Quotulatiousness

May 23, 2014

He was for the Veterans Health Administration before he was against it

Filed under: Bureaucracy, Government, Health, Military, USA — Tags: , , , , — Nicholas @ 08:33

The Wall Street Journal‘s James Taranto rounds up some amusing-in-hindsight bloviations by Paul Krugman about the efficiencies of the Veterans Health Administration:

There was no ObamaCare in January 2006, when former Enron adviser Paul Krugman wrote this:

    I know about a health care system that has been highly successful in containing costs, yet provides excellent care. And the story of this system’s success provides a helpful corrective to anti-government ideology. For the government doesn’t just pay the bills in this system — it runs the hospitals and clinics.

    No, I’m not talking about some faraway country. The system in question is our very own Veterans Health Administration, whose success story is one of the best-kept secrets in the American policy debate.

The “secret” of the VA’s “success,” Krugman argued, “is the fact that it’s a universal, integrated system.” That saves on administrative costs and allows for efficient record-keeping. Krugman acknowledged that the VA had a history of mismanagement and mediocre care, until “reforms beginning in the mid-1990’s transformed the system.” But wait. Hasn’t it been a universal, integrated system all along? Maybe the secret is something else. At any rate, the Phoenix revelations suggest it’s the system’s failures that are being kept secret.

Krugman lamented that his argument “runs completely counter to the pro-privatization, anti-government conventional wisdom that dominates today’s Washington.” That was 2006, remember, when Republicans had the White House and both houses of Congress. If Krugman is to be believed — a big “if,” to be sure — the Bush administration did a far better job running the VA than the Obama administration is doing now. Which reminds us of something Waldman wrote: “There’s an old saying that when they’re out of office, Republicans argue that government is inefficient and incompetent, and when they get in office, they set about to prove it.”

Krugman concluded that 2006 column as follows:

    Ideology can’t hold out against reality forever. Cries of “socialized medicine” didn’t, in the end, succeed in blocking the creation of Medicare. And farsighted thinkers are already suggesting that the Veterans Health Administration, not President Bush’s unrealistic vision of a system in which people go “comparative shopping” for medical care the way they do when buying tile (his example, not mine), represents the true future of American health care.

“Good Glitches,” anyone?

Krugman managed to get two more columns out of the glorious VA. One, in September 2006, also damned Medicare Advantage and complained that the administration opposed the idea of letting elderly vets use Medicare benefits at VA hospitals:

    “Conservatives,” writes Time, “fear such an arrangement would be a Trojan horse, setting up an even larger national health-care program and taking more business from the private sector.”

    Think about that: they won’t let vets on Medicare buy into the V.A. system, not because they believe this policy initiative would fail, but because they’re afraid it would succeed.

OK, but think about this: According to The-Military-Guide.com, “if you’re eligible for any level of VA care, whether it’s high-priority or low-priority, you’re no longer eligible for ACA exchange subsidies.” (ACA is an abbreviation for PPACA, in turn an abbreviation for the Patient Protection and Affordable Care Act, ObamaCare’s official title.) There are worse things than being excluded from ObamaCare, of course — but the VA may be one of them.

May 21, 2014

“The VA really is a good example of a single-payer, socialized health system”

Filed under: Bureaucracy, Government, Health, USA — Tags: , , , — Nicholas @ 07:22

J.D. Tuccille on the Veterans Health Administration:

Just a couple of years ago, Paul Krugman pointed to the Veterans Health Administration (VHA) as a “huge policy success story, which offers important lessons for future health reform.” He gloated, “yes, this is ‘socialized medicine.'”

Similarly, a letter touted by Physicians for a National Health Program trumpeted “the success of 22 wealthy countries and our own Department of Veterans Affairs, which use single-payer systems to provide better care for more people at far less cost.”

How could a bloated government bureaucracy achieve such low-cost success? As we found out recently, it’s by quietly sticking veterans on a waiting list and putting off their treatment for months — sometimes until the patients are far too dead to need much in the way of expensive care. Which is to say, calling it a “success” is stretching the meaning of the word beyond recognition.

