Cataracts

Things started looking kind of blurry, so I figured it was time for some new glasses.  It turns out, I have cataracts!  I have surgery this morning.

I had assumed that they just peel the cloudy film off.  It turns out that they take out the lens inside the eye.  But then, these days, they replace it with a lens implant that actually corrects vision!  The doctor told me that after all of this is over I might not even need glasses!  Which would be for the first time since around seventh grade.  I am astounded and kind of excited about it.

The operation is reportedly no big deal to go through, nothing to worry about.  My only concern is my vision between the first surgery and when it is all over–three weeks later, they’ll do my other eye, and then it takes a few more weeks to heal and for the brain to get used to the new optic signals–so I may have some visual limitations for a month or more.

I’m thinking that after today I’ll have one really good eye, adept at distant vision, but my other eye will still be bad and my glasses will be useless.  Will I be able to read?  Fool with the computer?  Later my other eye will get a new lens for close vision and all will be well.  (Realistically, I might need glasses for reading, though those reading glasses you buy at the drug store may be all I’ll need.)  But what to do until then?

I’m pretty sure I’ll find a way to function.  I’m not supposed to do anything for a couple days after the procedure, which I’m looking forward to also, an enforced rest without guilt.  I’ll probably keep up the blog–that surely doesn’t count as “anything”–though I might have trouble seeing for a day or two.  So if I miss some days of posting, you’ll know why.

Antibiotic woes

In today’s scientific livestock industry, cattle are often given antibiotics. Not as medicine but “to fatten them up.”  Apparently the drugs kill beneficent bacteria in the animal’s digestive system that causes them to put on weight.  Now the light has dawned in the minds of some medical researchers.  Could the heavy use of antibiotics among human beings be a factor in our obesity problems?  Are we fattening ourselves up like drugged cattle in a feed lot?  See Early use of antibiotics linked to obesity, research finds – The Washington Post.

In other antibiotic news, a “superbug“–a strain of bacteria completely resistant to all known antibiotics killed six people at the National Institute of Health’s Clinical Center.  The linked article estimates that 6% of American hospitals are infested with this thing.  (This doesn’t seem to be a case of what scientists have been worried about, bacteria that have developed a resistance to antibiotics because of their overuse and evolved into something that cannot be killed.  [That wouldn't be evolution, by the way, just natural selection, which I don't think anyone denies.  Faster animals outrun predators, animals adapt, and the fittest do survive.  What Darwin did was insist that natural selection eventually turns one species into another.]  Anyway, this superbug is normally one of those friendly bacteria that inhabits our bodies, but when a person’s immune system goes wrong, it turns into a monster.

The great soda grants

George Will describes how a stimulus program that became part of Obamacare shelled out millions of dollars worth of grants to lobby lawmakers against soft drinks:

Because nothing is as immortal as a temporary government program, Communities Putting Prevention to Work (CPPW), a creature of the stimulus, was folded into the Patient Protection and Affordable Care Act of 2010, a.k.a. Obamacare. And the Centers for Disease Control and Prevention (CDC), working through the CPPW, disbursed money to 25 states to fight, among other things, the scourge of soda pop.

In Cook County, Ill., according to an official report, recipients using some of a $16 million CDC grant “educated policymakers on link between SSBs [sugar-sweetened beverages] and obesity, economic impact of an SSB tax, and importance of investing revenue into prevention.” According to a Philadelphia city Web site, a $15 million CDC grant funded efforts to “campaign” for a “two-cent per ounce excise tax” on SSBs. In California, an official report says that a $2.2 million CDC grant for obesity prevention funded “training for grantees on media advocacy” against SSBs. A New York report says that a $3 million grant was used to “educate leaders and decision-makers about, and promote the effective implementation of . . . a tax to substantially increase the price of beverages containing caloric sweetener.” The Rhode Island Department of Health used a $3 million grant for “educating key decision-makers to serve as champions of specific . . . pricing and procurement strategies to reduce consumption of” SSBs. In government-speak, “educating” is synonymous with “lobbying.”

Clearly some of the $230 million in CDC/CPPW anti-obesity grants was spent in violation of the law, which prohibits the use of federal funds “to influence in any manner . . . an official of any government, to favor, adopt, or oppose, by vote or otherwise, any legislation, law, ratification, policy, or appropriation.” But leaving legality aside, is such “nutrition activism” effective? . . .

Research indicates that overweight individuals have “reasonably close” to accurate estimates of the increased health risks and decreased life expectancy associated with obesity. Hence the weakness of mandated information as a modifier of behavior. A study conducted after New York City mandated posting calorie counts in restaurant chains concluded that, while 28 percent of patrons said the information influenced their choices, researchers could not detect a change in calories purchased after the law.

Other research findings include: A study of nearly 20,000 students from kindergarten through eighth grade found that among those with easy access to high-calorie snacks in schools, 35.5 percent were overweight — compared with 34.8 percent of children in schools without such snacks. Nutrition policy is replicating a familiar pattern: Increased taxes on alcohol and tobacco mostly decrease consumption by light users, not the heavy users who are the social problem and whose demand is relatively inelastic.

The robust market in diet books, weight-loss centers, exercise equipment, athletic clubs, health foods — between 1987 and 2004, 35,272 new food products were labeled “no fat” or “low fat” — refutes the theory that there is some “market failure” government must correct. But as long as there are bureaucrats who consider themselves completely rational and informed, there will be policies to substitute government supervision of individuals for individuals’ personal responsibility.

