I have followed the last few days of oral arguments before the supreme court on the Affordable Care Act with interest. I still haven't developed an official opinion about the bill but for the most part find myself agreeing with most of the provisions in the law. However, the law is so complex and so huge I don't feel like I know everything about it, which worries me. I don't want to go into practice in a few years and get blindsided by some provision I wasn't aware of.
Health care in the US is sort of a mess. CNN recently did a story on a little girl who had a rare medical condition that required frequent, expensive medical care to keep her alive. Her parents rejoiced when the law was passed because it eliminated the lifetime spending cap. I think in this specific case the cap was at $5 million and the little girl was only 3 and up to around $3 million in care. Her parents were worried that she'd be kicked off the plan as soon as she hit her limit and her parents would have no way to pay for her care.
I have to spend one half day every other week with a family practice physician in Centerville. Last week when I was in I met a woman who had a son that she was not able to get coverage for because he had a "pre-existing condition." His father had been laid off, lost health insurance, and the boy lost coverage for more than a month, making insurance companies able to deny coverage based upon pre-existing condition. His parents were now facing bankruptcy trying to pay for his medical care because he was uninsurable.
As I understand it, this current bill really is contingent on the individual mandate, and it makes economic sense. How can you ask insurance companies to cover more expensive people (those with pre-existing conditions, no more lifetime limits) without increasing the base of healthy people to spread the cost out. Listening to the arguments it does sound to me like the individual mandate is indeed unconstitutional and an overreach of federal power. With that being said, what can we do to fix these problems?
I don't think any of us wants to see people with pre-existing conditions denied health insurance, nor do we want to see 5 year old girls kicked off their health insurance because they were born with an expensive medical condition. This seems like a very tough problem to tackle, and I certainly don't have the answers.
What do you guys think?
Wednesday, March 28, 2012
Tuesday, March 27, 2012
Best. Headline. Ever.
Creighton, were you and your pot-smoking partner Alex, by chance, in West Covina yesterday dressed in all black?
Found this on Drudge today and thought I'd share.
Friday, March 9, 2012
Utah Legislators at it again
Earlier this week, Utah legislators waded into controversy by passing "abstinence-only" sex education in Utah. Sponsors of the bill claim that sex education should be left up to the parents, and that this subject should only be taught in the home. Districts can completely opt out of providing sex education, but if they choose to teach sex education, they must teach abstinence-only.
This is an absolute joke. This is political pandering at its worst. Let me share why.
I received plenty of abstinence-only sex education at home and at school during seminary. This is the proper place for moral instruction. I can tell you that in high school (and Finn can vouch for this), ALL of my non-LDS friends were sexually active in one way or another and half of my LDS friends were sexually active. I think nationwide estimates put the number around 50-60% of all teenagers coming out of high school have had a sexual encounter.
Most of my friends practiced the "pull-out" form of contraception. This is the method of pulling out just prior to ejaculation to avoid sending sperm into the vagina. All of them thought they could never get a girl pregnant this way, but little did they know that there are sperm in the pre-ejaculate, and all of them were playing with fire every time they had sex. One of my LDS friends later told me he couldn't believe how naive he had been, and he counted himself very lucky he wasn't a teen father.
I heard other rumors in high school about contraception that were not true. Some girls thought if you douched with Coca-cola after having intercourse, that would destroy the sperm. Some of my friends thought if you had sex in a hot tub, the girl could not get pregnant. Many of them thought it impossible to get pregnant the first time they ever had sex. The list goes on and on.
We live in a real world. Obviously, I and all of you believe in abstinence-only before marriage. But what about after marriage? Many of us have used various forms of contraception, the likes of which I had no idea about until we had a two hour lecture on it from Andy Anderson's wife in physiology at Utah State. Did I instantly think that I had just been taught about how to away with sex like some Utah legislators are claiming and go out and start banging every girl I saw? No.
The current policy in Utah has parents sign a permission slip that allows the school to instruct the students about various forms of contraception, sexually-transmitted diseases, and other sex-related material. If you choose to withhold your child from these courses, you are absolutely permitted to do that, and currently about 10% of Utah parents do. That means 90% of Utah parents choose to have their children attend these courses to learn about these things.
