Hey, I want free medicine too

People are rightly protesting on religious grounds the fact that Obama has mandated that health care plans must cover birth control and morning after pills:

Most healthcare plans will be required to cover birth control without charging co-pays or deductibles starting Aug. 1, the Obama administration announced Friday.

The final regulation retains the approach federal health officials proposed last summer, despite the deluge of complaints from religious groups and congressional Republicans that has poured in since then. Churches, synagogues and other houses of worship are exempt from the requirement, but religious-affiliated hospitals and universities only get a one-year delay and must comply by Aug. 1, 2013.

Aside from the religious aspects, I think this whole thing is grossly unfair.  What about my migraines?  I should get free medicine.  And how about the heartburn that’s plagued me since my pregnancies?  I want free Prilosec.  Many of you, I’m sure, have medicines that you think should be free too.

My point is that, entirely aside from the ethics of forcing religious institutions to fund birth control, it’s simply wrong to make everyone in America underwrite one specific type of prescription.  Of course, in the world of socialized medicine, where the president gets to call the shots, rather than the people who actually foot the bills, there is no right and wrong:  there’s only politics.  The Hell with religious freedom or other outdated Constitutional doctrines.  We live in a modern age, with a modern president, one committed to turning us into the dying old world of Europe.

Californians: Do not get sick between Thursday and Saturday, because the unions are on the move

I’m surprised that there’s so little news about an upcoming nurses’ strike in Northern and Central California.  This story should be a big deal, in large part because the nurses who are going on strike in thirty-four Northern and Central California hospitals actually have no complaint.  Instead, they’re putting thousands of patients at risk because their union wants to show its sympathy to another union (emphasis mine):

Thousands of registered nurses plan to walk off the job at 34 hospitals in northern and central California on Thursday in one of the largest such labor actions here in years.

Up to 23,000 nurses could be involved in strikes at Children’s Hospital Oakland and the large Sutter Health and Kaiser Permanente systems, union leaders said.

[snip]

Kaiser nurses signed a contract earlier this year, but they plan a sympathy strike Thursday to support members of the National Union of Healthcare Workers, who will walk off the job at Kaiser facilities in a separate contract dispute.

Here in Marin County, there are three hospitals:  Kaiser in San Rafael, Sutter in Novato, and Marin General, which broke with Sutter a year or two back.  For up to three days, starting Thursday morning, there will be only one fully functional hospital in Marin, a county with more than 250,000 residents (emphasis mine):

Workers at all of the North Bay Kaiser facilities will be striking, but consolidated picket lines will be held in Santa Rosa, San Rafael and Vallejo, NUHW spokesman Leighton Woodhouse said. The strike would include about 220 workers across the North Bay, at facilities in Marin, Sonoma, Napa and Solano counties.

The California Nurses Association, with some 17,000 registered nurses at Kaiser facilities, will join the union as part of a sympathy strike, according to NUHW, which will amount to the largest strike in Kaiser’s history. Workers will walk off the job for one-, two- and three-day durations from September 21 to 23.

What’s just as bad is the way in which the hospitals, which cannot take the risk of patients dying because of the strike, will have to cope with the nursing deficit.  Kaiser, for example, is flying in strike-breakers, at a cost of $9,000 or so per strike-breaker.  The deal with these fly-in nurses is that they insist upon receiving a five-day contract, even though this strike is projected to last only one to three days.  While it would be impossible for Kaiser to have a replacement for each of the approximately 17,000 nurses on strike, the money Kaiser will be forced to pay out for this sympathy strike is outrageous.

Things are even more complicated than simply finding replacement nurses at incredible expense.  Most of the hospitals involved now have very complicated computer systems that are custom designed for each hospital chain.  These computer systems control everything:  nurse’s notes, doctor’s notes, pharmacy, lab tests, treatments, billing — you name it, it’s all computerized.  What these means is that hospitals are no longer fungible.  In the old days, a chart was a chart, and that was true whether you were in a hospital in Schenectady or San Francisco.  Nowadays, though, nurses have to understand computer systems that are unique to a given hospital.  That nurse who’s been flown in from out-of-state doesn’t know Kaiser’s or Sutter’s computer system.  For those nurses, it’s like having to fly a 747 when you’ve only flown a Piper before.

And again, let me remind you that the nurses aren’t walking off the job to improve their own working situation.  This is all about union solidarity.  So, my advice to you, if you live in the San Francisco Bay Area and the northern parts of Central California is to play it safe starting Thursday.  Even if your hospital isn’t one of the ones dealing with a strike, it might be feeling awfully overwhelmed.  If you were thinking of doing some DIY work with power tools, hold off a few days.  If you were planning on sending your kids to a park with lots of monkey bars, send them out to play on the lawn instead, or maybe just plunk them in front of the television.  For the latter part of this coming week, you can’t be too safe.

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A problem with medicine that ObamaCare won’t solve

I spent four hours at my Mom’s yesterday trying to organize her medicines.  I am more gray now than I was before.  My son, who was with me, kept saying “This is insane.  This is insane.”

The insanity operated at a lot of levels.  Some of the insanity comes about because my mother likes her medicines (my son calculated that she takes approximately 800 pills per month, or 9,600 pills per year), and because she takes them on a schedule of her own devising, entirely separate from what’s on the pill bottles.  This meant that, after I’d organized her 800 pills for the month according to the actual prescription, she announced that half the drugs in the boxes shouldn’t there because she doesn’t follow the prescription.  At this point, my son physically restrained me from leaping across the table and strangling her.  (I exaggerate.  He actually gave me a kiss and a hug when he realized I was getting very frustrated.)

Another aspect of the insanity is the uncoordinated medical care my mom gets.  I’m used to Kaiser, which operates on a centralized model.  The doctors all plug into the same computer system, so whether I go to an Ear, Nose & Throat specialist, a Generalist, or Dermatologist, each has access to my medical records, and can readily see what drugs, if any, I’m taking, and what treatments, if any, I’m getting. This means that I don’t get overlapping, duplicative, or conflicting drugs or treatments.  Also, because it’s not fee for service, Kaiser has an interest in efficient medicine, which includes cutting down on unnecessary pills.  Market competition, however, ensures that Kaiser doesn’t take this philosophy so far that it deprives its customers of necessary treatment.

My mother, however, refuses to make the market choice to go to Kaiser.  In the days before medicine went insane, Kaiser did not pay very well compared to private practice, and private practice doctors weren’t yet driven broke and mad by malpractice, managed care, and government regulation.  Medicine’s best and brightest, therefore, did not usually end up at Kaiser.  As medicine changed, though, with private practice doctors overwhelmed by the costs of malpractice insurance, and buried under managed care, government, and insurance requirements, Kaiser suddenly started looking very good.  As a result, in San Francisco and Marin, Kaiser provides some of the highest quality medical care available, all for one monthly cost, plus low medicine co-pays.

