Morning Ed: Health {2017.02.01.W}

Wow, this is scary and awesome. Good work, people.

Eric Boehm writes about how an arbitrary hospital licensing law led to an infant’s death. I can abstractly understand the notion of a “certificate of public need” given the entrepreneurship of many medical service providers, hospitals (as opposed to clinics and urgent care centers) tend to be financially self-limiting.

So if we end up able to pull this off, that may sidestep the question of paying organ donors. I, for one, welcome our porcine donors…

The worst of the ecig studies are the ones that present scenarios that no vaper would ever do, like 5 volts for ten seconds. Of course you’ll find carcinogens, and blaming that on ecigarettes is like burning steak to a crisp and finding carcinogens in the char and blaming the steak. Well, now they’re worried about carcinogens in char.

Only Trump can save us!

This is why Trump won. I mean, why Le Pen will or something.

I’d be interested to find out what May has in mind here, but my default is to keep them out, out, out.

Mother Jones takes a dark look at the medical side of childbirth, and takes issue with the anti-cesarean movement.


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Will Truman is a former professional gearhead who is presently a stay-at-home father in the Mountain East. He has moved around frequently, having lived in six places since 2003, ranging from rural outposts to major metropolitan areas. He also writes fiction, when he finds the time. ...more →

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64 thoughts on “Morning Ed: Health {2017.02.01.W}

  1. The French have been generally more accepting of state paternalism than people in the Anglophone world. Years ago there were a rash of books on why French women* were so thin and how you could do it to. Slate pointed out that the French get away with their diet to an extent because they are more accepting of state paternalism and the Third French Republic gently guided French people away from the eating habits that led to the obesity epidemic in Anglophone countries. This includes discouraging kids from snacking between meals. I’m not sure if the modern French would be as accepting of state paternalism though.

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  2. Chuck Schumer is already working on the smear campaign against Gorsuch

    “Given his record, I have very serious doubts about Judge Gorsuch’s ability to meet this standard. Judge Gorsuch has repeatedly sided with corporations over working people, demonstrated a hostility toward women’s rights, and most troubling, hewed to an ideological approach to jurisprudence that makes me skeptical that he can be a strong, independent Justice on the Court. ”

    http://www.businessinsider.com/chuck-schumer-neil-gorsuch-supreme-court-trump-2017-1

    He left out racist which makes me wonder if he is getting senile.

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    • Until and unless the Dems somehow engineer to keep Gorsuch in limbo for more than 12 months conservatives have no standing what so ever to complain about the treatment of their supreme court nominees without being laughed out of the room.

      That said I don’t personally think there’s much reason to go to the mat filibustering Gorsuch. Maybe some to get some hypocritical screeching out of the GOP but not so much that they need to seriously consider going nuclear on it. I feel like they’d be better off playing the bigger party and keep their power dry for when/if (heavens forfend) a liberal justice needs to be replaced.

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      • It seems like we’re at a point where it’s time to stop slowly walking down the path and just follow it to its logical conclusion. 2016 was the end of cooperation on the topic. There will never again be a bipartisan vote in support of a SC nominee. The SC filibuster is gone sooner or later, so we might as well whack it now. Seats will remain empty until the same party controls the White House and the Senate. The result will be more extreme justices on both sides. We might as well just accept it as the new normal and move on, skipping the faux-principled theatrics and pearl clutching.

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        • Chait agrees with you. I’m persuadable though I’m unsure if the Dems would be better off letting Gorsuch go by in the interest of appearing “the bigger man” on the subject and in the interest of really gaining credibility to fight next time when they may be replacing a liberal justice.

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          • I’m normally a “high road” type of guy, but I think the earth has already been scorched on this topic. Taking the high road doesn’t seem to yield any rewards beyond spiritual ones. Maybe that’s some solace for the small percentage of them who have souls. Along the same lines, fighting this nomination or voting for him makes no practical difference, so I’m indifferent.

            The only question is whether to force the filibuster to go away now or later. Even that doesn’t matter because it’s now clear that allowing the other party to obstruct your nominations in anyway can’t possibly pay off. The filibuster will never be a factor again. You’d be crazy to allow your opponents to have any input at all, because they won’t give you any ground when the tables are turned. From here on out, it’s whatever you can get away with.

