Plus c’est la même chose

Excerpts from an extensive article at the National Institute of Health (Because this is an extended quote, I’ve chosen to italicize it rather than indent for readability.).

Citations omitted:

THE SARS EPIDEMIC AND ITS AFTERMATH IN CHINA: A POLITICAL PERSPECTIVE

This “strange disease” alerted Chinese health personnel as early as mid-December. On January 2, a team of health experts was sent to Heyuan and diagnosed the disease as an infection caused by a certain virus… A Chinese physician, who was in charge of treating a patient from Heyuan in a hospital in Guangzhou, quickly reported the disease to a local anti-epidemic station… We have reason to believe that the local anti-epidemic station alerted the provincial health bureau about the disease,

On January 27, the report was sent to the provincial health bureau and, presumably, to the Ministry of Health in Beijing. The report was marked “top secret,” which meant that only top provincial health officials could open it.

Further government reaction to the emerging disease, however, was delayed by the problems of information flow within the Chinese hierarchy. For 3 days, there were no authorized provincial health officials available to open the document. After the document was finally read, the provincial bureau distributed a bulletin to hospitals across the province. However, few health workers were alerted by the bulletin because most were on vacation for the Chinese New Year. In the meantime, the public was kept uninformed about the disease.

[U]ntil such time as the Ministry chose to make information about the disease public, any physician or journalist who reported on the disease would risk being persecuted for leaking state secrets. A virtual news blackout about SARS thus continued well into February.

On February 11, Guangdong health officials finally broke the silence by holding press conferences about the disease.

From then on, information about the disease was reported to the public through the news media. Yet in the meantime, the government played down the risk of the illness. Guangzhou city government on February 11 went so far as to announce the illness was “comprehensively” under effective control. As a result, while the panic was temporarily allayed, the public also lost vigilance about the disease. When some reports began to question the government’s handling of the outbreak, the provincial propaganda bureau again halted reporting on the disease on February 23. This news blackout continued during the run-up to the National People’s Congress in March, and government authorities shared little information with the World Health Organization until early April.

In fact, the Chinese Center for Disease Control and Prevention did not issue a nationwide bulletin to hospitals on how to prevent the ailment from spreading until April 3, and it was not until mid-April that the government formally listed SARS as a disease to be closely monitored and reported on a daily basis under the Law of Prevention and Treatment of Infectious Diseases.

[T]here is no doubt that [CCP] government inaction paralleled by the absence of an effective response to the initial outbreak resulted in a crisis.

On May 12, the very same day that Premier Wen Jiabao released the new regulations to promote openness, the Beijing Morning News carried an article on how people who spread “rumors” about SARS could be jailed for up to 5 years.

You will have noted a few minor discrepancies in this account from our current situation. Locations, precise dates, leadership names. That’s because this 2004 article describes events that took place during the SARS outbreak in 2003. The players change, but the game remains the same.

Given the CCP’s track record, the World Health Organization’s deference regarding the 2019 virus is unconscionable. If you read the whole article, you’ll likely come away with the impression it was better handled in 2003.

Fumble Delay Abet

This is scandalous.

Brian H. Shirts, M.D., is a molecular pathologist at the University of Washington. He writes: We’ll see more shortages of diagnostic tests if the FDA has its way

“February was a frustrating month for my laboratory. We wanted to make tests to detect the virus that causes Covid-19. My virology colleagues had great ideas and solid testing platforms. The Food and Drug Administration told us to stop. [That link is worth reading!]

Why? Because of a quirk in FDA regulations. Diagnostic tests are currently regulated in one of two ways, and there’s no clear rule to determine which one applies to coronavirus tests. This uncertainty is a big part of why test shortages have caused a national crisis.

This uncertainty is no accident. James Bovard, at Mises Institute:

“Dr. David Kessler, who became FDA commissioner in 1990, quickly sought to intimidate the companies that his agency regulates. A laudatory Washington Post article concluded, “What he cannot accomplish with ordinary regulation, Kessler hopes to accomplish with fear.” Kenneth Feather of the FDA’s drug advertising surveillance branch boasted: “We want to say to these companies that you don’t know when or how we’ll strike. We want to eliminate predictability.”

See the notes at the end of this post.

