Gene Edward Veith Jr.'s Blog, page 471
August 14, 2012
Medicare, the free market, and a drug that doesn’t work
This story will make you discouraged about BOTH the government AND the free market when it comes to healthcare. Peter Whoriskey reports:
The U.S. health-care system is vastly overspending for a single anemia drug because Medicare overestimates its use by hundreds of millions of dollars a year, according to an analysis of federal data. The overpayment to hospitals and clinics arises because Medicare reimburses them based on estimates rather than the actual use of the drug.
The government for years has tried to rein in spending on the prescription drug, Epogen, which had ranked some years as the most expensive drug to taxpayers through the Medicare system.
Medicare’s current estimates are based on Epogen usage in 2007 for dialysis treatments. But since then, use of the drug has fallen 25 percent or more, partly because of Food and Drug Administration warnings about its perils and partly because Congress removed the financial incentives for clinics and hospitals to prescribe the drug. Because Medicare continues to reimburse health-care providers as if the dosing levels haven’t changed, the significant savings in doses has not translated into savings for the U.S. Treasury.
The amount of the overspending is more than $400 million annually, according to calculations done separately by The Washington Post and experts.
“I think we probably left money on the table,” said Rep. Pete Stark (D-Calif.), a critic of the way the drug had been used who helped shepherd through legislation that removed the financial incentives for bigger doses beginning in 2011.
The overpayment for Epogen reflects both the promise and difficulty of large-scale government reform of health-care spending.
For years, Epogen was one of a trio of anemia drugs — all manufactured by Amgen, a California biotech firm — that cost Medicare as much as $3 billion annually. Overall U.S. sales of the drugs exceeded $8 billion.
Nearly two decades after the drugs were first approved in 1989, their purported benefits were found to be overstated, and the FDA issued a series of stern warnings about their potentially deadly side effects, such as cancer and heart attacks.
At least some of their popularity stemmed from the fact that hospitals and clinics made lots of money using them: The spread between what they paid for a dose and what Medicare paid them to administer one reached as high as 30 percent, according to the Medicare Payment Advisory Commission.
The incentives drove up usage. By 2007, about 80 percent of dialysis patients were getting the drugs at levels beyond what the FDA now targets as safe.
Congress pushed Medicare to revise its payment system to remove the incentives for larger doses. Under the new system for dialysis patients, Medicare pays a set fee for a bundle of dialysis services and drugs.
via Medicare overspending on anemia drug – The Washington Post.
So Medicare reimbursed based on ESTIMATES rather than actual usage? And hospitals and doctors prescribed the drugs so much in part because “they could make so much money using them”?
Of course, the reason the drugs were so lucrative is because Medicare paid so much for them, so it’s the unholy alliance between the government and the private sector–which is at the heart of Obamacare– that is to blame. Still, this dashes further the assumption that our medical treatment is always based on objective considerations of patient care.
Are business practices that work in other profit-making enterprises fitting for health care? For example, why are all of these prescription drugs being advertised on television? Are patients now “consumers” who are expected to demand certain medicines from their physicians, in which case, what happens to objective determinations in the practice of medicine? Or are the physicians the target of these marketing campaigns, in which case, again, what happens to objective determinations in the practice of medicine?
Paul Ryan & Ayn Rand
Vice-presidential candidate Paul Ryan is a social conservative, a devout Roman Catholic with a strong pro-life record. And yet one of his most formative influences is reportedly Ayn Rand, the radical libertarian, an atheist who viciously attacked Christianity because it teaches love and compassion, advocating instead “the virtue of selfishness.” Those two influences, Catholicism and Rand’s philosophy of Objectivism, don’t seem to gibe.
Democrats are playing up the connection between Ryan and Rand in order to portray him as a heartless amoral extremist. Here Ryan tries to set the record straight:
“I, like millions of young people in America, read Rand’s novels when I was young. I enjoyed them,” Ryan says. “They spurred an interest in economics, in the Chicago School and Milton Friedman,” a subject he eventually studied as an undergraduate at Miami University in Ohio. “But it’s a big stretch to suggest that a person is therefore an Objectivist.”
