Morning Links

Monday, August 3rd, 2009
  • Hugo Chavez shuts down 34 radio stations. But remember, Venezuelans get free health care and stuff, so Chavez may well be a great man.
  • Elderly Columbia, Maryland couple who were subjected to a mistaken police raid file a lawsuit. This was the raid where, according to the couple, the husband asked if he could go out to restrain his dog. The police said no, then went out and killed it.
  • Cato’s Dan Griswold on the many benefits of immigration.
  • Britain’s NHS rations painkillers, says back pain patients will just have to cope, or find alternative treatment.
  • A while back we had the naughty librarians story. Now: tattooed librarians.
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  • 43 Responses to “Morning Links”

    1. #1 |  B | 

      Beautiful, tattooed, and well-read. That is sexy.

      (Lucky for me, that’s also my wife.)

    2. #2 |  Lee | 

      From the first paragraph for the NHS article.

      …should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

      Good luck getting the same injection here in the US when the cause is not known. The only doctors that would do it are probably quacks.

      Scare monger much?

      Lately you have been linking to stories that have no backup data and then this boogie man piece.

      If I wanted that shit I’d read Andrew Sullivan.

      Yes I know you are busy. Hopefully once you get your plate cleared off a bit your blogging quality will improve.

    3. #3 |  Ben | 

      At least Britain isn’t talking about banning the most effective pain killers out there because they won’t change the law regarding perscribing them as is, without tylenol like the US is.

    4. #4 |  Radley Balko | 

      Lee: The very concept of “chronic pain” is pain that has no known cause, or where the initial cause of the pain has long disappeared, but the pain persists.

      Doctors in the U.S. treat it all the time, including with injections.

      Also, under a more centralized health care system, it’ll be a lot easier for the government to monitor and harass the few remaining doctors who treat it with opioids.

    5. #5 |  Dave Krueger | 

      You guys keep getting your panties in a wad about cops killing dogs. I mean, let’s get a little perspective. Cops probably botch thousands of raids every year, but they only kill a few dozen dogs (probably less than a couple hundred, anyway). I think we should be celebrating their restraint. After they fuck up a raid, they’re probably not in a particularly good mood. We should be glad they only shoot the dogs rather than the people who, by not being criminals, wasted a lot of government time and energy.

      Cops don’t just screw up these raids because they have nothing better to do. They are skilled, hard-working, dedicated civil servants. One would think the public would do their part instead of selfishly insisting on their innocence. And it’s websites like theagitator that encourage this seditious unpatriotic insubordination to law enforcement professionals who daily put their lives on the line. You should start focusing on the positive rather than the negative. Keep in mind that these heroes, when successful, are daily locking up people who, up until then, no one even knew were dangerous criminals because they didn’t involve anyone but themselves in their crimes. That’s the most secret of all crimes because there is no one to complain. And it’s sweeping the nation, overwhelming the meager resources of our police departments.

      So let’s start seeing a little empathy toward our Boys in Blue. When a cop shoots a dog, understand he was forced into it by circumstances completely beyond his control, no less than if the dog viciously attacked him, grabbed his gun, and shot itself.

    6. #6 |  Stephen | 

      It must be Monday, Dave’s sarcasm is a little stronger than usual. :)

    7. #7 |  JS | 

      Stephen yea I noticed that too. Dave must get a little rest on the weekends to start off so strong on mondays. You go Dave!

    8. #8 |  Andrew S. | 

      Excellent sarcasm, Dave K. Almost got me to give you a neg.

      Radley @ 4 — That’s exactly what I worry about. My mother has MS. Luckily, it hasn’t turned into anything severe or debilitating to this point (about 10 years after diagnosis). But there are times where she’s in a great deal of pain and can’t do anything because of it. So this “War on Painkillers” really does worry me on a personal level as much as it does on a societal/pro-liberty level.

    9. #9 |  Dave Krueger | 

      I find it very disturbing that the medical system is suddenly experiencing a crisis that needs comprehensive government intervention (kind of like reform using a chain saw and a cattle prod) just as I’m getting to the age where I will probably be using it more often.

