Pharyngula

Medblogger alert

The Kaiser network is hosting a live webcast to discuss the influence of the blogosphere on health policy — the panel is tilted towards right wing bushites who prioritize money over health, so a more progressive contribution from the audience would be desirable. It’s going to be on tomorrow, Tuesday, at 1pm Eastern.


Oh, and if you worry about the future of health care, get a load of this: nurses in California can get continuing education credit by attending a Catholic conference full of woo. This is not reassuring. I don’t think a lecture on sex ed by a nun reciting papal dogma should count as education.

Comments

  1. #1 John Twilley
    July 28, 2008

    I for one, do NOT want a faith-based nurse hovering over me…
    I want a nurse that knows his/her stuff@ Not one that babbles about prayer and other religious nonsense.

    Hopefully the Blogosphere will let these chumps know what people actually need…not want.

    John

  2. #2 HumanisticJones
    July 28, 2008

    You know, if I was ever in a hospital and my doctor or nurse started rambling about how they’d pray for a successful operation, the will of god, etc., I’d probably demand another physician.

    Luckily all the operations I can remember have involved a doctor that’s rambled about the wonders of medical science that will ensure my successful operation and recovery. That being said, I might be a little wary of getting in the hospital if I’m ever in California with nurses cramming their certifications with Catholic woojy nonsense.

  3. #3 Sili
    July 28, 2008

    I’d assume everyone reads Goldacre’s miniblog, but just in case:

    Doc’s blogs sometimes blow confidentiality.

  4. #4 Kobra
    July 28, 2008

    I don’t think a lecture on sex ed by a nun reciting papal dogma should count as education.

    Not outside the bounds of psychological studies in the minds of the delusional; no.

  5. #5 Ranson
    July 28, 2008

    @ Sili

    I’ve always worried about my favorite medbloggers (Orac, Steve Novella) ever since Dr. Flea went down. We lost a good one to bad choices, there.

  6. #6 CG in Tucson
    July 28, 2008

    If you want, Medicare will pay someone to come to your house, drug you up with narcotics, and feed you woo on a daily basis: They’re called hospice nurses. Not even orthodox religious woo — this is the New Age version, where you flow into the light and meet up with your long-departed Aunt Hattie. But if you want, they’ll pay a conventional minister to show up too.

    Plenty of outrageous woo — right out in the open — in “literature” and hand-outs from almost any hospice in operation, almost all of which are Medicare-reimbursed. And right when you’re absolutely at your best and ready to argue with the idiots.

  7. #7 Annie
    July 28, 2008

    Thanks for the mention, PZ, even if I’m not yet elitist bastard worthy.

    The rest of youz – sharpen your wits and pencils and fire off some questions for Leavitt, he of the Bush watercarrying, science bashing poisonous partisanship and Goldstein of the WSJ Health Blog, where everything is translated into success if it makes money (such as his post about how emergency department overcrowding is a good business decision for the bottom line – he really wrote that link at my name is my evidence-based response).

  8. #8 NickG
    July 28, 2008

    When I was a resident, we had a guest speaker for what is possibly the best potential lecture in the entire emergency medicine core curriculum: rectal foreign bodies. The potential for humor is flat out amazing. So my program got a guest lecturer who was a Fellow of the American College of Emergency Physicians… and a Roman Catholic Nun.

    Seriously.

    And as you can imagine, she played it 100% completely straight. Not. One. Joke. So forget the woo or not… Catholic CME is crap.

  9. #9 Aquaria
    July 28, 2008

    If you want, Medicare will pay someone to come to your house, drug you up with narcotics, and feed you woo on a daily basis: They’re called hospice nurses.

    And yet my son’s best friend is about to have either his Medicare or Medicaid support eliminated by the government, which means he can’t buy the meds he needs after his kidney transplant.

    Thank goodness Canada is working with him for emergency asylum…

    Here’s what I would say to Kaiser: FUCK YOU, and the entire US so-called health care system. FUCK YOU ALL. I want what Canada has!

    Every year, my insurance benefits go up in price, along with my deductible, and my coverage lessens. Anytime I’ve had a surgery, I’ve ended up with piles of bills, never mind how I had goddamned insurance, and every surgery was on an outpatient basis. Our deductible is so high that I don’t go to the doctor unless it’s absolutely necessary. I mean, really, really high fever. Debilitating pain. Broken things.

    I have kidney stones, and I don’t go for treatment unless a few days doesn’t clear up any that are passing.

    I work, and I work hard. And this is how I have to live, in supposedly the greatest country in the world.

    Greatest, my ass. If I were younger or wealthier, I’d be out of here in a heartbeat. I hate this fucking place.

    What the FUCK is wrong with this country that people have to live this way?

  10. #10 Scott from Oregon
    July 28, 2008

    “What the FUCK is wrong with this country that people have to live this way?”

