Come Down To My Basement…I’ve Got Candy Down There…
Organized medicine is certainly facing a little bit of a faith crisis. From those they’re supposed to represent come cries that the AMA, specialty and state societies do not do enough for [put individual specialty here]. From the interested public and other interest groups comes cries that the AMA, specialty and state societies move to benefit the physician over the patient.
Throw amongst those pragmatic concerns the intellectual and long held criticism that organized medicine suppresses the supply of physicians and the scope of non-physician practice and is thus inherently anti-free market.
I’ve ignored this topic for long enough considering my considerable involvement in leadership roles within organized medicine and my libertarian leanings.
The clamoring from far right wing free market speakers like the late Noble Laureate above (who I respect considerably, despite the little joke above) and crazy think tanks like the Ludwig von Mises Institute is that the AMA is essentially a guild whose will the government has succumbed to. In a publication titled “100 Years of Medical Robbery” the think tank has this to say about the history of the American Medical Association and its goals:
In the days of its founding AMA was much more open–at its conferences and in its publications–about its real goal: building a government-enforced monopoly for the purpose of dramatically increasing physician incomes. It eventually succeeded, becoming the most formidable labor union on the face of the earth.
To accomplish the twin goals of artificially elevated incomes and worship by patients, AMA formulated a two-pronged strategy for the labor market for physicians. First, use the coercive power of the state to limit the practices of physician competitors such as homeopaths, pharmacists, midwives, nurses, and later, chiropractors. Second, significantly restrict entrance to the profession by restricting the number of approved medical schools in operation and thus the number of students admitted to those approved schools yearly.
The emphasis is my own.
I’ll offer a candid response to this. Through it’s history the AMA appears to have focused largely on improving physician income. Perhaps not as single minded or nefariously as the Ludwig von Mises Institute would have you believe but it remains. And the AMA has had considerable success doing such. The allowance of self goverance that medicine enjoys and the sway it holds over the scope of practice for other providers is incredible. I think there are some real issues of ‘patient safety’ buried in those issues, as the AMA would argue, but it is hard to argue that physician income did not, does not play a role in the AMA’s focus in securing physicians influence over who practices “medicine.”
Organized medicine was responsible for the Flexner Report and continues to hold the greatest sway over the number of physicians this country will (or will not) have by controlling the LCME and ACGME. To argue some conspiracy to suppress the number of medical students (and thus number of future physicians) through these entities is baseless, but it does display how much control organized medicine has wrested for physicians. As does the limiting of the scope of practice of all other medical practitioners. Indeed, that aspect of the AMA’s success (getting state governments to agree to follow their rules on who should be allowed to perform certain procedures or write perscriptions) may be the most marvelous.
It is clear that the ‘thinkers’ and ‘economists’ who criticize the AMA are far removed from the practice of medicine. Some of their rails simply show a lack of understanding of how medicine works. For instance, the article above tries to criticize the AMA’s restriction on who can practice medicine in the name of ‘patient safety’ and ‘quality,’ by saying,
A final challenge to the Lexus standard is the number of accidental deaths occurring in U.S. hospitals every year. Harvard University’s Lucian Leape estimated that there are approximately 120,000 accidental deaths and 1,000,000 injuries in U.S. hospitals every year. To understand what staggering figures these are, imagine a Boeing 777-200 with its maximum of 328 passengers crashing every day for an entire year with no survivors. This would add up to 119,720 deaths, still not as many as are killed through medical error in hospitals every year. UCLA Professor of Medicine Robert Brook, M.D., told the Associated Press, “The bottom line is we have a system that is terribly out of control. It’s really a joke to worry about the occasional plane that goes down when we have thousands of people who are killed in hospitals every year.”
