Category Archives: Medicine

Neurodiversity and the church: exploratory thoughts

Posted on by | No Comments

As I noted briefly a few weeks ago, the church has a neurodiversity problem which it needs to address.  Those of us who are neurodivergent in one way or another face challenges both in corporate worship and in the discipleship programs of the church, but the typical congregation is unaware or dismissive of these challenges.   If you or your children have ADD, or are on the autism spectrum, or deal with dyslexia, or have other neurological/neurochemical processing issues that make you different from neurotypical folks, you’re most likely on your own.  What works for “everyone else” ought to work for you, and it’s up to you to make it work.

Part of the issue is that neurotypical people do not understand what it is to be neurodiverse—and usually don’t see any need to.  Neurodivergent conditions are defined from the outside by neurotypical people, and they are defined symptomatically.  Put another way, these conditions (and thus, by extension, those who have them) are defined as collections of behaviors which neurotypical people see as problems that need to be fixed.  In some cases, they are defined morally and condemned as willful misbehavior by people who refuse to believe the condition actually exists.Read more→

An ironic unintended consequence of Obamacare

Posted on by | No Comments

I’ve posted before about Obamacare and the Law of Unintended Consequences, pointing out the great potential for government aggression in the health care sector of our economy to produce exactly the opposite of its intended purpose—but I have to admit, this one surprised me anyway:

Faced with mounting debt and looming costs from the new federal health-care law, many local governments are leaving the hospital business, shedding public facilities that can be the caregiver of last resort. . . .

More than a fifth of the nation’s 5,000 hospitals are owned by governments and many are drowning in debt caused by rising health-care costs, a spike in uninsured patients, cuts in Medicare and Medicaid and payments on construction bonds sold in fatter times. Because most public hospitals tend to be solo operations, they don’t enjoy the economies of scale, or more generous insurance contracts, which bolster revenue at many larger nonprofit and for-profit systems.

Local officials also predict an expensive future as new requirements—for technology, quality accounting and care coordination—start under the overhaul, which became law in March.

Moody’s Investors Service said in April that many standalone hospitals won’t have the resources to invest in information technology or manage bundled payments well. Many nonprofits have bad credit ratings and in a tight credit market cannot borrow money, either. Meantime, the federal government is expected to cut aid to hospitals.

Yes, you’re reading that right: the expansion of government-run health care looks to be resulting in . . . less government-run health care, and more for-profit hospitals.

All about the science? Don’t be so sure

Posted on by | 2 Comments

We may have gotten a lot of pious talk from this administration about setting science free from political agendas, but don’t believe it. William Saletan connects the dots on one illustrative example:

Fourteen years ago, to protect President Clinton’s position on partial-birth abortions, Elena Kagan doctored a statement by the American College of Obstetricians and Gynecologists. Conservatives think this should disqualify her from the Supreme Court. They understate the scandal. It isn’t Kagan we should worry about. It’s the whole judiciary. . . .

The basic story is pretty clear: Kagan, with ACOG’s consent, edited the statement to say that intact D&X “may be the best or most appropriate procedure” in some cases. Conservatives have pounced on this, claiming that Kagan “fudged the results of [ACOG’s] study,” “made up ‘scientific facts,’” and “participated in a gigantic scientific deception.” These charges are exaggerated. The sentence Kagan added was hypothetical. It didn’t assert, alter, or conceal any data. Nor did it “override a scientific finding,” as National Review alleges, or “trump” ACOG’s conclusions, as Sen. Orrin Hatch, R-Utah, contends. Even Power Line, a respected conservative blog, acknowledges that ACOG’s draft and Kagan’s edit “are not technically inconsistent.” Kagan didn’t override ACOG’s scientific judgments. She reframed them.

But Kagan’s defense is bogus, too. On Wednesday, at her confirmation hearing, Hatch pressed Kagan about this episode. She replied that she had just been “clarifying the second aspect of what [ACOG] thought.” Progressive blogs picked up this spin, claiming that she merely “clarified” ACOG’s findings and made its position “more clear” so that its “intent was correctly understood.” Come on. Kagan didn’t just “clarify” ACOG’s position. She changed its emphasis. If a Bush aide had done something like this during the stem-cell debate, progressive blogs would have screamed bloody murder. . . .

