Friday, April 18, 2014

You Say You Want Single-Payer Health Care

O, Canada!

If Obamacare was always meant to be a leap toward a single payer health care system, we are certainly within our rights to examine how well the system is working in… for example… Canada. 

Since Canada is an advanced industrial democracy, comparing us to them is certainly reasonable.

So says, Sally Pipes this morning. Having studied the Canadian system in depth, she draws some harsh conclusions:

Single-payer’s cheerleaders cite Canada as proof of the system’s superiority. It’s a foolish fetish: Our northern neighbor’s health-care system is plagued by rationing, long waits, poor-quality care, scarcities of vital medical technologies and unsustainable costs. That’s exactly what’s in store for America if we follow Canada’s lead.

Rationing means that needed care is unavailable to all but those who can pay for it out of pocket… presumably, by traveling to the United States. 

Pipes explains:

To keep a lid on costs, Canadian officials ration care. As a result, the average Canadian has to wait 4½ months between getting a referral from his primary-care physician to a specialist for elective medical treatment — and actually receiving it.

Mind you, “elective treatment” in Canada doesn’t mean Botox or a tummy tuck. We’re talking about life-or-death procedures like neurosurgery, orthopedic surgery or cardiovascular surgery.

Of course, some American states adopted Obamacare before the others. Take Massachusetts, where they call it Romneycare:

Bostonians face the longest wait times for an appointment in America, according to Merritt Hawkins, a consultancy. That’s no surprise, given that Massachusetts essentially enacted ObamaCare in 2006, four years before it went national. Even so, the average wait in Boston is 45.4 days — about three months less than in Canada.

Obviously, anyone who thought that the best way to defeat President Obama was to run a candidate who had implemented the predecessor of Obamacare in Massachusetts was wrong. Mitt Romney would do the Republican Party an enormous favor by retiring from the political scene.

But, going back to Canada, that very wealthy nation promises a lot more care than it can provide. Because, a system run by government bureaucrats is markedly inefficient:

There’s also a severe shortage of essential medical equipment. Canada ranks 14th among 22 OECD countries in MRI machines per million people, with an average wait time to use one at just over eight weeks. Canada ranks a dismal 16th in CT scanners per million people, with an average wait time of over 3.6 weeks.

The United States ranks second in MRI machines per-capita, and fifth in CTs.

Every Canadian is technically “guaranteed” access to health care. But long waits and the scarce resources leave many untreated.

Speaking of inefficiency, when people cannot receive needed treatment promptly, their conditions get worse. This means that they will need “more expensive and extensive treatments.”

Pipes writes:

When people aren’t treated in a timely fashion, their conditions worsen, which often means significantly more expensive and extensive treatments. The Center for Spatial Economics, a Canadian research outfit, estimates that wait times for just four key procedures — MRI scans and surgeries for joint replacement, cataracts and coronary-artery-bypass grafts — cost Canadian patients $14.8 billion a year in excess medical costs and lost productivity.

As for the cost, Canadians pay for it through taxes. Naturally, this does not apply to the people who do not pay taxes. In America, most of that cohort votes Democratic.

If you think that your insurance premiums are high, look at how much you would be paying in taxes to get Canadian-style substandard, rationed treatment:

Nor is Canadians’ treatment close to “free”: Patients may only have to pay a nominal fee when they get treatment. But the typical Canadian family pays about $11,300 in taxes every year to finance the public-insurance system.

If Not Botox, What?

If not Botox, what?

Is there any magical substance that will stop or even reverse the aging process where it really matters… on your face.

No one wants to lose face, but since, as I posted yesterday, Botox leaves people without a face, it is clearly not a solution.

Now, a Canadian laboratory has discovered that the key to reverse the skin’s natural tendency to age lies in… exercise. At least, it does so if you are a mouse.