      For example, when it comes to pain, you will never meet a bigger pussy than me. When I’m in pain, everyone around me is miserable. In fact, effective pain medication will be a matter of life any death for me simply because, without it, I will probably be murdered by those closest to me.

    10. #10 |  Joe | 

      Dave, you should shart that wisdom and wit at other blog sites too! I am sure you will get a big welcome at one in particular.

    11. #11 |  Fluffy | 

      It’s also striking to me that even though we are routinely propagandized that nothing should come between the patient and the doctor, and that the insurance companies are evil for trying to dictate the terms of care, no one in government seems to have any problem with introducing non-medical concerns into discussions of what painkiller policy should be.

      They are somewhat nakedly advocating that the use of painkillers be restricted because the widespread availability of painkillers helps support the black market. So they openly are arguing that decisions regarding medical care for individuals should be made, not on the basis of what is good for that individual, but on the basis of “social” concerns.

    12. #12 |  J sub D | 

      >Hugo Chavez shuts down 34 radio stations. But remember, Venezuelans get free health care and stuff, so Chavez may well be a great man.

      Wait a cottonpickin’ minute! Hugo is on the same team as the Obama Administration on the Honduras situation. It seems our mutual view of the constitutional crises there is that executive authority trumps the other branches of government and the rule of law.

      I’m amazed that our backing of the constitution ignoring socialist hasn’t received more press and criticism.

      http://www.realclearpolitics.com/articles/2009/08/01/why_does_obama_support_zelaya_97731.html

    13. #13 |  The Angry Optimist | 

      Lee, if you are a leftover from the Big Ugly Blog “War” this weekend, I would suggest not coming after somebody so viciously out of the gate.

    14. #14 |  Lee | 

      In this article there is no mention of a prior condition that caused the initial back-pain. You’re reading something into the article that is not present. It just says that the cause is not known. Those are two entirely different things.

      In high school my wife worked for the one of the top back groups in North Texas. The doctors talked about these types of patients all the time. They would send them to the ‘witch doctors’ if they could not determine what was causing the pain.

      Even with known issues, injections into the back are typically the treatment of last resort.

    15. #15 |  Lee | 

      Lee, if you are a leftover from the Big Ugly Blog “War” this weekend, I would suggest not coming after somebody so viciously out of the gate.

      Nope just a long time reader that is a bit disappointed with the quality lately.

    16. #16 |  Radley Balko | 

      …just a long time reader that is a bit disappointed with the quality lately.

      Think that might have something to do with the fact that we happen disagree on socialized medicine?

    17. #17 |  The Angry Optimist | 

      No, Lee, even “unknown” causes sometimes merit cortisone shots. For a long time I have suffered with chronic rotator cuff pain in my shoulder. Usually it merits a physical profile (I am in the military) some ice and some ibuprofen, but I still clench my way through most of the pain. Even though we have no idea what is causing it, my doctor has offered me the shots (with the caveat that they are a last resort AND that they will have to be done for life) – and he is not a quack.

      So, enough – non-“quacks” give out shots for chronic pain with an unknown source. It is a better option than 10K investigating and another 10K operating.

    18. #18 |  Chet | 

      It is a better option than 10K investigating and another 10K operating.

      And in England, where the NHS rations them, you’re forced – forced! – to buy them yourself! You know, like everyone in the US has to.

      If being forced to buy your own treatments of questionable effectiveness is fail mode for the NHS, what does that say about our system, where that’s standard for everyone? I think your example proves a little more than you expected it to, Radley.

    19. #19 |  The Angry Optimist | 

      Chet – so, people who pay taxes are not already “double purchasing” health care?

      Also, Chet, these shots are not “of questionable effectiveness” – anyone taking cortisone shots will tell you that they are wildly effective for pain management. You just have some kind of bizarre notion that we have to “get down and root out” the cause of pain, when, in fact, pain management is a wholly legitimate mode of medical thought t, and these shots are an EFFECTIVE course of treatment within that scheme.

    20. #20 |  Lee | 

      I am not necessarily for socialize medicine, but their have not been any decent proposals for changes to the system than we have now that would increase performance. We are paying too much for the results we receive.