By reframing ACOG’s judgments, she altered their political effect as surely as if she had changed them.

She also altered their legal effect. And this is the scandal’s real lesson: Judges should stop treating the statements of scientific organizations as apolitical. Such statements, like the statements of any other group, can be loaded with spin. This one is a telling example.

National Review, CNSNews, and Power Line make a damning case that courts mistook the ACOG statement for pure fact. In 2000, when the U.S. Supreme Court struck down Nebraska’s ban on partial-birth abortions, it cited ACOG: “The District Court also noted that a select panel of the American College of Obstetricians and Gynecologists concluded that D&X ‘may be the best or most appropriate procedure in a particular circumstance to save the life or preserve the health of a woman.’” That sentence, we now know, was written by Kagan. . . .

All of us should be embarrassed that a sentence written by a White House aide now stands enshrined in the jurisprudence of the Supreme Court, erroneously credited with scientific authorship and rigor. Kagan should be most chastened of all. She fooled the nation’s highest judges. As one of them, she had better make sure they aren’t fooled again.

On my read, Saletan is trying hard to underplay what Kagan actually did; I don’t think saying she “reframed” the ACOG statement is really sufficient, because the sentence she inserted was intended to deceive through misdirection. Even so, Saletan doesn’t shy away from the deceptive force of that statement, or the consequences of that deception.

Of course, this all happened under a previous administration, not the current one; but the fact that the President would appoint someone, not once but twice, to a high position who was guilty of seriously subverting science to a political agenda clearly shows that in fact he has no objection to doing so—as long as it’s his own agenda. Yuval Levin sums the matter up nicely:

What’s described in these memos is easily the most serious and flagrant violation of the boundary between scientific expertise and politics I have ever encountered. A White House official formulating a substantive policy position for a supposedly impartial physicians’ group, and a position at odds with what that group’s own policy committee had actually concluded? You have to wonder where all the defenders of science—those intrepid guardians of the freedom of inquiry who throughout the Bush years wailed about the supposed politicization of scientific research and expertise—are now. If the Bush White House (in which I served as a domestic policy staffer) had ever done anything even close to this it would have been declared a monumental scandal, and rightly so.

Or take another example, the moratorium on offshore drilling unilaterally declared by Interior Secretary Ken Salazar, which didn’t pass the smell test:

In a scathing ruling . . . New Orleans-based [federal judge Martin] Feldman overturned the administration’s radical six-month moratorium on deepwater drilling—and he singled out Salazar’s central role in jury-rigging a federal panel’s scientific report to bolster flagrantly politicized conclusions. In a sane world, Salazar’s head would roll. In Obama’s world, he gets immunity. . . .

Scientists who served on the committee expressed outrage upon discovering earlier this month that Salazar had—unilaterally and without warning—inserted a blanket drilling ban recommendation into their report. As Feldman recounted in his ruling:

In the Executive Summary to the Report, (Salazar) recommends “a six-month moratorium on permits for new wells being drilled using floating rigs.” He also recommends “an immediate halt to drilling operations on the 33 permitted wells, not including relief wells currently being drilled by BP, that are currently being drilled using floating rigs in the Gulf of Mexico.”

Much to the government’s discomfort and this Court’s uneasiness, the Summary also states that “the recommendations contained in this report have been peer-reviewed by seven experts identified by the National Academy of Engineering.” As the plaintiffs, and the experts themselves, pointedly observe, this statement was misleading. The experts charge it was a “misrepresentation.” It was factually incorrect.

Allow me to be more injudicious: Salazar lied. Salazar committed fraud. Salazar sullied the reputations of the experts involved and abused his authority.

You can’t downplay that one by saying Secretary Salazar “reframed” the work of the scientists his department had consulted, either, because their position was clear, unequivocal, and diametrically opposed:

A blanket moratorium is not the answer. It will not measurably reduce risk further and it will have a lasting impact on the nation’s economy which may be greater than that of the oil spill. We do not believe punishing the innocent is the right thing to do.

The lesson is clear: for the Obama administration, when the science conflicts with the agenda, go with the agenda.

Umm . . . about those “death panels” . . .