My mother’s traditional care is the exact opposite of the Kaiser model.  Although she ostensibly has a geriatric doctor who oversees and coordinates everything, the reality is that she goes to several private practice offices, none of which are connected to her geriatric doctor or to each other.  Heart Specialist A has no idea what medicine Endocrinologist B is giving my mom.  Theoretically, each sends an email to Geriatric Specialist C, apprising him of the situation, but it’s like the old game of telephone, where the message breaks down.  The situation is made worse by my mom’s personality, since she distrusts one of her geriatric doctors and, as I said, ends up taking the medicines to suit herself anyway.

The real problem, though, comes at the pill level.  Because my mom orders from different pharmacies, and because these pharmacies order drugs from different manufacturers, all of her pills look different from each other.  For a given prescription, Pharmacy X might send a purple 50 mg capsule, with instructions to take one at bedtime; Pharmacy Y might send a red/white 50 mg capsule, with instructions to take one at bedtime; and Pharmacy Z might send blue 25 mg capsules, with the instruction to take two at bedtime.  Regardless of cause, the result is that, from month to month, my mother, a very visual person, has no idea what her medicine is supposed to look like and often has no idea how many pills to take.

Pharmacy labels are also a problem:  They’re sooooo small.  The only company I know that has taken this issue seriously is Target, which specifically markets clear, large print, straightforward labels.  Unfortunately, my mother, a stubborn person, refuses the Target option.

The end result of this is that the labels my mom gets vary from pharmacy to pharmacy.  All, though, offer small writing, with the relevant information appearing almost randomly on the labels.  Between my mom’s macular degeneration and my middle aged eyes, both of us were struggling to compare the pills before us to the laundry list of medicines she takes.  Fortunately, my son was there to read the multi-digit numbers printed in microscopic font on the drugs themselves.

I don’t see how ObamaCare can fix this problem.  To begin with, it cannot change my mom’s psychology.  She’s going to do things the hard way regardless.  Second of all, you cannot replicate Kaiser on a nationwide scale.  If Kaiser were suddenly a government owned and operated business, with no competition, it would simply be Britain’s National Health Service, which is running out of money.  Read the British papers and you’re daily assaulted with stories of massive drug and treatment denials.

The lack of competition is the real killer (literally) for NHS patients.  In response to stories about old or sick people are left in hallways to die, deprived of food or drink, or otherwise abused, or about treatments and medicine denied, the British government organizes commissions that, after several years, release studies and make recommendations, which recommendations then slowly wend their way through the political process and are occasionally passed, only to be ignored by the hospitals, which have no competition.

ObamaCare doesn’t improve the confusing pill situation either.  There is no ObamaCare mandate requiring that all drugs look the same, regardless of manufacturer.  Nor can one force all pharmacies in a region to buy from one manufacturer, or require a single pharmacy to stick with one manufacturer regardless of price needs.  The best pill solution is a market-based solution, although Target is so far the only one that has seen the light.

As it is, I’m just going to keep adding the gray hairs, and dragging my son along to aid in my emotional stability.

Cross-posted at Right Wing News

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I’m being a doofus and I need your help

My daughter is trying to compare medical treatments and outcomes during the Civil War and during the current wars.  Broadly speaking, that’s quite easy, ’cause all you really need to know are antibiotics and sterile techniques.  Everything else is a subset (and yes, I know I’m grossly over-simplifying).

The problem for her is the level of detail she needs.  For example, she needs to know the number of amputations performed.  I can’t seem to communicate to her that, in the old days, they cut things off because they couldn’t fix them; nowadays, medical amputations usually finish the job that an IED started.

More generally, she needs statistics on medical treatments and outcomes during the current wars — the numbers of wounded and the numbers of surgical procedures performed.  Also, are any troops dying of infectious diseases?  (I know that, during the Civil War, dysentery was a great killer, just as malaria decimated troops in the Pacific.)  My daughter also insists that she wants data on the number of troops nowadays dying of infected wounds.

Do you guys have any suggested websites?  My searches have been ineffectual.  Comparing the state of medicine during the Civil War to the state of medicine now isn’t just comparing apples to oranges, it’s comparing shoes to caterpillars.

The fraudulent health care metric underlying Obama Care

ObamaCare represents an effort to bring America in line with European and other socialized health care systems.  The sales pitch is now, and has always been, that “studies” show that the other, socialized, systems are “better” than the American system.  The crown jewel of these “studies” is a 2000 World Health Organization analysis ranking systems.  Intuitively, I knew it was wrong.  I’ve lived in a socialized medicine country and I have family and friends who also live under such systems.  The systems offer the bare minimum to everyone.  They fiddle with their infant mortality statistics.  If people have the money, they come to America for treatment.

In the recent edition of Commentary Magazine, Scott Atlas actually looks at that World Health Organization study and discovers precisely why these horrible systems got such high rankings:  WHO’s people weren’t interested in medical outcomes, they were only interested in the number of people who had access to something very loosely called “medical care.”  You have to read the article, which is now available for free.  If you read nothing else today, this week or even this year, read this article — and then send it to everyone you know, twice.

Just a few observations about medical care

My mother is very old.  This means that she no longer actively contributes to society.  Her working and child-rearing days are over.  She lives off of her diminishing savings, a small pension and her social security checks.  In a utilitarian world, she has no value.  Because — thankfully — we haven’t yet reached that moral abyss, in our world, she has a high value:  my sister and I love her, and her friends like and respect her.

I mention this because I spent this morning in the hospital with my mother.  She has a recurring heart problem that can be fixed by cardioversion (i.e., electric shocks).

From the moment her heart went flippy-wacky this morning, she received the following treatment:  a phone call with her cardiologist; a visit from the onsite doctor at her retirement home; double doses of heart medicine; an ambulance trip to the emergency room; an hour stay in the ER, complete with IVs and blood tests from two different nurses; an ER bedside visit from her cardiologist; a trip up to the cardioversion room, which involved the nurse and an orderly to move the gurney; an hour-long prep, involving forms to fill out, expensiive monitors, all sorts of special sticky things that were put on her back and chest as part of the procedure; an anesthesiologist; the procedure itself by the cardiologist; and then a follow-up EKG to get a good sense of her sinus rhythm.