      I am a pragmatist, we will never have a completely free market system. We’ll not let Emergency Rooms turn away critical injured/sick people because of lack of insurance or lack of proof of insurance (not to mention how to insure the seniors). We’ll never get rid of Medicare or Medicaid. So the question is how much socialized medicine do you want.

      Have their been any suggestions other than “look at the problems this system over here has” or “OMG the government is going to take away your freedoms!!”?

      Soon as you put up an argument with some actual data to back it up and I might disagree with you.

    21. #21 |  Josh | 

      Something to add to this NHS discussion; the article mentions patients will have to pay £500 out-of-pocket for these costs.

      Under the socialized system, that price is greatly inflated from what the prevailing market price would be, since the single-payer system is generating an artificial demand.

      Now patients with chronic back pain will have to pay exorbitant prices thanks to a government-imposed system that treated patients with these ailments while encouraging those who probably didn’t need these treatments to have the gov’t pay for it as well.

    22. #22 |  Chet | 

      Chet – so, people who pay taxes are not already “double purchasing” health care?

      Apparently not, since the NHS can’t afford to provide 60,000 treatments for nebulous, unspecified back pain every year. Sounds like the tax payer isn’t paying for it.

      You just have some kind of bizarre notion that we have to “get down and root out” the cause of pain, when, in fact, pain management is a wholly legitimate mode of medical thought t, and these shots are an EFFECTIVE course of treatment within that scheme.

      I’d like to see the data on that, I guess. One thing the NHS does that we do not – can’t do, by law and by definition – is treatment effectiveness research.

    23. #23 |  Chet | 

      Under the socialized system, that price is greatly inflated from what the prevailing market price would be

      What would that price be, specifically? In the US, these shots can cost $1200 or more, depending on the dosage and location.

    24. #24 |  The Angry Optimist | 

      We are paying too much for the results we receive.

      Gah. See, Lee, you want an argument with statistics and numbers, and right off the bat you show that those numbers are not going to appeal to you at all. For you to start off with such a blatantly normative and collectivist judgment shows you are not amenable to discussion. “we” are not paying for “anything” – you might not like the amount individuals choose to spend on health care, but that is their call, not yours.

      As it stands, 85% of people have health care coverage, and the vast majority of the other 15% could be covered by either private insurance, Medicare or Medicaid, if they so chose. You are talking about massively socializing health care for 1% of the populace. No thanks.

    25. #25 |  expat | 

      “Britain’s NHS rations painkillers, says back pain patients will just have to cope, or find alternative treatment.”

      Fantastic. It’s great to see Britain finding yet another way of rationing care. If anyone cares to read the full guidance document, it’s here:
      http://www.nice.org.uk/nicemedia/pdf/CG88NICEGuideline.pdf

      The document contains plenty of other examples of rationed care and really is worth reading. It recommends against typical diagnostic tools. Chiropractors and osteopaths are described in equivalent terms as physical therapists and doctors despite their huge differences in training. The physical therapy service is badly overburdened so effectively the guidance is telling GPs to send these patients off for (much cheaper) acupuncture or chiropractic treatment instead.

      I’m an NHS survivor. To give you a hint of the overburden… I broke my back and my wait time for outpatient physical therapy was around 2-3 weeks. Once accepted as a patient, I had 3 x 20 minute visits over the course of 9 weeks. For less severe injuries (i.e., you’re not on medical leave from your job), the wait time can be four months or more. I’m in Scotland and they’re fond of saying it’s worse in England. I don’t know if that’s true or not.

      As an aside, private practice physical therapy businesses are booming over here. Quality can be quite variable, but the good ones tend to be in demand and charge more for their services. Funny how that works.

      My own (limited) experience with cortisone injections is that they are used after other treatments are ineffective and before surgical intervention… and when the injection is done properly, they can be enormously effective for pain management. The NHS has found yet another way of discounting doctors’ judgement to pinch a few pennies.

      What’s worse, I don’t really understand the cost savings here. A single cortisone shot can give someone months to years of benefit. Instead, these patients just add to the overburden, which means more GP visits, longer wait times for specialists and more money spent on ineffective treatments and/or painkillers.

