A Class I Would Love to Take

From the New York Times of all places, this video on a guy in Virginia who teaches people (it's all guys in the video) how to hunt, field dress and cook deer. I can only imagine how the comments section of the Times is full of angry vegans bemoaning the glorification of tasty Bambi being sauteed to perfection.............(this is what I'm doing thinking of tasty venison).

A Question About the French Health Care System

Reading the stories today about the cervical cancer recommendations, I was struck by two things. First, the MSM like this New York Times piece is really on board with what is now being called "science based medicine." Between you and me I thought medicine these days was SUPPOSED TO BE BASED ON SCIENCE ALREADY since we'd stop the bleedings and such.

Secondly, I know this is going to sound catty, but wasn't one of the big things about why our system sucked was that we already weren't very good at preventable deaths? Don't the Europeans and French in particular score really well on those measures of preventable deaths? So do we square limiting screening with this goal? Or did I miss something?

Some Truth Behind the Rhetoric

Living in Washington, DC is weird. I should know - I used to live there. The food scene is great, and there are a lot of young people who bring energy and relentlessly baseless optimism to the place. But everything closes early. Public transit is built around the needs of commuters and tourists. Almost no one, other than the city's African-American population, actually is born, lives, and dies in the area. And then there's the infestation of politicians.

Inevitably, it starts to influence people's minds, like Steve Pearlstein, who actually writes the occasionally smart business column in the Washington Post. However like most DC/NYC public intellectual types, hanging out in the halls of power clouds his perceptions, and it annoys me. Behold this quote from a column of his attacking Republicans for being "political terrorists" in the health care debate:

While holding themselves out as paragons of fiscal rectitude, Republicans grandstand against just about every idea to reduce the amount of health care people consume or the prices paid to health-care providers -- the only two ways I can think of to credibly bring health spending under control.

When Democrats, for example, propose to fund research to give doctors, patients and health plans better information on what works and what doesn't, Republicans sense a sinister plot to have the government decide what treatments you will get. By the same wacko-logic, a proposal that Medicare pay for counseling on end-of-life care is transformed into a secret plan for mass euthanasia of the elderly.

Now by and large I agree with him that Republicans are being fear mongers in this debate but he's not being honest when he says that our only choice is to "reduce the amount of health care people consume." He assumes, since he lives in DC, that the government must be more heavily involved in health care. Instead we could also use proper pricing to make people understand health care costs. But once he assumes that government is the answer, what he's saying, inevitably and unavoidably, is that some people who are "over-consuming" care will be limited in their access to care. If he admitted this, he'd understand that the reason why the Republicans "wacko-logic" is working with people is that the public rightly understands there's no such thing as a free lunch. The Democrats are soft-peddling the impact of their proposed changes and the impact of those changes.

Using very vague phrases like "better information on what works and what doesn't" is dancing around the fundamental issue. Note that Pearlstein doesn't say "perfect information." People facing life threatening situations don't want to hear about probabilities and costs. They don't want to hear that if something PROBABLY WON'T WORK that they can't have it because it's too expensive. And it's not easy for a bunch of experts to decide what "works" and what doesn't.

Imagine a 10 year old child who's life can be saved by a procedure with a high probability of success and very high cost. Now imagine a 75 year old columnist for the Washington Post who needs an expensive operation that might only extend life for a couple of years. In our screwed up system it is more likely that the old fart columnist would get the operation because of Medicare. That's wrong in my view. A panel of "experts" are more likely to do the opposite, but even they might discover that the child would die in a few years and the 75 year old might live another 25 or 30 years and add productively to society. And no matter what anyone on the left says, they will have to limit access to certain procedures based on "better" information. Overall society will save some money, but individual choice will be limited.

Which brings me to today's column by Pearlstein on the breast cancer recommendations. Much like many folks in the MSM, he's sort of surprised by the hoopla. After reviewing what the panel did, he says:

All that, of course, is exactly what the task force did, based on numerous studies done in different countries using different methodologies. In the end, it found that while some lives might be saved each year, the benefits of annual screening of women in their 40s were outweighed by the costs -- and that's without even getting into the financial costs, which run to several billion dollars a year.

That's the most honest statement I've seen yet about this entire debate. As I've noted here on a number of occasions, you CANNOT change this system without altering the winners and losers. If the reforms as currently written go through, more people who currently do not have health insurance and decent, not awesome, coverage will get it. In addition, people with awesome coverage (AARP and old farts I'm looking at you) will see an erosion in quality and access. Costs will increase. You can't get something for nothing.

Now if, IF we were going to have an honest discussion of these issues I'd start here. But since honesty has never been part of politics, I'd settle for compromise. Why not expand Medicaid for the poor and down-trodden. Push for cost controls in Medicare, and create a health system where people actually saw the costs of their procedures? That would, in my humble view, limit "over-consumption" or at least place those costs on those consuming. It's called personal choice and responsibility combined with broad public charity. It wouldn't kill us to start here.

