Lean Left

Totally Psyched!
Posted by tgirsch

I’m pretty sure, I’ve linked this before, but it’s a brilliant piece of satire. Flame on!

April 11th, 2008 | Satire, Health, Weekend Flame Bait, Humor | 2 comments

How Capitalism Will Make Sure You Don’t Have New Medicines
Posted by Kevin

This is an excellent post on how the financial incentives of our intellectual property regime are drying up new medicine research and production:

The report then critiqued the drug industry’s corporate culture, framed by the demands of Wall Street. The financial incentives formed by the stock market force R&D decision-makers to focus most of their attention on developing blockbuster drugs for proven mass markets. Minor aches and pains, allergies, depression, cholesterol management, acid indigestion – the rewards for a successful new entry in one of these categories, whether or not it represents a significant new advance over previous therapies, are measured in the billions of dollars in sales.

… This trend, noted in the GAO report, led the auditors to conclude that the nation’s patent laws were one of areas in need of reform if industry was going to refocus its attention on medically significant products. A series of laws and court rulings have given manufacturers the right to obtain new patents for minor changes in chemical structure, changes in routes of administration, and new uses for old products. These patent extenders provide substantial financial rewards to firms that focus their research attention on extending the marketability of their existing products instead of focusing on the truly new and innovative – always an inherently risky proposition.

The logic of modern capitalism dictates this situation. Companies will do what it is easiest and safest to make money, and that means hundreds of knock off drugs and drugs for minor or nuisance problems at the expense of therapies of major medical problems. Investors want the blockbusters, and so pharmaceutical companies try to provide those in the fastest and most-risk averse way. Combine that attitude with the existence of patents and with the ability to extend a patent for minor changes, and you have an industry where real innovation is being driven out.

The patent problem is rather interesting. Patents, whatever ill they do, are a requirement for modern capitalism. If anyone can sell your ideas, then there really is little incentive to commercialize them. In fact, since you may have to include the cost of research and development in your pricing, you could start out at a serious price disadvantage to your thieving rivals. But the existence of patents opens up another way to make money: manipulating patent rules. Coming up with new discoveries and then translating those discoveries into new treatment regimes is hard work, filled with uncertainty. Manipulating the patent laws to allow you to monopolize a market for an extra number of years is comparatively easy and comparatively less risky. Given those facts, the situation we find ourselves in today was pretty much inevitable. The rules of modern capitalism ensure that.

The only way out of this mess is fairly intrusive government regulation. Patent laws have to be changed to prevent the kind of extensions we see know, and the government has to use the power of its research budget to force the companies that benefit form that research to be less blockbuster focused and more general needs focused. Without those kinds of changes, the rule sof modern capitalism will ensure that the drying up of new medicines will continue.

Link via Ezra Klein at his fancy new digs.

December 12th, 2007 | Health, How Capitalism Will Ruin You | 10 comments

Abstinence-Only Education
Posted by tgirsch

I think we’re finally starting to see the effects.

December 5th, 2007 | Culture, Health | 2 comments

The Best Reason to Become Billionaire
Posted by Kevin

So that I can buy all the add time on CBS and play this add constantly:

I had dental surgery on Friday, and this is the first day I don’t feel like the loser of a particularly nasty fight. Blogging will resume sometime around the moment I can open my mouth without pain.

November 4th, 2007 | Health, Humor | one comment

$7 Billion A Year for S-CHIP?
Posted by tgirsch

No, that’s way too much money. Far better to spend six times that amount fighting the eeeeevil Marijuana problem.

A more even-handed look is here.

October 19th, 2007 | Politics, Health, Weekend Flame Bait | no comments

Afraid to Pick On Someone Her Own Size
Posted by Kevin

Ezra throws down the gauntlet, and Malkin runs away. Twelve year olds, apparently, are more her level of competition. Though, frankly, I am not sure I blame her. Based on her comments in the Times article about the attack on this family, Malkin’s argument is basically that no one should get any help until they are completely destitute:

But Michelle Malkin, one of the bloggers who have strongly criticized the Frosts, insisted Republicans should hold their ground and not pull punches.

“The bottom line here is that this family has considerable assets,” Ms. Malkin wrote in an e-mail message. “Maryland’s S-chip program does not means-test. The refusal to do assets tests on federal health insurance programs is why federal entitlements are exploding and government keeps expanding. If Republicans don’t have the guts to hold the line, they deserve to lose their seats.”

In Malkin’s world, you should sell your business, sell your home and then when that’s not enough to pay your severely injured children’s medical bills, because it wont be, then and only then can we consider giving you some help. That wrong morally and practically. The Frost’s as a family have been exemplary members of our society. They have worked hard, tried to start their own business, own a home, and done everything they could to improve the lives of their children. They have done everything we have asked of them, and Malkin still wants to leave them destitute and homeless because of a moments bad luck.

Morally, that’s disgusting: you should not have to reduce a person to pauper-y and abject destitution before you deign to assist him. That reeks of viciousness and a clueless sense of privilege unworthy of even the Medicis. Taking away everything a person has, destroying the dreams they have worked for, and eliminating options and possibilities for their children is despicable, especially when the cost of help is so small and the rewards are so large.

