A program in Michigan that saved 1500 lives over 18 months by maintaining checklists on patient care to prevent hospital infections has been shut down by the federal government. The federal Office for Human Research Protections (OHRP) defines the concept of a medical “experiment” so broadly that keeping tabs on patient care through checklists is deemed an “experiment” that requires express permission in advance from patients and physicians. To OHRP, it is better that patients die than that they be subjected to an “experiment” and that they and their physicians fill out elaborate forms after receiving extensive disclosures.
Dr. Atul Gawande notes that ”if the government’s ruling were applied more widely, whole swaths of critical work to ensure safe and effective care would either halt or shrink: efforts by the Centers for Disease Control and Prevention to examine responses to outbreaks of infectious disease; the military’s program to track the care of wounded soldiers; the Five Million Lives campaign, by the nonprofit Institute for Healthcare Improvement, to reduce avoidable complications in 3,700 hospitals nationwide.”
Institutional Review Boards set up under OHRP regulations impede and investigate academics who use interviews to collect information needed for social science research. OHRP apparently deems such routine information gathering to be “human experimentation” that triggers cumbersome notice and consent requirements under its regulations.
The Washington, D.C. school system recently spent tens of millions of dollars to buy sophisticated new boilers to heat the schools. Then it allowed them to break down because it wouldn’t spend a mere $100,000 per year maintaining them. It wouldn’t do the most basic things to keep them from deteriorating, like treating water to remove mineral deposits that build up in (and ultimately destroy) boilers. Now, it is spending more than $10 million per year to replace new boilers that are being destroyed through neglect.
It’s elementary knowledge to almost every resident of the Washington, D.C. area that the region has hard water that contains minerals, so certain appliances need distilled or treated water to operate effectively. That’s why I buy distilled water to use in the baby bottle sterilizer that cleans my daughter’s baby bottles. But nothing is too obvious for D.C. public school administrators to overlook. (The Washington Post story about this is entitled “The Price of Neglect,” Dec. 31, 2007).
Trying to “fix” health care is not easy, since it’s a bizarre amalgam of private provision of insurance and public spending and regulation, completely distorted by the counterproductive incentives of pervasive third-party payment. But one very simple step would be to simply have a national market in health insurance. Explains Merrill Mathews of the Council for Affordable Health Insurance in The Wall Street Journal (subscription required):
Why can’t people living in New Jersey buy health insurance available to residents of, say, Pennsylvania?
Rep. John Shadegg, an Arizona Republican, thinks they should — and today will reintroduce legislation to make that possible.
The Health Care Choice Act would allow residents in one state to buy health insurance that is available in and regulated by another state. If enacted, the law would create a competitive, 50-state market for health insurance, likely making it cheaper. It would do this without imposing a large cost on taxpayers and without creating a new government bureaucracy.
This should be a no-brainer for Congress. But a few years ago, Mr. Shadegg went looking for a Democratic cosponsor for his bill. He found one who initially signed on, then withdrew under pressure from Democratic House leaders who wanted to dismiss the Shadegg bill with the excuse that it lacked bipartisan support.
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In his Examiner column today, Tim Carney — with a nod to Bastiat — takes the company founded by Thomas Edison to task for eschewing innovation in favor of political rent seeking:
Had Thomas Edison employed the same business strategy as his 21st-Century heirs at General Electric, he would have lobbied Congress to outlaw the candle in 1879 when he perfected and patented the light bulb.
He surely could have masked his self-interested lobbying in some public interest claim, such as fire prevention or the need for wax conservation. Today, the mask is environmentalism.
Earlier this month, Thomas Edison’s GE, together with Sylvania and Philips won a legislative victory when Congress passed an energy bill that would outlaw sale of the standard light bulb by 2012.
Sylvania is the leading light bulb maker worldwide, and GE is tops in America. These two companies, together with Dutch-based Royal Phillips Electronics, concede they basically wrote the new light bulb law. It goes without saying that they stand to profit from it — at consumer expense.
That is because the energy bill raises energy efficiency requirements to a level that most incandescent light bulbs in use today cannot meet, which would force most people to switch to the more expensive compact fluorescent bulbs.
Of course, this isn’t the only special interest pork barrel project in the energy bill, but in this specific instance, it’s worth asking — If fluorescent bulbs are so great, why does Congress need to essentially mandate their use?
