American Elephants


Other Than That, ObamaCare is Doing Fine… by The Elephant's Child

When the Democrats started digging old plans out of dusty drawers, they decided, since they controlled both houses of Congress and the presidency, to go for government sponsored health care; they were absolutely sure that the American people were going to love it. Big mistake.

The cost of American health care had been climbing significantly, and Democrats were sure that they could significantly cut the costs of medicine by making the medical profession more efficient and insisting that they learn from the best practices of industry stars. Another mistake.

Democrats believed that the uninsured were a huge problem because people with no insurance were flooding emergency rooms and driving up costs. Turned out that most of those who used emergency rooms had insurance, they just couldn’t make appointments with their doctor for immediate help. Turned out that a large percentage of the uninsured did not have insurance because they could not afford it, but because they didn’t want to pay for insurance. They were healthy and unconcerned. Oops!

Democrats believed that if they added some nice benefits that people had never had before on their insurance like therapeutic massage, birth control and pediatric dentistry, the government insurance would be even more popular. They would just spread the costs of the new benefits across the board so the expense would not be noticed. They didn’t have an insurance actuary figure out the costs of including those benefits on a policy for 55 and 60 year-old folks who had no need for birth control or pediatric dentistry.

The CBO has issued a report that appears to show that ObamaCare will cost less and cover more people than expected. But their projections seldom turn out. There are just too many variables. The latest report says that ObamaCare will cost $104 billion less over the next 10 years than it thought just two months ago. The numbers rest on the CBO belief that premiums will be flat next year, but the industry has already warned of double-digit rate increases— a sharp rise that will drive costs up far beyond the CBO’s estimates.

Out of the blue, the Census Bureau has changed how it counts health insurance, just at the moment when ObamaCare is roiling the insurance markets. The effect will muddy comparisons between pre-ObamaCare and post-ObamaCare numbers. A lot of things we would like to know, like how many people gained or lost insurance under ObamaCare? Did government crowd out individual insurance? It will apparently take several years before we have answers to those questions.

The one thing that is increasing dramatically is unhappiness among physicians. Nine out of ten doctors discourage others from entering the profession. 300 doctors commit suicide every year. Depression among doctors is not new, but the level of unhappiness is on the rise. Being a doctor has become a miserable and humiliating undertaking, and many doctors feel that America has declared war on physicians and doctors and patients are the losers.

Many doctors just want out. More are running for Congress. Medical students opt for high-paying specialties so they can retire as soon as  possible. MBA plans for physicians are flourishing,  they promise doctors a way into management. The website called the Drop-Out-Club hooks doctors up with jobs at hedge funds and venture capital firms.

Some, including President Obama, seem to believe that doctors are paid way too much and if the government needs to save costs, they can just pay doctors less. This is the mindset that reduced Medicaid to such a point that those who go without health care may do better than Medicaid patients. Same goes for Medicare and the other government controlled health care systems.

More doctors refuse to accept health insurance. Some have gone into concierge medicine, where for an annual fee, the doctor is at your service for the year. The federal government is hoping to go after that escape from ObamaCare, and they are still intending to end Medicare Advantage plans.

Just processing insurance forms costs $58 for each patient encounter, according to Dr. Stephen Schimpff, an internist and CEO of the University of Maryland Medical Center.  Physicians have had to increase the number of patients they see. The end result is that the average face-to-face clinic visit lasts about 12 minutes, in which the doctor probably spends most of the time interacting with his computer.

Under ObamaCare the incentives are all wrong. The government adds ill-considered benefits to insurance policies in the hope of getting people signed up. This makes the insurance too costly for most people. The push from the government will be a constant effort to cut costs. Hospitals will push for doctors to see more patients in less time, so they can be adequately reimbursed. Doctors will be encouraged to pay less attention to the Hippocratic Oath and more effort to try to get adequately paid, or to get out of the profession—which will encourage the best and brightest to aim for other careers. Watch for a push for increased immigration of physicians from third world countries. Other than that…

 



The Standoff At the Bundy Ranch Ends— For Now. by The Elephant's Child

580x375xarticle-2603026-1D0F67D100000578-703_634x411-600x388.jpg.pagespeed.ic.Bu8r1HkGwH

The Standoff at the O.K. Corral Bundy Ranch is standing off. The overarmed and overaggressive Bureau of Land Management has announced that because of the risk of violence, it is withdrawing its forces, some 200 armed agents, including snipers and guard dogs. The county sheriff negotiated the settlement.