            Sad.

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              • There is that possibility. I really don’t get why people see him as such a disaster. He seems to be a respected appellate court judge. The Constitution allows Trump to nominate Honey Boo Boo or Vladimir Putin to the court, and I’m only 50% certain the Republicans would vote against it, so it seems like we should count our blessings and take it as a minor win that he took this one seriously.

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                  • See, this “picking battles strategically” is the Maginot Line of politics.
                    It is a remnant of the last war assuming a different type of enemy with different tactics.

                    Did Trump not appoint Roy Moore because he wanted to pacify Dems, because he wanted to get some Dem votes?

                    Hell no.
                    He didn’t pick Gorsuch anyway. Some aides did and thrust it under Trump’s nose for signature. Had they picked Moore, or Honey Boo Boo or Omarosa Trump would have signed off. We know this man and how he acts.

                    Dems have no power to gain favor with Trump; he and his base are animated by a seething hatred for us, and nothing will quench that fire.

                    There isn’t any universe in which Trump would decide publicly to “work with” Schumer or Pelosi or any other Dem.

                    We have absolutely nothing to gain from accommodation, moderation, “picking battles” or compromise.

                    Conversely, the more we enrage him, belittle him, and bait him into self-destructive petty fights, the more we connect Trump to every Congressman and Senator up for re-election, the better our chances of boosting Dem turnout in 2018.

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                    • Technically the Maginot line is the opposite of picking your battles wisely.

                      I don’t have any great advice for you all, since I’m ok the Gorsuch pick. I also think Garland should have gotten a hearing and a simple party line “No thankyou” vote (but I guess McConnell didn’t think he could hold the team together? I never got a good breakdown on that one).

                      But purely from a “what would I do” political prudence thing, I’d defend in depth and inflict political damage points as I slowly retreat to the next position. The question is this: what’s the damaging thing about Gorsuch?

                      Noah Millman is closer to your team than I, he ruminates:

                      To regain the initiative, Democrats need to focus their approach to Gorsuch on their fears of Trump. Ask him about the rights of non-citizens. Ask him about war powers. Ask him about political interference in regulatory oversight. Ask him about anti-trust. Ask him about government surveillance. Ask him about whistleblowers. Heck, ask him about the emoluments clause if you want. Make it look like you’re not trying to get business done or to make reasonable compromises — make it look like you’re trying to see if Trump might have played himself.

                      Were I in your shoes (well, I sort of am, from a different vector and with fewer (good) options)… your long game will be better than your short game. I don’t think you win as anti-Trump – in that game you are just aping Trump; rather you win as not-Trump. Don’t play the anti-Trump game.

                      But maybe that’s just a concern troll… hard to tell anymore.

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                    • Yes, I know Trump didn’t pick Gorsuch, because Trump has no effing clue with regard to what a good SCOTUS judge would be. So he was given the name, probably by someone in the GOP who cares about having a good judge on the SCOTUS (and first blush is that while he may be conservative, he isn’t radical or extremist in his views, so he would be a good replacement for Scalia). My fear is that, if the Dems decide to play political football with this when they don’t have the ability to carry the ball all the way, the GOP will stop caring about a good judge and shove a nutjob down all of our throats.

                      This is not the hill to defend to the end. Yes, raise a stink. Yes, shout about the hypocrisy of the GOP in all this. Yes, grill the man like an overdone steak during the hearings, but unless something comes out that shows the guy is an extremist, confirm him.

                      The GOP has gone (IMHO) kinda rabid, and the DNC needs to say “nice doggie” until they can find a rock.

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                    • He didn’t pick Gorsuch anyway. Some aides did and thrust it under Trump’s nose for signature. Had they picked Moore, or Honey Boo Boo or Omarosa Trump would have signed off. We know this man and how he acts.

