Age Discrimination: Patient and Doctor Edition

Here’s a story that taps my two main interests:

A MEMBER of the Bagisu Cultural Board has proposed that the retirement age for the circumcision surgeons (Bakhebi) be set at 60 years if their sight is still good.

He said this would minimise the accidents that occur during the operation. John Musila made the remarks at a consultative workshop on the promotion of safe male circumcision in the era of HIV/AIDS, held at Communications Centre hall in Mbale town on Saturday.

I’ll take the paragraphs in reverse order. As for reducing accidents during circumcision, clearly not performing circumcisions would be most effective. Again, I do not care what an adult chooses for himself (or herself). But that’s not what we’re ultimately discussing with this story. When introducing the HIV topic, we inevitably move from voluntary, adult circumcision to involuntary, child circumcision. Making the latter safer is better, but it is barely an ethical improvement.

Now I’ll assume only that we’re talking about voluntary, adult circumcision. In considering the libertarian implication of the age restriction, I’ll also assume the legitimacy of the state licensing the medical profession¹. Obviously it’s irrational to have a blind doctor. But what does age have to do with it? A 30-year-old doctor can go blind and a 75-year-old doctor can retain all of her capabilities. The test is competence, not arbitrary lines the may or may not lead us to a good result most of the time.

This is similar to suggesting that we must prohibit medically unnecessary circumcision, unless it’s imposed on children to meet their parents’ religion. There is no principle involved. In the scenario in the story, if the doctor is competent, no needless limits should be placed on him to prevent him from engaging in his profession. He must be free to trade his services to a willing customer.

¹ My default position on this low-priority issue is an endorsement of something close to our status quo.

Restrict Employer Choices, Have Fewer Employers

BusinessWeek has a debate today on the Employee Free Choice Act, which is up for consideration before Congress. I’m against based on the very little information I know. Essentially, the pro and con between Rep. George Miller (D-CA) and Home Depot co-founder Bernard Marcus provides the bulk of my knowledge. If Rep. Miller’s rhetoric sufficiently corresponds to what the Act would do, I’m against it because Rep. Miller demonstrates that he only recognizes rights that are convenient for his partisanship.

(Note: I’m not advocating the opposite of his view. Rather, I believe the relationship between employers and employees must be voluntary and mutual. I am not qualified to set all rules for all exchanges. No one is.)

To Rep. Miller’s essay:

Unfortunately, in recent years, the middle-class life has become increasingly difficult to maintain. Workers’ wages have stagnated as the cost of everything from milk to college tuition has skyrocketed. The staples of a middle-class life—a fair wage, access to health care, a sound retirement—are getting squeezed. The percentage of national income going to workers’ wages is at its lowest level since 1929, while the percentage of our nation’s wealth going to corporate profits is at its highest since the 1940s.

I’m a skeptic; I want data where Rep. Miller provides anecdote. He’s a politician, so I never expect to see it. But, for fun, I’ll assume he’s telling the truth. If “national” income is now being directed to corporate profits rather than to workers, then workers should become investors. They will claim “their” share of the “national” income.

Continuing:

The Employee Free Choice Act would fix this broken system so workers can freely exercise their right to organize. It would do three things. First, it would allow workers to use a majority sign-up process to form their union, without their employer vetoing that choice. Second, it would increase penalties on employers who violate workers’ rights. Third, it would ensure that, once workers form a union, collective bargaining leads to a first contract—not delay and more union busting.

Focusing on point two: what penalties do we have on employees who violate employers’ rights? (I refuse to concede Rep. Miller’s ridiculous use of employer/worker rather than the objective employer/employee.) To demonstrate what I mean by this, Rep. Miller later writes this:

If these advantages aren’t enough, an employer can fire a pro-union worker to make its point, or threaten to close the business down if workers vote the wrong way, without facing more than a slap on the wrist. At the end of this process, the NLRB holds an election on the employer’s premises.

Employees have rights, but employers do not. At least, they do not have the right to shut down their business if one of the inputs (labor) is not to their liking. That’s absurd. Rights belong to the individual, not groups. But if they applied to groups, all groups would have rights, not just the groups who agree with us. Starting a business is not an agreement to perpetuate the business beyond the owner’s desire to continue it. The Employee Free Choice Act seems to suggest that the ultimate decision in running a business – whether or not to continue – becomes the sole discretion of employees. This is a blatant violation of one individual’s rights to satisfy another’s (claimed) rights.

This is not any democracy that most Americans would recognize as such. Yet this is the system that opponents of the Employee Free Choice Act want to preserve. Another process exists. If an employer allows it, as some major companies already do, workers can avoid the conflict-ridden NLRB process and form a union by signing cards, the same way you might form a civic association. When a majority has signed up, the employer recognizes the union.

Unfortunately, current law allows employers to veto the use of this freer majority sign-up process—and they do. The Employee Free Choice Act would simply take this veto power away from the employer and restore the democratic principle of free choice to the workplace.