And, while the White House insists it learned from press reports about the secret waiting lists, Press Secretary Jay Carney acknowledges that the administration long knew about “the backlog and disability claims” that have accumulated in the VHA.

This should surprise nobody. Canada’s government-run single-payer health system has long suffered waiting times for care. The country’s Fraser Institute estimates [PDF] “the national median waiting time from specialist appointment to treatment increased from 9.3 weeks in 2010 to 9.5 weeks in 2011.”

Likewise, once famously social democratic Sweden has seen a rise in private health coverage in parallel to the state system because of long delays to receive care. “It’s quicker to get a colleague back to work if you have an operation in two weeks’ time rather than having to wait for a year,” privately insured Anna Norlander told Sveriges Radio.

[…]

So the VA really is a good example of a single-payer, socialized health system. Just not in the way that fans of that approach mean.

May 14, 2014

Another area for freedom of choice – the “right to try”

Filed under: Bureaucracy, Health, Science, USA — Tags: , , , — Nicholas @ 11:32

Amity Shlaes talks about a movement to allow more freedom of choice, but in an unusual and tightly regulated sector:

For decades now the Food and Drug Administration has maintained an onerous and slow approval process that delays the debut of new drugs for fatal diseases, sometimes for years longer than the life span of the patients desperate to try them. Attorneys and scholars at the Goldwater Institute of Arizona have crafted legislation for the states that would allow terminally ill patients to try experimental drugs for cancer or degenerative neurological diseases earlier. These “Right to Try” bills are so scripted that they overcome the usual objection to delivery of such experimental drugs: safety. Under “Right to Try,” only drugs that have passed the crucial Phase 1 of FDA testing could be prescribed, thereby reducing the possibility of Thalidomide repeat. Second, only patients determined to have terminal cases would be eligible to purchase the drugs, making it harder to maintain that the drug will jeopardize their lives.

Representatives in Colorado, Louisiana, and Missouri approved the “Right to Try” measure unanimously. Citizens of Arizona will vote on the effort to circumvent the FDA process this fall.

Why the popularity? The phrase “Right to Try” appeals especially in a nation that senses all too well the reductions in freedom that come as the Affordable Care Act is implemented. The recent success of The Dallas Buyers’ Club, a film about a man who procured experimental drugs for AIDS patients, also fuels the “Right to Try” impulse. Some of the popularity comes from our culture of choice. In Colorado, where citizens have choice about abortion, and now the choice to use marijuana, they may also get what seems an elemental choice, that to try to save their own lives.

But of course “Right to Try” also sails because of the frustration of tragedy. Years ago a man named Frank Burroughs founded the Abigail Alliance after conventional options failed to cure his 21-year-old daughter’s cancer. Abigail’s oncologist tried to get Abigail newer drugs, Erbitux or Iressa from AstraZeneca, the company with which Pfizer hopes to merge. But the drugs were not available in time to save the girl. The Abigail Alliance is attempting on the federal level what Goldwater is trying for states: The federal bill’s name is the Compassionate Care Act. “Those waiting for FDA decisions, mainly dying patients and those who care for them, view the agency as a barrier,” co-founder Steve Walker explained simply. And who can disagree? Many of the supporters of “Right to Try” or the Abigail Alliance are businesspeople or scientists who are motivated to honor ones they have lost to illness; others are racing to save sick family who are still living. Yet others labor for patients in particular or science in general.

May 11, 2014

QotD: Longevity

Filed under: Health, Humour, Quotations — Tags: , — Nicholas @ 00:01

It is not, naturally and generally, the happy who are most anxious either for prolongation of the present life or for a life hereafter; it is those who never have been happy. Those who have had their happiness can bear to part with existence, but it is hard to die without ever having lived.

John Stuart Mill, Three Essays on Religion, 1874

May 7, 2014

“I’ve been an oncologist for 20 years, and I have never, ever seen anything like this.”