I don’t know how much this morning’s care will cost (especially since it will be billed straight through to Medicare and her insurance), but I can guarantee you it will cost a lot of money.  Someone has to pay for the drugs, the ambulance, the ER bed, the lab tests, the cardioversion equipment, the EKG machine, and the eight people who took care of her (two EMTs, two nurses, a tech, and three doctors).

My mom’s stay raised two questions vexing to the statist:  First, do people in their high 80s deserve this kind of high level treatment?  In hardcore Soviet countries, the answer was always no, but it was never so crudely stated.  The fact was that everyone got equally lousy, minimalist care, but the elderly, by being sicker and more fragile, died more quickly.

European socialist countries also answer that question with a “no.”  They’re also not crude in stating it as a standard treatment principle.  It’s just that, if you read the British papers, you’ll discover that elderly people are ignored in hospitals, and that treatments that disproportionately benefit the elderly are phased out as too costly relative to their benefit.

(Apropos the manifestly abysmal care in socialist countries, we’ve all been told repeatedly that the care there is better than American health care.  To understand the vast fraud perpetrated on those trying to figure out whether socialized or free market medicine is better, you must read this Commentary Magazine article.  It’s behind a pay wall, so you either have to pay for the article itself or subscribe to Commentary Magazine.  I recommend the latter.  For a relatively low price, you get what must surely be the best magazine around.)

Second, how do you deal with the fact that modern medicine is so labor and equipment intensive?  Two hundred years ago, my mom would have been bled.  That would have been the end of the treatment and probably the end of my mom, too.  It would also have been very, very cheap.  Even fifty years ago, a practitioner’s options were limited to a few pills, some surgeries, and palliative care.

Today, the options seem endless — and they’re very costly.  The only way to bring down the cost is to refuse treatment, which can be done either through price controls, which make treatment prohibitively expensive for the provider, or through rationing, which makes the absence of treatment potentially deadly for patients.

Oh, wait, I forgot.  There is one more way to bring costs down:  the free market.  Competition is a beautiful thing.  As always, let me mention here the flash drives that used to sell for hundreds of dollars, and are now given away for free, like pens.  But for the socialists caught in their dilemma, the free market is the one route they refuse to consider.

MSM finally notices threats against politicians (sort of) *UPDATED*

From the moment Gov. Walker squared off against the public sector unions in Wisconsin, conservatives noticed something interesting:  The mainstream media, which was all aflutter about politician safety after a paranoid schizophrenic aimed a gun at a Democratic Senator, wounding her and killing a heroic Republican judge), showed remarkable restraint in reporting about threats against a Republican governor and Republican senators.  Indeed, the MSM’s restraint was so great, it failed to do any reporting at all.

The overwhelming silence got to Lee Stranahan — a self-identified Progressive — who felt compelled in all decency to call out the MSM for its hypocrisy:

Three questions for you.

  1. Do you think of Republicans and the Tea Party as dangerous, violent extremists?
  2. Do you think the Wisconsin protests over GOP Governor Scott Walker’s move to strip public sector employees of collective bargaining were peaceful?
  3. Do you scoff at the right wing notion that mainstream media like the New York Times, the TV networks and NPR have a liberal media bias against the conservatives?

If you answered ‘yes’ to all three of those questions, then let me ask you one more…

Why isn’t the mainstream media talking about the death threats against Republican politicians in Wisconsin?

[snip]

Burying the death threat story is a clear example of intellectual dishonesty and journalistic bias.

Don’t take my word for it, though. Look into the story of death threats in Wisconsin yourself and see who has been covering the story and who hasn’t. Try for a moment to see this story from the perspective of those who you may disagree with on policy and ask yourself how this looks to them. Can you blame them for feeling that way? Then take a few seconds and read those questions I asked you at the beginning of this article.

And then ask why progressives shouldn’t expect more from our media — and ourselves — than we expect from our political adversaries.

I don’t respect Stranahan’s political beliefs, which are antithetical to mine, but I certainly respect his personal integrity and his honesty.

I’m happy to report that one news reporter, perhaps influenced by Stranahan’s post, finally realized the error of her ways and focused on the threats to conservative politicians.  So it is that, today, the SF Chronicle has a front page story entitled “Threats directed at any state GOP.”

Isn’t that great?  The Chron is reporting about threats against California conservatives.

Okay, I confess.  I’m leading you down the primrose path.  What the headline really says is “Threats directed at any state GOP ‘turncoats.’“  In other words, the other threats against the GOP that the Chron seems willing to acknowledge are those coming from other members of the GOP.

But should California’s Republican politicians start barricading themselves in their houses and traveling with guards to protect themselves from their fellow party members?  Are they having their outlines drawn in chalk on the sidewalk, their home addresses published, their children threatened?  Well, not really.  What’s actually happening is that California state GOP people are hearing from the grassroots that, if they don’t pay attention to calls for true conservatism, they won’t be reelected!  How’s that for a front-page-worthy threat?  Those crazy Tea Partiers know how to play mean and dirty.

I’m beginning to understand the threat algorithm in the MSM:  Eight years of vile threats and imaginings against George Bush — ignore.  Insane shoots Senator he’s been stalking for four years — blame Tea Partiers.  Progressives and public union members threaten Wisconsin conservatives with death — ignore.  Tea Partiers warn that they won’t reelect wobbly GOP members — phrase so vaguely on newspaper front page that it looks to the casual reader as if Tea Partiers are ready to kill their own.

Being a member of the Progressive MSM means you never actually have to think.  How relaxing.

UPDATE:  Deroy Murdock compiled, verbatim, some of the Wisconsin death threats that the media yawns about.

UPDATE II:  When I wrote the above, I said that the SF Chron article was written to imply that Tea Party activists were actually violent.  At the time, I didn’t have proof.  Now I do.  As reliably as a stopped clock, one of my liberal facebook friends wrote that the California GOP was made up of “thugs” who “beat the crap” out of people.

The difference between withholding brutal treatment and killing someone

In the old days, medical treatment was more likely to kill than to cure.  For example, one can make a good argument that George Washington died because his physicians bled him to death.

It’s scarcely strange, then, that homeopathy was such a hit when it first appeared on the scene.  The principle, as I understand it, is that one puts a drop of something medicinal (or, often, poisonous) into a container filled with pure water.  Then, one takes one drop of that mixture and adds it to another container filled with pure water.  And then, one repeats that process again (and, perhaps, again).  The end result is a container filled with pure water.

People who practice homeopathy believe that the water has the essence of the medicine, and therefore has a curative effect.  Whether that is true or not, a patient in 1820 who was given pure water to drink was likely to suffer less, and perhaps heal better, than the patient who was bled, cupped, given mercury, and subject to other horrific pre-modern medical treatments.

