Note from Diana: Sorry that I didn’t post this announcement when the column was published! I didn’t realize that it was in the queue.

My latest Forbes column is now up: “Perverse Incentives and VA Health Scandals“.

I discuss the perverse incentives underlying the numerous VA health scandal. Too many on the political Left (such as New York Times columnist Paul Krugman) are quick to condemn perverse incentives in the private health system, while failing to mention similar (or worse) perverse incentives in government-run health systems.

Incentives matter.

 

Note from Diana: Sorry that I didn’t post this announcement when the column was published! I didn’t realize that it was in the queue.

My latest Forbes column discusses the latest debate over raising the legal age for smoking: “Smoking Is Bad, But 18-Year-Olds Should Be Allowed to Smoke“.

In particular, any debate on this should include the following three questions:

1) Is it the government’s job to stop legal adults from making unhealthy life choices?

2) Is it right for the government to restrict the freedom of adults over 18, because others under 18 might be more tempted to smoke?

3) Whose body is it, anyways?

People don’t always make the best choices for themselves.  But in a free society, they should be able to do so, provided they aren’t violating the rights of others.

 

 

Blackman On Net Neutrality

 Posted by on 11 May 2015 at 12:00 pm  Government, Internet, Technology
May 112015
 

Justin Blackman on “net neutrality”:

Imagine if hard drive providers had been so heavily regulated at the start of the tech boom that only a few, government-approved companies were able to bring their products to the marketplace. We would have never witnessed the same rapid expansion of storage capacity over cost, as there would have been far less incentive to innovate in such a stifling market. Software, however, would have continued to advance in its own relatively free domain, and would have very quickly run up against the limitations imposed by artificial controls on storage media.

In that environment, some software companies would start cutting deals with hardware and OS platform providers. They might, for example, contract that a certain amount of storage space always be dedicated to their product in order to guarantee a certain level of performance for their end users.

The government would then step in and tell these companies that hard drive access must be totally equal, and that no single company should be able to contract for any privileged access to storage.

What consumer would want this situation at all? The free hardware market is clearly far superior, because hard drive space is so plentiful and expanding so rapidly that storage limitations are, at worst, simply a matter of end user preference.

Now, imagine if the telecom industry had not been so heavily regulated by government that only a few, government-approved providers were able to bring telecommunications to the marketplace.

Would we even be having this debate about net neutrality?

A damned good question.

 

 

My latest column at PJ Media is a change of pace from the usual health care writing. It is entitled, “Should You Have to Speak with Others in a Way the Government Can Understand?

I discuss the demands by the federal government for “backdoor” access into your encrypted smartphone data and communications. Fortunately, Apple and Google are standing up to the government’s demands.  I explain why they are right to do so.

 

 

The Profit Motive: Not Always Good

 Posted by on 19 September 2014 at 10:00 am  Ethics, Government, Medicine
Sep 192014
 

This is a horrifying story: Cancer doc admits scam, giving patients unneeded chemo. This doctor gave unnecessary chemotherapy — basically, he poisoned his patients — for money. (The profit motive is usually a tremendous force for good… but not always.)

Here’s the bright spot in this morally bleak story — the nurse who turned him in as soon as she saw (in a job interview) him doing wrong:

Angela Swantek, a chemotherapy nurse who blew the whistle on Fata to state authorities in 2010, was in the courtroom during Fata’s guilty plea. She said she was relieved to hear him admit to things she witnessed years ago in his office. “I’m numb,” she said in a court hallway. “I’m not surprised though; I wondered how his team was going to defend him. The charts don’t lie.”

Swantek, 45, of Royal Oak, said she went to Fata’s office for a job interview in 2010 when she saw patients getting chemotherapy in a manner that wasn’t correct. “I left after an hour and half. I thought this is insane,” she said. That same day, Swantek went home and wrote a letter to the state and suggested they investigate him.

According to Swantek, the state did nothing and notified her in 2011 that they had found no wrongdoing. “I handed them Dr. Fata on a platter in 2010 and they did absolutely nothing,” said Swantek, noting she was elated when she learned the federal government charged Fata in 2013.

“I started crying,” she said. “I thought about all of the patients he took care of and harmed.”

