In the Annals of Internal Medicine I came upon an article:
Much Cheaper, Almost as Good: Decrementally Cost-Effective Medical Innovation
by
Aaron L. Nelson,
Joshua T. Cohen,
Dan Greenberg,
and David M. Kent
The title was a little off-putting, but the message was sound. In medicine it very rarely happens that we invent technology that is less expensive and almost as good. In all sorts of other fields we do that. India invented the Nano, a small, very cheap, very fuel efficient car. Apple created the iPod shuffle. I don’t know who invented the amazingly warm, rock bottom cheap microfiber soft fluffy fabric that my bathrobe is made of, but my hat is off to them. In medicine we keep innovating, and we make these things that are a tiny bit better than the thing before them, and are much more expensive. If cost were of no consequence this would not be an issue. But when we talk about more expensive, the millions of dollars that get spent on these new technologies quickly adds up.
In this article the authors look at some of the rare medical technologies that are less expensive than the pre-existing technologies with which they compete, and come up first with the cardiac angioplasty, or PTCA. In this procedure a blocked artery around the heart is dilated open with a balloon rather than being bypassed surgically. It is much cheaper to do it that way, but not quite as effective. But the researchers fail to point out that this procedure also allowed all sorts of people who wouldn’t have been able to tolerate heart surgery to live free of heart pain or heart attacks for years. So the technologies that are cheaper are, in a way, also sometimes better.
I merely point this out as yet another path toward responsible, successful, human centered medical care.
David Leonhardt has been writing some of the best articles out there on health care. His article on Intermountain Healthcare was superb. The Intermountain system is one of those low cost high quality organizations, maybe the best. Like the Mayo Clinic and Kaiser, it has salaried physicians. The biggest difference is probably its constant efforts to monitor care and encourage the use of protocols.
That leads to his second article on how the current reform bills could be improved. Overall, he sees the Senate bill as much stronger, though needing improvements. One of his recommendations is that we should include in the bill the “easy stuff” that will lower costs and improve care. Key quote……..
THE EASY STUFF Each year, about 100,000 people die from preventable infections they contract in a hospital. When 108 hospitals in Michigan instituted a simple process to prevent some of these infections, it nearly eliminated them.
If Medicare reduced payments for the treatment of such infections, it would give hospitals a huge financial incentive to prevent them. The Senate bill takes a small step in this direction by cutting payments to hospitals with high infection rates by 1 percent. The House bill merely requires hospitals to report their rates publicly. There are also other basic patient safety areas in which the bills can do much better.
This is an area I know well as I have helped implement it at our hospital. This is an area of improvement that would never have occurred without government intervention. There was no money to be made by sponsoring the necessary studies. No individual hospital was big enough to give the meaning necessary to substantiate the findings. The results are pretty eye opening, taking infections that required many days of hospitalization and thousands of dollars of care, down to a nearly zero incidence.
Yet, some hospitals still do not require use of the protocol. The physicians do not want anyone telling them what to do, especially government. Today, working at the smaller hospital which I sometimes cover, I was asked to put in a line by a cardiologist as he expected it to be difficult and it is a procedure I do much more than he. When I explained to the nurses in the Cath lab what equipment I needed, I was told that the doctors here don’t do that. I was shocked. What I asked required 30 seconds of work on their part. I will be making some phone calls tomorrow so this will change, but I think it illustrates the need for some government involvement in improving quality and, sometimes, costs. Unless there is direct profit to be seen, there is inadequate motivation to improve quality.
From a Rolling Stonereview of Who’s Next, some familiar admirers’ chuckles:
Such dynamics! The beautiful quietly lyrical moments of such selections as “The Song Is Over,” “Gettin’ In Tune,” and “Behind Blue Eyes” are juxtaposed with the thundering rock that is the marrow of those songs so that each is rendered even more poignant.
