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Free Minds & Free Markets

Stupid Laws Cause Dangerous Hospital Shortages

Despite popular misconception, this is not a pro-choice vs. pro-life situation.

This week, the American Civil Liberties Union (ACLU) filed a federal lawsuit alleging mistreatment of a woman in the days leading up to her miscarriage at a Catholic hospital in Muskegon, Michigan. The ACLU accuses Mercy Health Partners of negligence for, among other things, failing to direct Tamesha Means to a hospital that could have safely terminated her nonviable pregnancy after her water broke at only 18 weeks gestation.

The details of the hospital staff’s conduct can be found in the complaint. According to the ACLU, Means miscarried as Mercy Health staff members were preparing to discharge her—for the third time in two days.

It might be tempting to view the lawsuit as another attempt by pro-choice activists to force pro-lifers to subsidize or participate in conduct inimical to their moral convictions. But the facts of the case may well point to negligence. I make no claim either way.  

Instead, I wish to point out that Tamesha Means could not have easily gone to another hospital, perhaps one offering the full range of women’s health services, because there is no such hospital. Mercy Health is the only hospital in Muskegon County (population 170,000) and the only one within 30 minutes of Means’ home.

Michigan is one of 28 states that artificially caps the number of hospital beds available in a given region. To open or expand a hospital, health providers must first obtain a “certificate of need” (CON) by convincing state health planners that there is a need for more beds. (Another eight states have CON laws, but have rescinded their rules on hospital beds.)

CON proponents argue that providers will fill every bed they build room for, so restrictions on hospital bed inventories are necessary to hold down costs. Planners also want to ensure the number of beds is sufficient to meet a community’s needs. Michigan thus employs a complicated formula purported to arrive at the precise number of beds necessary to supply, but not oversupply, the market.

Using the formula, Michigan’s Department of Community Health has determined that the Muskegon region has too many beds—exactly 203 too many, in fact. Thus, any potential competitor wishing to enter the market would certainly be denied permission.  

Of course, eliminating waste is all to the good. But labeling all health care delivered after a certain point excessive is ham-handed. One wonders what planners think is happening in the 203 extraneous beds—each day all year. Is each patient who makes use of those beds receiving extraneous care? Of course not—some varying portion of the cost of care for every patient who walks through the door is inflated or otherwise inefficient.

Using certificate-of-need laws to combat costs is an attempt to treat the symptom while ignoring the disease. Moreover, it’s a futile attempt. According to the Federal Trade Commission and multiple academics, the preponderance of the evidence suggests CON laws do not actually restrain health costs.

Despite this evidence, CON laws have their defenders. State hospital lobbies, like the Michigan Health & Hospital Association, naturally welcome rules that protect their profits and clobber potential rivals. Other CON proponents are well-intentioned good-government types who do not trust competition to bring about good outcomes for patients.

But perhaps Tamesha Means would have been better served if the state allowed a competing hospital or two to serve Muskegon.

According to the ACLU, many Catholic hospitals will not terminate a pregnancy until the fetus’ heartbeat stops of its own accord—even when the mother’s life is at risk. Maybe that’s wrong. But using the courts to force Catholic providers to violate deeply held beliefs seems a fruitless strategy. Catholic hospitals are unlikely to implement the ACLU’s policy wish list no matter who wins the case.

A truly pro-choice plan of action would focus on repealing laws that circumscribe patients’ ability to choose from a variety of health providers.

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  • Sevo||

    So Gosplan won't allow it? MARKET failure!

  • Austrian Anarchy||

    Behind every "market failure" passion play, there is a bureaucracy setting the stage.

  • Hopfiend||

    This is beautifully expressed.

  • Tulpa (LAOL-VA)||

    I appreciate your attempt to walk the abortion tightrope while decrying this stupid restriction on beds, but you're tipping your hand using the circumlocution "full range of women's health services" to refer to abortion.

  • Dweebston||

    Ross, an editor for a publication with the tagline free minds, free markets, favors an approach that allows the Catholics their freedom of conscience while encouraging competitors to fill the inevitable niches?

    Who knew.

