Speaking of Instapundit, Glenn's regular readers will recall his recent posts about his wife Helen's hospitalization for implantation of an implantable pacemaker/cardioverter.
Said Glenn of the device: "The good news is that those things are available..."
He's right. But for Medicare patients, that good news is nothing to take for granted. Many of them simply haven't been able to get the device.
As our Ed Haislmaier reports for us, Medicare patients haven't had the same access to these devices as Americans with private health insurance have had. Says Ed:
[In]1985, the FDA approved the first implantable defibrillator and by 1989 the first cardioverter-defibrillator that could deliver a multi-stage shock therapy to correct heart rhythms. Since then, device companies have continued to innovate, simultaneously making ICDs more sophisticated and less costly.Read Ed's entire piece here.
But the story involving Medicare isn't so positive. Medicare first agreed to pay for ICDs for a limited number of patients in 1986. But it was not until 1991, and then again in 1999, that Medicare further expanded its definition of 'medical necessity' to cover ICDs for more Medicare beneficiaries.
In the spring of 2002, armed with new clinical trial data from the New England Journal of Medicine, ICD makers asked Medicare to further expand coverage. A year later, Medicare's Coverage Advisory Committee unanimously endorsed the expansion. By that time, private insurers were already paying for ICDs for patients with the same characteristics and the American Heart Association and the American College of Cardiology had already revised their treatment guidelines.
But not until June of 2003 did Medicare agree to a further coverage expansion, and then only to one-third of the recommended patient population. Only now is Medicare finally agreeing to the full ICD coverage criteria the private sector adopted two and a half years ago.
In announcing plans to expand coverage for IDCs, Medicare touted that it expects 25,000 more patients will receive IDCs in 2005, "potentially saving up to 2,500 lives." Thus, we may infer that Medicare's foot-dragging, bureaucratic coverage process probably resulted in the avoidable deaths of between 5,000 and 10,000 Medicare patients over the past two and a half years.
A big reason for Medicare's foot-dragging on IDCs is cost...
The hard truth is that, like national health systems abroad, Medicare saves money by limiting the availability of life-saving care...
Deacon and Hindrocket have it right in their Power Line commentary Monday: Bush should not entertain suggestions for judicial nominations from a bipartisan group of Senators, as suggested by very liberal Senator Charlies Schumer of New York.
For strategic reasons, Bush should show no weaknesses whatsover in the matter of judicial nominations. None.
Horace Cooper, a member of Project 21 and also a member of The National Center's board of directors, will be a panelist at a Changing Social Security: The Impact on African Americans forum tomorrow at the Joint Center for Political and Economic Studies (10 AM to noon).
Other panelists include Rep. Charles Rangel (D-NY), AARP Policy Director John Rother, Dr. Maya Rockeymore of the Congressional Black Caucus Foundation and Dr. Dean Baker of the Center for Economic Policy Research.
Derek McGinty will serve as moderator.
Horace will be the only participant representing a conservative/free-market point of view, so he'll need to take his vitamins tomorrow morning!
Addendum (3/5/05): The Joint Center for Political and Economic Studies has announced that the audio for the conference is available online for those who wish to listen in.
This story, by John F. Dickerson in the March 7 edition of Time magazine, is amazing:
George Bush knew Vladimir Putin would be defensive when Bush brought up the pace of democratic reform in Russia in their private meeting at the end of Bush's four-day, three-city tour of Europe. But when Bush talked about the Kremlin's crackdown on the media and explained that democracies require a free press, the Russian leader gave a rebuttal that left the President nonplussed. If the press was so free in the U.S., Putin asked, then why had those reporters at CBS lost their jobs? Bush was openmouthed. "Putin thought we'd fired Dan Rather," says a senior Administration official. "It was like something out of 1984."The article says the Administration is trying to fight this level of "misinformation" by "struggling to build relationships that go beyond Putin."
The Russians did not let the matter drop. Later, during the leaders' joint press conference, one of the questioners Putin called on asked Bush about the very same firings, a coincidence the White House assumed had been orchestrated...
If this story is true, it explains a great deal.
Hat tip: Drudge Report.
An Oregon Congressman apparently is offended by National Center Policy Analyst Ryan Balis' observation in the Washington Post that "smart growth" anti-sprawl policies in Portland, Oregon have tended to push housing costs higher.
