Daschle Is Gone And Gives Republicans Room
Friday, February 6th, 2009Now that Daschle bowed out, health care reform pushes to the back burner. Bob Laszewski is disappointed.
It is also possible that Obama’s biggest health care reform challenge may not come from Republicans but from those on the far left of his own party. Their pushing on things like a public health plan to compete with the private sector could be a big hurdle. While Daschle supported some of these things, like the public plan and a cost board, in his book he was also a skilled and pragmatic legislator and could well have done a good job managing the President’s left flank.
This will set the health care debate back months not weeks. It appears the economic crisis is deepening and there is talk of President Obama planning to come up with another giant bailout bill. That would take a lot of time and political capital.
Unlike Mr. Laszewski, I am not disappointed. What sounds like good policy (to some), in theory, would be terrible in practice, as I wrote before. So, I’m all for obstruction and scheduling difficulties.
Forget the particulars for a moment. The last thing America needs right now is government health care expansion (the government never shrinks). And besides, I want this whole thing to delay, delay, delay. The Republicans are woefully inadequate on the issues of health care and environment.
They need time to come up with a coherent message and a solid alternative to the Democrats. The Democrats can synthesize their views: Health Care For All! It sounds good. And more people believe that health care is a right not a privilege. As Baby Boomers age and get even more afraid–of aging and dying and the inevitability of being human, there will be a push for government guarantees.
Republicans need to address the real concerns in the market–that small businesses and individuals get hammered unfairly because they do not get to negotiate rates like big companies. There is also the problem of uneven coverage depending on the state. Liability and tort reform should be undertaken nationwide. In Texas, it has brought the best and brightest doctors here and lowered malpractice rates.
Doctors need to be pushed to automate. They also need to be tracked and better rated. Just like there are some drivers who cause all the accidents, there are some doctors making the most mistakes. These people need to be identified and either pushed out of the profession or given warning labels so patients are fully informed.
There are lots of changes that need to happen right now. They would result in lower costs, more accessibility and better care, and none of the ideas would mean nationalizing health care. Republicans need to get on the ball and get on top of this issue. With Daschle out of the picture, they have time to do it. Let’s hope they carpe diem.
Cross posted at Right Wing News
About The Surgeon General
Thursday, January 15th, 2009Isn’t the Surgeon General mostly a public relations figurehead?
And if Conyers and Krugman don’t like Sanjay Gupta I agree with Health Care BS, he must be the right man for the job.
Orgasms During Childbirth–UPDATED
Friday, December 12th, 2008I guess it’s going to be all sex all the time today at the blog. Oh hell, why not? The Blago scandal is boringly devoid of sex.
Back in the 70s when flower children everywhere were making sweaty, hot, hallucinogenic, pill-protected, STD-infested monkey love, a strange thing happened: babies. I know, it was a shocking side-effect to all the lovin’, man, and some of the parents kicked their wanton daughters out to suffer the indignities of being a single, pregnant, shunned lady. Enter Stephen and Ina May Gaskin who took in these women at a place called The Farm in Tennessee. I actually dig these two hippies. They revolutionized prenatal care and were forward thinking about unnecessary medical procedures like episiotomy, shaving, knocking the mom out during birth, etc.
The Gaskins also introduced the notion of an orgasmic birth.
I’ve read Ina May Gaskin’s books and seen the pictures. She was a revolutionary, forward-thinking woman who cared for many, many women. Her work transformed lives for the better. Now, there is a “new” childbirth movement centered on “orgasmic birth“:
First thing next month (Friday January 2) will be the primetime debut of a film that has been making the “under the radar” rounds of women and film festivals since May. ABC’s 20/20 will air the documentary “Orgasmic Birth”, by Debra Pascali-Bonaro, a childbirth educator and a doula, which asks the question: What would happen if women were taught to enjoy birth rather than endure it?
