Until the financial market collapse in October, the biggest issue in the 2008 presidential election was Iraq. Bush was The Devil™ who took us in and Obama was The Coward™ who would bring our troops home without victory. Rhetoric was heated hyperbole and exaggeration. It was bad.
Then Obama was elected. On Jan 21st, 2009, Obama used his first full day in office to talk to military and Iraqi experts for his big presidential war update. Obama said of the meeting, "I asked the military leadership to engage in additional planning necessary to execute a responsible military drawdown from Iraq." Drawdown is kind of a strange choice of words, but it demonstrates his resolve to leave Iraq acted upon on the very first day. He has acted to bring the troops home, just as he asked. Promise kept.
Perhaps more interesting is what he didn't do. He didn't spin around 180° and support a perpetual presence in Iraq as soon as he saw the confidential intelligence stuff that only Presidents see. He didn't call for troops to start being shipped home immediately and the war to be entirely declared a horrendous imperial mistake. It really was a moderate position: bring the troops home responsibly. Victory with honor in Iraq.
I like it. Fine, it's a little Nixonesque, but it's also a good thing to do. He has ended the "perpetual war" criticism of the USA (which would have been a smart trick for the Bush administration), but without actually scrapping the important work the troops are doing in Iraq (the same smart policy as the Bush administration clung to like a life raft).
Are troops actually coming home? In Feb., it was reported that "a substantial number of the 140,000 U.S. troops in Iraq would be home within a year." Just yesterday it was reported that "The United States will withdraw about 4,000 troops from Iraq by the end of October[.]" Is 4000 a substantial number of 140,000? Maybe if he's been doing that every month without me noticing. Also, General McChrystal (commander of the troops in Afghanistan) wants a surge similar to the one in Iraq - more troops and a major strategic adaptation; even if the troops leave Iraq, they won't necessarily be going home.
Update: this article says there will be 120,000 troops in Iraq by the end of the month. Thus, 20,000 troops have left Iraq since Obama was elected. 16 to 17% probably qualifies as "significant". I don't know how many went to Afghanistan or will in the upcoming troop surge, but it's more effect than I gave credit for. General Odierno, who made the announcement, said Iraq was an enduring U.S. interest but that insurgent problems had reduced greatly in the past two years. If Iraq loses the stability we've gained in the past two years, that will be Obama's primary legacy.
Obama also announced he would "consult with the Joint Chiefs […] in order to develop a comprehensive policy for the entire region." I like hearing him treat Iraq and Afghanistan as two fronts of the same military endeavor. They are. It's nice to hear politicians besides the Bush White House say so.
I suspect his allies on the anti-war left will be criticizing Obama for the same thing I'm praising him for: his symbolic attempts to "end the war" are diffusing criticism, but results demonstrate he's trying to win the war first. It's a beautiful thing!
Wednesday, September 30, 2009
Tuesday, September 29, 2009
Absolute Writer's Block Found Something
Here's a comment on high-end health plans ("Cadillac health plans"), taxes, and the economy generally. It's pretty interesting.
Monday, September 28, 2009
Obameter #119: The Domestic Abuse Czar
The promise: to ensure the federal government is doing all it can to prevent domestic violence by appointing a Presidential Adviser whose job will be to coordinate prevention policies and programs across all government agencies.
The action: Obama has appointed Lynn Rosenthal to be his adviser on violence against women. She served as the executive director of the New Mexico Coalition Against Domestic Violence, and before that as the executive director of the National Network to End Domestic Violence. There was a recent editorial on the subject from the New York Times.
The promise: kept.
The criticism: opponents of the choice claim that domestic abuse prevention policy has been distorted by feminists to include only violence against women (thus ignoring the plight of abused men). They claim that Rosenthal is a prime example of that anti-male distortion of the issue. This view is exemplified by this rebuttal by Examiner.com (not to be confused with the National Examiner, a supermarket tabloid). A single line from this source expresses this view well: "Ms Rosenthal is no advocate for women, rather she is only an advocate for the feminist political viewpoint regarding the issue."