Nowadays, medicine is much more effective, although some of the side effects can be every bit as nasty and even fatal as the old medicines.  Speaking personally, while I know Vicodin is an effective painkiller, I’d rather take the pain that the extreme vomiting reaction it induces in me.  Still, if Vicodin doesn’t work, there’s usually something else out there that will, if not as well, at least enough to be worthwhile.

The whole equation changes when people are at the end of the road with terminal illnesses.  At that point, curative medicines and treatments have ceased to cure, leaving the patient with the side effects, but no benefits.  Socialized medicine holds that, at this point, the State gets to call the shots, determining that the person with the illness should no longer get the treatment.  The only problem is that people don’t slot themselves into neat little charts.  Some are dying, but want to live; some are living, but want to die; some are told they will die, but their bodies refuse to listen to the message and insist on getting better.  Allowing individual decisions in an open marketplace is the scenario most likely to allow people to fulfill their biological destiny, whether it’s a swift death, or a slow one, a longed-for death, or one that the person fights against bitterly.  Leaving the process to the government ensures only that more will die regardless.

I actually blogged on this topic almost two years ago during the ObamaCare debate.  I focused on people I knew who had insisted, when healthier, that they wanted to die but who had discovered, when death came calling, that they wanted to live.  In a pre-ObamaCare world, both of these people were allowed to try for life.  Both ultimately died, but they were around longer than they would have been if the government had announced that they were unsalvageable.

Today, Zombie touches on the other side of that equation:  someone who, like my dad and my friend, thought he wanted death but who, unlike them, was denied the opportunity to change his mind.  What makes Zombie’s story especially horrific is that this was not a situation in which his relative simply had treatment withheld.  As I noted at the start of the post, when treatment becomes useless and onerous, withholding it may be a wise and humane decision.  Instead, it’s a story of a battle between caregivers, with some wanting to care for the body, and others intent upon hastening death.

After you’ve read Zombie’s post, please come back to me and share your thoughts.  If I had to summarize my view it would be this:  If I come to a point in my life when treatment is only painful, and offers no hope, I don’t think I’ll want treatment any more.  Nevertheless, that doesn’t mean I want my doctor or my government to hasten my death.  Instead, I want to be made comfortable.  I want to be fed, hydrated and medicated so that my body (and my soul, if I have one), can make the journey as nature (or God, if he exists) intended.

Of flight surgeons and physicals

When we met the Blues, one of the people we met was the team’s flight surgeon, who struck me as a lovely young woman:  warm, dedicated and intelligent.  I’m sure Neptunus Lex wasn’t talking about her when he wrote this hysterically funny post a few years ago.  (And no, I didn’t go hunting that post down.  NL conveniently linked to it as part of another post about the fact that General Petraeus has been successfully treated for early stage prostate cancer. )

Also, if you’re already at NL’s site, check out this post about the increase in violent crime in Chicago.  Every point is excellent.

Two stories about British dental care sound a tocsin about government involvement in health care

This is a matched set of stories from the London Times, both about British dental care, and both warning of the travails when the government both controls much (not all, but much) of the market.  The first story involves the horrible teeth British children enjoy under national dental care.  You’ll note that the culprits aren’t only diet and culture (which are, of course, very real concerns), but are also rationing’ the system’s past inability to entice people into being dentists, a problem offset now by enticements unrelated to the marketplace; and, significantly, the absence of a true free market to control the type of treatments dentists provide:

Children have had nearly one million teeth pulled out in a year as sugary diets and poor dental care took its toll. The number of tooth extractions carried out on children aged under 18 has risen by 12 per cent in five years, the NHS Information Centre said.

The figures support recent warnings that thousands of children are ending up in hospital because of their teeth, with many requiring a general anaesthetic. The latest data — the first to compare clinical activity before and after the Government’s recent overhaul of NHS dentistry — also showed that there were two million extractions carried out on adults in 2008-09, a rise of 220,000 on 2003-04.

Bad diets, poor brushing and shortfalls in the provision of dental care have all been blamed for the sharp rise in teeth pulling brought on by dental caries. The figures raise questions about the Government’s efforts to improve access to preventive dental care, including regular check-ups and fluoride treatments.

An overhaul of dental contracts was introduced three years ago to boost the number of NHS dentists and to end the “drill and fill” culture in which dentists were paid for the number of treatments carried out. The new contract was designed to allow dentists to spend more time on preventative work by paying them a flat salary.

An average dentist’s take-home pay is about £90,000 and many earn more than £200,000. They receive this wage regardless of whether they carry out simple or complex treatment.The figures revealed a sharp drop in more difficult procedures, such as crowns, bridges and root canal work. Crowns fell by nearly 50 per cent between 2004 and 2009 to 750,000, while the number of root canals fell by 40 per cent over the same period.

[I snipped here the competing statements about dental care from liberal and conservative politicians. I'll wrap up with the article's concluding fact.]

Earlier this year ministers agreed to a further overhaul of NHS dentistry after it emerged that it had led to even fewer patients accessing care. A review led by Professor Jimmy Steele of Newcastle University recommended that income should be determined by patient list size, quality of care and the number of courses of treatment.

The second story involves the bizarre system that has developed in Scotland, once again a landscape that doesn’t have entirely Communist health care (that is, only government controlled care), but that tries to provide a weird amalgam of public and private care in a government controlled environment (emphasis mine):

When Alfred Huynen was preparing to open a new dental practice he was forced to rip up the rulebook on marketing. Instead of advertising the service that he intended to provide, he concealed it, fearing that his acceptance of NHS patients would prompt huge queues.

Mr Huynen’s practice in Cove, Aberdeen, opened three weeks ago, spurning private patients in favour of those who are subsidised by the health service. During the five months that it took to build the surgery he kept the function of the building secret in an attempt to prevent long queues from forming outside. He even let some neighbouring businesses think that it was a takeaway. Now that word has leaked out, the practice has registered 3,000 people in three weeks.

Scots have long had a problem with accessing NHS dentists as practitioners often choose to go private instead of carrying out less lucrative health service work. The SNP government has worked hard to address the shortage by boosting the salary of NHS dentists, who can now earn up to £65,000. The poor provision means that surgeries who accept health service patients can look forward to lots of work.

[snip]

Mr Huynen said that people were travelling hundreds of miles because they were so desperate for an NHS dentist. “I can’t believe the distances people are coming from,” he said.

You’ll note from the last story that, when people have a choice, they don’t want government provided care.  They’re willing to pay twice — once by way of taxes that are taken from them by government coercion and once again by way of exercising their choice in the marketplace.  All that the government option does is suck money out of the marketplace without actually increasing patient care.

