Saturday, December 26, 2009

Qualify for government subsidy: become a(n involuntary) unionized government employee

 Next up: doctors, section 8 housing owners, ????? Grocery stores, drug stores???

A year ago in December, Ms. Berry and more than 40,000 other home-based day care providers statewide were suddenly informed they were members of Child Care Providers Together Michigan—a union created in 2006 by the United Auto Workers and the American Federation of State, County and Municipal Employees. The union had won a certification election conducted by mail under the auspices of the Michigan Employment Relations Commission. In that election only 6,000 day-care providers voted. The pro-labor vote turned out.
Many of the state's other 34,000 day-care providers never even realized what was going on. Ms. Berry tells us she was "shocked" to find out she was suddenly in a union. The real dirty work, however, had been done when the state created an "employer" for the union to "organize" against.
Of course, Michigan's independent day-care providers don't work for anybody except the parents who were their customers. Nevertheless, because some of these parents qualified for public subsidies, the Child Care Providers "union" claimed the providers were "public employees."
Michigan's Department of Human Services then teamed with Flint-based Mott Community College to sign an "interlocal agreement" in 2006 establishing a separate government agency called the Michigan Home Based Child Care Council. This council was directed to recommend good child-care practices—and not coincidentally, to serve as a "public employer." Although the council had almost no staff, no control over the state subsidies and no supervision of the providers' daily activities, it became the shell corporation against which the union could organize.
Thus the state created an ersatz employer and an ersatz "bargaining unit" against which what was essentially an ersatz union could organize.
Today the Department of Human Services siphons about $3.7 million in annual dues to the union—from the child-care subsidies. The money should be going to home-based day-care providers—themselves not on the high end of the income scale. Ms. Berry now sees money once paid to her go to a union that does little for her. She says she is "self employed and wants nothing to do with the union."

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Wednesday, December 16, 2009

No Connection - Hasting Center Essays Miss the Mark


The Hasting Center has published an online collection of essays called"The Values and Health Care Reform Connection" allowing the public to comment on health care and "American Values." You have to admire the awareness of the academics - not only have they noticed that the conservative, pro-life, religious “American” is concerned with values, but they are trying very, very hard to appeal to those of us with a Judeo-Christian background. I’ve only skimmed a couple of the essays so farm but I have found a glaring inability to stay on task or a basic lack of understanding of the world view of the intended target, uh, audience.
For example, in “Stewardship: What Kind of Society Do We Want?,” Len M. Nichols misses the mark in spite of peppering the essay with terms like “stewardship,” “abundant life” and “covenant” and appeals to the writings of John Locke and Thomas Jefferson.

 (Skip over the use of a faulty, biased 2009 Institute of Medicine report on the consequences of lack of universal health care insurance in the U.S., already thoroughly debunked by Steven Malloy’s “Junk Science” blog.)

In his appeal to “American Values,” Nichols attempts to define “stewardship” to include a “covenant” as a duty of property owners to ensure that the poor have food to eat. He refers to the book of Leviticus and Jewish Law that land owners leave “the corners” of their fields for the poor to glean, rather than going back to harvest all that is there.  While noting that the rule was propagated the “other books that Moses wrote,” Nichols explains that only adult males could own land "in ancient Palestine." He would have been better off referring to the “Torah” or “the Law,” which was given by G_d, not Moses, and to the Nation of Israel, since there was no “Palestine” at that time.

Nichols almost persuades me that he “gets it” in his discussion of the basis for rights: the belief that humans are created in the image of G_d. However, he asks what good is the right to life or the pursuit of happiness without access to essential health care and quotes Jefferson’s comparison of liberty with health. He does not seem to understand that both Locke and Jefferson described these as negative rights: the right not to be killed, and the right not to be enslaved or have ‘the fruit of one’s labor” forcibly taken. In other words, no one has the right to cause another to be sick, but there is no right to medicine or medical care.
Nichols does not resort to the usual call for Christians to remember the Good Samaritan. In fact, he turns to an argument that might be more appealing to Libertarians, whom he calls “a tiny group of argumentative people.” His discussion of rights and stewardship by is converted to support for the rationing of health care, noting that Leviticus does not require the landowner to bring the poor person home and cook him a meal. In this, too, he demonstrates his lack of understanding of the Judeo-Christian world view. The covenant to care for the sick and poor is between individual believers and G_d. Government hasn’t proven itself to be trustworthy enough for me to assign my duty to G_d over to its stewardship.

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Sunday, December 13, 2009

LifeEthics quoted about Doctors for America posts

I've been a little distracted, getting my house ready for the New Braunfels Republican Women's Christmas Tour of Homes, but I should be blogging more in the future.

Found a post at "RBO," (RealBarackObama) that quoted my reports (here and here) on the conference call with "Doctors for America," back in September. I like being known as someone capable of "serious sleuthing."

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Saturday, October 17, 2009

Aristotle ethics, RFK, and health care reform

The Wall Street Journal's daily newsletter by James Taranto, The Best of the Web Today, debunks a quote floating around the Internet to support the "right" to health care paid for by government. The blurb has been attributed to a translation from the writings of Aristotle, a translation from the original Greek by Robert F. Kennedy.

Unfortunately, the first reference to the quote is from 10 years after Senator Kennedy died, is credited to someone else, and the original cannot be found in the existing works of Aristotle.

From an article by Edmond Pellegrino, the last chairman of President Bush's President's Bioethics Council, written in 2008:
In attempts to establish the provenance of the text in question we have conducted an extensive search for its source and original wording. We have not been able to locate it. Our initial curiosity was aroused by several things, including that rights language did not seem to have the Aristotelian context, and health care, as such, was not included in Aristotle's works. We searched Nicomachean Ethics and Eudemian Ethics, and the Magna Moralia without successfully locating the quote. Nor could we find it in other of works of Aristotle: On Length and Shortness of Life, De Anima, Economics or the Fragments. "Rights" language certainly would stick out in Aristotle's virtue-based ethics.
That article by Dr. Pellegrino is available in pdf, here, thanks to the WSJ and Georgetown Bioethics.

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Thursday, October 08, 2009

Intentionally Skewed Cancer Survival Rates

 From Ann Coulter's latest report on Health Care Reform Myths:

European women are only 55.8 percent likely to live five years after contracting any kind of cancer, compared to 62.9 percent for American women.
In five cancers -- breast, prostate, thyroid, testicular and skin melanoma -- American survival rates are higher than 90 percent. Europeans hit a 90 percent survival rate for only one of those -- testicular cancer.
Most disturbingly, many cancers in Europe are discovered only upon the victim's death -- twice as many as in the U.S. Consequently, the European study simply excluded cancers that were first noted on the death certificate, so as not to give the U.S. too great an advantage.

I didn't know about that last manipulation of the cancer survival rates. 

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Sunday, September 20, 2009

Politics bites science

For a clear outline as to why you shouldn't believe that 45,000 people die each year because they don't have insurance, read the blog entry by John Milloy, publisher of "Junk Science" on last week's report in the American Journal of Public Health.

Forget that the authors are blatantly biased members of the "Physicians for a National Health Plan."

All you need to know is:
# Among the many problems with the study, here are four of the most glaring; all of which will likely be missed by the media:

* The researchers assumed that study subjects lacking health insurance at the time of the interviews did not subsequently gain or regain insurance coverage. In fact, a study subject could have received health coverage the very next day after the interview and this would not have been considered by the researchers.
* The researchers essentially assume that lack of health insurance at the time of interview is the causal factor in the deaths that occurred. No data was gathered to back up this assumption.
* None of the data collected during the interviews, including insurance status, was validated by the researchers.
* The study result is statistically weak. Combined with the peculiar date-of-death cutoff (the year 2000 as opposed to any other year), it raises questions as to whether the study result was produced by “data dredging” – essentially cherry-picking data that provides the desired result.

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Friday, September 18, 2009

Follow up from Doctors for America

Received this message a few minutes ago.

The only people who kept bringing up "what physicians can be doing now to ensure that Congress pushes forward to create meaningful health reform" were the same guys who made sure that the rest of us were on "listen-in" mode only.

Still no mention about the close connections with Senator Max Baucus, the Obama election and transition teams, the Center for American Progress and John Podesta, or (specifically) Dr. Murthy's own role on the transition team.