In anycase, the point is there are questionable assertions like this throughout the works of the libertarian thinkers who criticize organized medicine. Despite that, there is some validity to their points. As another Ludwig von Mises paper, “Bring Back The Guild System?” says,
Government regulations on the chiropractic profession, lay midwifery, and on the freedom of nurse practitioners to offer services within their competence, all of which make perfect sense from the point of view of the medical guild that lobbied for them, make no sense at all from the point of view of consumer wishes (as repeatedly expressed in polling data) or from economic considerations. In many cases, such people can provide health services far more cheaply than can licensed physicians (or, in the case of chiropractors, can provide services that licensed physicians do not provide at all), but consumers are prevented from making their own decisions regarding their medical care. Given the logic of the guild structure, no one has the right to be surprised to find that the AMA has put so much effort into undermining its professional opposition.
There is nothing wholly unique about physicians’ efforts towards this. Other professions do the same and also limit their membership through limiting education spots but medicine is certainly one of the most successful at it.
I will accept the blows Milton Friedman lands against the American Medical Association but let me make an argument on why the AMA’s actions are reasonable despite violating the libertarian ideal.
Let us call what the AMA and the rest of organized medicine does a necessary evil. It might not have been through all of its existence granted but today it is. It is because physicians are not playing on a level, free market playing field.
That is the question the thoughtful should be asking; not whether guaranteed access for all can work. Let us be honest, if you goal is improving utilitarian public health measures - life expectancy, infant mortality, time to treatment for diseases, access to care - then a single payer system could work in the United States, provided enough funding. Complaints and nay say against such a system by providers is nonsense and nothing but protection of self interest. There are tradeoffs with such a system, but there are trade offs with any health care system. Look at our current one. If you want to improve what the public would consider ‘health’ then a well funded single payer system would be far superior to our current system, no matter America’s ‘uniqueness’.
But should we do that? The real debate is should the government fund access for those who cannot afford it themselves. Who has such a right?
The Miller Center of Public Affairs tried to do that recently with a panel debate. On the transcript at times the talking heads fall short in defining the debate and staying on course, but it still something worthwhile to look at.
While You Were Busy Watching Dancing With The Stars A Little Bit More of Your Right To Privacy Died
So this 9th Circuit Court decision looked a little more outrageous when I first saw it, but it still remains a fine excuse to bring up the political topic most important to me. Civil liberties.
I’m sure it will come as a surprise to many but Border and Customs Agents can essentially seize any electronic device you are transporting into the U.S. and hold it for as long as it takes them to ’search’ it. And such is what they’ve been doing more of late.
Laptops may be scrutinized and subject to a “forensic analysis” under the so-called border search exemption, which allows searches of people entering the United States and their possessions “without probable cause, reasonable suspicion or a warrant”…
The 9th Circuit Court recently reaffirmed the legality of data on electronic devices being scrutinized under the border search exemption to the 4th Amendment. What I really disagree with is the breadth of the border search exemption, but ruling it extends to data on electronic devices is nothing new. As Wired and Yahoo! blogs point out such searches of computers has been upheld since at least 2004. But the claim that searches of US citizens at the border “are reasonable simply by virtue of the fact that they occur at the border,” (as the Supreme Court has put it) and current U.S. Customs law are far too broad of a mandate for current U.S. Customs.
Some discretion is being used in determining who gets searched and who does not. Allowing Border Agents such authority has some benefits, they are the ones on the front line, but it also has major pitfalls in terms of our privacy.
Let me frame the the security versus freedom issue. These are on a scale. We could always be safer at the expense of further rights. We could all renounce our right to privacy further and have cameras in our homes and renounce our right to property further and have the taxes to pay for people to monitor those cameras. True, the yield for each further bit of privacy we forfeit is probably less but the maxim holds.
That might seem like an obvious definition of the debate but I’m currently annoyed by arguments such as those claiming that if you’re not a criminal you have nothing to fear or asserting that the U.S. has to protect its borders. Such are ridiculous in that they contribute nothing in trying to define how to tilt the scale of freedom versus safety.
In any case, the border exemption is far too broad at present. I hate it.
As for the extension of such to electronic data, there is a reasonableness to the legal argument considering how the border exemption has been defined. However, the pragmatic result seems fishy at best.
We should try to maximize the return on our forfeit of liberties (such as the right to privacy). The return for checking IDs, checking citizenship, checking large vehicles for illegal immigrants or devices of terrorism is considerably higher than that for checking a number of laptops based on the suspicions of some GED carrying Border Agent.