“I reject her philosophy,” Ryan says firmly. “It’s an atheist philosophy. It reduces human interactions down to mere contracts and it is antithetical to my worldview. If somebody is going to try to paste a person’s view on epistemology to me, then give me Thomas Aquinas,” who believed that man needs divine help in the pursuit of knowledge. “Don’t give me Ayn Rand,” he says.
via Ryan Shrugged – Robert Costa – National Review Online.
For a more detailed examination of how Ryan now differs from Rand, see this.
August 13, 2012
More Classical Lutheran Education online
Faith Lutheran High School is a classical high school in Plano, Texas. Faith will now offer classes live using two-way HD-Video streaming through the Internet. The student will see the teacher on their home computer or lap-top, see the notes the teacher puts on the e-board, listen to the lecture, participate in live discussions with other students, and the teacher will be able to see the student as well.
Faith will offer the Omnibus 1 and Omnibus 3 classes taught from a Lutheran perspective. The Omnibus class consists of English, Theology, and History (3 credits) and is taught by a professional Lutheran school teacher with many years of classroom experience. Classes will start August 22, 2012.For more information, including cost and other details, call 972-423-7448 or send an email to: school@faithplanoschool.org.
I judge the superhero movies
Well, to celebrate our anniversary and to catch up with our fast-disappearing summer, my wife and I constructed a “double feature” (anyone remember those?) by seeing BOTH Spiderman and Batman: The Dark Knight Rises on a single Saturday, with a late lunch in between. We had a good time despite the Batman movie.
The Dark Knight Rises is pretentious, ponderous, ludicrous, and lugubrious. It makes me miss what I thought I was tired of–namely, irony. The movie was so serious, so full of itself, even while its main characters were putting on silly costumes. A super-hero movie can be philosophical or angst-ridden, but it needs to have at least some element of fun.
As the Spiderman movie shows. (Normally, one waits several weeks or months between superhero movies, so seeing them side-by-side makes the comparisons stand out.) The best part of that movie was the part I didn’t expect to like, yet another version of the origin story. But this time the origin made much more sense even than in the comic book (I write and criticize as a fan), picking up on the motif of interspecies genetic engineering. What the movie did especially well was in showing high school nerd Peter Parker gradually learning about his new superpowers. What science fiction and fantasy can do at their best is give us a sense of wonder. Juxtaposing the spidey powers (super strength, agility, ability to climb and hang upside down and swing on webs, sticky hands and feet) with the ordinary routines of school and family life was an effective way to stimulate the imagination. Later we get to the obligatory and conventional friend-turned-monster, but that’s all right, given the genre.
So what about any political themes in the Batman movie, as we discussed on this blog? It does pick up on the Occupy Wallstreet threat of an uprising against the wealthy and privileged, such as millionaire industrialist Bruce Wayne living in stately Wayne Manor (to use the comic book language). And it comes out decisively against the mob. (The best scene was the sight of thousands of police officers coming out of the ground to restore social order.) So the movie managed to be pro-rich, while still blaming the wealthy for economic and social disintegration. It presents the point of view of the wealthy-but-guilt-ridden-over-their-wealth. That is, the new base of the Democratic party.
(That’s not why I disliked the movie. That’s a perfectly defensible position and appropriate in many cases. I disliked the movie for the reasons given in the second paragraph.)
Olympics post-mortem
The Olympics are over. The United States took the most medals (104), including the most golds (46). China came in second, with 87, 38 being golds. The television ratings were huge. I resisted at first, but every time I would surf by, I would be drawn in. What were the high points? What were the low points? Any other observations about the games and their significance?
August 11, 2012
Romney picks Paul Ryan
Mitt Romney has chosen Wisconsin congressman Paul Ryan to be his vice-presidential running-mate. Ryan is known for his deficit-slashing budget proposal and his fiscal conservatism.
Does this help Romney? Will it rally conservatives behind him or just alarm the general public worried about Social Security reform?
iPhone App: Romney Selects Paul Ryan | The Weekly Standard.