If y'all would like to send your comments on to the WH Office of Public Engagement or D4A, here's the information:

-------- Original Message --------
Subject: Follow up on last night's White House call
Date: Fri, 18 Sep 2009 16:19:57 -0400
From: Vivek Murthy MD MBA, Doctors for America
To: hocndoc@flash.net

Dear Beverly,

Thank you for participating in last night's White House Physician's call. In particular we want to thank you for all of the thoughtful and substantive questions that you brought us. We hope those of you who didn't get an opportunity to ask a question during the call will still do so.

For those who didn't catch it last night, the e-mail given for the speakers on the call is: public@who.eop.gov

In recognition of the fact that the White House may not be able to reply to all e-mails expeditiously, we welcome you to cc us as well, and we will do our best to get you up-to-date information.

One of the topics that came up a few times last night is what physicians can be doing now to ensure that Congress pushes forward to create meaningful health reform. At Doctors for America, direct involvement of physicians is exactly what we do. If you haven't done so already, we welcome you to become more involved by filling out our volunteer form.

Sign up to volunteer: www.drsforamerica.org/volunteer.php.

In addition, we've created a video on our Action Center to highlight some of the things that you can do today to help ensure we take critical steps towards a better health system this year.

Watch the video to learn what you can do: www.drsforamerica.org/action_center.php.

Thank you again, for your participation and for your ongoing commitment to health reform.

Sincerely,

Vivek Murthy, MD MBA
Doctors for America

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Playing doctor with the White House

Who’s playing doctor with the White House: Another example of the lack of openness in the dealings of the Obama Administration

(Informed consent blurb: Organizing for America, etc., along with all the White House websites, are collecting data including email and other information from everyone who visits or contacts their sites. I got a couple of those emails from David Axelrod last month.

Don't worry - they already have my data. I used to email President Bill Clinton at least once a month and ask him to resign for the sake of our daughters – they are about the same age - because he'd set the women's movement back 50 years. He never answered. However, it occurs to me now that maybe that's why I was named to the Bush Administration's National Advisory Committee on Violence Against Women.)

On Thursday, September 17, 2009, I was web-surfing and searching Google news hits on the September 12th March on Washington and health care reform when I found information about a conference call between "Doctors for America," the White House "Office of Public Engagement" and doctors like me who somehow found out about the conference call.

I called in, but wasn't called on to ask my questions, so I re-wrote them as an essay (see below) and emailed it to info@drsforamerica.org I'm also sending the essay to the White House OPE.

When I started writing up my notes from the call, it finally occurred to me that – even though there was no attempt at disclosure - there might be a connection between "Drs for America," "Organizing for America" (whose website address is still "http://www.barackobama.com/ ," the same url once used by - and the remains of - “Obama for America,” the Barack Obama campaign machine.

I was slow to catch on, but I was right: The leadership at Doctors for America is made up of nearly the same roster of men and women who, in 2008, were the leadership of “Doctors for Obama” in 2008. Common names are Vivek Murthy, MD MBA, Mandy Krauthamer, MD MPH, Nikhil Wagle, MD, Alex Blum, MD, and Jay Bhatt, DO MPH

And, I was wrong: there’s a disclaimer at the bottom of the “Doctors for Obama” leadership page that says “Not affiliated with Obama for America.” (Yeah, right.)

In fact, former Obama Administration transition chief John Podesta's “Center for American Progress” funds the group :

May 04, 2009
'Doctors for America' launches
This may not wind up being decisive in the health care fight, but the organizing gap between the two sides continues to widen.
Sen. Max Baucus and the Center for American Progress Action Fund are announcing a new group on a conference call later this morning: Doctors for America, which is a reincarnation of Doctors for Obama, an arm of the Obama campaign that boasted more than 10,000 members.
The question of patients' relationships with their doctors is always a flashpoint in debating changes to the health care system, so doctors are often particularly credible messengers.
Today they'll "release new reports detailing the depth and breadth of America's health care crisis and announce a new effort to amplify physicians' voices in support of health care reform," according to the advisory.
By Ben Smith 11:07 AM
Here's the bio on the President and Co-founder, Vivek Murthy, MD MBA, at the Center for American Progress website:
Vivek Murthy is an internal medicine physician at Brigham and Women’s Hospital and an Instructor at Harvard Medical School. He received his undergraduate degree in Biochemical Sciences from Harvard University, his MD from the Yale School of Medicine, and his MBA from the Yale School of Management. He completed his residency training in Internal Medicine at Brigham and Women’s Hospital. Vivek is the co-founder of VISIONS and the Swasthya Project, international health non-profit organizations focused on HIV/AIDS education and women’s health, respectively. He is also the co-founder and chairman of Epernicus, LLC a web-based professional networking service for individual researchers and scientific institutions. Vivek’s past research has focused on the participation of women and minorities in cancer clinical trials; his current research interests include physician satisfaction and burnout. During the 2008 presidential campaign, Vivek served as a member of the Obama Health Policy Advisory Committee and the Obama New England Steering Committee.
Notes on the Conference Call

I couldn't catch all the names and I am not very good at telling who was speaking, but did try to take some notes from the opening statements. The quotations are the actual words of the speakers, the rest is my own interpretation and from memory.

The moderators talked about the "public option" as though it's a done deal and strongly pitched it as just a way to provide health care for people who have lost their insurance.

We were told that everyone will be required to have insurance, and that businesses will be asked to "chip in their part."

The White House has a plan to fix the SGR that has been pushed off over and over. In fact, there are plans for a “complete reform of the physician payment system.” without incentives for doing more procedures.

The President has given instructions to begin the medical liability demonstration projects to find a way to decrease defensive medicine while "mitigating risks to patients."

We were told that we are closer than we've ever been to health care reform this year.

The moderators were surprised by the second doctor who said he was from the former Soviet Union and that the public option would soon become the only option. They were adamant that the public option is not a pathway to single payer. (And besides, we all know that being paid by and regulated to the teeth by the government is not at all like working for the government.)

Later, one of the docs who called in asked specifically about the news stories that the public option was finished and the White House representative reminded us that the legislation is not written, yet. He was adamant that we shouldn't rule the public option out and that we should advocate with our patients and fellow doctors for that option.

One doctor asked about the effect on doctors with concierge or boutique practices and the other doctors who "opted out." The answer from one of the men was that these practices were just a reaction to cash pay patients who couldn't afford insurance.

There was a lot of excitement about one doctor's suggestion that doctors be required to give two years to a sort of National Healthcare Workforce. And huffy about the shortage of doctors that a Massachusetts doc reminded them that they'd have if all the uninsured were suddenly looking for primary care.

The woman naturopath was reassured that naturopathic primary care doctors would be evaluated by the same evidence based medicine that the traditional docs were judged by.

My letter to Doctors for America and the White House Office for Public Engagement

I’m Beverly B Nuckols, MD, the National chair of the Family Medicine Section of the Christian Medical Association as well as a member of the AMA, the Texas Medical Association and the American Academy of Family Physicians. I'm not officially representing the above, but I believe that my opinions are shared by a large number of doctors.

Many of my colleagues and I see the Patient Centered Medical Home plans, the protocols at Mayo and other medical centers that have been praised are attempts to model a bureaucratic form of practice for large practices so that they can do what the family doctor does every day.

My experience is that government bureaucracy is not only more restrictive and punitive than private insurers, the clout of the Federal government results in undesired UNINTENDED consequences all across the board. Doctors used to be the good guys, but now we feel as though we are assumed to be guilty of abuse of the system, largely due to Federal legislation and regulation.

These result in time and money spent on our futile attempt to keep up with Medicare regulations in order to avoid charges of fraud, abuse and waste. For instance: HIPPA, National Provider Identification numbers, bullet points and check boxes, E & M’s, procedure and diagnosis codes and qualifiers that change each year, and a whole alphabet soup of regulators.

In addition, government cost control attempts in the '90's actually limited the numbers of graduate medical slots, while encouraging sub specialty growth in relation to numbers of primary care doctors.

Making it all worse is the fact that under current Medicare payment schemes, Family Doctors who provide the same services as sub-specialists are paid less by Medicare.

Like the laws and regulations in the past, this year's “reform bills” and proposals are overly complicated and try to guarantee too much: school based clinics, nutrition data on menus and buffet lines, an overhaul of the federal income tax code, new lists of “enhanced penalties,” taxes, fines and the mixing of all of the above abuses with an overhaul of the Federal Income Tax.