I would’ve hoped, however much their legal arguments were in line with prior court holdings, that the 9th Circuit Court (here and here and here) would’ve had some gall and would’ve help reverse the general decline in our civil liberties.
Hamed’s 4-year-old son, Mohamed, was dying of cancer and needed an artery transplant that cost $5,000. The only savings Hamed had was what he fished from his pockets at the end of the day.
There was another way, one whispered about for those with nothing. A man could wager part of himself, slip into a hospital gown, and wake up with an incision above the gut.
Hamed sold a section of his liver for a bit more than the price of his son’s operation. The boy died in surgery.
With his scar healing and his son buried, Hamed, whose knowledge of anatomy would perhaps fill a single page, decided that driving a bus was not the fate of the man he wanted to be. He brokered his first liver deal four months ago. He earned $900. Four more sales have followed.
There are virtually no laws governing organ donations in Egypt. Or so the article makes it sound like.
Mohamed Queita, a member of the Egyptian parliament and the ruling National Democratic Party, has been working for 12 years to pass a law to regulate organ transplants and stop an expanding black market that draws patients from across the Middle East and as far away as Europe.
“It’s the worst kind of business in Egypt. It’s worse than slavery,” says Queita, who has no comprehensive statistics but notes that one Cairo clinic had a waiting list of 1,500 people willing to sell their organs. “I don’t want the poor turned into spare parts for the rich. . . . People are coming from all over to buy organs in Egypt. They’re mainly gulf Arabs. If you’re a rich man from the gulf, you go to a private Egyptian hospital that has contacts with organ brokers. Serious cases of poverty in this country are causing an increase in the theft and sale of organs.”
The emphasis is my own. This kind’ve paternalism is just wrong. There are terrible, horrific stories out there but no matter the motives or the life situation that forces someone into selling an organ, it seems something like such is a personal decision without any negative consequences for anyone else. The government has no place regulating such decisions.
It’s real simple - just let people do what they want with their bodies.
It isn’t like western societies’ bans on selling/buying organs are achieving their goals anyway. Protecting the poor? Maintaining some ‘equality’ in the distribution of limited organs? Nonesense.
You can’t make direct payments, but those with resources are still open to bettering their odds of getting an organ by doing everything just short of paying the previous owner of the organ.
Panda Bear and Graham have conflicting posts on the merits of ‘Social Justice’ and just what Social Justice entails.
Social Justice is certainly an amorphous term which in part makes the debate difficult to keep within a set of boundaries but essentially Social Justice is the idea that to each, as he deserves, goes the benefits of society. Those benefits paid for in the form of wealth redistribution.
The debate is a continuum from whether Social Justice should even be an ideal, all the way to exactly how one judges what individuals “deserve.” I think, despite some confusion, that Graham and Panda Bear are talking about the same thing.
Panda Bear worries about the free loader who exploits societal handouts by pretending to be a victim.
Social justice, as I understand, it about equality. Distributing shared, scarce public resources as equitably as possible. Nothing in it speaks of victimhood.
But the two positions on how Social Justice is defined aren’t mutually exclusive. The reality is that, at least subconsciously, victimhood has become the standard by which we evaluate what an individual “deserves.” And determining what of societal benefits an individual deserves is the whole practice of Social Justice.
[T]he mob, once it discovers it can vote itself access to other people’s wallets, is difficult to keep in check and the usual dependency triumvirate of ghetto, trailer park, and academia are perpetually braying for somebody else’s money. The extent to which this money can be secured depends on how many productive citizens can be lured onto the dependency plantation, usually by the proganda of fear and class envy. The problem with creating a welfare state is that it tends to fulfill the dire prophecies of its creators. The more productive citizens are taxed the more economic activity is stifled leading to stagnant economies where there are, in fact, no jobs for many people who would be employed if growth and economic opportunity were encouraged at the expense of stealing from one set of citizens to give to another.