To further frost the confection, Townshend wrings more than his money’s worth out of his £14,000-worth of synthesizers, making, I daresay, shrewder at once more adventurous and better-integrated–use of them than any rock experimenter before him.
In “Baba O’Riley,” for instance, he sets the stage for the band’s dramatic entrance with a prerecorded VCS3 part he obtained by programming certain of his vital statistics into a computer hooked up to the synthesizer, then treats the part as a drone while the song’s two major chords are transposed over it, and later has the band playing against it (that is, piling a few gigantic chords on it while it keeps going “Meepmeep-meep-meep-meep …”) to lead into a solo by guest fiddler Dave Arbus.
Next, on “Bargain,” he uses his ARP both as a solo instrument and as a backdrop to his own beautiful guitar solo.
There’s just so much to be astonished and delighted by on this album once you get used to its kinda chilly perfection …
Obama made some thoughtful and timely remarks on the Fort Hood shooting, but words alone can’t heal a nation’s wounds after such a horrible tragedy. If he wants to do a real service for the lives lost and their families, he should bring all the current troops overseas, who are barred down in unnecessary conflicts, home, and retire America from the empire game. The ultimate gesture to the dead is making sure that nobody else dies in these needless and immoral wars or as a result of them. But that will never happen under Barack Obama because he is not a real leader, just an eloquent sock puppet. Unfortunately, all his acts are dead gestures to an anxious people. But are Americans tired of presidents who only hold up appearances, and who are afraid to address head on the real and difficult choices that the country faces in this century. Only time will tell.
The market will be constrained over the next several years by the patent expiries and subsequent generic erosion of a number of key antipsychotic agents including AstraZeneca’s Seroquel (quetiapine fumarate), Eli Lilly’s Zyprexa (olanzapine), Bristol-Myers Squibb/Otsuka’s Abilify (aripiprazole) and Pfizer’s Geodon (ziprasidone), according to the study, from Decision Resources….
Moreover, patent expiries of branded antidepressants that include Wyeth’s – now Pfizer’s – Effexor XR (venlafaxine), Eli Lilly’s Cymbalta/Xeristar (duloxetine) and Forest/Lundbeck’s Lexapro/Cipralex (escitalopram) will further constrain the market, according to the report….
These patent expirations happen at various times between 2011 and 2018.
AllAfrica.com has a briefing on Securing Food Production in Africa, with stories on everything from William Kamkwamba’s homemade windmill to Alliance for a Green Revolution in Africa to agroforestry to genetically modified crops.
Free marketeers receive a cool reception nowadays but neither is socialism making much of a comeback, unless you count its mention on signs at Tea Parties. It’s never easy to develop a coherent economic response to a crisis when old ideologies lose relevance. Pragmatism therefore demands that we employ the best tools of our current system to address its greatest ills; a young real estate advisory and consulting nonprofit I know is a case in point.
Real Estate Advisory and Development Services (READS) raises funds through arranging real estate deals for budding charter schools as well as through writing grants, the more traditional work of a nonprofit. The president, Brian Keenan, told me, “Folks ask for reduced rates for our services, which actually are about half the rate of a for-profit. I tell them, ‘Our time is valuable. We can discuss when payment is made but we are unwilling to reduce our fee.’”
Keenan is a former banker and doesn’t fear sounding too commercial for the more delicate sentiments of the world of do-gooders. At the same time, he readily admits that he began his company because his old boss told him that he was “spending too much time helping floundering nonprofits with their real estate problems.”
Keenan’s work is emblematic of a generation of nonprofits not imbued with the anticapitalism of the 1960’s, nor evincing the noblesse oblige of late-nineteenth and early-twentieth century reformers. The triumph of capitalism is implicit.
Firms such as Keenan’s aim to harness a bit of the tremendous accumulated capital in our country in order to catalyze the full economic participation of underutilized and undertrained social sectors.
