Quick Roundup 306

Tuesday, February 26, 2008

Conception Advice

Over at the addictive group medical blog, MDOD, 911Doc, who plies his trade in an emergency department, offers the following advice for couples trying to conceive: "[D]rop out of school, drink a lot, lose your job, shoot heroin, and smoke crack. Works every time."

If you find the field of medicine interesting or want to see how government intervention in medicine interferes with the vital work of physicians, this is the blog for you. And did I mention that -- despite this and partly because of this -- it's often hilarious?

I was thinking of adding it to the sidebar already when I mentioned it the other day to my wife, who is going to start her residency this summer. Now, I have to add it!

So it's there! Enjoy!

Laura Mazer on "The Business of Healthcare"

One subject that frequently comes up at MDOD is the high financial cost imposed on hospital emergency departments by the Emergency Medical Treatment and Active Labor Act (EMTALA), which forbids hospitals to deny care to patients in an emergency setting regardless of ability to pay. Regarding EMTALA, I recommend Laura Mazer's recent article in The Undercurrent, which I read Saturday at my favorite pub.

In other industries, services provided for free are considered voluntary charity. They are provided only as far as they can be supported by the business's other income, and they are neither legally nor morally required. But in healthcare, any suggestion that a hospital accept only the patients it can afford to treat is greeted with moral outrage.
The article does a good job of showing the reader that medicine is just like any other life-sustaining enterprise, and that as a moral and practical matter, it should be left free from such government interference.

Wrong Reason to Oppose McCain-Feingold

An article at National Review Online considers the dilemma John McCain faces with his impending selection of a running mate and takes a look at the opposition to campaign finance "reform" of two strong contenders for the role.
On campaign-finance reform, McCaim's signature accomplishment in the Senate, both men described policy preferences that are greatly at odds with McCain's. "I've come to the point in my career, watching campaign finance reform, having been involved in it somewhat at a state level, that the premise that government can control this stuff, or should control this stuff, is flawed," [Minnesota Governor Tim] Pawlenty told me. "No matter what they do to regulate it, it always seeps out somewhere else, so I think a better system would probably have to have full disclosure, real time, online, instant disclosure -- but quit pretending, both as a constitutional principle, or as a matter of politics, that government can contain this." [bold added]
South Carolina Governor Mark Sanford unfortunately also agrees that "money" (meaning one person having the ability to help a candidate of his choosing when another does not) in political campaigns is morally wrong, but also impossible to stamp out.

This is exactly the wrong reason to oppose McCain-Feingold. Freedom of speech does not equal an entitlement to the means necessary to broadcast what one is saying or the "right" to deprive someone else of such means. Furthermore, preventing someone from donating to the candidate of his choice violates his property rights.

Freedom of speech and property rights are not necessary vices "everyone does" to get by under government supervision. They are inalienable individual rights. The great shame of the Republicans is that they seem to have forgotten these facts, if they ever knew them in the first place.

Worth Seventy-Two in the Bush

Anyone who doubts the power of philosophical ideas need look only to what Isaac Schrodinger often calls the "magic kingdom" for examples thereof:
Saudi Arabia began interrogating 57 men Saturday who were arrested after allegedly flirting with women in front of a shopping mall in the holy city of Mecca, a local newspaper reported. [links dropped]
How much more obvious can it be that adherence to Islam means a denial of earthly happiness? This religion urges its followers to murder themselves and infidels by bribing them with sex in the afterlife, and yet treats young men like criminals for attempting to become acquainted with young women.

And yet you don't see young men standing up for themselves and rejecting Islam all over the world. This is despite the fact that they know they are alive now and the women they flirted with are real, but that they have not one jot of evidence confirming the existence of the deity that allegedly insists that they be miserable during life in exchange for eternal happiness.

Epistemology, the branch of philosophy dealing with the question "How does man acquire knowledge?", is not just some drawing-room topic that has no effect on the real world. Every man who morally accepts the authority of the Saudi religious police ultimately accepts "faith" as a correct answer to that question.