    Lack of imagination. Lack of common sense. Lack of clarity of purpose.

    Your state could already have a wonderful health system up and running. Instead, y’all call yourselves progressive and bitch and moan that the federal government isn’t doing it for you.

    You give the feds large chunks of your cash via taxes, and they give it to Pakistan and Egypt, spend a fortune of it cruising battleships back and forth in Asain waters, hand it over to corporate farms in the way of subsidies, spend it on nuclear arsenals far beyond the need for protection…

    …run agencies like the Department of Education that do nothing but homogenize education and tamp down competition between school districts, etc.. etc…

    …and instead of standing up and putting a stop to the nonsense, you push for granting the feds more and more powers and ways to spend the money they coerce from you that could go into local health care systems that the world would envy.

    Systems in competition have a way of bringing the best qualities to the fore. This is true in biology and it would be true in state run health care systems. States will look to see what works and what doesn’t in other states and you have a self-improving system based on natural selection principles.

    But you have to stop thinking a ne’er do well Texan or a slick talking Chicago lawyer or a senile old POW can do this for you.

    That’s madness.

  11. #11 leki
    July 28, 2008

    Up here in Canada, physicians are allowed to refuse to provide emergency contraceptives (AKA: morning-after pill) to women if it goes against his/her religious beliefs. They can also refuse to prescribe any other prophylactic if they don’t believe in birth control. As well, pharmacists can refuse to fill emergency contraceptive prescriptions on religious grounds.

    Hospitals in Canada are all publicly-funded, but certain hospitals with religious affiliation (historically) remain so, and can refuse to provide certain medical treatments if they go against certain religious beliefs. For example, if you are a woman who has been raped and you are sent to one of the catholic hospitals in my city you will not be given emergency contraception. What really makes me irate is that they don’t tell rape victims that they are not receiving this treatment, and many times it is too late to take the morning-after pill once they have learned they weren’t administered it at the hospital. Or, the patient asks for emergency contraception, is denied, and then it is too late to take it once they are released after being treated in the non-administering hospital.

    Publicly-funded should mean secular, I think. Same amount of tax money goes to the catholic-affiliated hospital as it does to any other public hospital so they should be bound to provide the same medical treatment at both regardless of religion.

  12. #12 Ted Powell
    July 28, 2008

    Self-medication by our cousins

    According to New Scientist http://www.newscientist.com/article/dn14406-wild-orangutans-treat-pain-with-natural-antiinflammatory.html

    Wild orangutans have been spotted using naturally occurring anti-inflammatory drugs.
    … In 2005, [a researcher] witnessed an adult female pick a handful of leaves from a plant and then chew them, mixing the leaves with her saliva to produce a green-white lather. The female then scooped up some of the lather with her right hand and applied it up and down the back of her left arm, from the base of the shoulder to the wrist, just as a person would apply sunscreen. …

    The article gives other examples of self-medication, but this is thought to be the first observation of a wild great ape preparing and using an ointment.

  13. #13 Ben
    July 28, 2008

    “I don’t think a lecture on sex ed by a nun reciting papal dogma should count as education.”

    Gosh, good thing it’s not up to you. People continue to ridicule the Church’s teaching on sex even while 1 in 4 California young adults has an STD. Did you ever think that maybe the current belief about sex and it’s use/purpose is flawed?

  14. #14 NickG
    July 28, 2008

    Leki @11 “Publicly-funded should mean secular, I think. Same amount of tax money goes to the catholic-affiliated hospital as it does to any other public hospital so they should be bound to provide the same medical treatment at both regardless of religion.”

    You and I seem to agree that SPNIH (Single Payer National Health Insurance) is the best and most morally defensible system of health care financing. We also agree that a girl or woman should be free to choose when and whether she wants to be pregnant. Period. Without modifiers. Or exceptions.

    I also agree that emergency medicine has a greater responsibility to provide what is considered the standard of care even if the provider finds it morally questionable (for example EC.)

    However, I don’t believe that its reasonable to force any physician to practice (non-emergency) medical care that is against their conscience. An OB/Gyn who believes that abortion is murder should not have to perform them (except under emergency circumstances where another provider is not immediately available.)

    Moreover, just because something is the standard of care, that doesn’t mean that its either scientifically or ethically right. Medicine has a long history of providing care that we would today label as stupid if not down right malfeasance. And it was often the ethical decisions of providers to refuse to follow the current standard of care which eventually made us question that very standard. For example it used to be the standard of care to provide homosexual patients with conversion therapy. However if I was practicing medicine 40 years ago, I would neither agree with nor agree to practice such therapy.