The need and the opportunity are identical: Investing in socially marginalized children creates obvious value for the country entire but less obviously does so for particular, for-profit corporations. By leveraging the goodwill of socially-concerned citizens and, simultaneously, uncovering new profit streams, entrepreneurial-minded nonprofits demonstrate the latent productivity of large segments of the population and, eventually, attract further interest and investment.
Capitalism is excellent at providing opportunities to well-equipped and motivated entrepreneurs. It is less good at developing the talents, outlook, and networks of those who remained removed from its dynamics.
The wealth of our age gives us the luxury of seeking synergies between these two goals. Those who uncover such synergies have the potential to do good and to prosper.
I have held off writing about the Fort Hood incident as I do not see that much is gained by speculation. I would prefer to discuss causes and prevention after we know all the facts. However, Marc Lynch has a piece up at Foreign Policy that is too good to pass up. He reminds us, again, what the terrorist groups are trying to accomplish, and what we do to help Al Qaeda and other terrorists. Key quotes…
The grand strategy of al-Qaeda and its affiliated ideologues is, and has always been, to generate a clash of civilizations between Islam and the West which does not currently exist. Their great challenge is that the vast majority of Muslims reject their theology, ideology, strategy and tactics. That’s especially true of American Muslims. They therefore feel the need to change the environment in which Muslims live in order to change their calculations about the appropriateness of extremist identities and ideologies and actions.
Terrorism is a means towards that end. The object is to create a violent, polarized environment in which Muslims are forced to embrace a narrow, extreme version of Muslim identity. They want Muslims to accept a master narrative in which the Islamic umma is existentially threatened by Western aggression, and the only theologically and strategically appropriate individual response is to join the jihad in the path of god (as they have defined it).
They recognize that most Muslims won’t embrace this radical conception of their identity just through messaging, internet rhetoric, or preaching. To make inroads with mainstream Muslim communities, they need to change the context in which they live — to render their status quo unacceptable and to make their narrative resonate. And for that to happen, they need a lot of help — for the targeted governments to take inflammatory measures against their Muslim populations, for the non-Muslim citizens in the targeted countries to discriminate against them, and for the media to fan the flames of hatred and mistrust.
Understanding this strategy points towards some fairly obvious guidelines for judging various responses. Al-Qaeda and its affiliated ideologues don’t just want their targets to overreact with blanket crackdowns on the mainstream Muslim community — they are counting on it. They want to create a homogenous, undifferentiated Islam on whose behalf they speak and a coherent master narrative which justifies and validates their actions. American reactions which feed AQ’s master narrative, lump together disparate Muslim movements, and tar a wide range of Muslims with the AQ brush therefore serve al-Qaeda’s strategy. Responses which disrupt AQ’s narrative, disaggregate the Muslim world and relegate AQ to a marginal fringe frustrate its strategy.
As I have said before, al Qaeda does not pose an existential threat. They count on our overreacting and we do not let them down. It helps if one remembers that terrorism is violence with a political goal. They do not kill just for the sake of killing. There is a political purpose. Continue Reading »
Medecins Sans Frontieres had a story the other day in its Facebook feed on the Central African Republic, reminding me that I’m overdue to post an update on the interlocking set of conflicts surrounding Darfur and its neighbors. For this particular round up, I’m going to focus particularly on what’s being reported by humanitarian groups, although I may link a few other stories.
In fact, there are stories coming out of the Central African Republic that have nothing to do with the humanitarian crisis there. Kenya Airways has launched direct flights to Bangui, the largest city in the Central African Republic. An exiled former president is returning to the CAR to stand in the presidential elections slated for 2010.
South-western Central African Republic (CAR) currently faces a serious nutritional emergency. The crises in the mining industry, on which many of the region inhabitants depend, has been the last straw for an already highly vulnerable population.
Alerted by the local authorities, the Médecins Sans Frontières (MSF) teams have opened four feeding centres in one month in Carnot, Boda, Nola and Gamboula and implemented a number of outpatient treatment programmes in the area. The first assessments have revealed severe malnutrition rates way over the emergency threshold in some areas….