  • Tulpa (LAOL-VA)||

    Which wasn't what I was talking about.

  • Death Rock and Skull||

    How does shit taste?

  • Dweebston||

    I was being snarky, but not altogether toward you (though you do tend to sound gotcha-y). Whatever Eduard de Gex Van Halen says, the argument you summarize should be the thrust of libertarians on this issue. Fight for freedom of conscience, which is on the ropes, rather than prohibition, which is dead and buried.

  • Swiss Servator, referendiffic!||

    "Eduard de Gex"

    +1 System of the World

  • Francisco d Anconia||

    Let's keep healthcare costs down by preventing competition.

    Um...

    DERP!

  • Dweebston||

    You need to remember that healthcare provision is not a competitive market, because you can't go without an appendectomy the way you might your morning Starbucks. It's too important to be left in the hands of private providers.

    Or so the mythology goes. The fact that private providers provide healthcare whoever's paying, that the payments are extracted from the private sector, that coordination tends to be horribly bureaucratized (as CON laws demonstrate), ineffective (Oregon medicaid study), and generate the two-tier problem public option supporters want to eschew (the wealthy can always afford to fly elsewhere) all seems to suggest that healthcare is too important an industry to leave to public provision.

  • Killaz||

    Damn right. Markets are built on the laws of scarcity not on shiny baubles like leftist picture them.

  • James Taggart||

    Paul Krugman couldn't have said that better.

  • Death Rock and Skull||

    This is what progressivism looks like.

  • C. S. P. Schofield||

    But hardly exclusively Progressivism. In every era, the State (whatever form it has taken) has been absolutely CONVINCED that it can plan for every contingency, and oder the lives of the Little People far better than they could do for themselves. And in every era, the State has been wrong.

  • Death Rock and Skull||

    Progressivism is just the contemporary form of collectivism, so that's why I used it. All forms of statism have collectivist shit at their root.

  • VG Zaytsev||

    In every era, the State (whatever form it has taken) has been absolutely CONVINCED that it can plan for every contingency, and oder the lives of the Little People far better than they could do for themselves.

    This isn't actually true.

    Throughout most of history the state has only cared about the people under it's control to the extent that they provide taxes to support their masters and that they do not try to overthrow those masters.

    It's only in theocracies that the state dominates all aspects of life in an effort to impose god's will and remake society.

    And yes, progressivism is a religion and government dominated by them are theocracies.

  • Eduard van Haalen||

    Archbishop Kurtz of the Catholic Bishops' Conference responds to the ACLU's suit. Short version - the bishops reiterate Church teaching that both the pregnant woman and the chils are patients, and directly killing a patient is unacceptable for a doctor (or anyone). Sometimes lifesaving care for one patient endangers the other, as for instance some lifesaving operations on the mother kill the child.

    So the ACLUs real agenda is to force hospitals to treat unborn children as disposable unpersons, even at the cost of religious freedom, and even though the Church has saved more mothers than the ACLU ever did or will do.

    http://www.usccb.org/news/2013/13-232.cfm

  • Irish||

    So the ACLUs real agenda is to force hospitals to treat unborn children as disposable unpersons, even at the cost of religious freedom, and even though the Church has saved more mothers than the ACLU ever did or will do.

    Well, capitalism has saved more mothers than the Church or the ACLU and that didn't stop the Pope from running his mouth about that.

    Otherwise I agree with your post.

  • Eduard van Haalen||

    One thing capitalism does is enrich the Carnegies of the world who then give vast sums to charitable causes, but the charities themselves are not capitalistic. Some of these charities are run by Catholics (not Carnegie' charities). So you posit a false dichotomy since much of capitalism's wealth helps people through the instrumentality of the Church.

  • Francisco d Anconia||

    You don't help people by giving them charity (in fact, it often has the opposite effect). You help people by giving them a job.

  • Eduard van Haalen||

    Charity isn't just paying people to sit home and watch TV. It includes disaxter relief, like in the phillipines, helping refugees and migrants get on their feet and start businesses, giving a guy a suit of clothes for a job interview and/or the education to do the job.

