Who is John Galt?

two pounds of prevention

One argument in favor of universal healthcare is that by guaranteeing basic health services, more costly emergent care can be averted.  This theory holds, for example, that it would be cheaper to give everyone colonoscopies, removing their precancerous polyps, than it would be to provide costly surgery or end-of-life care for everyone whose polyps went on to become a cancer.

The problem with this argument is that it overestimates your odds of getting colon cancer.  Yes, it is cheaper to get a screening than to treat cancer, but the odds were already in your favor against getting any specific cancer -- the screening is just a way to be sure.

Giving everyone a colonoscopy is more expensive than just treating the few who would actually get the disease.  After all, you don't get colonoscopies because they're cheaper than cancer -- you get colonoscopies because it's a price well worth paying to catch cancer early.  Big difference.

In fact, there's evidence that screening actually opens up the floodgates to a bunch of costly treatment for conditions that would never have manifested with actual symptoms.

more on the rationer-in-chief

Something else from Betsy McCaughey's Op-Ed this week in the WSJ:

To reduce health-insurance costs, Dr. Emanuel argues that insurance companies should pay for new treatments only when the evidence demonstrates that the drug will work for most patients.

Translation: If you were sick like Ted Kennedy, treatments like the one he received should not be administered "because they might help."  Instead, the treatment should be provided "only if it will probably help."

Just as sure as Kennedy is dead now, Ezekiel Emanuel would not take that same chance on you.

That is "necessity."  That is "efficiency."

It is also rationing.

from the horse's mouth

Betsy McCaughey, yesterday in The Wall Street Journal:

Dr. Emanuel, brother of White House Chief of Staff Rahm Emanuel, has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of the Federal Council on Comparative Effectiveness Research. He clearly will play a role guiding the White House's health initiative. 

Dr. Emanuel says that health reform will not be pain free, and that the usual recommendations for cutting medical spending (often urged by the president) are mere window dressing. As he wrote in the Feb. 27, 2008, issue of the Journal of the American Medical Association (JAMA): "Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely 'lipstick' cost control, more for show and public relations than for true change."

When the President's bioethicist says --  and these are his own words, mind you -- that "cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely 'lipstick,'" you might want to look for a bioethics rationing model under the makeup.

If you're focusing on the "window dressing," you're falling for sleight of hand -- allowing yourself to get distracted by a diversion -- while they seek to roll out something they'd much rather not discuss.  You're studying the garnish and ignoring the entree.

McCaughey's piece is truly excellent, BTW.  Do read it.  She's got much, much more about Dr. Emanuel's vision of medicine, and we'll definitely be covering it here.

youtube does what the boob tube won't

The ad ABC and NBC won't air.

Our mainstream media seem to have forgotten that the First Amendment exists to ensure that they will challenge government -- not prop it up.

but then, you already knew that

The Fort Collins Colorodoan, on Rep. Betsy Markey's (D) townhalls:

Some people, including Medicare recipients, will have to give up some current benefits to truly reform the nation's health-care system, Rep. Betsy Markey told a gathering of constituents in Fort Collins on Wednesday.
..."There's going to be some people who are going to have to give up some things, honestly, for all of this to work," Markey said at a Congress on Your Corner event at CSU. "

She actually said "honestly."  Someone needs to tell Markey to get with the program.  Sounds like she's taking that whole "honestly" thing a little too seriously.  She's supposed to tell people that we're only going to eliminate the "unnecessary" care from healthcare, and let everyone hope that "unnecessary" refers to somebody else.

Oh, and this little nugget:

...But we have to do this because we're Americans."

Funny, I thought the whole point of being American was precisely that you don't "have to do" anything.  People used to come to America to get away from "have to."

the ted kennedy affordable health choices post

From CNN.com:

Surgery is usually followed by six weeks of radiation. Kennedy wrote in a Newsweek magazine article that he underwent proton-beam therapy, a type of radiation therapy, at Massachusetts General Hospital.

The hospital is one of only six centers in the United States that offers proton radiotherapy, according to the nonprofit National Association for Proton Therapy.
...
The average life expectancy is from 15 to 18 months after surgery, Morrison said. Only about 10 percent of patients are still alive after five years, Junck said.

This treatment would have been very expensive.  If it's only available at six facilities nationwide, then you know it's scarce.  And if that's what Ted Kennedy got, then you can bet that some expert somewhere believes it's the best there is.  Hell, they probably even debated whether any of those six facilities was better than the others; Kennedy didn't just get the best -- he would have gotten the best of the best.

And as good as that may be, more than half of the patients are dead within a year and a half, and all but 10% are dead within five years.  This is a very poor prognosis.

In fact, the prognosis was never even that good for Ted Kennedy -- he was 77 years old.  Even if his cancer had been cured, there's still a litany of things that might have killed him within five years.  Even if Kennedy had licked this cancer, he was very likely to have developed another one, or to succumb to a heart attack, stroke or some other "natural cause" within the next few years.  This was never anything but a long shot.

In other words, the money spent on Ted Kennedy's last couple of months was wasted.  This therapy was, in a word, "unnecessary."

pudding sticks

Denver Post: Democrat canvasser breaks windows at Colorado Democratic Party HQ "to stir up hate."

how big is a trillion?

Lately I've been hearing a trillion described as a thousand billions.  That's supposed to make it look big.

That's certainly accurate, but I think it assumes that most people have a better handle on how big a billion is than they really do.

I propose that we refer to a trillion as a million millions.  Now that's big.

A trillion is not just big -- it's astronomical.  Cosmic.  Carl Sagan famously said there were "billions and billions and billions..." of stars in the galaxy.  There are literally more stars than you can imagine.

And a trillion is ten times as big as that. 

The galaxy is dwarfed by our deficits.

two via drudge

How a "good" Obama presidency might look.

Gotta love that government healthcare.

ted kennedy, 1932-2009

I'll be respectful to the extent that there were probably Kennedys who actually liked Uncle Ted.  To them: I'm sorry for your loss.  And you probably don't want to read the rest of this post.