Tag: medicine

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free trade & free markets general freedom too much government

Doctoring Malady

medicine, healthcare, medical care, hospital, doctors

There is a doctor shortage. Economists who study such issues project that the shortfall will continue to grow.

That is, the pool of available professionals for advanced and general practice medicine is shrinking relative to demand.

A report last year at Definitive Healthcare provides a list of reasons:

  1. Shifts in physician and patient populations
  2. Most healthcare workers prefer not to work in rural hospitals 
  3. Medical school and residency programs are limited 
  4. Healthcare workers are burnt out 

What wasn’t mentioned? The COVID response debacle. When an elephant makes a deposit on the waiting room floor, don’t ignore it.

But, instead, the list of causes and cures was predictable: “too many administrative tasks” (need more assistants, or at least AI?); “poor work-​life balance” (but that’s always been the case); “insufficient salary” (you could see that one coming a mile away, right?).

A study published in March, “The Complexities of Physician Supply and Demand: Projections From 2021 to 2036,” prepared for the Association of American Medical Colleges, dips its timid toes in that topic, but says little of significance. 

And as I scrolled through a report on the study, I thought: this is none of my business. Just as it’s none of my business to fret much about the supply and demand for toilet tissue or garbage trucks. This is all supposed to be taken care of by “the market.” 

Trouble is, we do not have a free market in medical care. We have an over-​regulated, vastly subsidized healthcare system.

The key to the future supply of doctors is getting the government out of doctors’ business. Hesitating to turn that key, or saying that government “must do more,” merely makes the malady worse.

This is Common Sense. I’m Paul Jacob.

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Paralyzed Man Moves

brain, paralysis, medicine, science, magic

After falling on ice, a 46-​year-​old Swiss man became paralyzed, losing all mobility.

Now he is beginning to move again thanks to a brain implant that enables what the Dutch firm Onward, its inventor, calls “thought-​driven movement.”

The implant interprets neural impulses that are triggered when the patient intends to move. A second implant in his abdomen then stimulates parts of the body so that he can move them as he wishes.

Onward says that although its results are preliminary, “the technology works as expected and appears to successfully reanimate his paralyzed arms, hands, and fingers.”

This astonishing work is not without precedent. Over a decade ago, French neuroscientist Gregoire Courtine conceived of the possibility of a digital bridge between brain and body to help such patients.

It took a while to realize his dream. But this year, Courtine and Swiss neurosurgeon Jocelyne Bloch installed implants in a Dutch man, Gert-​Jan Oskam, to restore his ability to walk after he lost the use of his legs in a biking accident.

One unexpected benefit of their procedure is neural regeneration.

“What we discover,” says Courtine, “is that when using this system for a long period of time, through training, nerve fibers start growing again.… That was like the dream, regenerative medicine!”

Onward CEO Dave Marver says that the next step for its own implant technology is small trials, then a larger one, then “hopefully get FDA approval and make it available.”

What a wonderful world.

This is Common Sense. I’m Paul Jacob.

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First Amendment rights general freedom local leaders

De- and Re-certified

doctor, medicine, association, group think, censorship

“Around the country, a slew of doctors had board certifications removed and licensure threatened for sharing their COVID-​related opinions,” explains The Epoch Times, in an article devoted to one of those persecuted, Dr. John Littell of Florida.

Early in the pandemic, “Dr. Littell, a longtime family physician in Ocala and a medical school professor, began posting videos sharing his thoughts about COVID-​19 testing, treatments, and vaccines early in the pandemic,” Natasha Holt’s Epoch Times article narrates. “He was frustrated to find his content often was pulled down from his YouTube channel.” 

But the establishment’s efforts didn’t stop there. “[I]n January 2022 and again five months later, he received warning letters from the American Board of Family Medicine (ABFM), the organization that issued his certification for his medical specialty.”

His videos on YouTube and then the safe, free-​speech haven Rumble, spread “medical misinformation,” the board charged, warning that he could lose certification. But these were warnings. The board got a bit more serious and physical when they removed Littell from a public meeting, giving him the bum’s rush.

And then the board de-​certified him.

It’s a long story, but appears to have a happy ending, with Littell re-​certified and organizing a support group for medical professionals’ free speech rights, and the basic need to practice independent, patient-​centered medicine, and to disagree with the gimcrack “consensus” policies that establishment organizations impose.

