Nov 192013
 

Forbes has published my latest OpEd, “The Only Obamacare Fix Is For Obama To Legalize Real Health Insurance“.

My basic theme is that we need to legalize real “catastrophic-only” insurance, free of government mandates.  More broadly, instead of debating which new government entitlements to create, we should be vigorously debating which freedoms to restore.

Here is the opening:

The President has proposed a one-year “fix” to deal with the political fallout from his broken promise (or lie), “If you like your insurance plan, you will keep it.” Now it’s, “If you like your plan, you can keep it until after the 2014 mid-term elections. Maybe.”

But the problems with ObamaCare go much deeper than cancelled insurance. As surprising as it sounds, most Americans never had real health insurance to begin with — and were not allowed to by law. And the only cure for our current health insurance mess is to legalize real health insurance…

I discuss the history of how we got into our current mess and some concrete free-market reforms that would move us in the right direction. These include:

1. Eliminate the tax disparity between employer-provided health insurance and individually-purchased health insurance.

2. Eliminate all mandated benefits. Insurers should be free to offer to willing consumers inexpensive policies covering only catastrophic accidents and illnesses.

3. Allow insurers to sell policies across state lines.

(For more details, read the full text of “The Only Obamacare Fix Is For Obama To Legalize Real Health Insurance“.)

If you like these ideas, please feel free to circulate the column to friends, family members, etc.

You can also send your elected officials a quick e-mail. Please feel free to use and/or modify the template below:

Dear [Congressman or Senator]:

As the current problems of the Affordable Care Act are becoming more apparent to Americans, we need to consider genuine free-market reforms.

I like the ideas in this recent Forbes article, “The Only Obamacare Fix Is For Obama To Legalize Real Health Insurance“, including the following:

  1. Eliminate the tax disparity between employer-provided health insurance and individually-purchased health insurance. This would uncouple health insurance from employment and restore a level playing field to the individual insurance market. Individuals could then purchase policies that they kept even when they changed jobs (just as they already do with their car and homeowners insurance).
  2. Eliminate all mandated benefits. Insurers should be free to offer to willing consumers inexpensive policies covering only catastrophic accidents and illnesses. Insurers would remain free to offer richer policies that covered varying levels of elective procedures (but cost correspondingly more). Customers could purchase whatever levels of coverage they wished from willing insurers based on their own individual needs and circumstances.
  3. Allow insurers to sell policies across state lines. State mandates create 50 separate state markets rather than a single national market. A family insurance plan costing $3,000 in Wisconsin might cost $10,000 in New Jersey because of state regulatory barriers. Allowing interstate competition would quickly drive down prices and help many working families on a tight budget.

I hope Congress can discuss and debate these ideas as a way to truly fix our health care system.

[Signed your name, address, etc.]

 

PJ Media has just published my latest column, “Will Tomorrow’s Medical Innovations Be There When You Need Them?

My basic theme is that we must protect the freedoms necessary for the advancement of medical technology.

I start with a pair of vignettes:

How much has American medicine changed in the past 30 years?

Let’s turn the clock back to 1983. A middle-aged man, Dan, is crossing the street on a busy midday Monday. An inattentive driver runs a red light and plows into Dan at 45 mph, sending him flying across the pavement. Bystanders immediately call for help. An ambulance rushes Dan to the nearest hospital. In the ER, the doctors can’t stabilize his falling blood pressure. They prep him for emergency surgery. The trauma surgeon tries desperately to stop the internal bleeding from his badly fractured pelvis but is unsuccessful. Dan dies on the operating table.

The surgeon gives Dan’s wife the sad news: “I’m sorry, but your husband’s injuries were too severe. We did everything we could. But we weren’t able to save him.”

Fast forward to 2013. Dan’s now-grown son Don suffers the same accident. But within minutes of his arrival in the ER, he’s sent for a rapid trauma body CT scan that shows the extent of the pelvic fractures — and more importantly, shows two badly torn blood vessels that can’t be easily reached with surgery.