It’s not at all clear what this was all about. The family settled in the area in the late 1800s and has ranched in the area ever since. The federal government has allowed Nevada ranchers to graze their cattle on tracts of adjacent public lands for generations. The federal government later created the Bureau of Land Management (BLM) to administer and “protect” the vast “federal lands”* including the land the Bundy family’s livelihood is and was dependent upon.

*These lands are frequently called “federal land.” This is inaccurate. They are public lands, owned by the people, and the government supposedly “manages” them for the American people. I don’t think anyone has challenged this frequently used terminology in court, but they should.

I don’t know about you, but I have a real objection to all these armed forces, SWAT teams, and snipers attached to agencies of the government. The Coast Guard, Border Patrol (we read that they were reduced to firing beanbags), and ICE,need to be armed, but this is really going too far. The federal agency did quite a few dumb things. It tasered Cliven Bundy’s son Ammon, rounded up a bunch of the Bundy cattle, and then fenced off a “First Amendment Area” in the middle of nowhere to demonstrate the protection of an “endangered” desert tortoise.

The federal government told the Bundy family that a tortoise existed on the land and therefore the land’s usage for cattle would have to decrease — attacking the Bundy family livelihood, which has led to a 20-year legal battle.The legal battle would seem to have gone against the Bundy family, but the Bundy family can in fact claim to have enjoyed generations of grazing rights on public land — with an arrangement originating in the 1870s when ranchers were offered those rights an enticement for settling the West.

I have no knowledge of the legal aspects of the case, and I suspect that you can’t fight city hall or the federal government. I am deeply suspicious of any claim of “endangered species,” because those so designated usually aren’t actually endangered, and are only used as a tool to accomplish some other purpose. I don’t believe that the Endangered Species Act has ever “saved” a species. The problem is often a simple increase in the number of predators.

Breitbart has done a fine job of outlining the case, the rumors, the law, and the problems involved. I would suggest that the American people are troubled by our imperialistic government and the increased militarization of so many federal agencies who have no business with SWAT teams and armed attacks on ordinary citizens. The Bureau of Land Management brought the angry resistance on themselves, with overreaction.



The Social-Engineering Approach to Health Care by The Elephant's Child

John Goodman offers two fundamental ways of thinking about complex social systems: the economic approach and the engineering approach.

The social engineer sees society as disorganized, unplanned and inefficient. Wherever he looks, he sees underperforming people in flawed organizations producing imperfect goods and services. The solution? Let experts study the problem, discover what should be produced and how to produce it, and then follow their advice.

Goodman, the father of the health savings account, calls this “cookbook medicine” which gives doctors rules and protocols for treating patients with various symptoms, and they must record each step along the way. Cookbook medicine does not bother with the differences among people, and is the opposite of personalized medicine which aims to tailor the therapy to the characteristics of the patient.

While it is useful to consider the standard protocols, people are not all the same. Medicine adapted to the genetic makeup of a person is in its infancy, but shows promise. When the cookbook becomes a rulebook to be followed slavishly, we’re in trouble. When complying with endless checklists takes valuable time away from patient care — that’s what’s happening in American medicine. A recent study of emergency room physicians found that they spend more time interacting with screens than patients, clicking the mouse 4,000 times in a 10-hour shift.

The Affordable Care Act was heavily influenced by the engineering model. After all, our bureaucrats are certified experts, and what are experts for if not to tell everybody else what to do and how to do it. Only social engineers would think of running “pilot programs” to control health care costs. What is the purpose of a pilot program if not to find something that appears to work, so you can order everyone else to copy it. Therefore you have the mess of digitizing all medical records and the result that hospitals have different systems that cannot talk to each other?

Dr. Virginia McIvor, a pediatric physician at Harvard Medical School explains the problem:

When a healthy child visits, I must complete these tasks while reviewing more than 300 other preventative care measures such as safe storage of a gun, domestic violence, child-proofing the home, nutrition, exercise, school performance, safe sex, bullying, smoking, drinking, drugs, behavior problems, family health issues, sleep, development and whatever else is on a patient’s or parent’s mind. While primary-care providers are good at prioritizing and staying on time — patient satisfaction scores are another quality metric — the endless box checking and scoring takes precious time away from doctor-patient communication.

If you have been to a doctor recently, you have probably noticed the multiplication of forms you must fill out, questions you must answer. I have noticed that the form now contains a line for “refuses to answer,” which may indicate progress of a sort.

John Goodman is the father of the “health savings account” which works precisely as promised and has been a great favorite. He is president of the National Center for Policy Analysis (NCPA) and he blogs regularly on health care matters (you can sign up to receive his columns), and his book Priceless takes on the health care problem.