    Think of the Good Samaritan. What if he' been like the Levite and said, "that guy is to blame if he fell among thieves, he should just walk it off.".

  • Francisco d Anconia||

    You clearly implied capitalism required charity to help people. That is complete bullshit. Capitalism, in and of itself, has improved the quality of life of more people in the last century than the church has in 1500 years.

  • Eduard van Haalen||

    It wasn't capitalism as such which established hospitals, taught future capitalists in Catholic schools, cared for refugees, and the like. But capitalists contributed to these, often Catholic, projects. Why then are you pitting capitalism and the Church against each other?

    As to restraints on free enterprise, sure plenty of church people have advocated excessive regulation, but guess what? Businessmen have been very active in supporting such restrictions too, and I suspect their statist record is worse than that of the clerics.

  • Francisco d Anconia||

    Why then are you pitting capitalism and the Church against each other?

    Because your "leader" called capitalism the "new tyranny", essentially declaring war on the capitalist.

    Fuck him AND his ridiculous hat. As I said before Eddy, I don't give a flying fuck what the church has done in the past. What is it doing now?

    Question Eddy:

    Is the Pope wrong for calling capitalism the new tyranny?

  • Eduard van Haalen||

    Can you find the sord capitalism in the document? I couldn't find it.

    I found much to disagree with, see below. I also found a remark that business can be a "noble vocation" (and yes, I am aware of the statist reservations in that paragraph). I read a denunciation of government debt, putting Francis in advance of both U.S. political parties. I read praise of improvements in medicine and technology (with warnings about abuses).

    Yes, it's a mixed bag. No, I wouldn't have written that stuff if I were Pope. I've wished for a while that we could get a US pope with entrepreneurial experience. But you go into spiritual warfare with the Pope you have, not the Pope you wish you had.

    If I found the Pope constantly confirming and affirming my own views, I'd worry that I had simply picked a church to fit my pre-existing beliefs.

  • Francisco d Anconia||

    How can you disagree with the pope? The pope is infallible. If the pope declared capitalism the "new tyranny" you must agree with him because your religion insists the pope cannot be wrong. Saying the pope is fallible is a one way ticket to hell. Are you willing damn your immortal soul to follow what you know to be right? Or will you roll over on capitalism to ensure your eternal life in paradise?

    Which is it Eddy? Reason or Jeebus?

    Or will you just do the Catlick thing and confess your sins just before you kick off, say a couple Hail Mary's and never actually need to confront the contradiction?

  • Eduard van Haalen||

    "the Pope is infallible"

    Let us not forget the rest..."when speaking ex cathedra on matters of faith and morals."

    To my knowledge, an apostolic exhortation (as thiswas) has never been called infallible.

    And if everything he says is infallible, then he was infallible when he phoned one of his critics, Mario Palmaro, and said it wss important for him to receive that sort of criticism. I don't know the issue on ehich palmaro disagreed, but I believe it was a big one. Palmaro was very ill, and his criticism imperiled his soul, thePope would have warned him!

  • Eduard van Haalen||

    If his criticism

  • Eduard van Haalen||

    If you're concerned that my remarks may be heretical, just mail a copy of my posts to this address:

    Congregation For the Doctrine of the Faith
    Piazza de S. Uffizio, 11, 00193
    Roma, Italy

    If they want to talk to me, let me know, and I'll get in touch with them. If they say there are errors in my posts, I'll correct them.

  • Francisco d Anconia||

    I'm not concerned about your immortal soul in the least bit.

    My philosophy doesn't require me to turn myself inside out to justify it.

  • Eduard van Haalen||

    If you'd like to hear Tom Woods discuss the economic and doctrinal issues of the pope's rematks, check out cavalier973's link on the football thread.

  • Gozer the Gozerian||

    You left yourself wide open there...

  • Eduard van Haalen||

    What?

  • Gozer the Gozerian||

    I was replying to Francisco.

  • Francisco d Anconia||

    What?

  • Irish||

    I do not post a false dichotomy. Capitalism without the Church would raise billions out of poverty.

    What would the Church without capitalism do? We have a 1500 year case study if you'd like to look at the evidence.