    That said, in your example, providers should be required to inform patients that the option of EC is available and they should if the patient wishes facilitate her transfer to another facility. But then it seems that the EMS providers and police in a given area should know better than to take a female rape victim to a Catholic hospital (unless she was unstable and needed to go to the closest facility for medical reasons.) Where I practice all rape victims go to a level 1 trauma center about 12 miles from my hospital. This is not because we’re a Catholic hospital, but because the referral hospital has 24/7 availability of SANE nurses (Sexual Assault Nurse Examiner) who have special training and can do the exam better than the majority of emergency physicians.

  15. #15 oldtree
    July 28, 2008

    Oh Kaiser. You never get out alive. You get a number and a statistic but not what you signed up for.

  16. #16 DjtHeutii
    July 28, 2008

    This sort of thing is always dissapointing to hear about, but far to common a thing to really be a suprise.

    It would be a very good thing if superstitious nonsense would not only be avoided by “professional” medical people, but that they would do more to speak directly against it.

  17. #17 leki
    July 28, 2008

    Fine, an OB/Gyn shouldn’t have to perform an abortion if it against his/her religion. I agree. I think what bothers me is the lack of communication between those physicians who refuse to administer emergency contraception and the patient. There have been several instances of the patient not given an option to go to another hospital or seek alternate treatment elsewhere and thus not given the EC she asks for.

    In my city, there are two trauma centres and four other hospitals with ERs of varying capacity. In the majority of cases, rape victims are sent to one of the hospitals with OB/Gyne in-house, which just happens to NOT be the biggest trauma centre but one of three catholic hospitals. Luckily, one trauma centre also holds in-house OB/Gyne, but it is also a level one trauma centre located in the inner city and is usually on diversion for all but level 1 or 2 triage scores. Our EMS are not necessarily given an option to choose between hospitals–they go to the closest or the least busy, whichever their dispatcher chooses.

    Our police services have a 24/7 sexual assault response team that will respond to any hospital, but prescribing emergency contraceptives is still the physician’s responsibility.

    I am aware that there are certain practices that individual physicians may want to opt-out. ECT, for example, is something one psychiatrist I know refuses to use. I should have been clearer in my rant: a patient who is refused treatment by a physician based on his/her religious affiliation should be clearly instructed by that physician how to obtain the requested treatment. The refusing physician should explicitly outline how a patient can obtain EC. My issue is with communication, then, and not necessarily practice. Unfortunately, the communication seems to be lacking.

    At the same time, though, why is there not standardized practice between publicly-funded hospitals? I don’t mean that each hospital needs to provide exactly the same medical care in terms of specialties, diagnostic imaging capability and in-house practitioners. What I mean is that if you are a hospital that has OB/Gyne and you recieve the same funding as another hospital that provides OB/Gyne services, then the standard practices should be the same: contraceptives should be made available regardless of the religious or non-religious affiliation of the hospital. The physician still maintains the right to refuse to administer, but the patient can still recieve the same care as she would in a secular hospital (not all doctors or nurses or support staff in a catholic hospital are catholic, obviously). I’m just confused about the allocation of universal health care funds, that’s all.

  18. #18 JoJo
    July 28, 2008

    Ben #13

    Gosh, good thing it’s not up to you. People continue to ridicule the Church’s teaching on sex even while 1 in 4 California young adults has an STD.

    Do you have a cite for this?

    According to California Department of Public Health STD statistics (PDF), page 6 the STD rate for females 10-14 is 7.4%, females 15-19 is 7.6%, males 10-14 is 7.7% and males 15-19 is 8.0%. These numbers are mindboggling to me, but nowhere near 25%.

  19. #19 Scott from Oregon
    July 28, 2008

    “”You and I seem to agree that SPNIH (Single Payer National Health Insurance) is the best and most morally defensible system of health care financing.””

    The trouble with National systems is that they are not adaptable and they waste huge amounts of money, plus they are easier to corrupt and defraud.

    IF health care was state run, and had competing private choices, you get a better system.

    Oregon is a poor state but heavy in resources, for example. Rather than tax each citizen, it could use the income from timber harvesting to fund the Oregon Health system, rather than send the money as it does now to Washington DC where it gets spent on B-1 bombers. It is easier for a state to police its own system because the police are local entities already. You don’t need to duplicate resources to ensure compliance.

    California could have the best system on the planet, but instead, 30% of its taxable wealth goes to Washington, where the money is wasted on wars with foreign nations and paying interest on money the federal government borrowed to ensure it had control over everyone’s business…

    The whole idea of having Washington DC run anything is anathema to logic and common sense, given the track record of Washington DC.

  20. #20 leki
    July 28, 2008

    @ #19

    The Canadian government spends less per capita on health care than the US even though we have a universal system. You might have to wait longer for an MRI up here, but you won’t be denied treatment, ever.

    Mind you, I am of the mindset that health care isn’t a business but rather a basic human right, so no matter how much money pours into the system, health care was never meant to net zero at the end of the day (or make a profit!)