I’ve often criticized the “right to health care” by asking who defines that right in a society with limited resources. ‘Oh you get this yearly mammogram but not that colonoscopy.’ Any line drawn is nearly entirely subjective and indefensible compared to an expanded or contracted definition. Such applies to all welfare, all wealth redistribution, all Social Justice.
Yeah, Society Took The Corn From The Indians And Gave It To The Pilgrims
Graham speaks of ‘equality,’ but it appears to me that if Social Justice is something real then it calls for an equality of position. Here’s what I mean:
First, equality can be defined as an equality of opportunity, in the sense of nothing but natural impediments (your ability, circumstance, etc) to your progress up the social and economic ladder. In such a case Social Justice either doesn’t exist or is satisfied by you merely being alive and not being interfered with by other members of society.
Second, we can talk about an equality of position such that everyone has the same. In such a case Social Justice is paramount, but such calls for the complete redistribution of wealth.
No society, no individual can philosophically defend the determination that “Well you’re entitled to this much in food stamps but no more!” or “$400 in a housing stipend but nothing else!”
You either satisfy ‘equality’ by redistributing all wealth equally or you don’t redistribute wealth at all.
The Noble laureate Friedrich Hayek came to slightly similiar conclusions, in the sense that the problems of trying to determine what individuals ‘deserve,’ in order to satisfy Social Justice destroy the principle itself.
Social justice requires not merely that individuals receive what is rightly theirs in general terms, but that individuals and groups also receive some stipulated distributional share of the society’s total output or wealth. However, Hayek showed that in the market economy, distributions of income are not based on some standard of “deservedness,” but rather on the degree to which the individual has directly or indirectly satisfied consumer demand within the general rules of individual rights and property.
To attempt to distribute income shares by “deservedness” would require the government to establish some overarching standard for disbursing “social justice,” and would necessitate an economic system in which that government had the authority and the power to investigate, measure, and judge each person’s “right” to a share of the society’s wealth. Hayek suggested that such a system would involve a return to the mentality and the rules of a tribal society: government would reimpose a single hierarchy of ends and would decide what each member should have and what should be expected from him in return. It would mean the end of the free and open society.
I’ll keep my arguments philosophical and stay away from the pragmatic consequences of trying to implement Social Justice. Needless to say I agree with much of what Panda Bear concludes.
Wow, a medical requirement and not even one to take advantage of public services.
What I mean: while I don’t necessarily support, in full, mandatory car insurance there is a way of thinking about it that you’re using a public service which lends some credibility to the requirement. The same for mandatory vaccines for public school attendance. I don’t agree with that position but it’s an argument. But here, New Jersey is requiring pre-schoolers to get vaccines to attend private daycares. And the absurdity rises.
Starting in September, all children attending preschool or licensed day care centers will have to get an annual flu shot, Jacobs said. That makes New Jersey the first state to require flu shots for preschoolers or older students, according to the American Academy of Pediatrics.
If the private preschools want to make that a requirement, let them, but is this the state’s place? Even with these typical opt out rules in place,
New Jersey does grant an automatic exemption on religious grounds and allows exemptions for medical reasons.
In the Huffington Post article linked to above she says the Republican pro-life candidates are probably against oral contraception as well, and should be confronted on the issue. But what makes you scratch your head is comments like this,
Mitt Romney, Mike Huckabee, Ron Paul, Tom Tancredo, Duncan Hunter, and Fred Thompson all define life as beginning at conception or fertilization, in other words when sperm meets egg. (It’s worth noting that there’s no medical way of knowing when sperm meets egg. According to the American College of Obstetricians and Gynecologists, a fertilized egg isn’t even considered a pregnancy.)
[…]
If a candidate pledges to define life as beginning at fertilization, then anything that prevents implantation will end a life. And pro-lifers insist the pill does that. Birth control then becomes abortion, and as we know, abortion gets banned. Why hasn’t the media sunk its teeth into this little curiosity?
Here’s the source she links to as proof that pro-lifers (apparently all of them) claim OCPs prevent implantation.
I suppose all pro-lifers go around and blow up abortion clinics as well…as long as we’re going to make generalizations.