As a practical matter, pauperizing people like the Frosts is equally stupid. They are hardworking people who contribute to our economy and our community. Destroying the financially only serves to weaken both for no good reason. If the private insurance market cannot serve these people — and there is no doubt that it cannot serve large swathes of the working and middle class in this country — then it makes sense for the government to step in. The amount we spend on that kind of insurance is a pittance compared to the benefits we receive in return. Families stay together, children get the help they need to lean normal lives, small business owners aren’t forced out of business, and the ranks of the homeless are not increased. When the middle class and working people are provided with the security they need to ride out bad times, they repay society a hundred times over through their contributions to the our economy, culture, and neighborhoods. Frankly, I find it hard to beleive that anyone could argue otherwise with a straight face.

If the choice is between destroying lives or spending a small amount to help people survive health related catastrophes, I think the choice is clear. So, too, does Malkin. Perhaps that is why she is running screaming from the thought of having to face down a health care expert like Ezra Klein.

October 11th, 2007 | Politics, Economics, Health | 25 comments

SCHIP Nonsense
Posted by Kevin

This is a rather silly argument:

Maybe we should also make these people eligible for food stamps, housing subsidies, and free cigarettes. Why should anyone have to pay for anything anymore?

Come on, people! We’re talking about whether the government should pay for your two kids’ health insurance plans when you make more than $51,000 a year (more than the new national median income). I know that health insurance is not cheap, but neither are your mortgage and car insurance. You’re not going to ask the government to pay for those too, are you

We already do have subsidies for housing for some people in the middle class: it is called the mortgage interest deduction. In fact, a moments thought will show you that we subsidize quite a bit of middle class life. We do provide a kind of food subsidy: the cost of inspecting the food to make sure that it wont poison you is borne by the government. We subsidize the purchase of cars, sometimes directly through tax credits but more often through the road system. Highways and byways are paid for by the government and your car is essentially useless without them. We provide free education of or any child who wants it. That, too, is a subsidy of the middle class. We even subsidize health care: much of the important medicine we have today came as a result of NIH research.

We, as a society, have subsidized an enormous amount of modern life because, as a society, we have decided that it is immoral, inefficient, or impractical to leave those portions to individuals. Much of our lives are aided by government subsidies and we are better as a society and an economy for it. Arguing that middle class parents must, because they are middle class, pay for health insurance is exactly and precisely like arguing that middle class parents should pay for their own food inspection programs because they are middle class. Its a silly argument because it has nothing do with the actual reasons society subsidizes anything. If you don’t think arguments of morality or inefficiency or practicality — the arguments that have served as the basis for all good government interventions — then say so. But don’t pretend that the SCHIP expansion is somehow unique or that the government has not subsidized large swaths of American life or that those subsidies have had a positive effect on American society. Doing so just makes you look silly.

August 29th, 2007 | Economics, Culture, Health | 9 comments

Mmmm… Hog Fat
Posted by tgirsch

UPDATE: I found it. Behold the power of Google.

Are you eating your lard? Contrary to conventional wisdom, it may just be a healthy alternative:

But now that New York’s restaurant owners are being encouraged to face health facts and stop using hydrogenated oils, what oil should they use instead?

This is where Corby Kummer jumped in with a suggestion: lard.

Mr. Kummer, a senior editor at US magazine The Atlantic Monthly, penned a recent New York Times op-ed piece in which he sang the praises of lard (rendered and clarified pig fat). And if that sounds less than appetising, Mr. Kummer points out that every baker knows that there is no oil that produces a flakier or tastier pie crust. Lard also produces delicious fried chicken and fish.

Obviously, a healthy diet would not include large amounts of pies and fried foods, but lard can be used in any number of ways. And for those who think that “pure lard” means “pure danger,” Mr. Kummer offers this breakdown of lard’s fat profile:

• Lard is 40 percent saturated fat (compared to coconut oil’s 85 percent and palm kernel oil’s 80 percent)
• Lard contains “a very respectable” 45 percent monounsaturated fat (for more on the benefits of monounsaturated fatty acids (MUFAs) see the e-alert “Change your diet to avoid Parkinson’s disease” – 21/7/05)

Now, in spite of the MUFA content of lard, the medical mainstream might swoon at the thought of 40 percent saturated fat. After all, saturated fats will kill you, right? They’ll clog your arteries and stop your heart, correct?

Answers: No and No.

In a review of saturated fat studies that appeared last year in the American Journal of Clinical Nutrition, the authors (from the Department of Food Science and Technology at the University of California) noted that many mainstream researchers have narrowly focused on the hypothesis that saturated fat raises LDL cholesterol and the risk of coronary artery disease (CAD).

The UC authors write: “The evidence is not strong, and, overall, dietary intervention by lowering saturated fat intake does not lower the incidence of nonfatal CAD; nor does such dietary intervention lower coronary disease or total mortality.”

Elsewhere in their review they state: “The conclusion of an analysis of the history and politics behind the diet-heart hypothesis was that after 50 years of research, there was no evidence that a diet low in saturated fat prolongs life.”