According to Bill McKibben in an op-ed in The Washington Post, the biggest news of the year is that Jim Hansen has spoken. According to Hansen, who has risen in recent years from astronomer to wizard and now to high priest of a doomsday cult, the safe level for carbon dioxide in the atmosphere can be no more than 350 parts per million. So since it’s now 380 or 390 ppm, we’re already doomed and can stop worrying about it.
Oh, no, sorry, we can’t stop worrying about it. True, we’re just about cooked (like Hansel and Gretel in the oven), but there’s still barely time to save life on Earth if we turn off the lights and throw away the car keys this instant. The alternative, I guess, is to party now for tomorrow we die. Hmm, I can’t decide. What if there’s just a tiny chance that Hansen could be wrong? Wouldn’t drastically reducing our energy consumption cause colossal increases in human mortality and suffering?
The course of apocalyptic movements is generally similar. In order to keep the enthusiasm of its followers at a fever pitch and to attract new followers, it is necessary to keep stoking the fires with more and more outlandish claims. The hysteria peaks as doomsday is moved closer and closer to the present, and then — poof — it collapses. It appears to me that the global warming bubble has gone about as far as it can go before it descends into ranting and writhing on the ground or random outbreaks of mob violence.
Unfortunately for Hansen and McKibben as with so many previous prophets of the end of the world, reality isn’t cooperating with their chiliastic fantasies. Atmospheric concentrations of CO2 have increased by 4 per cent since the Kyoto Protocol was negotiated in 1997, but the global mean temperature has been flat since 1999. What they must have are some big disasters — and soon.
Humanitarians are perplexed by the fact that, despite their hard work and the fact that it’s the epicenter of the world’s largest aid effort, starvation in Darfur is increasing at a rapid pace. As reported by The New York Times today, malnutrition among children in the region jumped this year to over 16 percent, a 3 percent increase from last year.
Dr. Rigal said he was not exactly sure why child malnutrition rates were rising. But he cited more insecurity, restricted access for relief workers and a fresh round of displacements because of tribal fighting.
“There are many hypotheses,” he said.
What most humanitarians either do not understand, or decline to address, is that starvation is not caused by lack of money or even lack of food — therefore, no amount of either will solve the crisis in that country. Malnutrition is a direct result of a lack of freedom.
Darfur is no different than any other part of the world—if humans are there, then there’s a source of food somewhere. People simply need to be free to pursue a livelihood and protection that guarantees that they have a right to hold whatever they grow or create.. In other words, humans need principled and reliable protection of their rights to life and property. The people of Darfur, as the people in any part of the world, require a government that defends the rights of ALL individuals, not a selective few, as is the practice of the Sudanese government (using the term loosely).
Preventing starvation depends entirely on a person’s ability to plan ahead. Hunter gatherers of old were at the mercy of the weather and the migration patterns and health of their prey. Only after humans began to cultivate the earth and heard animals could we achieve consistent nutrition and a release from dependence on the elements. But in order to undertake a long-term project like planting a season in advance, or building a water delivery system, people need to be assured that they will be free to reap the fruits of their labors. Dr. Rigal is right that instability and displacement are contributing to starvation in the region, but they are not the primary causes. We need to address the reasons why people in Darfur are being displaced and experiencing instability.
Until the government in that region respects and protects the individual rights of every person in that region, throwing money at the problem is like (pardon my French) pissing in the wind; it doesn’t go very far.
Benazir Bhutto, who was murdered in a politically-motivated suicide attack, was the closest the Islamic world has yet got to a secular free-marketeer as a leader. Sadly, she dressed that in socialist rhetoric and demagoguery, and instituted authoritarian policies towards the press and judiciary that helped contribute to her downfall in the 1990s. The Telegraph‘s commendably objective obituary is here. After her ineffective first premiership, many forget that her second tenure was almost Thatcherite:
Her tight monetary policy produced a dramatic reduction in the budget deficit, pulling the country’s economy back from the brink of collapse, and earning it a clean bill of health from the IMF and World Bank.
The massive inflow of foreign investment gave rise to expectations of a new era of economic development for Pakistan. Her offer of lucrative packages for foreign investors garnered contracts for infrastructure projects worth many billions of dollars. And her privatisation programme was commended for its transparency and broad ownership approach.
Sadly, her father’s socialist-inspired authoritarianism manifested itself in other areas. What Pakistan needed was a free-market, secular approach that guaranteed important freedoms. She almost delivered that, but not quite.
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