While there are multiple medical certification boards in America, these are not free-​market concerns competing for customers. The government is heavily involved at every level. And the policies and “science” that Dr. Littell and others ran up against were not only political, but wrong — medically and morally. 

As we are increasingly discovering.

Which makes medical freedom more important than ever.

This is Common Sense. I’m Paul Jacob.

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Four of Five Doctors Disagree

Salem Witch Trial

“Thank goodness I don’t live in X,” we may say as we follow the news.

Billions live in Russia, Ukraine, China, Xinjiang, Tibet, Hong Kong, Cuba, New York, Chicago, Seattle, California, Canada, and other statist hellholes. The rest of us live elsewhere. Perhaps we congratulate ourselves on our wise choices of birth location and/​or subsequent residencies.

But people are copycats.

As producers, we are often inspired by great achievements and seek to emulate them. The destroyers among us, somewhat similarly, are eager to adopt the latest in fashionable assault on what the producers are doing.

So we don’t necessarily escape if, say, California prohibits physicians from discussing things medical whenever their judgment conflicts with state-​approved doctrine. Because next thing you know, lawmakers in Tennessee or Virginia will be saying, “Gee, that’s right, gag the doctors. Why didn’t I think of that?”

Legislative masterminds in California now want to harass doctors who recommend a non-​government-​approved treatment for COVID-​19. If AB 2098 is passed, it would authorize California medical boards to discipline doctors for “dissemination of misinformation” related to COVID-19.

The bill implies that no doctor can legitimately disagree with another about a particular case. (Yeah? See the history of medicine.)

When I say that this legislation assaults truth and truth-​seeking — which requires freedom of speech as a necessary corollary of freedom of thought in medicine or in any field — I speak for Californian doctors and California patients.

I speak also for us all.

This is Common Sense. I’m Paul Jacob.

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The Witch Trial of George Jacobs by Thompkins. H. Matteson

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This Is Just Huge

Dr. John Campbell, covid, treatments

“Why isn’t this in the newspapers?” 

That’s what Dr. John Campbell asked on his YouTube channel yesterday, reviewing several studies of ivermectin as an agent in the fight against COVID-​19 — but directly regarding the results of research out of Brazil. It was an impressive large-​number study, in which the researchers invited the whole population of Itajaí to participate, with 159,561 included in the analysis: 113,845 regular users of ivermectin and 45,716 non-users. 

“Seventy percent reduction in mortality in this study” of those who took a very “tiny dosage of ivermectin every fortnight, acting as a prophylaxis” over those did not. “I mean, this is just huge!”

Dr. Campbell, who has been a voice of calm science during the pandemic, goes on to say that “It’s almost as if information has been deliberately suppressed throughout the pandemic, to be quite honest.” With a wry look, he went on to say “No one’s saying that’s true, of course, but it’s almost like that.” 

Droll.

But non-​ironically, he insists the evidence is “powerful, present, and overwhelming.” 

“Seventy percent,” he marvels, “how do you argue with a number like that? It’s a very, very high number.”

And the decrease in hospitalization was 67 percent.

All in all, the study found less infection, fewer hospitalizations, and an astoundingly lower death rate in the ivermectin group.

Earlier in the video, the doctor considered another study, comparing the cheap anti-​parasitic to the far more expensive remdesivir, a Fauci-​pushed Gilead Sciences anti-​viral, with similar results.

It’s “almost as if” the expert class that spurned ivermectin doesn’t care if people die.

No one’s saying that, but.…

This is Common Sense. I’m Paul Jacob.

The studies:

Kerr L, Cadegiani F A, Baldi F, et al. (January 15, 2022) “Ivermectin Prophylaxis Used for COVID-​19: A Citywide, Prospective, Observational Study of 223,128 Subjects Using Propensity Score Matching.” Cureus 14(1): e21272. doi:10.7759/cureus.21272.

I. Efimenko, S. Nackeeran, S. Jabori, J.A. Gonzalez Zamora, S. Danker, D.Singh, “Treatment with Ivermectin Is Associated with Decreased Mortality in COVID-​19 Patients: Analysis of a National Federated Database.” International Journal of Infectious Diseases 116 (2022) S1 – S130.

