Month: January 2007

A Vision of a Future America

Smokers receive little sympathy for their habit and its consequences. Some of that is warranted, as I’ve told both of my brothers who smoke. It’s a stupid habit that’s known to cause serious health problems. Who in their right mind would start today, knowing what we know. But there are no apparent bounds to human stupidity, so smoking survives¹. That informs the public debate, but should not dictate it. It does, though, an it will increase if we move to a single-payer health care system. Are we immune to liberty-despising lunacy like this?

Smokers who refuse to give up the habit should be denied some types of surgery, a respiratory expert says.

Matthew Peters said denying smokers joint replacement surgery, breast reconstructions and some other types of elective surgery was justified because the operations were more risky and costly when performed on smokers.

“In healthcare systems with finite resources, preferring non-smokers over smokers for a limited number of procedures will deliver greater clinical benefit to individuals and the community,” Associate Professor Peters said in the latest issue of the British Medical Journal.

“To fail to implement such a clinical judgment would be to sacrifice sensible clinical judgment for the sake of a non-discriminatory principle.”

To be fair, in the context of a silly idea, it has its logic. But the rules must be convoluted to get there.

To Mr. Peters, greater clinical benefit to individuals results from denying procedures to smokers. I’m quite certain that the smokers will not derive greater clinical benefit. What Mr. Peters really means is the community. There is no individual in single-payer health care, just a utilitarian cost-benefit analysis where the parameters are set by an outside party. Perhaps the smoker values hip replacement surgery enough to pay for it himself, where the non-smoker will only have it done because it’s paid for by the government. There are only two people who can make that decision, and the bureaucrat isn’t one of them.

In a private market, the smoker would pay the added insurance expense for his habit, and would weigh the risk decision with his physician. All people are not alike, so it’s feasible that smoker X will have a different risk than smoker Y. Again, who is better qualified to make that individual decision, based on relevant facts, the doctor or the bureaucrat?

“Therefore, so long as everything is done to help patients stop smoking, it is both responsible and ethical to implement a policy that those unwilling or unable to stop should have low priority for, or be excluded from, certain elective surgical procedures,” he said.

I have no interest in seeing this in America. I don’t smoke, I don’t drink, and I’m a vegan. According to the standards of a bureaucrat, I probably come out alright, unless a bureaucrat deems insufficient milk intake a danger to bone health, for example. Then, like everyone else in America who isn’t perfect, I’m screwed. Should I be sent for dairy re-education to make sure my bones don’t become brittle? Extreme, yes. Impossible, no. “So long as everything is done to help patients stop …” and “those unwilling or unable to stop” are the clues.

I’ve determined the possible effects of my health choices. I understand what I could face and I’ve compensated as well as I can. And I’m willing to pay for the consequences, both in health and dollars if I’m wrong. That individual calculation gets pushed aside in the world of single-payer health care. Liberty demands that we not embrace that nonsense, but economics and quality of care dictate the same. Pick your preference. Unless you hate both, the choice is easy.

Source: Bodyhack

¹ I’m not talking recreational smoking, although that’s dangerous. I’m talking about addiction. When smoking begins to cause serious health problems and the smoker can’t quit, that’s the where stupidity can lead. Or should I say excess stupidity. And yes, as the rest of this entry will show, people are entitled to what is in my opinion excess stupidity to harm themselves.

We haven’t prohibited crime enough.

I know it’s the New York Daily News, but is nothing safe from hyperbole?

The city’s all-out push to boost the number of cops patrolling the streets has been crippled by the NYPD’s appallingly low starting salary for recruits.

Instead of adding 800 cops to the war on crime, as Mayor Bloomberg and Police Commissioner Raymond Kelly had hoped, the department failed to increase its numbers by a single officer over the past year, the Daily News has learned.

There’s a perfectly good free-market, libertarian argument in there, although it’s low-hanging fruit. The problem here is that this is being framed as “the war on crime.” Shouldn’t that be capitalized? Sloppy journalism, sloppy talking points, or both?

Via Fark.

What do you think it means?

