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Bioethics Medicine Politics

When burning stupid just isn’t enough…

…leave it to the Investor’s Business Daily to kick it up a notch to thermonuclear as an anonymous editorialist tries to criticize President Obama’s health plan by invoking the dreaded British NHS:

People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.

I realize that many of you saw this quote over at Ed Brayton’s blog, but the searing stupidity of the above statement just stands out so much that I had to add my little snark too. Can you guess why? It couldn’t be because Stephen Hawking was born in Oxford because during World War II it was considered safer to have children there than where his parents home was, namely North London. Having lived in the U.K. all of his life, since 1979, Hawking has held the post of Lucasian Professor of Mathematics at Cambridge.

I mean, come on. If you’re going to argue that Obama’s out to kill the disabled with his health care plan and use as an example a national health care system that, to you, would have let a genius like Stephen Hawking die because of his disability, shouldn’t you choose one that didn’t actually–you know–keep Hawking alive? If you’re going to demonize President Obama’s plan as euthanasia for the disabled, perhaps you should choose an example that doesn’t backfire so spectacularly! Really, in his all-fired eagerness to demonize President Obama’s health care plan by specious comparisons to the British NHS, couldn’t this anonymous editorialist at least have gotten his facts correct? More importantly, given such a risibly stupid error, can the IBD give me one good reason why I should take any other part of that editorial seriously?

I don’t think so.

Anyone who researches that sloppily very likely also thinks just as sloppily, which is one reason why there is only one appropriate reaction to such idiocy:

i-4fd96abe96347f6ad94121f67ed84302-picardandrikerdoublefacnm1.jpg

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

56 replies on “When burning stupid just isn’t enough…”

I’m reminded of that line from South Park: “If dolphins are so smart, why do they live in igloos?”

Ironically (hypocritically?) enough, if Hawking had grown up in the United States, he likely would have had trouble getting insurance coverage throughout adulthood due to “pre-existing conditions”.

I don’t know about “grown up in the US” since his ALS developed later in life and he could have already been covered, but he certainly couldn’t get coverage now.

They probably thought he was American because of the computer voice he uses. Retarded inference.

the editors have put a note on the article:

Editor’s Note: This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK.

The British NHS would have said that Hawking’s life is worthless? Because he is handicapped? And then what would they have done? Put him to sleep?

There’s a name for this kind of speech. It’s called defamation. Could we dream to see the NHS sur the anonymous coward? Wish it did!!!

Pablo, you’re right and I wasn’t clear. I meant that if he grew up here and continued to live here, he could have trouble getting coverage unless he managed to stay forever on the plan he was on when he developed the disease, assuming he didn’t get kicked off for costing too much.

JohnV,
Generally I’m very much against photoshopping, but in this case I think it’s appropriate. There just aren’t enough faces and palms in the world for this kind of fail.

There just aren’t enough faces and palms in the world for this kind of fail.

IIRC there’s a lovely effect for the GIMP which will give you the multiple-facing-mirrors effect. This sounds like a job for it.

Really what’s needed is a thorough scanning of the entire star trek:the next generation series in an attempt to get as much of the crew facepalming around one table.

Editor’s Note: This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK.

Er, nope: it implied that if he lived in the UK he’d be dead.

*Public service announcment*
Blog readers should be aware that the face-palm and head desk responses are in fact not compatible, and under no circumstances should you attemp to to both at the same time.
That is all.

OK… can any resident Trekkies (yes, capitalised first letter) tell us what this particular reaction was in response to…?

Enquiring minds want to know.

Hawking responds!
“I wouldn’t be here today if it were not for the NHS…I have received a large amount of high-quality treatment without which I would not have survived.”

The overweight is harmful to health because it can affect our body, such as the heart, blood pressure increases due to diabetes, gout, arthritis, hypertension, etc, and findrxonline say that the best way to lose weight is to eat a healthy diet and exercise. When performing exercises burn more calories.
Seven basic principles exist to develop and to maintain a diet healthy:
– To ingest varied meals.
– To maintain corporal the weight suitable.
– To choose a poor diet in fats saturated fats and cholesterol.
– To choose an abundant (vanities, coliflor vegetable diet, radish, beet, nabo, carrot, celery, peas, zapallos, artichoke, beetroot, eggplant), fruits (apple, orange, ½ grapefruit, mandarin, peach tree, ½ chirimoya, granadilla, papaya, melon, pear, fragmentation hand grenade grapes and sandia) and grains.
– To use sugar only moderately.
– To use salt and sodium only moderately.
– If it drinks spirits, do it with moderation.