And similar observations have been voiced many times by US physician Dr William Campbell Douglass II. Late last year Dr. Douglass wrote: “Countless studies show that the MORE animal fats people eat, the better their heart health. Need some proof from the real world? The African Masai, North American Eskimos, Japanese, Greeks, Okinawans, and our good friends the French all consume diets that are extremely high (by mainstream American standards) in saturated animal fats. Yet these people enjoy astonishingly low rates of heart disease, hypertension, and coronary events.”

So don’t fear the lard. Or - as Dr. Douglass puts it in his typically direct style: “Eat your animal fats!”

Of course, this shouldn’t be viewed as an invitation to eat lardsicles with a side order of lard at every meal. And as to the last part, the plural of anecdote is not data. But as I’ve been cooking with lard lately (Mexican mole cannot be made properly without it), you can bet your bottom I’ll be passing this along to my soon-to-be-dietitian wife. Anecdotally, at least, I’ve noticed that because animal fats (e.g., lard, butter, and God’s gift to mankind, bacon grease) are more flavorful, I tend to use considerably less of them when cooking than if I were using, say, vegetable oil.

Important note: If you’re going to use lard, as I do, you’re going to have to make it yourself. The stuff you can buy in a tub almost always contains hydrogenated lard, which is Very Bad for you. Fortunately, it’s actually pretty easy to make. Just ask your butcher or supermarket meat department for their unsmoked, uncured pork scraps — bacon’s no good here — and then put them in a 325 degree oven for about an hour. You’ll get liquid love, and some cracklins, to boot!

August 27th, 2007 | Health, Food & Cooking | 5 comments

I’m Still Not Eating It
Posted by Kevin

Broccoli is even more good for you than your Mom thought:

A compound found in broccoli and related vegetables may have more health-boosting tricks up its sleeves, according to a new study led by researchers at the University of California, Berkeley.

Veggie fans can already point to some cancer-fighting properties of 3,3′-diindolylmethane (DIM), a chemical produced from the compound indole-3-carbinol when Brassica vegetables such as broccoli, cabbage and kale are chewed and digested. Animal studies have shown that DIM can actually stop the growth of certain cancer cells.

This new study in mice, published online today (Monday, Aug. 20) in the Journal of Nutritional Biochemistry, shows that DIM may help boost the immune system as well.

“We provide clear evidence that DIM is effective in augmenting the immune response for the mice in the study, and we know that the immune system is important in defending the body against infections of many kinds and cancer,” said Leonard Bjeldanes, UC Berkeley professor of toxicology and principal investigator of the study. “This finding bodes well for DIM as a protective agent against major human maladies.”

August 21st, 2007 | Health, Food & Cooking | one comment

Computers Make Medicine Harder
Posted by Kevin

Unless you really work at integrating them:

linical information technology systems – especially those known in the health care industry as computerized provider order entry (CPOE) systems – promise to improve health outcomes, reduce medical errors and increase cost efficiency, but hospitals adopting them must plan for “immense” workflow issues and a host of other unanticipated consequences that come with them or face potentially crippling problems, concluded a study led by researchers at Oregon Health & Science University.
The researchers found in a survey of 176 hospitals where CPOE systems have been integrated into daily operations that unintended adverse consequences were virtually universal. CPOE systems are those that require a physician or other health care professional to enter prescriptions and other medical orders directly into a computer database.

For six out of eight previously defined categories of unintended consequences, more than 70 percent of the institutions ranked the level of impact on operations as “moderately to very important.” Those were issues involving alterations in workloads, workflow, communication patterns, never ending system demands, emotions and system overdependence that led to havoc during system failures. Doctors, for example, were spending much more time at the computer inputting prescriptions and other orders.

One of the reason the VA does so well compared to private systems is that it has a wonderful computerized record keeping system. Nut the VA is not like a private hospital. It has enormous incentives to reduce costs (since it is a government program dealing with veterans, and under great scrutiny as a result) and it generally has a patient in the system from their first visit to their death. Hospitals and private practice have neither advantage. Training is a short term drain on profits with a pay off that can only bessen far down the road and patients are truly transitory. It is rare for a patient to stay with one hospital or private practive for a significant amount of time.

Unfortunately, these problems are preventing the adoption of system that literally save lives:

At least 400,000 preventable drug-related injuries occur in hospitals each year, the Institute of Medicine of the National Academies reported last year, and illegible handwritten prescriptions figure in a significant share of them. Prescriptions ordered electronically are safer and, combined with decision support tools, automatically alert prescribers to possible interactions, allergies and other potential problems, the Institute said, and urged that all health care providers have electronic systems in place by 2010.

Fears that the CPOE “cure” might be worse than the disease likely are impeding the diffusion of CPOE throughout hospitals in the United States, the authors of the JAMIA paper asserted. Those fears gained credence when a pediatrics hospital in Pittsburgh attributed a higher mortality rate to its CPOE system—mistakenly, it later turned out—and when Cedars-Sinai Medical Center in Los Angeles, hospital of the stars, shelved its $34 million system after a staff revolt.

One small advantage of a single payer system might — and I stress might as the political will to enforce this change would have to be present — force private practioners to use these kinds of systems as they are both a life and cost saver.

