Life Is Hard...

New York Times Almost Gets It!

This article praises the Medicare and Veterans Administration for instituting reforms that are saving lives across the country. Some exerpts.

The Problem:

Lifesaving treatments often are forgotten while doctors and hospitals lavish patients with an abundance of care, which can involve expensive procedures of questionable value. The results are high costs, unnecessary medicine and wasted opportunities to save lives and improve health.

The Solution:

...Medicare administrators decided to focus on just a few treatments at first, for a few common diseases - pneumonia, heart attacks and heart failure - where there was little controversy about whether those treatments worked and an abundance of data showing that doctors and hospitals often did not provide them.

The Results:

But not long ago, only 30 percent of V.A. patients who should get the vaccine received it (the national average is 50 percent). The rude awakening came when the department showed individual teams of doctors and individual clinics and hospitals how often they were vaccinating and how their rates compared with those of other medical teams. "It's pretty revealing to have the data," Dr. Perlin said. "Absent the data, you think you are doing a pretty good job."

Now 90 percent of V.A. patients who should get the vaccine do.

"By increasing the rate of pneumonia vaccination just for patients with emphysema, the V.A. saved 6,000 lives," Dr. Perlin said.

And how did the government achieve these amazing results?

So the agency asked the nation's hospitals to report how well they did in providing these treatments if they wanted this year's cost-of-living increase in Medicare payments. Ninety-eight percent complied.

Medicare expects that now that the hospitals' performances are public, many will try to improve. "People will begin to feel a little awkward if everyone else is doing better and they're not," Dr. Jencks said.

The next step, Dr. Jencks said, is "aligning payment with what you want people to do."

To that end, Medicare has a pilot program to pay hospitals for improving on a number of quality measures, including mortality rates and readmission rates for hip or knee surgery. Hospitals in the top 10 percent for a given condition, for example, will be paid an extra 2 percent. The agency will pay less if performance deteriorates. The project involves 278 hospitals affiliated with Premier, a nationwide organization of nonprofit hospitals.

Dr. Jencks said he expected that in the future hospitals and doctors would be paid according to whether they gave patients treatments that worked. "It is very clear that we are moving toward pay-for-performance," he said.

Holy Smokes! Market reforms, including publicly available performance data! Why, this sounds like... [drum roll] ... Compassionate Conservatism! And whaddya know, it is working.

So what word or phrase was conspicously absent from the article?

How about "Bush Administration"?

Pull The Beam Out Your Eye Already

One could spend a lifetime just fisking this single article. (mirror available here)

Just a few things that particularly bothered me.

1) The misuse of scripture. Excerpt:

1 John seems to be obsessed with language like this: 'How can you say you love God, who you have not seen, if you do not love your brother and sister, who you have seen?' Who are in need of food, clothing, shelter? The implication of the doctrine of the Antichrist is that there is an economic disparity in the community, and people are using their religion, not practicing it."

First, charity is when you give of your own to those in need. Charity is not when you take from one man and give to another. That is called wealth redistribution. It is also called thievery. Second, Christ said, "The poor you have with you always", which sounds like a pretty strong statement on the usefulness (or uselessness) of a government-engineered "War On Poverty."

2) The straw-man Antichrist. First, redefine the word to fit your preferred meaning, then invent evidence to bolster your opinion! Excerpt:

The idea of deception is crucial. The Antichrist isn't the devil, the opposite of God. He's an evil human masquerading as a golden god....

In this sense, the Bush church is Antichristlike indeed. It is institutionalized deception, anti-American ugliness with a beguiling face, a neocon job. Only when necessary does it employ the perilous bald-faced lie, the outrageously transparent duplicity—the political equivalent of Robertson arguing that "Do unto others" indicates Christ's support of capitalist selfishness. More often, a smoothly dissembling surface is preferred. Rove notoriously emulates Machiavelli; the Christian right is a stealth movement, infiltrating school boards and mainstream churches and every institution of democracy like a thief in the night—in order to undermine, overthrow, and replace democracy with theocracy. Bush is the father of lies. The Union of Concerned Scientists proclaims Bush's lies about science "unprecedented." In With God on Their Side, Kaplan concludes, on mountainous evidence, "The goal is not to engage your opponents in the public square, but to kneecap them, or send them into exile."

First, how do you engage your opponents in the public square, when they call you the Father of Lies, lump your advisors together with Machiavelli, and compare your supports to 'thieves in the night?' Second, although I can't speak for the context of Robertsons "Do unto others" commentary, since I have never listened to anything the old fellow has to say, I can still easily see how "Do unto others" applies to a capitalist society. Namely, to have honest economic relations with your fellow man! That is, don't cheat him, don't steal from him, and don't covet his belongings. See: Wealth Redistribution. Third, and really this should be obvious by now... Yes, there is 'mountainous evidence' that global warming is real. Well duh. (If it wasn't my city would still be covered with a giant ice cube.) The clincher is that there is NO 'mountainous evidence' that humans are responsible. Deal with it.