One of my small joys with blogging is reviewing the interesting ways people find Rolling Doughnut. Sometimes it’s traditional approaches. I leave a comment on someone’s site and hits follow. Other times, the fine spiders at Google send something my way that makes no sense to me. When did I talk about Nick Lachey’s penis? Never? I didn’t think so, but the hits still arrive. And then there are the people who don’t quite know what they’re looking for, so randomness is bound to happen. Like this:

controversial topic of euphemizing dogs

I never knew how controversial that might be, probably because I have no idea what that means. I know what the person meant, but surely Google can’t. Can they? And more important, in the words of my friend Melissa, how do these people get by in life? Seriously, I don’t understand. But I love it so much. Even when people drive me nuts, it’s little moments like this that remind me why I like free inquiry and thought. The world would be a little less acceptable if everyone thought like me.

Actually, that’s not true, but I think you know what I mean. I’m euphemizing dogs.

Who negotiated these prices?

I love Whole Foods. Every weekend, Danielle and I buy groceries at our (not-so) local store. The prices are comparable to other supermarkets for the products we buy. Add better quality produce and an enjoyable shopping experience, and Whole Foods is the perfect grocery store. Yet, I understand that no company can be perfect. Witness this found on the shelf for a can of soup:

I’d probably keep that one a secret if I managed Whole Foods. I’m left wondering who printed that out and failed to notice a negative savings. As a software developer, I cringe at code so dumb that it lets that slip through the evaluation process. I did laugh at the absurdity, and we weren’t going to Target this week, so -20&#162 savings soup it was. But now we know, buy soup at Target.

What prices do they deserve?

Someone should remind Rep. John Dingell that many Americans can think beyond what we’re told. For example, his comments about the Medicare drug bill have another side:

“Republicans had their shot at making the drug bill work, and seniors are still not getting the prices they deserve,” said Representative John D. Dingell of Michigan, the chief sponsor of the Democratic proposal.

“Republicans chose to take care of their friends in the drug industry,” Mr. Dingell said. “It’s our turn to prove that the bill can work for seniors.”

And now Democrats have their shot at making the drug bill work. Does anyone doubt that Democrats will choose to take care of their friends in the “senior citizen industry”? All they’re trying to prove is that Congress can ignore the laws of economics. Good luck with that. I’m sure the Republicans are to blame for not effectively repealing those laws. But Democrats will have better luck. Right?

I know who’s carrying the oil can.

We knew this was coming, so only minor credit is warranted:

On its second day under Democratic management, the House yesterday overwhelmingly approved new rules aimed at reining in deficit spending and shedding more light on the murky world of special-interest projects known as earmarks.

Under the new provisions, the House will for the first time in years be required to pay for any proposal to cut taxes or increase spending on the most expensive federal programs by raising taxes or cutting spending elsewhere. And lawmakers will be required to disclose the sponsors of earmarks, which are attached in virtual secrecy to legislation to direct money to favored interests or home-district projects.

Admirable, although I don’t trust anyone in Congress to pick spending cuts in the equation. Balanced budgets are better than deficits, but barely under the principle-free government that’s emerged out of abandoned understanding of the Constitution. The only safeguard we have right now is the veto pen, and we know how well that isn’t working under the current administration.

In recent months, with revelations that lawmakers had earmarked funds for projects with little public benefit, earmarks had became a political embarrassment and a symbol of fiscal profligacy.

Revelations? Who didn’t know this was going on? That’s a bizarre way for a journalist to phrase the recent attention to the long-standing problem of reckless spending. But, in case anyone feels we need new evidence that Congress (i.e. Democrats) will botch the implementation of Pay-as-You-Go, consider:

So far, fiscal restraint appears to be gaining the upper hand. As he left the House chamber yesterday, [House Ways and Means Committee Chairman Charles B.] Rangel said he is scouring the tax code for tax breaks that benefit special interests. If the beneficiaries “don’t put their hands up, it’s out,” he said, suggesting that the money saved could go toward paying for the repeal of the alternative minimum tax.

Good grief. The squeaky wheel gets the oil is not wise fiscal policy. All Rep. Rangel is saying here is that he’s seeking political contributions for his re-election campaign. If you have a tax loophole that you’re fond of, it’s available for a price. The more things change…

Economic Thought of the Day

George Will gets it right today on the coming push to increase the federal minimum wage:

But the minimum wage should be the same everywhere: $0. Labor is a commodity; governments make messes when they decree commodities’ prices.