  21. #21 dubiquiabs
    July 28, 2008

    Let’s not cause collateral damage to nurses who happen to be catholic. Some of the best nurses I’ve known were nuns, typically older, with little tolerance for nonsense of any kind, and quietly dedicated to patient care. Only the garb pointed to their being catholic.

    It’s another matter when doctrine gets in the way of care and prevention, as it increasingly appears to do. IMO, health professionals should have their license suspended if they are caught making decisions on the basis of doctrine against the wishes of their patients. Let’s start with pharmacists who don’t fill prescriptions for contraceptives.

  22. #22 Dan
    July 28, 2008

    P.Z. You must have it in for Catholics. California has an enormous Catholic population. (some of them may actually need a nurse now and then) It isn’t going to hurt the nurses to actually learn about the teachings of a church that many of the patients belong too.

    If you search using the terms: Catholic, California & population – you will discover that the Catholic population of California is growing & GROWING. Catholics are expected to be a third of the population by 2025.

    Why would you as an educator have anything against learning something that might help one in the healthcare field deal with concerns that a patient may have?

    And by the way professor, I couldn’t find where the speaker was identified as being a ‘nun’ – I did find that she holds a Doctoral degree though.

    Besides, look on the bright side – maybe this continuing education may help nurses to convince Catholic patients to try contraception – or maybe have ‘just one’ abortion.

    So it seems to me that you might just have it in for Catholics……

  23. #23 DjtHeutii
    July 28, 2008

    “So it seems to me that you might just have it in for Catholics……” – Dan

    Or, he just has something against nonsense, and not anything in particular against “Catholics.”

  24. #24 Dan
    July 28, 2008

    “Or, he just has something against nonsense, and not anything in particular against “Catholics.””

    Did you look at the continuing education course? How exactly is the course ‘nonsense’?? – given the fact that Catholics do make up a large portion of the population. Healthcare professionals need to be aware of the beliefs of diverse populations – just look at how the beliefs of Jehovah Witnesses can affect their care. More knowledge will NOT adversely affect care – so I am inclined to suspect that P.Z.’s problem is one having to do with this course being related to Catholic teachings.

  25. #25 Jules
    July 28, 2008

    Goodness no! You don’t want the U.S. Government to run any sort of health care operation! While, I am sure there are a few shining examples in the VA and IHS, there are also some severe shortcomings.

    Look at the VA and how surprised everyone was last year by Walter Reed. Surprised? Geez, I thought that was common knowledge. Another poor example of government run care is the Indian Health Service. Why, just last week the GAO released a report stating that after an investigation of just 6 of the 160 service units run by IHS, the Property Department had lost $15.8 MILLION worth of Property. Imagine how much patient care 15.8 million dollars can buy… People are dying and an incompetent federal bureaucracy allows this to happen. I think each of these organizations needs more money, but what they really need is some good leadership and a thorough housecleaning.

    I work in one of these fine institutions, and I can tell you that the department and agency that I work in is plagued by a severe lack of business acumen and leadership skills. There is no sense of purpose and the focus of *the patient* is not there at all. It’s very, very sad.

    No – No – No to Federal Government controlling our healthcare. Unfortunately, I don’t know what the best solution is, but I know what isn’t going to work. There are too many special interests in play.

  26. #26 MS
    July 28, 2008

    The RCC’s position on birth control has gone beyond merely impractical and stupid, has gone beyond even wrong-headed and immoral. It’s insane and evil. How anyone can look at the world today and not conclude that there are just too many people is a mystery. There’s not a single major problem facing the world that isn’t connected to overpopulation–not always directly caused, but at least exacerbated.

    That a bunch of celibate old men living in palaces, who have never provided for a family, and who have spent most, if not all, of their adult lives being waited on hand and foot and having their every physical need taken care of by the labor of others, would have the gall to tell desperately poor people that’s wrong to use birth control, but not wrong to bring children that you can’t provide for into an already overcrowded world…in the end words fail me when I try to express just how evil that really is.

  27. #27 Pieter B
    July 28, 2008

    I used to work at a major Southern California med school, in the affiliated hospital. You’d be amazed at the woo that can get CE credits. I recall seeing a flyer on a bulletin board advertising an altie-med convention for which CEs were available, which included alternative cancer treatment, herbal medicines, therapeutic touch and the like — and this was almost 20 years ago. Here’s one of the first Google hits as an example of what’s out there today. After taking the Guided Imagery course, you’ll be able to “Name three clinical conditions that can be treated with guided imagery.” Treated? OK. But will the treatment actually do anything?

  28. #28 DjtHeutii
    July 28, 2008

    “More knowledge will NOT adversely affect care – so I am inclined to suspect that P.Z.’s problem is one having to do with this course being related to Catholic teachings.”

    Well, one can be against “Catholic teachings” because they are nonsense and not because they have any particular axe to grind against people who happen to accept those teachings.

    I, for one, think that one can still respect people as Human Beings while thinking that their beliefs are utter nonsense.