August 3rd, 2007 | Health | one comment

Advance in Finding Cause of SIDS
Posted by Kevin

Every new parent spends the first few weeks of their child’s life trying to get the little buggers to sleep for more than twenty minutes a t a time. Once they manage that feat, they spend hours of their lives standing over cribs, making sure their little ones are still breathing. Very few things are more terrifying to parents than SIDS –Sudden Infant Death Syndrome. One moment a perfectly healthy baby is snoozing in its crib. The next, it is dead, breath chased out of it as if by black magic. Now a small study seems to suggest a means of determining which children are at risk for SIDS:

One of the greatest medical mysteries of our time has taken a leap forward in medical understanding with new study results announced by Dr. Daniel D. Rubens of Children’s Hospital and Regional Medical Center in Seattle. Rubens’ study published in July, 2007 in Early Human Development found all babies in a Rhode Island study group who died of Sudden Infant Death Syndrome (SIDS) universally shared the same distinctive difference in their newborn hearing test results for the right inner ear, when compared to infants who did not have SIDS. This is the first time doctors might be able to identify newborns at risk for SIDS by a simple, affordable and routine hearing test administered shortly after birth. In the study, medical records and hearing tests of 31 babies who died from SIDS in Rhode Island were examined and compared to healthy babies. Rhode Island has a particularly robust database of newborn hearing test data.

… The SIDS infants in Rubens’ study showed a consistent four point lower score in their standard newborn hearing tests, across three different sound frequencies in the right ear, when compared to babies that didn’t die from SIDS. Additionally, healthy infants typically test stronger in the right ear than the left. However, in each of the SIDS cases studied, the right ear tested lower than the left, reversing the test results of healthy babies.

This is a small study, involving only 31 children from only one state. But the correspondence appears to be strong and if this is borne out, it could be a large step in saving children’s lives. Not only does a test for susceptibility to SIDS mean that children who need to be watched more will be, but the nature of the test — hearing screen — suggests a vector for further research into what causes SIDS:

It is known that the inner ear contains tiny hairs that are involved in both hearing and vestibular function. Rubens proposes that vestibular hair cells are important in transmitting information to the brain regarding carbon dioxide levels in the blood. He postulates that injury to these cells will disrupt respiratory control, playing a critical role in predisposing infants to SIDS.

This could be the beginning of a truly remarkable breakthrough in pediatrics.

July 31st, 2007 | Science, Health | no comments

Fsck Phil Bredesen
Posted by Kevin

The coward that killed Tenncare seems to think he is an expert on making health care affordable:

We’ve felt the pinch in Tennessee, and we’re not alone. The skyrocketing cost of health care is a national problem that deserves a national solution. Unfortunately, that day - when America comes together to address the issue of health care costs from a national perspective - has not yet arrived.

But as Governor of Tennessee, I cannot in good conscience stand by and wait for the folks in Washington to act on a problem that today impacts the lives and livelihood of every hardworking man and woman in America. That’s why, last year, I presented to the General Assembly a plan for what we can do here in Tennessee to offer a helping hand to our citizens - folks who work for modest wages, for small businesses, for themselves.

Cover Tennessee, is a modern, fiscally cautious, down-to-earth approach. It’s not the “end-all, be-all” solution to our problem. It is not another big government entitlement program. It is not TennCare part 2. What it is instead is a starting point that, if we’re successful, will allow us to grow step-by-step in a fiscally responsible way.

Well, isn’t that lovely. Good ol’ Phil, doing everything he can to help the poor and middle class of Tennessee who are stuck without health care. Sounds like quite a guy. Except that Phil Bredesen didn’t do one thing to help save Tenncare when he had the chance. He ran from the fight like rabbit runs from a wolf. He rejected out of hand any steps that might have saved Tenncare:

I have said this before, but it bears repeating: Bredesen is a deliberate coward. There were things that Bredesen could have done to save money before he tried to gut the program. He refused to join other states in a program to purchase drugs in bulk — a move that the former head of TennCare said would have saved the state about 500 million dollars. As I mentioned before, simply changing the way paperwork was done would save millions:

Bredesen’s failure is even worse than I thought. e is leaving many easy to implement things undone. Bredesen is literally leaving hundreds of millions of dollars of easy savings on the table. One egregious example is this:

This year TennCare will pay its managed care contractors $245 million, or nearly 5% of the $4.96 billion in health services which they administer. Those rates are relics of a past when the contractors were true HMOs that accepted financial risk. They are now only administrative services organizations (ASOs). They do not manage care. They pay claims and issue eligibility cards, which can be done for a fraction of present rates. In 1993, the last year before TennCare began, the Medicaid contractor that performed those functions received $8.5 million to administer $1.78 billion in claims, a rate of less than half of one percent. The state should not pay HMO prices for ASO service.

If TennCare would abandon its reliance on for profit HMOs to push paper around, and instead went back to the old system with the same percentages, the savings would be substantial. If the costs were one half of one percent, on 4.96 billion dollars of claims, then the state would be paying 24.8 million dollars — a savings of 220.2 million dollars a year. That is about 38% of the money Bredesen is going to save by kicking these people off TennCare:

South Knox Bubba highlights the fact that this kind of stupidity still goes on today:

Rehashing of old wingnut talking points in comments reminded me of something that was bugging me earlier this week.