Another very important thing for a balanced diet is the one to ingest approximately 2 liters of water to the day; this will allow eliminating some toxins, that you maintain a perfect state of moisturizing in your skin and in addition to favor the loss of weight.

Mr. House, do you have some kind of reading disability? Oh, and the drinking lots of water bit is a fallacy, and you lost many points with the “eliminating some toxins” gambit.

Erm, Mr House? I think one of us is lost… I just checked and it’s not me. Oh and “To choose a poor diet in fats saturated fats and cholesterol.” sounds like a mistake, and “To use salt and sodium only moderately.” sodium? Not some thing I would willingly put in mt mouth, could get hurt that way.

I have a question for Americans as far as your bizzare existing healthcare scheme. Currently I’m watching the TV show “Breaking Bad” in which the protagonist is a cancer patient, but cannot afford the treatment. Because he doesn’t have the right “insurance” (a concept I still can’t get my head around), he is forced to pay for the very expensive treatment himself. The inference is that if he couldn’t afford it, the healthcare system doesn’t care and would just let him die.

Is this a generally accurate picture? Is it really true that if you cannot afford insurance, or your insurance isn’t comprehensive, etc, that you’re just simply left to die, untreated by the medical complex? If this is true it really is quite bizzare. I’m from New Zealand, and here if you get sick, you go to the hospital and get treated. There’s no mention of money, insurance, medical fees etc. Everyone who gets cancer gets treated. If I’m in a car accident, I get taken to the hospital and treated. If I suffer a stroke, I’m taken care of. Healthcare here is for everyone, not just those with fat pockets.

We do have a scheme called the Accident Compensation Corporation (ACC) under which a small amount is deducted from wages at source (everyone who works pays, and the rate depends on your work industry). The scheme means anyone who has an accidentwhich prevents them from working will continue to receive 80% of their wage until they’re fit to work. ACC also pays for related treatment and rehabilitation.

By no means is our healthcare scheme perfect, and there’s a lot of areas it needs to improve on. For people who don’t have confidence in government healthcare, we have a private healthcare industry, but it’s rarely used.

Chris:

Currently I’m watching the TV show “Breaking Bad” in which the protagonist is a cancer patient, but cannot afford the treatment. Because he doesn’t have the right “insurance” (a concept I still can’t get my head around), he is forced to pay for the very expensive treatment himself.

Pretty close. There are programs (government programs) to pay for some treatment.

There is also this thing called the pre-existing condition where the insurance company can refuse to take you on as a client if you have a disease. I heard a great rant this morning from a progressive talk show host who went on about this (about the first ten minutes of this radio show podcast).

Chris:

As a physician working under our healthcare system here in the USA for 40 years, I can tell you that most people who require care for urgent or potentially life=threatening illnesses can and do get the necessary treatment. The big problem here is that until now, those insurers who provide the finances for most of this care must put the well-being of their investors ahead of their subscribers. If the two are in conflict, of necessity, the patient gets the short end of the stick. Although situations such as you describe in the TV show certainly can arise, there are extensive tax supported resources to which patients can apply for most such cases. If we had a basic, widely available tax supported (certainly not free) system, on top of which those who so chose could seek additional benefits and coverage from commercial sources, there would be very few individuals in this country lacking necessary health services.

“If we had a basic, widely available tax supported (certainly not free) system, on top of which those who so chose could seek additional benefits and coverage from commercial sources, there would be very few individuals in this country lacking necessary health services.”

Why not free though? For some perspective, here in NZ if I have the sniffles and want to see a doctor, I can see my GP for a fee of somewhere around $50, and he’ll prescribe me some antibiotics or similar, which are heavily subsidised so will cost me a couple of dollars. I fully agree that these types of primary care services need not be free, as long as they’re widely affordable.

But it’s beyond my paradigm to imagine coming down with a chronic illness requiring ongoing treatment and having to pay for it. It’s not as if I’m against user-pays generally, because I’m not. But healthcare is a necessity of life. If someone cannot afford ongoing treatment, that treatment shouldn’t be withheld under any circumstances. So why not just have universal healthcare like every other country? Get out of the paradigm of the insurance companies, who are just there to clip your ticket. Health insurance is another layer which is totally unnecessary in healthcare in my view.

Chris, what generally happens is that you pay for the treatments until you are effectively destitute, then you apply for Medicaid and your healthcare is covered. In elderly couples like my parents, when one is no longer able to live at home, the spouse who is able to live on their own gets to keep ~$100000 plus their home, car and social security check. Everything else goes to pay for nursing care (~$6500/month in my father’s case).