  29. #29 Dt
    July 28, 2008

    Assholes if you listend to the church and didn’t have sex outside of marriage, there would be less STD. Think about it you freaks.

  30. #30 DjtHeutii
    July 28, 2008

    “Assholes if you listend to the church and didn’t have sex outside of marriage, there would be less STD. Think about it you freaks.” – Dt

    Please post the peer reviewed studies that support this assertion.

  31. #31 Rob
    July 28, 2008

    And if priests followed their religion, there wouldn’t be multimillion dollar judgments against the diocese.

    If a priest can’t be bothered, you expect individuals to follow it?

    Think about it you cretin.

  32. #32 jimvj
    July 28, 2008

    #25:
    There is no way you work in a US government institution involved in healthcare, given the blatant errors in your post.
    First, Walter Reed is an ARMY hospital. It is NOT a VA run hospital. The VA system provides very good services given its budget constraints. Its overhead, waiting times, and other measures of efficiency compare very well to private hospitals.

    Second, when people talk of federal (or state) run single payer system, they are talking about the insurance/payment part of the system only. NO ONE IS ADVOCATING THE GOVT TAKING OVER THE PROVISION OF CARE. (At least no serious person is.) If you had even a cursory knowledge of the debate on healthcare in the US, you would have known this.

    Third, the overhead of most private health insurers (this is the part of every healthcare dollar that provides NO HEALTHCARE) is 25 to 35%. The overhead for the federally run Medicare is below 5%.

    Your post shows what is wrong with the healthcare debate in this country. Too many people have knee-jerk reactions (SOCIALISM!!, GOVT CONTROL!!, etc) instead of disussing solutions that have been shown to work in every other advanced country in the world. Most of them provide better care, includind preventivi care, for 50% of the cost of our private hodgepodge of a system.

    Every other advanced country has deemed healthcare to be a basic human right, not a privelege. There are many approaches to how they attempt to provide this basic right. You might want to read up on how Switzerland, Japan, Germany, France, Taiwan, Canada, etc have acheived much better results with about half the cost.

  33. #33 jimvj
    July 28, 2008

    Yeah, yeah… including, preventive, privilege.

    preview please.

  34. #34 Scott from Oregon
    July 28, 2008

    “Your post shows what is wrong with the healthcare debate in this country. Too many people have knee-jerk reactions (SOCIALISM!!, GOVT CONTROL!!, etc) instead of disussing solutions that have been shown to work in every other advanced country in the world. Most of them provide better care, includind preventivi care, for 50% of the cost of our private hodgepodge of a system.”

    Our system stinks because it is half government–half private, but not in any meaningful or functional way.

    Europe and other nations have better social systems because they don’t spend on self-preservation as a nation, they rely on the US to do that. Look at our “defense” spending, and calculate just how many MRI’s that could buy.

    State run systems that run parallel to private systems of insurance, removing the federal government out of the equation altogether, will allow each state to modify their system to suit their state. Oregon would use its timber sales to augment its system. Nevada would use gambling revenue. Alaska would use its oil. California, its wine. Hawaii, it tourism.

    You don’t have to just slap another federal tax on everybody and claim the situation solved. The federal government is 9.6 TRILLION dollars in debt and they just raied their debt ceiling another 800 BILLION.

    That is not even mentioning the obligations it holds that it can’t pay in our near future.

    By moving the solution to the states, you can make the small government repubs happy, the progressives happy and the populace happy. As the argument stands right now, no one is happy and half the population will be unhappy with whatever the other half does.

    If you grant the power to the fed and keep giving it money, it will keep taking the power and abusing it as it has for the 45 years of my lifetime. It will take your money and buy bombs that it needs for wars that it feels are more important…

  35. #35 Robster, FCD
    July 28, 2008

    How are catholics biologically different from other humans? Perhaps there is a tendency towards temporal lobe seizures, considering the number of “visions,” but they bleed the same, have GI side effects with opiates the same, etc, etc.

    Being married to a person who was (until recently) employed at an evidence based CME company, this is what we don’t need. Where medical education companies used to be highly regulated, and kept a close eye on each other, hoping a competitor would make a biased statement, so they could file a claim… Until Big pharma decided that they were taking too big a PR hit and decided that only non profits and universities could offer CE credits.

    We know that woo pushers don’t fact check competitors. So expect a drop in quality as some of the better companies go under, while woo flourishes among the less ethical members of the non-profit groups (not all, just the bad ones).

    ———–

    For those whining about how mean PZ is, read the damn link about the conference. It ain’t presentation of new information, new technique, new technology, or even support of best or better practice. Its religious woo, which while culturally relevant, is not worth 4.6 credits, as it does not present heath communication information on how to help patients make good decisions based on medical science.