The Congressman responds with his own letter to the Post:
In his Feb. 9 letter, "The Cost of Containing Sprawl," Ryan Balis wrote: "Suppressing housing development as demand for it grows will cause prices to skyrocket. This is evident in Portland, Ore., long considered a model for 'smart growth' planning."Says Ryan:
According to the National Association of Realtors' Web site, the median price for a single-family home in the Portland region in the third quarter of 2004 was $215,000. This compared favorably to the cost of homes in sprawling Denver, $241,800 (second-quarter data); Las Vegas, $283,200; and the Washington area, $362,400. Also, The Post has run several articles about skyrocketing housing prices in Northern Virginia, an area known for its lack of growth-management policies.
Sprawling onto unlimited supplies of land has never made housing affordable and never will. Portland's housing remains relatively affordable in large part because its smart-growth policies have curbed sprawl onto farmland and made it easier to build more types of housing on less land inside the urban-growth boundary. The result is a more livable community -- and less expensive housing. Indeed, Portland's housing prices are substantially lower than those of every West Coast city from San Diego to Seattle.
U.S. Representative (D-Ore.)
Congressman Earl Blumenauer claimed the following: "Portland's housing prices are substantially lower than those of every West Coast city from San Diego to Seattle." However, a just released housing affordability study by the National Association of Home Builders placed at least three West Coast metro areas ahead of Portland for the 4th quarter of 2004: Salem, Oregon; Olympia, Washington and Eugene-Springfield, Oregon.My two cents: The Congressman is mixing apples with oranges. Knowing that Denver's home prices are higher than Portland's tells us nothing about the impact of "smart growth" policies on Portland prices. Furthermore, the Congressman's contention, for which he provides no support, that reducing the available supply of land for homebuilding reduces home prices violates the law of supply and demand.
We still contend: "Smart growth" policies tend to increase home prices, making homeownership more difficult for lower-income individuals and families. But we agree with the Congressman on one thing: When they do find a way to buy a home, the homes will probably be built on smaller lots.
Michelle Malkin is publicizing a call for Type O blood donors to join a bone marrow registry in order to help a desperately-ill Marine.
As my blood is Type O-, the "universal donor" type that is considered liquid gold to vampires, I've made a point of giving blood many times. Also, back in the 80s, I joined the bone marrow registry at the NIH in Rockville, MD. It was an easy process -- easier than giving blood, in fact. I simply donated about four test tubes worth of blood and answered a number of predictable questions about what I had been up to, to help make sure that if I was called upon to donate, I wouldn't transfer any nasty diseases. Since then, all I have to do to remain active on the registry is tell them if I move, so I can be located if needed.
Once in all those years I was called. I was a close match for someone. They asked me to come in and give a bit more blood for more extensive testing, to see if the match was close enough. It wasn't, but they kept my more detailed information in my computer profile for a possible future match.
People might think the big advantage to joining a bone marrow registry is the benefit to the recipient. I suppose if I ever donate marrow and it saves someone's life, that would be true. But the fact is that it has worked out as a selfish thing for me. Every time I hear on the news, or see a poster up on a restaurant window saying that someone needs a marrow transplant and they can't find a matching donor, I have the satisfaction of knowing that my information is on file and has been checked. That's worth a lot to me.
For more information about becoming a donor, visit the National Marrow Donor Program. You can see if a marrow donation center is located near you by visiting here, but you don't need to live near one to join the registry. You can visit here to see if you are eligible to donate.
Far be it for me to suggest a possible compromise settlement to any of the controversies relating to the Prince Charles-Camilla Parker-Bowles wedding (royal controversies give the British press their raison d'etre), but I have a suggestion that could resolve questions regarding the legality of Prince Charles marrying in a civil ceremony.
Specifically, since a good argument can be made that British law proscribes civil weddings for royals, but reasonable doubts exist, and given widespread and not unreasonable sentiment that the head of the Church of England ought to be married in a church (should not he who is the shepherd lead his sheep?), Parliament should approve a compromise bill, to whit:
No Act of this government should be interpreted to prohibit the legal marriage of a member of the royal family by a civil ceremony under the same laws applicable to the civil marriages of British subjects, save that no offspring of a purely civil marriage will be considered legitimate descendants for purposes of succession to the throne.I'm sure I wrote that in American-ese (it was very hard for me to even type the word "subject"), but the Parliamentary fellows could hoity-toity it up in a few seconds flat.
