The Case for Rationing Medical/Surgical Care

I believe in medical care rationing, especially in end-of-life treatments. I believe in it for the following reason: I have seen doctors perform triple coronary artery by-pass operations on people over 90 years of age. I estimate that that operation at that age might increase life expectance by as much as 2 months. As you might expect, the operation probably costs more than $100,000 when all hospital costs are included in the calculation. The two months gained by surgery would probably be dominated by pain and disability, not to mention the hospital complications which might very well take the patient’s life by the onset of pneumonia or some other post-surgical complication. I have seen patients with terminal cancer or advanced dementia started on chronic hemodialysis (artificial kidney) with almost no hope of extending life or ameliorating suffering. The only benefit of these two kinds of treatment accrue to the doctor who makes a lot of money by doing them.

Medical and surgical treatments with negligible hope of extending life and decreasing suffering should not be entertained. It must be stated that decisions for the above kinds of extensive medical and surgical treatments are very often not recommended by the doctors involved. Frequently, these decisions are forced by strong-minded family members who do not understand the implications and complication rates of  such treatments.

It seems to me that the only way to eliminate these irrational and clinically bad decisions for treatment is to ration them out of consideration by categorically denying payment for them through Medicare rules.

The problem is that one often hears stories about patients who benefited significantly by the above type of interventions, and these stories are not insignificant. Our moral obligations are to preserve life and comfort and to do no harm. Anecdotes about aged and diseased patients who were benefited by heroic medical and surgical care are definitely exceptions to the rules. The large majority of the time, however, when old age and concurrent diseases are present, outcomes are not beneficial. Policies should not be made on the basis of anecdotal information such as these stories. Medical and surgical decisions should be made on the basis of realizing the most good for the most patients with the least amount of suffering and disability.

In these days of rising medical costs and limited money one must also consider the efficiency of money spending in an attempt to get the most “bang for the buck.” We should give consideration to the idea that for the cost of one triple coronary artery bypass procedure, one can buy thousands of doses of immunizations against shingles, measles, and other common diseases. This will prevent death and disability far more efficiently than heroic surgical and medical treatments on aged patients.

Readers should know that I speak for myself when I make the above points. I am 76 years old. I have lived a good life; I know my Savior and where I am eventually going; and I do not want anyone to apply the heroic measures so common today to my care. No thanks!

Governmental Deterioration Rises To New Levels

We, Americans, are learning each day to trust the government less and less. Many among us are unsettled by abuses that have become obvious in the IRS, the Justice Department, the Benghazi affair, and government surveillance programs run by the National Security Administration. We wonder—what is to be done about the mess in Washington!

Now, we are losing our ability to maintain our own privacy because of unheard of governmental surveillance programs. Many think that this loss flies in the face of the Fourth Amendment, which reads, “The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated….” I greatly fear that this loss of privacy will someday backfire on us and produce effects even worse and more ubiquitous than the terrorist actions our NSA is attempting to avoid by all this surveillance of phone and e-mail records.

There was a day when we, Americans could trust our government to consist of honest and moral men and women. We could trust them to uphold the principles of our Constitution and adhere to biblical standards. But…no more!

We have seen in our time a President elected to office who saw fit to hire burglars to raid the offices of the Democrat Party in the Watergate building in order to get the plans of his political opponents. We have seen a man elected to the Presidency who was caught seducing one of the office girls on the floor of the oval office. Now, we see a President who rejects the idea that truth can be realized or understood. President Obama has written in The Audacity of Hope, “Implicit…in the very idea of ordered liberty is a rejection of absolute truth, the infallibility of any idea or ideology or theology or ‘ism,’ any tyrannical consistency that might lock future generations into a single unalterable course….”

Unless America returns to its former state of proper moral consensus, we will never, again, realize a government we can trust. Electing presidents, senators, and congressional representatives who are womanizers, unfaithful husbands, tax cheaters, and draft dodgers will never recover for us a faithful and trustworthy government. The moral condition of our government leaders IS VERY IMPORTANT. Many have said that the personal morals of a president make no difference—the only thing that counts is his performance in his official position. That is simply wrong. We, Americans, need to examine carefully the morals of our leaders before we blindly elect them to office.

 

 

Organizations Follow the Leader

My wife, Nancy, has pointed out to me that people in about any organization adopt the attitudes and policies of the leader. This is especially true about the government where prominent people in executive positions are in those positions by political appointment—they are appointed because the absolutely agree with the views of the leader; and they frequently are where they are because they are “yes men.” They can be trusted not to make waves.