Kudos to her for reporting him to the authorities, rather than just walking away. If only those authorities had done their job…

 

Monica Hughes recently gave an excellent talk on, “The Transformation of American Healthcare: Lessons from the Veterans Administration and Existing FDA Standards of Care” to Liberty On The Rocks at Flatirons.

 

Her talk is now available on YouTube (3 parts).

Part 1

Part 2

Part 3

Disclaimer and synopsis:

DISCLAIMER: The speaker is not a medical doctor or health care practitioner. The ideas in this video are not intended as a substitute for the advice of a trained health professional. All matters regarding your health require medical supervision. Consult your physician and/or health care professional before adopting any nutritional, exercise, or medical protocol, as well as about any condition that may require diagnosis or medical attention. In addition, statements regarding certain products and services represent the views of the speaker alone and do not constitute a recommendation or endorsement or any product or service.

Synopsis: In January 2014, Robb was diagnosed with glioblastoma multiforme (GBM), one of the deadliest brain cancers in existence. Nicknamed “The Terminator” the median survival time is around 11 months. Robb had brain surgery on January 16, which was performed by a team of surgeons while Robb was awake. The surgery was a success.

Monica’s research into the post-surgery treatments that worked best for other survivors showed that they were not approved by the Food and Drug Administration, so they’d have to go to a cancer center that sprouted up in Tijuana, Mexico for treatment which included a 100 year-old immune system booster called Coley’s Vaccine.

Bio: Monica Hughes has bachelor’s, master’s, and PhD degrees in biology and has taught college biology since 2006. Previously, Monica served as a medical writer for National Jewish Health, a premier research hospital for respiratory and immune disorders, and is now a patient advocate specializing in literature research.

Robb LeChevalier has served in the Air Force and has a bachelor’s degree in electrical engineering. He designed his own home situated in the foothills outside of Denver, and currently develops high speed electronics for his own company, Astronix Research. He has been an Objectivist for 40 years.

More: Robb was given 2 months to live without surgery, a maximum of 6 months to live with surgery only, and an unspecified amount of time with additional therapy due to the unusually aggressive nature of his particular tumor. He and his wife Monica faced seemingly insurmountable hurdles by the Veterans Administration along the way, including timely care from the VA and a delay of emergency surgery that could have cost Robb his life had they not pushed for a special dispensation from a panel of VA doctors within the 48 hours leading up to his scheduled surgery. They are currently contesting 58 claims denials by the VA totaling nearly $250,000 in unpaid medical bills.

In the days following Robb’s surgery, they discovered that immunotherapy held the best chance of long-term and quality survival for this cancer. Historical 3 year survival with FDA-approved standard of care for GBM is around 7%. 3-5 year survival for some GBM patients in clinical trials using cancer vaccines is between 20%-50%, depending on the vaccine. Yet they discovered that due to FDA regulations, it is impossible to enter these clinical trials without first or concurrently undergoing FDA-approved standard of care, and that such care would greatly reduce his likelihood of responding to immunotherapy, if he was lucky enough to meet the criteria for the study and be placed in the treatment arm of such a trial.

Given these poor odds, Robb chose to forego all standard of care therapy after surgery, and opted for an immunotherapy protocol abroad that, according to current MRI results, has left him without evidence of disease. As of June 10, 2014, their new low deductible PPO health insurance policy, purchased on the Obamacare exchange, has not paid out a single penny of reimbursement for Robb’s cancer treatment.

(Note: I also discussed their case in my 5/28/2014 Forbes piece, “VA Denies Coverage For US Air Force Veteran With Malignant Brain Tumor“.)

Jun 172014
 

These confessions of an ex-TSA agent — Dear America, I Saw You Naked — are well worth reading. For example:

We knew the full-body scanners didn’t work before they were even installed. Not long after the Underwear Bomber incident, all TSA officers at O’Hare were informed that training for the Rapiscan Systems full-body scanners would soon begin. The machines cost about $150,000 a pop.

Our instructor was a balding middle-aged man who shrugged his shoulders after everything he said, as though in apology. At the conclusion of our crash course, one of the officers in our class asked him to tell us, off the record, what he really thought about the machines.

“They’re shit,” he said, shrugging. He said we wouldn’t be able to distinguish plastic explosives from body fat and that guns were practically invisible if they were turned sideways in a pocket.

We quickly found out the trainer was not kidding: Officers discovered that the machines were good at detecting just about everything besides cleverly hidden explosives and guns. The only thing more absurd than how poorly the full-body scanners performed was the incredible amount of time the machines wasted for everyone.