But I mean seriously is she citing this as a scientific source? Really? Because I can tell you right now why this isn’t an issue and it’s because the scientific consensus is that hormonal contraception IS NOT AN ABORTIFICENT except in the sense it poses a marginal theoretical risk of such. The consensus, no matter what Cristina Paige or some pro-life groups claim, is that OCP’s nearly flawless mechanism of action revolves around it preventing ovulation in the first place.
For combined oral contraceptives and progestin-only methods, the main mechanisms are ovulation inhibition and changes in the cervical mucus that inhibit sperm penetration. The hormonal methods, particularly the lowdose progestin-only products and emergency contraceptive pills, have effects on the endometrium that, theoretically, could affect implantation. However, no scientific evidence indicates that prevention of implantation actually results from the use of these methods. Once pregnancy begins, none of these methods has an abortifacient action.
The emphasis is my own. Can both sides at least try to understand the science a little better instead of cherry picking?
Any sort of talk like this needs to point out such risk of “abortion” is highly theoretical and any warnings of such exist because of political pressure for them to. All evidence points largely to other mechanisms of action.
Seriously, this is why the public shouldn’t even voice their opinion on medical issues like this. Sorry if that is crass, but really an influential and important liberal posting essentially radically misinformed opinions on this subject is damaging. She’s obviously more than free to do so, but she and others are doing more damage than good by opening their mouths.
Same for the other side. What type of ridiculous notion is this from a pro-life publication?
[An] example is found in the testimony of a famous Supreme Court case, namely Webster vs. Missouri. In public arguments before the entire world, the attorney representing the pro-abortion forces of Reproductive Health Services, Mr. Frank Susman, declared: “The most common forms of what we generically in common parlance call contraception today, IUDs, low-dose birth control pills, which are the safest type of birth control pills available, act as abortifacients. They are correctly labeled as both.”
Oh well.
—————————-
1. Rivera, Roberto, Irene Yacobson, and David Grimes. “The Mechanism of Action of Hormonal Contraceptives And Intrauterine Devices.” American Journal of Obstetrics and Gynecology 181 (1999): 1263-1269.
Off of medicine for a moment and on to civil liberty sort of things.
Senator Dodd is causing a ruckus by attempting to put a hold on a Senate intelligence bill which spells out some warrantless wiretapping stuff, including apparently granting immunity to any telecos who turned over records to the NSA (which, by the way was carrying on warrantless wiretapping of Americans before 9/11 it now looks like).
That’s all nice and good, and admittedly I’m not exactly happy at my neighborhood teleco for their wimptastic lack of backbone in this whole ordeal. But protection from some civil suits (this shouldn’t even be discussed as a criminal matter) should pale in comparison to the loss of business if this country had any civic sense about it.
I’m never ready to heap a whole ton of social responsibility on the commercial sector. Not to be an apologist but if the government is telling them it’s a requirement, I’m not sure we should expect them to pay their legal department to protect the constitution.
Okay, that doesn’t sound right. We should expect such of them, but the most appropriate avenue is probably to speak by your checkbook.
I’m sure plenty will have legitimate suits when if the whole breadth of the ordeal becomes known, and there’s some nobility in trying to keep those avenues open.
The Senator from Conneticut is worth some praise for promising a fillibuster if Senate Majority Leader Harry Reid doesn’t recognize his “hold,” which would I admit be pretty remarkable (Reid’s disregard for Senate tradition…not the fillibuster). But as the clapping for Senator Dodd dies down just realize this is small potatoes; the real responsible party in this mess is obviously not the phone company but the White House.
Senator Dodd On A Potential Fillibuster
As such the real question is, despite the “compromise” Congress managed with the White House, where was Senator Dodd’s filibuster when the actual FISA renewal bill came up? That’s what we really needed.
Who remembers Starchild Abraham? This is the 16 (now 17) year old with relapsed lymphoma who tried to turn down another round of chemo and radiation therapy. In a “sickening” compromise (what good is a “compromise” otherwise?) Virginia child services and him and his family decided he could forgo chemotherapy as long as he agreed to radiation therapy.