Today’s announcement about the study of liability makes me worry that our Texas laws concerning tort reform will be over come by Federal inertia and interference.

1. Why not just look at Texas’ experience with tort reform rather than wasting time and money on new studies?

2. Is it possible to make the legislation smaller in scope so that it is focused on providing help for those patients and families who cannot afford or access medical care?

3. What plans are there to ensure training and sufficient payment for family physicians and other primary care doctors who are in the best position to coordinate care for our patients in the "Medical Home?"


Edit: added this 4th question that I believe I sent to Doctors for America:
4. Could the fines and mandates be replaced with tax incentives, removal of restrictions on Health Savings accounts, return of the major medical plans and the removal of the barriers preventing patients from owning their own health care insurance?

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Thursday, August 06, 2009

Former Senator Explains Consequences of Bill Language

Former Senator from Tennessee, Fred Thompson, explains the consequences of the language concerning end of life care that is included in the current version of House Bill 3200.

I do read the language as making the counseling mandatory, although not necessarily a demand that doctors (or nurses, if they are the "primary care providers") tell a patient that they must refuse or be willing to withdraw medical intervention at the end of life.

Of course, there's the pesky problem that no one has written the approved counseling language or produced the approved documents, yet. That will be done by "the Secretary," if and when the Bill passes with this provision still in place.

Here's what I think happened: the Committee or staffer who wrote that section thought that offering payment for what was mandated in the "Stimulus bill" earlier this year would be a politically advantageous move.

However, since no one knows what will actually be required by the Secretary of Health and Human Services, and there is no note as to which doctors will be responsible to counsel patients, I forsee a repeat of the confidentiality snafus and stumbling blocks that happened after the "HIPAA" became law. Remember when every single doctor and pharmacy had each patient sign a disclaimer, no one knew who could talk to whom, and a whole lot of money, time and energy was wasted making sure that you knew that the provider knew that the government wanted us to keep your medical information private - at least from everyone except the government agencies who demanded documentation, ICD-9 and CPT codes and qualifiers?

Here's Senator Thompson's essay:

FRED THOMPSON: Phantom pains at The Post

Fred D. Thompson

A Page One article in Saturday's Washington Post blaring the headline "Talk Radio Campaign Frightening Seniors" states, "A campaign on conservative talk radio ... has sparked fear among senior citizens that the health care bill moving through Congress will lead to end-of-life 'rationing' and even 'euthanasia,' " and that the bill has been described as "guiding you in how to die."

The story's continuation inside -- under the headline "Conservatives Have Seniors Fearing 'Euthanasia' as Part of Reform" says that, like arguments about abortion coverage, this has become a distraction to the president's broader health care agenda.

The reader looking for examples of this "talk show" campaign will be disappointed. Not one talk-radio host is quoted, and no specific radio show is mentioned (though The Post does quote an interview done on my radio show, without telling the reader the interview was done on a radio show). However, the article does make use of information supplied by off-the-record "Democratic strategists." One is free to conclude for oneself who has launched a "campaign."

It does seem that the words attributed to unnamed conservative culprits are fairly mild compared to the hysteria coming out of left-wing Web sites and blogs. My favorite is the one found on the Huffington Post, where Republicans are accused of saying that granny would be shot in her wheelchair under a provision in the Obama-Pelosi-Waxman health care bill.

Let's discuss whether these deranged seniors are being misled by people who actually may have read the bill. (Presumably this offense cannot be laid at the feet of their representatives of Congress.) Although I have never said anything like the things attributed to radio talk hosts, the article states that "the attacks on talk radio began when Betsy McCaughey ... told former senator Fred D. Thompson (R-Tenn.) that mandatory counseling sessions with Medicare beneficiaries would 'tell them how to end their life sooner' and would teach the elderly 'how to decline nutrition -- and cut your life short.' "

The basic position of the bill's proponents seems to be that these consultations are totally voluntary, that seniors should have the benefit of such end-of-life consultations and that the consultation provision is nothing more than to get doctors reimbursed when a consultation occurs at the patient's request. The "let's get the doctor paid" rationale was swallowed whole by The Post's writer, Ceci Connolly.

Those concerned by this provision believe it to be mandatory and wonder why the government is involving itself in the doctor-patient relationship and with end-of-life decisions.

Section 1233 of the bill, having to do with Medicare, describes the "advanced care planning consultation" as between the individual (a spouse and next of kin are not mentioned) and a "practitioner," described as a physician, a nurse practitioner or a physician's assistant. (It does not appear that it is a requirement that the physician in question be the patient's physician of record.)

In legislation, an issue as to whether an action is mandatory or not can be resolved quickly by a glance at the statute, which will state that (in this case) the consultation either "shall" be taken or "may" be taken. Remarkably, neither phrase is used in the statute in question.

Rather, the statute just describes what a consultation is and then strictly prescribes in mandatory language what must be included in the consultation as well as what may be included. For example, in Paragraph 4, a consultation "may include the formulation of an order regarding life-sustaining treatment" and may include an order for "the use of artificially administered nutrition and hydration."

The drafters of the provision were either sloppy, befitting a situation in which a complicated, 1,000-plus-page bill, controlling one-sixth of the economy, is rushed through the legislative process. Or it might be that the drafters desired an intentionally vague statute, knowing administration officials would be drafting regulations for the implementation of the bill after it passed.

As it stands, there is more than ample reason to believe the provision was meant to be mandatory with regard to the practitioners. Otherwise, why have the provision in the bill at all? If getting the doctors paid for a voluntary consultation really was the provision's intent, an amendment of two or three lines would have fixed it. As it is, it is two lines in a five-page provision full of specific instructions about what doctors, nurses or doctor's aides must explain to the patients.

Seniors are reminded daily by the media that Medicare is going broke, that the country must cut Medicare costs and that the last days of life are by far the most expensive. Now they are being told by the administration -- one that has been less than transparent on this bill and a host of other issues -- that this bill will cut Medicare costs. They are learning that they are "coincidentally" being asked about end-of-life issues at the government's behest, perhaps by a stranger who is receiving Medicare reimbursement payments. How long do you think it will take a Medicare patient to figure out which decisions will cost the government money and which will save the government money?

This is no reflection on medical professionals. They clearly are being put in a position they neither have asked for nor are completely qualified for. However, I am gratified that a president who can matter-of-factly accuse doctors of routinely removing a child's tonsils solely for financial gain has newfound trust in a doctor's or some hospital employee's ability to consult and even help draw up legal documents regarding end-of-life issues.

If this is all just a misunderstanding about whether this provision is mandatory or not, it can be resolved readily. Let's see if the supporters of the provision are willing to add language to the bill making it clear that there is no requirement that these consultations take place. Better still, they should drop this provision from the bill and let patients discuss these matters with their families, their clergy, lawyers who have expertise in living wills and powers of attorney, or whomever else they desire.

So is this a conspiracy to kill off granny? No. Will seniors be forced to make decisions they don't want to make? No. But will "practitioners" be encouraged to have end-of-life discussions that include when it might be best for patients to allow their life to end earlier than it has to? Of course. And seniors have a right to be satisfied that there is not, at the heart of this process, undo consideration given to cost-cutting.

In the end, it depends on how comfortable one is with having the government in the middle of this process. That is what this discussion is really all about.

Fred D. Thompson, a former Tennessee Republican senator, hosts a nationally syndicated radio show (www.fredthompsonshow.com).

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Thursday, July 30, 2009

Page 425 (end of life counseling)

I received several emails over the last few days concerning page 425 of the House Bill on Health Reform, HR 3200, which outlines mandatory end of life "options" counseling.

Technically, it appears on the surface to allow doctors (and other "providers") to charge for the counseling. But, yes, it's mandated counseling and in the wrong hands, it might encourage withholding of care more than some of us would like -- and certainly more that others might like.

Can you imagine a more personal and private subject? The subject should be broached by your family doctor. But it appears that every doctor who sees Medicare patients will be responsible. I can imagine the emotional undertones of different doctors as they recite the standardized language and present the forms to be signed! And then, the counseling will be reported to the Center for Medicare and Medicaid Services, with the appropriate modifying code.

I object to the mandated repeat counseling when someone gets sick, the inclusion in the "Medicare and Me" handbook with language to be formalized by the Secretary and forms for the counseling. I've mentioned before how "hot" an issue this could be, even with my limited exposure to the debate.

