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Hiển thị các bài đăng có nhãn whats. Hiển thị tất cả bài đăng

Thứ Tư, 1 tháng 5, 2013

ObamaCare vs. neglect --what's better for your health?

Most Americans -- even those who are legislators -- know very little about the details of President Obama’s Affordable Care Act, so-called "ObamaCare." Next year, when it goes into effect, we will learn the hard way.

Many people lazily assume that the law will do roughly what it promises: give insurance to the uninsured and lower the cost of health care by limiting spending on dubious procedures.

Don’t count on it.

Consider just the complexity: The act itself is more than 906 pages long, and again and again in those 906 pages are the words, “the Secretary shall promulgate regulations ...”

If only government would neglect the rest of health care! Then we’d have better service and better care at lower cost.

“Secretary” refers to Secretary of Health and Human Services Kathleen Sebelius. Her minions have been busy. They’ve already added 20,000 pages of rules. They form a stack 7 feet high, and more are to come.

Our old health care system was already a bureaucratic and regulatory nightmare. It had 16,000 different codes for different ailments. Under our new, “improved” system, there will be more than a 100,000.

Government likes to think regulations can account for every possibility. Injured at a chicken coop? The code for that will be Y9272. Fall at an art gallery? That means you are a Y92250.

There are three different codes for walking into a lamppost -- depending on how often you’ve walked into lampposts. This is supposed to give government a more precise way to reimburse doctors for treating people and alert us to surges in injuries that might inspire further regulation.

On Government-Planned World, this makes sense. But it will be no more successful than Soviet central planning.

Compare all that to a tiny part of American medicine that is still free-market: Lasik eye surgery.
Its quality has improved, while its costs have dropped 25 percent. Lasik (and cosmetic surgery) are specialties that provide a better consumer experience because they are a market. Patients pay directly, so doctors innovate constantly to please them. Lasik doctors even give patients their cell phone numbers.

President Obama didn’t kill American free-market health care. It began dying during World War II, when government imposed wage and price controls. 

At first, companies said, “Great, stability!” But then they realized that they could not attract better workers without raises. So companies got around the rules, as companies do. They gave “benefits,” like health insurance.

Government then distorted the market further by giving employer-based health insurance better tax treatment than coverage you buy yourself.

But employer-based insurance is nuts. Many workers feel locked into their jobs. Company insurance largely destroyed the health care free market, since employees rarely shop for the best service at the lowest price.

Now ObamaCare may kill what’s left of that market.

Maybe we will soon be like Canada, where some people wait years for treatment. A producer from my TV show went to a Canadian town where the town clerk pulls names out of a box and then phones people to say: “Congratulations! You get to see a doctor this month!”

But there is at least one area where Canada offers cutting-edge, life-saving technologies. Unfortunately, to get this care, you have to meow or bark. Veterinary care is still handled by the market. Providers innovate or go out of business.

Markets find ways to make things better and cheaper. ObamaCare often forbids that. For example, it requires that every insurance policy cover preventive care and “breastfeeding support.” It insists that mammograms and colonoscopies be provided without any deductible.

It’s tempting to believe that such rules prevent illness and save money, but there is little evidence they will. 

Some people will undergo invasive procedures that shorten lives instead of extending them. Some of us want those tests; some don’t. 

Government controlled medicine means we  all get them and pay for them, regardless of whether we want them. Government control kills consumer choice.

Lucky Lasik and cosmetic surgery patients! Their treatments are better in part because government doesn’t consider them important enough to subsidize and regulate. If only government would neglect the rest of health care! Then we’d have better service and better care at lower cost.

And we’d have choices.

John Stossel is host of "Stossel" on the Fox Business Network. He's the author of  "No, They Can't: Why Government Fails-But Individuals Succeed," "Give Me a Break" and of "Myth, Lies, and Downright Stupidity." To find out more about John Stossel, visit his website at johnstossel.com.


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Chủ Nhật, 28 tháng 4, 2013

What's next from Pope Francis?

If Pope Francis I’s success were to be rated for style alone, the new leader of the Roman Catholic Church is off the charts. The College of Cardinals could not have chosen a man more appealing to the world – to Catholic and non-Catholics alike.

His warm, disarmingly open demeanor, along with his apparent willingness to break with convention, have brought him converts of the popular sort. The former archbishop of Buenos Aires, Jose Mario Bergoglio, has been changing minds for some time. He is embraced by unassailable defenders all around, religious leaders, human rights figures among them.

But as the new pope settles in to his job,  the question now is whether style will convert into an ability to handle substantive issues that have not gone away. The pope takes over at a trying time for the church – observance among Catholics is shrinking, and faith is shattered by the unresolved child sexual abuse scandal.

Pope Francis also has to contend with an administrative mess at the Vatican that prelates acknowledge has been a legacy of two popes who –whatever their qualities—were cerebral and hands off when confronted with bureaucracy. In particular, he faces a scandal at the Vatican Bank, which is awash with charges of mismanagement and corruption. The hope among priests is that he will work out the problems and that the pope’s sympathetic touch will be a great boon for the fortunes of the church and beyond.

Francis I appears to be onto something. A pope with a moral message carries enormous weight in the world – it has been so since the dawn of modern communications. I’ve just written a book "The Pope’s Last Crusade"--about the little-known Pope Pius XI, who inaugurated Vatican Radio in 1931 and raised his voice against Hitler and Mussolini. He became an icon of opposition to Fascism in Europe at a time when all other media there were censored.

Then, as now, Jewish leaders and others were praising the pope as an advocate for human rights.

Similarly, decades later, I was present when Pope John Paul II visited Chile in 1987 when visited during the Pinochet regime and called for justice. The pope can offer hope beyond the confines of the church.