The analysis: whether Lynn Rosenthal is a good choice for the position depends on which side of the political divide is actually right. Previous to this research, I had no opinion about who was right or wrong here; is there a politically-motivated distortion of the issue, or is the divide caused by ill-informed paranoia formed into a political faction? In an attempt to posit an answer, I'll critique the debate between these two sides with the NYT piece and a piece from the Washington Post representing the established system and the Examiner.com article and another from the Heritage Foundation representing the opposing view. All four of these articles are editorials and, thus, face lesser fact-checking before publication.
The frequency of domestic abuse assaults is cited by all four articles: NYT says domestic violence affects "as many as one in four women"; the Washington Post says "women experience about 4.8 million" assaults every year (that's about 1 ½%) ; Trudy Schuett writes "there is no evidence that 'one in four' women are affected" for Examiner.com; and while the Heritage Foundation doesn't address any specific statistic, they opine that such figures are "often exaggerated by [measuring] whether or not a woman has ever been abused in her lifetime rather than whether or not abuse is occurring within a current romantic relationship". They proceed to claim that "around 20 to 30 percent" as a current abuse rate is only accurate for the highest-risk demographic of "older mothers on welfare", not women generally.
Digging around in a CDC report, I found the estimates "1.9 million women [...] are physically assaulted" and "1.3 million women [...] are physically assaulted by an intimate partner" annually. I don't know whether those groups overlap (I only read the 3 page Executive Summary, not the full 71 page report), but even if they don't it's still 3.2 million per year -- far too many, but significantly less than the 4.8 million claimed by the Post. They could both be telling the truth, though; maybe the Post's definitions are simply more inclusive, perhaps including unfulfilled threats of harm or estimating unreported violence.
I also side with the Heritage's point that lifetime figures do not accurately depict the current state of domestic violence. Overall, it does look like a little exaggeration for effect has wiggled it's way into the popularly cited statistics.
The Examiner piece claims that the fact the announcement "was relegated to the Vice President" shows disinterest in the issue from the Obama Administration. All evidence suggests, however, that domestic violence is a Biden pet issue. It makes sense for him to make the announcement given his deeper interest in the topic. The critics aren't impeccable with their judgments, either.
Lynn Rosenthal was once the executive director of the National Network to End Domestic Violence (NNEDV). Ms. Schuett criticizes that organization for "promot[ing] the questionable 'solution' of divorce as the only approach" to domestic violence. By my judgment, a physical assault from a spouse completely justifies the victim's choice to divorce. If Ms. Schuett is advocating that victims stay in abusive relationships she is clearly wrong.
But that's not clearly what she is doing. The Heritage source describes a "Healthy Marriage Initiative" that would teach young and especially at-risk couples how to create a healthy, successful marriage as a preventative measure against domestic violence. That is an alternative to both divorce and endurance of violence. This program has it's own grounds for criticism, the most obvious to me being the worry of increased government involvement in people's marriages and romantic relationships. And, just like the "more status quo" side of the issue, they have counter-arguments to these criticisms. Heritage says "participation in marriage programs will be voluntary; no one will be 'coerced' to participate."
It does seem that domestic violence against men is being largely ignored, both by Obama's appointment and by the established philosophy more generally. But every source I've found says that, statistically, men suffer from fewer instances of domestic violence and less harm per instance. It's not unreasonable to focus on the worst part of the problem with more emphasis.
It seems to me that the Examiner.com article degrades into politically partisan attacks after that, seemingly throwing every criticism she can think of against the wall to see what sticks. The Heritage proposal is more interesting to me, as it is both a positive construction of what should be done (rather than what should not) and because it is more calm, rational, and methodical in it's advocacy. In fact, the more I read the article the more I support it's advocated plan. It sounds like a great idea!
I'm going to cut this a little short - it's late and I'm sleepy. If the Obama administration is appointing Rosenthal as an alternative to Trudy Schuett's "do nothing" approach, I applaud the choice. If Ms. Rosenthal is being offered as an alternative to the philosophy and policies offered in the Heritage article, I believe a strong opportunity has been lost, perhaps even to political partisanship as has been alleged.