I hope that someone with sensitivity is in the Secretary's office, assisting with decisions on the literature and forms.

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Wednesday, July 29, 2009

ABC explains the Obama Administration

ABC News Senior White House Correspondent Jake Tapper has written an article, "When Academic Words Become Political Ammunition," that gives an anonymous "White House official's" rebuttal to the many concerns expressed about President Obama's choices for advisers and "czars" who will affect the shape of health care policies. He attempts to debunk criticisms of the philosophies of Ezekial Emanuel, MD (a bioethicist who is heading the push for control of health care finance and delivery in order to provide universal insurance) and John Holdren, director of the White House's Office of Science and Technology Policy.

The problem is that with Medicare and Medicaid, about half of medical care in this country is already paid for using tax dollars, and we are currently considering expanding tax dollar payment for nearly all health care in the Nation. I disagree with Ezekial Emanuel's position, referenced in the Hastings journal article, "Where Civic Republicanism and Deliberative Democracy Meet," which is linked (in pdf) at Tapper's essay:

Americans fear that if society guarantees certain services as "basic," the range of services guaranteed will expand to include all - or almost all - available services (except for cosmetic surgery and therapies not yet proven effective or proven ineffective). So rather than risk the bankruptcy of having nearly every medical service socially guaranteed to all citizens, Americans have been willing to tolerate a system in which the well insured receive a wide range of medical services with some apparently basic services un- covered; Medicare beneficiaries receive fewer services with some discretionary services covered and some services that intuitively seem basic uncovered; Medicaid beneficiaries and uninsured persons receive far fewer services.


In fact, while we are concerned about the amount of taxes that will be imposed, the Tapper essay points out that we are very much afraid that government interference in health care will result in more limitations, so that none of us will be allowed, much less "guaranteed," to seek medical care that will prolong our lives and make us feel better, unless we are seen as members of a group that is more valuable than others. The examples that Dr. Emanuel gives and our observation of the government pre-paid medical care schemes around the world lead us to believe that, the more health care is financed by tax dollars, the more expensive and rationed it becomes.

Academic mind experiments that do not draw a line between what is acceptable and what is condemned by the authors understandably will be interpreted by others as at best, neutral, at worst, in support of condemnable acts.

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Saturday, July 25, 2009

Congressman Henry Cuellar on Planned Parenthood

Went to this morning’s McQueeney, Texas meeting where Henry Cuellar was met with an overwhelming group of constituents upset over what's happening in Washington, DC.

Rep. Cuellar told us that he voted in favor of Planned Parenthood funding yesterday because they give care to “mothers” and he does everything he can do to support mothers. (I suggested that we go to any PP office today and that I bet no mothers come out of the building.)

The people of Guadalupe County- maybe 100 to 150? - turned out to protest the health bill and tax and cap. There were some tough questions about gas prices and about whether private insurance will survive.

People laughed when Cuellar said the bill is “revenue neutral.”

Believe it or not, the man was adamant that he has good private insurance and that he wants to keep *his* private insurance! Why not put all the government employees on Medicare or the VA (depending on their background). Why do we give and give so that our employees can have better benefits than we can afford?

He constantly talked about organizations and corporations that supported the bills, ignoring that the constituents in front of him do not. He handed out paper after paper (how green is that?) supporting the health bill and tax and cap.

He talked against the Blue Dogs, but did say that he wouldn’t allow Pelosi to bring the bill to a vote by bypassing the Committees.

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Thursday, July 23, 2009

Myth: doctors take out tonsils needlessly

Then, there's the charge that doctors will needlessly take tonsils out. First, it's unlikely that your Family Physician or Pediatrician does surgery. Second, I don't think the ENT's are getting paid for these anymore, unless they jump through hoops to prove that they're not over-doing it.

AP: In trying to rally support for health care overhaul, Obama described a patient who sees a physician for a sore throat, or a parent who brings in a child with a sore throat.

"Right now, doctors a lot of times are forced to make decisions based on the fee payment schedule that's out there. ... The doctor may look at the reimbursement system and say to himself, 'You know what? I make a lot more money if I take this kid's tonsils out,'" Obama told a prime-time news conference.

The president added: "Now, that may be the right thing to do, but I'd rather have that doctor making those decisions just based on whether you really need your kid's tonsils out or whether it might make more sense just to change — maybe they have allergies. Maybe they have something else that would make a difference."

Video and here.

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Obama Press Conference Transcript

The transcript of the press conference is on line at the Washington Post.

However, if you want an annotated version, try this blog.

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Wednesday, July 22, 2009

Thoughts on Obama's health speech July 22, 2009

Why doesn't the President just say that the Executive branch employees in his Administration will get rid of their insurance and go on Medicare???

Not a doggone thing that the President is talking about tonight - except for the taxes, the increased bureaucracies and the requirements that Pharmacy companies discount meds - is in the Bills that are being proposed by the House or the Senate.

The government is not paying for those private insurance costs -- the tax cuts for insurance is not the burden that will break the federal budget.

(And by the way - the White House is the people's house. It's only being used by this man.)

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Monday, March 30, 2009

Texas Legislators Seek to Limit Funds for Human Embryo Destruction

Senator Steve Ogden is a Texas Hero!

Sen. Steve Ogden, R-Bryan, though, said critics exaggerate what his 24-word "budget rider" would do. He said it simply assures that the budget's $700 million for research doesn't underwrite destruction of embryos.

"There is a significant moral concern amongst many Texans that a human embryo really meets every scientific definition of human life that's out there and that we shouldn't be using human embryos for scientific experiments," Ogden said.

The dispute flared early last week. The Senate Finance Committee, which Ogden heads, took only two minutes late Monday to consider his rider. It says, "No funds appropriated under this act shall be used in conjunction with or to support research which involves the destruction of a human embryo."

The provision was adopted, 6-5, with Sen. Robert Duncan, R-Lubbock, joining four Democrats against.


The Dallas Morning News reports (free registration required) that some Texas embryonic research advocates claim this move will "embarrass" Texas. Of course, they also claim that embryonic stem cell research only involves "embryos that would be discarded, any way" Since we know that much of the research involves specially created, "disease specific" embryos, the latter is false.

And so is the first objection. Every week, we are reading about new ways to reprogram adult cells to achieve the stem cells that are needed to study and treat disease without ever going near an embryo. Former proponents of embryonic research and producers of new embryos for stem cell research like George Daley are switching their focus toward non-embryonic research. Texas researchers have been early stars in this research, among the first to using umbilical cord blood for stem cell research.

Texas doesn't need to waste our money following the false trail of embryonic stem cell research when there is so much promise in more treatments, sooner, from non-destructive and non-embryonic research.

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Sunday, March 29, 2009

Why the medical home sounds good but won't work

A sister Family Physician says in her blog, "Musings of a Dinosaur,"

It is the source of endless angst among family doctors in solo and small group practice, because the structure of the PCMH excludes us by definition. The PCMH is advertised to work best in large group practices like Kaiser and the Mayo Clinic. All I can say is "DUH!"You know what the PCMH really is? Nothing more than this:

IT'S A WAY TO MAKE LARGE GROUP PRACTICES WORK MORE LIKE A SOLO DOC!!!

I am already performing every meaningful function of the PCMH. So is virtually every physician in solo and small group practice. There is absolutely nothing to be gained -- and a significant amount of money to be lost; this thing is expensive! -- by adopting any of this PCMH shit. Somehow that doesn't seem to stop our Academy from tossing us to the wolves by simply ignoring us.

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Monday, March 16, 2009

The "Rescission of the Regulation Entitled 'Ensuring That Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law'” was posted on the Federal Register on March 10th, with the announcement of a 30 day period in which to comment. The full announcement can be read here. (PDF Acrobat document) Comments must be made by April 9th.

Please consider taking a look at the website Freedom2Care to learn more about the problem of restricting conscience. You can use one of their forms online to let the Administration and Health and Human Services Secretary Sebelius know how you feel or to tell your story.

To send a comment directly to the HHS, go to the website, http://www.Regulations.gov and fill in the form there or send an email to proposedrescission@hhs.gov.

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Friday, March 06, 2009

Trust me, I have no conscience (Again and again, and again)

Siricou Raven, that gadfly of the prolife blogger, says I'm using scare tactics, that the NHS pays for dialysis, and that we pro-conscience doctors are afraid that 'THE GAYS WILL DESTROY MEDICINE!!!!' Oh, and Bush did it!