There are great things happening in medicine that are promising for the future. The engineering rulebook is not interested in other people’s expertise or innovation.

The social engineer sees society as disorganized, unplanned and inefficient. Wherever he looks, he sees underperforming people in flawed organizations producing imperfect goods and services. The solution? Let experts study the problem, discover what should be produced and how to produce it, and then follow their advice. – See more at: http://healthblog.ncpa.org/cookbook-medicine-2/?utm_source=newsletter&utm_medium=email&utm_campaign=HA#more-36412
The social engineer sees society as disorganized, unplanned and inefficient. Wherever he looks, he sees underperforming people in flawed organizations producing imperfect goods and services. The solution? Let experts study the problem, discover what should be produced and how to produce it, and then follow their advice. – See more at: http://healthblog.ncpa.org/cookbook-medicine-2/?utm_source=newsletter&utm_medium=email&utm_campaign=HA#more-36412
The social engineer sees society as disorganized, unplanned and inefficient. Wherever he looks, he sees underperforming people in flawed organizations producing imperfect goods and services. The solution? Let experts study the problem, discover what should be produced and how to produce it, and then follow their advice. – See more at: http://healthblog.ncpa.org/cookbook-medicine-2/?utm_source=newsletter&utm_medium=email&utm_campaign=HA#more-36412


Shining a Light on the Dark Corners of Big Bloated Government by The Elephant's Child

Coburn

How many bureaucrats does it take to screw in a lightbulb? According to USA today, It takes 10 different offices at the HHS to tun programs addressing AIDS in minority communities. Autism research is spread out over 11 separate agencies. Eight agencies at the DOD are looking for prisoners of war and those missing in action. Schriever Air Force Base in Colorado has 8 different satellite control centers to control 10 satellite programs.

These are simply 26 new areas pointed out by the Government Accountability Office, where federal government programs are overlapping, duplicative, fragmented or just inefficient. There are 162 areas so identified in part reports. This gives Congress a clear map for saving tens of billion of dollars a year.

We owe this list to Senator Tom Coburn (R-OK), who wrote the legislation requiring this annual report, which is now in its fourth year.  “Turning this ready-made list of cuts into savings is one of the best ways Congress can regain the trust and confidence of the American people”, he said. “At the end of the day there are no short cuts around the hard work of oversight and identifying and eliminating waste.” The prepared testimony said:

It is impossible to account for how much money is wasted through duplication, in part because the government doesn’t keep track of which programs each agency is responsible for.

“One of the most troubling things in GAO’s report is the number of agencies that have no idea just how much taxpayer money they are spending on their programs,” said House Oversight Committee Chairman Darrell Issa (R-CA). He has sponsored legislation , the Digital Accountability and Transparency Act, that would require the government to better track spending data from Congress to an agency to its ultimate recipient. The bill has passed the House 388-1 last year and waiting for a vote from the Senate.

The agencies in question will object. Every agency in question will feel their slice of the pie is more important, and losing budget and personnel diminishes the agency. Bureaucracies always have empire-builders in their ranks. They just are not often recognized, because they have been good at telling their superiors how necessary that budget and that staff are to the good of the nation.

Many of GAO’s recommendations deal with some of the most complex and challenging areas across the federal government,” said Beth Cobert, the deputy director for management at the Office of Management and Budget, in a statement. “Fully addressing them is a long-term process that in many cases will take years to implement.”

Uh huh. Shine a spotlight on them and see what happens to the dark corners. Last year, the GAO reported that the two main groups responsible for POW/MIA issues were “unable to resolve disputes”  about who was responsible for what. When last month, National Public Radio detailed how bureaucratic and slow the search for remains was, DOD Sec. Chuck Hagel ordered that POW/MIA efforts be streamlined into a single office.

This is what transparency and sunlight are all about. A media that is too lazy,  uninterested, or partisan to do their traditional job as governmental watchdog, actually costs taxpayers money. A bloated, expansive government that is more interested in being important and powerful than in freedom and thrift harms everyone.



The IRS Scandal: Day 335 — Heating Up! by The Elephant's Child

The IRS scandal is heating up again. Darrell Issa’s committee has released emails that show Democratic staffers from the House’s Government Oversight and Reform Committee communicating with the IRS about True the Vote, an anti-voter fraud organization that the Democrats wanted to suppress. It appears that Elijah Cummings, the ranking Democrat on the committee, to whom these staffers reported, may have lied during a committee hearing when he denied that his staffers had put the IRS on the trail of True the Vote.