That’s spot on. The essay is not perfect, as Kip at A Stitch in Haste points out with a useful economics lesson, but the conclusion is the same. The correct minimum wage is $0. If the uninitiated come away with the wrong justification but the correct conclusion, we can work on the reasoning. Short-term isolated problem versus long-term widespread damage. Easy choice if those are my alternatives.

Of special note, I love this line that Kip wrote to explain Will’s loose semantics:

…sloppily knocking a foul ball down the right-wing line…

His entire post is worth reading, and shows why he should be widely read, but that phrase by itself is excellent. I wish I’d written it.

The scalpel will not teach responsibility.

This editorial is a mess, so it’ll be easiest to just jump in:

In inner Sydney it has been estimated that between 10 and 18 per cent of the homosexual population are HIV/AIDS-affected, similar to the UN’s figures for parts of Africa.

In NSW and Victoria, the rate of diagnosis of infectious syphilis doubled between 2001 and 2005, “almost entirely through increased numbers of cases among homosexual men”.

Alarmingly, the NSW Government has failed to take the smallest step toward preventing the spread of AIDS and syphilis, though still parading its support for the homosexual community’s annual orgy of self-celebration, the mardi gras.

You know where this is going, right? I’ll get to that in a moment, but it’s impossible not to also highlight the implication of “the homosexual community’s annual orgy of self-celebration” as an important facet in this essay. It will return. But let’s get back to what is the painfully inevitable nonsense masquerading as a strategy:

The step that NSW Health Minister John Hatzistergos won’t take is the adoption of circumcision as a routine surgical procedure.

His health department describes the removal of the foreskin as “social circumcision” and not to be performed in the state’s hospitals unless a clear clinical need is established.

Last month, the World Health Organisation (WHO) established such a clear clinical need. It stopped two large clinical trials it was conducting in Kenya and Uganda because it felt the results were so overwhelmingly positive for the circumcised group it could not ethically proceed without offering those in the uncircumcised control group the chance to get snipped.

The writer of this essay, Piers Akerman, made the illogical leap from it being unethical to not offer circumcision to the still-intact adults in the study to demanding that the New South Wales Health Minister adopt circumcision as a routine surgical procedure¹ for infants. The WHO’s conclusion included the two key words Mr. Akerman is now ignoring, as well as buried-but-appropriate warnings that circumcision is not a magic bullet. As such, there is not a “clear clinical need” for sexually-inactive infants.

Continuing:

The NSW Government is in politically correct self-denial, as is Sydney’s homosexual community.

While spokesmen such as The Sydney Morning Herald’s cultural commissar David Marr and High Court judge Michael Kirby make gay marriage their gay issue of choice, their cohorts are dying because governments see no mileage in doing more than promoting so-called safe sex.

This at a time when a group within the homosexual community has been identified as promoting high-risk sex and actively pursuing infection or passing it on in a macabre practice known as “bug chasing”.

Mr. Akerman is woefully misinformed if he believes that circumcision will prevent HIV infections among those who are “bug chasing”. Circumcision is not immunity from infection. It will still be possible to become infected without trying too hard. But it’s easier to lambast gays as a group for the irresponsibility of a few than to focus on irresponsible behavior by individuals, gay and straight. The consequences should fall on those who are irresponsible, not infants.

Despite what came before the conclusion, it takes a strained thought process to propose this:

Reckless indifference to safe sexual practices by members of the homosexual community is responsible for most of the transmission of HIV/AIDS in Australia.

State governments need to get off their politically correct hobby horses and prescribe the operation to all male infants to give them a better chance to avoid this plague.

This is ridiculous, as should be clear by the two statements I’ve emphasized. Some gays will behave irresponsibly. This warrants circumcising all male infants, the majority of whom will not be gay? Unless we can identify which infants will be irresponsible when they become sexually active, routine infant circumcision is not the answer. Even then it wouldn’t be acceptable, but until that discussion is warranted, routine infant circumcision as an HIV preventative is little more than a universal punishment for potential future irresponsibility that only placates Mr. Akerman’s apparent animosity towards gays.