There are financial ways around that maximum number if you plan far enough ahead and set up a legal trust, but I believe the trust would have to be set up 4 years before the application for Medicaid for it to be untouchable. And that $100k is it for my mother, a very healthy 76-year-old who gets all of $450/month from social security.

And my father can have a maximum of $2000 in his name to remain eligible for Medicaid. If be goes over, he is immediately dropped and would have to reapply.

(The specifics of this vary from state to state. They are relatively similar, though. And Medicaid is tax-funded medical insurance for the indigent.)

@18 – Episode “Matter of Perspective”, a knockoff of Rashomon. Riker gets some kind of gross with some space hoochie, and/or manhandles her, and this is reactions to them watching “re-enactments” of the testimony, which in this case make Riker looks like a total crushing rapist.

Fun episode.

I’m not really worried about examples of famous physicists making it…..they’re genuises, they’ll figure out how to get coverage. You know who’s not a genius? My grandma.

Screw everybody. Fix it. The freakin’ poindexters in charge better fix it. This much freakin’ cash flow (which is what it all is…it’s not the “care” being redesigned) reshuffled in some way (via insurance, medicaid, government plans, whatever) should be able to be made into a workable plan. I’m sick of bullshit delaying it. What’s sad is it’s also the people who it’s meant to help protesting. They’re just gullible and passionate.

Ahh, the flaws in the ol’ 1st amendment.

It’s hard to understand how someone going ill deserves to first become destitute, and then stays destitute for as long as the treatment takes. Which in some cases can be as much as 50 years (or even more). It’s not quite reasonable. Unless you want to blame people for being run over, or having a congenital disease.

btw, it’s not a flaw of free speech that people say dumb shit. That’s clearly people’s fault. The big problem isn’t the free speech as such, it’s that these idiots think it means they’re doing a good thing by yelling at people they disagree with, without ever listening.

Free speech is nothing if nobody listens.

– If it drinks spirits, do it with moderation.

The vodka is good but the meat is rotten.

I have a question for Americans as far as your bizzare existing healthcare scheme. Currently I’m watching the TV show “Breaking Bad” in which the protagonist is a cancer patient, but cannot afford the treatment. Because he doesn’t have the right “insurance” (a concept I still can’t get my head around), he is forced to pay for the very expensive treatment himself. The inference is that if he couldn’t afford it, the healthcare system doesn’t care and would just let him die.

Is this a generally accurate picture? Is it really true that if you cannot afford insurance, or your insurance isn’t comprehensive, etc, that you’re just simply left to die, untreated by the medical complex?

It’s not exactly true, but there is some truth to it. Let me relate to you what happens in my state in my field, namely breast cancer. If an uninsured woman is diagnosed with breast cancer, she becomes eligible for Medicaid. However, if she has an abnormal mammogram or a lump and has not yet been diagnosed yet, she has to pay out of pocket for a biopsy to diagnose her cancer. There is a charity fund that will pay for such biopsies, but it is taxed to the breaking point.

Several months ago, I saw a woman with an abnormal mammogram who required a biopsy but who also had some medical problems that needed to be tuned up before she could have surgery. The fund would only pay for the biopsy. It would not pay for the pre-op medical evaluation. Ultimately we got her into the free clinic, but it was a struggle and she had to wait. She also needed other imaging studies to work up other abnormalities unrelated to her breast. Those too were not covered. We ended up doing an expeditious biopsy of her mass and it was cancer. She was then eligible for Medicaid and could get all her other medical problems taken care of.

It makes little sense.

I’ve had several patients with abnormal mammograms who need biopsies who don’t take their needed antihypertensives because they don’t have insurance and can’t afford them. Trying to get them their drugs so that we could get their blood pressure under control so that they could have their biopsies turned out to be a major hassle.

Again, it makes little sense.

To be fair to the Investors Business Daily and the individual who wrote that piece, It is easy to understand the source of the confusion. Obviously, he is assuming that Professor Hawking is an American. This is probably due to the fact that he lacks the classic British accent. Personally, I think he sounds like he comes from Texas (Instruments).

The British are praised for spending half as much per capita on medical care. How they do it is another matter.

The real mystery is how US health care manages to cost more than twice the OECD average, and still perform among the worst.

http://www.oecd.org/dataoecd/46/33/38979719.pdf

Only Norway and Luxembourg spend more tax dollars/capita on health. So much for the “socialized health care” scare.

To add to Orac’s and Harvey’s excellent posts I am sometimes amazed at the amount of time lost trying to be an advocate for some of my patients, between phone calls letters mostly regarding therapies that may be considered standard therapy by most practitioners but don’t fall into the insurers protocols or worse protocols that are enforced by a single physician at the top who can’t possibly appreciate all the variables and nuances in each specialty.The cynical part of me sometimes thinks that insurance companies bank on the individual physician simply not having the time to pitch a fit over every denial of care,and this may figure into some of the more calculated denials.