Such is the condition of the executive branch of our government. It seems perfectly obvious to anyone that the President’s attitudes toward conservative groups have filtered down to the lower level bureaucrats in the IRS, the EPA, the DHS, the Defense Department, and the Department of Health and Human Services.

President Obama has made precious little effort to take into consideration the views of his political adversaries; and he seems bent on castigating them at every opportunity. His henchmen in all the other government agencies are following suit. This policy began during the administration of Andrew Jackson; it took a brief respite in the administration of Abraham Lincoln; and it is now in full flower during the reign of Barack Obama. The policy of ignoring and disparaging political adversaries makes no room for constructive functioning of a loyal opposition.

The failure to listen to ideas from the right is bearing fruit in the widespread opposition to Obamacare. It now seems obvious that 27 states are not going to buy into the Medicaid bribe by the Federal Government offered by the “Affordable Care Act.”  In fact, House Republicans voted to repeal The Affordable Care Act two weeks ago.

In other areas such as gun control or immigration he either carries no weight or has a negative influence. Obama’s other forays into leadership, such as minimum wage and the common core curriculum are not popular either.  This is a president who has been unable to compromise, see other perspectives, and bring a cooperative group together to accomplish the needs of the nation. Hopefully, our next president will be able to lead our country into a bigger and better future.

 

 

Common Core Curriculum—Dumbing Down Education

I have written on this page my aversion to the widely accepted Common Core Educational standards.  Common Core is being instituted all over the United States—at least in 45 of the states.

The National Governors Association and the Council of Chief State School Officers have written this national curriculum; and it is strongly supported by the Obama Administration. There is nothing new about the Curriculum; it is a decades old idea fostered in the Clinton era by Marc Tucker, president of the National Center on Education and the Economy. Mr. Tucker proposed a system of labor-market boards at the local, state, and federal levels where curriculum and job matching will be handled by government functionaries.

Since the early 1990’s the state of Massachusetts has found a way to beef up the educational prowess of their high school graduates by instituting rigorous academic standards, teacher testing, and high-quality tests that students must pass to graduate from high school. These three measures have caused Massachusetts graduates to move from mediocre performance on the SAT tests in the early 1990’s to first place in the nation in 2005. In that year, Massachusetts students scored best in the United States in all categories on the National Assessment of Educational Progress tests.

Why do states adopt the Common Core? It is simply because of money paid to them by the Federal Government for buying into the system. Of course, they understand that the Feds have LOTS of money. The Feds get it from China and give it to local school boards.

One home-schooling mother in our family has told us that if she were to use the Common Core in her teaching she would have to tone down her teaching so that it complies with lower academic standards than the standards she is using now. That’s dumbing down education in order to comply with government standards.

This post was resourced from the Wall Street Journal of 5/28/13 page A15.

The Case For Abiding the Law

Most laws are meant to stop people from doing something, and to penalize those who disregard those laws. More generally, laws are meant to protect the society from the lawbreakers.

But our immigration laws are different. Here the whole focus is on the "plight" of those who have broken the laws, and on what can be done to lift the stigma and ease the pressures they feel, so that they can "come out of the shadows" and "normalize" their lives.

Merely using the word "illegal" to describe their breaking the law is considered to be a sign of mean-spiritedness, if not racism.

On the other hand, if an ordinary American citizen breaks a law, no one cares if he has to live in fear for years -- "in the shadows," as it were -- worrying that his illegal act will be discovered and punished.

No cities announce that they will provide "sanctuary," so that American law-breakers will be protected from the law. But, in some places, illegal immigrants are treated almost as if they were in a law-breaker protection program. What is even more remarkable about this special treatment is that you are not supposed to think about special treatment of illegal immigrants as special treatment. Somehow, they are awarded a special place in our concept of justice—a special brand of compliance with the law is applied to them.

It seems in the American mind that illegal immigrants may "earn" their citizenship. But an ordinary American citizen cannot “earn” his way out of complying with the law. Ordinarily, penalties apply to those who break the law.

Some have argued that all illegal immigrants should be found and deported. We are told that there is no way that the government can find all the people who are in the country illegally and deport them. Does anyone imagine that the government can find all the embezzlers, drunk drivers or bank robbers in the country? And does anyone think that this is a reason why the government should stop trying to enforce laws against embezzlement, drunk driving or bank robbery? Or…let embezzlers, drunk drivers and bank robbers "come out of the shadows" and "normalize" their lives?