The emails show the Democrats calling True the Vote to the IRS’s attention and requesting records about that organization. Lois Lerner was anxious to provide for them. The staffers do consistently refer to “publicly available” information, so there is no evidence that the IRS shared confidential taxpayer information with the Democrats.

House Republicans are closing in on Lois Lerner. The Department of Justice under Eric Holder has failed to do anything about the IRS scandal, or any other scandal involving the Obama administration. It is clear that Lois Lerner has broken the law. The House is threatening to hold her in contempt. If Eric Holder refuses to act, they can, if necessary, arrest and imprison her.

There is no evidence that the IRS pursued any progressive group at any time. Documents show that Ms. Lerner actively corresponded with liberal campaign-finance groups Democracy 21 and the Campaign Legal Center which had asked the IRS to investigate if conservative groups including Crossroads GPS were violating their tax-exempt status. After personally meeting with those groups, Ms. Lerner contacted the director of the Exempt Organizations Examinations Unit in Dallas to ask why Crossroads had not been audited. “You should know that we are working on a denial of the application,: Ms. Lerner wrote in an email.

The Ways and Means Committee disclosed that in January 2013, Ms. Lerner asked her staff to examine five conservative groups that the website ProPublica had called “controversial dark money groups,” including Americans for Responsible Leadership, Freedom Path, Rightchange.com, America is Not Stupid, and A Better America. Four of those groups eventually got the full IRS super-scrutiny treatment and three were audited.

It is particularly interesting that the groups that had to undergo extra examination from the IRS were those who wanted to prevent voter fraud, and those who expected to donate to Republican candidates. Democrats have been aggressive in trying to block any attempt to require photo ID to assure voters are who they say they are and entitled to vote. Kinda’ makes you thing that Democrats depend heavily on voter fraud to win elections, doesn’t it?



What is this “Social Justice” Thing? by The Elephant's Child

Everybody, or at least all Liberals, seem to talk about “Social Justice” all the time, but what do they mean by that? What is social justice?

We have a Constitution that has served us well for 228 years, and in all that time has been amended only 27 times. We have laws and courts that, for the most part, administer the law fairly, and when it isn’t fair, we try to fix it. Leave it to the Left to come up with a whole new kind of “justice” that will better serve their feelings. Now they are trying to expand social justice to environmental justice and economic justice. Make everybody absolutely equal except for us important people in the progressive aristocracy, who will administer the justice. It is of course, hogwash.

Jonah Goldberg explains the hidden agenda behind the words, and it is not either noble nor caring, and turns out to be something that is clearly — not just at all.



If You Want More Jobs, Stop Destroying Them. Incentives Matter. by The Elephant's Child

ObamaCare is not a popular subject, and as people actually begin to interact with it, it’s going to be a lot less popular. Democrats are desperate to make their stand for the mid-term elections about something entirely different. They have decided on the culture wars.

Today it is “Equal Pay for Women” which everyone thought was dead as a doornail after it became illegal to pay a woman differently than a man for the same job— way back in 1963— when the Equal Pay Act of 1963 was passed. President Obama is out there again today trying to claim that women are paid only 77¢ for the same job for which a man was paid $1.

Since that is against the law, it’s hardly surprising that the only place it still happens is in the increasingly lawless White House, where female aides are indeed paid less than male aides.

whitehouse

Obama brags about the Lily Ledbetter Act which he claims was to make equal pay for women a reality, but it actually only eliminated the time limit for filing discrimination claims — and was more correctly referred to as a law to benefit trial lawyers (who donate to Obama).

Nevertheless you constantly hear the 77¢ claim. Why? It is a statistical anomaly. When you look at male and female careers, men are apt to do the dangerous or high risk jobs. They have traditionally been in logging, mining, high-rise construction, linemen, explosive experts —jobs that pay way more because of the risk involved. Women are more apt to be secretaries, teachers, social workers. Women frequently drop out of the job market to raise children, for a few years or for longer periods.Women just assume more responsibility for child-rearing than men. The 1978 Pregnancy Discrimination Act recognized that fact.

The 77¢ number comes from the Bureau of Labor Statistics. The figure refers to the annual earnings of full-time, year-round workers. It doesn’t compare comparable men and women, and does not reflect that full-time men work 8%-10% more hours per week than full-time women.