The message of the film is “that women can journey through labor and birth in all different ways. And there are a lot more options out there, to make this a positive and pleasurable experience,” Pascali-Bonaro tells ABC. “I hope women watching and men watching don’t feel that what we’re saying is every woman should have an orgasmic birth.”
But the title certainly catches attention, referring to what Pascali-Bonaro calls “the best kept secret” of child birth – that some women report having an orgasm as the baby exits the birth canal.
Right.
Having given birth rather easily, sans medication and more than once, the notion that women can experience sexual bliss during birth seems absurd. I’ve seen the videos and I’m not hating on any woman’s experience, but please. All sorts of changes need to happen in prenatal and birthing care, but the wild assertions and expectations of orgasms will defeat the true aims of the natural birth activists by making them look like wild-eyed nutters.
And another thing, I recognize that the birth canal has multifaceted uses, still, I can’t help but to think that this orgasm business is just one more way to sexualize, well, everything. The birthing isn’t about having a healthy baby or a woman surrendering to the primal forces of motherhood. Oh no! It’s selfish and all about a peak experience, man. It’s the narcissism-part of the hippie thing that bugs me.
Motherhood isn’t entirely about self-sacrifice, but giving birth is pretty darn self-sacrificial. Your body isn’t your own. And out of the experience comes an entirely new creature. And yes, some women have babies to be the center of attention and make it all about themselves. They are annoying. They don’t need encouragement. This orgasm business will just add fuel to the self-obsessed culture. It will also delude women into thinking that it’s a likely outcome. Silly-headed women who believe this will often end up with C-sections because they have such inane expectations of birth. It’s called labor for a reason. Birthing is hard work.
One of the most barbaric medical fields in America is obstetrics. For reasons of liability, ignorance and tradition, a process that has existed since the beginning of time is made into a “procedure”. Birthing is a process for woman and child and with different treatment, women would be empowered by motherhood rather than being the recipient of medicine. Babies aren’t a disease to be cured. Right now, that’s often how pregnancy and birthing are treated. That needs to change.
UPDATED:
Fausta adds this:
Certainly, childbirth is the most binding experience a couple can possibly experience. A considerate and supportive husband can and will do a lot of things to ease the wife’s discomfort during labor. In a sense, it is a spiritual experience, too. But take my word for it, having a fully formed, seven and a half pound, twenty-two inch human being squeeze out of a narrow opening doesn’t happen without pain. That’s just the way it is.
A Medical Mess This Way Cometh
Monday, December 1st, 2008This post could be obscenely long, there are so many potential problems in the health care field. I’m going to try to make this brief and concise.
There are about to be many more old people than people to care for them. Gen X is about half the size of the Boomers. The Boomers are going to need more care. And it’s expensive. Oh, and Medicare Advantage Medicare costs more than traditional Medicare. Doesn’t everyone want an advantage?
Doctors are leaving hospital care of due to time, stress, and liability. Medicare does not pay more for complicated, time-consuming and probably-going-to-die-anyway patients.
Doctor-hood doesn’t carry the glamor it once did. Smart people are going into other professions.
Doctors feel the pressure to deliver and it’s going to get worse if Obama has his way. (It would with McCain, too.)
This is a short list. The aging population-increased medical costs-decreased pay-fewer doctors complex is not pretty. In addition, the doctors who continue practicing, are seeing their own quality of life diminish.
To continue practicing but have fun doing it, doctors seek out cash-based specialties like dermatology and plastic surgery. Internal medicine just stinks. America will end up being like Great Britain: importing doctors from third world countries. I’m not sure if that’s a bad or good thing.
Cross-posted at RightWingNews and The Houston Chronicle
“There Is No Such Thing As A Genetic Epidemic”
Monday, November 24th, 2008Autism: “There Is No Such Thing As A Genetic Epidemic”
Cancer maybe? Genetic switch with an environmental trigger? I think both can be explained that way.
Insurance For All…Sounds Good Doesn’t It?
Thursday, November 20th, 2008So the New York Times reports that insurance companies are willing to “deal”:
While insurers would be required to sell insurance to any applicant, nothing would guarantee that consumers could afford it. Rate regulation promises to be a highly contentious issue, since it pits the financial interests of insurers against those of consumers.