Now, back to Dr. Shirts:

“The VALID Act, introduced in Congress in early March, aims to address the confusion about who regulates diagnostic testing, but it would make the situation worse. If the VALID Act passes, we would see shortages in diagnostic tests for even more diseases than Covid-19, including cancers.

Under one system of regulation, laboratory directors are licensed by their states to develop tests through a set of rules called the Clinical Laboratory Improvement Amendments (CLIA). When a CLIA-licensed lab creates a test and documents that it works, doctors can order that test.

Diagnostic testing, and interpreting those tests, is considered the practice of medicine. The FDA is not allowed to regulate the practice of medicine. Yet it is responsible for regulating medical devices. Diagnostic tests use machines, sample tubes, and other tools that are clearly medical devices.

Here’s where the second system comes in: The FDA approves devices — not the lab that produces it — on a case-by-case basis. So which diagnostic tests are devices regulated by the FDA and which are laboratory-developed tests regulated through CLIA?

The FDA gets to choose…

The VALID Act will give the FDA power to create more monopolies on diagnostic tests. CLIA-licensed labs will be shut out of producing new tests that perform as well as FDA-approved versions — or better than them. The result will be higher costs and periodic shortages…

The VALID Act was created because large pharmaceutical companies wanted to have monopolies on cancer tests…”

If you recall, the FDA granted a monopoly to the CDC for CCP virus test kits. The kits were quite late, few, and didn’t work.

With the VALID Act, the FDA is going to be able to create a public/pirate partnership – making private industry more like the CDC.

Notes. Thoughts on complex and uncertain ‘law’ in the hands of unaccountable bureaucrats.

“After having thus successively taken each member of the community in its powerful grasp and fashioned him at will, the supreme power then extends its arm over the whole community. It covers the surface of society with a network of small, complicated rules, minute and uniform, through which the most original minds and the most energetic characters cannot penetrate, to rise above the crowd. The will of man is not shattered, but softened, bent, and guided; men seldom forced by it to act, but they are constantly restrained from acting. Such a power does not destroy, but it prevents existence; it does not tyrannize, but it compresses, enervates, extinguishes, and stupefies a people, till each nation is reduced to nothing better than a flock of timid and industrious animals, of which the government is the shepherd.”
-Alexis de Tocqueville

“We’re after power and we mean it… There’s no way to rule innocent men. The only power any government has is the power to crack down on criminals. Well, when there aren’t enough criminals one makes them. One declares so many things to be a crime that it becomes impossible for men to live without breaking laws. Who wants a nation of law-abiding citizens? What’s there in that for anyone? But just pass the kind of laws that can neither be observed nor enforced or objectively interpreted – and you create a nation of law-breakers – and then you cash in on guilt. Now that’s the system, Mr. Reardon, that’s the game, and once you understand it, you’ll be much easier to deal with.”
-Ayn Rand.

Germ theory denialism

99% of the anti-vaxxers in and near Portland, Oregon will call you a “science denier” if you suggest CAGW is debatable in any way. Simultaneously, they choose to risk the death of their children from measles.  Never mind the danger to others of providing many more disease vectors.

State of emergency declared in US measles outbreak

This is a serious disease we had eliminated in the United States 20 years ago, until these morons decided to believe the germ theory of disease didn’t apply to them; while inviting thousands of poor people from third-world countries to live among them without medical exams.

Apparently, there’s no victim-identity group for “children who haven’t had measles vaccinations.” Odd, since there is one for “sex-transitioning 10 year olds.”

Perhaps the fact that measles is a very serious disease when contracted by an adult male contributes to the disdain for vaccination among these Rousseauian wannabes.

Finding out what’s in it

Changing Stance, Administration Now Defends Insurance Mandate as a Tax

When Congress required most Americans to obtain health insurance or pay a penalty, Democrats denied that they were creating a new tax. But in court, the Obama administration and its allies now defend the requirement as an exercise of the government’s “power to lay and collect taxes.”

…“For us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase,” the president said last September,

He forgot to add, “Until we have to defend it in court.” Of course, the question is semantic, whatever term is used.

Insurers Push Plans Limiting Patient Choice of Doctors

The relentlessly rising cost of health insurance is prompting some small Massachusetts companies to drop coverage for their workers and encourage them to sign up for state-subsidized care instead,…

Since April 1, the date many insurance contracts are renewed for small businesses, the owners of about 90 small companies terminated their insurance plans with Braintree-based broker Jeff Rich and indicated in a follow-up survey that they were relying on publicly-funded insurance for their employees.

