NPR Article on half male/half female chickens:

That’s neat stuff. I don’t know much about these chickens. Cool stuff though. Some humans have what’s called mosaicism, where their body is made of two populations of cell, one with a chromosomal abnormality and one that doesn’t. In some cases the person can have ambiguous genitalia.

I decided to take today off. I’m only reading stuff that isn’t directly related to medicine. So, I picked up the monthly newsletter from the MSMA (Missouri State Medical Association). It laid out the healthcare bill in a simplified format, and stated point by point why it doesn’t support it (in contrast to the AMA). They bring up some good points.  I was on the fence before regarding if I want this bill to pass, but I’ve decided I hope it doesn’t. Regulating insurance companies and requiring people to have health insurance are good things, and I think laws need to be passed to make this stuff happen. There are a bunch of problems though: (1) It does nothing for torte reform. Obama said frivolous lawsuits only account for like 1% of healthcare spending. That doesn’t take defensive medicine into account. (2) It doesn’t eliminate SGR (“sustainable growth rate,” a built in system in medicare that decreases spending by decreasing the amount physicians are reimbursed for services). (3) It creates a new bureaucracy with power to independently control medicare at a pretty extreme level. (4) According to the newsletter, the bill would “effectively ban” the development of physician owned hospitals.

Overall, the bill empowers government bureaucrats, and de-empowers physicians. That can’t possibly be good for American healthcare.

Overall I don’t think the specific concern (“if doctors would be required to accept forced-on-us healthcare plans”) would become a huge problem. I know what this argument is getting at though. Medicare doesn’t pay doctors as much as private insurance. If their was a government option, it would pay as much as medicare. Cuts in medicare spending are a constant threat to control costs. “Cuts in medicare spending” translates exactly to paying physicians less for specific services. I’d be a lot more concerned if the government option was still part of the bill.

I’m not sure if private insurance will start paying doctors less if this bill passes. The way I understand it, private insurance companies pay more because of competition. They want patients to buy their insurance; doctors won’t accept insurance that doesn’t pay them well; they pay well so doctors will accept their insurance and patients will buy it. It gets more complicated with insurance through an employer, but that’s the basic idea. Hospitals and doctors accept medicare for a number of reasons. Money is one. A lot of the rest is pure human compassion.

As far as the federal government requiring physicians to accept a specific type of insurance… We doctors pay for our own training, which costs hundreds of thousands of dollars. The government had better pay us back if they want to put such financial limits on how we practice. We’re not government employees. Besides, we have a monopoly on medical know-how. That’s a lot of power. They’d better not try to push us around.

This is an example of one of the worst conditions ever. Parts of the brain that allow a person to move are damaged, but parts responsible for sensation and cognition still function to a degree. It can be hard to diagnose, but this fMRI stuff will probably make the diagnosis a lot easier. As far as the ethical stuff is concerned…we’re standing on the doorstep of a catastrophe in the healthcare system, directly related to rising costs. This condition is rare compared to the number of people who truly become vegetables because of less selective brain damage. I cared for armloads of them at St. Elsewhere.  It costs ungodly amounts of money to keep someone with either condition “alive.” Costs have to be cut somewhere. Metaphorically speaking, we either cut mammography for 40 year old mothers with early breast cancer, or we stop keeping vegetables “alive,” even if there is the off chance they have a spark of consciousness somewhere.

I side with the mothers.

I like this term. It seems inflammatory – I know. But it is an honest description of a necessary mechanism of any universal systems of healthcare. We can’t just shovel money at hopelesscases involving patents who are more than likely not even fully present. And at some point, any such system will have to assemble a group of qualified people – a panel – to investigate and determine what represents a “hopeless” or non-feasible case.
If your politics isn’t benefited by the word “death” you can play with the semantic. Call it Life Panels if you want. Let’s wrap it in numerous layers of ambiguous arbitrary catch-phrase description. Regardless, the necessity remains and the debate is valid. Not adding guidelines for the mechanism in a bill establishing universal healthcare changes nothing. Universal healthcare at our stage of medical technology requires death panels.

I still don’t have much love for the Creationist movement, but this Ben Stein movie is hilarious. It, among other things, follows scientists who were blacklisted for being associated with “intelligent design.” It’s pretty well done. Made me laugh.

The problem I have with the word ”patriotism” is that it is inseparable from loyalty to ones country, and that (in general) it only comes into common use when we are at war. When we are at war, one is considered patriotic if one is willing to either go kill people for our country, or support those who go kill people for our country. Most wars in history (including those we have fought) are grossly immoral. Just read any book written by someone who served in WWI. As I said earlier, there were lots of great patriots in Nazi Germany.

In that line of thought, patriotism’s only function is rallying a population to love there own country, and hate another country (or group) enough to want to go kill people. It serves no other purpose.

Everyone would consider himself a patriot by Kevin’s definition, but though the definition sounds nice, it is functionally incomplete. War is required for patriotism to exist. War is bad. Wars do not make one great.

Craziness. I actually don’t know how to feel. I’m totally behind increased health insurance regulation, but this bill was getting out of hand. This last deal with the unions was a bit much. The Nevada thing was somewhat forgivable. The senator was looking out for his constituency. That’s totally fair. But this deal with the unions (partially exempting their insurance from the status of “Cadillac health insurance”) was ridiculous even from my point of view. It was done to keep union financial support for the democrats. That’s really, really, really partisan. I don’t see how the country could possibly benefit from that. The American people can’t stand for that kind of politics. We’ve apparently spoken in Massachusetts.