As the soft paternalism of incentives fails, there will be increasing resort to the hard paternalism of mandates and proscriptions. Hence the increasing need to supervise our supervisors, the government.

via George Will: Why government needs a diet – The Washington Post.

Another thing, besides it being illegal for the government to fund efforts to lobby the government.  Who is getting these grants, and how are they spending that $15 million?  Educating  policymakers should require some handouts, a PowerPoint set up, and maybe some coffee and doughnuts.  How could that cost $15 million?

Medicare, the free market, and a drug that doesn’t work

This story will make you discouraged about BOTH the government AND the free market when it comes to healthcare.  Peter Whoriskey reports:

The U.S. health-care system is vastly overspending for a single anemia drug because Medicare overestimates its use by hundreds of millions of dollars a year, according to an analysis of federal data. The overpayment to hospitals and clinics arises because Medicare reimburses them based on estimates rather than the actual use of the drug.

The government for years has tried to rein in spending on the prescription drug, Epogen, which had ranked some years as the most expensive drug to taxpayers through the Medicare system.

Medicare’s current estimates are based on Epogen usage in 2007 for dialysis treatments. But since then, use of the drug has fallen 25 percent or more, partly because of Food and Drug Administration warnings about its perils and partly because Congress removed the financial incentives for clinics and hospitals to prescribe the drug. Because Medicare continues to reimburse health-care providers as if the dosing levels haven’t changed, the significant savings in doses has not translated into savings for the U.S. Treasury.

The amount of the overspending is more than $400 million annually, according to calculations done separately by The Washington Post and experts.

“I think we probably left money on the table,” said Rep. Pete Stark (D-Calif.), a critic of the way the drug had been used who helped shepherd through legislation that removed the financial incentives for bigger doses beginning in 2011.

The overpayment for Epogen reflects both the promise and difficulty of large-scale government reform of health-care spending.

For years, Epogen was one of a trio of anemia drugs — all manufactured by Amgen, a California biotech firm — that cost Medicare as much as $3 billion annually. Overall U.S. sales of the drugs exceeded $8 billion.

Nearly two decades after the drugs were first approved in 1989, their purported benefits were found to be overstated, and the FDA issued a series of stern warnings about their potentially deadly side effects, such as cancer and heart attacks.

At least some of their popularity stemmed from the fact that hospitals and clinics made lots of money using them: The spread between what they paid for a dose and what Medicare paid them to administer one reached as high as 30 percent, according to the Medicare Payment Advisory Commission.

The incentives drove up usage. By 2007, about 80 percent of dialysis patients were getting the drugs at levels beyond what the FDA now targets as safe.

Congress pushed Medicare to revise its payment system to remove the incentives for larger doses. Under the new system for dialysis patients, Medicare pays a set fee for a bundle of dialysis services and drugs.

via Medicare overspending on anemia drug – The Washington Post.

So Medicare reimbursed based on ESTIMATES rather than actual usage?  And hospitals and doctors prescribed the drugs so much in part because “they could make so much money using them”?

Of course, the reason the drugs were so lucrative is because Medicare paid so much for them, so it’s the unholy alliance between the government and the private sector–which is at the heart of Obamacare– that is to blame.  Still, this dashes further the assumption that our medical treatment is always based on objective considerations of patient care.

Are business practices that work in other profit-making enterprises fitting for health care?  For example, why are all of these prescription drugs being advertised on television?  Are patients now “consumers” who are expected to demand certain medicines from their physicians, in which case, what happens to objective determinations in the practice of medicine?  Or are the physicians the target of these marketing campaigns, in which case, again, what happens to objective determinations in the practice of medicine?

Give fetuses anesthetics before aborting them

On Thursday, Arizona’s law forbidding abortion after 20 weeks went into effect.  It prohibits abortions performed after the point at which science shows that the fetus can feel pain.  The Arizona law was upheld by a court, and similar “fetal pain” bills are in the works in other states.  A small victory, perhaps, but it does underscore the fact that the fetus in the womb is a human being.  But pro-abortion zealots cannot tolerate even this small concession.  Harvard law professor I. Glenn Cohen offers a different solution for fetal pain:

As proof that fetuses are capable of feeling pain, Nebraska’s law notes that physicians often administer anesthesia to fetuses. This is done to relax muscles or to prevent neurodevelopmental problems later on — not, medically speaking, to control pain. But if these fetuses were capable of feeling pain, administering anesthesia would likely prevent any sensation of pain, just as it does in children and adults. Thus, there is no legal reason to prohibit abortion at 20 weeks: We can prevent fetal pain during an abortion — without burdening a woman’s right to that abortion — by requiring the administration of anesthesia to the fetus.

via The flawed basis behind fetal-pain abortion laws – The Washington Post.

 

Obamacare provisions that go into effect today

As of today, women can get free contraceptives and abortifacients, as well as other goodies that their insurance will have to give them without co-pays to doctors:

Democrats hailed the Aug. 1 introduction of these Affordable Care Act services as a turning point at which the American public would finally grasp the magnitude of healthcare reform.

The new services that will be required to be offered under insurance plans without a co-payment are well-woman visits, gestational diabetes screening, domestic violence screening and counseling, contraception and contraceptive counseling, breastfeeding support and supplies, HPV DNA testings, sexually transmitted infections counseling, and HIV screening and counseling.

via PJ Media » Dems Seize Message on Hill Hours Away from Contraceptive Mandate.

Health & Human Services considers “morning after pills,” “week after pills,” and other measures that prevent the embryo from attaching to the womb or that cause expulsion to be “contraceptives.”  For those who believe life begins at conception, that is abortion.  And we are all going to be paying for that, even if your religion forbids it.


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