A 17-year-old who won a court battle against state officials who tried to force him to undergo chemotherapy for his lymphatic cancer is in remission following radiation treatments over the past year, the teen and his doctor said.
Cherrix is not cured, but “he is N.E.D., our abbreviation for ‘no evidence of disease.’ He’s in a total remission,” [his radiation oncologist, Dr.] Smith said Thursday.
“There may be some microscopic tumor somewhere still there, but everything we see is gone,” Smith said.
Kind’ve happy, kind’ve sad news. His odds of relapsing are obviously very high. Beyond the plight of Starchild, there is something disturbing for the big picture. The reason I’ve revisited this story is because of this paraphrase,
Art Caplan, director of the Center for Bioethics at the University of Pennsylvania, doubted the immunotherapy had value. But he said Cherrix’s seemingly improved health shows the state was right to intervene.
“He’d probably be dead by now if they (state officials) did not react,” Caplan said.
As I’ve said before: I don’t know Starchild or his family, I don’t know how mature he is, I don’t know his level of understanding and competency. But if he meets a kind’ve minor threshold on those measurements, what is Art Caplan doing promoting this kind’ve paternalistic beneficence over Starchild’s autonomy? Maybe the reporter took whatever quotes provided in part out of context.
Even so, there are plenty who have jumped to the side of the state in forcing treatment on this kid. Yikes.
The Center for Bioethics at UPenn is pretty darn prestigious and I’m sure Dr. Caplan is incredibly well respected. But I just don’t understand how he and so many others jump on this kind’ve arbitrary date for granting autonomy. As Art Caplan himself has published,
When a patient wants to follow nontraditional medicine and chooses not to enter the hospital, no one can force him or her to do so even if it means the loss of his or her life and much grief for his or her spouse and family.
But not before you’re 18? Ethics is certainly not equivocal with law. These are separate issues: when the state grants autonomy and when it actually exists. Shouldn’t we explore each case independently? Apparently not if the reporter’s presentation of Dr. Caplan’s position is to be taken at face value (which you certainly can’t always do); the ends justify the means.
Bioethics Rule #1: Patient Autonomy Bioethics Rule #2: Don’t Create Superintelligent Mice Bent On World Domination
I agree with every level headed health care provider out there in that Starchild was pursuing hopeless “woo” instead of reinduction chemotherapy. His course was, potentially is, a virtual death sentence.
And I think that is irrelevant.
You cannot use the decision you’re judging (in this case the therapy for his lymphoma) to determine competency or maturity, that’s a ridiculous notion.
And if in all other measurements of competency Starchild was sound then, even with his parent’s influence on his decision, he should’ve been allowed to make it. Like anyone with a heart a part of me is happy to see at least partial therapy put on him. On the one hand it is great seeing him in remission (however long lasting) but at the same time I’m worried about what this says about paternalism in medicine and government. In the end, however happy I am to see him doing well I think you have to let the kid (and indeed any mature patient) make their own decision.
The Schiff Amendment to H 2082, the annual Intelligence Authorization Act, passed. And then the entire bill passed. Right down party lines. Which leaves a slim margin for the bill to get out of the Senate with anything comparable to the Schiff Amendment.
In anycase, the Schiff Amendment reaffirms the FISA as the sole authority under which domestic wiretapping by the federal government can be undertaken. I couldn’t be happier. Here’s what the ACLU had to say,
“Congress has signaled that it will not allow the president to continue the National Security Agency’s illegal eavesdropping,” said Caroline Fredrickson, Director of the ACLU’s Washington Legislative Office. “Passage of the Schiff/Flake amendment is Congress drawing a line in the sand. This amendment reaffirms that FISA is the law and it needs to be followed.”
The Bill ends plans by the Bush Administration that would give the NSA the freedom to pry into the lives of ordinary Americans.