Posted on by | No Comments

The media may have assured us that Gov. Palin didn’t know what she was talking about when she coined that phrase, and the Democrats may have insisted there was no such thing lurking in ObamaPelosiCare’s shadows—but try telling that to the man President Obama nominated to take over government health care, Dr. Donald Berwick,

an outspoken admirer of the British National Health Service and its rationing arm, the National Institute for Clinical Effectiveness (NICE).

“I am romantic about the National Health Service. I love it,” Berwick said during a 2008 speech to British physicians, going on to call it “generous, hopeful, confident, joyous, and just.” He compared the wonders of British health care to a U.S. system that he described as trapped in “the darkness of private enterprise.”

Berwick was referring to a British health care system where 750,000 patients are awaiting admission to NHS hospitals. The government’s official target for diagnostic testing was a wait of no more than 18 weeks by 2008. The reality doesn’t come close. The latest estimates suggest that for most specialties, only 30 to 50 percent of patients are treated within 18 weeks. For trauma and orthopedics patients, the figure is only 20 percent.

Overall, more than half of British patients wait more than 18 weeks for care. Every year, 50,000 surgeries are canceled because patients become too sick on the waiting list to proceed. . . .

With the creation of NICE, the U.K. government has effectively put a dollar amount to how much a citizen’s life is worth. To be exact, each year of added life is worth approximately $44,305 (£30,000). Of course, this is a general rule and, as NICE chairman Michael Rawlins points out, the agency has sometimes approved treatments costing as much as $70,887 (£48,000) per year of extended life.

To Dr. Berwick , this is exactly how it should be. “NICE is not just a national treasure,” he says, “it is a global treasure.”

And, Dr. Berwick wants to bring NICE-style rationing to this country. “It’s not a question of whether we will ration care,” he said in a magazine interview for Biotechnology Healthcare, “It is whether we will ration with our eyes open.”

My one complaint with Michael Tanner’s article is its title, “‘Death panels’ were an overblown claim—until now” . . . are you really so sure about that? If the claim isn’t overblown now, maybe it never was. Isn’t it just possible, Mr. Tanner, that Gov. Palin understood from the beginning what it took you a while to figure out? So the Democrats said there were no death panels in the bill. So they also said, “If you like your present health insurance, you can keep it”—but they didn’t write the bill that way. (Rather to the contrary, actually.) Who’s really worth believing here?

The culture of death and the death of culture

Posted on by | No Comments

In an excellent short essay in the latest issue of The City, Baylor’s Francis J. Beckwith responds to a Washington Post column by one T. R. Reid claiming that ObamaPelosiCare would reduce the number of abortions. His evidence? There are more abortions per thousand women in the U.S. than in countries like Denmark, Japan, Germany, and the UK. Of course, the birth rate’s also quite a bit higher in the U.S. than in those countries, so his choice of statistic is more than a little disingenuous. But then, as Dr. Beckwith points out, there’s also a much deeper and more profound problem with Reid’s argument:

The prolife position is not merely about “reducing the number of abortions,” though that is certainly a consequence that all prolifers should welcome. Rather, the prolife position is the moral and political belief that all members of the human community are intrinsically valuable and thus are entitled to the protection of the laws. “Reducing the number of abortions” may happen in a regime in which this belief is denied, and that is the regime that the liberal supporters of universal health coverage want to preserve and want prolifers to help subsidize. It is a regime in which the continued existence of the unborn is always at the absolute discretion of the postnatal. Reducing the number of these discretionary acts by trying to pacify and accommodate the needs of those who want to procure abortions—physicians, mothers, and fathers—only reinforces the idea that the unborn are objects whose value depends exclusively on our wanting them.

A culture that has fewer abortions because its citizens have, in the words of John Lennon, “nothing to kill or die for, and no religion too,” is a sad, dying, empty culture. Mr. Reid seems to think being prolife is just about instituting policies that result in fewer abortions. But it’s not. It’s about loving children, life, and the importance of passing on one’s heritage to one’s legacy.

As Dr. Beckwith points out, that cultural emptiness—we might say, the absence of a strong pro-life impulse—has profound negative consequences:

What is going on in these nations is a shared understanding among its citizenry about the nature of its culture and its progeny: our civilization’s future and the generations required to people it are not worth perpetuating. It is practical nihilism, for each nation believes that its traditions, customs, and what remains of its faith are not worthy of being preserved, developed, and shared outside of the populace that currently occupies its borders. In practical terms, this means, for one thing, that the present generation of Europeans older than 55 will not have enough future workers to sustain their own health care needs when they are elderly.