Now, just as then, however, the pope will have to speak up and change minds. Francis is riding with good will and an expectation he will succeed.

The Reverend James Martin, a well-known Jesuit in the United States says that this is a perfect moment for such an unassuming, iconoclastic pope. He says the choice of the first Latin American and first Jesuit pope represents a sea change for the Catholic Church.

"It is a recognition that the center of gravity in the church has shifted,” he told me. “It is an immense turning point for the Catholic Church.”

There is a potential difficulty for the church, though. He is not expected to offer any major doctrinal changes, especially concerning the most controversial areas some members of the church are looking for. Don’t expect new declarations about celibacy among priests, or bringing women to the priesthood, or changes in the view of abortion and contraception.

In particular, the pope indicated this that he has no intention of changing his predecessor’s decision to order a crackdown on the largest assembly of U.S. nuns, who were judged to be challenging the Vatican’s conservative line and promoting “radical social themes.”

It remains to be seen whether his style and personal appeal will win points despite such controversies. The pope is pointing to an all-inclusive church – reaching out to other denominations and stressing concern for the poor.

Francis made contact with religious leaders of other faiths even before his installation. Key among his guests at that ceremony, for example, to highlight the immediate change was Batholome I, the head of the Eastern Orthodox Church. It was the first time a leader of his group had attended the installation of a Roman Catholic pope in 1,000 years.

The pope also won praise from Rabbi Abraham Skorka, a prominent Jewish leader in Argentina; they wrote a book together, On Heaven and Earth. Relations also have thawed quickly with Muslims, who had strained contacts with Pope Benedict XVI. Sumer Noufouri, the secretary general of the Islamic Center of Buenos Aires, told the Washington Post that the new pope “is a person who listens and who knows Islam. (It is) an opportunity for a fresh start in relations…”

In the final analysis, said Father Martin, the immediate acceptance of the pope is a matter of spirit.

“Holiness is naturally attractive to people,” he said.  “It is glimpsing the divine.”
                  
Little more than a month after the start of his papacy, Francis has shown that he intends to come across as a pope for all seasons.

Peter Eisner has been an editor and reporter at the Washington Post, Newsday and the Associated Press. He is the author of the new book "The Pope's Last Crusade: How an American Jesuit Helped Pope Pius XI's Campaign to Stop Hitler" (William Morrow 2013). For more visit his website: www.petereisner.com


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Thứ Ba, 16 tháng 4, 2013

Fear and the bombings in Boston -- what's normal, what's not

Unless we are in imminent danger, fear is the enemy of our health. Our heart races, our blood pressure goes up, we sweat, yet there is nothing for us to do. We fret, fail to sleep, and enter what I call a self-renewing cycle of worry. Hopefully, this won’t be our sustained reaction to the Boston Marathon bombings.

Most of the media medical attention on the bombings thus far has focused on the loss of limb and life, and on those who are hospitalized and struggling to recover. 

This is as it should be. 

But for those at the finish line both spectators and runners alike, it was fear that was the major reaction. Jay Soroko, senior producer at Fox News, was running in the marathon and was several blocks from the finish line when the bombs went off. He was trapped there for hours with hundreds of other petrified runners. “It was surreal,” Jay said. “It was like I was inside a bubble. It was easily the scariest event of my life. I was so worried about my loved ones’ safety.”

The goal of terrorists is to scare us. Just a few of  die, but the rest of us panic. 

For those who experienced the bombings directly, the images will live in their minds for the rest of their lives. There is a significant risk of Post-Traumatic Stress Disorder, complete with flashbacks, nightmares, depersonalizations, anxiety and depression. Psychotherapy may help some of these people to recover more quickly.

For the rest of us, as we sit transfixed by the news accounts, there is a danger of over-personalizing the risk, as occurred after 9/11, when more people were afraid to fly and took to the highways where they were then far more likely to die in car accidents as a result.  

Right now, as we are mesmerized by the images coming from Boston, there is the same kind of risk.  The more we worry unnecessarily, the more risks we may take in our own lives. We hear a loud noise, and we jump, for just an instant feeling that a bomb may have gone off in our own neighborhood.

This reaction isn’t healthy, but it is part of our voyeuristic attachment to the 24 hour news cycle. We think we need to take the risk seriously and protect ourselves, but at the very center of our brains sits the powerful amygala, an almond-shaped organ that generates strong emotions including fear. Unfortunately, the amygdala can be fooled; research from Elizabeth Phelps, a psychologist and neuroscientist at NYU has determined that we may have the same kind of hormonal reaction to danger we see on a video screen as one we experience directly ourselves.  

In other words, we can generate our own an outpouring of stress hormones in response to a perceived rather than a real risk. This fight or flight reaction is intended for if you are under attack, the victim of a real roadside bomb, rather than just watching one on TV.

America is understandably on edge today. But we need to gain perspective on this act of apparent terrorism as quickly as possible. Remember, the goal of terrorists is to scare us. Just a few of  die, but the rest of us panic. 

It is normal to feel vulnerable and to worry after an event like this, but if you find yourself obsessing on the news and it is interfering with your sleep and making you feel helpless, then it is time to pull back, watch less TV, and divert your attention elsewhere. And remember, if you want your children to be calm, then be calm yourself.

The less we obsess on the events in Boston on Monday, the less we panic, the better for our collective health.

Dr. Marc Siegel is an associate professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center. He is a member of the Fox News Medical A Team and author of several books, including "False Alarm; the Truth About the Epidemic of Fear"; He is also the author of "Swine Flu and Bird Flu." His most recent book is  The Inner Pulse: Unlocking the Secret Code of Sickness and Health. 


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