The Paycheck Fairness Act (PFA) is based on the faulty idea that “It’s Not Fair” in the interest of capturing more votes from women. The bill forces employers to raise women’s pay by sharply reducing their ability to defend what they believe is a justified differential in pay based on merit.  The PFA limits the use of work experience or education to discriminate by requiring employers to demonstrate that they are job-related ‘necessities.’ The bill authorizes grants to supporters of the bill like the AAUW for training women in negotiation skills. Men are excluded. It will increase the cost of employing women, and so reduce job opportunities. It will also provide a bonanza for lawyers.

If you make it more costly to hire someone, employers will hire fewer someones. The current theme in the media is the continuing dearth of jobs, the Great Recession with few jobs, why aren’t there more jobs? No one seems to point out that Obama is passing more and more laws and more regulations that eliminate jobs. Whether the Affordable Care Act, the continuing drive to shut down coal-fired power plants and destroy the entire coal industry in the name of climate change, or the simple refusal to approve the Keystone XL pipeline — Obama talks jobs, but his ideas are that only government really creates jobs. Then we’re back at “crumbling roads and bridges,” job-training programs, and improving education. Same old talk.

It drags on. Businesses I patronized regularly close. Supposedly the job situation here is fine, but health clubs are closing and the biggest ones are increasing their advertising. If you pay attention to new advertisers, you can tell what businesses are hurting.



EPA Subjects Human Victims to Lethal Pollutants, Doesn’t Warn of Risks! by The Elephant's Child

McCarthy testifies before a Senate Environment and Public Works Committee hearing on her nomination to be administrator of the Environmental Protection Agency

The Environmental Protection Agency has for years been basing their actions on the need to protect human beings from dangerous air pollutants and fine particulate matter (PM). The findings of the Office of Inspector General’s March 31 report say the EPA has followed all laws and regulations concerning human studies research.

While the IG’s report absolves the agency of breaking rules, it notes that the EPA did in fact expose human test subjects to concentrated airborne particles or diesel exhaust emissions in five studies done in 2012 and 2011. And it didn’t bother to plainly inform the subjects of the dangers the agency emphasizes in the proposals for their actions. When the EPA tells Congress about a proposed action, they can tell you exactly how many kids will die from asthma, and how many old folks will die from heart attacks. That’s how they get their way. What congressman could risk refusing to save dying kids?

The agency has said that fine particulate matter can cause premature death, a risk for older individuals with cardiovascular disease. A 2003 EPA document says even short-term exposure to PM can result in heart attacks and arrhythmias for people with heart disease. Long-term exposure can result in reduced lung function and even death. A 2006 review by the EPA reiterates that short-term PM exposure can cause “mortality and morbidity.”

“Particulate matter causes premature death. It doesn’t make you sick. It’s directly causal to dying sooner than you should,” former EPA administrator Lisa Jackson told Congress on September 22, 2011. “If we could reduce particulate matter to healthy levels it would have the same impact as find ing a cure for cancer in our county.”

So why has the EPA been subjecting unknowing human guinea pigs to high levels of carcinogens and potentially lethal pollutants in order to justify tough new air quality standards?  The EPA has been carrying out these unethical human experiments in which subjects are made to inhale freshly pumped-in diesel truck exhaust fumes — without advising them of the risk to their health — which the EPA claims may be mortal. Junk Science.com, October 5, 2012:

EPA has admitted to a federal court that it asks human guinea pigs to sacrifice their lives for regulatory purposes — at $12 per hour.

  • Failure to provide/obtain written consent. The Common Rule, as codified in federal regulation 40 CFR 26.117, specifically requires that written informed consent be obtained when risk of serious injury or death is involved in an experiment. As the consent form provided by EPA makes no mention of the risk of death, written consent acknowledging that they are willing sacrifice themselves for EPA regulatory purposes is not obtained.

EPA administrator Gina McCarthy sounds much like her boss. She doesn’t know anything about that, all studies are of the highest quality, etc. etc. etc.

Steven Milloy, founder and proprietor of JunkScience.com, which attempts to inject real science into phony government claims, has impeccable credentials. He writes that the “EPA air pollution scare is debunked by the best data set ever assembled on particulate matter and deaths.” In a subsequent column he explains just what the rules are on different kinds of studies.

Every time the EPA introduces a new policy that results in another power grab, the need for the power grab is couched in terms of how many kids are going to die from asthma, although doctors don’t even know what causes asthma. I find that suspicious. Yet with all the dead kids off there in the not distant future, the EPA is involving kids in their experiments without informing them or their parents of what the EPA believes to be their expected demise. They are deliberately exposing kids with asthma to what they regard as dangerous levels of toxic pollutants— which they then try to cover up. How do they get volunteers? Breitbart dug up some examples.

