Tag Archives: Health Care

Five Bad Men Screw Us Again, Part 2

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(1) As further evidence that the all-male, all-Roman Catholic, all-Republican majority on the Supreme Court is willing to sacrifice legal principles to ideology, consider this statement from Justice Alito’s opinion: “A corporation is simply a form of organization used by human beings to achieve desired ends”.

Among those ends, however, is limiting the liability of the corporation’s owners, as discussed in this article from Mother Jones. The author explains how ascribing the owners’ religious beliefs to a corporation undermines the idea of a corporation:

[Quoting from an earlier Supreme Court decision:] “Linguistically speaking, the employee and the corporation are different ‘persons’, even where the employee is the corporation’s sole owner. After all, incorporation’s basic purpose is to create a distinct legal entity, with legal rights, obligations, powers, and privileges different from those of the natural individuals who created it, who own it, or whom it employs.” 

That separation is what legal and business scholars call the “corporate veil,” and it’s fundamental to the entire operation. Now, thanks to the Hobby Lobby case, it’s in question. By letting Hobby Lobby’s owners assert their personal religious rights over an entire corporation, the Supreme Court has poked a major hole in the veil. In other words, if a company is not truly separate from its owners, the owners could be made responsible for its debts and other burdens.

(2) The Hobby Lobby ruling was supposedly a limited one. But anytime the Supreme Court rules, lower courts invariably extend the Supreme Court’s “logic” to other cases. Believe it or not, the Supreme Court itself has already ordered lower courts to do just that, as Mother Jones reports:

Less than a day after the United States Supreme Court issued its divisive ruling on Burwell v. Hobby Lobby, it has already begun to toss aside the supposedly narrow interpretation of the decision. On Tuesday, the [Court] ordered lower courts to rehear any cases where companies had sought to deny coverage for any type of contraception, not just the specific types Hobby Lobby was opposed to.

In related news, religious leaders have written to the White House asking that proposed regulations regarding the hiring of lesbian, gay, bisexual and transgender people by federal contractors include a religious exemption.When this issue comes to the Supreme Court, we can expect the Republican majority to agree that discriminating against people based on their sexual orientation and even their gender is one more religious belief the government should not burden.

(3) In maybe he most bizarre development of all, the Court yesterday granted a request from Wheaton College to be temporarily exempted from filling out and distributing copies of a particular government form. The form in question allows a non-profit religious organization to declare its opposition to insurance coverage for contraceptives. From the Supreme Court’s ruling:

The applicant need not use the form prescribed by the Government, EBSA Form 700, and need not send copies to health insurance issuers or third-party administrators.

Instead, the Court said it would be sufficient to send a letter to the Department of Health and Human Services stating the organization’s opposition to contraception without identifying its health insurance issuer or third-party administrator. Apparently, the majority agreed that the prescribed use of Form 700 would constitute a serious burden on Wheaton College’s religious beliefs, while sending a letter to the government wouldn’t or didn’t.

The three women on the Supreme Court pointed out the absurdity of this latest ruling in a dissent called “unusually fierce” by the New York Times. Justice Sotomayor stated that this latest ruling “undermines confidence” in the Court. She also pointed out what should be obvious to everybody:

Thinking one’s religious beliefs are substantially burdened — no matter how sincere or genuine that belief may be — does not make it so.

(5) Remember to vote, even in mid-term elections like the one four months from now, and, most importantly, never vote for a Republican.

Five Bad Men Screw Us Again

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I didn’t want to write about the Supreme Court decision in Burwell vs. Hobby Lobby Stores. That’s the recent case in which the Republican majority ruled that a corporation can refuse to provide health insurance for certain kinds of contraception on religious grounds. However, one way to stop thinking about something is to write about it, and this is not a subject that’s fun to think about:

1) It’s no coincidence that the five Republicans on the Supreme Court are prone to rule against and ignore the rights of women to end or prevent pregnancies. Those five Republicans are all Roman Catholics.

2) Having previously declared that corporations should be allowed to spend on political campaigns because they have the same right to free speech that people do, the Republican majority has ruled again that corporations are no different from people. The law at issue in Burwell vs. Hobby states that the government should not “substantially burden a person’s religious beliefs”. Although corporations are treated as persons in some legal contexts, and it’s proper for the government to respect people’s religion up to a point, it makes no sense to ascribe religious beliefs to a corporation.