  • Francisco d Anconia||

    We have a 1500 year case study

    Amen brother!

  • Eduard van Haalen||

    Really? Rodney stark would disagree.

    Even some monasteries were capitalistic, developing improvements in agriculture. And you may even heard of a monastery that makes and sells caskets for when you're let down gor the last time.

    The laity picked up capitalism in the Middle Ages, when Europe wasvstill Catholic.

  • Francisco d Anconia||

    Perhaps you missed it? The other day your Pope called capitalism the "new tyranny".

    Tell us how you feel about your new leader Eddy?

  • Eduard van Haalen||

    I said I easn't endorsing his remarks, but all te accusations of socialism, marxism and fascism were unsubstantiated. I don't think he's rejecting his predecessors who renounced all three, but if he endorsed any of ghe condemned ideas he wasn't doing it ex cathedra.

    I don't recall if he used the word capitalism, but theres a case to be made that he conflated the rich in his home country who, IIRC, get wealth by non libertarian means and live next to squalid hovels - if that - next to which the homes of american poor people look like palaces, with American wealth-creators like gates who not only improve peoples lives but give much of their earnings to charity (and gates with his support of public schools is arguably more statist than the pope).

    At least the pope is attentive to criticism and phoned up one of his conservative critics to wish him well in his illness and say how important it was to have people disagreeing with him.

    And I suspect that unlike many commentators here, the pope supports protecting vulnerable poor children with mandatory vaccination.

  • Francisco d Anconia||

    VATICAN CITY (Reuters) - Pope Francis called for renewal of the Roman Catholic Church and attacked unfettered capitalism as "a new tyranny", urging global leaders to fight poverty and growing inequality in the first major work he has authored alone as pontiff.
    The 84-page document, known as an apostolic exhortation, amounted to an official platform for his papacy, building on views he has aired in sermons and remarks since he became the first non-European pontiff in 1,300 years in March.

    In it, Francis went further than previous comments criticizing the global economic system, attacking the "idolatry of money" and beseeching politicians to guarantee all citizens "dignified work, education and healthcare".

    Not sure how many times I need to point this out to you Eddy, but your pope is an immoral socialist pig.

    Why does he hate the children?

  • Eduard van Haalen||

    I've said I'm not endorsing his words. But by calling him a socialist (unless you simply mean socialist as a synonym for non-libertarian), you're making some specific claims. You're saying he wants the government to own the means of production, distribution, and exchange. You're saying he's rejected Rerum Novarums powerful denunciation of socialism. You're ignoring Francis' description of business as a "noble vocation."

    So it's not socialism we're dealing with, but an overzealous regulatory agenda, a sort of New Dealism. Isn't that bad enough without the s-word?

    As I suggest below, maybe he has a difficult time distinguishing the Argentinian method of wealth accumulation from the more healthy methods of other countries. He can stillmlearn. He's expressed appreciation of his critics before. So faras far as I can tell he's proposed nothing dogmatically.

  • Francisco d Anconia||

    Deflect and deny all you want Eddy. Government guarantees of work, education and healthcare are socialist tenets.

    Just to be clear...

    You disagree with the pope?

  • Eduard van Haalen||

    I've said I'm not defending him. I've said I'd be uncomfortable with a religion whose leaders only confirmed my pre-existing views. I've said he seems to have confused rhe Argentine-style rich with the US rich.

    I had thought socialist tenets were government ownership. At least that's what I was told when growing up among socialists.

  • Eduard van Haalen||

    Correction - I *am* defending the pope against the charge of socialism/fascism/marxism. I'm *not* defending the contested paragraphs in their entirety, but I wish people would get the nuances so they know what they're disagreeing with.

  • Tulpa (LAOL-VA)||

    I'm actually in agreement with Sevo here.

    Pope Fran is not only batshit insane on this issue, he is stomping all over the previous teachings of the Crutch's own Magisterium (Rerum Novarum in particular). It's one thing to condemn materialism, another to condemn capitalism itself.

  • Death Rock and Skull||

    In this case, it sure appears that the little bugger was likely to die anyway.