But recently, researchers at McMaster University in Ontario began to wonder if such alterations were inevitable. Earlier studies at McMaster involving mice that were bred to age prematurely had shown that a steady regimen of exercise could stave off or even undo the signs of early aging in these animals. When members of this breed of mice remained sedentary, they rapidly grew wizened, frail, ill, demented, and graying or bald. But if they were given access to running wheels, they maintained healthy brains, hearts, muscles, reproductive organs, and fur far longer than their sedentary labmates. Their fur never even turned gray.

Of course, we humans long ago swapped our fur for naked skin. But if exercise could keep animals’ outer layer from changing with age, it might, the researchers speculated, do the same for our skin.

But, does the same apply to humans? First results suggested that it did, but the researchers needed to factor in lifestyle and diet. So they ran an experiment. The results were surprising:

So the researchers next set a group of sedentary volunteers to exercising, after first obtaining skin samples from their buttocks. The volunteers were aged at 65 or older and, at the study’s start, had normal skin for their age. They began a fairly straightforward endurance training program, working out twice a week by jogging or cycling at a moderately strenuous pace, equivalent to at least 65 percent of their maximum aerobic capacity for 30 minutes. This continued for three months. At the end of that time, the researchers again biopsied the volunteers’ skin.

But now the samples looked quite different, with outer and inner layers that looked very similar to those of 20- to 40-year-olds. “I don’t want to over-hype the results, but, really, it was pretty remarkable to see,” said Dr. Tarnopolsky, himself a middle-aged exerciser. Under a microscope, the volunteers’ skin “looked like that of a much younger person, and all that they had done differently was exercise.”

As it happens, exercise does not erase wrinkles or other signs of good character and wisdom. Still, it clearly improves the quality of what the Times calls, “the skin beneath our shorts:”

Nor is there evidence that exercise reverses wrinkling and other damage from the sun, some of which many of us accumulate during outdoor exercise. Still, Dr. Tarnopolsky said, “it is astonishing to consider all of the intricate ways in which exercise changes our bodies” —including the skin beneath our shorts.

If none of that works, there’s still the tried and true formula for saving face: stay out of the sun and never smile!

Wherefore, the Ukraine

This morning David Goldman sizes up the crisis in the Ukraine. Since his commentary proved to be exceptionally accurate on the crisis in Egypt, we take his views with the utmost seriousness.

Admittedly, improving on what foreign policy experts have been saying is not a great challenge, but, someone had to do it.

First, Goldman debunks their wishful thinking. He dismisses the idea that the recent rebellion against the elected president would put the Ukraine on the road to democracy.

For those who worry about Putin sending his army into the Ukraine, Goldman points out that the commanders of the Ukrainian army are… Russians.

He writes:

When Ukraine imploded, our leaders–from Victoria Nuland at the State Department to the neo-conservatives–rather assumed that we would reverse Ukraine’s polarity to the West, and humiliate Russia with the loss of Crimea. Putin called our bluff, and we had no viable military options.

Putin doesn’t need to send the Red Army into Ukraine. Every Ukrainian officer above the rank of major came up through the ranks in the Red Army. Ukrainian commanders won’t fight the Russians. They are the Russians. Yesterday we watched Ukrainian paratroopers turn their armored vehicles over to Russian separatists. Maybe John McCain can send them more weapons to hand over to Moscow.

As always, Goldman offers us some much-needed perspective on the reality of the Ukraine:

Never mind that Ukraine is a basket case with a per capital income a tenth that of the European Community, whose best young people (along with some of its worst) have left the country, with a ruined economy and a declining population. Putin isn’t playing by the rules printed on the inside top cover of the board game. He’s another Hitler! Where is our Churchill? It’s a Monty Python remake of Dr. Strangelove. A few provocateurs holding a Russian flag pass out handbills demanding that Jews in Eastern Ukraine register with the authorities, and the whole of the media as well as the Obama administration hyperventilates, until the affair is exposed as a hoax.