I am convinced that the EPA is an organization of environmental zealots solely interested in their own power. I have been writing about them for years, and I think the agency should be shut down and permanently shuttered. They exist only because of the bogus environmental scares fostered by the U.N.’s IPCC for political reasons, not scientific ones.

If fine particulate matter is not dangerous to human health, the EPA needs to stop using it to justify its power grabs. If it is dangerous the EPA has no business conducting tests on human subjects. And not to fully inform the poor guinea pigs of the dangers of the tests is beyond despicable.



There Is No Right To Be Free From Being Offended. by The Elephant's Child

How did we get to this spot in the history of the world when the guiding rule of society seems to be —”You must not offend anyone.” Is it an outgrowth of the self-esteem movement that did so much damage to our national psyche?  Do not disagree with me or you might damage my self-esteem?

In the last few days, a Mozilla executive was expelled from his position at the firm he co-founded by left-wing campaigners who determined to punish him, not for something he said in his role at the company, but for a donation he made to a California ballot initiative that defined marriage in the customary terms in which it had been defined for several thousand years. A donation that was made 6 years ago. The Los Angeles Times helpfully had published a list of all donors to the anti-Proposition 8 ballot issue.

Also in the last few days, one Adam Weinstein, who writes at Gawker, called for literally sending people who have the incorrect views about global warming to prison. “Those malcontents must be punished and stopped,” he wrote. He is not the first to suggest that conservatives should be sent to prison or a concentration camp for their crime of disagreeing with liberal thought.

Charles Murray, an important social scientist of our times, was denounced as a “known white supremacist” by Texas Democrats for holding improper views about education policy.

Condoleezza Rice was invited to speak at this year’s commencement ceremony at Rutgers University where she would receive an honorary doctorate. The faculty criticized the university decision, saying “Condoleezza Rice…played a prominent role in the administration’s effort to mislead the American people about the presence of weapons of mass destruction.” The editorial staff of The Daily Targum said “Do the positive aspects of her personal accomplishments really outweigh the destruction of war she contributed to during her political career? She was a major proponent of the 2003 invasion of Iraq, which has been arguably the worst and most destructive decision in the history of U.S. foreign policy.” All of which goes to prove that if you want to major in history, you should select some other university.

Then there’s Lois Lerner who is facing contempt charges relating to her role in using the IRS as a weapon against the Obama administration’s political enemies for their improper thought and advocacy.

Harry Reid, a liberal champion of campaign-finance reform, was caught channeling tens of thousands of dollars to his granddaughter, while carefully omitting her surname (same as his) from official documents, and hiding the transaction. When discovered, he quickly wrote a check to his campaign to cover-up his indiscretion. At the same time,Mr. Reid has been viciously attacking the Koch Brothers, who are prominent philanthropists, especially in seeking a cure for cancer, for implausible crimes because the Libertarian brothers donate to conservative causes.

I don’t know what part the self-esteem movement, in which most of our current adults were raised, plays into this liberal failure to recognize that good and honest people may have opinions that differ from theirs, or if it even does; but it is all right, and they just need to suck it up. Conservatives often marvel at the march in lockstep of Liberals. They regularly espouse the same ideas in exactly the same words, and apparently assume that no one will notice.

I have generously always assumed that the wordsmiths at Think Progress come up with what they hope will be the most fortuitous description of an idea or a policy to sway the minds of potential voters, then run the preferred words by a few focus groups to assure that they’ve got the best verbiage, then send it out to every Democrat politician who might use the words in public.  If that is the case, you must also assume that the Democrats in question don’t bother their pretty little heads with boring things like economics and history, and the long-term effects of past legislation. No scientific studies for this bunch, they will be told the proper language. Consider the words “The Patient Protection and Affordable Care Act,” that’s some major wordsmithery!

As evidence, I offer the media’s longstanding effort to capitalize on Republican disagreement—all that crowing about how Republicans are at war among themselves. We don’t all think the same, we do study history, we do pay attention to how legislation actually plays out, and we even read scientific studies. We are ordinary human beings and we have our own opinions, and aren’t afraid to disagree. Disagreement is —normal.  We’ll present our evidence, and try to compromise eventually, but we never, never march in lockstep.

Jonathan Rauch said it nicely in his Kindly Inquisitors, using ‘liberal’ in the classical sense: “Liberal science is built on two pillars. One is the right to offend in the pursuit of truth. The other is the responsibility to check and be checked.”