And:

But the only people who hated the body-scanners more than the public were TSA employees themselves. Many of my co-workers felt uncomfortable even standing next to the radiation-emitting machines we were forcing members of the public to stand inside. Several told me they submitted formal requests for dosimeters, to measure their exposure to radiation. The agency’s stance was that dosimeters were not necessary—the radiation doses from the machines were perfectly acceptable, they told us. We would just have to take their word for it. When concerned passengers—usually pregnant women—asked how much radiation the machines emitted and whether they were safe, we were instructed by our superiors to assure them everything was fine.

“Security Theater” seems like too benign of a term for these absurdities, I think. Now go read the whole article.

Jun 092014
 

Liam Neeson narrated this excellent video in defense of NYC’s horse carriages. (Alas, embedding is disabled.) These people love and care for their horses: the horses live good lives, and they’re treated well.

I’m disappointed — but not surprised — that real estate interests seem to be the driving force here, in alliance with “animal rights” activists. It’s pure Bootleggers and Baptists:

Bootleggers and Baptists is a catch-phrase invented by regulatory economist Bruce Yandle for the observation that regulations are supported by both groups that want the ostensible purpose of the regulation and groups that profit from undermining that purpose.

For much of the 20th century, Baptists and other evangelical Christians were prominent in political activism for Sunday closing laws restricting the sale of alcohol. Bootleggers sold alcohol illegally, and got more business if legal sales were restricted. “Such a coalition makes it easier for politicians to favor both groups. … [T]he Baptists lower the costs of favor-seeking for the bootleggers, because politicians can pose as being motivated purely by the public interest even while they promote the interests of well-funded businesses. … [Baptists] take the moral high ground, while the bootleggers persuade the politicians quietly, behind closed doors.”

The original 1983 article is well worth reading: Bootleggers and Baptists-The Education of a Regulatory Economist.

As the article in Foxhunting Life observed:

If we love foxhunting and are willing to defend our sport against those who would take it away from us, we cannot stand mute and allow our relationships with the horse and the other animals we love be separated from our lives piece by piece (carriage horse, racehorse, hunt horse, trail horse), specie by specie (horse, hound, dog, cat), and location by location (city, town, farm). We’re all connected.

The least we can do is communicate with our fellow citizens about these well-funded campaigns masquerading as animal welfare. The animal rights activists are few in number but have an inordinately loud voice. We who actually live, play, and work with animals are also relatively few in number, and we need to ratchet up the volume of our collective voice. The great majority of citizens have no preconceived opinions of who’s right and who’s wrong. They can only form their opinions based upon what they read and what they hear.

By the way, if you want to quickly judge whether a horse is cared for well, look at its feet: if they’re neatly trimmed (and shod), then the horse is probably in good hands. If they’re a mess, then the horse is probably neglected and maybe abused too.

 

My second Forbes piece in two days again discusses the VA health scandal: “Three Factors That Corrupted VA Health Care And Threaten The Rest of American Medicine“.

Here is the opening:

Veterans Affairs Secretary Eric Shinseki has resigned in the wake of the waiting times scandal. But the problems at the VA go much deeper than a single man. His eventual successor will have his hands full dealing with the toxic combination of problems that fueled the crisis: a shortage of doctors, perverse incentives, and a widespread culture of dishonesty. And these problems could affect the rest of America under ObamaCare…

The first two of the three factors are already in play under the Affordable Care Act (aka “ObamaCare”) and there are troubling early indicators that the third may take root as well.  If this happens, Americans had better watch out.

 

My latest Forbes piece is now up: “VA Denies Coverage For US Air Force Veteran With Malignant Brain Tumor“.

I discuss the bureaucratic hurdles that USAF veteran Robert LeChevalier had to endure when diagnosed with glioblastoma multiforme (a very malignant brain tumor).  Fortunately, he and his wife Monica Hughes have a lot of grit and tenacity.

I’m glad to publicize their open letter to the VA, and I hope it gets some attention!

Monica also posted this photo, which I used in the Forbes article with her permission:  “Here are the 58 claims denials, totaling $250,000 of emergency care, that we have received by the Veteran’s Administration. Excuse? Robb was too healthy. He hadn’t sought any care at the VA in the prior 5 months. Really.

 

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