A three-day nationwide polio vaccination campaign began on 30 October throughout Chad, including in the east where according to the World Health Organization the rate of routine immunizations is among the weakest nationwide.
On 27 October lab results confirmed six new polio cases, bringing the number of confirmed cases in Chad in 2009 to 30. Two regions are newly infected, Wadi Fira in the east and Batha in central Chad….
On a less happy note, an International Committee of the Red Cross staff member was abducted last night in eastern Chad.
A Douala tabloid a few weeks ago thought it had found the scoop of the year, when it “discovered” that a “Chadian” had been sitting in the Cameroon National Assembly over the years. As the search for the truth continues, it must be emphasized that Cameroonian boundary regions with neighboring countries, from east to west and from north to south abound with ethnic communities that stretch beyond international boundaries.
Chad is no exception. Chad is Cameroon’s northern neighbour with which it shares a boundary of over 500 kilometres. Since Chad’s independence on August 11, 1960 cooperation with Cameroon has been very steady and growing with each passing year….
Top fashion designers are making dolls to fund a vaccination effort in war torn Darfur. Meanwhile, South Sudan has been hit by an outbreak of kala azar (also known as visceral leishmaniasis), a parasitic disease transmitted by the sand fly.
… The Obama plan calls for a greater dialogue among the United States, international partners and Sudan to end the Khartoum government’s support of attacks in Darfur and spur implementation of the CPA while pressing the Sudanese to get tougher on terrorism. The Obama strategy includes potential sanctions if certain benchmarks to progress that remain classified are not met.
Herman Cohen, former assistant secretary of state for African affairs in the administration of President George H.W. Bush, lauded the strategy, telling America.gov, “The Obama administration is implementing a very pragmatic policy toward Sudan.” …
Leading LRA rebel commander Charles Arop surrenders to Ugandan army? (The Lord’s Resistance Army has moved between Uganda, Sudan, the Central African Republic, and the Democratic Republic of Congo, as it engaged in a long standing guerilla war, so, though it formed to fight the Ugandan government, the surrender of an LRA commander would affect other countries as well.)
… but not by me. A friend who came to our meeting from Mormonism reposts an account of his written 3.5 years ago, describing our meeting and how liberal Quakerism compares to Mormonism.
The Guardian today ran a story wherein an unidentified International Energy Agency whistleblower claims “the US has played an influential role in encouraging the watchdog to underplay the rate of decline from existing oil fields while overplaying the chances of finding new reserves.”
This may well be, and we need to alternatives to oil if for no other reason than it allows us to get out of the Mideast.
That said, I’m uncomfortable with a significant source for the story being unidentified. How do we know the person quoted isn’t some nicely compensated shill for an energy trader with a long position in oil, attempting to talk up the price?
This is kind of cool. While listening to Live Ireland radio, I heard familiar words set to an unfamiliar beat. Sean Tyrrell sings Louis MacNeice’s poem, “Bagpipe Music,” under the title, “No-Go,” on his album, Cry of a Dreamer. I suspect some readers here would enjoy “Bagpipe Music,” if you haven’t read it already.
It’s no go the picture palace, it’s no go the stadium,
It’s no go the country cot with a pot of pink geraniums
It’s no go the Government grants, it’s no go the elections
Sit on your arse for fifty years and hang your hat on a pension.
It’s no go my honey love, it’s no go my poppet,
Work your hands from day to day, the winds will blow the profit
The glass is falling hour by hour, the glass will fall forever
But if you break the bloody glass you won’t hold up the weather.