  36. #36 Zeno
    July 28, 2008

    I wrote that post on my blog after hearing a radio spot promoting the Moraga conference. At first I was ignoring the commercial (as I usually do), being only vaguely aware that someone was nattering about an all-day celebration of Humanae Vitae (yeah, that sounds like a winner), when suddenly there’s a tag line near the end of the spot telling nurses they can get continuing education credit. That’s when I went on-line looking for more details.

    Professor Janet E. Smith, one of the featured speakers, has an FAQ on her school website that has some pretty amazing stuff in it. Her answer to “Where can I find good information about homosexuality?” is (1) NARTH and (2) the Family Research Council. Good information? These recommendations are just crazy, since both NARTH and FRC are completely ideologically driven. NARTH claims to “cure” homosexuality, but its founder’s son is a gay rights activist. Nice “cure” job!

    But why was I surprised? I shouldn’t have been.

  37. #37 Treva
    July 28, 2008

    I am an atheist, but I would go to the seminar on Catholicism and sexuality. Having worked with women in an OB/GYN practice I found it helpful to be familiar with the teachings of sexuality in different denominations. I don’t have to believe or even pretend to believe what the patient believes, but I do want to be able to do all I can for her and accept her as she is. Ignorance of things that influence a person’s sexuality is not the path to helping them.

  38. #38 James Vijay
    July 28, 2008

    #34:
    Why are you conflating defense dollars with healthcare dollars? If you think the DoD budget is too large, protest that. But what does that or the price of tea in Timbuktu have to do with making the payment for healthcare more efficient?

    Please read up on how other countries have dealt with this problem. Please realize that for-profit private healthcare insurance has no added value. It essentially skims off about 30% of the money paid in – to pay off CEOs and investors.

    We have to take out the profit motive from the payment mechanism for healthcare – because it provides no added value, and discriminates against the poor, the unemployed, etc.

  39. #39 swangeese
    July 28, 2008

    Dan and others-

    Many people are rightfully concerned that the Catholic Church is trying to influence policy through the backdoor. And these fears aren’t unfounded considering that there are Catholics that are actively trying to shut down abortion clinics or deny access to contraceptives.

    If Catholics want to follow the Church’s teachings–fine. Unfortunately that isn’t enough and the Church actively tries to force its policies on everyone.

    So when you drag your beliefs into the public square, don’t be upset when they are criticized. The world isn’t the binary place that is taught in church.

    Even in a world without contraceptives, teens will still have sex. And while I think that abstinence should be encouraged, it is unrealistic to think that all teens will abstain. Therefore they need a comprehensive sex education and learn how to prevent unwanted pregnancy and STDs.

    Abstinence only education only encourages ignorance about sex.

    And despite the numbers, it would appear that most Catholics either use or support the use of contraceptives.

    MS is spot on about how out of touch the clergy is with reality. I have a good friend that is a Catholic priest. He means well ,but he doesn’t live in the real world.

  40. #40 Scott from Oregon
    July 28, 2008

    #34:
    “Why are you conflating defense dollars with healthcare dollars? If you think the DoD budget is too large, protest that. But what does that or the price of tea in Timbuktu have to do with making the payment for healthcare more efficient?”

    Because the source of the income IS THE SAME POOL. You can only extract X amount from a system without collapsing the system. The taxes raised and used for the Dod is money taken from the money available to pay into health care needs.

    You can’t just keep adding to the extraction without eventually destroying American’s ability to pay for it.

    As we are seeing in our economy now, the credit we are running on and which has funded our war needs to be repaid.

    The only way to repay the loan is to raise taxes or figure out one more way to fake a booming economy i.e. the housing boondoggle boom…

    That’s not going to happen, no matter what the government tells you.

    Once taxes get raised, there is less available to pay into a health care system.

    That is the current reality.

  41. #41 NickG
    July 28, 2008

    @25 “Goodness no! You don’t want the U.S. Government to run any sort of health care operation! While, I am sure there are a few shining examples in the VA and IHS, there are also some severe shortcomings. Look at the VA and how surprised everyone was last year by Walter Reed. Surprised? Geez, I thought that was common knowledge. Another poor example of government run care is the Indian Health Service.”

    And the reason that those agencies offer the level of care they do is their completely abysmal funding. The VA is in fact a shining example. They operate for a little over half of what most private insurers do, yet their outcome data (with regard to things like survival after MI, time to development of renal complications after diabetes diagnosis, rate of smoking cessation in COPD patients, length of survival for HIV+ patients) is generally better than most private insurers – see end of post for reference links. This is because the VA pinches every penny till it screams. You may not get a mint on your pillow, but your survival after HIV diagnosis will be better than if you were insured by BCBS.

    Its similar to performance of the US educational system. We generally bemoan the fact that in comparison with other developed nations we usually perform in the high teens (15-20th), yet its not surprising when you understand that we rate in about the same place with regard to *funding* of education. Generally you get what you pay for. And when the US gets something shitty, its because we pay Wal-Mart prices.