Irving Kristol wrote: “In every society the overwhelming majority of people live lives of considerable frustration and if society is to endure, it needs to rely on a goodly measure of stoical resignation.”

Feel free to offend. Stand up for what you believe. Refuse to be cowed by those who claim to be offended. We don’t do “thoughtcrime” in the United States of America, do we?



“Mission Accomplished” says Obama. Now What? by The Elephant's Child

I had a routine doctor’s appointment last week. As she interacted with the new computer system rather than me, my doctor said “I should have gone to secretarial school instead.”

So after “Obama’s ‘Mission Accomplished’ moment—his triumphal Rose Garden speech claiming ObamaCare is now here to stay—where are we? No one believes Obama’s lofty claims for the numbers of enrolled people, and the number who have actually paid their premiums (the only point at which the numbers are real) are numbers that will have to come from the insurance companies.

The underlying signs of the health of this dreadful medical law are something quite different. Kaiser Health News published the following:

Janis Finer, 57, a popular primary care physician in Tulsa, Okla., gave up her busy practice two years ago to care full time for hospitalized patients. The lure? Regular shifts, every other week off and a 10 percent increase in pay.

Lawrence Gassner, a Phoenix internist, was seeing four patients an hour. Then he pared back his practice to those who agreed to pay a premium for unhurried visits and round the clock access to him.  “I always felt rushed,” said the 56-year-old. “I always felt I was cutting my patients off.”

Tim Devitt, a family physician in rural Wisconsin, took calls on nights and weekends, delivered babies and visited his patients in the hospital. The stress took a toll, though: He retired six years ago, at 62.

Physician stress has always been a normal fact of life, but anecdotal stories suggest a significant increase in the level of discontent, especially among primary care doctors who play the central role in coordinating patient care. Just as millions of Americans are obtaining health insurance through ObamaCare because of the threats of fines, or because their insurance policies were cancelled— often because the benefits they chose did not match the government’s one-size-fits-all standard.

A 2012 Urban Institute study of 500 primary-care doctors found that 30 percent of those age 35 to 49 planned to leave their practices within five years. The rate jumped to 52 percent for those over 50. A RAND study for the American Medical Association found that nearly half of physicians called their jobs “extremely stressful” and more than one-quarter said they were “burning out.” Unhappy doctors make for unhappy patients, and unhappy patients result in unhappy doctors.

Janice Finer, who left primary care to work with hospital patients, didn’t want to have to deal with insurers, hiring staff, and the business of a practice —sold her practice to a hospital. But hospital administrators dictated the pace. She was required to see 22 to 28 patients a day. At one point, she said, she was scheduled to see patients every 11 minutes. But meeting patients’ needs is not just busy work, but it doesn’t generate revenue.

President Obama contributed billions to help defray providers’ costs of going digital. The goal was a national system that would provide the government with statistics for further control. Not happening. Every hospital may have a different system, and none of them talk to each other. Digital records mean entering numbers and words in lots of repetitive boxes, but the old kind of personal, nuanced information that was in a doctor’s note, aren’t included. “Many physicians told us “I used to be a doctor, now I’m a clerk.” Anyone who uses a computer can recognize the potential for error. Typos are a way of life. Some doctors have started using ‘scribes’ —laptop carrying assistants who fill in the blanks and take notes— which adds another level of cost.

The association of American Medical Colleges estimates that the U.S. will be short about 45,000 primary care doctors in 2020 when 260,000 are projected to be practicing. Doctors used to encourage their kids to go into medicine. They’re not doing that anymore.

President Obama in his “Mission Accomplished” speech stressed the objective of the Democrats who drummed up this mess: “We are making sure that we are not the only advanced county on earth that doesn’t make sure everybody has basic health care.” Tinkering and improving are expected to lead to single-payer health care which is the their ultimate goal.

Nationalizing health care inevitably leads to conflicting problems.Government programs always cost more than was estimated — way more. The government’s sole incentive quickly becomes a demand to reduce costs.

The incentive for hospitals and clinics is the need to get adequately paid for their services. Those incentives lead to a reduction in innovation unless it is proved to reduce costs— so fewer medical inventions, fewer new drugs.

And pressure on doctors and personnel is to do more in less time with fewer and cheaper materials.  The incentive is also for doctors to leave the profession or for doctors to become government employees. What is inevitable is a lot of burned-out doctors who become more cynical and less caring. Ezekiel Emmanuel, who was one of the advisers for ObamaCare, has advocated disposing of the Hippocratic Oath.