So, as we have seen in the Netherlands, involuntary, non-voluntary, and voluntary euthanasia will certainly become the great cost containers (or as they say more candidly in Alaska, “death panels”).

That’s about it. At its heart, the pro-abortion position is a bet on power; the abortion regime is a classic example of the tyranny of the majority, the powerful abusing the powerless because they can and it suits them. Even the weakest and most powerless women are still infinitely powerful by comparison to their unborn children; and of course, many children are aborted not because women desire the abortion but because they are coerced into it by someone else, usually by the father of the child. Though there are exceptions, almost all abortions are essentially matters of convenience for somebody, driven by the unwillingness to sacrifice pleasures in the present for the sake of the future, and the refusal to allow the self to diminish so that someone else may grow.

This is malignant individualism, a cancer of the ego; and it is not only destructive of human life insofar as it drives the abortion mills, it is also destructive of human flourishing on a broader scale, because it is absolutely inimical to any sort of healthy culture. True growth depends on the willingness to sacrifice, or at least invest, the present for the sake of the future; true culture, healthy culture, arises out of love of life and openness to life, even when that love and that openness carry with them a real cost. To choose abortion is to choose the opposite: rather than choosing life at the cost of one’s convenience, comfort and pleasures, it is to choose death for the sake of protecting one’s pleasures, convenience and comfort. That may be pleasing in the short term, but in the long term, no good can come of it.

Was this what you had in mind, Madam Speaker?

Posted on by | No Comments

Nancy Pelosi famously declared that they’d have to pass the health care bill to find out what’s in the bill. Well, now we’re finding out:

“Turns out ObamaCare means if you like your health plan you can lose it. The president didn’t have to actually strong-arm companies into dumping their employee health insurance because his bill carried financial incentives to virtually guarantee that result,” [Rep. Joe] Barton said. “But something’s very wrong when, like AT&T found out, paying $600 million in penalties will allow you to stop paying $2.4 billion for insurance, leaving both workers and taxpayers stuck. I suppose we can’t know for some years how many thousands, hundreds of thousands or even millions of workers will lose their company insurance because of health care reform, but I know that it will be a breach of faith for most of them and a tragedy for some.”

Why Mitt Romney is not the GOP frontrunner

Posted on by | No Comments

Never mind the polls, he’s nothing of the sort. This sums up why:

Put bluntly, President Obama has hitched his wagon to ObamaPelosiCare. Barring a major foreign-policy catastrophe (which is certainly possible; I’m still somewhat surprised we got no major attacks last year), and maybe not even then, it’s hard to imagine a scenario for 2012 in which his health care bill is popular and he himself is not—and at this point, that’s the only scenario under which a Romney victory is at all plausible. The fact of the matter is, however hard Gov. Romney tries to argue that his plan in Massachusetts was fundamentally different than the Democrats’ national plan, he just has no case; they both come straight from the Teddy Kennedy playbook.

Now, in all fairness to Gov. Romney, the field has shifted somewhat on health care in the last few years; as Stephen Spruiell points out, it wasn’t all that long ago that even the Heritage Foundation supported individual mandates for health insurance, something which is now universally opposed on the Right; Orrin Hatch even submitted a health care bill in the Senate which took that approach. The problem for Gov. Romney is, he took his cue from that and signed a health care bill into law—and now that his bill hasn’t reduced costs in Massachusetts (or helped much of anything else, really), and now that the political center has shifted to leave his accomplishment firmly on the political Left, he’s stuck with it. It’s possible he may be able to find a way to deal with that and put himself back within the conservative mainstream; but until he does that, he cannot with any intelligence be called the GOP frontrunner or anything close to it. As of now, the only thing one can reasonably call his presidential hopes is a mirage.

Good for Nebraska

Posted on by | 2 Comments

This is good news:

The Nebraska legislature has signed off on a bill that Governor Dave Heineman will sign today that could head to the courts and ultimately weaken further the Roe v.Wade Supreme Court decision that has resulted in 52 million abortions. The bill bans abortions after 20 weeks of pregnancy based on the well-established concept of fetal pain.