Well, what do you expect of people who don't have consciences and who are told by the Powers that be that we must violate any oaths we've taken for money and law?

It's not Gays and Lesbians we're trying to protect ourselves and our consciences from - its their lawyers. Beginning in 2005 and through last month, ACOG broke one of the strongest tenets of modern medicine: Thou shalt not put thy colleagues in greater malpractice risk.

The conscience protection ruling is a synthesis of current laws. The synthesis was only necessary because in 2005, the American College of Obstetricians and the American Board of OBGyn turned their quiet attack on pro-life residency candidates (few programs will accept pro-life doctors) into an effort to change laws (lobbying the US Senate) and amended their own ethics policies to put not only ACOG members, but all doctors at risk of losing their certification, their licenses, and increased our lawsuit risk.

Obama, what's-her-name, and Daschle are bought and paid for by Planned Parenthood and NARAL. (Daschle sent out letters against George Bush in '04, on NARAL's letter head. After the SCOTUS allowed the Partial Birth Abortion Ban, Sebelius vetoed 3 separate bills due to their limits on abortion. And Obama made his famous "first thing I do is sign FOCA" speech to PP)

Most people have access to the $4 Walmart drugs. Our little town has 2 low cost clinics, one is free of charge, one has a cost of less than $5. Everyone who can raise the money can have the latest and greatest -- not so in the NHS. A few years ago, it was illegal to sell Tamiflu in Great Britain, because NICE said it was.

Years before that, Dialysis was limited to those under 55 years old. Echoing that, this year, a man in his 50's was told he would not get surgery to stabilize his ankle until he kicked his nicotine habit.
http://www.dailymail.co.uk/news/article-481617/Doctors-refuse-fix-builders-broken-ankle-unless-quits-smoking.html

Our hospital has indigent care, as does our County. We doctors see patients for cash and are aware when their costs are out of pocket. (My phone has a program that has formularies for local insurance plans. The patient and I discuss whether they want the once a day Tier 4 drug, the twice a day Tier 3 or the 4 times a day generic.)

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Friday, February 27, 2009

Obama moves to overturn Conscience rules

For a couple of years, LifeEthics has covered the conscience of physicians and what it would mean if a doctor, nurse or hospital were to be forced to go against their consciences. My review is here.

From the LA Times, we learn that President Obama plans to rescind the ruling clarifying conscience laws in force in the US today:

Conscience' rule on abortions may be overturned
The Obama administration wants to clarify a Bush policy that lets healthcare workers deny services because of moral beliefs.
By Noam N. Levey
February 27, 2009
Reporting from Washington -- Taking another step into the abortion debate, the Obama administration today will move to rescind a controversial rule that allows healthcare workers to deny abortion counseling or other family planning services if doing so would violate their moral beliefs, according to administration officials.

The rollback of the so-called conscience rule comes just two months after the Bush administration announced it late last year in one of its final policy initiatives.


Inevitably, no matter what they say, the outcome will be to further politicize abortion and to force doctors to perform abortions and assisted suicide, force Catholic hospitals to allow abortions and sterilizations and - inevitably - physician assisted suicide.
Last month without official ceremony, Obama overturned a controversial ban on U.S. funding for international aid groups that provide abortion services.

The move by the Department of Health and Human Services to throw out the conscience rule is being made equally quietly as most of Washington focuses on the president's blockbuster budget plan.

On Thursday officials stressed that before the administration finalizes the rollback, a standard 30-day comment period seeks input from people across the ideological spectrum.

"We believe that this is a complex issue that requires a thoughtful process where all voices can be heard," said one official, who was not authorized to speak on the record about the policy change.

The officials said the administration would consider drafting a new rule to clarify what healthcare workers could reasonably refuse to do for their patients.

For more than 30 years, federal law has allowed doctors and nurses to decline to provide abortion services as a matter of conscience, a protection that is not subject to rule making.

In promulgating the rule last year, then-Health and Human Services Secretary Mike Leavitt said it was necessary to address discrimination in the medical field.

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Saturday, February 21, 2009

US behind on regulation of reproductive technology

After hearing/reading for the last 8 years that there is too much regulation of research, there's now a call from the Jonathan Moreno and the "Progressives"(at the website that grew out the Center for American Progress, originally founded by John Podesta, Obama's advisor) for regulation of reproductive technology. See this post at the "Science Progress" blog.

Scroll down to the middle of the blog post on regulation to see a fantastic interactive map of regulation across the world.

Unfortunately, the regulation may not be easy to come by, or what those of us who are pro-life might wish for. The progressives mock those of us who believe that even embryonic humans have the right not to be intentionally killed or enslaved. See the comments in this review of Yuval Levine's book, Imagining the Future.

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Wednesday, January 28, 2009

Senate defeats Republican SCHIP pro-life measure

Senator Martinez from Florida introduced an amendment to the Senate Bill concerning the children's health insurance bill that would have prohibited tex money going to non-government organizations in other countries and used to promote abortion, lobbying foreign governments to change their laws to accept abortion, and which would give those organizations more money to perform abortions.

This amendment would have placed into law the "Mexico City Policy" that President Obama overturned on Friday, January 23, 2009.

The vote went pretty much along party lines, with the exceptions of Republican Senators Collins and Snowe of Maine, Senator Spectre of Pennsylvania and Senator Mulkowski of Alaska. One Democrat, Senator Nelson of Nebraska, voted in favor of the prolife amendment. (Thanks to LifeNews for reporting the votes.)

The Senate version will allow families that exceed 400 times the Federal poverty limit t0 $88,000 and, in some cases, with incomes over $100,000, per year.

For more on the SCHIP Bill, see the Associated Press' "GOP fails to limit children's health program."

Democrats want to more than double spending on SCHIP. President Barack Obama has urged Congress to quickly send him a children's health bill that he can sign into law. The House has already passed a bill comparable to the one before the Senate.

Republicans offered an alternative approach through an amendment sponsored by Sen. Mitch McConnell, R-Ky. McConnell argued that his amendment focused more on helping low-income families and did not rely on tax increases to pay for the additional health spending. His amendment also would not allow federal funding to extend health coverage to children of newly arrived legal immigrants, as the Democratic bill allows.

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Tuesday, January 27, 2009

Elections have consequences (abortion, contraceptives, committees)

ABC's This Week with George Stephanopolis ran an interview with Speaker of the House Nancy Pelosi on Sunday, January 25, 2009. The transcript is here.

Stephanopolis allowed the Speaker to gloss over her policy that does not allow debate or amendments from the House floor, or that no Republicans were allowed to see or vote in Committee on last week's SCHIP Bill ("H.R. 2 is rushed legislation by the Democrat Majority that did not hold a single committee hearing or allow amendments to be offered on the bill."), and were only given a summary at 5:30 AM on the day of the vote.

STEPHANOPOULOS: The president has made it pretty clear he wants this to be a real bipartisan effort. Yet House Republicans have said they have been shut out of this process. There were no Republican votes in the appropriations Committee, no Republican votes in the Ways and Means Committee.

PELOSI: Well, because the Republicans don't vote for it doesn't mean they didn't have an opportunity to.
While I believe that true contraception, as in prevention of the union of sperm and oocyte, is ethical, I had planned to move strait to the Speaker's comments about Family Planning funds. However, it appears that the President was listening to the voters, even if the Speaker hadn't.
Posted: Tuesday, January 27, 2009 11:41 AM by Domenico Montanaro
Filed Under: White House, Congress

From NBC’s Mike Viqueira
The provision within the stimulus that would allocate money for contraceptive programs through Medicaid will be pulled out of the package.

NBC News confirms that the president called Henry Waxman, the chairman of the committee that inserted the contraception provision into the stimulus during the mark up last week, to ask him to remove the measure from the bill, according to a Democratic leadership source.

In short, the idea has simply become too controversial. Speaker Nancy Pelosi's defense of the program over the weekend, where she indicated that it would be a money saver, was not well received.

So that provision is out.

Complicating matters, both Minority Leader John Boehner and No. 2 Eric Cantor have told House Republicans that "all Republicans should vote against the stimulus" if it remains "in its current form," according to a GOP leadership aide.