An interventional radiologist inserts a catheter into the femoral artery in Don’s right leg. Watching live on the fluoroscopy screen, the radiologist skillfully guides the catheter through the various twists and turns of the arterial system and positions it at the first of the two “bleeders.” From within the blood vessel, he injects specially designed “microcoils” into the torn artery and stops the bleeding. He then guides the catheter to the second bleeder and repeats the procedure. Don’s blood pressure recovers. The surgeons now have time to repair Don’s pelvic fractures and other internal injuries.

The surgeons give Don’s wife the good news: “Your husband’s injuries were pretty bad. But we were able to fix everything. He’ll still have to go through recovery and physical therapy. But he should be back to normal in six months”…

For more, read the full text of “Will Tomorrow’s Medical Innovations Be There When You Need Them?

(The material for the opening vignettes was drawn from two excellent presented last month at the 2013 annual meeting of the American Society of Emergency Radiology. )

Update #1: A great example of medical innovation coming from unexpected places was this 11/14/2013 New York Times article describing how an Argentinian car mechanic saw a Youtube video on how to extract a stuck cork from a wine bottle and realized it could also be used to help extract babies stuck in the birth canal.

His idea will be manufactured by Becton, Dickinson and Company and has already undergone initial successful safety testing in humans. It could save the lives of many babies in Third World countries and also reduce the need for Caesarean section in industralized countries.  (Via Gus Van Horn.)

Update #2: For those interested in the real-life technology used in the fictional scenario I discussed, here’s a nice medical slideshow from UCLA interventional radiologist Dr. Justin McWilliams, “Life-saving Embolizations: Trauma and GI bleeding“.

Nov 062013
 

PJ Media has posted my snarky column, “Obamacare and the Wages of Spin“.

The basic theme: Don’t piss on my back and tell me it’s raining.

Here is the opening:

Many years ago, the writer Ayn Rand noticed a curious kind of backpedalling from the political Left. First, they’d claim that socialism would provide enough shoes for the whole world. But when economic reality caught up with them, and they failed to deliver on their promises, they’d turn around and claim that going barefoot was superior to wearing shoes. In modern parlance, those broken promises weren’t a bug, but a feature!

In the past few weeks, we’ve seen precisely this pattern coming from defenders of ObamaCare. For example…

Read the full text at: “Obamacare and the Wages of Spin“.

 

October 2013 is Breast Cancer Awareness Month.

Hence, it’s apropos that Forbes has just published my latest OpEd on this topic, “Why The Federal Government Wants To Redefine The Word ‘Cancer’“.  Here is the opening:

The federal government wants to reduce the number of Americans diagnosed each year with cancer. But not by better preventive care or healthier living. Instead, the government wants to redefine the term “cancer” so that fewer conditions qualify as a true cancer. What does this mean for ordinary Americans — and should we be concerned?…

I discuss the reasons behind the proposed redefinition, why it could matter from a political (as well as medical) standpoint, and implications for patients and doctors.

I’d like to thank Dr. Milton Wolf for providing the quote at the end!

(Read the full text of”Why The Federal Government Wants To Redefine The Word ‘Cancer’“.)

 

PJ Media has published the final segment of my 4-part series on the changing face of American medicine under ObamaCare, “How Patients Can Protect Themselves Against Big Medicine“.

Earlier segments include:

Part 1: “Your Future Under Obamacare: Big Medicine Getting Bigger” Part 2: “How Big Medicine Will Affect Patient Care” Part 3: “The Eyes of Big Medicine: Electronic Medical Records

[Crossposted from the FIRM blog.]

Sep 272013
 

Whoops! I forgot to post this when it was published. — DMH

PJMedia published part 2 of my 4-part series on changes in American health care: “How Big Medicine Will Affect Patient Care

Here is the opening:

The first article of this series described how the ObamaCare law is fueling the rise of government-controlled Big Medicine. This second article will take a closer look at how Big Medicine will control how what medical care patients can receive.