This compromise settles the matter neatly, in my view. As a biological child is unlikely to result from a marriage in which the bride is 57 (adopted children are ineligible to succeed under British law), it is unlikely that any individual will be denied succession under this plan. Yet, deference to the Church is retained, as is the incentive for future royals to marry within the Church.
Furthermore, there is precedence for this in the "His Majesty's Declaration of Abdication Act 1936," the law under which Edward VIII not only abdicated, but formally renounced all rights of his descendents to the throne. The 1936 law was approved by Parliament in a single day, though the circumstances then were a bit more compelling than those at work in this case.
In addition to the United Kingdom, 15 other countries (the so-called "Commonwealth Realm" nations) recognize the British monarch as their head of state. Any change in the laws governing the succession to the British throne must also be adopted by the Parliament of each of these nations in order for the changes to apply in these nations. Thus, if my suggestion were to be adopted by the British Parliament, yet not adopted by all or some of the other Commonwealth Realm nations, a split could develop if both William and Harry died childless and Charles and Camilla had a biological child.
This scenario, while unlikely, at least has the entertainment value of permitting us to envision a world in which countries such as Australia, Canada, New Zealand and tiny Tuvalu recognized the British monarch as their head of state -- but did not recognize Britain's choice of monarch.
The tabloids would love it.
E-mail in response:
Before you begin to pontificate at least TRY to get your facts straight ... I'm sorry to hear that it was "very hard for [you] to even type the word 'subject'." You really shouldn't have struggled so ...So the British monarch has no subjects? How can one be a monarch without subjects?
Britons have not been considered "subjects" of the Queen for many years. In common with nationals of other democratic countries we are known as "British citizens."
The term "British subject" means one who has allegiance to the crown. It was last used as a legal term referring to individuals in the British Nationality Act of 1948.
Addendum 2/25/05: The term "subject" continues to have legal meaning and official use in Britain -- see this list of types of British citizenships on a British government passport application website, for instance -- but the legal definition of "British subject" (as a citizenship class) now appears to apply only to a narrow group of individuals born before 1949.
So, should we replace the word "subject" in my proposed law above with the rather wordy phrase "British citizens who are not members of the royal family"? Seems rather awkward... but then, everything about this wedding appears to be a bit on the awkward side.
"We Europeans always want to have the world from yesterday, whereas the Americans strive for the world of tomorrow," says this piece from the English-language version of the German newsweekly Der Spiegel.
Though the piece appears at first glance to be about President Bush, there's plenty in here to warm the hearts of Reagan fans.
Hat tip: Ed Haislmaier and Lucianne.com.
I've been reading and hearing sentiments like this -- namely, that the conservative coalition is heading for a split between small-government "libertarians" and social conservatives for something like 25 years now. I assume it went on before that, but I wasn't yet noticing.
Considering that this split has supposedly been imminent for a quarter century or more, it sure is overdue.
That's because it is not happening. I could go on and on about why, but I will be succinct instead. This will require some use of generalizations, so be warned in advance about that.
First, the social conservatives want smaller government. Aka, Grover Norquist's "leave us alone coalition." Small-government/libertarian conservatives love to threaten social conservatives with departure in part because many moderates are embarrassed about being aligned with the un-hip social conservatives. (By the way, are we still in high school?) If the libertarians ever out-recruit the social conservatives the social conservatives will probably just ask them if they plain to support the appointment of activist judges. If they don't the social conservatives will be happy and if they do they actually are liberals.
Second, of Bill of INDC Journal's threat ("One day [we moderates] simply snap, our better judgment overwhelmed by a wacky sense of humor and stewing anger, and you'll wake up to a nightmarish world where the senior senator from Mass rides into the sunset as SecState and Billary is floating doomed socialized medicine schemes out of the Oval again."): Been there, done that. Jimmy Carter, Bill Clinton. Every time you do that, the country comes back, righter than ever. In fact, you wandering "moderates" helped get us Reagan (response to Carter) and the Republican Congress (response to Clinton). Every time the coalition squabbles, it gets reminded of the importance of sticking together. And a few million other people are reminded, too.