Filed under: Business, Health, Science — Tags: , , , — Nicholas @ 15:30

In Forbes, Matthew Herper looks at how Novartis is transforming itself in an attempt to conquer cancer:

“I’ve been an oncologist for 20 years,” says Grupp, “and I have never, ever seen anything like this.” Emily has become the poster child for a radical new treatment that Novartis, the third-biggest drug company on the Forbes Global 2000, is making one of the top priorities in its $9.9 billion research and development budget.

“I’ve told the team that resources are not an issue. Speed is the issue,” says Novartis Chief Executive Joseph Jimenez, 54. “I want to hear what it takes to run this phase III trial and to get this to market. You’re talking about patients who are about to die. The pain of having to turn patients away is such that we are going as fast as we can and not letting resources get in the way.”

A successful trial would prove a milestone in the fight against the demon that has plagued living things since dinosaurs roamed the Earth. Coupled with the exploding capabilities of DNA-sequencing machines that can unlock the genetic code, recent drugs have delivered stunning results in lung cancer, melanoma and other deadly tumors, sometimes making them disappear entirely – albeit temporarily. Just last year the Food & Drug Administration approved nine targeted cancer drugs. It’s big business, too. According to data provider IMS Health, spending on oncology drugs was $91 billion last year, triple what it was in 2003.

But the developments at Penn point, tantalizingly, to something more, something that would rank among the great milestones in the history of mankind: a true cure. Of 25 children and 5 adults with Emily’s disease, ALL, 27 had a complete remission, in which cancer becomes undetectable. “It’s a stunning breakthrough,” says Sally Church, of drug development advisor Icarus Consultants. Says Crystal Mackall, who is developing similar treatments at the National Cancer Institute: “It really is a revolution. This is going to open the door for all sorts of cell-based and gene therapy for all kinds of disease because it’s going to demonstrate that it’s economically viable.”

H/T to Megan McArdle for the link.

May 3, 2014

Fat’s negative health impact reconsidered

Filed under: Food, Health, Science — Tags: , , , — Nicholas @ 09:19

Hmm. Today seems to be health news day. In the Wall Street Journal, Nina Teicholz looks at the dubious science behind the saturated fat demonization we’ve all seen in so many health stories:

“Saturated fat does not cause heart disease” — or so concluded a big study published in March in the journal Annals of Internal Medicine. How could this be? The very cornerstone of dietary advice for generations has been that the saturated fats in butter, cheese and red meat should be avoided because they clog our arteries. For many diet-conscious Americans, it is simply second nature to opt for chicken over sirloin, canola oil over butter.

The new study’s conclusion shouldn’t surprise anyone familiar with modern nutritional science, however. The fact is, there has never been solid evidence for the idea that these fats cause disease. We only believe this to be the case because nutrition policy has been derailed over the past half-century by a mixture of personal ambition, bad science, politics and bias.

Our distrust of saturated fat can be traced back to the 1950s, to a man named Ancel Benjamin Keys, a scientist at the University of Minnesota. Dr. Keys was formidably persuasive and, through sheer force of will, rose to the top of the nutrition world — even gracing the cover of Time magazine — for relentlessly championing the idea that saturated fats raise cholesterol and, as a result, cause heart attacks.

[…]

Critics have pointed out that Dr. Keys violated several basic scientific norms in his study. For one, he didn’t choose countries randomly but instead selected only those likely to prove his beliefs, including Yugoslavia, Finland and Italy. Excluded were France, land of the famously healthy omelet eater, as well as other countries where people consumed a lot of fat yet didn’t suffer from high rates of heart disease, such as Switzerland, Sweden and West Germany. The study’s star subjects — upon whom much of our current understanding of the Mediterranean diet is based — were peasants from Crete, islanders who tilled their fields well into old age and who appeared to eat very little meat or cheese.