By a vote of 44-5, the Nebraska unicameral legislature this morning gave final passage to the Pain Capable Unborn Child Protection Act introduced by Speaker Mike Flood.

One small step toward a more just and compassionate society.

The proof of the pudding

Posted on by | No Comments

There are many on both sides of the political divide who believe that the passage of ObamaPelosiCare is basically final, pointing to other great entitlement programs of the past such as Social Security and Medicare. They could very well be right; it’s very hard to get rid of government bureaucracies once founded, as they have a way of creating their own constituencies. I remember Republicans campaigning on abolishing the Departments of Energy and Education; once they had the chance, they never even tried to follow through.

And yet . . . the proof of the pudding is in the eating, and the health care “reform” package was sold on the promise that it would improve health care and reduce health care costs. Our president went around declaring that once the bill was passed, Americans would find out that we actually like it after all. Therefore, it seems to me that if it fails to deliver on those promises, there will be a sufficient political constituency to repeal this law (if one can refer to anything so bloated by a term which suggests organization and coherence).

As such, I’m guessing that if Robert Samuelson is right to declare that “Obama’s proposal is the illusion of ‘reform,’ not the real thing,” it won’t last long. If I’m wrong and it improves our health care system, then the public will accept the significant new government intrusion into our privacy and autonomy, and it will stick around. This situation has at least this potential merit: ideas will be judged by their consequences. That, if nothing else, is as it should be.

Uncharted waters

Posted on by | No Comments

I think Greg Sargent captured the significance of yesterday’s big vote better than anyone I’ve yet read:

Last night’s big health reform victory made history in many ways, but in hard political terms perhaps the key one is this: This is the first landmark piece of reform that passed over the unanimous opposition of one major party.

Both Social Security and Medicare had bipartisan support. While they were both the achievements of Democratic presidents, there isn’t a clear sense in the public mind that it was entirely the work of one party over the implacable opposition of the other one.

Now an achievement of equal magnitude—health care reform, which will dramatically reshape a vital aspect of American life—is about to pass into law as the work of one party and one party alone. The other party emerges from this battle defined entirely by its unanimous opposition to it.

This could have more dramatic repercussions than any of us know right now, perhaps helping define the differences between the two parties for years, in a way that no other major political battle has.

Republicans say—publicly—that this will play in their favor, and claim the public will reward them for showing the fortitude to stand firm against a far-reaching expansion of government into a deeply personal aspect of our lives. Democrats counter that Americans will realize that the dreaded government takeover warned against by reform foes is a caricature—and that once they do, it will reinvigorate the pact between government and the American people.

All this is to say that the real argument underlying this fight—this chapter in the larger ideological showdown over the proper role of government in our lives, an argument that has taken mutiple forms throughout our history—is only beginning. There will now be an actual law that frames and defines this debate. And the fact that each party placed all its chips on competing visions dramatically ups the stakes, with untold consequences to come—not just for the parties, but for the prospects of future far-reaching legislative initiatives.

The one wrinkle he doesn’t catch is the one Jay Cost highlights:

Harold Lasswell defined politics as who gets what, when, and how. By this metric, ObamaCare is bad politics for the foreseeable future. Like any major piece of legislation, this bill assigns winners and losers. The winners will be those who today are uninsured, but who will (eventually) acquire insurance. But there will not be a major reduction in the uninsured until 2014. So, the actual winners are going to be pretty few in number for some time.

Meanwhile, the losers begin to feel the effects immediately. Between now and the next presidential election, ObamaCare is going to pay out virtually zero dollars in benefits, but it will take billions out of Medicare. This is bad for seniors. They have an incentive to oppose portions of this bill (while supporting others, like the closing of the “Doughnut Hole,” which Republicans will never repeal). While the Democrats will claim that this reduction in benefits will have no effect on the quality of their care, CBO is much less certain . . .

After decades of developing a reputation for defending the interests of senior citizens, the Democrats have put it in serious jeopardy with this legislation. And they’ve done so right at the moment when demographic shifts are making the senior population more powerful than ever.

How will it all play out? Only time will tell.