Hogan's Alley

Wednesday, July 21, 2010

Obama Attacked From An Unexpected Front

President Obama has now received criticism about America's contribution to fight AIDS and other diseases in Africa.  Bishop Desmond Tutu has complained in an op ed in the Times that Pres. Obama is less helpful to Africa's health crisis than was Pres.Bush .

Wow.  Worth a read.

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Tuesday, July 20, 2010

Trouble On The Horizon For Medical "Reform"

"House Speaker Nancy Pelosi is “the mother of health care,” Vice President Joe Biden proclaimed Monday", according to the Washington Post.

 Well, that sort of bravado will no doubt play well on the Democratic chicken dinner circuit.  But sooner or later the realities of the new "Obamacare" legislation will be obvious.  Mostly the chickens will come home to roost by about 2014, well after the next presidential elections.  Until then, those who crafted this budget busting legislation will have to hope that a stiff upper lip will help them survive the next electoral round, which, after all, is the most any of them, regardless of party, ever contemplate.

In a very prescient piece in the Washington Post, Robert Samuelson reports on the findings of an Urban Institute study of the outcomes of the Massachusetts health reform effort, which looks very much like the stew crafted (as in witch crafted) by the President and the Democrats in Congress.

Read it and weep:

People have more access to treatment, though changes are small. In 2006, 87 percent of the non-elderly had a "usual source of care," presumably a doctor or clinic, Long and Stockley note in the journal Health Affairs. By 2009, that was 89.9 percent. In 2006, 70.9 percent received "preventive care"; in 2009, that was 77.7 percent. Out-of-pocket costs were less burdensome.

But much didn't change. Emergency rooms remain as crowded as ever; about a third of the non-elderly go at least once a year, and half their visits involve "non-emergency conditions." As for improvements in health, most probably lie in the future. "Many of the uninsured were young and healthy," writes Long. Their "expected gains in health status" would be mostly long-term. Finally -- and most important -- health costs continue to soar.

Yes, some of the young and healthy who have traditionally been uninsured will possibly seek medical attention that will uncover chronic diseases like hypertension and diabetes.  But will the numbers who avail themselves of this newly available care be so tiny as to have virtually no financial impact on their need for care later in life?  Look at the example of those who use emergency rooms for a form of primary care.  Many of them had Medicaid before yet continued the habits and inclinations of a lifetime.  People tend to act in their own self interest, not in what may in fact be the rational manner viewed as obvious by academics.  They do what offers them the percieved path of least resistance.  This is one of the major realities that will prevent  the anticipated savings from accruing as predicted.

Nor did anyone in the recent debates over medical reform even raise the problem of fee for service medicine.  It is as hot a potato as cutting Medicare benefits for seniors.  It will never happen in the 2 - 4 year life cycles of our politicians.   At least not till we are all staring  over the edge of a massive debt crisis that forces painful cuts and tax increases.

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Saturday, July 17, 2010

Know Your Fruits and Vegtables

Just when you thought there might not be any more uses for the fancy, schmancy MRI equipment lying around hospitals and universities, a new one has emerged.  Hey, I've got a good idea, lets check out some fruits and vegetables and produce films of their insides.

Here, displayed for your edification, are films of several famous vegetarian delights and at least one that is not so famous.  Does anyone know what the hell Durian is?  Well I got curious, so you could look it up.  Yuck.

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Thursday, July 15, 2010

18th Century Ships In Strange Places

The Times reports that the remains of an 18th century ship, probably used as part of an early landfill to extend Manhattan, have been found at the World Trade Center site.

Via Twitter, Damon Lindelof asserts: "For everyone who is asking... no. It is NOT the Black Rock.

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Monday, July 12, 2010

The Truth About Class Warfare

I have been tempted to come out of hibernation by this morning's column by Ross Douthat in the NY Times.  Ross rightly notes that the constant flow of money from the middle class is not mostly going down the income ladder, but rather up.  Headed towards those who take all the outrageous "risks" that leave many very, very wealthy under the shade of protections and benefits they are very careful to see embedded in our laws.  The cost, of course, is paid by those who play by the rules, the vast middle class from which most government income originates.

Key quote:

The left-wing instinct, when faced with high-rolling irresponsibility, is usually to call for tax increases on the rich. But the problem, here and elsewhere, isn’t exactly that we tax high rollers’ incomes too lightly. It’s that we subsidize their irresponsibility too heavily — underwriting their bad bets and bailing out their follies. The class warfare we need is a conservative class warfare, which would force the million-dollar defaulters to pay their own way from here on out.

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