• A new way of monitoring heart failure

The NZ Herald has an interesting article about a new way of monitoring people who have congestive heart failure.

Basically a set of scales and a blood pressure monitor are wirelessly connected to a cellphone: that’s the Bluetooth mentioned in the article, which sends data between gadgets via radio waves. The cellphone then sends the data to the hospital each day. If people forget to take their readings the hospital is supposed to chase them up.

One of the symptoms of heart failure is fluid accumulation in the body. People are supposed to weigh themselves daily and phone the hospital if they gain more than 2 kg overnight. Of course people do forget to weigh themselves, and the hospital won’t know if they’ve forgotten. A sudden worsening of congestive heart failure often leads to hospitalisation and/or death, but close monitoring and a rapid response to problems reduces the likelihood of these outcomes. That’s why this system has people weighing themselves.

Most people with heart failure are elderly, and it will be necessary to make the gadgets user-friendly and reliable in order to overcome unfamiliarity with and resistance to technology. Those patients who aren’t able to manage this form of self-monitoring are likely to have carers who can do it for them.

No system is foolproof (at the patient end or the staff end), but this looks like a simple and effective way of improving the management this condition.

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• Nanny-state proposal for reducing smoking

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This is from the NZ Herald:

A proposal to license tobacco retailers and turn cigarette packs into plain packages bearing only health warnings has found strong support.

In planning for the “end game” of widespread tobacco use, researchers canvassed public health physicians, policy officials in the Ministry of Health and other departments, and journalists.

They floated five proposals:

[1] Creating a Smokefree Commission that could require licensing of retailers, ban sales near schools, take over wholesaling, and end the glossy branding of tobacco and cigarette packets, turning them into generic, plainly packaged products displaying only health warnings.

[2] A weaker form of the commission, with licensing, but keeping existing links between suppliers and retailers.

[3] Progressively reducing tobacco import quotas, which would probably force prices up.

[4] Changing the law to make it easier to sue tobacco firms successfully.

[5] Making the tobacco industry responsible for reducing smoking, with stiff penalties if it failed to meet targets.

There is so much wrong with this insane and evil plan that it’s hard to know where to start. Here’s a partial list:

• I find it hard to believe that anyone would be so naive as to think that this would actually reduce the consumption of cigarettes. Illegal drugs almost always come in plain packaging and as far as I know no one has said “I don’t like buying marijuana when it’s wrapped in tin foil so I’ll quit right now”.
• this is yet another example of state employees trying to tell everyone else what’s good for them
• this scheme would also be a violation of property rights, i.e. it would control what cigarette companies do with the packaging that they own (as do the current regulations)
• “take over wholesaling” – sounds like Communism to me
• banning sales near schools would be a violation of property rights that would effectively be stealing money from shop owners (by reducing their profits)
• a Commission would be yet another waste of taxpayer’s money
• licensing would be yet another compliance cost for businesses that are being bled dry by the government
• when it comes to suing tobacco companies I have no sympathy for the claimants because nowadays everyone knows that smoking is bad for you. I understand that there was a time when tobacco companies told lies and hid the truth, but even then common sense would have told people (if they’d listened) that inhaling smoke that makes you cough is bad for you. Making it easier to sue tobacco companies is a Marxist notion based on the belief that big business is bad
• making the tobacco industry responsible for reducing smoking? Have these people been smoking something that isn’t tobacco?

Where do these totalitarian nanny-state ideas come from? From a bunch of university academics of course. It’s no coincidence that these people – who are state employees – almost always come up with ideas that further the state’s plans. All around the world we see that academics are hand in glove with the state, history shows that most of the leftist ideas come from academic circles, and a great many politicians come from academic backgrounds. Why do people teach in universities (or any school)? Because they want to control what future generations think, and people who want to control other people are attracted to politics, so a move from academia to politics is perfectly natural. Just think about Helen Clark’s career.

The bottom line is this: the state has no right to control what people put into their bodies. Furthermore, it is unjust to penalise shop owners and tobacco companies when attempting to control what people put into their bodies. The state should butt out and mind its own business, because it has no business taking an interest in tobacco in any way whatsoever (no pun intended).

I hope to see a free world where shops can sell whatever they like to whoever wants to buy it and each smoker bears the cost of their decisions, rather than having taxpayers bear the cost when they are dying of emphysema. The cost of health insurance would be a true and just disincentive for smokers.

What do you think about this proposal and the points that I have raised?