    26. #26 |  Windy | 

      This couple should be suing each cop who was involved in this travesty of justice as individuals. The taxpayers should not have to cover the costs of this suit, nor any judgement or settlement amount. This kind of cruelty would stop really quickly if people started suing the cops who are guilty of misconduct as individuals instead of suing the department or government jurisdiction.

      It would also help if cops who do not participate in such travesties would report to their superiors and the media those who do, instead of hiding behind the “blue line” and keeping quiet about abuses of power, wrongful arrests, etc..

    27. #27 |  JS | 

      They can’t. Police officers in this country can’t be sued for what they do on the job.

    28. #28 |  Lee | 

      I had another thought while at lunch.

      I’m pretty sure that we would all agree that the British system is socialized medicine (far more than our system already is).

      Is the Swiss model socialized medicine?

    29. #29 |  The Angry Optimist | 

      Lee – No.

    30. #30 |  Windy | 

      “They can’t. Police officers in this country can’t be sued for what they do on the job.”
      That’s a fucked policy, if true. Victims should change that by attempting to file lawsuits, anyway, and we should be lobbying law firms and such agencies as the ACLU (and other similar) to help get the laws changed, otherwise it will only get worse, until the point where people begin to take their freedoms back with guns.

    31. #31 |  joev | 

      well alrighty then. that was a compliment i offered to dave with a bit of tongue in cheekiness.

      apologies you didn’t find it appropriate radley.

      dave, nice one sir.

    32. #32 |  joev | 

      oops, nevermind, different story. jeesh, i need to get more coffee i me on mondays.

    33. #33 |  Helmut O' Hooligan | 

      #26 Windy: “This kind of cruelty would stop really quickly if people started suing the cops who are guilty of misconduct as individuals instead of suing the department or government jurisdiction.

      It would also help if cops who do not participate in such travesties would report to their superiors and the media those who do, instead of hiding behind the “blue line” and keeping quiet about abuses of power, wrongful arrests, etc..”

      Very well said, Windy. However, people (and their lawyers) go for the institution rather than the individual, because that is where the money is. But change is always possible.

      I think you are really on to something. Litigation against rogue or incompetent LEO’s should not be about the money. It should be about principle. It should be about exposing people that have violated an oath and abused the public trust. If we want to separate the bad and the ugly from the basically good in policing, we need to take steps to remind officers that they are INDIVIDUALS, not a monolithic group. As such, they will be held responsible as individuals for their actions.

      As lawsuits against individual officers become more common, I think more cracks will begin to show in the blue wall. Even officers who are “on the fence,” ethically speaking, may just decide that they don’t want to be a part of shady dealings because they don’t want to be hauled into court. And for those officers who are opposed the rogue behavior, this change will make them bolder. Individual law suits, coupled with other innovations such as cell phone cameras, youtube and other “little brother” empowerment programs could produce a major shift in the relationship between police and citizens.

    34. #34 |  Chet | 

      As it stands, 85% of people have health care coverage

      So do most of the people who are bankrupted by medical bills. “Coverage” isn’t the answer; “adequate coverage” is. Ending rescission, which none of the insurance company executives would agree to do. (Every single one flat-out refused to do so when asked to by Congress.)

      We’re not talking about “1%”. That’s an absurd distortion. We’re talking about everybody.

    35. #35 |  Dave Krueger | 

      When you listen to the health care reform debate, the one thing that seems crystal clear is that almost everyone in the debate thinks it’s going to make health care cheaper for them.

      If it passes and it costs anything close to what they predict, I hereby promise to walk from LA to NYC naked.

    36. #36 |  Cynical in CA | 

      “When Grunt the family dog started barking, court documents indicated one of the officers enticed the dog to coming running and shot him point blank. “I lost my best friend. He helped me when I needed him to help without being told or trained,” said Kevin Henderson.”

      I have to restrain the urge to vomit.

      Sometimes I wish the human race never existed. Its capacity for cruelty is infinite.

      How on Earth anyone can support the State and its agents is beyond my comprehension. It is Stockholm Syndrome writ large.