The Tennessean reported that the state had problems with a company contracted to manage pharmacy benefits. The state’s response? To more than double the amount the state pays them from $15.2 million to $37.9 million. Sweet!

The company, First Health, was recently acquired by Coventry Health. Coventry Health’s earnings (i.e. profits) have increased by 300% since 2001. No wonder health care costs are skyrocketing.

Oh, and according to the transcript of this conference call about the acquisition (PDF format) they wouldn’t rule out eliminating First Health’s pharmacy benefit management business at some future date, assuming I correctly interpret the question by analyst Christine Arnold and the CFO’s (now CEO) response.

By the way, that conference call is an excellent look into the minds of senior management at health care “provider” outfits. People are their first priority. Not. It’s a perfect example of why profit needs to be removed from the health care equation.

Bredesen didn’t even try to take on the established players. He didn’t try a single real reform, he didn’t try to take on the business interests that were costing Tenncare money, he didn’t even try to crack donw on fraud — enrollment or billing. He just wined about lawyers and said the words “government program” like they were a curse and gave up without even the appearance of a fight. After all, what are the health concerns of the poor and the unlucky, right?

The study found a mixed scene for those taken off TennCare rolls. Many with multiple chronic health conditions can’t get health insurance. Some found their way through the complicated safety net system, a low-cost option called CoverTN, while others did not.

Primary care was generally available to the unenrolled either through emergency room visits or CoverTN. However, hospitals absorbed much of that cost. Also, social services agencies, like the CHC, have made changes to programs to meet new needs.

The CHC was bursting at the seams prior to TennCare reforms, Morris says. Now it is scrambling to handle the volume, but also deliver quality care. TennCare patients were an easy target, he says, because of perception.

To quote myself, Bredesen simply adopted Republican talking points and turned his back on a program that was both the moral and practical thing to do. He refused to take on either the powerful pharmaceutical and HMO lobbies or the Republicans, and consigned 323,000 people to poor health care — and sometimes death. If I had wanted a governor afraid to stand up for Democratic principles, if I had wanted a governor more interested in the favor of pharmaceutical and HMO companies than the citizens of the state, if I had wanted a governor who spoke in RNC platitudes, then I would have voted for the Republican. It was political cowardice of the rankest kind, and Bredesen should never, ever be allowed to escape it. It should be tied around his neck like a millstone until it crushes his career under its weight.

Just like his cowardice is going to crush the life out of some of Tennessee’s citizens.

July 31st, 2007 | Politics, Health | 2 comments

Death to Antibiotic Resistant Superbugs … And Chewing Gum
Posted by Kevin

Life works in mysterious ways:

A method for making instant steam, without the need for electricity, promises to be useful for tackling antibiotic resistant ‘superbugs’ like MRSA and C. difficile, as well as removing chewing gum from pavements and powering environmentally friendly cars, reports Nina Morgan in Chemistry & Industry, the magazine of the SCI. ‘The value of instant steam lies in creating truly portable steam that can be generated intermittently on demand,’ says Dave Wardle, business development director at Oxford Catalysts.

The company is already in talks with UK specialist steam supplier OspreyDeepclean about possible applications for steam cleaning hospitals, Wardle adds. An as-yet unpublished 2006 study at University College London Hospital, commissioned by OspreyDeepclean, showed that dry steam applied at temperatures ranging from 150 to 180 C could destroy bacteria, including MRSA and Clostridium difficile, in less than two seconds, without the use of chemicals.

Ina ll seriousness, this could be fantastic news. We as a culture have helped evolve, through our careless and over-use of antibiotics — a class of superbugs that antibiotics cannot kill. Without an effective means of fighting these bugs, mortality rates in hospitals will contiue to climb and there is the very real possibility that we will start seeing these bugs outside of hospital environments. Obviously, this method does nothing for people who have contract one of these infections, but it does appears as if it could work wonderfully as a preventive measure. A simple, effective, easy to use and almost instantaneous disenfciting process would go a long way to making our hospitals much more superbug resistant.

And giving us chewing gum free sidewalks, let’s not forgot …

July 30th, 2007 | Environment, Science, Health | 2 comments

This Seems Fishy
Posted by tgirsch

From a new report:

Fewer high school students are having sex these days, and more are using condoms. The teen birth rate has hit a record low.

…snip…

The teen birth rate, the report said, was 21 per 1,000 young women ages 15-17 in 2005 — an all-time low. It was down from 39 births per 1,000 teens in 1991.

“This is very good news,” said Sondik. “Young teen mothers and their babies are at a greater risk of both immediate and long-term difficulties.”

The birth rate in the 15-19 age group was 40 per 1,000 in 2005, also down sharply from the previous decade.

Why does this seem fishy? Because they only mention the teen birth rate, without talking about the teen pregnancy rate. If the teen birth rate fell by a substantially larger margin than the teen pregnancy rate, then there’s only one logical explanation for the discrepancy: abortion. I don’t know what’s happened to the teen pregnancy rate as compared to the birth rate, but this is the only reason I can imagine why they wouldn’t mention the pregnancy rate.