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education and schooling First Amendment rights social media

Our Authoritarian Moment

Youtube, censorship

Was it something I said?

Yesterday, YouTube removed the video of my latest episode of This Week in Common Sense. Why? The platform claims I violated its “terms of service” and “community standards” by providing “medical misinformation.”

Funny, YouTube did not specify which statement in the video was incorrect, much less provide any citation to back up its “misinformation” claim.

This sort of authoritarianism is quite common these days. We’re just supposed to take the Authority’s word that It Possesses the Whole Truth.

No debate. No dissent.

There is not even a reference or consult.

Which is what Dr. Byram W. Bridle, PhD, Associate Professor of Viral Immunology Department of Pathobiology at the University of Guelph discovered.

He refused to provide evidence of vaccination. So his Canadian university “banned” him “from campus for at least a year.” And sat by while colleagues and students abused him for being “anti-​science.”

Thing is, as he points out in his Open Letter to the academic institution, not one of the tenured immunologists of the University of Guelph thinks there should be mandatory vaccination. All are very concerned about the goal of universal vaccination. Since not one of the available vaccines appears effective enough to produce sufficient immunity in recipients “herd immunity,” the goal must be mere “herd vaccination.” 

Dr. Bridle is especially annoyed that the university does not allow him to demonstrate his natural immunity to the disease, which simply does not interest the pro-​vaccination bureaucrats.

Worse yet, at no point in the university’s deliberations over the vaccine mandate did administrators consult their own immunology department!

That’s not “following the science.”

Like at YouTube, it’s a political campaign: science not required.

This is Common Sense. I’m Paul Jacob.

Note: I first heard about both stories from my podcasting sparring partner, who produced two stories on his website regarding Dr. Bridle and tipped the hat to historian Tom Woods.

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Politicians & Pain

opioid, crisis, pain, drug, law, politician, ban, prohibition, control, medicine,

Whenever a new panic runs through corporate media and the grapevine — and especially when the lesson is supposed to be ‘we’ve gotta do something!’ — it is time to slow down. And look at the facts.

The opioid crisis is one of those panics.

The almost immediate reaction from politicians has been to point their quivering fingers at doctors and drug companies on the theory that doctors have been over-​prescribing opiates, instigated by pharmaceutical companies.

Seems a ‘round up the usual suspects’ approach to public health.

Now there appears to be good research to back up our skepticism. According to Cato’s Jeffrey A. Singer, recent studies show “there is no correlation between opioid prescription volume and non-​medical use or opioid use disorder among persons age 12 and over.” Nevertheless, Dr. Singer notes, “policymakers and law enforcement continue to pressure health care practitioners into undertreating patients in pain.” 

An under-​treatment result is scarier, to me, than the desperate and dangerous self-​medication problem that must lie at the core of the crisis we read about. Patients in too much pain because doctors are afraid of government harassment are pushed to unsupervised pain management … which looks an awful lot like a simple description of the opioid crisis itself.

Singer provides confirmation of an unintended effect: the fentanyl and heroin overdose rate “continues apace” even as the opioid prescription volume plummets.

“At a recent international breast cancer conference experts stated the under-​prescribing of opioids to breast cancer patients in the U.S. is now comparable to treatment in third world countries,” warned Singer. 

One word: yikes.

I am tempted to define today’s politics itself as a kind of pain mismanagement.

This is Common Sense. I’m Paul Jacob.

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opioid, crisis, pain, drug, law, politician, ban, prohibition, control, medicine,

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Hooray for Congress!

right to try, treatment, healthcare, Rights, FDA, democrats, Congress, medicine, experimental,

When Congress behaves badly, I criticize. When it works well, I applaud. 

I’ve waited a long, long, long time to put my hands together in polite applause.

It happened yesterday. 

The U.S. House of Representatives passed a Senate bill, largely along party lines, to give those facing a terminal illness the “right to try.” That is, the right to try experimental drugs and treatments that haven’t yet been approved by the federal Food & Drug Administration (FDA). 

Of course, Congress doesn’t actually give us rights. We have always had the common law right — indeed, the human right — to freely seek a path to wellness when we are ill. 

From time immemorial. Even before the FDA.

So, this legislation was, more correctly put, a way to announce that the congressionally-​created FDA would stop blocking our freedom … provided we are dying and the government-​approved medical establishment has no more licensed hope to offer.