Here’s some more Noisy Dove ranting for you. Since calling my honest conclusions a Noisy Dove rant seems to make you feel superior – or less threatened perhaps

Hey now. There’s no need to get offensive. You were ranting. You love ranting.

I get really exhausted having these conversations. My personal beliefs on politics and economics are distinctly British. Its probably because I’ve been getting my news from the Economist since medical school. I let them think for me on this kind of stuff. They know more than me. The magazine is socially liberal and economically conservative. Oddly, they think Bush was one of the worst presidents in U.S. history.

American liberal political philosophy is no more illogical than American conservative political philosophy. Whenever I read something that says Bush was nobly defending our nation, and that Obama has a secret ulterior motive, I can’t help but to put on a liberal American hat and start fighting for their ideology. I just can’t help it.

I hate strong political views, because they’re dangerous, and almost across the board based on a simplified version of reality that jives with some kind of flawed political ideology. Look at the current healthcare reform bill. It is a total disaster, and the price tag is like a trillion dollars. I can almost guarantee it will make healthcare worse for everyone. Look at the war in Iraq. The American people were led to support it based on a lie. Its cost us at least a trillion dollars, and we still may loose the damned thing. On top of that, it has cost the U.S credibility throughout the world.

My point is that I don’t think we should have such strong emotional ties to political ideas. Good doesn’t come from it. They can devolve into the kind of nonsense conversations that noisydove and drdove get into.

I suppose my point is that our political conversations would be a lot more informative if they weren’t filled with characterizations of the opposing side. I have something to learn from American conservatism. You all have something to learn from American liberalism.

For Noisy Dove: Ok, that was a beautiful Noisy Dove political rant, but you’re missing my point. I’ll try to explain.

For Professor Dove: My belief that Obama is trying to merge to two Americas is based on his background and political actions. Apart from a few token consessions, nothing he’s done has been for those with power and money. That’s basically the opposite of GWB. Obama’s pushing this current healthcare reform, which will be harmful to everyone except the 40 million uninsured Americans. The democratic goody-bag (aka economic stimulus) did little for businesses, and much more for “the little guy.”  And as to your comment:

“It does, however, appear that Obama is trying something drastic to help the poor.  But capitalism doesn’t exist without the poor.  It would be interesting to hear your thoughts on how America will look in 15 years as far as the inner city world, the well-off world, and how the overall economy will function.”

I have no idea how things will look. I just know that Obama is trying to shrink the gap between the rich and the poor. Unlike Noisy Dove and Glenn Beck, he doesn’t think policies designed to do so will destroy the country. He just thinks it is the moral imperative of a government to represent all the people, including (if not especially) the poor and ignorant. Some, including Obama, actually think shrinking the gap between rich and poor will make the country stronger. If the bank CEOs had been under tighter control, the world wouldn’t be in an economic down turn. His policies reflect his ideals.

OK, so I’ve finally gotten a free minute to think about something other than cancer. I’m back in the conversation.

…the main difference between Bush and Obama is thusly:  I truly believe that Bush sought additional governmental power for the soul sake of protecting us.  I once believed Obama would fall in that same category, but based on my observations, I believe he seeks government power to control us and industry.  Maybe that is too far.  I never once thought that Bush had an underlying political agenda other than to protect us, strengthen our military, and support long-term economic growth.  Obama, to me, has an underlying political motive that scares me, mainly because I am not sure what it is.  I can only guess.  My guess is less power for the people.

I appreciate Professor Dove’s sincerity. It makes having a thoughtful conversation with someone with a differing opinion much easier. Bush and Obama are both guilty of having an underlying political agenda. Bush’s was taking control (for our economic gain, of course) of one of the most oil rich countries in the world. He pretended like we needed to take over Iraq because they had WMDs. That wasn’t true, and the intelligence was cooked. If lying about your motivations for attacking a sovereign nation doesn’t count as having an underlying political agenda, I don’t know what does.

Regarding Obama:
There are two Americas. We all belong to the first. We’re part of a group that has a decent chance of gaining economic stability. Even though our high school wasn’t the best, it at least gave us the bare bones we needed to get into and through college. Health insurance is relatively easy for us to come by, because we either have jobs or have the intelligience to find alternate ways to get it. None of us has been shot at, our parents weren’t single and 17 years old when they had us, and our experience tells us that selling crack and basketball aren’t the only two ways to escape hell, and get money and respect. That’s the second America. The inner city is large, and millions of people live there. They have no hope, because they’re ignorant (schools are horrible…I went to college with a few for a couple weeks…not pretty…ill prepared for anything but 6th grade), poor, and desparate.

Obama’s goal is to help merge the two Americas. If that means greater government control of business, and less individual freedom, I think that’s sacrifice he’s willing to make.

Reagan couldn’t have cared less about the second America. Homelessness exploded under his economic leaderships, as did the number of individual millionaires. The Bonfire of the Vanities is a classic book abou thelater. Obama doesn’t think that’s right.

Obama’s going to lie about how his ecnomic plans will help everyone. They won’t. They’re going to hurt people with money, and they’re going to try to help those without it.

Whether or not throwing money at the problem is going to work (standard democrat logic) is a totally different question. Then again, the trickle down effect wasn’t exactly a success either. Kind of like the war in Iraq.