It is not which side you support that makes you right or wrong, but the quality of the argument you support. Of the four articles, the Heritage Foundation offers the best argument (though I would like to read a similarly well reasoned rebuttal from feminist or administration sources). Obama's heart is in the right place, but I doubt Rosenthal and her new position can make the existing philosophy and policy work better than it has ever worked. A more complete approach, such as combining the kinds of prevention programs the Heritage Foundation describes with the crisis handling of Rosenthal's specialty, would presumably work better than doing more of the same thing.
I think Obama missed an opportunity to both effectively curtail domestic violence and reach across the aisle with his choice. It's a shame, but it's only a little shame. He could've done a lot worse.
The action: Obama has appointed Lynn Rosenthal to be his adviser on violence against women. She served as the executive director of the New Mexico Coalition Against Domestic Violence, and before that as the executive director of the National Network to End Domestic Violence. There was a recent editorial on the subject from the New York Times.
The promise: kept.
The criticism: opponents of the choice claim that domestic abuse prevention policy has been distorted by feminists to include only violence against women (thus ignoring the plight of abused men). They claim that Rosenthal is a prime example of that anti-male distortion of the issue. This view is exemplified by this rebuttal by Examiner.com (not to be confused with the National Examiner, a supermarket tabloid). A single line from this source expresses this view well: "Ms Rosenthal is no advocate for women, rather she is only an advocate for the feminist political viewpoint regarding the issue."
The analysis: whether Lynn Rosenthal is a good choice for the position depends on which side of the political divide is actually right. Previous to this research, I had no opinion about who was right or wrong here; is there a politically-motivated distortion of the issue, or is the divide caused by ill-informed paranoia formed into a political faction? In an attempt to posit an answer, I'll critique the debate between these two sides with the NYT piece and a piece from the Washington Post representing the established system and the Examiner.com article and another from the Heritage Foundation representing the opposing view. All four of these articles are editorials and, thus, face lesser fact-checking before publication.
The frequency of domestic abuse assaults is cited by all four articles: NYT says domestic violence affects "as many as one in four women"; the Washington Post says "women experience about 4.8 million" assaults every year (that's about 1 ½%) ; Trudy Schuett writes "there is no evidence that 'one in four' women are affected" for Examiner.com; and while the Heritage Foundation doesn't address any specific statistic, they opine that such figures are "often exaggerated by [measuring] whether or not a woman has ever been abused in her lifetime rather than whether or not abuse is occurring within a current romantic relationship". They proceed to claim that "around 20 to 30 percent" as a current abuse rate is only accurate for the highest-risk demographic of "older mothers on welfare", not women generally.
Digging around in a CDC report, I found the estimates "1.9 million women [...] are physically assaulted" and "1.3 million women [...] are physically assaulted by an intimate partner" annually. I don't know whether those groups overlap (I only read the 3 page Executive Summary, not the full 71 page report), but even if they don't it's still 3.2 million per year -- far too many, but significantly less than the 4.8 million claimed by the Post. They could both be telling the truth, though; maybe the Post's definitions are simply more inclusive, perhaps including unfulfilled threats of harm or estimating unreported violence.
I also side with the Heritage's point that lifetime figures do not accurately depict the current state of domestic violence. Overall, it does look like a little exaggeration for effect has wiggled it's way into the popularly cited statistics.
The Examiner piece claims that the fact the announcement "was relegated to the Vice President" shows disinterest in the issue from the Obama Administration. All evidence suggests, however, that domestic violence is a Biden pet issue. It makes sense for him to make the announcement given his deeper interest in the topic. The critics aren't impeccable with their judgments, either.
Lynn Rosenthal was once the executive director of the National Network to End Domestic Violence (NNEDV). Ms. Schuett criticizes that organization for "promot[ing] the questionable 'solution' of divorce as the only approach" to domestic violence. By my judgment, a physical assault from a spouse completely justifies the victim's choice to divorce. If Ms. Schuett is advocating that victims stay in abusive relationships she is clearly wrong.
But that's not clearly what she is doing. The Heritage source describes a "Healthy Marriage Initiative" that would teach young and especially at-risk couples how to create a healthy, successful marriage as a preventative measure against domestic violence. That is an alternative to both divorce and endurance of violence. This program has it's own grounds for criticism, the most obvious to me being the worry of increased government involvement in people's marriages and romantic relationships. And, just like the "more status quo" side of the issue, they have counter-arguments to these criticisms. Heritage says "participation in marriage programs will be voluntary; no one will be 'coerced' to participate."