    Fortunately, we spend in excess of 15% of our GDP on health care. If we turned that over to the VA and told them to expand and cover everyone, we’d have hands down the single best health care system in the world.

    http://www.annals.org/cgi/content/full/141/4/272
    http://content.nejm.org/cgi/content/abstract/348/22/2218
    http://www.annals.org/cgi/content/full/141/12/938?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=veterans+health&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

  42. #42 Matthew, RN
    July 29, 2008

    @#6: The purpose of hospice nursing is not to disseminate woo, it’s to help individuals who have about six months or less life to live (as determined by their health care team) as a result of illnesses — such as terminal cancer, end-stage renal disease, end-stage dementia, etc. — be more comfortable. Most of the work is trying to figure out how to deal with severe pain while still keeping the individual alert (enough) to at least minimally be interactive.

    I know many, many hospice nurses, but not one that utilizes power crystals, etc. Even if a bit of that slips in there, I’d much prefer my tax money helping those who are dying to be comfortable than to attempt to obliterate some of the Middle East.

    I am a cancer nurse, and, yes, woo is rampant in nursing. That’s why I’m going to get my PhD in Horribleness, find a second-hand cape, and attempt to take nursing back from woo-dom.

    I’ll probably fail.

  43. #43 Aquaria
    July 29, 2008

    Your state could already have a wonderful health system up and running. Instead, y’all call yourselves progressive and bitch and moan that the federal government isn’t doing it for you.

    Congratulations on being ultimate thread jerk-off.

    I live in Texas. I’m progressive, and have long supported a European or Canadian health care system. Unfortunately, I can’t do it alone, I can’t change a backwards state all by myself, so save your sanctimony.

    And fuck you very much.

  44. #44 Interrobang
    July 29, 2008

    The trouble with National systems is that they are not adaptable and they waste huge amounts of money, plus they are easier to corrupt and defraud

    Um, yeah, like the profit motive doesn’t waste huge amounts of money, lining the pockets of CEOs and shareholders while not doing Thing One to actually provide healthcare. On top of that, guess what, for profit healthcare kills people. Healthcare in Canada isn’t run by the government; it’s administered and funded by the government. If you think that’s a distinction without a difference, you need help.

    The rest of the world also isn’t getting a military subsidy from the United States. The short answer is, we’d be fine if it weren’t for you. The United States creates most of its foreign policy problems itself, mostly because it has this enormous war machine and an outsized sense of entitlement, and feels compelled to use both. (How many dictators in various “useful” banana republics have you propped up, up until they were no longer useful, at which time you had them deposed? I can think of at least three just off the top of my head. Damn right the Bush Administration “knew” Saddam Hussein had had weapons of mass destruction; Donald Rumsfeld kept the receipts.)

    People who think that government is the problem get problematic governments. Me, I’m constitutionally guaranteed “good government” (look it up), and generally, that’s what I get. I like it that way.

  45. #45 Scott from Oregon
    July 29, 2008

    “Congratulations on being ultimate thread jerk-off.

    I live in Texas. I’m progressive, and have long supported a European or Canadian health care system. Unfortunately, I can’t do it alone, I can’t change a backwards state all by myself, so save your sanctimony.

    And fuck you very much.”

    I see. But YOU CAN change a federal system? Ha! So Texas is backward but Oregon and California are not. We get our systems, they work, Texas rolls around to our way of thinking. You think changing everyone’s view in the country is EASIER than changing the views of your state? Or the state next to you?

    I am giving you a solution to have universal health care and you tell me “fuck you”? What kind of progressive response is that?

  46. #46 Scott from Oregon
    July 29, 2008

    “The rest of the world also isn’t getting a military subsidy from the United States. The short answer is, we’d be fine if it weren’t for you. The United States creates most of its foreign policy problems itself, mostly because it has this enormous war machine and an outsized sense of entitlement, and feels compelled to use both. (How many dictators in various “useful” banana republics have you propped up, up until they were no longer useful, at which time you had them deposed? I can think of at least three just off the top of my head. Damn right the Bush Administration “knew” Saddam Hussein had had weapons of mass destruction; Donald Rumsfeld kept the receipts.)”

    Umm, The US government, the federal government, is spending vast amounts of American taxpayers resources on military nonsense overseas. THAT WAS MY POINT.

    As an American, I would like to remove the power incentive from the federal government and give the power of governance back to local entities.

    Instead of paying taxes to the federal government so they can go on warring rampages at the whim of the stooge in charge, give it to the state governments who now have to beg the federal government for money.

    If I have a problem with what my state government does with my money, I can drive to the capital and talk to my government.

    Who but those who live around DC can actually get in to see those who make decisions for you?

    Not to mention the distance and expense of travel.

    10 trillion in debt, a collapsing dollar, an unending war escapade, and y’all want to find ways to give this entity MORE of your money?