As it turns out, Dr. Keys visited Crete during an unrepresentative period of extreme hardship after World War II. Furthermore, he made the mistake of measuring the islanders’ diet partly during Lent, when they were forgoing meat and cheese. Dr. Keys therefore undercounted their consumption of saturated fat. Also, due to problems with the surveys, he ended up relying on data from just a few dozen men — far from the representative sample of 655 that he had initially selected. These flaws weren’t revealed until much later, in a 2002 paper by scientists investigating the work on Crete — but by then, the misimpression left by his erroneous data had become international dogma.

Take every salt report with a pinch of salt

Filed under: Food, Health, Science — Tags: — Nicholas @ 09:11

Salt is bad for you, as we’ve been told for years and years. It raises your blood pressure and makes you more prone to strokes and other nasty health issues. Except … perhaps not:

The more salt we eat, the more water our body retains. This increases blood pressure, at least until our kidneys flush out the salt and water. Those who see salt as a problem believe that the effect on blood pressure is more lasting, and that if too much salt is ingested over a long period of time it will cause hypertension and perhaps death. A much-cited study carried out by America’s National Institutes of Health in 2001, called the DASH-sodium study, found that participants put on diets that were lower in sodium than the control group ended up with significantly lower blood pressure. This study forms the basis for many of the public-health pronouncements that demonise salt. America’s dietary guidelines, based on “a strong body of evidence”, put salt at the top of the list of things to avoid.

The body of evidence, though, is rather weaker than the American government lets on. The DASH study is one of many that have looked at the effects of salt intake on health. Others have failed to produce similar results. The English study mentioned above finds a correlation, but other factors — such as a simultaneous decline in smoking — seem more likely to account for the improved health outcomes. In 2011 two meta-analyses, which look at the results from many different studies, were published by the Cochrane Collaboration, a non-profit that reviews medical evidence. The first found that reducing salt intake leads to lower blood pressure, but concluded that there is “insufficient evidence” that this will lead to fewer premature deaths or a lower incidence of heart disease. The second concluded, rather simply, that “we do not know if low salt diets improve or worsen health outcomes.” The authors went on to say that “after more than 150 [randomised controlled trials] and 13 population studies without an obvious signal in favour of sodium reduction, another position could be to accept that such a signal may not exist.”

Some researchers go a step further, claiming that reducing salt intake actually increases a person’s risk of dying. The body needs some amount of sodium; if it gets too little the kidney secretes an enzyme called renin that can lead to hypertension. Some studies have found that low sodium levels were associated with increased risk of heart failure. Others suggest that a low sodium-to-potassium ratio may be the key to heart health. Much depends on the individual. The evidence is inconclusive, yet public-health officials have long presented the link between salt and heart disease as if it were fact. Such confidence is not warranted. There are plenty of reasons to avoid a full English breakfast, but salt may not be one of them.

April 28, 2014

Kate Lunau talks to Ray Kurzweil

Filed under: Health, Science, Technology — Tags: , , — Nicholas @ 15:38

I’m interested in life extension … I have no particular hankering to die any time soon, although I admit there is some truth in the aphorism “Many wish for immortality who don’t know how to spend a rainy Sunday afternoon”. Ray Kurzweil wants immortality, and he’s doing what he can to make that happen:

Ray Kurzweil — futurist, inventor, entrepreneur, bestselling author, and now, director of engineering at Google — wants to live forever. He’s working to make it happen. Kurzweil, whose many inventions include the first optical character recognition software (which transforms the written word into data) and the first text-to-speech synthesizer, spoke to Maclean’s for our annual Rethink issue about why we’re on the brink of a technological revolution — one that will improve our health and our lives, even after the robots outsmart us for good.

Q: You say we’re in the midst of a “grand transformation” in the field of medicine. What do you see happening today?

A: Biology is a software process. Our bodies are made up of trillions of cells, each governed by this process. You and I are walking around with outdated software running in our bodies, which evolved in a very different era. We each have a fat insulin receptor gene that says, “Hold on to every calorie.” That was a very good idea 10,000 years ago, when you worked all day to get a few calories; there were no refrigerators, so you stored them in your fat cells. I would like to tell my fat insulin receptor gene, “You don’t need to do that anymore,” and indeed that was done at the Joslin Diabetes Center. They turned off this gene, and the [lab mice] ate ravenously and remained slim. They didn’t get diabetes; they didn’t get heart disease. They lived 20 per cent longer. They’re working with a drug company to bring that to market.