It does seem that domestic violence against men is being largely ignored, both by Obama's appointment and by the established philosophy more generally. But every source I've found says that, statistically, men suffer from fewer instances of domestic violence and less harm per instance. It's not unreasonable to focus on the worst part of the problem with more emphasis.
It seems to me that the Examiner.com article degrades into politically partisan attacks after that, seemingly throwing every criticism she can think of against the wall to see what sticks. The Heritage proposal is more interesting to me, as it is both a positive construction of what should be done (rather than what should not) and because it is more calm, rational, and methodical in it's advocacy. In fact, the more I read the article the more I support it's advocated plan. It sounds like a great idea!
I'm going to cut this a little short - it's late and I'm sleepy. If the Obama administration is appointing Rosenthal as an alternative to Trudy Schuett's "do nothing" approach, I applaud the choice. If Ms. Rosenthal is being offered as an alternative to the philosophy and policies offered in the Heritage article, I believe a strong opportunity has been lost, perhaps even to political partisanship as has been alleged.
It is not which side you support that makes you right or wrong, but the quality of the argument you support. Of the four articles, the Heritage Foundation offers the best argument (though I would like to read a similarly well reasoned rebuttal from feminist or administration sources). Obama's heart is in the right place, but I doubt Rosenthal and her new position can make the existing philosophy and policy work better than it has ever worked. A more complete approach, such as combining the kinds of prevention programs the Heritage Foundation describes with the crisis handling of Rosenthal's specialty, would presumably work better than doing more of the same thing.
I think Obama missed an opportunity to both effectively curtail domestic violence and reach across the aisle with his choice. It's a shame, but it's only a little shame. He could've done a lot worse.
Saturday, September 26, 2009
I Like Movies
It occurred to me yesterday, after watching three DVDs in a row, that I really like movies. (They were The Last StarFighter, Knowing, and Iron Will. I recommend them all., three stars each.) I have around 200 movies and seasons of TV shows in my house. I have seen them all with three exceptions:
Pretty much the only genre of movies I don't like are ones set up as filmed stage plays. Grease, Hair, Rent, modern takes on Shakespeare, etc. That whole genre irks me. Second most hated is the genre of stupid comedies, like Shallow Hal or Scary Movie, especially if they're stupidly oversexed.
My favorite genres are historical dramas (John Adams, Pride & Prejudice, Fat Man & Little Boy, etc) followed by hard science fiction (The Man From Earth), followed by popcorn sci fi (Star Wars, Star Trek, Serenity).
I'm generally opposed to rampant sex, violence, or language, so I generally steer clear of movies rated R or worse. I will make occasional exceptions, most obviously for The Matrix. Which ruled. There are no sequels. None. Ever.
I love animation in both it's Disney-ish and Anime forms. Animation is capable of greater emotional power and persuasive influence than live action, especially in showing beauty and mystery. Pixar is the best production company ever, largely because they understand and wield that power.
In general, I love movies.
- I haven't seen all of 8 Seconds because I hate it.
- I haven't seen all of Grease (at least not in one sitting) because I hate it.
- I haven't seen Footloose because I fear it's going to remind me of Grease.
Pretty much the only genre of movies I don't like are ones set up as filmed stage plays. Grease, Hair, Rent, modern takes on Shakespeare, etc. That whole genre irks me. Second most hated is the genre of stupid comedies, like Shallow Hal or Scary Movie, especially if they're stupidly oversexed.
My favorite genres are historical dramas (John Adams, Pride & Prejudice, Fat Man & Little Boy, etc) followed by hard science fiction (The Man From Earth), followed by popcorn sci fi (Star Wars, Star Trek, Serenity).
I'm generally opposed to rampant sex, violence, or language, so I generally steer clear of movies rated R or worse. I will make occasional exceptions, most obviously for The Matrix. Which ruled. There are no sequels. None. Ever.