The bottom line on Obama Care

Karl Rove nicely articulates the bottom line facts driving Obama’s fear-mongering game to force through immediate and irrevocable changes to America’s health care system:

Mr. Obama’s problem is that nine out of 10 Americans would likely get worse health care if ObamaCare goes through. Of those who do not have insurance—and who therefore might be better off—approximately one-fifth are illegal aliens, nearly three-fifths make $50,000 or more a year and can afford insurance, and just under a third are probably eligible for Medicaid or other government programs already.

For the slice of the uninsured that is left—perhaps about 2% of all American citizens—Team Obama would dismantle the world’s greatest health-care system. That’s a losing proposition, which is why Mr. Obama is increasingly resorting to fear and misleading claims. It’s all the candidate of hope has left.

And while we’re on the subject of rationed health care

Faced with an epidemic, England is already planning on rationing:

Thousands of patients could be denied NHS treatment and left to die under ‘worst-case’ emergency plans for a swine-flu epidemic.

The blueprint would force doctors to ‘play God’ and prioritise intensive-care treatment for those most likely to benefit  -  ruling out patients with problems such as advanced cancer.

The ‘scoring’ system would be introduced if half the population became infected with flu.

[snip]

The scale of their concern is highlighted in the Department of Health’s report: Pandemic Flu – Managing Demand and Capacity in Health Care Organisations.

Detailing plans to ration hospital treatment, the report warns that if half the population were infected, 6,600 patients per week would be competing for just under 4,000 intensive-care beds.

Around 85 per cent of those beds could already be full with day-to-day emergencies.

To allocate ventilators, beds and intensive-care equipment doctors would have to ‘score’ patients on their health and prognosis as well as seriousness of their conditions.

Those who failed to respond to treatment would be subject to ‘reverse triage’ – in which they were taken off ventilators and left in NHS ‘dying rooms’ with only painkillers to ease their suffering.

Patients with underlying illness such as advanced cancer or the last stage of heart, lung or liver failure  -  and those unlikely to survive even if they were given treatment  -  would not be given an intensive-care bed.

Definitely what we want over here — right, folks?

Actually, I’ll freely concede that we probably would do precisely the same if we had an epidemic.  In an epidemic situation, rationing is inevitable, because an overwhelmed system cannot cope.  What I’d like to think, though, is that our system will be less overwhelmed than the creaking National Health Service, which already does rationing to cope with its inefficiencies.

Herding seniors to the abattoire *UPDATED*

Don Parker nails both the costs and hypocrisy behind the mandate in the new health care bill that seniors be gently steered towards a cheap death.

UPDATE:  Thanks to Old Flyer for reminding me of this, which fits in so perfectly with the new plan:

UPDATE II:  A story from my dad’s old joke book.

In long ago Japan or China (or amongst the Eskimos, or something else), a young boy came across his father carry a large basket on his back.  In the basket was the boy’s grandfather.

He asked, “Father, where are you taking grandfather?”

“Shh,” said the father.  “Grandfather is old and sick.  He eats, but he does not earn.  I’m taking him to the river, where I will leave him to die.  It will be better for all of us.”

“Oh, father,” said the boy.  “That is an excellent idea.  But be sure to bring the basket home, so that I can use it for you one day.”

All cultures living on the margin of survival have used abandonment as a way of culling the herd so that the strong can survive.  The Hansel and Gretel story is a perfect example of this.  With too many mouths to feed, the children were left in the wilderness.

My question, of course, is whether we, in America, have come to that marginal existence?  The Left thinks we have.  I don’t — or, at least, I hope we haven’t.

The high US infant mortality canard

Another chapter in the “lies, damn lies and statistics” is the repeated claim from proponents of European-style socialized medicine that the US has the highest infant mortality rate of any first world country.  This is a scathing indictment, implicating American poverty, racism, prenatal and post-natal care.  The only problem is that it’s completely false, and is based on the fact that Europe, when it does its infant mortality statistics, ignores fragile infants that were doomed from their live births:

Infant mortality rates are often cited as a reason socialized medicine and a single-payer system is supposed to be better than what we have here. But according to Dr. Linda Halderman, a policy adviser in the California State Senate, these comparisons are bogus.

As she points out, in the U.S., low birth-weight babies are still babies. In Canada, Germany and Austria, a premature baby weighing less than 500 grams is not considered a living child and is not counted in such statistics. They’re considered “unsalvageable” and therefore never alive.

Norway boasts one of the lowest infant mortality rates in the world — until you factor in weight at birth, and then its rate is no better than in the U.S.

In other countries babies that survive less than 24 hours are also excluded and are classified as “stillborn.” In the U.S. any infant that shows any sign of life for any length of time is considered a live birth.

A child born in Hong Kong or Japan that lives less than a day is reported as a “miscarriage” and not counted. In Switzerland and other parts of Europe, a baby is not counted as a baby if it is less than 30 centimeters in length.

Soviet-style healthcare for thee but not for me

Here is absolutely everything you need to know about the proposed Obama/Democratic health care plan:

The president is barnstorming the nation, urging swift approval of legislation that is taking shape in Congress. This legislation — the Affordable Health Choices Act that’s being drafted by Sen. Edward Kennedy’s staff and the Health, Education, Labor and Pensions Committee — will push Americans into stingy insurance plans with tight, HMO-style controls. It specifically exempts members of Congress (along with federal employees; the exemptions are in section 3116).

I think that one bit of information should tip off Americans to the real nature of this plan.

Deconstructing the Obama health care plan

Okay, it’s actually called the Kennedy bill, but it’s the realization of Obama’s insistence on the federal government forcing and funding mandatory health insurance.  Keith Hennessey, in addition to giving links for you to read the bill yourself, explains the substantive parts of the bill, as well as the probable practical and economic effects the bill will have.  As to the latter, here are just a few things Hennessey gives us to worry about:

  • The government would mandate not only that you must buy health insurance, but what health insurance counts as “qualifying.”
  • Health insurance premiums would rise as a result of the law, meaning lower wages.
  • A government-appointed board would determine what items and services are “essential benefits” that your qualifying plan must cover.
  • [snip]

  • Those who keep themselves healthy would be subsidizing premiums for those with risky or unhealthy behaviors.
  • [snip]

  • The Secretaries of Treasury and HHS would have unlimited discretion to impose new taxes on individuals and employers who do not comply with the new mandates.
  • [snip]

And while Hennessey points out the flaws in the bill, the Wall Street Journal explains all the false data and unsupported assumptions that drive the bill.

