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April 07, 2006

Link of the Day: Aisle-Reaching Edition

I don't agree with Tigerhawk on everything, but his post on our society's tendency to value the intense suffering of the very few over the large benefits of the great many is really a must-read. He takes some gratuitous shots at progressives, but the essential tension he identifies is not progressive nor Democratic in origin -- it's societal, affecting the right and the left in equal measure. The media, and Fox News may in fact be the worst offender here, lavishing obsessive, hysterical coverage to the deaths of a couple people from any drug. See the ridiculous hype over the statistically insignificant deaths from RU-486, which remains far safer than childbirth or surgical abortion, and is not coming from the left.

As for his concerns that progressives will have trouble making these decisions under a single payer system, they belie the fact that most progressives want to move to such a structure because we believe choices about withholding care should be made by medical experts, not wallet biopsies. Nevertheless, his post, when freed from its partisanship, is thorough and thought-provoking, and folks should read it.

April 7, 2006 | Permalink


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Hey, thanks. That's me, 'Tiger "Gratuitous Shots" Hawk.' I am, after all, from New Jersey.

Posted by: TigerHawk | Apr 7, 2006 12:19:51 PM

Ezra, I appreciate the point you're trying to make here, but if you think that government-run (or government-financed) health care systems won't be subject to political maneuvering and special-interest lobbying, you're kidding yourself. Every time a state tacks on an additional insurance benefit mandate, or Medicare decides to cover a new treatment or device, you can be sure that some group has lobbied the state capitol or CMS to "prove" that said law/mandate/coverage extension is absolutely necessary for the majority of the population.

You also mention wanting issues of "withholding care" to be left to medical experts, not wallet biopsies. Fair enough. But in a single-payer system, medical experts and hospitals make decisions about how much care they can reasonably provide in a year based on their global budgets, which are, in turn, allocated by bureaucrats, who are, in turn, appointed by politicians, who try, in turn, to please the people who voted for them.

Feel free to argue that single-payer is a more humane way to provide health care equitably, but don't pretend that just because we're talking about the magical world of health care, politics won't play a huge role in deciding who gets what.

Posted by: Adrienne | Apr 7, 2006 12:26:22 PM

Of course they will be. But I still think that process, even partially infected by politics, will be more equitable, humane, and rational than the current, income-based dystopia. I'll take partially bad over totally awful any day of the week.

Posted by: Ezra | Apr 7, 2006 12:34:41 PM

Well-written it may be but the core of the argument is yet one more libertarian rant about the FDA. After Vioxx, Rezulin, Propulsid and the rest, is there anyone outside the WSJ editorial page that swallows the line that the agency should adopt a less cautious approval process?

And the FDA should weigh the intense suffering of a few against a mild benefit to many. Disability is bad but its better than a rapid death. The agency has to weight the extent of the suffering, not just the number of affected. There's the analogy to football, where you're not supposed to try and catch punts inside your own ten yard line, even though more often than not you'll pick up a few yards because when you're wrong it's a catastrophe.

Posted by: quietstorm | Apr 7, 2006 1:14:29 PM

I think you're naive, but then, I'm sure the feeling is mutual :)

Posted by: Adrienne | Apr 7, 2006 1:18:07 PM

Word ;-)

Posted by: Ezra | Apr 7, 2006 1:32:12 PM

My impression is that there's some data at this point to suggest that early surgical abortion may be safer than RU-486. Of course, contraception, including Plan B, is much safer than either, and, as you say, RU-486 is still safer than childbirth. The hysteria here has a clear political agenda; I think a better example for the point you're trying to make would be all the overhyped pretty-white-girl-disappearances stories.

Posted by: Rebecca Allen,PhD,ARNP | Apr 7, 2006 1:52:01 PM

"Wallet biopsies"? Ha! You're a genius!

Posted by: Farinata X | Apr 7, 2006 2:12:37 PM

Its the trial lawyers who work to keep great drugs which occasionally have sideeffects from being brought to the market.

Posted by: dan | Apr 7, 2006 4:38:13 PM

I don't know if it's where Ezra got it, but "wallet biopsy" was used on the most recent Sopranos.

Posted by: washerdreyer | Apr 7, 2006 11:00:33 PM

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