    37. #37 |  Dave Krueger | 

      #36 Cynical in CA

      How on Earth anyone can support the State and its agents is beyond my comprehension.

      It’s just a few bad apples, you know.

    38. #38 |  Helmut O' Hooligan | 

      #36 Cynical:

      If you feel that way about the human race in general, why focus on the crimes of the state and its agents specifically? What about multinational corporations, not-for-profit entities, partnerships, houses of worship, communes, tribes, families and other groups composed of human beings? With or without the state, you will have to interact at some point with organized groups of people. Margaret Thatcher was dead wrong. There IS such a thing as society, and it appears whenever two or three people begin to work together or depend on one other in some way.

      I believe the focus of freedom-loving people should be to encourage people to see themselves primarily as individuals who need to take responsibility for their own behavior. If this leads to different forms of organization in the future, so be it.

    39. #39 |  Dave Krueger | 

      #38 Helmut O’ Hooligan

      There IS such a thing as society, and it appears whenever two or three people begin to work together or depend on one other in some way.

      You call it society, I call it a mob. You say tomato, I say…
      :)

    40. #40 |  expat | 

      What would that price be, specifically? In the US, these shots can cost $1200 or more, depending on the dosage and location.

      No way. The cost of a cortisone injection is much lower than $1200. That high cost is because of all of the mark-ups along the food chain.

      Cortisone has been around a while, so as far as medicines go, it is probably pretty cheap. Other more recently-developed steroids might be more expensive. The specialist’s time is the big expense for the actual delivery of treatment. Embed into the specialist’s time the cost of running the clinic for the amount of time you took up and that should be your total cost for treatment. Most likely, you don’t pay the specialist directly for his/her time. Presumably, both you and your employer pay another company for health insurance for you and your insurance company would make the payment for your treatment to the clinic or hospital. You might have a copayment due at the clinic when you get your treatment. In order to make profit, your health insurance company wants to spend as little of your and your employer’s money as possible on your treatment. The insurance company could also take several weeks or months to pay for your treatment. Clinics and hospitals have to employ anywhere from an individual to an entire billing department just to deal with insurance claims. The clinic or hospital probably charges the insurance company the actual costs of delivering treatment plus the cost of the additional staff and resources required to obtain that payment, including the lag time between services provided and payment received. I am oversimplifying. Costs for the uninsured who are billed via the same department as the insurance companies, discrepancies between what insurance providers actually pay (e.g., Medicare saying it will pay X for a treatment, even if actual cost Y exceeds X) and all of the bits of paper or electrons flying between clinics, hospitals and insurance providers justifying care also help drive up costs. I’m probably missing other costs, but everything combined makes up that treatment cost of $1200+. I would be surprised if the cost of the actual treatment itself made up even half of that amount.

    41. #41 |  SusanK | 

      I wouldn’t wish chronic pain on anyone, except maybe Lee, who seems to think it doesn’t exist.
      First time I had a cortisone shot, I thought it was HEAVEN.
      The biggest problem with chronic pain sufferers are the people who minimize the torment of it because they think it doesn’t exist. Its something that is extremely hard to wrap your head around until it happens to you. That’s why we have prosecutors charging doctors and patients for prescribing or using “too much”.

    42. #42 |  Chet | 

      Most likely, you don’t pay the specialist directly for his/her time. Presumably, both you and your employer pay another company for health insurance for you and your insurance company would make the payment for your treatment to the clinic or hospital. You might have a copayment due at the clinic when you get your treatment. In order to make profit, your health insurance company wants to spend as little of your and your employer’s money as possible on your treatment. The insurance company could also take several weeks or months to pay for your treatment. Clinics and hospitals have to employ anywhere from an individual to an entire billing department just to deal with insurance claims. The clinic or hospital probably charges the insurance company the actual costs of delivering treatment plus the cost of the additional staff and resources required to obtain that payment, including the lag time between services provided and payment received. I am oversimplifying.

      The next time someone has doubts that single-payer will actually reduce costs, can I just point them to your post? Thanks.

    43. #43 |  billy-jay | 

      Medicare will go away on its own. The only question is if it will take everything else with it.

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