On another note, there’s this:

In 2005, 47 percent of high school students — 6.7 million — reported ever having had sexual intercourse, down from 54 percent in 1991. The rate of those who reported having had sex has remained the same since 2003.

Thirty-four percent of the students reported having had sex during a three-month period in 2005. Of those, 63 percent — about 3 million — used condoms. That’s up from 46 percent in 1991.

This is further evidence that comprehensive sex education is an unequivocally good thing. Study after study shows that comprehensive sex ed works in two ways: it reduces the number of teens who engage in intercourse, and it increases contraceptive use in those who do.

Also note that the rate at which teens have sex is unchanged since 2003, which means that most of the decline came in the era of comprehensive sex ed rather than via “abstinence-only” education.

It seems to me that if you’re “pro-life” or anti-abortion, you should be all in favor of comprehensive sex ed.

UPDATE: According to these stats (PDF table 1), from 1991 to 2002, the rate of teen pregnancy dropped more than the teen birth rate (a 34.6% drop versus a 30.4% drop, respectively). At the same time, the abortion rate dropped by 42% (bottoming out by 1999/2000), and by 2002, a larger percentage (57.0%) of teen pregnancies ended in live birth than in 1991 (53.6%). So it seems my initial assumption about abortions playing a role was incorrect. At the same time, the arguments against “abstinence-only” education are only strengthened by these statistics.

More interesting stats from the document (although not necessarily relevant to this discussion):

• The five states with the highest teen pregnancy rates in 2000 were: Nevada (113), Arizona (104), Mississippi (103), New Mexico (103), Texas (101)
• The five states with the lowest rates: Maine (52), Minnesota (50), New Hampshire (47), Vermont (44), North Dakota (42)
• The Southwest and the Southeast seem to be the regions with the highest teen pregnancy rates.
• New England and the Upper Midwest seem to be the regions with the lowest teen pregnancy rates.

Without specific stats to back it up, it seems to me based on regions that a combination of widespread poverty, high population density, and (somewhat ironically) conservative religious beliefs all factor into higher pregnancy rates. Note that population density is a bit tricky: Nevada (worst teen pregnancy rate) has a low statewide population density (18.21/sq. mi.), but given that 76.6% of its population lives in Clark County (metro Las Vegas) and another 16.4% lives in metro Reno (93% total between the two counties), it’s got a highly localized, high-density population (241.8/sq. mi. in Clark County, and 64.5/sq. mi. in metro Reno).

July 13th, 2007 | Politics, Health, Weekend Flame Bait | 16 comments

The Morality of Abortion
Posted by tgirsch

Consider these two propositions:

1. A woman who is unable and/or unwilling to properly care for a child should not have a child.
2. A woman who is unable and/or unwilling to properly care for herself should not have a child

These propositions, it seems to me, are entirely uncontroversial. But here’s where the controversy comes in: I submit that becoming pregnant in no way changes those two propositions. And that therefore, in such circumstances, not only is abortion not an immoral choice; it’s the morally correct choice.

Discuss.

(And before anyone tries to go down the “why don’t we just kill unwanted children” road, children are fundamentally different, in that they are already independently alive, and may be cared for by literally anyone, not just the biological mother. Until we have {a} viable pregnancy transplants; and {b} enough willing transplant recipients, save it.)

July 13th, 2007 | Health, Weekend Flame Bait | 83 comments

Does That Make Gordon Gecko Linux or Windows?
Posted by Kevin

Music City Bloggers has a post up highlighting a comment thread discussing Sicko and markets in health care. One of the commentators, Hammock, says this:

I’m glad that there is greater public discussion of the flaws in the U.S. health care system. What bothers me is that Moore and everyone else seems not to carry the argument beyond “we should get better care” and “health insurance companies are greedy”. Greed produced my clothes, my house, and the computer I’m using right now.

Even if it were an unregulated market, there are options other than single-payer or nationalization. There are policies that can guarantee care while encouraging competition to control costs and promote innovation. No one seems to be willing to discuss them, possibly because these ideas are complicated.

…

Just to make the argument clear: Greed is not a sufficient condition for an undesirable outcome. Greed is not even incompatible with desirable outcomes. In the right institutional arrangement, greed is a necessary condition for desirable results. So why denounce greed, rather than the institutional environment?

I will indeed state that making categorical statements like “Greed is always bad” are overly simplistic (libertarians run into the same problem when they invoke simple principles such as “non-initiation of force”). It is almost always possible to construct an example in which any hard-and-fast, black-and-white moral rule does not hold.

…Economics might be able to tell us something about the true nature of the problem–why does this market work poorly, whereas others work well? But that would require a careful and thoughtful discussion that would probably bore most people, so no one–not CNN, not Michael Moore–has the discussion. Instead we get grandstanding and entertainment.”