Life expectancy was 20 a thousand years ago; 37, 200 years ago. We’re now able to reprogram health and medicine as software, and that [pace is] going to continue to accelerate. We’re treating biology, and by extension health and medicine, as an information technology. Our intuition about how progress will unfold is linear, but information technology progresses exponentially, not linearly. My Android phone is literally several billion times more powerful, per dollar, than the computer I used when I was a student. And it’s also 100,000 times smaller. We’ll do both of those things again in 25 years. It’ll be a billion times more powerful, and will be the size of a blood cell.

April 9, 2014

QotD: “Perhaps being a boy is a learning disorder”

Filed under: Bureaucracy, Education, Health, Quotations — Tags: , , — Nicholas @ 00:01

… more children are being diagnosed with “autism spectrum disorders” than ever, specifically that diagnoses have gone from one in about a hundred and fifty to about one in sixty eight. A lot of these diagnoses are for children with extremely mild Aspergers, right at the borderline between normal (whatever that is) and Aspergers. Now this may be a result of more people suffering from ASD’s, especially extremely mild Aspergers, as a result of cumulative mutations and pregnant women being exposed to environmental risks. Or it could be that ever since the Fed’s started throwing money at diagnosing and providing educational services for kids with ASD’s they have become the diagnoses de jour. In fact, it is worth noting that since the Feds started throwing more money at ASD’s and less at ADD and ADHD the number of children diagnosed with the former has increased and the latter two decreased. Apparently getting more Federal funding causes learning/psychological disorders and getting funding cut cures them.

That or educators are blowing off the needs of kids with disorders that are not “getting the love.” My own personal opinion is that favored problems get over-diagnosed and those not blessed with Fed money get under-diagnosed. Shame on the education establishment either way.

It should also be noted that whichever disorder is getting attention it seems to hit males about four times as often as females. In fact, it seems that a lot of the descriptors of symptoms for various ASD’s and ADD read like pretty normal behavior for boys.

Perhaps being a boy is a learning disorder (there’s a large number of females who would nod their head in agreement with this thesis).

A.X. Perez, “Old News Interpreted”, Libertarian Enterprise, 2014-04-06

April 8, 2014

Choosing when to die

Filed under: Europe, Health, Liberty — Tags: , , — Nicholas @ 06:52

Colby Cosh discusses the latest Swiss innovation to come to the tabloid newspapers’ attention:

Five or six times I must have read the story about the relatively healthy little old English lady who killed herself rather than struggle on through the “digital age”, and I still cannot quite think what to make of it. Surely there is something noble about leaving life on what are as nearly as possible one’s own terms, with some strength left, after a full, long, largely happy existence.

Unlike a lot of self-described “environmentalists”, she clearly believed the Malthusian script and took the recommended action: “The environmentalist was also worried about the damage being wrought on the planet by overcrowding and pollution.” If she was that worried about poor old Mother Earth, one might wonder why she took so long to take her leave of it.

I suppose Dignitas does its best to make sure oldies aren’t being urged to suicide by impatient heirs, but surely there is only so much the staff can do, and it is in their interest to do as little as possible. It is certainly easy to imagine ethically dubious ways of encouraging the irritability of a cranky, inconvenient old person. Oo, hardly worth the trouble of gettin’ out of bed in the morning, is it, gran? Oh, dear, are your lungs givin’ you a hard time again? Tsk, must make you want to chuck it all in sometimes. If you are a person of British descent, you take in a certain amount of this glum, boggy attitude with every meal anyway. It comes naturally.

And there is my only real concern about institutionalizing the right to die … that it will encourage a certain haste: not among the elderly or afflicted, but among their caregivers, descendents, and prospective legatees. I think you should have the right to decide when to die, but it is a situation that offers the unscrupulous and unprincipled a quicker route to impose their desires on others.

But who is ready to have the government issue packets of Nembutal every five years with Canada Pension Plan cheques? Whatever solution we decide on for the convenience of the legitimately ailing or hopeless, I want the doctors — who, after all, belong to a profession that cannot seem to stop prescribing useless antibiotics for upper respiratory infections — to have as little to do with it as possible. Physicians are not saints, and they will follow the “easier for me” heuristic, like other primates, if non-negotiable aspects of their duty are thrown open to fiddling. “Do no harm” has been at the top of the list for 2,400 years, and, please, keep in mind, it took them 2,200 of those to give up therapeutic bloodletting.

Exactly.

April 6, 2014

Obamacare, viewed from a distance

Filed under: Government, Health, Politics, USA — Tags: , , , — Nicholas @ 09:16

Peggy Noonan attempts to look at Obamacare apart from the daily battles over details:

As I say, put aside the argument, step back and view the thing at a distance. Support it or not, you cannot look at ObamaCare and call it anything but a huge, historic mess. It is also utterly unique in the annals of American lawmaking and government administration.

Its biggest proponent in Congress, the Democratic speaker of the House, literally said — blithely, mindlessly, but in a way forthcomingly — that we have to pass the bill to find out what’s in it. It is a cliché to note this. But really, Nancy Pelosi’s statement was a historic admission that she was fighting hard for something she herself didn’t understand, but she had every confidence regulators and bureaucratic interpreters would tell her in time what she’d done. This is how we make laws now.

Her comments alarmed congressional Republicans but inspired Democrats, who for the next three years would carry on like blithering idiots making believe they’d read the bill and understood its implications. They were later taken aback by complaints from their constituents. The White House, on the other hand, seems to have understood what the bill would do, and lied in a way so specific it showed they knew exactly what to spin and how. “If you like your health-care plan, you can keep your health-care plan, period.” “If you like your doctor, you can keep your doctor, period.” That of course was the president, misrepresenting the facts of his signature legislative effort. That was historic, too. If you liked your doctor, your plan, your network, your coverage, your deductible you could not keep it. Your existing policy had to pass muster with the administration, which would fight to the death to ensure that 60-year-old women have pediatric dental coverage.

[…]

The program is unique in that the bill that was signed four years ago, on March 23, 2010, is not the law, or rather program, that now exists. Parts of it have been changed or delayed 30 times. It is telling that the president rebuffed Congress when it asked to work with him on alterations, but had no qualms about doing them by executive fiat. The program today, which affects a sixth of the U.S. economy, is not what was passed by the U.S. Congress. On Wednesday Robert Gibbs, who helped elect the president in 2008 and served as his first press secretary, predicted more changes to come. He told a business group in Colorado that the employer mandate would likely be scrapped entirely. He added that the program needed an “additional layer” or “cheaper” coverage and admitted he wasn’t sure the individual mandate had been the right way to go.

Finally, the program’s supporters have gone on quite a rhetorical journey, from “This is an excellent bill, and opponents hate the needy” to “People will love it once they have it” to “We may need some changes” to “I’ve co-sponsored a bill to make needed alternations” to “This will be seen by posterity as an advance in human freedom.”

March 28, 2014

Putting the WHO global pollution death figures into perspective

Filed under: Economics, Environment, Health — Tags: , , , — Nicholas @ 07:56

James Delingpole agrees that the most recent WHO report on deaths due to pollution is shocking, but points out where the press release does a sleight-of-hand move:

Even if you take the WHO’s estimates with a huge pinch of salt — and you probably should — that doesn’t mean the pollution problem in some parts of the world isn’t deadly serious. During the 20th century, around 260 million are reckoned to have died from indoor pollution in the developing world: that’s roughly twice as many as were killed in all the century’s wars.

Here, though, is the point where the WHO loses all credibility on the issue.

    “Excessive air pollution is often a by-product of unsustainable policies in sectors such as transport, energy, waste management and industry. In most cases, healthier strategies will also be more economical in the long term due to health-care cost savings as well as climate gains,” Carlos Dora, WHO Coordinator for Public Health, Environmental and Social Determinants of Health said.

    “WHO and health sectors have a unique role in translating scientific evidence on air pollution into policies that can deliver impact and improvements that will save lives,” Dr. Dora added.

See what Dora just did there? He used the shock value of the WHO’s pollution death figures to slip three Big Lies under the impressionable reader’s radar.

First, he’s trying to make out that outdoor pollution is as big a problem as indoor pollution. It isn’t: nowhere near. Many of the deaths the WHO links to the former are very likely the result of the latter (cooking and heating in poorly ventilated rooms using dung, wood, and coal) which, by nature, is much more intense.

Secondly, he’s implying that economic development is to blame. In fact, it’s economic development we have to thank for the fact that there are so many fewer pollution deaths than there used to be. As Bjorn Lomborg has noted, over the 20th century as poverty receded and clean fuels got cheaper, the risk of dying of pollution decreased eight-fold. In 1900, air pollution cost 23 per cent of global GDP; today it is 6 per cent, and by 2050 it will be 4 per cent.

But the third and by far the biggest of the lies is the implication that the UN’s policies on climate change are helping to alleviate the problem.

March 17, 2014

QotD: Psychology

Filed under: Health, Quotations — Tags: , , — Nicholas @ 07:05

It’s extremely important in this connection to remember that psychology is not a science, not even remotely. It is not the product of careful hypothesis-formation and controlled, repeatable, peer-reviewed experiment. It is nothing more than a collection of folklore and the armchair opinions of committees, less credible and valid than global warming. The authority it speaks from is purely political.

I know all of this because in college, I was a psychology major, myself, until I saw how empty the field is of anything resembling science or a decent, genuine regard for the well-being of other people. I read Dr. Thomas Szasz, beginning with his The Manufacture of Madness — in which he defines schizophrenia as a particular relationship between a therapist and his patient — and changed my major.

Five hundred years ago, if you were discovered to be in possession of a volume of the Book of Common Prayer that had a misplaced comma on Page 151, you might ultimately be burned at the stake for heresy. This had absolutely nothing to do with religion, it was simply an easy way for the political elite to justify disposing of its perceived enemies.

Psychology, as a body of “knowledge”, is more than just a little fallible. It will commonly declare some violent criminal “cured” and fit to interact peacefully and productively with society, following which the monster will immediately go out and axe-murder an entire family.

Psychology can be fooled into incarcerating individuals who are perfectly sane, as it once did with Nellie Bly, a courageous reporter investigating conditions in a New York mental asylum late in the 19th century. Nor have its powers of diagnosis much improved since then. On the other hand, if, like Ezra Pound or Frances Farmer (look them up), you hold opinions contrary to those the government wants you to hold — especially today on global warming, gun ownership, race relations, or the meaning and significance of the U.S. Constitution — it will more than question your sanity, it will lock you up and tear it to bits.

And today, when it does that, uniformed and armored thugs will show up at your home to shoot your dogs, stomp your kittens to death, terrify your family, empty out your gun safe, and murder you if you resist. Soon it may be enough to say that if you own guns you must be insane.

L. Neil Smith, “The New Inquisition”, Libertarian Enterprise, 2014-03-16

March 16, 2014

QotD: American “cheese”

Filed under: Bureaucracy, Europe, Food, France, Health, Humour, Quotations, USA — Tags: , — Nicholas @ 10:05

Everyone thinks America Alone is about Islam and demography, but in fact it has a whole section in it on cheese, called “The Pasteurization is Prologue”. Page 181:

    I’ve never subscribed to that whole “cheese-eating surrender-monkey” sneer promoted by my National Review colleague Jonah Goldberg. As a neocon warmonger, I yield to no one in my contempt for the French, but, that said, cheese-wise I feel they have the edge.