What I really wanted to be able to do was give the Utah lawmakers a multiple choice test covering the material of sex-education and see if the could even pass. My guess is that most would get about half the answers right. As a parent, I want my children to have sex education at school and then be able to talk to them about it and answer any additional questions they might have.
As soon as the bill passed, thousands of calls were put into the governor's office, a petition gaining tens of thousands of signatures (including mine and most the students in my medical class), emails and letters have all been sent to prod the governor to veto the bill. On an LDS church owned news website, the following poll was conducted:
This is an absolute joke. This is political pandering at its worst. Let me share why.
I received plenty of abstinence-only sex education at home and at school during seminary. This is the proper place for moral instruction. I can tell you that in high school (and Finn can vouch for this), ALL of my non-LDS friends were sexually active in one way or another and half of my LDS friends were sexually active. I think nationwide estimates put the number around 50-60% of all teenagers coming out of high school have had a sexual encounter.
Most of my friends practiced the "pull-out" form of contraception. This is the method of pulling out just prior to ejaculation to avoid sending sperm into the vagina. All of them thought they could never get a girl pregnant this way, but little did they know that there are sperm in the pre-ejaculate, and all of them were playing with fire every time they had sex. One of my LDS friends later told me he couldn't believe how naive he had been, and he counted himself very lucky he wasn't a teen father.
I heard other rumors in high school about contraception that were not true. Some girls thought if you douched with Coca-cola after having intercourse, that would destroy the sperm. Some of my friends thought if you had sex in a hot tub, the girl could not get pregnant. Many of them thought it impossible to get pregnant the first time they ever had sex. The list goes on and on.
We live in a real world. Obviously, I and all of you believe in abstinence-only before marriage. But what about after marriage? Many of us have used various forms of contraception, the likes of which I had no idea about until we had a two hour lecture on it from Andy Anderson's wife in physiology at Utah State. Did I instantly think that I had just been taught about how to away with sex like some Utah legislators are claiming and go out and start banging every girl I saw? No.
The current policy in Utah has parents sign a permission slip that allows the school to instruct the students about various forms of contraception, sexually-transmitted diseases, and other sex-related material. If you choose to withhold your child from these courses, you are absolutely permitted to do that, and currently about 10% of Utah parents do. That means 90% of Utah parents choose to have their children attend these courses to learn about these things.
What I really wanted to be able to do was give the Utah lawmakers a multiple choice test covering the material of sex-education and see if the could even pass. My guess is that most would get about half the answers right. As a parent, I want my children to have sex education at school and then be able to talk to them about it and answer any additional questions they might have.
As soon as the bill passed, thousands of calls were put into the governor's office, a petition gaining tens of thousands of signatures (including mine and most the students in my medical class), emails and letters have all been sent to prod the governor to veto the bill. On an LDS church owned news website, the following poll was conducted:
I know this is a small sample size but for 80% of likely conservative readers to think Gov. Herbert should veto this bill is significant.
However, Governor Herbert obviously doesn't care what the people of Utah think:
"Herbert was not available for comment Friday, but a spokeswoman said the governor's office has received thousands of calls, emails and letters regarding HB363. Herbert has said that he will not be swayed by mass email campaigns and would make a decision based on what is the best policy for the state of Utah."
I know some of you may argue that it's no place for the government to be teaching your children about sex education. I would argue that a public education should be correcting myths and providing correct information about contraception and including an element of abstinence being the best policy. Information and knowledge is not something to be feared but embraced. If Governor Herbert decides politics is more important than the health of teenagers, he will lose my vote and support come next election.
Just a conclusion from a national study done on abstinence-only sex education programs:
"This assessment of the impact of formal sex education programs on teen sexual health using nationally representative data found that abstinence-only programs had no significant effect in delaying the initiation of sexual activity or in reducing the risk for teen pregnancy and STDs. In contrast, comprehensive sex education programs were significantly associated with reduced risk of teen pregnancy, whether compared with no sex education or with abstinence-only sex education, and were marginally associated with decreased likelihood of a teen becoming sexually active compared with no sex education."
Sunday, March 4, 2012
Some Rights Are More Equal Than Others
Is contraception a right?
Much of today's political discourse skirts the question whether this or that activity or status or good or service is a "right."