I love animation in both it's Disney-ish and Anime forms. Animation is capable of greater emotional power and persuasive influence than live action, especially in showing beauty and mystery. Pixar is the best production company ever, largely because they understand and wield that power.
In general, I love movies.
Friday, September 25, 2009
Obameter #77: Fund Community-Based Prevention
I'm sick of describing health care. My view boils down to a single point: American health care is generally better, if you can get it. Our system specializes on specialization at the expense of universal insurance. So many countries have universal health care, so everyone can get B+ medical care but A+ care remains elusive. We could do the same. But why should we?
Expanded funding for that kind of broad, general care was promised by Barack Obama and $851 million to that effect was announced by Michelle Obama. The Obama Administration is very successfully pursuing the health care reforms he believes in and I oppose.
It has become redundant to say so.
I need a new perspective on the issue. I need to think about it in a new way. To that end, I present a rebuttal to the Green Party's argument in favor of universal health coverage.
The way in which this is socialism is that it cuts off the peaks of the mountains to raise lower elevations. It raises the worse case by sacrificing the best case. The American spirit is an aspiration to achieve the best case - or, preferably, to create an even better best case. To remove the best possible outcome from possibility is unAmerican. That is why we are the only industrialized nation without universal health care. We associate ourselves with the best possible outcome. Thus, eliminate the best possible outcome is to hurt ourselves.
Expanded funding for that kind of broad, general care was promised by Barack Obama and $851 million to that effect was announced by Michelle Obama. The Obama Administration is very successfully pursuing the health care reforms he believes in and I oppose.
It has become redundant to say so.
I need a new perspective on the issue. I need to think about it in a new way. To that end, I present a rebuttal to the Green Party's argument in favor of universal health coverage.
- They argue that the United States is the only industrialized nation that does not consider health care a right. That's true, and logically correct. Rights are things government cannot do to you. Government cannot restrict your associations or self-expression, take your property, punish you without a trial... those are rights. Health care is done for you. It is a service, not a right.
- They argue that the US health care system is not the best in the world because American health is low. That is because people are not using the system. Individual patients of the American health care system achieve better health than patients of other health care systems. By that measure, the American system is the best health care system in the world.
- American health care is more expensive than that elsewhere in the world. Of course it is. Most health care elsewhere is general care. Most health care in the USA is specialist care. Specialist care is more expensive than general care. It's also more effective.
- The American system denies people service based on their ability to pay. Universal health care denies people services based on limited availability of specialist services. We have the "oversupply" of equipment stated because of the redundancies of competitive industry. If you remove that cause, we will face the same limited supply of specialist services that other nations face.
- They argue that no laws, rules, or regulations would limit choice of health care provider under a universal care system. This is true. Scarcity, not rules, would dictate availability. The rest of their arguments in this section are against corporate restrictions on health care, which I oppose just as much as I oppose government restrictions on health insurance. You get more choice when you pay for it yourself.
- They argue that universal health care is not "socialized medicine" because the government is only paying for the health care, not providing it. This is true. It's socialized medical insurance. They also mention that approximately 2/3rds of people support universal coverage. Speaking of rights, why force a system onto the other third that they don't want? Individual states can already provide universal medical coverage at the state level, leaving people the choice of whether to pay for it by choosing what state they live in.
- In arguing that the American system is not being reformed, they compare for-profit and not-for-profit medical care prices. What does that have to do with government handling of payments? Apart from that, this just repeats the third point about costs: American health care is more expensive and more effective at the cost of availability.
- They blame corporate lobbies for health care not passing. Why would corporations oppose it generally? It transfers the costs of health insurance from them to government. Medical corporations lobby against universal care to save themselves. They also fund most of the world's medical technology research and development. Maybe it's a good thing they exist.
The way in which this is socialism is that it cuts off the peaks of the mountains to raise lower elevations. It raises the worse case by sacrificing the best case. The American spirit is an aspiration to achieve the best case - or, preferably, to create an even better best case. To remove the best possible outcome from possibility is unAmerican. That is why we are the only industrialized nation without universal health care. We associate ourselves with the best possible outcome. Thus, eliminate the best possible outcome is to hurt ourselves.