                      This is why I think we should take the win. Any time one of his aides does something sensible and Trump doesn’t make it about himself and get involved, that’s probably a good thing. As long as the Supreme Court doesn’t seem like a place where his ego is at stake, maybe he won’t feel the need to interject. What I don’t want is for him to tear up the next one his aides give him while muttering, “I’ll show them all…”

                      If we want to provoke him to escalate things out of spite, we should probably do it on issues with a shorter time constant than the lifespan of a healthy judge in his 40s.

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  3. Re: Soda Ban

    Lee is onto something here. The French have been more accepting of state paternalism and also rigid enforcers of standards for a long time. You can see this in French wine where they insist that to be properly labeled Wine X, it needs to come from a very specific region and probably be done in very specific ways. Champagne is only Champagne if it is a sparkling wine (white) from the Champagne region.

    The Angloworld especially the U.S. generally scoffs at these things but Europe especially France thinks these distinctions matter. They also have a culture of meals being proper breaks instead of a quick bite on the go or something you do at your desk. They don’t seem to eyeroll at the no e-mails after dark rules usually. Though these rules get wildly misinterpreted in the U.S. media for laughs.

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    • According to various BBC documentaries I’ve watched, the British used to believe that meals should be proper breaks and at least an hour but than the Americans came in during the 1980s and put pressure on people to work more and get things done. We were regarded as fierce task masters who ended the boozy lunch.

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  4. From Reason’s article:

    A Reason investigation relying on public records requests, legal documents obtained from sources who worked on LewisGale’s COPN applications, and interviews with experts in the COPN process reveals how Virginia’s hospital licensing laws are driving up prices, lowering the quality of care, and putting lives at risk.

    I’m sure the next installment will involve how a couple couldn’t reach healthcare services in time because they had to drive a few extra miles to a hospital-affiliated emergency room as opposed to a freestanding ED operated by a private entity, as most states prohibit them.

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  5. More evidence of The Trump Effect:

    For the first time in about 20 years, Israel has announced it will build a new settlement in the West Bank, Prime Minister Benjamin Netanyahu’s office said Wednesday.

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  6. The Mother Jones article needs to be viewed in the context that some news sources have a made a decision the last decade or so to cast childbearing in a bad light, almost as if they’re trying to use these kind of extreme, frightening stories as a form of population control. “It will totally destroy your body! You’ll never be the same!! It’s the worst thing you’ll ever endure!! Also you’ll get postpartum depression and breastfeeding sucks and raising kids is not what you thought it was going to be!!! So totally not worth it!!!”

    The irony is, studies have found women who are terrified of childbirth are more likely to experience extreme pain and their labors take longer. They’re also more likely to experience postpartum depression.

    Caesarian itself is a kind of population control because many women can only have 2-3 of them, meaning that people are forced to limit the size of their families whether they want to or not. People don’t realize when they’re young and scared and having their first baby, but you may want 3 or 4 children and not be able to because of a decision that was made possibly without medical indication.

    There’s a difference between medical malpractice (no doctor should give a woman who’s had a caesarian section, pitocin) and a widespread problem that is ruining women’s lives. To single out a VBAC at 42 weeks with pitocin and an over 9 lb baby as an example of natural childbirth gone awry is misleading and unfair. The doctor should not have done it, and most doctors would have refused. Even if it had been planned beforehand, the plans would have changed as time passed had the doctor been doing their job.

    Research indicates that even young women who have never had children sometimes develop urinary incontinence and as women age more and more will develop it even if they’ve never had children. C-sections can cause them by severing nerves. Most of us laugh about it. Most women are not sad and scared about a little leaking pee, that’s why they joke about it on Friends. A minority of women have serious life-affecting problems, but it’s not the norm like the article was portraying it to be.

    Cherry picked data (the article cites one study that shows epidurals are ok, but many others that show they cause issues for people) the most extreme situations…it’s a hit piece. Surely the point can’t be that women need MORE c-sections, since experts agree they’re being used far too often. If their point is to say “let’s use c-sections when needed, and avoid them when not” then they could have done that without the fearmongering.

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    • The article is absolutely correct that the ideal for childbirth is presented as “non-surgical, no pharmaceuticals” and that women are seldom told how even that has risks of injury and long-term complications.

      “Surely the point can’t be that women need MORE c-sections”

      If you read the article all the way to the end you’ll learn what the point is.

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