According to Goldman, Putin will now sit back and watch the Ukraine fall apart, waiting for the opportunity to pick up whatever pieces he chooses:

The threat, as the great chess theorist Aron Nimzowitsch wrote, is mightier than the execution. Putin will let the West take ownership of the Ukrainian disaster until it festers, and then he will pick and choose what he wants. We will huff and puff and bloviate about Putin, the new Hitler, while Ukraine’s economy disintegrates. Bismarck’s aphorism applies: die ganze Ukraine ist nicht die gesunden knochen eines pommerschen Grenadiers wert.

Thursday, April 17, 2014

Your Face on Botox

I assume that the powers that be at Jezebel meant this montage as a public service. If so, they have succeeded.

Using clips from a series of “Real Housewives…” shows they have offered a multitude of screen shots where women with Botoxed faces try to express emotion.

The moral of the story is that a Botoxed face cannot express anything resembling human feeling.

If this does not deter people from Botox, nothing will.

The Downside of Antidepressants

I have occasionally remarked that, while anti-depressants are a good thing they are not that good of a good thing.

Today, Dr. Doris Iarovici of Duke University asks a similar question. She knows that many students take pills to regulate their emotions. She knows that many physicians think nothing of helping students to medicate the emotions that arise from difficult life situations.

For some it might be a good thing. But there is surely a downside.

Iarovici writes:

Antidepressants are an excellent treatment for depression and anxiety. I’ve seen them improve — and sometimes save — many young lives. But a growing number of young adults are taking psychiatric medicines for longer and longer periods, at the very age when they are also consolidating their identities, making plans for the future and navigating adult relationships.

Are we using good scientific evidence to make decisions about keeping these young people on antidepressants? Or are we inadvertently teaching future generations to view themselves as too fragile to cope with the adversity that life invariably brings?

Good point. When psychiatrists hand out medication for every emotional upset, they are telling young people that they cannot manage their lives by using their own mental resources.

Even though psychiatrists are uncomfortable about handing out so many brain-altering substances, students (among others) expect to receive them. The media has been trumpeting the message that Prozac et al. will save your life, even make you a new person. Better yet, insurance companies pay more for writing prescriptions than they do for longer conversations.

More students arrive on campus already on antidepressants. From 1994 to 2006, the percentage of students treated at college counseling centers who were using antidepressants nearly tripled, from 9 percent to over 23 percent. In part this reflects the introduction of S.S.R.I. antidepressants, a new class of drugs thought to be safer and have fewer side effects than their predecessors.

While bemoaning the fact that today’s patients are being induced to believe that they cannot function without some psychoactive substance, we must note that many of today’s psychiatrists do not know enough, have not had enough training to help patients make their way through complex life situations.

It’s nice to blame the insurance companies, but, for all we know, many psychiatrists are at their best writing prescriptions, and at their worst giving advice.

To illustrate her point, Iarovici describes a patient of hers, a young women who was trying to get off of anti-depressants. The patient was not happy with life without her anti-depressants, but still, Iarovici points out, was she really ill or was she facing a difficult life situation.

Surely, the young patient was depressed, but she was also suffering from anomie, the kind that is produced by disrupted routines and social dislocation.

Iarovici describes the anomie:

My patient had moved away from her husband to start graduate school, since his job kept him in another state. She’d expected the temporary separation to be hard but navigated it smoothly, focusing on school, with occasional visits.

In the summer, she moved in with him and was surprised to feel emotionally “muted.” It was nothing like her college depression, but she worried. She’d counted on the reunion being easy.

As she looked back, she acknowledged that moving again, leaving behind new school friends and routines, and not having the structure of school or work to fill her time might have challenged anyone. She noticed small ways in which she and her husband were growing in different directions, and this alarmed her. She wanted to resume medication, thinking that maybe the summer would have gone better with an antidepressant.

And also:

But my patient’s symptoms were only one part of a compelling life story: that of a young woman trying to balance personal aspirations with intimacy. She was discounting her emotional reactions to difficult life events. These struggles might be the very moments that precipitate personal growth.