Thursday, September 24, 2009
Comparing Apples to Apples in Health Care
In the modern health care debate, it is extremely tempting to compare the American system as it exists now to foreign systems that resemble to degrees the universal health care system currently before the American legislature. It's quite a rational way to estimate the influence this new legislation would have if passed.
The most common comparison along these lines is life expectancy. That comparison is not rational at all. Medical care availability, it's effectiveness, and that of medical insurance affects life expectancy in ways deeply clouded by causes of death that cannot possibly be altered by medical attention. Americans drive more and further than citizens of other nations, increasing our vehicular accidents and, thus, on-the-scene deaths from that cause. We have radically more firearm deaths to the same effect. We are culturally more likely to try to personally, physically stop violent crime or armed robbery, which again decreases our life expectancy in ways unrelated to medical insurance, care, and science.
How do we measure up on direct comparisons of specific causes of death? That is a far better comparison of effectiveness of medical care. Of 100 patients for a given disease, what percentage are alive one year, five years, ten years later? That is a level scale.
So how do we compare? There are thousands of causes of death that could potentially be covered, and information for uncommon approach is less readily available. The full answer is beyond the scope of a blog post and of my own capability as a researcher. But I'll address what few examples I have found.
Of 31 countries statistically analyzed by one recent CDC-funded study (as reported by WebMD, for those without subscriptions to medical research websites), the U.S. has the highest 5-year survival rate for breast and prostate cancer. France and Japan beat us out for the other two cancer types covered, colon and rectal cancers.
If this factor alone were all to consider, it would put the USA tied or ahead of both France and Japan. World Health Organization declared France to have the best health care system in the world [source]. By the same WHO source, Japan ranked 6th and the USA ranked 37th.Already, conflict arises. According to Wikipedia, "The WHO [...] placed heavy emphasis on the health disparities between rich and poor, funding for the health care needs of the poor, and the extent to which a country was reaching the potential health care outcomes they believed were possible for that nation." [source] Thus, theirs is more a measure of whether health care is universal than whether it is effective.
The USA also leads the world in gunshot wound survival rates. With all our extra practice, does anyone doubt that claim? The effect on life expectancy would be neutralized by our far greater frequency of occurrence of gunshot wounds, yet it testifies of the effectiveness of our medical capability.
According to Wikipedia's coverage of a international cardiac study, "Canadian patients [...] had a 17% higher risk of dying from heart attacks than did U.S. patients." It is further suggested that that the American culture of cardiac treatment is more effective at saving heart attack victims' lives because of "the greater use of invasive procedures in the U.S." and that "specialized procedures are only available in central hospitals" in Canada but are more abundant in the USA. This suggests that more advanced care is less available under a universal health care system, and that the difference is responsible for a significant number of people's lives. [source]
(If I have not said so previously, let me say so now: I don't believe universal health care creates "death panels" who decide whether you live or die, but rather that financial realities will create shortages of certain advanced and expensive care options. Previously I considered some hospital accountant encouraging against certain procedures, but after reading the previous example my views are altered to say "Exactly like that.")
Of course,two three examples are insufficient to prove anything. My argument is limited by the comparative difficulty of coming up with comparisons of various nations by cause of death. But the approach is better logic and, so far, seemingly puts the existing US heath care system in a far better light. How sure are we that our health care system is so horribly behind the other industrialized nations of the world?
If we can't be sure it's broken, why are we striving to fix it?
Updated at 11:45 am on 24 Sept 2009.
The most common comparison along these lines is life expectancy. That comparison is not rational at all. Medical care availability, it's effectiveness, and that of medical insurance affects life expectancy in ways deeply clouded by causes of death that cannot possibly be altered by medical attention. Americans drive more and further than citizens of other nations, increasing our vehicular accidents and, thus, on-the-scene deaths from that cause. We have radically more firearm deaths to the same effect. We are culturally more likely to try to personally, physically stop violent crime or armed robbery, which again decreases our life expectancy in ways unrelated to medical insurance, care, and science.
How do we measure up on direct comparisons of specific causes of death? That is a far better comparison of effectiveness of medical care. Of 100 patients for a given disease, what percentage are alive one year, five years, ten years later? That is a level scale.
