Posts tagged with: medicine

With all this talk of health care reform this year, I couldn’t help but do some digging into the real aspects of the proposals. Ranging from the completely disruptive universal medical care plan from California Governor Arnold Schwarzenegger to the socialist-like plan from Senator Ted Kennedy (D-MA) in the 110th congress, health care is big on the agenda for 2007. I am afraid that if the policies proposed by Schwarzenegger and Kennedy are passed, future generations will witness a detrimental effect on our economy. Kennedy’s home state of Massachusetts, being the first state to provide universal health care to its citizens, has already seen negative aspects in regards to business and job creation.

These arguments for universal health care come disguised in many forms, but all contribute negatively to the economy. The idea of making health care affordable and available to citizens is an excellent idea, however, Governor Schwarzenegger’s and Senator Kennedy’s ideas are the wrong way to go.

Forcing employers to provide health care and penalizing them for not providing coverage is not the right direction to head.

The state of Massachusetts employs a combination of subsidies and penalties to make insurance more affordable and to force people to buy it. The law requires employers with 11 or more full-time employees to offer health coverage or be subject to a $295 fee for each employee, as well as face being billed for services their uninsured employees get.

Because of this policy, employees are going to lose other benefits and suffer pay cuts, or even be fired. The cost of medical insurance is extremely high. The real solution rests in not forcing employers to provide coverage, but to make insurance more affordable.

The answer lies in eliminating all of the fraudulent law suits filed every day by money-hungry lawyers who are completely destroying the medical system. As lawyers sue doctors, malpractice insurance premiums increase. The number of personal injury litigations has steadily increased at a rate of 12% since 1975.

Jury Verdict Research, a database of plaintiff and defense verdicts, says awards in medical liability cases increased 43 percent in 1999, from $700,000 to $1,000,000. Jury awards in medical malpractice claims jumped 43 percent in one year—from $700,000 in 1999 to $1 million in 2000. Juries are compensating plaintiffs more generously than in the past. From 1994 to 2000, Jury Verdict Research found that more than half of medical malpractice jury awards were for $500,000 or more.

Seeing the direct correlation between health care cost and the cost of medical malpractice insurance for doctors (driven up by law suits), the root of the problem is obvious. This must be attacked before anything else. If Senator Kennedy and Governor Schwarzenegger want to see real progress, their plans must be disregarded and tort abuse must be solved first. There are various other aspects to their plans that are also misinformed and misdirected, but I’ll save that for another time.

Go to this page to watch a short video highlighting the story of one man’s fight against Canada’s health system.

The film is focused on the defects of socialized medicine and so, naturally, does not deal with the serious problems existing in other systems (such as the United States). But it is an effective display of a problem that every attempt to manipulate prices encounters: how to make supply meet demand.

Jim Aune, blogger-in-chief at The Blogora, complained yesterday about his health care treatment. He says, “I have been in constant pain for 36 hours. I actually used a cane to go to the office yesterday for some meetings. The problem? I have a trapped nerve in my abdomen from a double hernia repair a year ago. I got shot up with steroids about 3 weeks ago, and that worked for about 5 days, but I still can’t walk without a ripping sensation (as if my right leg were being separated from my side).”

That sounds horrible. He continues: “I’m about to go see the doctor again today (he’s a nice guy, as family practice doctors usually are, as the anesthesiologist at the pain clinic), so I decided to read up on the Internets about this condition. Now, a little learning, especially online, is a dangerous thing, but it appears that entrapped nerves have gone from happening in 1% of hernia repair patients to closer to 40%, and the speculation is that the new use of plastic mesh is a possible cause.”

It seems that Aune somehow associates John Stossel with his problem. “Enter the biggest jackass on television: John Stossel of 20/20, who believes that the market solves all problems, and that any government intervention in that frictionless market creates no end of bad ‘unintended consequences.’”

What is Aune’s argument against Stossel? After citing a Daily Kos item, Aune contends, “markets are wonderful things, but they only work in cases of ‘symmetric information.’ That is,they work efficiently when both parties to an exchange have nearly similar information.” (Last night’s episode of ER dealt with a very similar issue).

Markets only work in cases of symmetric information. Is this true? Or is the opposite true? Hayek’s observations about the nature of diffuse and unequal information are the basis for his arguments against the practicality of state intervention. As Steven D. Levitt and Stephen J. Dubner put it in their book Freakonomics, “We accept as a verity of capitalism that someone (usually an expert) knows more than someone else (usually a consumer).” Medical care isn’t the only example of information asymmetry, of course. Typical ones include car sales, or especially car repair, but they can apply in any instance where there is particular expertise involved.