When I was just a Sig-twig, a friend and I took it upon ourselves to write what WE considered to be uplifting poetry on the blackboard before our English class started. Being teenagers, we tended toward the cynical and dark. Her father had translated Catullus, so the less overtly sexual bits of that collection made it to the board. “Bagpipe Music” was one of my choices. Every day, the teacher walked briskly to the board and erased our selections, apparently without reading them. I refer you to the great Barry Louis Polisar’s “song,” “The Poetry Lesson.” When you hit the link, scroll down to “Naughty Songs for Boys and Girls” and go to number 15 on the playlist, and you can hear it for yourselves.
SPOILER WARNING-
OPTIMUS PRIME DIES. AND THEN HE IS MAGICALLY RESURRECTED.
I didn’t have any new insights into the healthcare debate, so I thought I’d bitch about the word ‘cheesy’ instead.
“Cheesy.”
I don’t object to all uses of this term, certainly not the ones that are actually listed on dictionary.com:
“–adjective, chees⋅i⋅er, chees⋅i⋅est.
1. of or like cheese: a cheesy aroma; a cheesy taste.
2. Slang. inferior or cheap; chintzy: The movie’s special effects are cheesy and unconvincing. “
Nor do I mind so much when people describe failed melodrama as ‘cheesy.’ I find unsuccessful attempts to move me a lot more uncomfortable than crummy fx. (Like, um…in TRANSFORMERS-REVENGE OF THE FALLEN, the CG was state of the art but Optimus Prime’s touching death scene made me want to throw up and die, because nothing Michael Bay can do will ever make me care about Optimus Prime…I wouldn’t personally use the word ‘cheesy’ for that, I’d probably go with some variation of ‘retarded’ but I don’t think ‘cheesy’ would be totally misapplied either.) What I really dislike is when people apply it to things they ACTUALLY find emotionally affecting.
As in “I love Lord of the Rings even though it’s so cheesy.”
Which, as far as I can tell, means “I am slightly ashamed to admit that I enjoy Lord of the Rings more than The Great Gatsby, even though I know that Gatsby is high art and LOTR is for kids.”
Well, screw that. If you prefer LOTR to Gatsby, don’t make excuses for yourself. You’re right and F. Scott Fitzgerald is wrong.
There were two very interesting articles out on health care this weekend. One of very high quality that everyone interested in reform should know about. The other has some flaws but brings up interesting thoughts.
First, Wilper, et. al. have published in the American Journal of Public Health the best, recent study looking at the association between mortality and the lack of health insurance. The methodology in this study looks very sound in my judgment. While not perfect, for a study of this size, it is surprisingly thorough. (Tell me what you think Janice) The bottom line is that about 45,000 people now die per year as a result of not having adequate insurance so that they can pay for their health care.
The premature death of thousands of Americans can be translated into monetary terms using the economic “value of a statistical life.’’ Government economists use this methodology to help determine whether the cost of new government regulation (stricter pollution controls, for example, or food safety rules) is worth the value of lives saved. Insurance companies also use this approach to help estimate compensation levels for wrongful death. These estimates vary widely, from around $3 million to $12 million.
US government agencies typically use a figure around $7 million to represent the lost economic output from each death. If we conservatively use only half of the government figure, or $3.5 million, it suggests that the annual cost to the US economy of 40,000 deaths is about $140 billion. That adds up to a cost of more than a trillion dollars over a 10-year period – even taking future inflation into account – well above the cost of enacting a health care package.
A second way to estimate the cost of not enacting health care legislation is in terms of life expectancy. US life expectancy – at 78.11 years, ranks around 40th in the world and well below countries with universal health care. If we were to match Canadian life expectancy, for example, that would translate into an extra two years and 1 month of life expectancy for every American.
Putting a value on a life is not easy. Cowen has cited studies showing that people value an extra year of life at about $50,000 to $100,000. How does that translate into an extra 30 or 40 years? Determining what the contribution to the economy might have been is also difficult. How many of those people would have lived with health care, but not been able to work because of their illness?
Then there is the issue of productivity and health, i.e., what happens if health care makes you more functional, lets you work more or better? Key quote….