In a more rational world, our government would concern itself with Saudi Arabia only to the extent that it needed to to protect our property and lives from such people, and their mistake would destroy only their own lives.

(Scott Powell offers some further thoughts on this incident.)

-- CAV


: Added links to articles by Laura Mazer and Byron York.


Stella said...

Thanks for this post, especially the link to MDOD -- I'm going to be reading that one regularly from now on.

Gus Van Horn said...

Sure thing!

z said...


I have a youtube account and subscribed to the ARI account, and it has good videos from time to time. Thought your readers may like to know. Also, Peikoff has podcasts frequently on his website. You probably already know, just spreading the word...z

Burgess Laughlin said...

... the Emergency Medical Treatment and Active Labor Act (EMTALA), which forbids hospitals to deny care to patients in an emergency setting regardless of ability to pay.

I wonder whether this applies to all hospitals. In years past, I have read news articles about "private hospitals" that are not required to conform to this law, unlike "public hospitals" which are ostensibly private but are subject to many controls. Also, I wonder, do such public hospitals receive any benefits from government--such as research grants for clinical studies? I don't know.

I am not sure but I vaguely recall that the distinction is that "private hospitals" operate with prepaid contracts. Usually only wealthy people can afford them.

Perhaps someone in your audience knows the answer.

I wonder too if there is a parallel to colleges and universities. Some receive no federal funding and are not subject to any pressures. But, again, I don't have the technical knowledge to answer my questions.

Gus Van Horn said...


From the looks of this article, it would appear that a hospital can simply close its emergency department and continue to operate otherwise. I could, of course, be wrong.

Regarding your question about hospitals receiving federal benefits, my educated guess is that any hospital engaged in research is getting at least some federal funding beyond whatever they are normally getting from such sources as Medicare.

Your question of whether there is a parallel between private hospitals and such institutions as Hillsdale College is a good one that I simply don't know the answer to.


Mike said...

EMTALA is relevant to my work. A hospital can ignore the emergency care requirement if that hospital declines federal subsidies.

Of course, none of them do, so they are all stuck with the "unfunded mandate" as it is euphemistically called in health care administration.

I suppose an objectivist hospital might be able to operate without this issue, but the federal dollars aren't so much accepted for profit -- they are taken to guarantee the hospital a certain baseline level of activity, so they can maintain a consistent "census" of health professionals. Without maintaining a consistent census, it becomes a bit unwieldy to properly staff the place to the degree that would be necessary to respond adequately to emergent inpatient needs.

There's more to it than that, but the underlying issue is, that money comes with strings attached, and EMTALA is among the thickest.

Gus Van Horn said...

Thank you for the information. The tie-in to federal money certainly looks like it could explain how EMTALA was initially justified by the feds -- and accepted by the hospitals.

Burgess Laughlin said...

Based on what I have seen over the years, some opponents of "socialized medicine" speak only or mostly of the destructive effect of governmental controls on hospitals, doctors, and patients. Unfortunately, these opponents seldom if ever speak of the special statist privileges that some hospitals and doctors receive.

Anyone who opposes restrictive medical legislation should, I think, likewise oppose all hand-out legislation such as licensing of physicians and nurses (a narrowing of competition); subsidies for hospitals; and tax support for medical schools.

Doing so, besides being moral, may also make such intellectual activists more persuasive--because they will be more consistent in applying their principle of capitalism.

Gus Van Horn said...

That is an excellent point, Burgess.

I don't see that many Objectivists will fail to consistently reject statism for lack of appreciation of being principled, but being ignorant of the sort of government favors obscured by EMTALA and the like strikes me as a very easy trap to fall into.

Thanks for bringing up this aspect of the decline of freedom in medicine.

Jim May said...

Burgess echoes the point made by Ayn Rand in regard to all subsidies: government encouragement is just as bad as government suppression. He who pays the piper, calls the tune.

Gus Van Horn said...

The notion, popularized by the left, that the government is somehow "impartial", serves to help people forget that that is the case.

(Who gets called on to regulate everything? But whose research is automatically assumed to be biased due to its funding source?)