August 10, 2012
Obama is winning
Bad news for Republican in the electoral college:
*** Romney leads in CO, but Obama’s ahead in VA and WI: Last week, President Obama campaigned in Florida and Ohio — just as new Quinnipiac/New York Times/CBS polls showed him leading (and above 50%) in those two states. But today, as he begins a two-day swing through Colorado, the same polling outfit shows him trailing Romney among likely by five points in the state, 50%-45%. That said, new Quinnipiac/New York Times/CBS surveys also show Obama leading in Virginia (49%-45%) and Wisconsin (51%-45%). So out of the six battleground states that Quinnipiac has polled in the past two weeks — Colorado, Florida, Ohio, Pennsylvania, Virginia, and Wisconsin — Obama leads in five of them. And speaking of polls, a new national Washington Post/ABC survey finds that Romney’s fav/unfav is still underwater at 40%-49% versus Obama’s 53%-43%. In fact, ABC adds that Romney “is laboring under the lowest personal popularity ratings for a presumptive presidential nominee in midsummer election-year polls back to 1984.”
via First Thoughts: The final three – First Read.
I don’t know about that last point. I know lots of people who would give Romney an unfavorable rating while still voting for him. Still, I thought it was the economy, stupid! Why, despite everything, is Obama still doing so well?
The early church on abortion
Charles Pope, a Roman Catholic priest in Washington, D.C., is compiling a list of quotations from the early church on abortion, which is not a modern invention but was extremely common during the Roman Empire. Some samples:
The Didache (“The Teaching of the Twelve Apostles”) ca 110 AD. Thou shalt not murder a child by abortion. (2:2)…The Way of Death is filled with people who are…murderers of children and abortionists of God’s creatures. (5:1-2)
Letter of Barnabas, circa 125: You shall not kill either the fetus by abortion or the new born
Athenagoras the Athenian (To Marcus Aurelius), ca 150 AD: “We say that those women who use drugs to bring on abortion commit murder, and will have to give an account to God for the abortion…, [For we] regard the very fœtus in the womb as a created being, and therefore an object of God’s care… (# 35).
Clement of Alexandria: (circa 150 – 215 AD) Our whole life can go on in observation of the laws of nature, if we gain dominion over our desires from the beginning and if we do not kill, by various means of a perverse art, the human offspring, born according to the designs of divine providence; for these women who, if order to hide their immorality, use abortive drugs which expel the child completely dead, abort at the same time their own human feelings. Paedagogus, 2
Tertullian circa 160-240 AD: For us, we may not destroy even the fetus in the womb, while as yet the human being derives blood from other parts of the body for its sustenance. To hinder a birth is merely a speedier man-killing; nor does it matter when you take away a life that is born, or destroy one that is coming to birth. That is a man which is going to be one: you have the fruit already in the seed. Apology 9:6 . . . .
Minucius Felix (180 – 225 AD): Some women take medicines to destroy the germ of future life in their own bodies. They commit infanticide before they have given birth to the infant (Octavious (30, 2))
St. Basil the Great (330 – 379 AD): The woman who purposely destroys her unborn child is guilty of murder. With us there is no nice enquiry as to its being formed or unformed. In this case it is not only the being about to be born who is vindicated, but the woman in her attack upon herself; because in most cases women who make such attempts die. The destruction of the embryo is an additional crime, a second murder, at all events if we regard it as done with intent. The punishment, however, of these women should not be for life, but for the term of ten years. And let their treatment depend not on mere lapse of time, but on the character of their repentance. Letter 188:2
St. Ambrose: (339 to 397 AD) The poor expose their children, the rich kill the fruit of their own bodies in the womb, lest their property be divided up, and they destroy their own children in the womb with murderous poisons. and before life has been passed on, it is annihilated. Hexaemeron”, (5, 18, 58)
via Ancient Testimonies Against Abortion | Archdiocese of Washington.
There are more, and the church fathers are in complete agreement about this.
UPDATE: There is a whole book on this subject that I’ve read years ago and can heartily recommend: Abortion and the Early Church: Christian, Jewish and Pagan Attitudes in the Greco-Roman World
by Michael Gorman.
“Liking” as free speech
Well, the consensus as to my query about whether you would like a “like” feature in the comments seemed to be “dislike” and “thumbs down.” (That’s what we need: a voting plug-in so we can do polls and surveys! I am curious about someone’s reference to a larger range of responses that someone has put together. And maybe something to help people keep track of threads and responses. We’ll look into some possibilities and maybe try some, letting you voice your opinion after the fact to see if you “like” a feature or not.)