Update: For a refreshing look at common sense overtaking the bigotry and stupidity, read the comments at Mr. Akerman’s blog entry for his published essay. They started out badly, but recovered well.

¹ We’re discussing socialized medicine here, with the procedure paid by the taxpayers through the government. Parents in Australia can still circumcise their male children for any reason on their own dime.

Mob rule isn’t activist?

Not much needs to be said about this vote in the Massachusetts legislature, a follow-up to this post:

Massachusetts legislators approved a measure yesterday that next year could allow voters to overturn a historic same-sex marriage law in the only state in the nation where such unions are legal.

Before I go further, it’s important to note that 62 of 185 legislators voted for the measure, a vote that equal just above 33.5%. Okay, so on to Gov. Mitt Romney, who will be is running for president in 2008:

“This is a huge victory for the people of Massachusetts,” Romney said in a statement. “In a democracy, the voice of the people is sovereign.”

This is what partisan, wedge politics has achieved. A presidential candidate views 33.5% support as “the voice of the people.” Pathetic.

There is one other interesting quote in the story:

“It’s in the best interests of children and society for marriage to be defined as between a man and woman,” said Glen Lavy, a senior counsel with the Alliance Defense Fund, which strongly favors banning same-sex marriage. “The battle to preserve marriage in Massachusetts as between a man and a woman is alive and well.”

Sentence one: please provide proof. Sentence two: the battle is now to return marriage in Massachusetts to the definition of a man and a woman. Accept it or not, but marriage in Massachusetts is now between two consenting adults.

Capitalism doesn’t require stupidity

Interesting news out of Milwaukee:

If you wanted to buy condoms 30 years ago, you had to bear the embarrassment of asking a pharmacist to fetch them from beneath the counter.

Now with thieves wiping out the entire stock of prophylactics in some stores, more retailers are putting them back out of reach – and, in some cases, are even locking them up.

Nothing surprising so far, at least when looking at the simple concept that stores aren’t in the business of offering five finger discounts. Until purchased, the condoms belong to them. If they want to lock them up, fine. If they want to place them on a shrine in the middle of the store with a giant spotlight, fine. Their property, their prerogative.

Of course, the nanny statists disagree:

“We are certainly concerned about the availability of condoms in stores,” said Eric Ostermann, executive director of the Wisconsin Public Health Association.
…

“We’d hope they would not present any obstacles to getting their product in the community,” Ostermann said.

Encouraging people to keep themselves safe is wonderful, but the puritanical, irrational fear of sex and all things regarding the body is too embedded. Wouldn’t it be better to disassociate the stigma from sex in general, making it easier to buy condoms without shame? More capitalism and less puritanism.

To be fair, Mr. Ostermann is not making an anti-capitalist, public before profit statement, but an understandable lament based on our puritanical society. Yet, someone will probably suggest legislation requiring stores to provide simple access to condoms in the public interest, without regard to likelihood of theft. Before we take that silly route, stores or some other enterprising soul could follow the suggestion of the many Fark commenters in the thread where I found the story: vending machines. Simple and effective.

Instead, we get feel-good corporate gobbledygook like this:

Other stores, such as Walgreens, mostly keep condoms in a highly visible area in the store where thieves would be more concerned about employees catching them in the act of stealing. Several Walgreens that had placed condoms behind their counters have since been instructed to return them to the sales floor, said Carol Hively, corporate spokeswoman for the pharmacy chain, based in Deerfield, Ill.

“It’s our policy not to lock up condoms,” Hively said. “Shrink can vary from store to store, but in general it is in the interest of public good and safety to keep the condoms unlocked.”

It’s in the interest of those who are responsible enough to practice safe sex and pay for that protection that they have access to condoms when they attempt to purchase them. Walgreens is free to do what it wants, but what would it rather have, a thief who returns to the store multiple times because he didn’t get infected or a paying customer who returns to the store multiple times because he didn’t get infected? The potential embarrassment of the customer should be considered, as any smart business will consider its customer’s needs and wants. But meeting customer needs at a loss is crazy.

Or, in the words of a friend of mine, buying condoms shouldn’t cause embarrassment because it’s a sign that the buyer will be having sex. Customers should be proud.