I have a different question.  In 1994, when the Clinton’s first tried to created government health care, conservatives launched the brilliant Harry and Louise ad campaign.  (To the extent Harry and Louise have returned, they’re now demanding nationalized health care, which is beyond scary.)  Why haven’t I heard about a single ad initiative aimed at the average American to help him or her understand that there is a disaster in the making here?  Is it because, with DVRs, people no longer watch commercials?  If that’s the case, how in the world do we circumvent the Obama media and get solid information out to ordinary people?

Lucky Obama

October 2008:  McCain finally looks poised to lead in the polls, the market collapses and cool, calm, collected, Ivy League educated Obama vaults forward to victory.  April 2009:  It starts to look as if both the American public and Congress may be getting leery about Obama’s proposal to nationalize healthcare (i.e., have the government take control of America’s medical system) and the swine flu hits.  Obama has a plan:  “Hey, kids!  Let’s nationalize healthcare!”

Medieval dental care under Britain’s NHS

When I was growing up, my father was a teacher with a lousy salary and lousy benefits.  The only good thing he had was his dental plan.  It was a wonderful dental plan.  Provided that we got our teeth cleaned and checked twice a year, it would pay the total cost of any dental work needed.  (And, unsurprisingly given the careful maintenance our teeth got, we never needed fancy dental work.)  One of the side benefits of the plan was that it got me in the habit of making regular visits to my dentist to keep my teeth up to par.

Going to England for my junior year abroad didn’t change that habit.  About half way through the year, I decided that I absotively, posolutely needed to get my teeth cleaned, even if I had to pay out of pocket for the experience.  While visiting a friend in Surrey, I managed to get an appointment with her dentist.

The tooth cleaning I got was, to this spoiled American, surprising.  First, the dentist did it himself, as opposed to a technician.  He explained that, since people didn’t get their teeth cleaned, technicians weren’t trained in the task.  He had been trained at dental skill, he said, but his skills were rusty.

And rusty they were.  If you’re like me, you’re used to a very thorough cleaning:  gum measurements (to check for recession); a careful scraping of every surface; sonic assistance on the scraping, if need be; a gentle scrub with that polisher doo-hicky and some abrasive paste; and finally a good flossing.  When I leave the dentist, my teeth are so clean you can eat off of them.

In England, all I got was a less than gentle scrub with that polisher doo-hicky and some abrasive paste.  That was it.  That was what past for dental hygiene.  It became apparent to me why British teeth have been a long-standing American joke.

Despite (or perhaps because of) Britain’s national health care system, British dentistry apparently continues to be a century or two behind America’s.  Today’s British news informs us that Britain’s dentists pretty much treat tooth problems as they’ve been treated for thousands of years:  they pull the tooth. Indeed, it seems that, when it comes to dental care, the only difference between British dental care today and British dental care in the 1850s, 1750s, 1550s, and ever further back in time, is the anesthetic:

Thousands of Britons are having teeth needlessly pulled out, it was claimed yesterday.

The number of extractions has soared by 30 per cent in four years, according to figures obtained by the Liberal Democrats.

The party claims this demonstrates how much dental care has deteriorated under Labour, leaving thousands missing out on treatment that could save their teeth. More than 175,000 Britons had their teeth extracted under general anaesthetic in 2007/08, up 40,000 on the 2003/04 figure, a parliamentary answer revealed.

Figures show thousands of people are having their teeth pulled out needlessly when they could have been saved

Of these, 44,300 were aged between six and 18 and 14,200 were under five years old. LibDem health spokesman Norman Lamb said: ‘The extraordinary number of people needing their teeth extracted under general anaesthetic could well be the result of the appalling access to NHS dentistry.’

He pointed the finger at the general difficulty in finding a Health Service dentist since the Government introduced a ‘botched’ contract in April 2006.

Designed to increase access to NHS dentistry, the deal actually saw hundreds of dentists leave the NHS.

The number of patients seeing a dentist fell by 1.2million, leaving thousands without the treatment that could have stopped their teeth getting so bad that they had to be pulled out.

But dentists’ salaries have soared by 11 per cent since the change – to an average of more than £96,000.

Mr Lamb added: ‘The dental contract was supposedly designed to improve the situation, but the staggering rise in tooth extractions proves the massive failures of thisbotched initiative. The crisis in NHS dentistry is one of this Government’s most shameful legacies.’

Although the rate of extractions increased throughout the four-year period following April 2003, it gathered pace after the new contract for NHS dentists was introduced.

You can read the rest here.

As I read it, aside from Britain’s generally laughable dental standards, a huge government error has doomed millions of Britain’s to medieval care. That’s what happens when you have one provider, and the provider screws up. There are no alternatives. There is no marketplace to adapt and provide. Everything simply collapses.

Patient safety is not a focus when the government calls the shots

For three years, a single British hospital that was obsessed with following government health care mandates to the letter, succeeded only in killing 1,200 patients unnecessarily:

Twelve NHS trusts are being investigated following a damning report which today slammed ‘appalling’ care at a single hospital.

Hundreds of patients may have died after bosses at Staffordshire General focused on Government targets rather than safety, the Healthcare Commission said.

A ‘shocking’ catalogue of failures over a three-year period were disclosed after an investigation found hospital managers had sought to save millions by adopting foundation status.

[snip]

Among the findings of yesterday’s report were:

● receptionists carrying out initial checks on emergency patients

● too few consultants, with junior doctors left in charge overnight

● two clinical decision units used as ‘dumping grounds’ for A&E patients to avoid breaching four-hour waiting targets, one of which had no staff

● nurses so ill-trained they turned off heart monitors because they didn’t understand them

● delays in operations, with some patients having surgery cancelled four days in a row and left without food, drink or medication

● vital equipment missing or not working

● doubling of life-threatening C diff infection rates, which were kept from the hospital board and the public

● a target of £10 million savings which was met at the expense of 150 posts, including nurses

● more debate by the board about becoming a foundation trust than about patient safety

[snip]

Investigators were inundated with complaints from patients and relatives, the most it had ever received, including Julie Bailey, 47, who set up a campaign group following the death of her mother in November 2007 at the hospital in Stafford.

She was so concerned about her 86-year-old mother Bella that she and her relatives slept in a chair at her hospital bedside for eight weeks.

‘What we saw in those eight weeks will haunt us for the rest of our lives’ she said.

Thirsty patients drank out of flower vases, while others were screaming in pain and falling out of bed.

[snip]

Director of the Patients Association Katherine Murphy said ‘Government targets have directly impaired safe clinical practice and money and greed for Foundation Trust benefits has taken priority over patient’s lives.’