At present, insurance premiums are generally regulated by the states and often vary according to a person’s age, sex, medical history and place of residence within a state. In the individual market in most states, a person with a history of serious or chronic illness can be charged much more than a healthy person of the same age and sex.
Mr. Hamm, a member of the board of America’s Health Insurance Plans, said the group might offer recommendations to define “a fair and appropriate rating structure.”
Alissa Fox, a vice president of the Blue Cross and Blue Shield Association, said the individual mandate was an indispensable corollary of any approach forbidding insurers to reject applicants because of health status.
“Insurance works best when everyone is in the pool,” Ms. Fox said. “You need healthy people in the insurance pool to help pay for sicker individuals who are much more motivated to buy coverage.”
Insurers did not say how the government should enforce an individual mandate: whether through fines, tax penalties or other means. Politicians have also been reluctant to specify details of enforcement, which could prove highly unpopular.
Here is how “health care for all” in this form will wreck the economy but make health insurance companies very rich:
Right now the economy is already restricting. What does that mean? It means that receivables, income, is down. So, businesses are doing their best to NOT lay-off anyone yet. It’s near Christmas, and trust me, no one wants to tell people they don’t have jobs before the holiday season. So, business owners are doing what they can. They are not buying new equipment. They are not expanding. They couldn’t get a line of credit to take on a new project if they wanted to anyway. They are trying to cut costs other ways. They are considering how to increase prices subtly and finding it impossible to do. They are hoping things turn around in January.
In January, if future contracts don’t look better, there will be some tough choices made. Employees will have to go. Business operations slowed.
In February, Barack Obama and the insurance industry cut a deal. All Americans are required to own health insurance because right now, sick people buy it because they need it and that cuts into profits. Businesses will be required to offer insurance.
If the company was making any money, it won’t after this legislation.
The economy will constrict further. More employees will lose jobs because the companies simply can’t afford to pay them. It was already a struggle making payroll in the tough economy. It will be worse.
With unemployment inching up to 10%, the government will decide “something must be done”. That something will be this: employers will be forced to submit to egregious employment rules. The government will make it more difficult to fire an employee. Employers will stop hiring, because once they hire, they can’t fire. This will further tighten the economy.
Since less people will be working and the government will need more tax revenue, fast food restaurants will be taxed. You name it, there will be a tax here and there and everywhere to help “modify” behavior. Plastic bags in New York. French fried steak in Texas.
No, it won’t be socialism. Not strictly, in the Marxian sense. It will be an Americanified socialism where big businesses collude with the government for power. As long as these two groups make money, the individual will be forced into submission. Their choices restricted. Their money not their own.
That is where this legislation will take us. Oh, and at first, unhealthy people everywhere will be so relieved. But then, see, the government will have to make “tough choices”. The 400 pound man will not be on a list for a heart transplant because of his poor lifestyle choices. The 80 year old woman won’t be given a hip replacement because she’s too old and the new joint would outlast her. Bureaucrats will be deciding, even more than now, how your health will be treated.
And the costs will increase, just like they have been anyway.
The rich will still get better health care. They’ll pay for what they want. The best doctors won’t see anyone BUT rich people because they can get paid more. And the poor people will get the same kind of substandard care, but worse–they won’t have a job.
Insurance for all….sounds good doesn’t it?
Update: Here’s an idea! How about innovation?
Cross-posted at RightWingNews.com
Waking Up During Surgery
Tuesday, November 18th, 2008Waking Up During Surgery
This happens more than it’s reported. Yikes.
My Latest Pajamas Media Article: Yes, You Can Be Fit And Fat
Wednesday, September 17th, 2008Here’s a snippet:
The definition of “healthy” has serious ramifications both medically and economically. People may or may not change their lifestyles based on bad information when they should be taking a different course.
Read the whole thing here.