I discuss how government controls over health spending will lead to controls on the health care you may be able to receive. These controls interpose the government between the doctor and the patient, endangering the doctor-patient relationship.

 

Forbes has published my latest piece, “How Much Will Your Life Be Worth Under Obamacare?

Here is the opening:

How much will your life be worth to the federal government under ObamaCare? Less than you might think. We can make an educated guess by looking at which medical screening tests the government U.S. Preventive Services Task Force (USPSTF) considers worthwhile…

I also discuss problems with one-size-fits-all government medical recommendation, and how President Obama and his doctor knowingly violated guidelines set by his own federal task force.

(For more details, read the full text of “How Much Will Your Life Be Worth Under Obamacare?“)

Tips for Going to the ER

 Posted by on 1 July 2013 at 1:00 pm  Emergencies, Health, Health Care, Medicine
Jul 012013
 

As y’all know, I recently interviewed emergency medicine physician Dr. Doug McGuff about “Avoiding the Emergency Room” on Philosophy in Action Radio. If you’ve not yet heard it, you can listen to or download the podcast here:

Toward the end of that interview, Dr. McGuff offered some tips for if you do end up in the ER, including being very honest and factual about your symptoms. Along those lines, I recently stumbled across an article with useful tips for getting better care at the ER. Here’s the list of basic recommendations, but check out the article for more details.

  • Avoid nights, weekends and holidays
  • Call your regular doctor before you go
  • Bring a list of your medications
  • Have your medical records and tests handy
  • Make sure your hospital treats what’s ailing you
  • Try to be understanding
  • Bring somebody with you
  • Avoid the ER altogether

Obviously, if you’ve just been run over by a bus, you’re just going to have to muddle along as best you can. However, often you can plan in advance, and in that case, the advice is good!

 

PJ Media recently published my latest OpEd, “Is Obamacare’s Fatal Flaw Taking Effect?

I discuss how ObamaCare requires voluntary cooperation of people who will be harmed by the law — which gives Americans a powerful weapon.  Don’t be a willing accomplice to a law you don’t support!

I’d also like to thank Dr. Megan Edison for allowing me to quote her.

Update: I’m also encouraged by the fact that some former supporters of the law appear to now be having second thoughts: “Unions break ranks on ObamaCare” (The Hill, 5/21/2013)

May 062013
 

Dr. Beth Haynes of the Benjamin Rush Society has a nice OpEd in the Huffington Post, “Almost All Americans Lack Health Insurance“.

She adds much-needed conceptual clarity in the discussion over health policy by discussing the nature of genuine insurance, as opposed to our current system. From her piece:

What is insurance? Think about your auto, life and homeowner’s insurance. Each of these is designed as a means to pay for unexpected, unpredictable, very expensive occurrences outside of the control of the policyholder. Insurance is a means of financially protecting people from the risk of unlikely but high-cost events. To build up sufficient funds, the insured pays a premium calculated on their specific chance of experiencing a covered event. Insurance companies can only stay solvent if what they take in as premiums is greater than what they pay out in claims (plus business expenses and a competitive profit).

So what is it we have that we call health insurance but isn’t? We have the prepayment of medical expenses. We expect our “insurance” to cover predictable, relatively inexpensive events like health maintenance checks, minor illnesses and injuries — and to pay for them with minimal out of pocket spending. Under Obamacare, these expectations will be mandated by law. The new law actually makes it illegal for insurance companies to charge individuals premiums equal to their risk of making claims. It’s like having a law requiring homeowner’s insurance to pay for lawn care, house painting and water heater replacement, while at the same time prohibiting the companies from operating an actuarially sound business.

Instead of genuine insurance, we are moving towards a system of bad pre-paid care.

For more details, read the full text of “Almost All Americans Lack Health Insurance“.

And by the way, under Dr. Haynes’ leadership, the Benjamin Rush Society has been sponsoring an excellent series of debates on important health policy issues. Go check out their website for details and videos!

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