The Friends Committee on National Legislation analyzes the health care reform act that the House just passed. (I already shared this link on Facebook when we were in the last minute lobbying of the House stage, but it can’t hurt to also share it on the blog for those who haven’t seen it already.)
For all of you NaNoWriMo folks out there, how to write a great novel (I forget exactly who I got this from, but it was from another of my Facebook friends, I think from one of the people in my Quaker meeting doing NaNoWriMo).
One of the aspects of the torture program that really bothered me was the amateurs they hired to consult and advise about torture. The lack of any experience with interrogation by the psychologists they hired was well documented in Jane Mayer’s book, The Dark Side and here, by Ackerman. I had assumed that they never even asked the opinions of people with real experience interrogating prisoners, especially Muslim terrorist prisoners. I was wrong. Daphne Eviatar in a Washington Independent article notes that they received an opinion from our most experienced interrogators, they just ignored the advice. Key quotes…….
FBI/CITF agents are well trained, highly experienced and very successful in overcoming suspect resistance in order to obtain valuable information in complex criminal cases, including the investigations of terrorist bombings in East Africa and the USS Cole, etc. FBI/CRT interview strategies are most effective when tailored specifically to suit a suspect’s or detainee’s needs or vulnerabilities. Contrary to popular belief, these vulnerabilities are more likely to reveal themselves through the employment of individually designed and sustained interview strategies rather than through the haphazard use of prescriptive, time-driven approaches. The FBI/CITF strongly believes that the continued use of diametrically opposed interrogation strategies in GTMO will only weaken our efforts to obtain valuable information.
The memo goes on to list the interrogation techniques being used, and then to list which ones are “not permitted by the U.S. Constitution.” Those include: the use of stress positions for more than four hours; hooding; 20-hour interrogation segments; stripping a detainee of all clothing; and exploiting individual phobias, such as fear of dogs, to induce stress. They also include the use of scenarios designed to convince a detainee that death or severe pain is imminent for him or his family; waterboarding (here called “use of wet towel and dripping water to induce the misperception of drowning”); and exposure to cold weather or water.
All of those techniques, we now know, continued to be used by the Defense Department.
The FBI also warned that the use of such techniques would make any evidence derived inadmissible in federal court and if admissible in a military commission, likely to be given “little or no weight.”
The FBI drafters of the memo further explained that most of those techniques, particularly the last four, would also violate the U.S. anti-torture statute. It recommended that they not be used.
At this point, torture fatigue has pretty well settled in. The new administration wants to concentrate on health care, energy and the economy. They have little to gain by pursuing an administration that is out of power. Such an investigation risks exposing Democrats who may also be culpable. Still, I hold out hope for a truth commission of some sort. Continue Reading »
“During one of his liaison trips to Hanoi, Colonel Harry (Summers) told Tu, “You know, you never beat us on the battlefield,” Colonel Tu responded, “That may be so, but it is also irrelevant.”
George Washington led one of the most famous insurgent campaigns of all time. On paper, it was a total mismatch. British GDP was 100 times that of the colonies. The British army and navy were among the best, if not the best, in the world. However, Washington knew that the British had major commitments in the rest of the world. The cost of empire was high. he also knew that he had time on his side. He needed just an occasional victory to keep up hope. That is what he got and eventually the French aided us in our final push.
The Taliban also know that time is on their side. America has commitments elsewhere and the cost of empire is high. The Taliban also need a few victories of some sort to maintain hope. Dan Green at the Armed Forces Journal documents how they have chosen to obtain their hope generating victories. They are having their big successes off of the battlefield. Key quotes……
The Taliban’s positive political program has at least five aspects: Justice, micropolitics, reconciliation, laissez-faire and democracy. While the Taliban will impose their will on villagers if they have to, and they often do so violently, they also have a positive agenda that seeks to entice supporters to their banner.