They spoke inside their weekly conference meeting, behind closed doors. Afterward, both men came to the on camera stake out. The House will begin debate on the stimulus package late today, with no votes expected until tomorrow. Debate is expected to begin somewhere close to 5 p.m. ET.

The way your U.S. House works is that anyone who wants to offer an amendment to be considered on the floor has to go to a committee, the Rules Committee, beforehand.

The Rules Committee is a complete and utter tool of the majority leadership.
(Emphasis mine, BBN.) It decides which amendments will be allowed on the floor for consideration. The minority is habitually unhappy with the result, as their measures, especially the ones that have a chance of passage or contain some political mischief or "poison pill" language, are barred. The Rules committee meets this afternoon to make its decisions.
So, besides politics, what's all the fuss about?

Part of the problem is the $50 million for the National Endowment for the Arts, ACORN, $200 million for sod for Washington, DC parks, $20 Billion for electronic medical records, and the emphasis on global warming research (with its increased costs for housing, transportation, food production and all aspects of our daily life).

One day after the 36th Anniversary of Roe vs. Wade and as the number of electively aborted children in the United States alone (non-medically necessary, not associated with "rape, incest, or the life of the mother") approaches 50 Million, President Obama overturned the so-called "Mexico City Policy" or "global gag rule." US tax dollars will once again be allocated to organizations that advocate abortion as birth control, and even those that lobby to change the laws of other nations to allow abortion where it is not currently legal. Every news article I've seen conflates the gag rule with limiting non-abortifacient contraception. However, the only restriction is that on abortion.

Another Bill now in the House and Senate, would wipe out abstinence-based sex ed and mandate emergency contraception according to the Rochester, NY newspaper:

* House member Louise Slaughter submitted the Prevention First Act of 2009 (H.R. 463/S.21). In the Senate it was introduced by Democratic Senate Majority Leader Harry Reid.

The legislation focuses on reproductive and sexual health issues, and in some cases reverses Bush administration policies. It provides funding for comprehensive sex education programs, and none for abstinence-only sex ed. Other provisions include mandatory access to emergency contraception for rape survivors, and a requirement that hospital staff provide factual, science-based information on EC, including instructions that it doesn't cause abortions.

The bill would also force health insurers to offer equitable coverage for prescription contraceptives.


And then, finally (from the first link above), Speaker Pelosi on Federally funded contraception for the poor:

STEPHANOPOULOS: Hundreds of millions of dollars to expand family planning services. How is that stimulus?

PELOSI: Well, the family planning services reduce cost. They reduce cost. The states are in terrible fiscal budget crises now and part of what we do for children's health, education and some of those elements are to help the states meet their financial needs. One of those - one of the initiatives you mentioned, the contraception, will reduce costs to the states and to the federal government.

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Monday, January 26, 2009

More pictures from the March for Life in Washington DC

These pictures are from our camera, my phone and my husband's phone.


I wore my white coat to the Rally, with extra layers underneath, but had to keep the heavy coat over it most of the time. We Texans still got pretty cold over the three hours we were at the Mall.

I'm wearing a "Texas Alliance for Life" cap.



The handsome bearded guy in the long coat on the far left is my husband.

The crowd was slow to gather due to its size. As I said in my earlier post, it took over 1 1/2 hours for us to clear the Mall. (I tried to sneak out the side. It took 30 minutes to weave across the crowd, and I ended up surrounded by the same group of people I'd begun with, as I walked out of the street onto the sidewalk of the art museum!)

There was no way that we were going to make it to the Supreme Court Building while the speeches were still going on, much less get near the speakers.



So, our group decided to visit the Newseum, the museum of news journalism that recently opened. (It's done well, but I'm not sure it's worth $20 a visit.) The pictures that seem to be from above the crowd were taken on the 4th floor balcony of the Newseum.


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Sunday, January 25, 2009

National March for Life Washington, DC, January 22, 2009




Several hundred thousand people gathered for the National March for Life on the Mall in Washington, DC on January 22, 2009 to mourn the 36th Anniversary of Roe vs. Wade. My husband and I were among them, along with two friends.

It took 1 1/2 hours for all of the Marchers to pass onto Constitution Avenue as they left the Mall on the way to the Supreme Court. That first picture above shows the last of them as they wound their way around the Capitol.

We saw pro-life activists everywhere we looked in DC throughout the week. There were groups of teens and some of the women wearing buttons declaring "I regret my abortion" at our hotel. We shared an elevator with Father Frank Pavonne of Priests for Life on Thursday night.

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Sunday, January 18, 2009

Texas teens form pro-life club

And, it seems that the kids in Coppell, Texas (near Dallas) are only "anti-abortion" because of the undue influence of their families and churches. From the Dallas Morning News:
Abortion rights advocates say it's even harder for them to organize high school students because of the focus on abstinence.

"We're up against a movement that has federal dollars going into public schools," said Kierra Johnson, director of Choice USA. "You compound that with what they could be learning in church, and it sets us back in terms of outreach to young people under 18."


Of course, the Dallas Morning News calls the club "anti-abortion," not "pro-life." In spite of the fact that the kids call themselves "The Pro-Life Club." The author calls for tolerance on the part of the "anti-abortion crowd but can't even bring herself to use the term the teens would prefer.

I guess the DMN doesn't keep up with the latest research. Otherwise, they'd know that the study on abstinence that was in the news earlier this month informed us that teens - whether they sign a pledge or not - who come from religious, conservative backgrounds are more likely to delay their first intercourse for about 3 years longer than their peers. I nominate the author of the article,Katherine Leal Unruth, her editor, and Ms. Johnson for Twits of the Year and definitely award them my own Yellow Brick Road award. ("Do Not Look Behind the Curtain, Ignore That Little Man." Or small woman.)

Bravo Coppell teens, their parents, and their churches!

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Sunday, January 11, 2009

Teen Pregnancy Rates Increase at Same Rate as Others

It seems that everyone decided to have more babies in 2006, including teen girls from age 15 through 19.

The summary of the CDC report is available as a news release, here. A 100-page report is available pdf containing more numbers and breakdown of the data is at this link.

I don't believe that the information will answer any of the big political debates. The unmarried mother rate is too high, teens have too many babies too young, too few women begin prenatal care in the first 3 months, and too many had early births - both planned (scheduled C-sections) and unplanned.

We definitely need to discuss some of these numbers, however. 39% of children of white mothers, 50% of children of Hispanic mothers (who have half of all babies) and 70% of children of black mothers are born outside of marriage. The numbers of babies born to mothers under 15 years old should be a scandal (especially in the Black and Mexican and other Hispanic populations) and the focus of both public health and law enforcement. See pages 39 through 45) Note that the numbers of pregnancies under 15 have fallen precipitously since the 1980's, but the Hispanic community still

The biggest surprise to me? 494 women had babies after 50!

By the way, 2006 was the first year in quite a while that the US birth rate has reached replacement level.

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Tuesday, December 30, 2008

New study on virginity pledges and behavior

The article in question can be downloaded from Pediatrics, here.


The final "wave 3" data came from the group that the author calls "adolescents" -- who were 22 years old. Data from those who had married was treated as "missing."

We don't know anything about the actual sex ed courses that the students took, who paid for the course, or whether they actually took a course or just made a pledge.

From the article: “Virginity pledges are also now used to measure AOSE program effectiveness, which the US government considers successful if they produce many virginity pledgers, irrespective of participants’ sexual behavior.”

(Is it true that the pledge is considered a marker for the success of abstinence-only sex ed? I know that I’ve read several articles showing short term increase in the intention to remain abstinent, so that would not surprise me. However, I haven’t seen this “marker.”)

As far as I can tell, it appears that the author took data from a series of national questionnaires , matched kids for background and family, and found that they have similar outcomes after 5 years.

Oddly, a huge number - 80% - of the pledgers denied having pledged in follow up. The other number that seems to stick out is that the non-pledgers did pay for sex and/or get paid for sex more often.

Nevertheless, the only study that I’ve seen that measured pregnancy rates after a course that included teaching proper condom use did not show prevention of pregnancy, either. I posted a review of the pay-for-view article in the British Medical Journal.

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Monday, December 01, 2008

Causal link between abortion mental illness claimed

Fergusson of Australia has published more data on his birth cohort from ChristChurch, New Zealand. This time, he's claiming causal relationship between abortion and later mental illness. A 3 invited comments in the same journal seem to accept that his conclusion is true: Abortion responsible for depression, anxiety, and substance abuse, at least do some degree.