As you can see, the above story does not relate one of those increasingly frequent situations in which the British government decided to withhold treatment or tests from a single class of patients because the patients are more expense than they are worth.  The government wasn’t directly involved here at all.

The problem, instead, was that a hospital, rather than seeing patients at its customers, saw the government as its patron, and redirected its energies accordingly.  And because there was no connection between the patients and the hospital in terms of complaints (that is, the hospital didn’t care about the patients, who were not paying the bills themselves, nor did they have a direct relationship with an insurance company that wanted to keep their custom), the hospital managed to go for years without having to react to criticism or complaints.  It was only when patients and their families were able to achieve a critical mass that made a noise loud enough to spur the government to action that the hospital’s conduct finally came under scrutiny.

It’s a reminder to us all that the market speaks loudly and quickly.  The government may ultimately have the loudest voice of all, but getting it to speak is often an agonizing task for a consumer who is deprived of a true marketplace and, instead, is utterly dependent on the government to give him a voice.

Chipping away at liberals’ belief in Obama’s program *UPDATED*

For reasons too complicated to explain, I have more than a passing knowledge about medical informatics — or, in simple terms, the trend to put all patient records in computerized systems.  That’s why, at a soccer game, a young woman who is clearly an Obama supporter asked me what I thought of the move to put all American medical records in a federal database.  “What harm can it do?” she asked.

We both agreed that a comprehensive federal medical database probably couldn’t harm people financially, the way identity theft scams can.  I suggested to her, though, that federal control over medical records — could harm people in much more significant ways.  For example, I said, a 50 year old, vital man, might not want the feds responsible for keeping secret the fact that he has to use Viagra.  Likewise, I said, no one wants information about their hemorrhoids to go much beyond their own doctor.  Hackers, I pointed out, could easily blackmail or humiliate people with information such as that.

Further, I said, it’s not only, or even primarily, the big diseases like cancer or AIDS that are the problem.  For most people, privacy means keeping around them a zone in which they forever function like a healthy young person, free of warts and erectile dysfunctions and fibroids and whatever other systemic failures people don’t want to admit to having.

She was much struck by this argument.  She certainly agreed with me that the average citizen would be wise not to trust the government with his or her secrets.  She understood, as I do, that government loses control of secrets, that a hostile administration may give away secrets, that individual government employees abuse secrets and that, by the nature of government, too many people know the secrets.

The gal pointed out, though, that we already give that same information to insurance companies, hospitals and doctors offices, and that they too have that information on their computer systems.  That’s different, I explained.  In those cases, there’s a one on one quid pro quo that precedes the entity’s taking on and computerizing that information.  Thus, I, personally, agree to go to that doctor and I acknowledge that, as a necessary adjunct to my treatment, the doctor needs to create and maintain my medical records.  Likewise, I choose to have insurance and, as part of that agreement, I also agree that it is reasonable for the insurance company, before it pays for my health care, to know what’s wrong with me.

With a federal database, though, I don’t get to make that agreement.  The federal government, as it just did, dictates by legislative fiat that it is entitled to create and control these records — and, being the government, to lose, abuse, publicize, sell or, ultimately, use these records as a justification to deny me medical care entirely.  There is no quid pro quo here.  There is no contract.  There is simply a federal government using its vast power to access and control, not only my big secrets (assuming I have any), but my little, humiliating secrets, the ones that knock down the sphere of physical inviolability all of us like to believe we have around ourselves.

I doubt I shook this gal’s faith in Obama, or the Democrats, or even the spendulus plan.  But I like to believe I made her think. And maybe once she’s done thinking about this, she’ll start thinking about something else too.

UPDATE:  A little off topic, but a good reminder that you should never, never, never trust the government with your secrets.

A glimpse into the future of Obama care

Again, Britain reminds us of the possible consequences of allowing the government to control health care.  (See here and here.)

As always, what amazes me about the Left is it’s never ending optimism about the government.  Its members will cheerfully concede that the government pretty much bungles most of the things on which it gets its hands, and they’re terrified of the government when the “other” party is in power.  Nevertheless, in masterful cognitive dissonance, they’re always willing to turn over more and more of their lives to that same government.

Despite failure after failure after failure, those on the Left are always perfectly sure that this time (with Carter, with Clinton, with Obama, etc.), they’ll get it right.  They’ll never concede that their theory is flawed — that statism is imperfect and by its nature cannot achieve they goals they set for it — but will always insist that the execution was flawed and that this time it will work.  A hundred million lives have been lost in this quest for statist perfection, and hundreds of millions more have been made drab, depressing, demoralizing and dangerous.

Let me say it again:  The market is imperfect, but the spur of competition forces those who wish to survive to offer a service that consumers will buy.  In a properly functioning marketplace, the government’s only role should be to ensure that no one is cheating the market. If one takes away this competition — making government the only game in town — there is nothing, absolutely nothing, that gives the workers in that statist system any incentive to provide a decent service.  So what if they do nothing at all?  There’s nowhere else to go.

Convincing people with ideas

I carpooled to a soccer game today.  The driver, who is someone I don’t know very well, is a very charming man who is quite obviously a potential Obama voter.  He wasn’t quite sure about me and, since he was a very civil individual, he never came out and either insulted McCain or lauded Obama.  He did say, though, that he thought it was the government’s responsibility to provide medical care.  He also characterized Vietnam as a complete disaster.  That gave me an interesting opportunity to explain to him a few historic facts he didn’t know — because very few people know them.

I started out by reminding him of something that most people forget:  the Vietnam War was a Democratic War.  Kennedy started it and Johnson expanded it.  (Nixon, the Republican, ended it.)  I didn’t say this in the spirit of accusation, because I wasn’t being partisan.  I said it to give historical context to a larger discussion about freedom versus statism.

I noted that, in the 1930s — and, again, most people have forgotten this — the major battle in Europe was between two Leftist ideologies:  Communism and Fascism.  When he looked a little blank, I pointed out that the Nazis were a socialist party, a fact he readily conceded.   I also reminded him that, in the 1930s, given that Stalin was killing millions of his countrymen, and that Hitler hadn’t yet started his killing spree, Fascism actually looked like the better deal.  World War II demonstrated that both ideologies — both of which vested all power in the State — were equally murderous.

Men of the Kennedy/Johnson generation, I said, saw their role in WWII as freeing Europe from the Nazi version of socialism.  When that job ended, they saw themselves in a continuing war to bring an end to the Communist version of socialism.  Again, they were reacting to overwhelming statism.

Thus, to them, it was all a single battle with America upholding the banner, not of freedom, but of individualism. They knew that America couldn’t necessarily make people free or bring them a democratic form of government, but that it could try to protect people from an all-powerful state.  That’s always been an integral part of American identity.  He agreed with everything I said.