In the face of corrupt and/or murderous government officials, a nonfunctioning judiciary, and the perversion or suspension of Pashtunwali traditions, the typical villager has a limited ability to seek justice for the things that bother him most: murder, theft, assault, rape, and land and water disputes. For the Taliban political agent, this vein of discontent is rich and can be mined by appealing to the structures of justice created by Sharia law. While the villager may not be inclined to support Sharia law in its totality, he is likely to do so in the absence of a viable alternative. Because the Taliban agent is sitting in the villager’s home, solicits his grievances and quickly seeks to remedy them, the villager is hard-pressed to support a government that is often distant and abuses its authority.
Along these same lines, the Taliban practice micropolitics to a remarkably high degree of sophistication. The Taliban political agent will find any problem that a village or individual may have and will make it his own. If a village is hoarding water from a stream, causing a down-stream village’s crops to fail, the Taliban will enlist with the aggrieved party. If a tribe has been abused by the Afghan government, the Taliban will join with them to seek justice. This political granularity stands in marked contrast to the sometimes inept, ineffective and insouciant efforts of the Afghan state and the sometimes counterproductive work of the coalition.
The Taliban’s political program is also furthered by their “do no harm” approach to the central drivers of local politics and economies. If a farmer wants to cultivate poppy, the Taliban allow it. If he once worked for or supported the Afghan government, he is allowed to reconcile with the Taliban. If a tribal leader wants his authority respected, they will do so if it furthers their agenda. Additionally, if villagers feel that “their” government does not represent them or has unfairly attacked their interests, then the Taliban preach inclusion, grievance and justice. Against this well-crafted, flexible, dynamic and pervasive program, U.S., coalition, and Afghan efforts lag significantly.
The Taliban are essentially all Pashtuns. They know and understand the local people and culture. They live there. Continue Reading »
The other day I received an email from one of my Senators, Sherrod Brown. You may remember him as the senator who claims diabetes makes you more compassionate and fair. The subject line of the email reads, “Health Reform: Ends Industry Discrimination Against Women, Protects Ohio’s Seniors.”
I have my doubts about it protecting seniors but now the discrimination against women part is my focus. First, I wonder if women ever tire of being the perpetual victims. Do women ever tire of being portrayed as helpless and impotent, as needing the constant assistance of men and government to be able to survive day to day life? Apparently not as one of the actions of feminism has been to perpetrate this image and insist on special government programs and laws to benefit the powerless, downtrodden female.
Secondly, how much discrimination do women face from the health care industry? To answer this question, I’ve explored the services available at hospitals in the greater Cincinnati area.
At Christ Hospital, where my two youngest children were born, you can click on the “Departments” menu, go down to “Women’s Services” and find: Birthing Center, Breast Health, General Health Information for Women, Prenatal Clinic, Reproductive Services, Women’s Health Today Magazine and Women’s Surgery Center. Bethesda North and Good Samaritan Hospitals have women’s programs that include Maternity Services, Breast Care, Specialized Gynecology Care, Fitness, Programs and Classes and TriHealth Nurse Midwives. The Mercy Hospitals conduct a The Spirit of Women program.
Across the Ohio River in northern Kentucky, St. Luke’s Hospital’s services include Birthing Center, Breast Health Center, Nurse Midwives, Perinatal Centers, Physicians for Women and Women’s Heart Health. St. Elizabeth’s in northern Kentucky provides a Women’s Wellness program. (St. Elizabeth’s and St. Luke’s are affiliated at some level.)
This is not to say that any of these programs are not legitimate but none of these hospitals has any apparent similar programs for men. No prostate cancer centers or programs, no men’s health centers, etc. If the result of discrimination against women is having the health care industry catering to your every need, we need more of this, not less.