The articles are in the British Journal of Psychiatry.for pay, but here's the discussion:

(a) For both models there was consistent evidence that even after extensive covariate adjustment, exposure to abortion was associated with a modest but detectable increase in rates of mental disorder. The concurrent data suggested that after adjustment for confounding those exposed to abortion had
rates of mental health problems that were 1.37 (95% CI 1.16–1.62) times higher than for those who had not become pregnant (P50.001). The lagged model produced a slightly lower estimate of 1.32 (95% CI 1.05–1.67, P50.05).
(b) Pregnancy loss was associated with a modest increase in the rate of problems using the concurrent measures of pregnancy outcome, with those who experienced a pregnancy loss having a rate of mental health problems that was 1.25 (95% CI 1.01–1.53) times the rate for those who were never pregnant (P50.05). However, under the lagged model, pregnancy loss was not associated with later outcomes, with an adjusted RR of 1.06 (95% CI 0.79–1.43, P40.70).
(c) For both models, having a live birth, whether with or without
an unwanted/adverse reaction, was not associated with significant
increases in the overall rate of mental health problems when due allowance was made for confounding variables

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Monday, November 24, 2008

Beyond Belief 3: Candles in the Dark, From early in October, 2008, video is on line. The program invites scientists to discuss ways in which science can enlighten society.

The first sessions I've watched so far are part of the Panel on "This Is Your Brain on Morality."

Jonathan Haidt,
describes morality as,
"Moral systems are interlocking sets of values, practices, institutions, and evolved psychological mechanisms that work together to suppress or regulate selfishness and make social life possible."

He notes that human societies serve to to control the free riders who do not contribute, the selfish, or those who do not display altruism and/or who harm others. They do this by encouraging moral values such as:

1. Harm/care (Discussion in other segments identifies this as equaling empathy.)
2. fairness/reciprocity (This is later called fairness.)
3. In-Group loyalty (altruism or the cooperation in large unrelated groups)
4. Authority/respect (humans, unlike animals, don't depend on just fear, but involve feelings of love)
5. Purity (Proper use of the human body,not necessarily sex, but in terms of drug use, too. He notes that Liberals are likely to consider purity in food very important.)(I thought about the way that smoking has become unacceptable.)


Haidt says that "Any nation is a miracle in evolutionary terms," since large scale cooperation among unrelated groups is not seen among animals, as it is in humans. He believes that traditional societies tend to use all 5 foundations to control "free riders" or the selfish, while liberals tend to use the first two and discount the other three.

An example and a way to understand this concept described by Haidt is to note that "E pluribus unum" is the national motto of the United States. He believes that Liberals are easily painted by "the right" as obstacles in the unity or coherence of society by emphasizing their love for rebellion, autonomy, individuality. (Or "Change" vs. "Country First"? Well, so much for that.)

Haidt has some really clear ideas about good and bad and insight into politics that I'd never thought of, before. Watch the faces of the audience, especially during the last few minutes: I think they're having the same experience.

And then, Sam Harris ("Can We Ever Be Right on Right and Wrong?") proceeds to confront Jonathan Haidt while sucking all the joy out the audience when he starts talking about the failure of science to "demolish" the idea that science can't guide society on morality.

(Harris may have been angered by the teasing he took about how long he's been working on his Ph.D.)

Harris flatly states that there are moral truths, and believes that the study of "human brain science" can inform society on what "goodness is in the public domain." He focuses on religion and seems to imply that religion is a poison.

Harris embraces what he calls "bounded utilitarianism," without regard to Haidt's values as they could shed light on the morality of his examples, including empathy, fairness, and then, altruism. Just as most people are ignorant about "biology, history, chemistry, and everything else worth understanding," most of them are "ignorant about the basis for human well being." He claims that some day, it will be scientifically correct to say that some societies are better than others, because they produce "lives worth living" vs. "lives barely worth living." I believe that he fails in his argument - and chooses poor phrasing as above) and very weak examples that are easily proven immoral by such values as Haidt's.

Harris contrasts morality as "well being among conscious human beings" vs. "superstitious beliefs." He refutes the claim that people can know whether they are happy other than how they fit within their society and absolutely equates conservative religious Americans with the Taliban in Afghanistan -- with no recognition that he is calling on "empathy," "fairness," as his own values and discounting them in others. (And he displays his ignorance about fundamental evangelical Christianity by describing "The Rapture" incorrectly. That makes me wonder about those of his examples that I'm not familiar with.)

The videos can also be viewed (and turned into MP4's) on Google videos.

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Saturday, November 22, 2008

Why we need legal protection for the conscience

The pro-abortion forces are objecting to the regulations that Secretary Leavitt has been working on, claiming that the Bush Administration is trying some "last minute" manipulations.

However, LifeEthics reported way back in September 2005 about a move to make referral for abortion mandatory for doctors -- in a sneaky way, too:
The American College of Obstetricians and Gynecologists (ACOG) is sponsoring a bill that would require that all doctors refer patients to abortionists. ACOG is asking that Senators tuck this provision into the the FY06 Labor, Health and Human Services, and Education Appropriations bill. According to an internet alert from the American Association of Pro-Life Obstetricians and Gynecologists, if the provision is not voted down by our Senators, every doctor would be required to help arrange abortions at the patient's request.


The American Journal of Bioethics devoted one of its debates to conscience in 2007. LifeEthics reviewed the subject, here.

ACOG stirred the pot again, about a year ago, as reported in these posts:

Governments threaten physicians for anti-abortion policy

Tuesday, December 11, 2007: CMDA to ACOG: Stop Attack on Conscience

Tuesday, December 11, 2007: Text of Letter from CMA to ACOG on Conscience

Wednesday, December 12, 2007: Doctors, Abortion and Conscience


In response, the conversation about these specific clarifications of the regulations has been covered on LifeEthics and at the Christian Medical and Dental Association since March, 2008:

Saturday, March 15, 2008: Secretary of Health Supports Conscience


Thursday, April 03, 2008: Gynecology and Obstetrics Policy makers respond to doctors on conscience

Saturday, August 02, 2008: Forcing Pro-life Doctors Out of Baby Business?



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Thursday, November 20, 2008

Insurers, you go first

You did know that due to the Social Security Act and the Patriot Act your medical records can be viewed and copied by anyone who claims to be an agent of the Secretary of Health and Human Services, didn't you? Or that those same agents write their own subpoenas? (The best reference is this ACLU webpage, although most of the regulations were there in a weaker form before the Patriot Act.)

Health insurers - the American Health Insurance Plan group and Blue Cross/Blue Shield - said that they would begin covering everyone regardless of pre-existing conditions if the government will mandate the purchase of their products and subsidize Medicaid and SCHIP. And so grows the government ownership of health care.

From what I've seen of mandatory auto insurance, prices don't go down when the government forces everyone to buy a certain product. I don't believe in government mandates as a rule and haven't been favorably impressed with the way government interference in health care, with the creation of HMO's, ERISSA, and the invasion that has resulted in our current draconian Medicare rules and regulations.

Not to mention $2 Billion dollar stock option bonuses and $125 Million dollar salaries, such as those given to William McGuire by United Health Care in the past and the $13 million to $15 million salary of his successor in 2006 and 2007. (For a look at the compensation of the big companies, click on the names of companies at this page.)

I do believe that insurers abuse their ability to refuse or limit coverage and increase fees due to prior conditions. The industry should be able to evaluate the effect of removal of pre-existing conditions by looking at the history of the insured in States like Texas, which do not allow such limitations for most people covered by employers' health insurance. Let us see those numbers and facts and demonstrate your trustworthiness before we even consider using government laws to increase your customer base.

From the press release of the American Health Insurance Plan group:

Health plans today proposed guaranteed coverage for people with pre-existing medical conditions in conjunction with an enforceable individual coverage mandate.

Under the new proposal, health plans participating in the individual health insurance market would be required to offer coverage to all applicants as part of a universal participation plan in which all individuals were required to maintain health insurance.

Health plans also said that premium support for moderate-income individuals and broad spreading of risk was necessary to promote affordability and maintain premium stability in the individual health insurance market.

To ensure that all Americans can access coverage, health plans also reiterated their long-standing support for making eligible for Medicaid every uninsured American living in poverty and strengthening the Children’s Health Insurance Program.