I then moved to the issue of socialized medicine, which I pointed out, again, gives the state all the power.  The state, I said, has no conscience, and it will start doling out medical care based on its determining of which classes of individual are valuable, and which are less valuable, to the state. My friend didn’t know, for example, that Baroness Warnock of Britain, who is considered one of Britain’s leading moralists, announced that demented old people have a “duty to die” because they are a burden on the state.

A few more examples like that, and we agreed that the problem wasn’t too little government when it comes to medicine, but too much. Health insurer companies operating in California are constrained by something like 1,600 state and federal regulations.  I suggested that, rather than give the government more control over the medical bureaucracy, we take most of it away.  He conceded that this was probably a good idea.

Lastly, I reminded him what happens when government steps in as the <span style=”font-style: italic;”>pater familias</span>.  He didn’t know that, up until Johnson’s Great Society, African-Americans were ever so slowly “making it.”  As a result of the Civil Rights movement, opportunities were opening for Northern Blacks, and they — meaning the men — were beginning to make more money.  The African-American family was nuclear and starting to thrive.

This upward economic trend collapsed in the mid-1960s, and its collapse coincided absolutely to the minute with government social workers fanning out to black communities and telling them that the government would henceforth provide.  Since it seemed stupid to work when you could get paid not to work, black men stopped working.  They also stopped caring about their families, or even getting married, since unmarried mothers did even better under welfare than intact families.  In a few short years, not only did African-Americans as a group collapse economically, their family structure collapsed too.  Men were redundant.  The state would provide.  Again, my friend nodded his head in agreement.

The ride ended at that point but, as he was dropping me off, my friend told me (and I think he was speaking from his heart), that it was an incredibly interesting ride.  And I bet it was, because I gave him real food for thought in the form of facts and ideas that fall outside of the orthodoxy that characterizes our ultra-liberal community.

Cross-posted at Right Wing News and McCain-Palin 2008.

NHS leaves British women in pain

From Genesis 3:16 (after the expulsion from Eden):

To the woman He [God] said,
“I will greatly increase your pains in childbearing;
with pain you will give birth to children.

I’m feeling Biblical after having read a story about another one of the “miracles” of universal healthcare, as in effect in Britain:

Hundreds of women are being forced to give birth without proper pain relief because of staff shortages at an NHS hospital.

Mothers-to-be are being denied epidurals – which numb the body from the waist down  – because of a lack of anaesthetists.

[snip]

The failure flouts guidance from four Royal Colleges, including the Royal College of Midwives and the Royal College of Obstetricians, that women should have access to an epidural within 30 minutes of requesting one.

It adds to mounting concern about the quality of NHS maternity care, with midwives in some hospitals expected to attend to three women in labour at the same time due to staff shortages.

I like epidurals.  Epidurals are good things.  I know there are some women who want to have the full experience of childbirth, but have two long, long labors, one mostly without an epidural, and one entirely with an epidural, I know what my preference is.  Those poor women.  But what can you expect in a medical environment that doesn’t adequately reward people to go through the long, hard slog of becoming a doctor?

A blow to freedom of religion

Fertility treatment is big money, so there are gazillions of treatment centers in most communities.  One such center in San Diego County may well have been put out business, though, by a California Supreme Court ruling mandating that physicians have to provide treatment to lesbians and other unmarried women, even though doing so goes against their religious beliefs:

California doctors who have religious objections to gays and lesbians must nevertheless treat them the same as any other patient or find a colleague in the office who will do so, the state Supreme Court ruled unanimously Monday.

The justices rejected a San Diego County fertility clinic’s attempt to use its physicians’ religious beliefs as a justification for their refusal to provide artificial insemination for a lesbian couple. The ruling, based on a state law prohibiting businesses from discriminating against customers because of their sexual orientation, comes three months after the court struck down California’s ban on same-sex marriage.

“This isn’t just a win for me personally and for other lesbian women,” said the plaintiff, Guadalupe Benitez. “Anyone could be the next target if doctors are allowed to pick and choose their patients based on religious views about other groups of people.”

[snip]

“This court is allowing two lesbians to force these individuals to choose between being doctors in the state of California or being able to practice their faith,” said attorney Brad Dacus of the conservative Pacific Justice Institute, which filed arguments backing the doctors.

Benitez, now 36, sued North Coast Women’s Care in Vista (San Diego County) and two of its doctors, saying they told her in 2000 that their Christian beliefs prohibited them from performing intrauterine insemination for a lesbian. The doctors later said they would have refused the treatment for any unmarried couple.

They referred Benitez to another clinic for the insemination, which cost her thousands of dollars because it wasn’t covered by her health plan, her lawyer said. She did not become pregnant then, but since has borne three children and is raising them with her partner of 18 years.

You can read the rest here.

I can’t do any better than to echo Dacus: “This court is allowing two lesbians to force these individuals to choose between being doctors in the state of California or being able to practice their faith.”  All of you know from my previous posts that I believe that, where a marketplace exists, it ought to control the outcome of these matters — and that’s true even if I disagree with the business owner’s beliefs or decision.

It would be different if this were a situation akin to the Jim Crow South and there was a monolithic wall of hatred against gays and lesbians seeking infertility treatments.  Here, however, the contrary is true, because there is a thriving market and fertility clinics make much of their money off of lesbians.  Even in conservative San Diego, as the story above indicates, there are people willing to serve that market.  Further, I find it very hard to believe that, in all of San Diego, the defendants’ office was the only one that worked with the gal’s health plan.

The bottom line for me is that, if that office wanted to do itself out of business based on religious principles, that’s a market decision, not a “court denying people their livelihood based on their beliefs” situation.  And this is, again, different from a monopoly situation such as that at the Minneapolis airport, where almost all the taxi drivers were Muslim, where airport passengers were a captive market, and where the Muslims refused to accept dogs or alcohol in their cabs.  That situation, obviously, was closer to the Jim Crow analogy, where there is no real marketplace.

One other point of interest.  The San Francisco Chronicle story from which I quoted above has an interesting caption:  “Doctors can’t use bias to deny gays treatment.”  Doesn’t that sound as if some ER doctor had before him a gay person who was dying on the table and just walked away because the doc was a homophobe?  That would certainly be a dreadful situation, worthy of that caption, especially because imminent death again implies no marketplace.  A busy marketplace, however, in which doctors turn away money because of their religious principles, strikes me as a different situation altogether, and one that does not deserve that type of lede.

For a good analysis of the legal errors in the Court’s opinion, go here.