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Related posts:

The pointless death of an undercover policeman

The minimum drinking age

Sue Kedgely can’t force people to live healthy lives

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• Doctor-Bullies Flourish In Public/State Hospitals

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A friend was telling me about being bullied by a hospital midwife, and this reminded me of the times that I have been bullied by hospital doctors. I believe that bullies flourish in public/state health care. Why so? Before I get to the answer allow me to explain the New Zealand situation.

The health care situation in New Zealand

Basically the state has a near-monopoly on health care. Private hospitals only provide elective and sub-acute procedures, so anything complex or acute (e.g. car crash injuries or a heart attack) goes to a public hospital. I met a guy who had a knee replacement (elective surgery) done in a private hospital, then experienced a pulmonary embolism (an acute, complex, life-threatening condition where there is a blood clot in a lung) as a complication of surgery so was transferred to a public hospital because private hospitals in New Zealand cannot manage this problem. There’s really no escape from the state health care system (chaos?) in New Zealand.

Why do bullies flourish in public/state health care?

Because the staff in a public hospital are effectively in no way accountable to you, the patient.

When you are paying a medical person for their services you are purchasing a portion of their time and that person is beholden to you, just as an employee is beholden to his employer during his hours of employment. When a doctor is paid by the state, using money taken from taxpayers at gun point, that doctor is beholden to whom? Yep, the state.

Allow me to explain. When you – let’s call you Lee – go to a private doctor or other medical professional there is a contract (exchange of promises) between you: you are saying “I will pay you $X if you provide the medical services that I require”. In return the doctor says “I will provide you the medical services that you require if you pay me $X”. Both parties know that the other party can walk away if the promises are broken (breach of contract), and because you are a party to the contract the doctor knows that he must provide what you want in order to receive his profit.

Compare this with a public health care system where the state says to a doctor “I will pay you $X if you provide medical services to Lee”, and the doctor says “I will provide medical services to Lee if you pay me $X”. You the patient, the slab of meat in the bed, are merely incidental to this contract and have no control over it or the parties to it. The doctor knows that he must provide what the state wants – not what you want – in order to receive his profit. If, as is often the case, the medical services that you want or need are different to what the state is willing to provide that’s just too bad.

Why do bullies flourish in public/state hospitals? Because the patients have no effective control over them: in other words, when you go into a public hospital you are the mercy of the staff. Bullies are attracted to situations that give them power: being a doctor or other medical professional gives power, and being a doctor or other medical professional in a public/state hospital gives more power. The bullies know that you are disempowered as a result of being removed from the contractual process by the state’s overwhelming power. They also know that they can get away with bullying, because history shows that “little or nothing” is the usual result when patients complain about state employees.

Josef Mengele is a good example of a state-protected doctor-bully – he’s the Nazi well known for experimenting on humans at Auschwitz-Birkenau. “That can’t happen in New Zealand”, you say. Wrong: what Mengele did is, in my opinion, only a step or two away from what Herb Green did when he experimented on women without their consent or knowledge and killed some of them. I am referring to the “Unfortunate Experiment” at National Women’s Hospital, in which Green did not treat a condition widely believed to lead to fatal cervical cancer in order to see if that was what really happened (details here and here). If Green did what he did with malice aforethought (intent to kill) he would be as much a murderer as Mengele is, but Green most probably had good intentions. Despite this, you can make a good case for saying that Green has blood on his hands.

Do bullies flourish when there is a free choice of health care providers?

Let me speak from personal experience. A few years ago I went to a dentist that was recommended to me and found that he was an unpleasant individual with an arrogant manner. Because the state in no way controls which dentist I go to I never went back to him and he suffered financial loss as a result. That’s how capitalism works: those who don’t provide the best service lose money if the state does not interfere with the free market (I have met many doctors and other medical professionals in public hospitals who are far, far more unpleasant and arrogant than this dentist but, sadly, I have never had the option of voting with my wallet and going to another hospital because the state has interfered with the free market, i.e. taken away my freedom to choose. State institutions are refuges for various forms of life that cannot survive in the real world).

Compare this with my optometrist, who is is very nice, very competent, and has always provided good service. I have a free choice of optometrists, so I keep going back to him because he provides what I want. That’s how capitalism works: those who provide the best service are rewarded with more money (profit). The profit motive is often maligned, but it is a good thing because it results in you and I getting what we want.

In my experience doctors and other medical professionals almost always have a better attitude when they know that I have freely chosen to consult them and bring profit to them. Those who know that I have no choice about who I consult because the state has taken it from me are far more likely to be uncaring, rude, off-hand, bullying, and the like. That’s human nature, i.e. very few people are willing to make an effort and provide good care when they can make little effort and be paid the same amount. Less work, same money – that’s the situation in a state-protected monopoly and it’s a no-brainer for the staff. That’s why going to the DMV, state hospital, city council, etc. is normally so painful.