In the UK, you just get referred to a specialist within weeks (there are targets), without any payments, appeals to charities, etc. No need to make crystal meth!

Orac – Looking at these figures for NHS in England http://www.performance.doh.gov.uk/cancerwaits/2008/q3/index.html , how do they compare with the US in terms of time-scale, and effectiveness of treatment? I used to work for a cancer hospital, and my impression was that the US led in certain areas, but that Europe was pretty good overall with more access, with the NHS generally coming third (due to our relatively low spend), although improving. Your insight would be appreciated.

Heraclides @#18:

OK… can any resident Trekkies (yes, capitalised first letter) tell us what this particular reaction was in response to…?

Enquiring minds want to know.

It’s actually two facepalm pictures Photoshopped together – this one and this one. As to which exact episodes the respective screenshots are from…pass.

You know that things have got pretty bad when the British Diplomats are finding themselves drawn into the debate to counter the lies and distortions about the NHS that the anti-healthcare reform nuts are spreading.

http://www.guardian.co.uk/world/2009/aug/11/nhs-united-states-republican-health

It would be great if the diplomats did more to challenge the myths that are being spread (many provided by the UK’s own notorious right-wing press) but I’m not terribly optimistic that they will do so.

“there would be very few individuals in this country [USA] lacking necessary health services.”

Very few? There shouldn’t be a single one, in a civilised country.

I once trained at a call / claims processing center for a health insurance company, and the policy was in fact to automatically deny care for many, many procedures. They said that most of these procedures were in fact covered, but that the patient had to call and contest it. Since many people were too sick / confused by the system to do so within their window when you could appeal, they got out of paying many legitimate claims, thereby improving their profitability.

Bunch of bastards, if you ask me.

Another anecdote, but about conflicts of interest. I was a radiology conference the other day (I’m a third year MD student), and the radiologist lecturing took potshot after potshot at “Obamacare” and talked about how Obama would get rid of specialists. Before the lecture he was joking with the chair about how the insurance companies fly him and his family to vacation spots to give lectures. What a shithead.

Why not free though? For some perspective, here in NZ if I have the sniffles and want to see a doctor, I can see my GP for a fee of somewhere around $50, and he’ll prescribe me some antibiotics or similar, which are heavily subsidised so will cost me a couple of dollars. I fully agree that these types of primary care services need not be free, as long as they’re widely affordable.

One important point is that even if there were no charge at the point of provision, they still would not be free. Somebody’s paying for them, via taxes if nothing else. “Free” healthcare is really just a nicer way to say “healthcare where the cost is hidden”.

Chris:

We do have a scheme called the Accident Compensation Corporation (ACC) under which a small amount is deducted from wages at source (everyone who works pays, and the rate depends on your work industry). The scheme means anyone who has an accidentwhich prevents them from working will continue to receive 80% of their wage until they’re fit to work. ACC also pays for related treatment and rehabilitation.

The equivalent here is Accidental Death & Disability Insurance. (I was rather disappointed when I first learned what AD&D stood for. For a blissful moment, I was wondering if my employer was going to fund role-playing games!) Also short-term disability insurance, which is something your employer may take out to keep paying you while you recover from an injury or illness. (My maternity pay came out of a short-term disability fund, for instance.) AD&D is sort of like life insurance, except you don’t have to be dead to collect.

But it’s not guaranteed. It’s just like health insurance in the US. You can take out a private AD&D insurance policy yourself, or you may get one as part of your employee compensation package (your benefits beyond your base pay). In the latter case, your employer may cover the cost of the policy completely, or may cover part of it, or may allow you to upgrade the coverage for an additional charge (taken automatically out of your paycheck), or may only provide you with a group rate on AD&D that you pay for yourself. Most large corporations offer AD&D coverage for the employee and maybe the employee’s spouse as part of their base benefits package, but require you to chip in for your children. Smaller employers may not be able to offer that, although AD&D (like life insurance) generally has lower premiums than regular health care, owing to the fact that it’s not going to have to pay out as often.

If you’re too broke to afford AD&D, the only government-funded alternative is Social Security. Normally, you only collect Social Security after retirement, but you can also start collecting at a younger age if you become disabled. It’s not going to be anywhere near 80% of your base pay, though.

Really, I think once you’ve imbibed the fragmentation hand grenade grape, you can stop worrying about the health insurance. Probably explains the disappearance of Mr. House.