This reminds me of the Windows vs. Linux flame wars or the various “my favorite programming language is obviously superior to your favorite programming language” that infest the internet. I am a programmer and have been a sys admin and network security engineer. I have worked on, literally, almost every single operating system and programmed in most programming languages. I have networked computers in Appletalk and written code to run on Os/2. I have written programs in C for Unix and Perl for Windows. I have written fat clients, smart clients, and web based clients. I have done applets and ajax and, God help me, active x. I have written Windows services and Unix daemons. Yesterday I wrote code in three different languages on two different operating systems. And you know what? I wouldn’t hesitate to use any technology I have used in my career again (Well, okay — maybe not VB). Whatever the Linux fanboys and Windows geeks may say, whatever the Perl partisans and Python propagandists might claim, programming languages and operating systems and design methodologies are just tools. Nothing more, nothing less. The trick is to use the right tool for the right task.

Greed, or, more accurately, markets, are the same way. They are a tool, not a revelation from the burning bush. Greed is not the only tool in our possession and it must be judged the same way all other tools are: by how well it does it job. You cannot look at a situation and think to yourself “how can I make markets work better here”. That is like looking at a nail and thinking, “hmm, how could I get that nail into this piece of wood using this hacksaw”. The appropriate question is whether or not greed is the right tool for the job. And I think it is pretty clear that if the job is designing a decent health care system in thsi country, the answer is “no”.

Markets create incentives for insurance companies to behave atrociously. The simplest way for an insurance company to become profitable is to never pay out any claims. Thus, insurance companies go to great lengths to not enroll people who can be expected to have high medical costs down the line and to find reasons to deny people the benefits for which they have paid their premiums. Assuming that doctors are driven by the same greed first considerations (most aren’t; but that is a complication for another day) they too have incentives to act in something other than the patient’s best interest. If they are paid by the insurance company per patient, they have every incentive to stack the patients high and push them through fast. If they are paid by the insurance company per procedure, then they have every incentive to order up as mush work as possible. The former leads to missed diagnosis and incomplete treatment; the latter leads to over exposure to antibiotics, unnecessary pain anddiscomfort for the patient, and longer waiting times for needed treatments and equipment for everyone else. Greed, in other words, is bad for your health.

This is obvious once you step back and look at the problem without the need to make it fit into a market based solution. But you must take that first step of not picking your tool before you diagnose the problem. Markets and greed are not required in every aspect of our lives. They are not revealed wisdom or the secret to everlasting success and happiness. They are just tools, the functional equivalent of a hammer. And not every problem in the world is shaped like a nail.

July 12th, 2007 | General, Politics, Economics, Culture, Health | 22 comments

How To Lose 50 Pounds In Six Months
Posted by tgirsch

OK, that’s probably an unrealistic result for most — 20-25 pounds is more sustainable — but still, Sleitbartfast has some decent tips on the subject, and actually is approaching that result.

June 29th, 2007 | Health | no comments

Health Care Apples And Oranges
Posted by tgirsch

This morning, a friend of mine sent me this smoldering piece of crap from the Wall Street Journal, and I just couldn’t let it go without comment.

‘I haven’t seen ‘Sicko,’” says Avril Allen about the new Michael Moore documentary, which advocates socialized medicine for the United States. The film, which has been widely viewed on the Internet, and which will officially open in the U.S. and Canada on Friday, has been getting rave reviews. But Ms. Allen, a lawyer, has no plans to watch it. She’s just too busy preparing to file suit against Ontario’s provincial government about its health-care system next month.

Her client, Lindsay McCreith, would have had to wait for four months just to get an MRI, and then months more to see a neurologist for his malignant brain tumor. Instead, frustrated and ill, the retired auto-body shop owner traveled to Buffalo, N.Y., for a lifesaving surgery. Now he’s suing for the right to opt out of Canada’s government-run health care, which he considers dangerous.

So, to start, we’ve found someone who’s got a complaint — maybe legitimate, maybe not — against the Canadian health care system. We’ve already started off on a bad foot, by making two fatally-flawed assumptions. The first is that anyone is arguing that the Canadian health care system is perfect. To my knowledge, absolutely no one argues this. The second is that just because there are problems with another country’s system, this somehow implies that ours is necessarily better. It simply doesn’t follow.

June 28th, 2007 | Politics, Health | 15 comments

These Creepy, Mercenary Parents Are . . . Well, What’s the Big Deal, Anyway?
Posted by KTK

Tgirsch alerts me:

This one’s all yours.  Via Nashville Is [S]Talking.

The URL is for “Help My Baby Live”, whatever that is. I can’t get the page to load. After Googling around, I found a reference to a couple of low-lifes who are demanding $50,000 in contributions or they’ll have an abortion - I assume this is the reference in question.

What to say? First, it’s very likely a scam: either there isn’t a pregnancy or they have no intention of aborting anyway. If that were true, they could be liable for false solicitation.

If they really mean it . . . well . . . why does it matter? It’s only marginally more tasteless than Pat Robertson’s Oral Roberts’s prophecy that God would kill him if his sheep didn’t cough up $8 million in record time. The people who are going to object to this baby thing are the ones who didn’t object to Robertson’s bullshit, and as usual, there’s no reason to take them seriously.