In addition, people’s right to practice their religion as they wish does not give them the right to harm other people. According to the majority opinion, however, a corporation can not only have religious beliefs, those beliefs should be honored even though acting on those beliefs negatively affects the corporation’s employees, their families and the rest of society (one of the majority’s suggestions is that taxpayers pay for contraception if corporations won’t – as if the Republicans in Congress would agree to that). 

3) Religion can be a wonderfully flexible way to justify all kinds of behavior. In this case, the corporations claimed that dropping all health insurance coverage for their employees, so that their employees could instead get insurance through the government-run exchanges, would also infringe on their (the corporations’) religious beliefs, even though allowing their employees to use the government exchanges would save the corporations money and benefit their employees. “It is our firmly-held, specific religious belief that you should get your health insurance through our company instead of a government website, but it shouldn’t cover certain kinds of care.” Right.

4) Allowing employers to dictate which health insurance their employees have, on religious or any other grounds, is yet another reason the United States should join the rest of the industrialized world and adopt taxpayer-supported, government-regulated, single-payer health insurance.

5) The idea that the owners of a business shouldn’t be forced to spend money for something they don’t like assumes that the money in question is theirs, just like the money in your checking account is yours. However, economists have found that the money a company spends on health insurance would otherwise generally be paid to employees as wages. After all, health insurance is a form of compensation and businesses tend to offer as little compensation as possible (except for senior management, of course). As Uwe Reinhardt writes:

Evidently the majority of Supreme Court justices … believe that the owners of “closely held” business firms buy health insurance for their employees out of the kindness of their hearts and with the owners’ money. On that belief, they accord these owners the right to impose some of their personal preferences – in this case their religious beliefs — on their employee’s health insurance…. [But research shows that] the premiums ostensibly paid by employers to buy health insurance coverage for their employees are actually part of the employee’s total pay package — the price of labor, in economic parlance – and that the cost of that fringe benefit is recovered from employees through commensurate reductions in take-home pay.

6) This is a case in which religion is being allowed to trump science. These corporations object to particular kinds of contraception on the grounds that they are equivalent to having an abortion. But medical researchers have shown that the methods in question (certain intrauterine devices and the “morning after” pill) don’t actually work that way, as discussed here:

The owners of Hobby Lobby told the Court that they were willing to cover some forms of contraception but believed that the so-called morning-after pills and two kinds of IUDs can cause what they believe to be a type of abortion, by preventing a fertilized egg from implanting in the uterine wall or causing an already implanted egg to fail to thrive… The scientific consensus is against this idea…Most scientists believe that [these methods] interfere with the ability of sperm to get to an egg in time to fertilize it before they die….Research does not support the idea that they prevent fertilized eggs to implant.

If a religious belief is based on faulty science, that belief should be given less respect by the rest of us. It’s safe to assume, for example, that even this Supreme Court would have ruled differently if the religious belief in question had been that certain kinds of contraception cause droughts.

7) There have been a lot of dumb arguments in favor of this decision or suggesting that it’s not a big deal. The truth is that this decision could set a very bad precedent, opening the door to other claims for special treatment, especially given the Republican majority on the Court. In addition, trying to find a job with another company isn’t a great option for many people; getting pregnant is a very big deal; IUD’s are among the most effective form of birth control; it can cost some women a month’s pay to get one; the morning after pill is an important option for women; and choosing to have sex shouldn’t disqualify people from getting appropriate medical care (people also choose to smoke, spend a lot of time on their couches and eat at McDonald’s). As the saying goes, if men could get pregnant, abortion would be a sacrament.

8) It’s been clear since their decision in Bush vs. Gore, when the Republican justices decided that we didn’t need an accurate vote count in a Presidential election, that lacking proper legal justification for their decisions won’t stop them from advancing their political agenda. All Supreme Court justices issue rulings consistent with their political perspectives, but these particular justices are extremists. They may have some shame, but it’s hardly worth mentioning.

Your Doctors Might Kill You But Going to the Dentist Will Be a Breeze

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Two pieces of medical news caught my eye this past week.

First, according to the New York Times, physicians at the highly-respected University of Pittsburgh Medical Center are going to start putting selected patients to death. Not through improper care, but on purpose.

The idea is that patients who come into the emergency room on the brink of death because of a life-threatening injury will occasionally have all of their blood replaced with freezing salt water. That means their hearts will stop beating and their brains will stop working. They’ll be dead.

This will be done in order to give surgeons more time to do their job. Instead of having a few minutes to address the gunshot wound or other injury, they may have up to an hour to operate before the patient suffers brain damage. The medical staff will then resuscitate the patient by replacing the cold salt water with nice warm blood.