The bill now goes to President Trump. “People who are terminally ill should not have to go from country to country to seek a cure,” he declared in his last State of the Union, “I want to give them a chance right here at home.”

Democrats overwhelmingly disagreed. 

“This will provide fly-​by-​night physicians and clinics the opportunity to peddle false hope and ineffective drugs to desperate patients,” argued Rep. Frank Pallone (D‑N.J.).

Rep. Jan Schakowsky (D‑Ill.) likewise charged that the legislation “puts patients at risk by allowing the sale of snake oil.”

But of course these patients are dying. That’s already as “at risk” as it gets. Our right to live includes a right to try to live.

This is Common Sense. I’m Paul Jacob.

 

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Accountability folly free trade & free markets general freedom moral hazard nannyism national politics & policies responsibility too much government

DumpCare

healthcare, Trumpcare, Obamacare, medicine, costs, regulations, Medicaid, single payer

Speaker of the House Paul Ryan insists that his “TrumpCare” plan to replace ObamaCare will decrease medical insurance rates. Others argue that his American Health Care Act will increase those rates. Likewise, he expects it to reduce strain on federal budgets; others deny this outright. The “coverage” issue is just as contentious.

TrumpCare is a mess because it is isn’t “DumpCare.” What’s needed is not yet another regulation-​plus-​subsidy system. We need repeal and then … more repeals.

Unfortunately, President Donald Trump has never really been on board with this. He has promised that no one would lose “coverage,” assuming that “coverage” is “health care.”

It is not. State charity programs like Medicaid (upon which ObamaCare relied way too much) are merely ways to pay for services. Dumping a gimcrack payment system is not the same as decreasing medical services. “DumpCare” wouldn’t dump care, only insane government.

For example, we know that health care outcomes for poor folks without Medicaid turn out to be better than poor folks with Medicaid.* Increasing the number of people on formalized subsidy programs is no panacea.

Besides, ObamaCare severely under-​delivered on “coverage.”

New programs, nevertheless, are traps, regardless of demerit: once you provide a benefit, folks come to rely on it and demand more — objecting when it’s taken away. Which is why few programs are ever repealed, despite failing to meet original expectations.

So far, the “small government party” hasn’t found the courage to actually limit government. Do Republicans really believe what they say, that fewer regulations and subsidies will lead to lower costs and better service?

It seems Republicans won’t take their own prescription.

This is Common Sense. I’m Paul Jacob.

 

* Oregon’s 2008 Medicaid “natural experiment” provides reasons to question the merits of the program. As the initial, randomized, controlled study found, “Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services.…”

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ideological culture individual achievement national politics & policies

Ditch Your Male Doctor

woman, female, doctor, gender, medicine, illsutration

It’s the Christmas season, so wait to do this until the New Year, but … be sure to fire your male doctor.

He’s a quack.

At least, that seems to be the gist of James Hamblin’s “Evidence of the Superiority of Female Doctors,” a report in The Atlantic on a new Harvard School of Public Health study.

“Patients cared for by female physicians,” Hamblin writes, “had lower 30-​day mortality than did patients treated by male physicians.” The rate for female physicians was 11.07 percent and for males 11.49 percent.

Though a “modest” difference, it’s still “clinically meaningful.”

The study (conducted by an all-​male team) tracked more than 1.5 million Medicare patients treated by nearly 60,000 general internists.

“If male physicians were as adept as females, some 32,000 fewer Americans would die every year — among Medicare patients alone,” concludes Hamblin. “[T]hese numbers may be what it takes to spur equal (or better) compensation and opportunity for female physicians.”

NBC News played the equal pay angle as well: “Many hope the new study pushes hospitals to promote and pay women equally.”

Still, in a poignant moment of concern for the lesser sex, correspondent Kristen Dahlgren advised, “Maybe not a reason to ditch your male doctor, but there might be lessons to learn from his female colleagues.”

Indeed, the study explained that “physician sex by itself does not determine patient outcomes,” arguing instead that “differences in practice patterns between male and female physicians” must be investigated.

Smart.

The other thing, of course, is that every doctor, male or female, is an individual — not merely an XX- or XY-​chromosome carbon copy.

Sex isn’t everything.

This is Common Sense. I’m Paul Jacob.

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woman, female, doctor, gender, medicine, illsutration