As to whether it’s a good idea to do this kind of thing, it certainly seems . . . questionable. It seems at first glance incredibly crass to essentially sell your own decision whether to carry a pregnancy to term. And when your kid eventually finds out that you had made up your mind to have an abortion unless someone paid you not to, they may voice some objections. It also just seems greedy: pregnancy and raising a child are expensive, and that’s an issue for every prospective parent, but most people can get through it without needing $50K in cash up front. However, although this (Web begging) seems a strangely cold-blooded way to approach the problem, it’s really not very different from the decisions many people make all the time.

For many people, the decision whether to carry through an unplanned pregnancy may very well hinge on financial issues - and appropriately so. What this couple are really saying (if they’re on the level) is that they can’t afford to have a child now without some financial assistance, and that their decision whether to do so or not will depend on whether their financial situation improves quickly. That’s not only not objectionable, it’s perfectly reasonable. Putting it in the form of a de facto threat to have an abortion unless someone ponies up is rather crude, but it’s equivalent to simply saying “This is how much we need, and we can’t realistically take on this burden otherwise.” - which, again, is reasonable. (In fact, you could say that it would be a better world if a lot more couples had that conversation with themselves at the appropriate time.) As to why they need $50K, that’s their business. It may just be a scam, but if it’s not they may have serious financial problems others aren’t aware of - maybe they’re in debt, maybe they know the infant will have special care needs, or whatever. Nobody has to contribute if they don’t want to, but it doesn’t seem to me unreasonable for them to ask, or impossible that they could be sincere.

As for those who simply can’t keep from judging others, especially regarding pregnancy, consider that what they’re asking help in doing is exactly what the objectors would like to force them to do unilaterally - so giving the money is a way of moving them toward the result you want, and away from the other.

The best part about this, of course, is that the people who will feel an urgency about donating are the anti-choicers, who normally prefer to simply take away people’s right to make such decisions for themselves but in this case can only pay to support the decision they hope will be made. So much of that $50K will come from people who would otherwise use it to make choices like this impossible - which is all to the good. (In fact, I’m tempted to suggest that every pro-choice woman who is ambivalent about pregnancy for financial reasons should threaten to abort unless they receive $50K in donations exclusively from people who can prove they have previously donated to an anti-choice organization. Draining the Ameritaliban and putting their money to good use for once would truly turn your bun in the oven into a little bundle of joy.) So-called “crisis pregnancy centers” run by anti-choice outfits are notorious for the meager or non-existent aid they actually provide to pregnant women, and the complete lack of support they offer after birth. Forcing them to provide aid that will really make a difference both during and after pregnancy, and refusing to allow them to dictate how it will be used, or to impose some sort of religious requirement, is a very effective way of seeing just how much money they’re willing to put where their mouths are (in fact, if this demand turns out to be a strategy expressly motivated by that consideration, I’d call it brilliant!).

So, in the end, although this situation seems somewhat cold-blooded, it’s not much different from the kinds of very practical decisions people are forced to make about pregnancy and child-rearing every day. It seems as if these potential parents could be more tactful (though again I’ve only seen others’ vituperative responses to them, so I may be judging unfairly), but I don’t know that they’re doing anything wrong. I hope this doesn’t presage a heartlessly monetary view of their relationship with their eventual child, but even there they would be well within the mainstream of lousy parenting. And finally, if this ends up taking $50K out of the whack-job anti-choice community, that would be some very sweet icing on an otherwise ordinary cake.

June 28th, 2007 | General, Politics, I do too have a life, Religion, Culture, Health, Privacy | 4 comments

Evangelical Ignorance At Its Finest
Posted by tgirsch

No Utopian nostalgia here, no, not at all:

Feminists heralded the proliferation of abortion as a tool by which to “empower” women and give them control over their lives and destinies. But power is being pregnant. Because it gives you control over other people’s lives. Embryos and fetuses get you treated like royalty. Not only do people cede the right of way to you; not only do people in line at the ladies’ room let you get in front of them; but if the man who impregnated you sticks around for just a few more months, you get to lie on the couch all day and just point to things, and they magically come to you. You just have to say, “Honey, I think I’m craving a —,” and the chocolate-banana-peanut-butter milkshake appears in your hand. What can be more powerful?

The rest of it manages to be even worse than that excerpt, an almost artful mix of anti-woman and anti-child rhetoric.

Show of hands:

Women with children who didn’t get that sort of treatment, please raise your hands…
OK, now those who did, please raise your hands…

This just reinforces the idea that the purpose of women is to make babies, and that it’s the only reason why they’re important. I’m sorry, but it’s really hard to view this sort of closed worldview with anything other than contempt.

H/T: Joe Carter, who links this approvingly, by the way.

UPDATE: Apparently, I wasn’t as clear as I should have been. The “Evangelicals” I’m referring to in the title are the ones, like Joe, who are approvingly citing the linked editorial. I didn’t mean to imply that the author was an evangelical. Just an idiot. Of course, when the best critics can do is to pick nits about the authorship of the article, rather than engaging the substance of what’s written, that pretty much tells us everything we need to know.

UPDATE 2: Amanda Marcotte isn’t quite as kind to this as I am.

April 24th, 2007 | Religion, Health | 39 comments