Why are there immigration laws in the first place? For the benefit of the American people -- not for the benefit of people in other countries who want to come here.

Political and media elites treat the American people as if they are the problem -- a problem to be circumvented with pious promises about border security that have not been kept for decades.

All this argument ignores the fact that we, Americans, are faced with a serious humanitarian problem. Those of us who have dealt with illegal immigrants face to face for years, realize that these poor people just cannot be humanely dealt with by kicking them out. Christian ethics, also, indicate a kinder approach to the problem of illegal immigrants.  These unfortunate immigrants need our help; but circumventing our laws does not seem the right route to me.

I sincerely hope that any new immigration laws are not undertaken without securing the border first and then making a guest worker program that can be enforced to the benefit of both Americans and immigrant Mexicans. Living with chaos at the border is no way to run an immigration policy.

The President “Resets” the War On Terror?

The President has announced a wind-down of the war on terror. He says the al Qaeda is a shell of its former self; and he has inferred the war has been won. Who believes that—with al Qaeda making marked gains to control territory in north Africa, launching more deadly strikes in Iraq, killing American diplomatic personnel in Benghazi, controlling more and more of the insurgency in Syria, launching strikes against Pakistani and Afghan targets, and threatening Israel?!! All this is not to mention the enemies of Israel, Hezbollah and Hamas, attacking Israeli military over their own borders and raining down rockets on Israeli targets from Gaza and Lebanon. This war is winding down??

It seems obvious that the president is only conceding the battle to the enemy and wasting all the effort and cost Americans have paid to keep our nation and the rest of the free world free.

Foreign powers know perfectly well how to interpret the President’s words. Those words about protecting Americans against attack have exactly the same weight as his words about establishing a “red line” against the Syrian government if they were to use chemical weapons against their enemies—that is, absolutely nothing. The President is a toothless tiger. No enemy in their right mind will pay a bit of attention to his empty threats.

The primary and most important job of the Federal Government is to protect the American people. Our President and his administration is not doing that—he echoes the words of British Prime Minister, Neville Chamberlain in the early last century when he thought he had placated the Nazis in Germany. He announced “peace in our time;” that promise brought nothing but disaster on the free world.

Unfinished wars seem to be the pattern of policy in American government. Viet Nam was the first and now we are faced with another surrender to an aggressive enemy. America can do better than this!

 

How To Make a Blog

I know from correspondence with those who read my blog there are many of you who would be good bloggers. Establishing a blog is very easy; and it takes less than 60 seconds to do it. Here’s how:

Go to blogspot.com and just follow the directions. I less than an eyewink you will be on your way to posting blogs. Then, as you think of issues that interest you, write the posts that you would like to disseminate. Save every post you write so that you can refer to them in the future—sure enough, you will think later about the same issue and wonder if you every blogged on that issue. If you have all your posts in the same folder or on the same file, you will know whether you have blogged on that issue in the past.

Change your blog post twice weekly or more often; this keeps people interested in reading it. Make your blog posts short enough so that people can read it in less than two minutes. People will get bored and quit reading if you write a post that is too long.   

The next thing you need to do is get some people to read your blog. To do this, establish a sign-off statement on your e-mail that announces to everyone you write to that you have a blog and ask him or her to look at it. Create a business card for yourself with your blog url on it so that everyone you give a card to will know how to find your blog.

Next, establish a bunch of friends on Facebook and announce through that medium that you have a blog for them to examine. Now, speaking about Facebook, it is a good idea to post your blog posts on that social media site. You can do it by using the “notes” facility if the blog post is longer than the ordinary site for comments on FB. It is a good idea to post the title of your blog posts on Twitter also. You probably will not have enough characters on Twitter to post your entire url, so…go to the url shortener, “bitly” to shorten the url so that it can be used on Twitter.

Don’t just sit at home and wish you could get your ideas out in the culture. Put them on a blog so that others can use and appreciate them.  Undoubtedly, you will be blogging on issues about which you have learned by reading the papers or the internet. Be sure to reference your quotations, stating clearly where they came from and who wrote them originally. Do not plagiarize.

Blog, Twitter, and Facebook posts are a good way to tell people about your faith in Christ—that is just a suggestion of the many ideas you can spread around.