    I had hoped my fellow Athiests were smarter than that…

  47. #47 Hap
    July 29, 2008

    I am giving you a solution to have universal health care and you tell me, “F*** you”? What kind of progressive response is that?

    Um, an evidence-based one? Giving examples of systems that follow the model you suggest that work (have similar or better health-care outcomes) and are cheaper (which isn’t hard – everyone is cheaper that the US) would help. Since examples of such with government “interference” are legion, you have a fairly high bar to meet.

    Oh, you meant solutions congruent with libertarian principles? Good luck with that.

  48. #48 Scott from Oregon
    July 29, 2008

    “Um, an evidence-based one? Giving examples of systems that follow the model you suggest that work (have similar or better health-care outcomes) and are cheaper (which isn’t hard – everyone is cheaper that the US) would help. ”

    Ummm Europe is an example. If you think of each European country as a “state”, you have a situation that is similar to what I am saying.

    You don’t have “EU” healthcare. You have France health care, English health care, and so on.

    Each system caters to a smaller group than the whole, but the whole is catered to.

    All it takes is a resetting of the mind to the possibilities state governments can achieve without buying into the notion that only Barack Obama can help you.

    The federal government is about to drive the US into the financial primordial ooze as it is, so as you swoon over the possibility of more federal intervention in society, remember, some dumb athiest liberal from Oregon told you about it way back in July.

  49. #49 cheeb
    July 29, 2008

    #37: “I am an atheist, but I would go to the seminar on Catholicism and sexuality. Having worked with women in an OB/GYN practice I found it helpful to be familiar with the teachings of sexuality in different denominations. I don’t have to believe or even pretend to believe what the patient believes, but I do want to be able to do all I can for her and accept her as she is. Ignorance of things that influence a person’s sexuality is not the path to helping them.”

    This. Speaking as a pharmacy student.

    Part of medicine is understanding the cultural and religious beliefs of your patients. The conference is perfectly acceptable as CE.

  50. #50 kc
    August 19, 2008

    If you want to be taken seriously as a scientist or intellectual thinker, some of this rhetoric needs toning down.

    Understanding the reasoning behind any religious understanding of human sexual behavior is, indeed, a fine reason for a pharmacist or doctor to take the course.

    Beyond any ethical or religious consideration is the debt we owe Catholics for developing Natural Family Planning. (It’s not the rhytmn method.) Not only is it extremely effective as contraception, or, conversely, very helpful for women who struggle with infertility, but as a woman, I hate the idea of filling my body with unnatural chemicals, just to be sexually available 24/7. I guess I can see why guys would like it. I love the idea of not peeing estrogen into the water supply each day. Not to mention the links with blood clots and breast cancer and the pill. Not one artificial method I researched came without a at least one negative cost to women. Even condoms without spermicides often have bad reactions to latex for women over time.

    Then there’s Natural Family Planning. Free and no physical cost. And you don’t want people learning about it because you don’t want to take a break from sex when you’re fertile and not planning a baby, and you figure everyone must be like you?

    So.. we get some ridiculous caricature of a nun reading papal encyclicals? I doubt it. Such a snide comment makes PZ look the unreasonable one.

  51. #51 SC
    August 19, 2008

    kc,

    Thanks for sharing.

    We all know the spectacularly silly beliefs and disdain for natural human desires and women’s freedom that underlie Catholic teaching on sexuality and reproduction.

    No one here wants to prevent people from learning about your loopy methods. In fact, here:

    http://www.usccb.org/prolife/issues/nfp/information.shtml

    If, based on your own ignorance, archaic beliefs, and/or personal preferences, you do not wish to use contraception, then don’t. No one here cares.

    If you dislike or fear sex, as you appear to, then have it as infrequently as you wish, or not at all. No one here cares.

    But keep your screwed-up religious beliefs away from my body, and tell your dictatorship-supporting, pedophile-hiding, rapacious, authoritarian, misogynistic, bigoted Church to keep its cracker-loving paws off of public policy.

  52. #52 Rev. BigDumbChimp, KoT
    August 19, 2008

    Beyond any ethical or religious consideration is the debt we owe Catholics for developing Natural Family Planning.

    Easy to say we owe them a debt considering their ridiculous stance on other forms of birth control (which in turn some are disease control). And besides why would you want family planning, I thought you catholics were supposed to be all pro-creatin’ like crazy.

  53. #53 Zeno
    August 21, 2008

    Beyond any ethical or religious consideration is the debt we owe Catholics for developing Natural Family Planning. (It’s not the rhytmn method.)

    The old-fashioned rhythm method involved limiting sexual intercourse to the woman’s intermittent periods of infertility. Natural Family Planning is completely different. It involves limiting sexual intercourse to the woman’s intermittent periods of infertility. See? It’s Rhythm Method 2.0, not 1.0!

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