Of course, Sherrod Brown is another mindless liberal parroting the same drivel liberals have repeated since the mid-Sixties. The real issue is that the liberals want to control ever more of our society in every way they can. Freedom means that people, and organizations, can act in ways that liberals don’t approve and we can’t have that. And, do women ever get tired of being treated as helpless little things that can’t possibly make it on their own. The chauvinists of decades ago held women in higher regard than today’s liberals.
Other health care related items courtesy Instapundit:
Did you ever wonder why there is no WalMart equivalent in health care? I have. While the current emphasis in the health care reform effort has been on expanded coverage, it is health care costs which need to be addressed in the long run before only the most well to do amongst us can afford medical care.
America is the land of the entrepreneur. Make it better, different or cheaper, then get it on the market. WalMart has been the king of cheaper. While WalMart has its detractors, it provides goods at low costs. There are downsides. First, the quality is often lower. However, consumers have spoken. They have been willing to buy cheaper clothes, appliances, whatever, knowing that they will just replace them more often. Next, the facilities are far from glamorous. Huge cinder block buildings with florescent lighting. No mistaking it for a Neiman Marcus. Lastly, service. Buy jewelry or perfume from an upscale store and you are helped by a young, attractive, solicitous employee. At Walmart you need to find the employee, wait until they are available, and they are usually just as gray and fat as the rest of us. America’s store.
Given these downsides, why hasn’t a WalMArt in health care come along? Health care would seem to be an obvious service that could fit into a discount model. First, it has become very expensive. There is a crying ned for lower costs alternatives. Next, just like restaurant chains, there is advantage to providing the same product at every franchise. Best practice medicine has been shown to be, usually, cheaper. Continue Reading »
I never feel comfortable with self promotion, but for the indefatigable out there check out my latest essay under the Featured Works section, “The Chasm Between the Economy and Finance.” For the not-so-indefatigable, just check out the intro, corporate profits, and the ending. Comments, as always, are welcomed.
David Wood at Politics Daily answers the question I have been pondering in the debate about troop levels for Afghanistan. Do we have enough troops? Key quotes…..
Here’s what worries the planners: The Army has 44 brigade combat teams (BCTs), its basic deploying unit of between 3,500 and 4,500 soldiers. Of those, 19 brigade combat teams are already committed, including 11 in Iraq and five in Afghanistan. One BCT is stationed in Korea, one trains deploying soldiers at the National Training Center at Fort Irwin, Calif., and one BCT is on strategic alert for potential crises.
There is a relentless and punishing logic to this pace. Maintaining one brigade combat team in the field requires two others on standby. So, for every unit in combat, planners keep a second one in training and a third one in “reset” after a long combat deployment – time when the Army can send its soldiers off for advanced schooling, absorb new replacements, receive new gear. Thus, a total of three BCTs are tied up.
Just to maintain the 16 current brigades in Iraq and Afghanistan is, let’s see, three times 16 is 48 and – oops! We’re already out of BCTs! And here’s the White House blithely batting around numbers like 40,000 more troops. That’s roughly eight BCTs, which do not exist. And you wonder why the open-air courtyard in the middle of the Pentagon is full of colonels striding around waving their arms and muttering to themselves?
Or we could just flog our existing troops some more as Wood points out. That would include deploying unstable, incompetent loners with a propensity for shooting their fellow soldiers. At some point, the indefinite nature of these wars, in terms of length, goals, endpoints, almost everything, has got to take a toll. Troop supplies and the money to keep them there cannot last forever.
I live in a nation where it ain’t what’s physical that fights us
Now it’s silent strikes from political insiders
- Deacon the Villain, Cunninlynguists – “Dying Nation”
When tragedy strikes a people, it’s easy to look outside for a cause to explain the sudden event. It could be an ideology, a nation, a religion, or, supposedly, a network of terror cells who will die for all three. But rarely do a people look inward, and respond to the situation out of understanding and compassion rather than fear and hatred. Yesterday, tragedy again struck America, in Fort Hood, a military base in Texas, and the new ground zero for the wars in Iraq and Afghanistan.