The problem for patients becomes getting an appointment, getting use of expensive diagnostic equipment, and facing long waits for seeing a doctor and seeing a specialist and just getting the needed care. A frequent look at British newspapers’ accounts of the latest NHS scandal is proof of where it all leads.

If health care is free or low-cost at the point of service, the incentive is to overuse medical care which is what got us here in the first place. When someone else is paying the bill, there is no incentive for thrift,  which drives up costs and the vicious cycle repeats and  grows slowly worse, and harder to change.  Incentives matter.

 

 



SWAT Teams From the EPA, NOAA, and the Department of Education? by The Elephant's Child

SWAT team

The proliferation of federal SWAT teams is troubling. In late February four armed federal agents with a drug-sniffing dog descended on the Taos Ski Valley in what was called a “saturation patrol.” The agents were working on tips of possible drug selling and impaired driving in the ski resort’s parking lot and surrounding area. The armed agents were from the U.S. Forest Service.

Did you know that the Department of Education has SWAT teams? They can invade your home at gunpoint and hold you and your family in custody for hours. In 2011, federal “education” agents busted down the front door of Kenneth Wright’s Stockton home at 6 in the morning. Wright’s terrified children— 3, 9, and 11 were forced to sit in a patrol car for two hours, Wright was in custody for six hours.

The Education Department had a broad search warrant and seized paperwork and a personal computer. The agents, 13 from the Education Department and a couple of police officers — told him they were investigating his estranged wife’s use of federal aid for students. She didn’t even live in the house.

Are you obeying all the thousands of regulations in the Federal Register? Are you prepared for early-morning break-ins by the USDA, Railroad Retirement Board, Bureau of Land Management, Tennessee Valley Authority, Office of Personnel Management and the Fish and Wildlife Service, Department of the Interior, EPA, Postal Inspection Service, U.S. Park Service, and NOAA— the folks who monitor the atmosphere and forecast the weather have 96 special agents and 28 armed enforcement officers.

An armed EPA raid in Alaska sheds light on 70 federal agencies with armed divisions. The incident that sparked the raid was last August when a team of armed federal and state officials descended on the tiny Alaska gold mining  town of Chicken,  Alaska — looking for possible violations of the Clean Water Act. This is not the first time the EPA has descended on citizens with a SWAT team, but it is clearly excessive. Violating the Clean Water Act indeed.

We’re getting into Fourth and Fifth Amendment territory here.



Slash the Budget of the Department of Agriculture! by The Elephant's Child

Just briefly looking around the USDA website convinced me that the Department of Agriculture has way too many bureaucrats employed, and their conception of what they should be doing is way too broad. I have never known anyone who has paid the slightest attention to the USDA’s guidelines as to just what we should be eating, which is just as well because they have mostly been wrong anyway.

The schools, unfortunately, have to pay attention because they get funding, but anyone who has ever visited a school lunchroom notices that enormous quantities of food end up in the garbage. The kids have mostly hated Michelle Obama’s school lunch program. The USDA’s high carb diet was all wrong, butter is fine, they’re still trying to reduce “greenhouse gas emissions” although carbon dioxide in the atmosphere is what makes plants grow, and apparently, according to the EPA, soon their mission will be to reduce cow flatulence.

The federal Dietary Guidelines Advisory Committee is currently working on updating nutritional guidelines to conform with Mrs. Obama’s ideas and new scientific evidence. Mrs. Obama has been behind the drastically altered school lunch menus and the federal push to change restaurants’ most popular items to healthier fare and add calorie counts to every menu. She also has a new nutritional food labeling scheme.

One of the committee members, Miriam Nelson,  feels the guidelines shouldn’t be confined to nutrition, but should include the long-term sustainability and environmental impact of crops recommended for eating.  Another committee member is pushing a “plant-based diet” — suggesting that meat eating is not sustainable.

Another new idea under consideration are federal phone texts to obese citizens warning them regularly of their unhealthy eating behavior.

I pay no attention to the “my plate” guidelines, and I’m sure you don’t either, but the work of this committee guides the food purchases by the feds for government cafeterias, school meals across the country, all branches of the U.S. military and the entire federal prison system.

Michelle has insisted that the White House chef change from sugar to fruit purees to sweeten foods, but the White House consumes six different kinds of pie for Thanksgiving, The state dinner for the president of France came in at 2,500 calories per plate — a more-than-healthy whole day’s allowance. Remember that when you get your text-message from the government telling you what to eat, and reminding you that you are officially categorized as obese.




Follow

Get every new post delivered to your Inbox.

Join 6,439 other followers

%d bloggers like this: