Guilty until proven innocent

A news release issued by the FDA on Tuesday said:

The U.S. Food and Drug Administration (FDA) is seeking a permanent injunction against Sharkco Seafood International Inc., located in Venice, La. The injunction is intended to stop the seafood processing company from distributing scombrotoxin-forming fish in interstate commerce. Consumption of scombrotoxin-forming fish that are not properly preserved or refrigeratedcan result in scombroid food poisoning, a foodborne illness that results from eating spoiled or decayed fish. Scombrotoxin-forming fish most commonly include mackerel, sardines, tuna, bluefish, and mahi mahi.

The government’s complaint, filed today by the United States Attorney’s Office for the Eastern District of Louisiana charges Sharkco Seafood and its owners, Khai Q. Nguyen and Tuan Q. Nguyen, with violating the Federal Food, Drug, and Cosmetic Act by failing to establish and implement an adequate Hazard Analysis and Critical Control Point (HACCP) plan for their scombrotoxin-forming fish. FDA requires all seafood processors and distributors to have a HACCP plan that determines and monitors food safety hazards associated with their products.

“FDA repeatedly warned and tried to work with Sharkco Seafood,” said Michael Chappell, acting associate commissioner for regulatory affairs at FDA. “The company had ample time to take correction action, which it failed to do. An effective seafood HACCP plan is critical to safeguard the health of the American people. We will take prompt action against companies whose poor business practices could jeopardize the public health.”

According to the government’s complaint, FDA inspections showed that the defendants failed to have an adequate written HACCP plan for their scombrotoxin-forming fish operation, despite numerous warnings by FDA. The formation of scombrotoxin can be adequately controlled when fish are appropriately preserved or refrigerated. Once formed, however, scombrotoxin cannot be removed or destroyed by washing, freezing, or cooking the affected fish.

No illnesses have been associated with Sharkco Seafood’s scombrotoxin-forming fish products. The company produces other seafood products, which are not affected by this action.

Note that last paragraph: No illnesses have been associated with the company's products. So the FDA isn't seeking an injunction against Sharkco as retribution for making its customers sick. It's seeking an injunction because Sharkco hasn't followed the FDA's bureaucratic requirements to prove that it won't make anyone sick. In other words, Sharkco is assumed guilty because it hasn't proven itself innocent. That's backwards.

Bo-Tax

One of the Senate's creative ways to steal money to pay for healthcare "reform": A tax on plastic surgery not considered necessary to correct congenital defects, the results of an injury, or the aftermath of a disfiguring disease.

Plastic surgeons are protesting the tax, but they're going about it the wrong way. They argue that the tax is being proposed because plastic surgery patients are seen as wealthy housewives who can afford to pay a little extra, but that in truth the majority of their patients are not affluent, and that therefore this tax would hurt working-class Americans.

That's true, but it's not the argument plastic surgeons should be making. By arguing that the government shouldn't steal from their patients because they aren't rich, plastic surgeons have conceded that it's okay for the government to steal from someone, and it only remains to be seen who that someone is. And once you've made that concession, it's an awful lot easier to convince politicians that "someone" should be people who can afford mole removals and breast implants, whether or not those people had to spend years saving for the surgery, than that "someone" should be labor unions or grandmas and grandpas or any other politically savvy group. As the New York Times article states:

Dr. Teitelbaum, the Santa Monica surgeon, seconded that opinion, and called the proposed tax “cowardly.”

“You’re taxing a disorganized group that has no one of its own representing it,” he said. “There’s no American Society of Plastic Surgery Patients.”

Dr. Teitelbaum said some patients might be embarrassed to admit to having had cosmetic surgery. “They don’t want to come out and march on Capitol Hill,” he said. “You’re not going to have a million-man Botox march.”

In a system where the group with the loudest voice and the most political pull gets its way at the expense of others, the individual suffers -- particularly the individual who's afraid to speak out for his own rights.

Instead of arguing that their patients don't have the money the Senate thinks they do, surgeons should be arguing that the government has no right whatsoever to meddle with the services they offer to patients, whether by taxation, regulation, or any other means. The idle trophy wife who gets breast implants for her husband has the same right not to be taxed as the burn victim who has his destroyed skin reconstructed, even if the public may not be as sympathetic to her wish for surgery as to the burn victim's. The government should not tax plastic surgery -- not because plastic surgery is purchased by the middle-class as well as the rich, but because the government has no proper purpose in medicine.

A reminder at Thanksgiving

I've been working a lot lately. A LOT. Much of this work is (no) thanks to the FDA; I can't go into details, but not only has it been long hours, but I may also have to work this weekend. For the girl who deeply enjoys preparing the Thanksgiving meal for her family, this is a severe annoyance.

Here's the thing, though...this is just one year of annoyance for me. For doctors, nurses, and other healthcare professionals, it may be EVERY year that holidays are not days spent with family, but days spent on call or working at a hospital. Emergencies don't take holidays.

Young people know this (or they should) when they choose to enter the medical profession. An ER doctor knows he'll have to trade in Mom's turkey and stuffing for a night of IVs and sutures. An obstetrician knows that, instead of flying across the country to open presents by the Christmas tree, she needs to be on call for any babies who decide to show up on December 25th. A nurse knows she may have to sign on for extra shifts in December to handle all of the ice-, snow-, and drunkenness-related injuries instead of going to holiday parties.

How many people do you think will be willing to sign up for that life when healthcare "reform" pushes healthcare professionals' salaries lower and lower, when insurance companies pay the same rate for treatment on Thanksgiving Day as they do for some random day in August, when we start paying doctors the same amount of money per patient regardless of how much care that patient gets?

No moral leg to stand on

Very quick commentary, since I don't have time to write much about this:

House Democrats are accusing the pharmaceutical industry of increasing prices in anticipation of cost cuts from whatever healthcare "reform" bill passes. They haven't said what they'll do if an investigation says that the pharma companies are "price-gouging," but I wouldn't be at all shocked if antitrust proceedings and massive fines ensued.

Now, if the pharmaceutical industry hadn't been in bed with the government all along, trying to get universal health care passed (with the obvious benefit to the industry of more customers buying drugs), it could proudly say that the government has no moral right to tell companies how to price their drugs. But seeing as how the industry's leadership is trying so hard to get government force on its side, it has no moral defense against the use of force.

Going quiet for a while

I probably won't post here again until after the Thanksgiving holiday. Not that there isn't PLENTY to say about health between now and then...but I'm going to be working an absurd number of hours and will have zero time to blog. Can't post the reason publicly except to say that the Food and Drug Administration is a large source of the pain. Boo, FDA!

Chopping the tallest poppies

From the Boston Globe, via the New York Times, comes this little gem:

Health economists are increasingly advocating a cost-cutting method known as “bundling,’’ in which health providers receive a lump sum to care for a patient with a particular medical condition, say, diabetes or heart disease. The House bill calls for the administration to develop a plan for bundling, while the Senate Finance Committee version of the bill gives it until 2013 to create a pilot program.

This type of payment system has been proposed in Massachusetts, which is struggling under the burden of universal health care. All I can say is, if you have a medical condition, you'd better hope you're one of the easy-to-treat patients with that condition, because this payment system creates a pernicious incentive for your doctor not to treat you. If my doctor gets $20,000 to care for my heart disease whether I get $4 generic statins for it at Wal-Mart or a $25,000 bypass surgery, which one do you think he will recommend? What if the statins aren't going to cut it? Don't assume that doctors are going to take all patients and use the profits from the below-average-cost ones to pay for the above-average ones. They're simply going to refuse to treat patients who need more work than the average Joe.

This is just another way in which "universal health care" will make care less available, not more.

Guidelines for Survival Under Socialized Medicine

A friend of mine and fellow Objectivist, who asks to be identified only as Christian W., posted this excellent set of advice on Facebook. With his permission, I'm sharing it here. Christian originally hails from a country in which socialized medicine is already a reality, so we can learn from his experience in the unfortunately highly likely event that that's what we get in America.

Guidelines for Survival Under Socialized Medicine
by Christian W.

Folks, socialist medicine is likely inevitable in the United States. I think that it will either be implemented by means of sweeping bills like the one now approved by the House, or by a continued gradual strangulation of freedom in healthcare. The trends towards fascism and socialism have grown increasingly stronger over generations, and little will change their essential trajectories in our lifetimes. (I hope to be proven wrong.)

I think that it is still very worthwhile to wage an intellectual battle against the collectivist juggernaut, but it is also time to consider some personal strategies for coping with the coming deterioration of healthcare in this country.

Here are few general practical guidelines for personal survival:

1) Rationing and shortages are inevitable under socialism. Therefore you must plan your life as if no healthcare will be available for you at all except in cases of acute trauma requiring ambulance transport. (There are some other exceptions, but this is the essence of health care in countries like Sweden.)

Absence of modern medical services means that you have to take meaningful steps to minimize the risk of acquiring a chronic illness or disease of aging and/or lifestyle. You will have to become your own doctor, primarily focusing on disease prevention. Special emphasis should be put on proper diet and exercise. Know these fields as if your life depends on it.

Note: Don't become overly reliant on supplements as a way to mitigate less-than-optimal dietary and lifestyle choices, because supplements that are in any way effective will gradually be outlawed, as they already are in Europe. The pharmaceutical industry lobby, in collusion with power-lusting congressmen/bureaucrats, will ensure this.