In the interest of showing good will, let the sellers go first.

I'd rather see a law allowing various levels of coverage, including support for Health Savings Accounts (rather than the ridiculous limits on numbers that we currently have) and encouraging more major medical and high deductible plans.

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Wednesday, November 19, 2008

"A return to power"

That's the sub-heading from Science Magazine's "Obama takes the reigns." The story was yesterday's little "ScienceNOW" report on the (newly created) Office of the President Elect's selection of Mario Molina, who will be co-lead for the review of the White House Office of Science and Technology Policy. Molina has received the Nobel Prize for his discovery of the nature of the "hole" in the atmospheric ozone layer. He worked in the Clinton OSTP.

That's the sub-heading from Science Magazine's "Obama takes the reigns." The story was yesterday's little "ScienceNOW" report on the (newly created) Office of the President Elect's selection of Mario Molina, who will be co-lead for the "review" of the White House Office of Science and Technology Policy (OSTP) Molina received the Nobel Prize for Chemistry for his discovery of the effects of chlorofluorocarbon gases of the "hole" in the atmospheric ozone layer. He worked in the Clinton OSTP. You can watch him talk about global warming, here.

The (newly created) Office of the President Elect also announced that Robin Alta Charo would join the group "reviewing" the Department of Human Health and Services, especially the issues of bioethics, health care and science policy. Charo is a lawyer, one of the founding members of the Center for American Progress and their Bioethics Initiative (a pdf transcript) and Science Progress, formerly on the "medical advisory" boards of the Alan Guttmacher Institute and Planned Parenthood and on Clinton's National Bioethics Advisory Committee that made the recommendations on human cloning (continue with cloning for research, but have a 5 year moratorium on cloning for reproduction). She's notable for coining the term the "endarkenment" as description for President Bush's Bioethics Council (more, here) and for her comments that there shouldn't be any problem with abortion for sex selection and that cloning might prove that there isn't a God and we humans are just a step in evolution.

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Monday, November 17, 2008

More on the Obama Transition Team

Many of the coordinators of the Agency Review Teams and the Working group members have already been reviewed by Daily KOS-er "joehoevah," here. This is not my usual referral, and he doesn't look for the connection to Podesta, but I couldn't demonstrate the left-leaning nature of this team nearly as well. (Let me know if the page disappears, I've archived the information.)

I use the political terms because of the need for balance in the appointments to medical, scientific and bioethics jobs and advisory committees. When all of the OTT have worked for "progressives" and such pro-abortion men as Daschle, Gebhardt, Waxman, and/or are credited with claiming that Senator McCain cannot send an e-mail (Pfeiffer), their politics are more than relevant.


There are several famous (on Google) Lisa Browns, including a State Senator from Washington and an actress. This one is a former Clinton Staffer who's spent the last few years at the American Constitution Society for Law and Policy, teaching lawyers and law students to oppose "an activist conservative legal movement [which] has gained influence - eroding these enduring values and presenting the law as a series of sterile abstractions. This new orthodoxy, which threatens to dominate our courts and our laws, does a grave injustice to the American vision."


Here's Lisa Brown on a youtube video, introducing a briefing by the American Constitution Society on the 2nd Amendment.

And from the 2nd page of my "progressive" Google search:

"The American Constitution Society for Law and Policy is one of the nation's leading progressive legal organizations. Founded in 2001, ACS is composed of law students, lawyers, scholars, judges, policymakers, activists and other concerned individuals who are working to ensure that the fundamental principles of human dignity, individual rights and liberties, genuine equality and access to justice are in their rightful, central place in American law.

"This conference provides an extraordinary opportunity to engage and energize members of the moderate and progressive legal community as we begin a concerted effort to reclaim the Constitution and ensure that our laws and public policy reflect our nation's founding values," said ACS Executive Director Lisa Brown."

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Friday, November 14, 2008

Science in Obama's Administration

After lots of 'Net speculation on science and medicine advisory councils and committees in addition to mine of this morning, we find out that the Obama leader for the transition team on the President's Council on Bioethics Review Team will be Jonathan Moreno the associate at the bioethics arms of the Center for American Progress, founded by co-chair of the Obama "office of the President-Elect" transitionist John Podesta.

And Moreno and Podesta are not the only "Progressives" on the transition team. Note the names Tom Perez (that's a Word document), Anthony Brown, Pam Gilbert ( a .pdf from the Center for American Progress online book, "Change for America"), Nicole Lurie, (former Clinton HUD appointee, lesbian rights attorney and San Francisco Supervisor) Roberta Achtenberg, Bruce Katz, Jim Roosevelt.

And that's just one sub-committee and only the top lines of the result of their Google searches.

Among the chatterers are the authors of Science Progress, an online newsletter and blog (with a biannual print edition) for the Center for American Progress. Jonathan Moreno is the Editor - - which is not mentioned at all in the Moreno biography linked above - - and all the usual suspects are on the advisory board. If you like the "match game" we used to play as kids, compare the names on Science Progress' advisory board with the Clinton National Bioethics Advisory Commission.

Those virtual pages contain advice from Moreno, Weiss, and Bernard Lo on what sort of scientists ought to be appointed by President-elect Obama and his minions and to which offices.

While Moreno advocates for the return of the science adviser to Presidential Cabinet meetings, Lo wants a National Bioethics Advisory Commission (the name that the Clinton appointed group used in the '90's) that not only will advise the President and the Administration by answering their specific questions, he wants the new NBAC to act:
"the Council should be addressing the nation. The Council should reach out to the American people, for example, by inviting testimony from community organizations and patient and public advocacy groups, soliciting public comments on draft proposals, and responding to criticisms by explaining the reasons why suggestions were not accepted. Further, a new council could approach communication with the public as a two-way street. Rick Borchelt and Kathy Hudson have argued here on Science Progress, “the end game of public engagement should be empowerment: creating a real and meaningful mechanism for public input to be heard far enough upstream in science and technology policymaking and program development to influence decisions.”"
Professor Lo is the co-author of one of the popular textbooks on Bioethics, Resolving Ethical Dilemmas. (Although not pro-life or based on a Christian worldview, the principles in use for clinical ethics are covered fairly well. In fact, it was the text assigned in my clinical ethics class at Trinity International University, as part of the Bioethics Masters Degree program.)

I don't believe that Professor Lo actually wishes to have a trickle up scientific policy from the citizens to direct science and ethics or public policy about either. Science cannot give empirical evidence, conduct controlled experiments or make an argument for one or the other approach to determining public policy. However, I believe that Lo, along with so many of the progressives, prefer to have scientists and academics decide science policy for the public and government, and to have carte blanche, without regard to the pro-life, religious or cultural beliefs of others. And that, in my opinion, is just as influential as money and careers in the opposition to the Bush science policy and bioethics appointees.

Science Magazine contains at least one more comment on the upcoming Obama administration appointees (Subscription only, I'm afraid.)

Gregory A. Good's review of Zuoyue Wang's book, In Sputnik's Shadow, completely ignores the inclusion of many men and women who belie his description of the President Bush as only appointing "advisers who told [President Bush] what he wanted to hear." He should at least be aware of examples such as the service of Michael Gazzaniga on the President's Council on Bioethics, Paul Wolpe as NASA's ethicist, even Jonathan Moreno as an adviser for the Department of Health and Human Services during the Bush Administration.

Of course, most of the discussion is about representation and money for research. However, if you enjoyed the match game above, take a look at the actual "incumbents" who are paid governmental appointees under President Bush, available in an online book available for free, here. There's more information here on jobs and volunteer science and technology advisory committees. Compare those names and backgrounds to the authors of a similar report from 2005, here. Now, take a look at the names on the advisory boards of Science Progress, Nature, Science Magazine, and (again, of course) the American Journal of Bioethics and at the people featured on the "Science Debate 2008" webpage videos.


Where does the balance fall between the right and the left, between the pro-life and the pro-choice?

(As one of the thousands of appointees by the Bush Administration, I am deeply offended that Good would imply that anyone who served did not do so with "the best interests of the country at heart." Is this projection on his part? Good will soon leave the History Department of West Virginia University for the American Institute of Physics - a society of societies that must have too much money to come begging to the government if they have a budget for a Center for the History of Physics, but you can e-mail him at greg.good@mail.wvu.edu through the end of the year.)

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