The right for an employer to determine that she will employ individuals on the condition that they deal with them individually rather than collectively – the employer’s freedom of (voluntary) association – is subject to the whim of the majority. Remember that potential and current employees for any organization can always refuse to continue providing their services. If the employer is unable to find enough people willing to agree to her terms, she will either offer better terms or go out of business. This is the freedom of association perpetuated by natural incentives for cooperation that need no encouragement from government. Rep. Miller’s advocacy for the Employee Free Choice Act shows his misunderstanding of the American concept of individual rights.

Presidents sign the bills that control the economy.

Via John Cole, this editorial cartoon (original source – Steve Greenberg):

Of course this is too blunt to be accurate. There is the additional guilty party, the Congress. It’s more reasonable to suggest that their guiltier, but the nature of our political system produces the marketing message conveyed in this cartoon. Better to just take the message that politicians lie.

Take the beauty of divided government as the better lesson. It’s not perfect because you can see the results of divided government under Reagan, Bush, and Bush. Maybe they would’ve been worse with unified government. Maybe not. I don’t want to speculate here. So I’ll just suggest that pre-W Republican fiscal partisanship controlling Congress and a philandering Democratic fouling the White House are approximately what America needs forever more. Petty distractions from the task of legislating. Maybe we’d no longer need to believe in the same change every four, eight or twelve years.

Uncivil Debate

Everyone on the Internets knows about Godwin’s Law, right?

“As a Usenet discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches one.”

It’s been adapted from Usenet to now apply to the Internets. And it does, because we’ve all seen it in action.

What about YouTube? Has anyone expressed the necessary observation? Maybe, but if not, I’m proposing Tony’s Law:

As the number of comments on a YouTube video grows, the probability that a gay slur will be introduced approaches one.

I’m researching cellphones, so I watch videos. I figure, maybe the comments will help, since actual user experience is good. And there, the most recent comments are just ignorant attacks on sexuality. I remembered this is why I don’t read YouTube comments any more. This probability of bigotry is also why I installed YouTube Comment Snob. (Which clearly didn’t work 100% effectively in this case, but it’s better than nothing.)

So, consider that a new Internets rule if someone hasn’t proposed it already.

Saturday Linkfest: Economics Questions

During a hurricane, is it better to have no gas at a low price or some gas at a high price?

For police motorcycles, is it better to ride American motorcycles or ride quality at the best price? Maybe those are the same subset of the market, but Senator Obama is hardly making that a requirement.

When setting CEO pay, is it better for an organization to consider the general health of the organization or the general health of society? Does the former not lead to the latter?

How did presidential candidate Obama determine that we need to double funding for the Manufacturing Extension Partnership? (Link provides no answer, making this question non-rhetorical.)

If presidential candidate McCain wins, how will he dictate to “… oil producing countries and oil speculators that our dependence on foreign oil will come to an end – and the impact will be lower prices at the pump”? Doesn’t the law of supply and demand suggest that, if we have less oil available for purchase, the price will increase rather than decrease? Will we have a new national anti-price gouging law to “repeal” the law of supply and demand?

Today’s lesson: America is the land of economic opportunity, where we can legislate low-paid CEOs buying American motorcycles improved through government picking supply-chain winners and refueled with air-masquerading-as-cheap-gas. And we’ll solve global warming, too, since the motorcycle won’t have any gas to burn!

Blue is the new professionalism?

Via Amy Alkon, I see that TSA has new uniforms. (Conveniently unveiled on September 11th. Symbolism, woohoo!) I have no doubt this will improve the airport security experience. It says so right on the website. Click on What’s Behind the Uniform and you’ll be treated to exciting claims. For example:

ENGAGED WORKFORCE

TSA is revamping the checkpoint process and relying on more personal interaction to detect suspicious behavior. Training officers to increase one-on-one passenger interaction will foster a calmer, quieter environment that will result in a better experience for travelers and increased security.

Should I assume that the gaggle of TSA officers who attempted to bully me last month for exercising my rights hadn’t undergone the new training yet? Will new uniforms enable them to foster a calmer, quieter environment that doesn’t include 7 attentive thugs blocking the line for all passengers and patronizing me that their thuggery is somehow making us safer? Have they been corrected to understand that personal interaction that ends with me exercising my rights does not, in fact, mean that I have engaged in suspicious behavior in need of detecting?

I’m not counting on it.

Government can and will break its own rules.

When I say that the introduction of single-payer healthcare would not lead to the en – or even a significant reduction in – the circumcision of infant males in the United States, I do not hope I’m right. But I still see no reason to think I’m wrong. My analysis includes the evidence that countries with nationalized healthcare don’t pay for ritual/cultural circumcision. I also understand that claiming any particular market is somehow different is dangerous. But it’s quite clear that Americans have an irrational affinity for cutting the genitals of male children. That is a political rather than economic factor in this debate. Our politicians have never shown an ability to say “no” when confronted with a choice of excessive spending or the potential loss of votes. Wrap in religion and it’s a perfect combination for everyone to ignore facts (and the child).