2) Treat your body as a delicate vintage automobile that you must take exquisite care of, since spare parts and/or access to a professional mechanic are either nonexistent or excruciatingly expensive. Many organs and systems of the body have good self-repair mechanisms, while others, unfortunately, have not. Thus, for example, participating in sports that may wear down joints or cause other permanent damage should be minimized. (Services like hip replacements will not be readily available.) Many health-conscious people are unaware that the modes of exercise that they are applying may have short term health benefits, but could be detrimental in the longer term. Be informed, and always apply the ancient medical maxim "First, do no harm."

3) Avoid contact with the public healthcare system as much as possible. It can be deadly to be sucked into the machinery even for a minor issue. Misdiagnosis and faulty, dangerous, treatments and medication regimens are commonplace under socialism (just as in Dark Ages "medicine"). In many areas of medicine, particularly those related to especially politicized areas like CVD and other "life-style" diseases, government-franchised practitioners are often dangerously ignorant of essential facts. Remember that the worst aspect of socialist medicine is that medicine as a rational science is epistemologically destroyed by eliminating the role of the doctor as a sovereign, independently thinking, professional. [SDZ: I consider that last point an incredibly important observation that needs to be spread widely.]

4) Don't trust at face value any pronunciation or recommendation that comes out of organizations like the FDA, USDA, NIH, American Diabetes Association, American Heart Association, the medical industry lobby, or your medical insurance company. I deliberately lump together government agencies and some influential private entities here, because these are all primarily (or, in the case of the private organizations, to a very significant degree) vehicles for dissemination of propaganda having scant to do with the furtherance of objective health information.

Obtain your health information from honest clinical practitioners with proven track records, and from primary scientific sources. The latter can be done either directly, for example, by reading research papers (if you have the time and appropriate background knowledge to do so) or by finding experts that apply sufficiently rigorous epistemological standards to interpret and explain the content of such scientific sources for the layman. (Aim to get a second opinion on all important issues.)

5) Consider becoming a "medical tourist". Medical services are already cheaper, safer, and provided with better care for the patient in many former third world countries. (Thailand comes to mind.) If you'll ever need to travel overseas to save your own life, swear to never forgive those of your countrymen who let America deteriorate to such a despicable state.

Praying won't make it so

I'm a second-year student in the Objectivist Academic Center, and the class is currently working through the difference between the metaphysically given (such as the law of gravity) and the man-made (such as traffic laws). The man-made is the result of choice, and as such is subject to praise or criticism. The metaphysically given simply is what it is, and all the whining, crying, and pleading we do will not change it. Neither will praying.

What's this got to do with health? According to the Los Angeles Times, religious Congressmen have slipped into the healthcare "reform" proposal a provision that insurers be required to pay for "religious and spiritual healthcare," including "prayer treatments" offered by Christian Scientists.

If an individual believes he can deny the metaphysically given, that by praying or paying someone else to pray for him, he can kill the cancer cells growing in his body, or heal a broken bone, that is his problem. He should be left to his own devices. He can go ahead and waste his money on "treatments" that do nothing -- that can do nothing. As long as he spends his own money or money given to him voluntarily, he violates no one else's rights, and he will be the only victim of his own poor decision.

But this law would force insurers to act against their own judgment, so that some individuals can indulge their fantasies that their own wishes and prayers can change nature. Any insurer willing to examine the facts of reality -- and it had better examine them, if it wants to stay in business -- would eliminate coverage of such "treatments," knowing that they would never produce any value in return for the money paid for them. The "religious and spiritual healthcare" provision would force insurers to act against their rational judgment and pay for these services, and it would force those of us who know the difference between the metaphysically given and the man-made to pay for them, since insurers would have to distribute the cost of "prayer treatments" across all customers.

It doesn't seem like a big issue -- after all, "prayer treatments" cost an awful lot less than MRIs. But it's an illustrative one. There is no benefit -- not "prayer treatments," not in vitro fertilization, not autism therapy, not even heart transplants -- that justifies the violation of the rights of insurers to offer coverage on whatever terms they choose, nor the violation of the rights of consumers to purchase the coverage that best suits their personal needs. And that's why a mandate is so evil -- it turns decision-making about insurance from a voluntary exchange between insurer and insured into a dictate from bureaucrats and whatever special interest of the month is calling. That insurance mandates are evil is something all the prayer in the world won't change.

I rule

26.2 in New York City!

It was amazing. Before this race I said NYC was something I would probably only do once, figuring that the logistics of such an enormous race would be too much of a pain to do again. I was wrong. The elation of having so many people encouraging you along those miles, the fun of seeing so many different neighborhoods, the unbelievable feeling of coming into Central Park for those last couple of miles, is worth repeating. I think I'm going to apply for Chicago next year, but another NYC run in the next five years is a definite possibility.

My weight-loss success really helped me in my goal of running a better race. My previous personal record was 4:45:58, and I cut that to 4:28:30! This, even though my old PR was set on the flat course of Philadelphia, and my new one involved running up and down a lot of damn bridges :)

I feel amazing, and will post some pictures when I get them!