Levitt and Dubner go on, “But information assymetries everywhere have in fact been mortally wounded by the Internet.” Now it is true that in practice, as in Aune’s experience, there are all kinds of limits on the potential for the Internet to even out information. It takes time, access, and a certain amount of patience to educate oneself about certain medical conditions, for example. Thus Levitt and Dubner go on to admit, “The Internet, powerful as it is, has hardly slain the beast that is information asymmetry.”

Aune later asserts, “markets do not work efficiently when information is asymmetric.” Maybe they don’t work as efficiently as they might otherwise, but they still seem to work, and perhaps better than any other option available to us. And there are methods for the sharing of information and such that does not necessitate government involvement (independent ratings, consumer reviews, and the like).

It’s not clear what Aune’s solution is (if there is one in his complaint), but I take it that Aune is arguing at least implicitly that the government needs to be the entity that solves the problem of information asymmetry. Would he rather have no choices, even the limited ones he is inadequately informed about, and instead have the government decide for him? Why don’t we just make doctors government employees? Then they can enforce the course of treatment they deem best.

Blog author: jballor
posted by on Wednesday, September 13, 2006

Two pieces on Christianity Today’s website this week are worthy of comment. The first, “Despair Not,” reminds us that “there is something worse than misery and death.” The author Stephen L. Carter interacts with C.S. Lewis’ famous book, The Screwtape Letters, to show that “the terrible tragedies that befall the world work to Satan’s benefit only if we despair. Suffering, as Screwtape reminds his nephew, often strengthens faith. Better to keep people alive, he says, long enough for faith to be worn away. The death of a believer is the last thing the Devil wants.”

Dietrich Bonhoeffer criticized the impetus to deny the value of suffering in this life. In his Ethics he wrote of modern nihilism and Western godlessness:

The loss of past and future leaves life vacillating between the most brutish enjoyment of the moment and adventurous risk taking. Every inner development, every process of slow maturing in personal and vocational life, is abruptly broken off. There is no personal destiny and therefore no personal dignity. Serious tensions, inwardly necessary times of waiting, are not endured. This is evident in the domain of work as well as in erotic life. Lasting pain is more feared than death. The value of suffering as the forming of life through the threat of death is disregarded, even ridiculed. The alternatives are health or death. What is quiet, lasting, and essential is discarded as worthless.

The other CT piece is a book review by David Fisher of Reclaiming the Body: Christians and the Faithful Use of Modern Medicine. The book’s authors argue that “modern medicine… emphasizes the autonomy of the individual and holds up the supreme end of bodily perfection. These goals are not only unattainable, but more importantly, are inconsistent with the Christian faith. The book points out the dangers of society’s worship of and allegiance to medicine for its perceived ability to defeat or forestall death. While our Christian beliefs should protect us from this deification of medicine, the authors remind us that we often fall into the same trap.”

Indeed, the authority and influence of medicine on our lives and behavior can be seen as a kind of scientism, in which science, in this case in the form of medicine, takes on “a priestly ethos — by suggesting that it is the singular mediator of knowledge, or at least of whatever knowledge has real value, and should therefore enjoy a commensurate authority. If it could get the public to believe this, its power would vastly increase.” Authors Joel Shuman and Brian Volck issue “a call to transformed Christian living, one that emphasizes the importance of viewing medicine through the lens of the larger community of the body of Christ.”

With respect to the worship of health and life in and of itself, or “vitalism,” Bonhoeffer says,

Vitalism ends inevitably in nihilism, in the destruction of all that is natural. In the strict sense, life as such is a nothing, an abyss, a ruin. It is movement without end, without goal, movement into nothingness. It does not rest until it has everything into this annihilating movement. This vitalism is found in both individual and communal life. It arises from the false absolutizing of an insight that is essentially correct, that life, both individual and communal, is not only a means to an end but also and end in itself.

One important and indeed hopeful way to talk about death as an end, in addition to death as a means to an end, or “our entrance into eternal life,” is in this way: as “an end to our sinning.”

Blog author: kschmiesing
posted by on Thursday, September 7, 2006

An interesting debate is going on over at Mere Comments. The main thread has to do with the morality of the Bush Administration’s approval of over-the-counter sales of the morning-after pill and the implications for Pennsylvania’s U.S. Senate race. Leaving those issues aside, I was struck by a comment from “Daniel C.”, claiming that the problem really presents an “excellent case for dismantling the Food & Drug Administration.”

It’s a question worth raising. I don’t know enough about the history or current practice of the FDA to judge definitively one way or the other, but I know that there exists significant discontent with its role as (ostensibly) the nation’s guardian of food and drug safety. For example:

1. It constructs unreasonable obstacles to the delivery of medical technology.
2. It stifles pharmaceutical innovation because regulators are biased toward caution as opposed to risk.
3. Its evaluation process is distorted by rampant conflicts of interest on the part of the experts it employs to evaluate new products.