Tag: medicine

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

Accountability crime and punishment general freedom ideological culture moral hazard nannyism national politics & policies privacy too much government U.S. Constitution

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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Tags Congress, Democrats, experimental, FDA, healthcare, medicine, right to try, rights, treatment

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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Tags costs, healthcare, Medicaid, medicine, ObamaCare, regulations, single-payer, Trumpcare

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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Tags doctor, feminism, gender, gender pay gap, healthcare, medicine

general freedom nannyism national politics & policies too much government

A Federalist Prescription

FDA, self medication, drugs, medicine, death, illustration

California has become the 32nd state to stand up for the dying.

Gov. Jerry Brown just signed the “right to try” law that the Goldwater Institute has been pushing. It allows diagnosed terminally ill patients with only a few months left to live to try “experimental” medications.

These are drugs that haven’t passed through all the Food and Drug Administration’s many hoops.

The rationale for the law is that the FDA’s decade-long, costly process is ostensibly designed to prevent “dangerous” drugs from being regularly prescribed and sold and used in the United States. To save lives, you see. But it is simply cruel to hold patients in the process of dying to the strict standards of the slow, bureaucratic federal bureaucracy. Cruel because purposeless.

The Goldwater Institute’s press release clarifies the law like this: “Right To Try is limited to patients with a terminal disease that have exhausted all approved treatment options and cannot enroll in a clinical trial. All medications available under the law must have successfully completed basic safety testing and be part of the FDA’s on-going approval process.”

Hardly radical. Indeed, it seems such a meek and mild move, to me. If you are dying, and your doctor is obliging, who is harmed?

Two things, though:

Had Americans a right to self-medicate — like we did before the Progressive Era nanny state bureaucracies were set up — this issue would not even come up. These reforms are necessary because we are not Once upon a time, all Americans could choose any medication.
This is yet another example of states effectively nullifying federal law.

More please.

This is Common Sense. I’m Paul Jacob.

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Tags FDA, medicine, nanny state

Common Sense crime and punishment nannyism responsibility

First, Do No Harm

I wish Annette Bosworth were my doctor. Since she lives and practices medicine more than1300 miles away, in South Dakota, that’s not to be.

Sadly, the question to be answered, officially, is whether Dr. Bosworth will be permitted to provide medical care to anyone in her state. Following convictions on 12 felony counts pertaining to petitions she circulated, the South Dakota Medical Board has asked Bosworth to surrender her license.

Today, Annette appears at a hearing before the medical board regarding the ultimate resolution of her status to legally practice medicine. Announcing she would fight to try to save her license, Dr. Bosworth declared, “I just can’t give up.”

No one seems to doubt that she is a caring and capable physician. At her sentencing, Judge John Brown noted the many letters he received supporting her, mostly from patients, concluding that, “you did good work.”

Even Attorney General Marty Jackley, who prosecuted her, agreed: “I join in the court’s recognition coming from those that know Dr. Bosworth best, her medical patients, that she is capable of helping them.…”

“It’s just a terrible shame,” offered her attorney Robert Van Norman, “for her, for all of us, in a rural state, to lose permanently this woman’s talents.”

It’s difficult to remain optimistic, given that Dr. Bosworth and the state medical board have clashed again and again over the years. Yet, if the board follows the “do no harm” principle of medicine, they’ll not prevent Dr. Bosworth from regaining her license and again providing the highest quality of care to the people of South Dakota.

This is Common Sense. I’m Paul Jacob.

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