She concludes:

We walk a thinning line between diagnosing illness and teaching our youth to view any emotional upset as pathological. We need a greater focus on building resilience in emerging adults. We need more scientific studies — spanning years, not months — on the risks and benefits of maintenance treatment in emerging adults. Maybe someday, treating people like this young graduate student, I won’t have to feel like we’re conducting an experiment of one.

Iarovici is certainly correct. But, one would like to know how many psychiatrists are trained to help their patients to build resilience and to manage their lives.

Hating Freedom

As is his wont, Mark Steyn has a few more things to say about the current brouhaha over Ayaan Hirsi Ali and Brandeis University.

He wishes to emphasize that left thinking people have decided that free speech protection does not apply when one's words offend Islam.

When a Western feminist like Germaine Greer speaks out in favor of female genital mutilation, Brandeis welcomes her. When Hirsi Ali speaks out against the same practice, she is  disinvited… eventually, denounced for being strident and provocative.

Steyn explains:

White feminist Germaine Greer can speak at Brandeis because, in one of the more whimsical ideological evolutions even by dear old Germaine’s standards, Ms Greer feels that clitoridectomies add to the rich tapestry of ‘cultural identity’: ‘One man’s beautification is another man’s mutilation,’ as she puts it. But black feminist Hirsi Ali, who was on the receiving end of ‘one man’s mutilation’ and lives under death threats because she was boorish enough to complain about it, is too ‘hateful’ to be permitted to speak. In the internal contradictions of multiculturalism, Islam trumps all: race, gender, secularism, everything. So, in the interests of multiculti sensitivity, pampered upper-middle-class trusty-fundy children of entitlement are pronouncing a Somali refugee beyond the pale and signing up to Islamic strictures on the role of women.

While we all wait to see how many Muslims are willing to stand up for Hirsi Ali’s right to free expression, we note, with Steyn that Islam, as a cultural force, has long been the enemy of free and open inquiry and debate.

During Europe’s Dark Ages, learning was kept alive by Muslim scholars. Human civilization owes a debt to Averroes and Avicenna, among others, for protecting the writings of Aristotle et al.

But, now, students on American campuses have learned that since all questions have been settled, no debate, no diversity of opinion should be allowed.

Good-bye, marketplace of ideas.

Steyn notes:

Young Erin Ching at Swarthmore College has grasped the essential idea: it is not merely that, as the Big Climate enforcers say, ‘the science is settled’, but so is everything else, from abortion to gay marriage. So what’s to talk about? Universities are no longer institutions of inquiry but ‘safe spaces’ where delicate flowers of diversity of race, sex, orientation, ‘gender fluidity’ and everything else except diversity of thought have to be protected from exposure to any unsafe ideas.

University campuses must now be “safe spaces” where no one will ever challenging the prevailing orthodoxy.

Muslim cultures have been operating according to this rule for a thousand years. We are within our rights to ask: At what price? What are the consequences of stifling free expression, intellectual and scientific inquiry, to say nothing of free enterprise.

Steyn sums it up:

As it happens, the biggest ‘safe space’ on the planet is the Muslim world. For a millennium, Islamic scholars have insisted, as firmly as a climate scientist or an American sophomore, that there’s nothing to debate. And what happened? As the United Nations Human Development Programme’s famous 2002 report blandly noted, more books are translated in Spain in a single year than have been translated into Arabic in the last 1,000 years. Free speech and a dynamic, innovative society are intimately connected: a culture that can’t bear a dissenting word on race or religion or gender fluidity or carbon offsets is a society that will cease to innovate, and then stagnate, and then decline, very fast.

One is naturally reminded of famed atheist Richard Dawkins’ remark:

All the world’s Muslims have fewer Nobel Prizes than Trinity College, Cambridge. They did great things in the Middle Ages, though.

Of course, Dawkins was widely attacked for the remark. He later tried to set things straight:

I should have compared religion with religion and compared Islam not with Trinity College but with Jews, because the number of Jews who have won Nobel Prizes is phenomenally high.”