The Declaration of Independence has a partial list of self-evidently "inalienable" rights that drafters, including one slave owner, agreed were bestowed on all men by their Creator. Life, liberty, and the pursuit of happiness. In the Bill of Rights, the vague Pursuit of Happiness became Property (5th Amendment). Modern discussion of "rights" have warped the concept to the point that it is near meaningless to speak of "rights."
Housing and healthcare are widely regarded (now) as rights. Compare these with the type that are included in the Bill of Rights, and some real differences emerge.
Housing and healthcare are goods and services. I can enjoy them only if someone pays for them. If they are a right, they must be supplied to me. But who pays for them? The builder or doctor, or a current or future taxpayer, must be compelled to provide them. So their rights to liberty or property are undone by my right to housing or healthcare. New rights aren't bestowed by the Creator, they are supplied by government force.
Because they come through government force, new rights are not "inalienable." They are very alienable. Just ask the employees of church hospitals and soup kitchens. If they had a right to contraception, some political pressure was all it took to wipe the right away. So new rights come and go with each political breeze.
With one interesting exception old rights are "negative" in the sense that they are couched as things the government should not interfere with. My (old) rights may bump up against your (old) rights, in which case government (usually via the courts) plays referee. But old rights almost always are: "Government, don't ____" Fill in the blank with "muzzle me" or "censor my book" or "confiscate my gun" or "tell me what to worship."
The only exception I can think of is the right to defend yourself from criminal prosecution. This includes the right to a speedy jury trial, to cross-examine witnesses, and to have an attorney help you. These are resources the government must allow you to have in order to take on the government.
New rights are not like old rights. New rights aren't about restricting the government from interfering in your life. New rights are about empowering the government to run your life by fostering dependency on government-supplied goods and services.
Once you say healthcare is a right, then contraception drugs and services must be free, and the refusal of government to force someone (everyone? the wealthy?) to pay for it is tantamount to a ban. Government must also pay for abortion. I really don't understand how the Catholic Church or anyone else can be surprised by any of this.
The Constitution is not so much about the "what" as about the "who." Once government gets to determine people's rights without reference to the Constitution, there is no telling what "rights" will be inflicted on us.
Much of today's political discourse skirts the question whether this or that activity or status or good or service is a "right."
The Declaration of Independence has a partial list of self-evidently "inalienable" rights that drafters, including one slave owner, agreed were bestowed on all men by their Creator. Life, liberty, and the pursuit of happiness. In the Bill of Rights, the vague Pursuit of Happiness became Property (5th Amendment). Modern discussion of "rights" have warped the concept to the point that it is near meaningless to speak of "rights."
Housing and healthcare are widely regarded (now) as rights. Compare these with the type that are included in the Bill of Rights, and some real differences emerge.
Housing and healthcare are goods and services. I can enjoy them only if someone pays for them. If they are a right, they must be supplied to me. But who pays for them? The builder or doctor, or a current or future taxpayer, must be compelled to provide them. So their rights to liberty or property are undone by my right to housing or healthcare. New rights aren't bestowed by the Creator, they are supplied by government force.
Because they come through government force, new rights are not "inalienable." They are very alienable. Just ask the employees of church hospitals and soup kitchens. If they had a right to contraception, some political pressure was all it took to wipe the right away. So new rights come and go with each political breeze.
With one interesting exception old rights are "negative" in the sense that they are couched as things the government should not interfere with. My (old) rights may bump up against your (old) rights, in which case government (usually via the courts) plays referee. But old rights almost always are: "Government, don't ____" Fill in the blank with "muzzle me" or "censor my book" or "confiscate my gun" or "tell me what to worship."
The only exception I can think of is the right to defend yourself from criminal prosecution. This includes the right to a speedy jury trial, to cross-examine witnesses, and to have an attorney help you. These are resources the government must allow you to have in order to take on the government.
New rights are not like old rights. New rights aren't about restricting the government from interfering in your life. New rights are about empowering the government to run your life by fostering dependency on government-supplied goods and services.
Once you say healthcare is a right, then contraception drugs and services must be free, and the refusal of government to force someone (everyone? the wealthy?) to pay for it is tantamount to a ban. Government must also pay for abortion. I really don't understand how the Catholic Church or anyone else can be surprised by any of this.
The Constitution is not so much about the "what" as about the "who." Once government gets to determine people's rights without reference to the Constitution, there is no telling what "rights" will be inflicted on us.
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