I know for a fact, though, that some of you “dislike” some of the comments, enough to contact me offline about them. Which means that it is probably time for another of my exhortations: Don’t hijack topics! Don’t resort to insults or name-calling! Don’t be vicious! And, for heaven’s sake, at some point, just let it rest. You don’t need to have the last word. I mean, what more can be said after 200 comments on William Tell, though notice that after 100 or so comments , we typically have drifted far away from the topic of William Tell or whatever it is.
But, in honor of the original topic, I offer this, showing the power and the vast constitutional implications of just hitting a “like” button:
Daniel Ray Carter Jr. logged on to Facebook and did what millions do each day: He “liked” a page by clicking the site’s thumbs up icon. The problem was that the page was for a candidate who was challenging his boss, the sheriff of Hampton, Va.
That simple mouse click, Carter says, caused the sheriff to fire him from his job as a deputy and put him at the center of an emerging First Amendment debate over the ubiquitous digital seal of approval: Is liking something on Facebook protected free speech?
Carter filed a lawsuit claiming that his First Amendment rights had been violated, and his case has reached the U.S. Court of Appeals for the 4th Circuit. This week, Facebook and the ACLU filed briefs supporting what they say is Carter’s constitutional right to express his opinion, signaling the case’s potentially precedent-setting nature.
The interest was sparked by a lower court’s ruling that “liking” a page does not warrant protection because it does not involve “actual statements.” If the ruling is upheld, the ACLU and others worry, a host of Web-based, mouse-click actions, such as re-tweeting (hitting a button to post someone else’s tweet on your Twitter account), won’t be protected as free speech.
via A Facebook court battle: Is ‘liking’ something protected free speech? – The Washington Post.
Do you think hitting a “like” button should count as free speech? And while free speech means that the government must not punish people for expressing what they think, does free speech mean that individual citizens have to tolerate whatever someone says or symbolizes and that their bosses shouldn’t be allowed to fire them for it?
August 9, 2012
Party squelches pro-life Democrats
Washington Post columnist Melinda Henneberger on pro-life Democrats trying to get a hearing at the platform committee but getting shot down. She comes up with an interesting parallel, that abortion is to Democrats what gun rights are to Republicans, an untouchable issue that allows for no compromise:
Democratic dissenters on the issue of abortion have made their case to the platform committee, arguing that the party should change its language enough to allow for some diversity of opinion on the matter and return to the “big tent” approach of the Clinton years.
The effort is probably doomed; NARAL Pro-Choice America President Nancy Keenan is on the committee, and those pushing for the change were happy just to get to testify; they weren’t even allowed to do that four years ago.
This time around, Janet Robert, who founded Minnesota’s progressive talk radio station AM 950, with talkers such as Ed Schultz and Thom Hartmann, was given seven minutes to make the case, and she used it to argue that the party simply cannot win back Congress without Democrats who differ from the ’08 platform on this one issue. She cited a slew of stats, including a Gallup poll from last year in which 44 percent of Democrats said abortion should only be legal “in a few circumstances.”
The plank they want to rewrite says the party “unequivocally” supports Roe v. Wade and spells out that “we oppose any and all efforts to weaken or undermine that right.” . . .
There’s no question that Democrats won the House in ’06 by running more moderate candidates in districts the party would otherwise have lost to Republicans.
But the abortion rights lobby writes big checks and wields such unlimited power that I’ve long thought abortion rights have become to the Democrats what the Second Amendment is to Republicans — who are so terrified of the “slippery slope” that even the most common-sense gun restrictions are out of the question. Nobody wants to buck the lobby with bucks.
via Democratic abortion foes push for change in platform – She The People – The Washington Post.
The last time Democrats won big, they courted social conservatives and ran some moderate candidates. Another theme of this column is that Democrats aren’t going to do that this time.
Democrats claim to be the party of compassion and social justice, championing the marginalized and supporting the little guy. I can’t take that seriously as long as they so uncritically support abortion. What is so “liberal” about being for abortion? Women’s rights? But isn’t that more of a libertarian way of thinking, the sort of individualist mindset that leftists condemn when they see it in conservatives? At any rate, I can respect pro-life liberals, when you can find them, as being generally consistent in their principles. But pro-abortion liberals are sort of like those early Americans who believed passionately in freedom, despite their glaring inconsistency of also believing even more passionately in slavery.