“Publicly-funded” may be the most dangerous phrase in the English language. Of course, you’ll be able to keep your doctor and your current health insurance under a Federal plan. The president said so.

Lost in Taxation

[W]ith ObamaCare, the agency [IRS] is now responsible for “the most extensive social benefit program the IRS has been asked to implement in recent history.” And without “sufficient funding” it won’t be able to discharge these new duties…

Well, well. Republicans argued during the health debate that the IRS would have to hire hundreds of new agents and staff to enforce ObamaCare. They were brushed off by Democrats and the press corps as if they believed the President was born on the moon.

No. That’s Hawaii.

I can’t wait to find out what’s in the financial “reform” legislation.

The very definition of a modern major death panel

Brought to you directly from the Kevorkian annex of the UK’s National Health “Service.”

Sentenced to death on the NHS

Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors have warned.

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

RTWT

Consumer driven health care


Here is an interesting post on market driven health care from National Center Blog’s David Hogberg, who picks a bone with someone named Matthew Holt.

Holt uses LASIK eye-surgery as an argument against consumer driven health care. Since LASIK cost has fallen 30 inflation-adjusted percentage points in the last decade and since customer satisfaction averages 93 percent, it seems a poor example. Apparently, Mr. Holt’s complaints are that consumers are not well enough informed, and that advertising fails to reveal that the services of all providers are not identical.

The National Center Blog does a fine job of pointing out that this objection is basically twaddle, but let me add a bit, including a personal experience and some prognostication.

I’m near the front edge of the baby boomer cohort and until very recently, had had no experience with any medical condition that could be considered chronic, i.e. with long term implications. The short version of the story is that at the urging of my better half I undertook a sleep study to find a cure for what she claimed was a snoring problem.

The diagnosis of sleep apnea offered a choice of 60 percent successful surgery requiring an overnight stay in an ICU and 4 weeks of recovery, much of it very painful, or a potentially uncomfortable machine which I would probably have to use every night for the rest of my life.

I decided I’d try the machine first. I was naturally interested in the comfort features most likely to allow me to avoid surgery. So, I did some research. There is no central information source for these machines, but there are many vendors on the internet and a multitude of discussion groups and even blogs. I discovered a great deal about the machines through advertising, and I settled on certain features.

Armed with an idea about what I should look for, much in the way I would research a car or a major appliance, I obtained a second opinion and a prescription for this “Class A Medical Device.” I expected my final decision to be made after a visit to some kind of showroom where I could estimate the utility for travel, the control functions, features I may not have already discovered and general reputation of various manufacturer’s offerings. That is, I wanted to speak with a salesman.

Such a place only exists on the internet. Instead, I received a call from the respiratory technician of my doctor’s choice, who informed me he had a particular device ready and could deliver it in a couple of days. I asked about the features that were important to me, features that had never been discussed with me by anyone in the not-consumer driven health care arena. I was informed that I did not need those features because my prescription did not specify them. I informed him that since I would likely be using this thing for the rest of my life, I thought the features did matter. After a great deal of goofing about with a health care system that had already decided I was not competent to participate in this decision, I got what I wanted.

The point is that the “health care system” isn’t really prepared for consumer choice. The prognostication is, that as more baby boomers bump into such issues, they will bring both their expectations of consumer choice and their intransigent feelings of “specialness” to bear in ways the health care system had better get ready to appreciate, even if Matthew Holt never does.

LASIK enjoys 93% customer satisfaction because it involves cutting your eyes with a laser. I bet people tend to be interested in the success rates even more than I was with my machine.

Now, add to that the fact that a Health Savings Account combines the tax reduction advantages of a traditional IRA with the tax avoidance advantages of a Roth IRA. That is, contributions to an HSA are tax deductible and, if you spend the proceeds on health care they are never taxed.

You can pass on an HSA as an inheritance. You will not be able to do that with Mr. Holt’s opinion.

Consumer interest in medical care is clear, and the market will supply more and more information as baby boomers demand it. We haven’t had a free market in health care for decades and we don’t have one now. Speculation about the dearth of this market is premature.