So how do we compare? There are thousands of causes of death that could potentially be covered, and information for uncommon approach is less readily available. The full answer is beyond the scope of a blog post and of my own capability as a researcher. But I'll address what few examples I have found.
Of 31 countries statistically analyzed by one recent CDC-funded study (as reported by WebMD, for those without subscriptions to medical research websites), the U.S. has the highest 5-year survival rate for breast and prostate cancer. France and Japan beat us out for the other two cancer types covered, colon and rectal cancers.
If this factor alone were all to consider, it would put the USA tied or ahead of both France and Japan. World Health Organization declared France to have the best health care system in the world [source]. By the same WHO source, Japan ranked 6th and the USA ranked 37th.
The USA also leads the world in gunshot wound survival rates. With all our extra practice, does anyone doubt that claim? The effect on life expectancy would be neutralized by our far greater frequency of occurrence of gunshot wounds, yet it testifies of the effectiveness of our medical capability.
According to Wikipedia's coverage of a international cardiac study, "Canadian patients [...] had a 17% higher risk of dying from heart attacks than did U.S. patients." It is further suggested that that the American culture of cardiac treatment is more effective at saving heart attack victims' lives because of "the greater use of invasive procedures in the U.S." and that "specialized procedures are only available in central hospitals" in Canada but are more abundant in the USA. This suggests that more advanced care is less available under a universal health care system, and that the difference is responsible for a significant number of people's lives. [source]
(If I have not said so previously, let me say so now: I don't believe universal health care creates "death panels" who decide whether you live or die, but rather that financial realities will create shortages of certain advanced and expensive care options. Previously I considered some hospital accountant encouraging against certain procedures, but after reading the previous example my views are altered to say "Exactly like that.")
Of course,
If we can't be sure it's broken, why are we striving to fix it?
Updated at 11:45 am on 24 Sept 2009.
Wednesday, September 23, 2009
Obameter #76: Fund Health Care Training
Obama promised to expand the financial support government provides for the training of health care personnel. In the big stimulus bill, he did so to the tune of $500 million. Promise kept.
I am completely unfamiliar with any political issue surrounding this promise or it's fulfillment. Were health care personnel previously under-trained? Did they need that money? Was it enough? Was it too much? Is there any mechanism in place to make sure it's going to the right people and making a difference? It seems to come completely out of the blue.
It's one of the approximately 140 independent items passed as one huge, joint program above and beyond the usual government spending budget in the huge omnibus American Recovery and Reinvestment Act of 2009, unofficially called the Stimulus Bill. One criticism of the big stimulus bill is that you could hide entire programs in the bill and no one would even find and address them before they became law. No oversight. No debate.
I'd say this is a perfect example. It sounds good, sure. Who wants untrained medical personnel? I suppose it's part of a greater emphasis on health in America, but I wasn't aware of any major lack of training problem in the medical field or that this spending has or will actually improve American health. Wikipedia has 6 words on the topic. Google News has seemingly no related search results. Have you heard anything about it? Has there been any debate, consideration, or discussion of this point at all?
I guess it was slipped in completely under the radar. I wonder what else passed that no one noticed.
I am completely unfamiliar with any political issue surrounding this promise or it's fulfillment. Were health care personnel previously under-trained? Did they need that money? Was it enough? Was it too much? Is there any mechanism in place to make sure it's going to the right people and making a difference? It seems to come completely out of the blue.
It's one of the approximately 140 independent items passed as one huge, joint program above and beyond the usual government spending budget in the huge omnibus American Recovery and Reinvestment Act of 2009, unofficially called the Stimulus Bill. One criticism of the big stimulus bill is that you could hide entire programs in the bill and no one would even find and address them before they became law. No oversight. No debate.
I'd say this is a perfect example. It sounds good, sure. Who wants untrained medical personnel? I suppose it's part of a greater emphasis on health in America, but I wasn't aware of any major lack of training problem in the medical field or that this spending has or will actually improve American health. Wikipedia has 6 words on the topic. Google News has seemingly no related search results. Have you heard anything about it? Has there been any debate, consideration, or discussion of this point at all?
I guess it was slipped in completely under the radar. I wonder what else passed that no one noticed.
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