“There’s a name for this kind of speech. It’s called defamation. Could we dream to see the NHS sur the anonymous coward? Wish it did!!!”

UK libel law may be very plaintiff friendly indeed, as we’ve seen with the Simon Singh case, but the NHS wouldn’t be able to sue even if it wanted to. Government bodies can’t be defamed under English law, although individuals working for them can.

Somebody’s paying for them, via taxes if nothing else. “Free” healthcare is really just a nicer way to say “healthcare where the cost is hidden”.

It’s not ‘hidden’ at all, just more fairly distributed.

But if the intended point is that it’s more fairly distributed, then it doesn’t get called “free.”

Kind of like “free gift with every purchase.” No, you mean “extra thing I have to buy along with whether I want it or not.”

Scott, is that you? Will I have to call in the NotScottBot?

(To explain: The Scott I’m familiar with is a libertarian troll on another blog.)

I’m all in favor of healthcare for all regardless of willingness to pay, but I do have to admit, it annoys me when I hear blanket statements like (paraphrasing) ‘healthcare is a basic right and no one should ever be turned away.’ Noble sentiment, to be sure, but where do we draw the line? For example, some of the recent biologicals for certain cancers may costs hundreds of thousands for a course of treatment and only provide a few additional months of life–how much of our limited healthcare spend should that take up? What about patients who could alleviate their symptoms with lifestyle modification but instead rely on branded drug treatments–do we give them the same consideration as another person who doesn’t have the option of self-management?

If we can improve the system we have and do more with the resources available, then we must. And in a perfect world, sure, healthcare for everyone, and as much as they want. Until we get there, however, there’s no denying that lines will be drawn.

Pretty sure that would be a different Scott. If you could specify the blog, though, I could certainly confirm whether or not I post there.

And just to make my opinions on this subject clear – I’d actually be in favor of scrapping our current insurance-based scheme entirely and replacing it with a straight-up single-payer system. In principle, anyway, though I admit it’s impractical. My point here has simply been that “free” is pretty much always a gross misnomer in this context.

Scott: Apologies – you sound too intelligent and reasonable to be The Other Scott.

IBD corrected the obvious and embarrassing stupid:

“Editor’s Note: This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK.”

They didn’t correct it. They omitted the entire section where they state that Dr. Hawking “wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless”.

Dr. Hawking responded to this by stating: “I wouldn’t be here today if it were not for the NHS,” he told us [The Guardian]. “I have received a large amount of high-quality treatment without which I would not have survived.”

In the US, imagine what would have happened to him if Dr. Hawking were not wealthy or a Senator. Dr. Hawking is the very refutation to the entire IBD article.

Oh, and they left in the misleading stupid:

“Can’t happen here, you say? ‘One troubling provision of the House bill,’ writes Betsy McCaughey in the New York Post, “compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, Pages 425-430).'”

Right.

I’m sure they quote-mined Ezekiel Emanuel as well.

We are out-spent and out-gunned. Our “representatives” in Congress and the Senate don’t represent us and the media feed us crap. If only we knew that we outnumber them…sigh.

@Scott:

Here in the UK we call it “free at the point of delivery”. Help?

Scott – of course I didn’t mean to imply that healthcare literally has no cost in NZ, that’s ridiculous. I’m an accountant, so you don’t need to worry whether I have the fortitude to understand these concepts, but thanks for your condescending nonsense. I’m fairly sure even a five year old could have figured it out, but thanks.

On the other hand, the NZ system has some odd ommissions. For example, my brother got a severe brain injury while cycling. Yep, the hospital medical care was fine, and he was then transferred to a rehab centre for young people (< 65) with brain injuries and ACC covered that. But there was another guy there at the rehab centre whose brain injury had been caused by illness and his rehab wasn't covered by the state so the staff were trying to find cover for him. Nursing home care isn't paid for by the NZ state until the married couple have run down their assets sufficiently. Plus my father-in-law is on a whole complex of drugs, about which half are apparently addressing the side-effects of the other half. It seems that every time him and the doctor find a stable combination the medical system changes which drugs it funds for one of the particular conditions that he has so him and the doctor have to go through all the rounds of trying to balance off the side-effects again. (He won't take our money). And there's the issue that there's plenty more health funding for hip operations for elderly patients than for checking for and treating glue ear in South Auckland children, because the elderly have far more time to be engaged in public affairs than poor parents of young kids. Never mind that glue ear can be cheaply fixed and really affects children's performance at school.

There would be very few individuals in this country (USA) lacking necessary health services.”

Very few? There shouldn’t be a single one, in a civilised country.

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