Category: Science and Other News

Veterans Health Administration Realizes It Should Buy, Not Build, Software

doctor-technologyImagine if you learned a government agency built its own office furniture, HVAC, or telephones. Even if there were a massive amount of corruption in government purchasing, it would be remarkable if a bureaucracy could do a better job building than buying.

Yet, for decades, the Veterans Health Administration has tried to do that with its Electronic Health Record (EHR). I cannot think of another health system that has built its own EHR, rather than buy it from a vendor. It makes as little sense as a health system manufacturing its own MRI machines.

President Trump’s newly appointed VA Secretary has confirmed he will throw in the towel on the VA’s home-brew system, VISTA, and buy a commercial EHR.

Medicare, Medicaid, Veterans Health At High Risk For Fraud, Waste, Abuse

InsFormSmallThe Government Accountability Office (GAO) has published its biennial update of federal programs “that it identifies as high risk due to their greater vulnerabilities to fraud, waste, abuse, and mismanagement…”

Healthcare programs feature high on the list. Medicare, the entitlement program for seniors, and Medicaid, the joint state federal welfare program for low-income households, are longstanding members of the list; and the GAO notes that legislation will be required to fix them: “We designated Medicare as a high-risk program in 1990 due to its size, complexity, and susceptibility to mismanagement and improper payments.” “We designated Medicaid as a high-risk program in 2003 due to its size, growth, diversity of programs, and concerns about the adequacy of fiscal oversight.”

So, that would be 27 years for Medicare and 14 years for Medicaid. Seen any progress?

Zika in Florida: A Case of Government Failure

Happy Older Couple in Beach ChairsAs readers know from a previous post, I was in Florida for Christmas, trying to unwind. Do you know who else was in Florida? Mosquitoes carrying the Zika virus! How did the U.S. government fail in its fundamental duty to protect us from this invader?

Most agree that government has a role to play in preventing and suppressing epidemics, a classic public-health problem. Viral or bacterial infections are not passed from animal to person, or person to person, by voluntary exchange. Instead, proximity to another’s infection can lead to an individual’s becoming infected, notwithstanding any market interaction.

So, even the most freedom-oriented individuals accept government spending and restrictions on individual choice when the threat of epidemic increases. In 2014, the arrival at Dallas-Fort Worth airport of a man carrying the Ebola virus caused some lawmakers to seek a ban on air travel from countries where Ebola had broken out.

Life Expectancy Drops First Time Since 1993

cdcThe Centers for Disease Control and Prevention (CDC), a federal agency, has reported the remarkable news that U.S. life expectancy has dropped for the first time since 1993. According to Mortality in the United States, 2015 (NCHS Data Brief No.  267, December 2016):

  • Life expectancy for the U.S. population in 2015 was 78.8 years, a decrease of 0.1 year from 2014.
  • The age-adjusted death rate increased 1.2% from 724.6 deaths per 100,000 standard population in 2014 to 733.1 in 2015.
  • The 10 leading causes of death in 2015 remained the same as in 2014. Age-adjusted death rates increased for eight leading causes and decreased for one.

The one death rate which improved was for cancer. So, we are “winning” that war, at least relatively speaking.

The entire decrease was for life expectancy at birth. Life expectancy at age 65 was unchanged from the previous year. In other words, children and working-age people are bearing the burden of this decline.

Zeke Emanuel, Obamacare Architect, Visits Trump To Urge One-Term Presidency

Confident DoctorsLast Wednesday, the Trump transition team disclosed the remarkable news that Ezekiel Emanuel, MD, an architect of Obamacare, was Mr. Trump’s first official guest of the morning. The spokesman demurred with respect to the details of the conversation, but I can guess: Dr. Emanuel was urging Mr. Trump to remain in office only one term, in accordance with Dr. Emanuel’s principle that people should be cut off at age 75.

