 to $3.95 for basic whole milk and 2%. I suspect being at the end of the transportation chain plays a role.

       2. The main difference being that only a couple of people on a farm actually need a high level of education, in order to do the planning, while the rest of the farmhands can get by with on-the-job training, and a far less in-depth education, to run a farm that will feed literally tens of thousands of people. There simply is not enough time in the day for doctors to cover as many people as farmers. And, while some work really doesn’t require a nurse’s level of education to support the doctors, there’s still the issue that ANYTHING could go sideways in treating a patient, and that would open up the doctor to liability.

          If a farmer uses the wrong pesticide on his potatoes, he loses a larger percentage of his plants than he expected. This hurts his bottom line, but we aren’t in a position where this is going to kill anyone.

    2. Part of the difficulty, though, is that even the simple things – due to gov’t interference, usually justified by the consequences of bad health care – require the person who does the hard stuff. An awful lot of doctoring involves little stuff, or you get a doctor involved because you need a prescription.
       Markets (whether free or not) change over time, with technology or knowledge or sunspots. But only free markets adapt reasonably well.

33. 1945 – “Just following orders”
    2017 – “Just doing my job”

    1. 309x:
       http://www.schlockmercenary.com/2011-01-20

34. I just realized there’s nothing here on malpractice suits, which drive up the cost of healthcare.

    Limit malpractice suits to like, you know, actual real live malpractice. Doctoring is an art as well as a science. We don’t all respond to the same medicines the same way. My wife breaks out with sulfa drugs- I don’t. Amoxicillin works great on her; I might as well pop sugar pills; they’ll do the same- nothing for me. She takes lisinopril, an ACE inhibitor for high blood pressure. Has side effects I don’t like. I take amlodipine besylate, a calcium channel blocker. Keeps the blood pressure down without that side effect. Last visit to my primary doctor he said virtually the same thing. Prescribing drugs for high blood pressure is guesswork. And sometimes people have to go through several. And sometimes they have no clue what causes BP to go high. I’ve been to the ER 3 times because my BP got to stroke range.Last time 190/90. And I was taking my BP medicine daily. A week earlier I had given blood- 120/80. Perfectly normal. Nothing had changed in that week. No stress, no new job, Nothing. So now I’m taking the same medication,, but more, with another. Guesswork.

    1. Deforming incentives in general:
       View at Medium.com

    2. You are actively engaged in the doctor/patient partnership, the purpose of which is your continued good health. Some patients just want a magic pill that makes it all better, and some doctors want you to just shut up and do as I say.
       Varying levels of responsibility and authority on both sides of the equation.

35. “No, because the profit motive doesn’t belong in health care”
    Let’s consider some details. Are healthcare staff allowed to choose their employer, to change jobs, or even quit healthcare altogether? I suggest that ‘profit’, in the sense of wages less necessary expenses, plays a role in such decisions. Do suppliers supply things – electricity, scalpels, ECG machines, mops and buckets free of charge? Or do they expect to make a profit? Do the builders of hospitals do it just for fun? Or do they too expect to turn a profit at the end of the project? So regardless of whether anyone approves of the fact, profit is deeply embedded in healthcare, as in every other sector of the economy where participants have any choice whatsoever.

    1. Any careful look at non-profits, such as United Way, tends to find them terribly inefficient, often corrupt and generally rewarding upper management far better than for-profit companies do (particularly when you allow for the financial scale of operations.)

       I don’t need to go on a rant this evening, but the “Not For Profit” scam is one of the most obscene ideologies ever played on humanity.

       1. Even since they started including personnel costs– this is still a major problem, because you’ll have 3k volunteers…and 10 very well paid management.

          ******

          I still think Goodwill should get credit for recycling, though.

36. To counter Bernie’s slogan “Medicare for All” I use “VA for All”. Just imagine the efficiency of the VA, spread over 20x as many customers.

    As for “it’s altogether not clear at all why these same forces shouldn’t cut medical costs as well” — sure it is. The answer is that they do. More precisely, in those few parts of medicine where the free market remains in existence — things like cosmetic surgery or LASIK — prices have dropped because of competition and the incentive to reduce costs. But for the most part, medicine is NOT a free market, it is a government-controlled monopoly where free market mechanisms are not welcome and not seen. So prices go up, not down, and change randomly depending on who you are, who you work for, and what the phase of the moon is.

37. I have never met a free market advocate of medicine who does not recognize and accept non-market allocation in terms of emergency care, specifically via the non-market system called triage.

    It’s an important footnote to recognize triage and to explain *why* that limited exception is ok, properly fenced off with limiting principles so the exception doesn’t swallow the rule, and what is the reason we’re all generally ok with triage causing more suffering and against surge pricing which would be a market method of dealing with the circumstance that triage is for.

    First is to note that triage causes excess suffering because it is designed, and functions well at minimizing loss of life at the cost of extending suffering for those condemned to delays in treatment by the triage system. We’ve all made a moral decision that some non-fatal suffering is an acceptable payoff for a reduced fatality count when medical systems are overwhelmed and resources have to be quickly, efficiently deployed to reduce fatalities.

    It’s important to cover these things because they take away all the central planner’s best arguments away from them when you reconcile the free market with triage. Solidarity, the common good, human decency, these are the heartstring appeals of the statists who falsely claim that free market medicine will cause wicked outcomes because the market has no sense of solidarity, the common good, or human decency.

    These statists are wrong. But they have to be shown wrong. Examining triage is a very good way to do it.

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