Third, it is silly to draw excessive conclusions from who speaks at CPAC. Aside from the big names, CPAC panelists and speakers tend to be chosen by the sponsors. If you care about who speaks, instead of talking about taking one's chips and going home, become a sponsor of the thing. Any group big enough to be worth keeping in the coalition will find no difficulty doing all the sponsoring it needs to do. (Hint: Send in a check.) Similarly, the CPAC audience is not a demographically pure slice of modern American conservatism -- neither are Ann Coulter's fans. Draw conclusions from who boos at what and what you have learned is -- the opinion of the people who booed. The very people who booed a defense of President Bush's immigration proposal voted for, why, could it be -- President Bush? They probably volunteered for him, too, and gave his campaign some of their money. This is a split? It sure looks like a governing coalition to me.
Fourth, political movements that stop having debates (modern American leftism, I am speaking about you) sicken and die. Differences of opinion among groups and individuals in the conservative coalition are a sign of intellectual strength and vitality. If you consider yourself part of the conservative coalition but have a point of view, whatever it might be, that is not currently dominant within the coalition, here's two possibilities: 1) You and your allies aren't very good at explaining why you are right, or 2) You're not right. Work on it.
These folks are encouraging individuals to ratify the Kyoto Treaty.
Are signers expected to reduce their personal carbon dioxide emissions by at least five percent under 1990 levels?
If so -- word to the wise, whatever else you do -- don't sign it!
Here's an overseas perspective on America's decision not to ratify the Kyoto Treaty. Worth reading in its entirety, but here is an excerpt:
...in a democracy such as the U.S., it is not possible to browbeat a president into doing something which is deeply unpopoular with the general population. In tin-pot countries such as Azerbaijan, Congo, Djibouti, Iran, Kyrgyzstan, Liberia, Myanmar, Pakistan, Russia, and Syria, the president can ratify anything he likes, because if he bothers with elections at all, they are mere formalities which simply prove that the incumbent should be in office for life. In short, if the world wants the U.S. to ratify the Kyoto Protocol, they are going to have to make a decent case and sell it to the general population of the United States. (In Europe this has not been necessary, as thanks to the EU, sweeping decisions are made at a lofty and detached level guarded by a phalanx of bureaucratic jargon and overpaid consultants, meaning there is no longer a requirement to gain approval from the ignorant masses.)Hat tip: I learned of this from Tim Worstall, by way of Michelle Malkin.
...To the average Yank, and to a great many other people (including myself), the Kyoto Protocol looks as though it has been craftily developed by political parties wishing to hobble the U.S. economy. Until such time that somebody steps forward and persuades them that this is not the case, the Yanks are not going to budge - and nor should they...
Notice (thanks to Wizbang for the pointer) that when the former leader of Britain' Conservative party, Iain Duncan Smith, wrote an op-ed about the influence blogs could have on Britain, the first example of blog empowerment ("blogpowerment"?) he thought of had to do with Britain's socialized medicine system.
Namely, that "patients who have waited and waited for [National Health Service] care" will find a voice through blogs.
Michael Barone, Iain Duncan Smith and others have written that blogs make conservatives more mainstream and leftists more radical. They thereby conclude that blogs, on balance, help the right.
I submit that the advantage goes deeper -- to the nuts and bolts of policy debate. Blogs filled with the grievances of the victims of socialized medicine will be the best answer to those who might be swayed by Ted Kennedy and others to seek to impose that sort of system on us.
I propose that, as a 40th birthday gift to the American people, we expand Medicare over the next decade to cover every citizen from birth to the end of life.Beware of Kennedys bearing gifts.
-Ted Kennedy, January 12, 2005
Sean at Everything I Know Is Wrong has a top-flight post on global warming.
Let me put it more directly: global warming may or may not be happening -- anyone who tells you that they know for certain, one way or the other, is lying to you. The best, most accurate statement that can be made about global warming is, "we don't know, and we don't have any way to tell -- the world is too big."Sean explains much in a very few words. If global warming bores you but you think you ought to read something about it every once in a while just to keep up, read Sean's post here. (If global warming doesn't bore you, click here.)