Health Savings Accounts Continue To Grow

credit-card-2One of Donald Trump’s campaign promises is to make Health Savings Accounts more widely used. The purpose of HSAs is to give patients more directly control over health spending, and reducing the share of spending controlled by insurers. Unfortunately, the 2003 law which established HSAs requires they be linked with a highly regulated type of health insurance policy.

These policies, like all health insurance today, give insurers power to dictate prices instead of allowing prices to be formed through interactions between patients and providers (that is, a normal market process). So, these health insurance policies are not as popular as truly consumer-driven plans should be.

Nevertheless, HSAs (which are bank accounts, not health insurance policies) are growing like gangbusters, according to new research from the Employee Benefits Research Institute (EBRI). As I wrote previously, EBRI is a rock-solid member of the health-benefits establishment. If Trump wants to expand the use of HSAs, EBRI’s evidence suggests he is pushing on an open door.

Banning Organ Sales in Free Countries Enables Harvesting Prisoners’ Organs In Unfree Ones

utyutruyTwo new films, one a documentary and one a drama based on the same facts, expose one of the most horrific markets operating today: Communist China’s selling of organs harvested from prisoners of conscience.

Ten thousand “transplant tourists” travel annually to communist China, where they pay top dollar to get organs transplanted on demand. The Boston Globe’s Jeff Jacoby summarizes how China became the go-to destination for desperate patients on waiting lists:

Castro’s Death and Cuban Health Care

cuba-flagThe recent death of Cuban dictator Fidel Castro brought forth a grotesque encomium from the Canadian Prime Minister, Justin Trudeau, who asserted “Mr. Castro made significant improvements to the education and healthcare of his island nation.”

Michael Moore, producer of propaganda dressed as documentaries, made a film in 2007 called Sicko, in which he also praised Cuban health care. The reality was different. According to a U.S. intelligence cable published by WikiLeaks, a local person employed by U.S. intelligence covertly observed:

  • Many young cancer patients reportedly have become infected with Hepatitis C after their surgeries. Contracting Hepatitis C after surgery indicates a lack of proper blood screening prior to administering transfusions. All blood should be screened for Hepatitis B, C, HIV and Syphilis prior to use. Patients have no recourse and are not fully informed of the seriousness of such an inadvertent infection.
  • Patients had to bring their own light bulbs if they wanted light in their rooms. The switch plates and knobs had been stolen from most of the rooms so one had to connect bare wires to get electricity. There was no A/C and few patients had floor fans. Patients had to bring their own sheets, towels, soap and supplemental foods. Hospital food service consisted of rice, fish, rice, eggs, and potatoes day after day. No fresh fruits, vegetables, or meat were available.
  • The laboratory equipment is very rudimentary – a simple CBC (complete blood count) blood test is calculated manually by a laboratory technician looking through a microscope and counting the individual leucocytes, lymphocytes, monocytes, etc.

The White Man’s Burden: More Drinking, Drugs, and Suicides Since 2000

Senior Man ThinkingMore nonsense has been written about white nationalism/supremacy in the wake of Donald Trump’s election than anyone should have to read. So, it is a pleasure to find some actual data analysis on the role of non-college educated white citizens in the success of the Trump candidacy, especially versus Mitt Romney’s failed 2012 campaign.

The Economist has estimated health status explains the Trump vote better than being a non-college educated white citizen does. The sicker you are, the more likely you are to have voted for Mr. Trump. Non-college educated whites are also likely to be sicker, so the two variables are not independent. Nevertheless:

Single-Payer Setback: Canadian Doctors Without Contract For Over Two Years

OHIPPhysicians in Canada’s largest province, Ontario, have rejected a contract negotiated between the Ontario Medical Association and the provincial health ministry. The more than two-year old dispute shows no sign of ending.

Every Canadian is covered by his provincial government’s health plan. So, doctors have only one plan with which to contract. Each doctor cannot decide how much he wants to charge his patients. Instead, he is dependent on a centrally bargained contract which determines fees for every procedure and practice from the skyscrapers of downtown Toronto to windswept hamlets on the frozen shores of Hudson’s Bay.