No Such Thing as a Free Mammogram

Mrs. Fundman and I "discussed" the new recommendations for mammograms last night after dinner and a few drinks. I say "discussed" because I hadn't read much about it and she was pretty wound up after a long day with FundInfant at the pediatricians. As a conservative who watches too much Glenn Beck/John Nash, she saw the specter a conspiratorial future of cost-cutting once Obamacare passed the Congress. I just suggested it might be related to the changes that doctors had recently recommended to prostate exams for men.

Well today I officially apologize to Mrs. Fundman, because the White House is apparently freaking out over the panel and its potential impact on the debate. The quote from the Post, not Fox or some right-wing blog, that got me was:

Under health-care reform legislation pending in Congress, the task force's recommendations would be used to help determine the basic coverage that insurance companies would need to offer for preventive services. But task force officials said that played no role in the panel's decision and costs were never considered.

Yeah, sure. That's why the White House has issued about 35 public statements saying that this had nothing to do with the reform.

Just as an fyi - this little piece was brought to my attention by a friend in the UK, which has socialized medicine. A panel there just decided not to give people with liver cancer a drug which is proven to extend life because it's too expensive. And the drug apparently has some positive effects on breast cancer as well - not that any Brit will ever enjoy those benefits.

Folks as I've noted before, there is NO WAY to increase access and decrease costs without limiting available treatments. Full stop. The question is which alternative is more just, and that's a discussion we don't want to have in this country.

Why I'm a Total Cynic about Greenies, Part 345

Behold today's New York Times piece on the decline of carbon offsets. In it the reporter, Elisabeth Rosenthal, decides to interview the president of a non-profit in the UK, a guy named Paul Dickinson.

Paul, tells Times readers "that rather than buying offsets he had sharply scaled back on flying and was instead taking trains or conducting meetings by phone or teleconference."

Huh, funny, because as his bio says HE FOUNDED A TELECONFERENCING COMPANY.

Then there is another environmental expert quoted in the article, Anja Kollmuss. She claims to be a "scientist," but she's not. Her degree is in Urban and Environmental Planning. She tells the Times readers that "buying offsets won’t solve the problem because flying around the way we do is simply unsustainable." Well she should know. As her bio notes SHE'S BEEN WORKING ON A PROJECT IN RURAL INDIA FOR SEVEN YEARS. That means she's been flying a couple times a year back and forth to and from Europe to India. I mean, what's her carbon footprint like?

Does any reporter ever, EVER check their sources? Is anyone in the Green movement not a total hypocrite? It took me literally five minutes to find this information, and yet the Times parades these hypocrites around to make people feel badly about flying? Ms. Rosenthal appears to be the Times lead reporter on environmental issues, and she can't even check to see how unbiased her sources are? This is America's paper of record?

Flying is one of the greatest advances in human history. It has allowed people to live remarkably better lives. It allows medical patients to receive donor organs, transports goods all over the world, and sends Doctors Without Borders to rural areas. Ms.Rosenthal, please stop bashing modernity and making regular people who don't fly back and forth all over the world feel badly for hoping over to Iowa twice a year to visit Mom and Dad.

Apparently, the Fox News War is Over

Remember when the President basically declared war on Fox News and tried to get the removed from the White House press pool?

Well apparently that was very twelve-minutes-ago because on Wednesday, one day after the off-year elections that had no broader implications for Democrats in which independent voters went fleeing to the GOP, David Axelrod, he who declared Fox non-news on October 18th, granted said agency this exclusive interview with Major Garrett.

Hell, the Argentine military did better in the Falklands than the administration did in that conflict. Talk about surrender. The next thing you know Anita Dunn will be interviewed by Glenn Beck with his insane collection of pictures, chalkboards and arrows pointing everywhere.

The internal polling at the White House must be fucking horrible among independents for them to cave this quickly. I generally don't put too much stock into off-years meaning a whole lot because one year is forever in politics, but the way the White House is acting they sure seem scared.

Here's an Idea, Use History

Three days removed from the Democrats losing gubernatorial races in NJ and Virginia, I have been struck by the way that Democrats have downplayed the results saying the races were unrelated to national events while Republicans have hammered away at the national implications for themselves and Obama.

So I thought to myself, "Self, didn't the Dems win in Virginia in 2005 with Bush in the White House? How did each party spin the story four years ago?"

The answer my friends is here in this MSNBC piece analyzing the 2005 outcomes. Note the similarities. The Democrats crowed about the national implications (and they were right) while the Republicans suggested it was all about local issues.

In the meantime, sorry I've not been posting to my 4 longtime readers. You can all come in off the ledge as I'm going to try to be better about writing more regularly.