There is one fact in the above narrative that is not accurate. If you’ve guessed that countries with nationalized healhtcare pay for ritual circumcision, congratulations, you understand politics at the expense of economics. From England:

… medical opinion has swung against it, and the procedure is now mainly carried out here for religious reasons.

As such, according to NHS guidelines, it should only be carried out, and paid for, privately.

But an investigation by More4 News has found an increasing number of health trusts are bowing to pressure, and offering circumcisions free on the NHS.

I’d normally embed the video here. I do not like the still image presented before the video plays. You can find it at the link above, or directly here.

Take note that no one in the report mentions what the boys might want. It’s a religious requirement for the parents to impose on their children. That’s enough for everyone to ignore the obvious questions beyond the cost, even though unnecessary circumcision is unjust, both morally and legally. But even in a culture like England that generally does not circumcise, mix the parents’ religion with an inability to pay and the state pays. America will be different how?

The bit about “unscrupulous circumcision practitioners” is particularly fascinating. The doctor interviewed in the beginning of the report operates in a glass house. No, he’s not a mechanic circumcising an infant with a soldering iron. Yet, he is a professional sworn to an oath placing the patient’s health as his first priority. As long as his child patients are healthy when he mutilates them, he is nothing more than an unscrupulous circumcision practitioner with training. The physical results may be less troublesome, but those children will still carry the mark of his criminal lack of ethics for the rest of their lives.

Post Script: I still detest the idea of single-payer healthcare because of the inevitable deterioration in health and care before we get to any discussion of rights.

Seven Years Later

To commemorate today’s anniversary, I’m reposting my entry from two years ago. I’d phrase some of my statements to be clearer, but overall my sense of our world remains unchanged from what I expressed then. Not much has changed in our political discourse, unfortunately but without surprise. I won’t suggest it’s getting worse, but we have almost two months to endure before election day.

———-

I don’t want to belabor any of the obvious points about this anniversary. We all know what today is. We were all there in our own way to witness the horror, wherever we were that morning. Today is different only because we have the perspective that time alone can bring.

What irks me about today is that we’ve had a clear failing in leadership. It would be easy to pick on the president or some other member of the administration or in the Congress. No, that’s the wrong answer. We’ve had a failure in leadership among every politician who has used that day to sell us fear rather than answers. We’ve had a failure in leadership by every government official charged with keeping us safe who has acquiesced to believing that the ongoing threat is so existential that the ends justify any and all means. Worst of all, we’ve had a failure in leadership among every voter who has accepted the fear and the acquiescence to obtain some sense of safety, no matter how irrational or illusory. [ed. note: for example]

Despite the rhetoric to the contrary immediately following the events of that day, I should’ve expected the nature of the partisan political desire to provide the only solution and to claim credit before achieving success. That’s the nature of the job, although it doesn’t have to be. And government officials are charged to follow orders, despite the options to defy unconstitutional orders built into the system through years of need. Again, this is not surprising. The failure to lead in any of these positions is foreseeable. It’s this failure in ourselves to reject elected representatives who care more about their careers than our lives that I think about most today.

This failure is not in politicians of any specific party. The Republican quest for a permanent majority has blinded them to their supposed core principles of liberty and limited government. They want us secure from attack, but not secure in our minds. They wish to walk the balance of these two contradictions by using fear as a campaign tactic to assure us that pulling the (R) lever every November is the only way to prevent that day from happening again. This is crass and shameful, not deserving of even a temporary majority.

The Democratic quest to oppose an administration they’ve hated since 2000 blinds them to the clear need for opposition to provide a vision of success when the majority has strayed. They forget that good people can possess bad ideas. Someone must remind them that the failure of this president is not desirable. Too many Democrats believe that opposition should rejoice in the majority’s failure. They have also settled for believing that America can act as a turtle and retreat to the apparent safety of our shell. They are wrong. They do not deserve to replace the Republicans.

But we accept this. We believe it’s more important to know who to blame for government failures leading to that day than to know how we can fix those problems before they fail us again. We hate President Clinton or we hate President Bush. We believe we are in a religious war or we believe that we are fighting a few fringe lunatics who justifiably hate us for our alleged arrogance. Those coarse generalizations are insidious. The truth, of course, is somewhere in the middle. We know this even when our representatives pretend that we don’t. But we do nothing about it. The venom has carried on for nearly five years. This is dangerous.

When the inevitable push for November begins, with its parade of symbols from that day, we must say that we’ve had enough. We must say that we do not believe that day’s lesson should be permanent fear and hatred. We are strong for the principles we stand on. They have led us to our power and standing in the world. We must show that our ideals are true. Revenge against our enemies, across oceans or across the street, does not serve us. Justice and peace are all that matter.

We must demand that our representatives lead. If they refuse to be accountable, we must vote them out and find new representatives. We must expect solutions instead of fear and blame. We are all on the same side. Disagreement does not equate to a desire or willingness to lose. We showed that we could be united following that day. We must return to that. That is the way to respect America and our continued strength. By leading we find a safer future.

That is how I want to honor those who died that morning.