I Can Put This Thing Away Now Maybe…
In case you’ve forgotten, before the NSA wiretapping scandal broke searches of foreigners for national security purposes were governed by FISA which created the special/slightly secretive Foreign Intelligence Surveillance Court. Despite the fact the court hardly ever turns down or modifies federal law enforcements’ requests to perform electronic surveillance on or undertake a physical search of individuals and their property, the Bush administration felt it necessary to just cut them out of the loop after 9/11. Instead they let the NSA wiretap whoever the hell their computer models/data mining told them might be engaged in terrorism.
Because of FISC’s general historical agreement with the vast majority of executive requests to engage in wiretapping, this doesn’t seem like a huge burden on the NSA or the Bush administration. Just go back to the decade old status quo (at the least). And the Schiff Amendment, in direct contrast to the version of the 2008 Intelligence Authorization Act the Bush administration was backing, will hopefully do that.
I think the Los Angeles Times is focusing on the wrong thing with their summary of a new study on the efficacy of the HPV vaccine in the NEJM,
Although the vaccine, called Gardasil, blocked about 100% of infections by the two human papilloma virus strains it targets, it reduced the incidence of cancer precursors by only 17% overall.
[W]hen Koutsky and her colleagues considered lesions caused by all strains of the virus, the vaccine reduced the risk by only 17%.
Because researchers had previously believed that 50% of all serious precancerous lesions were caused by types 16 and 18, this rate of protection seemed inexplicably low.
Dr. George F. Sawaya and Dr. Karen Smith-McCune of UC San Francisco called the benefits of the highly touted vaccine “modest,” and said that young women and their parents should take “a cautious approach” to vaccination because of the many unanswered questions about its efficacy.
“The effect is fairly small,” Sawaya said in a telephone interview. “The recommendation for widespread vaccination of women after they become sexually active may need to be rethought.”
Sawaya suggested in the editorial he co-wrote that the small size of the protection could be because other strains of HPV are filling the gap when types 16 and 18 are eliminated.
After finishing the article you might think the Los Angeles’ Times denouncement of the Merck’s HPV vaccine as inefficacious had some bearing on the real debate going on in this country - mandating the HPV vaccine for school age girls.
It doesn’t. Indeed, in many ways the FUTURE II study further defines the necessity of immunizing girls at school age.
Look the vaccine does what it is supposed to do. Yes, there are limitations to it:
It only protects against two of the four major oncogenic Human Papilloma Viruses
Not all cervical cancers are associated with HPV infection
You must be immunized prior to HPV 16 or 18 infection (basically before the start of sexual activity)
Attorney General Alberto Gonzales says he accepts responsibility for mistakes made in the firing of eight federal prosecutors, but he won’t be resigning from his post, despite calls from politicians for him to do so.
The civil liberties board charged with reviewing the NSA’s wiretapping program has signed off,
A White House privacy board is giving its stamp of approval to two of the Bush administration’s controversial surveillance programs - electronic eavesdropping and financial tracking - and says they do not violate citizens’ civil liberties.
Democrats newly in charge of Congress quickly criticized the findings, which they said were questionable given some of the board members’ close ties with the Bush administration.
Bipartisan outrage erupted on Friday on Capitol Hill as Robert S. Mueller III, the F.B.I. director, conceded that the bureau had improperly used the USA Patriot Act to obtain information about people and businesses.
The report found many instances when national security letters, which allow the bureau to obtain records from telephone companies, Internet service providers, banks, credit companies and other businesses without a judge’s approval, were improperly, and sometimes illegally, used.
Moreover, record keeping was so slipshod, the report found, that the actual number of national security letters exercised was often understated when the bureau reported on them to Congress, as required.
My question is if this is an intentional concession by the administration.
I did my undergrad work in USC's School of Cinema-Television Cinematic Arts. I have a Bachelors of Fine Arts in Writing for Screen & Television. I loved it, but a future of waiting tables and taking meetings with B-List producers was not for me.
This blog is ostensibly to discuss healthcare policy and maybe educate a few of my fellow medical students. But it will stray into current events, politics, and other science topics when they draw my interest
Other odd notes about me:
I've skied half the resorts on this list (Squaw Valley/Lake Tahoe, Snowbird/Park City, Whistler, Taos, Vail)
I "played" lacrosse in high school and through a club level team in college
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