This procedure has been successfully used on animals like pigs and dogs, but never before on a person. The hospital is planning to perform Emergency Preservation and Resuscitation (EPR) about once a month for a couple of years before reaching a decision on its effectiveness.

One might think that killing your patient is a clear violation of the medical maxim: “first, do no harm” (primum non nocere). But since the patients in question will already be in cardiac arrest, and very likely to die anyway, and since the kind of death they’ll suffer is expected to be temporary and should give them a much better chance of surviving their injury, it isn’t clear that the doctors will be harming anyone, at least in the usual sense.

Perhaps a more troubling issue is that patients being subjected to this kind of procedure won’t be in a position to give their consent. They’ll already be unconscious. So the medical center has publicized this new procedure in and around Pittsburgh and given prospective patients the opportunity to opt out if they choose. But the default setting in case you’re ever shot or stabbed in western Pennsylvania and end up in the UPMC emergency room will be to receive EPR (and possibly meet your maker), if you are a suitable candidate.

The other news that caught my eye is that researchers in England claim to have come up with a new treatment for tooth decay. The procedure is called Electrically Accelerated and Enhanced Remineralisation (EAER). Dentists will use a very small electrical current to accelerate “the natural movement of calcium and phosphate minerals into the damaged tooth”. In effect, your tooth will heal itself with some encouragement from your dentist. The procedure wouldn’t require an anesthetic, drilling or a filling (and dentists would become more popular people).

It isn’t clear from the article in the Guardian how long it will take to fix a cavity this way. In an ideal world, your cavities could be repaired through EAER at the same time your gunshot wound was repaired through EPR. But that probably won’t be possible for a few years yet.

There Is A Cure For Science Denial

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Once Florida is underwater and we all have polio, it will be better.

That’s what Samantha Bee concludes in the Daily Show video here. Left-wing stupidity isn’t one of my usual topics, but it appears to be the relevant phenomenon in this case. The title of the video is “An Outbreak of Liberal Idiocy”.

Bacteria Are Our Friends, Except When They’re Not

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It’s good to remind ourselves occasionally that we human beings are little worlds of a sort. Each of our bodies is composed of trillions of cells (about 40 trillion, based on a recent estimate), each going about their individual business, and many more microorganisms, mainly bacteria, each going about their business too.

I’m not sure why it’s good to remind ourselves of this fact, but it seems like something worth keeping in mind. It might, for example, help us not be so fearful of bacteria. They’re not necessarily bad for us. For one thing, they help us with digestion. More surprisingly, some scientists believe that, before people began frequent applications of soap and shampoo, one kind of bacteria (Nitrosomonas eutropha) flourished on people’s skin, acting as a “built-in cleanser, deodorant, anti-inflammatory and immune booster by feeding on the ammonia in our sweat and converting it into nitrite and nitric oxide”.

That’s the theory behind an article in the New York Times by a woman who went one month without using soap or shampoo. Aside from her greasy hair, she didn’t notice any ill effects. Nobody complained about her odor. In fact, after encouraging the growth of N. eutropha on her body for a month, her skin was in better shape than when she started the experiment. The scientists involved hope that bacteria might one day be used to treat various skin conditions, like eczema and acne, and even help certain wounds heal more quickly.

That’s the good news. The bad news (which is much worse than the other news is good), is that medical authorities are calling attention yet again to the spread of dangerous antibiotic-resistant bacteria. The Guardian reports that a group of senior British scientists expressed concern last week that we face “the prospect of people dying from routine infections because effective antibiotics no longer exist”. One scientist said:

In the near future it is possible that a scratch from a rose thorn could become septic. Without effective antibiotics, septicaemia could easily set in and result in death. It is a terrible prospect, but a very real one. We are facing a return to the state of affairs that existed before antibiotics were discovered.

Any kind of surgery and treatments that affect the immune system could all become life-threatening. As a stop-gap measure, the scientists recommend that hospitals go back to having old-fashioned rooms with widely-separated beds and windows that can be opened to allow in fresh air. 

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Unfortunately for us communities of cells and bacteria, the drug companies aren’t developing new antibiotics, because there is little profit to be made off drugs that people only take for a short period of time. Chalk another one up for capitalism and the free market. 

As dangerous bacteria continue to evolve, it becomes increasingly likely that epidemics will sweep the world before new antibiotics or other treatments will be available, unless there is increased government support for the needed research. The alternative is to wait for the problem to get so bad that it becomes profitable to fix it. 

Taking these developments into account, it’s safe to assume that one day many of us will be dead from bacterial diseases we don’t know how to fight. But our skin will be in the best shape ever.