    When I’m at the lunch counter in America and I order a cheeseburger and the waitress says, “American, Swiss or Cheddar?” I can’t tell the difference. They all taste of nothing. The only difference is that the slice of alleged Swiss is full of holes, so you’re getting less nothing for your buck. Then again, the holes also taste of nothing, and they’re less fattening. But, either way, cheese is not the battleground on which to demonstrate the superiority of the American way.

Most of the American cheeses bearing European names are bland rubbery eunuch versions of the real thing. I wouldn’t mind if this were merely the market at work, but it’s not. It’s the result of Big Government, of the Brieatollahs at the United States Department of Agriculture:

    In America, unpasteurized un-aged raw cheese that would be standard in any Continental fromagerie is banned. Americans, so zealous in defense of their liberties when it comes to guns, are happy to roll over for the nanny state when it comes to the cheese board… The French may be surrender monkeys on the battlefield, but they don’t throw their hands up and flee in terror just because the Brie’s a bit ripe. It’s the Americans who are the cheese-surrendering eating-monkeys — who insist, oh, no, the only way to deal with this sliver of Roquefort is to set up a rigorous ongoing Hans Blix-type inspections regime.

I’m not exaggerating about that. Nothing gets past their eyes, and everything gets pasteurized. That’s why American “cheesemakers” have to keep putting stuff into the “cheddar” — sun-dried tomatoes, red peppers, chocolate chips — to give it some taste, because the cheese itself has none. And, if you try to bring in anything that does taste of something, the US Government’s Brie Team Six seizes it:

    The US fate of the bright-orange, mild-tasting French cheese has been in jeopardy for months and the Food and Drug Administration has blocked all further imports.

    Why? Because US regulators determined the cantaloupe-like rind of the cheese was covered with too many cheese mites, even though the tiny bugs give mimolette its unique flavor.

    No formal ban has been put in place, but 1.5 tonnes (3,300 pounds) of cheese were blocked from being imported, and nothing is going through US customs.

“No formal ban has been put in place” — because that would involve legislators passing laws in a legislature and whatnot. So they just banned it anyway.

Mark Steyn, “Live Brie or Die!” SteynOnline.com, 2014-03-13

Alcoholics Anonymous and addiction

Filed under: Health — Tags: , , — Nicholas @ 09:27

In Maclean’s, Kate Lunau talks to Dr. Lance Dodes about Alcoholics Anonymous:

Dr. Lance Dodes has spent more than 35 years treating people who are battling addiction, including alcoholism. In his new book (co-written with Zachary Dodes), The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, Dodes takes a hard look at Alcoholics Anonymous, a worldwide organization that describes itself as a “non-professional fellowship of alcoholics helping other alcoholics get and stay sober.” Today, there are more than 5,000 AA groups in Canada alone, which are free and open to anyone. Dodes, a retired assistant clinical professor of psychiatry at Harvard Medical School, argues that some groups — and many for-profit private rehab centres based on the 12-step model — are often ineffective, and can cause further damage to addicts.

Q: How did you come to work on addiction?

A: I first became involved with alcoholism and addiction in the ’70s, when the place I was working, which is now part of Massachusetts General Hospital in Boston, needed to develop an alcoholism treatment unit. I was director of psychiatry, so I said, “I’ll develop it.” Afterward, I became involved in various addiction treatment programs, including running the state’s largest compulsive-gambling program. Over the years, I became very familiar with AA. It became clear that, while AA works for some people, the statistics just didn’t back it up. The real problem is that [doctors] refer 100 per cent of their patients with alcoholism to AA, and that’s the wrong thing to do 90 per cent of the time.

Q: AA has more than two million members around the world. You say its success rate is between five and 10 per cent. How, then, do you account for its enduring popularity?

A: AA is a proselytizing organization. The 12th step is to go out and spread the word, and they do. Because there are so many people in prominent positions who are members of AA, it gets tremendously good press. If AA were simply harmless, then I would agree that a seven per cent success rate is better than zero. But that’s not the case. It can be very destructive. According to AA, AA never fails — you fail. AA says that if you’re not doing well in the program, then it’s you. So you should go back and do the same thing you did before: Do more of the 12 steps, and go to more meetings.

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