Race does not come into it. It is pure religion and culture. Something about the cultural tradition of Jews is way, way more sympathetic to science and learning and intellectual pursuits than Islam. That would have been a fair comparison. Ironically, I originally wrote the tweet with Jews and thought, That might give offense. And so I thought I better change it.

Of course, one does not like to paint any culture with such a broad brush. It’s like saying that all Muslims are terrorists, which is absolutely false.

And yet, a civilization may be judged by its track record, by what it has and has not contributed to the betterment of its people. When it comes to Islam, and increasingly, when it comes to the Western radical left, the record is not very inspiring.

Wednesday, April 16, 2014

Bossy but Unsatisfied

Oh, my! Oh, my!

Ms. Bossy is having a problem. She’s so completely befuddled that she has written to Emily Yoffe, author of Dear Prudence.

You see, Ms. Bossy is a strong woman. She is in control. She is in charge. One suspects that she even climaxes during sex with her husband. And yet, and yet, she finds herself unsatisfied.

Having succeeded in taking charge of her husband, she now wants him to change his stripes and to become an alpha male. She wants him to ravish her in bed. One imagines that this has something to do with feeling like a woman, as opposed to feeling like a feminist.

It’s cognitive dissidence at war against itself.

Ms. Bossy—my epithet-- doesn’t say that she is a feminist, but you do not have to read between the lines or peek beneath the sheets to know that she is. It’s also easy to see that her husband is a good feminist, a sensitive, caring, compassionate soul who is happy to see her reaching her full potential by living out her bossiness.

Here is her letter:

I'm a take-charge kind of woman, and my husband normally is happy to let me control most situations unless they are serious issues dealing with our family. Our marriage works on that capacity. The trouble I have is, in the bedroom, I actually want the opposite. I want him to take the lead, be more commanding, and me to be more submissive. He goes along, does what I want, and half the time I have to guide him, goad him, and tell him to tell me what he wants or just simply do it. I'm finding it difficult to have a discussion with him about what turns my crank per se. Our sex life is good, we both walk away satisfied, but I just know it would be so much better (for me) if he went outside his normal personality a bit. How do you suggest I go about telling him, hey, I want you to be more demanding/bossy/alpha/dominant in bed?

Of course, the irony is especially rich: she is bossing her husband around and telling him to be more bossy.

Emily Yoffe gets it:

It is somewhat ironic that you're in the position of saying, "OK, next on the agenda, I order you to stop taking orders from me when we're in bed, and start acting more caveman. I want you to drag me by the hair (don't pull really hard, just kind of tug) and take me against the bathroom wall when we're getting ready to go out because you find me so sexy you can't wait." The reason the Fifty Shades of Grey trilogy was such a sensation is because lots of women, even alpha women like yourself, want to feel taken in bed. But when you are an alpha woman and you have an egalitarian relationship, it's hard to say, "Please be a beast!" 

Yoffe recommends that the two of them have a conversation, but, it seems that that is more the problem than the solution. They have been having conversations. During the soulful communications she expresses her feelings and tells him what her needs are. Were he to do as she says, he would be playing a role in her script, thus, conceding his free choice, whatever is left of it, by taking orders from her.

One fears that this woman is in one of those situations where you can’t get there from here.

If she really wants him to become more of a beast in bed, she will have to learn to behave differently, to give up power, control and command, to become more feminine. Perhaps she would like to do so. I suspect that she doesn’t know how.

The unspoken side of the story is that if this goes on very much longer she will feel compelled to find someone who will ravish her… only it won’t be her husband.

Having turned hubby into Casper Milquetoast, she will now go looking for a biker dude, a bad boy, someone who is so completely incult that he’s never heard of Betty Friedan or Gloria what’s-her-name.

She will, in other words, find someone who will call the bluff, who will disrespect her sensibility, who will be the man that her husband has been warned not to be. She will find Macho Man… though probably not in the Village People sense of the term.