About Those Personal Insults
Monday, September 8th, 2008When lefties comment, they almost always include personal slander just for fun. Staying on topic seems to be impossible. A favorite one at my place is to sneer about whether or not I’m a “real” doctor as if the commenter as full-time blogger, or computer engineer, or architect, or grocery bagger, has more right as a citizen to share his opinion than I do.
When I started the blog, my intention was to write posts for my patients and consulting clients. I focused on health and business and the business of health for a while, but it quickly morphed into the way my blog is today: a hodge-podge of things that interest me–mostly, right now, politics. (I have a whole series planned on losing weight, but Sarah Palin keeps getting in my way. Oh well!) So, the “Dr.” Melissa Clouthier fit. Plus, and all, I am a doctor.
Technically, I’m a doctor of chiropractic or D.C. Like medical doctors, I got an undergraduate degree. I got a Bachelor of Arts in Theology and minored in Mass Communications with an emphasis (maybe 3 credits short of another minor, I think) in psychology. Then, I went back to school for premed to take chemistry, biology, organic chem, etc. Then, I went to chiropractic college where the first two years of curriculum is nearly identical to medical school with the exception that there is more radiology and less pharmacology than at med school. Both groups take physiology, microbiology, pathophysiology, neurology, gross anatomy, etc (DCs spend over a year in “dead lab” doing dissection). When my son spent four months in the ICU, the interns and residents and I went through our text book lists. Wonder of wonders, we all learned from the same texts. The paths grow more divergent at the end of school because chiropractors are more focused on nutrition and physical medicine where medical doctors learn surgery. Chiropractic is a non-surgical profession.
Like medical doctors, chiropractors must pass national and state boards. I have friends who have taken both and they all say that the chiro boards are tougher. I’ll take their word for it. I chose chiropractic over medicine because the profession is more in line with my philosophy: chiropractic emphasizes personal responsibility for health.
You’ll have to take my word for it: I could have chosen to go to medical school. I chose not to. It is true that some students cannot. Medical school is more challenging to get into, but almost no one is kicked out. Chiropractic college is easier to get into but more challenging to stay. There is a high drop-out rate compared to med school, or was when I was there. The upside is that people who screwed around in undergraduate school who get their act together can still enter the health care field.
The bottom line is this: there are good and bad doctors of all stripes. Reputation matters. Do not assume that because a person has an MD or DC or PhD or JD or whatever behind his name that he’s some sort of genius. His degree demonstrates a level of one kind of intelligence–the ability to learn a copious amount of minutiae and spit it out on exams. His degree demonstrates a will to finish something that takes a long time and long hours to accomplish. He may or may not be clinically smart. He may or may not have a decent bedside manner. He may or may not have the intuition necessary to make difficult diagnoses. He may or may not continue his education once he starts practicing and just do the minimum state-required continuing education.
Doctors are human. Some are stupid. Some are lazy. Some are apathetic. Some are burnt out. Some are post-call and exhausted. Some have a very limited knowledge base. All have bad days.
So, enough with the insults about my profession. When I opine about politics I’m not doing so as a doctor, I’m doing so as a citizen.
When I talk about health care topics, I’m coming from the perspective of a doctor who practices chiropractic, nutrition, Chinese medicine, and has post-graduate certifications in acupuncture and neuro-somatic techniques.
Chiropractors have been the object of ridicule for as long as they offered an alternative to traditional medicine. This is an economic argument as much as anything. The medical profession, like many monopolistic professions, didn’t like competition. They managed to roll osteopathy into medicine, but couldn’t convince chiropractors to assimilate. There has been animosity ever since. A free market solution exists–let the patient choose. And the patient chooses.
Back to the snide personal comments. It is so interesting to me that those on the left who preach tolerance, are the ones who have insulted me as a woman, a mother, a doctor. Personal attacks about my looks and my body seem especially de rigeur. Most of these comments don’t see the light of day, now that I have comment moderation because they, obviously, add nothing to the discourse.
Add something to the conversation: stay on topic.