Do bullies flourish when there is a free choice of health care providers? Common sense and my experience indicates that they do not, because capitalism is a form of natural selection.

In summary

1. Bullies, be they doctors or other medical professionals, flourish in state/public hospitals because the state has made them effectively unaccountable to their patients and protects them when they do bully.
2. State disempowerment of individuals leads to gross injustices in medical situations, ranging from bullying to killing.
3. The profit motive and contracts freely entered into give us protection against doctor-bullies.
4. Bullies do not flourish when individuals can freely choose their medical provider.
5. Free choice leads to lots of .

Finally, I’d like to say that I have met a few public hospital doctors who are superb clinicians and a pleasure to talk to.

What do you think about that points that I have raised here?

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Related articles:

Why does Obama want to eliminate private health insurance via Single Payer/Universal Health Care?

Everything You Love You Owe to Capitalism

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• Woman kills son whilst stoned but drugs are a victimless crime

The comments button is at the bottom right of this post.

The NZ Herald and Stuff have both reported the case of Wendy-May Connon who, according to the crown prosecutor, drove after smoking cannabis. She travelled at excessive speed*, crashed and killed her son Konrad Truger.

Then on Kiwiblog Bok said in reference to this case

Yep Libertarians.. it is a victimless crime….

And Angus added

Bok, true. Much of the libertarian doctrine only applies in a Robinson Crusoe type situation. (before companion Friday shows up at least]

Do they also think that alcohol should be illegal because people drive whilst drunk and kill children? If not they are exercising a double standard.

Back to the Connon case: with all due respect to Bok and Angus, they are mistaken and have conflated (joined together) two separate things.

Wendy-May Connon did not harm anyone when she smoked marijuana. She did harm someone when she drove whilst under the influence of that marijuana. Her smoking was victimless, her driving under the influence was not, and they are two separate actions because smoking marijuana does not inevitably lead to driving under the influence of that marijuana.

To put it another way, taking drugs only harms the person who takes the drugs. If a person does something stupid whilst under the influence of drugs that is something else entirely, and if a person commits a crime in order to obtain drugs that is something else entirely.

If you are going to take alcohol and/or marijuana you know that you are likely to do stupid, dangerous things whilst under the influence, so please, please, please ensure that a sober person is around to stop you from doing those stupid, dangerous things. That person must be willing and able to use physical force to restrain you if necessary; if Connon had had a sober protector her son would still be alive. Also, if you drink yourself to the point of sleep or unconsciousness you are very likely to vomit and inhale that vomit so that you drown: it happens all the time. This can be avoided if you have a sober person around who knows how to put every sleeping and unconscious drunk into the recovery position, so that your mates don’t wake up and find you dead on the sofa with a pool of vomit around your head.

Drugs are a victimless crime: Wendy-May Connon did not harm anyone when she smoked marijuana. She did harm someone when she drove whilst under the influence of that marijuana. They are two separate actions.

What are your thoughts regarding this case and the legalisation of drugs?

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Related posts:

The pointless death of an undercover policeman (my arguments for drug legalisation)

Was Pablo Escobar a danger to the public?

Drink-driving should be legalised

* Marijuana is a sedative, so I was surprised that someone would drive at excessive speed after taking it. However, according to an abstract on Medscape “Marijuana use also directly increases risk-taking behavior in some settings”.

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• Update: Govt forces folic acid into bread

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This is an update to my earlier post Govt forces folic acid into bread.

This is from Stuff:

Rules forcing bakers to add folic acid to bread could be scrapped within months of coming into force if the Government secures a review.

Food Safety Minister Kate Wilkinson said yesterday that she could reverse the 2007 decision to make folic acid mandatory in most bread from September regardless of the outcome of the review.

But there is a catch folic acid fortification was agreed under the trans-Tasman food safety treaty and Australian agreement is needed for any review.

That is unlikely before the next ministerial meeting in October, a month after the requirement takes effect.

Ms Wilkinson said New Zealand would lobby for support ahead of the summit and, if agreed, the review could be completed by January.

She believed New Zealand would then be free to take a fresh look at folic acid in bread.

“If the review is in place [completed], then at that stage we think we have the option to opt out, whatever the review says.

“My thoughts at the moment are that I would rather have fortification on a voluntary basis, thereby giving New Zealanders a choice.”

The beneficence of our Food Safety Master knows no bounds, but those are only her thoughts “at the moment” so who knows what they will be when the next moment arrives. We all know that moving lips on a politician indicate that lying is occuring, but let’s hope that Wilkinson does restore a fraction of our freedom.

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