    And the "endangering patients" logic could justify doctors overriding all kinds of procedures that patients agree to, like kidney donations.

  • Eduard van Haalen||

    I heard of a guy who killed an old woman and triedto minimize his crime by saying she would have died anyway. He still got convicted.

    And, of course, ALL of us are going to die anyway, it's just a matter of timing.

  • mr lizard||

    OT: (former?/retired?) army colonel a little late to the party, but nonetheless calling for gun grab.

    http://www.esquire.com/blogs/p.....uns-120313

    Also I lost the link. But apparently he works with some DHS contractor and has responded to criticism of his article with

    "I'm sorry about your future"

    I really hope these assholes aren't stupid enough to do what the above implies. The disruption to the economy would send most of the world into the dark ages... All for what? A power boner? The lulz?

  • mr lizard||

    Link to the quote

    http://zeroanthropology.net/20.....he-future/

    Disclaimer: some of this was found through infowars

  • Francisco d Anconia||

    Rest assured, this asshole's opinion is shared by a fraction of a percentage of the rest of the US military. He's maybe a tenth of a percent.

  • Irish||

    It must really make progs throw a fit that they so completely lost the gun control issue. We're at all time lows of support for gun control, and they keep writing these incoherent screeds where they bitch and moan and stamp their feet. It is wonderful.

    Charles Pierce's moronic rants are the best. I especially love Pierce because he's a barely competent writer and an incoherent thinker who nonetheless published a book called "Idiot America."

    It's really interesting that it always seems to be the biggest nitwits most intent on claiming that everyone around them is a moron.

    As Epi would say: PROJECTION!

  • mr lizard||

    IDK, when dudes like this start slipping their leash (and mask) while being tied into DHS I start getting antsy.

  • ||

  • Austrian Anarchy||

    Years ago there was one of those television preachers out West who wanted to open a free hospital and was denied, for this same reason. The argument was there were already empty beds in his region, so he could not open a hospital. Folks around here I knew in the hospital business found it to be perfectly logical. Odd bunch they.

  • Tulpa (LAOL-VA)||

    I wonder if they'd apply the same logic to restaurants.

  • Austrian Anarchy||

    Pretty sure some of them applied the same logic to alcohol outlets, through the limited licensing schemes.

  • Sevo||

    Tulpa (LAOL-VA)|12.7.13 @ 3:16PM|#
    "I wonder if they'd apply the same logic to restaurants."

    In SF, yes, they do.
    The existing owners claim there are too many restaurants and get brain-dead hipsters to agree ('they're gentrifying the place, dude!').

  • Eduard van Haalen||

    Oh, and any guesses who invented hospital in the first place?

  • Tulpa (LAOL-VA)||

    Is this one of those Hitler questions?

  • Eduard van Haalen||

    Thr Church invented the hospital; Hitler invented the reverse-hospital for killing healthy people.

  • Ken Shultz||

    The Knights of St. John?

  • Generic Stranger||

    Wrong.

    Try the early Egyptians. Well, at least, they're the first to have documented evidence of them.

    The term "hospital" did come from the church, but places of healing were around for quite a bit before that.

  • Sevo||

    Darn you! Leave those cherries there for Ed!

  • Eduard van Haalen||

    Ok you got me, there were pre-Christian hospitals.

    But I noticed this in the linked wikipedia article:

    "The declaration of Christianity as acceped religion in the Roman Empire drove an expansion of the provision of care." Then centurues of examples of Christian hospitals in Europe.

  • Eduard van Haalen||

    "The details of the hospital staff's conduct can be found in the complaint."

    The plaintiff's lawyers' version of the facts can be found in yhe complaint. Unless the author can independently verify the claims, he should simply call them allegations.

  • Death Rock and Skull||

    "many Catholic hospitals will not terminate a pregnancy until the fetus’ heartbeat stops of its own accord—even when the mother’s life is at risk"

    We already know that Catlicks are bad at economics.

  • Gozer the Gozerian||

    Everyone remember the Civil Aeronautics Board?

    Good times.

  • Death Rock and Skull||

    It went away?

    Next you'll tell me the ICC went away.

  • Gozer the Gozerian||

    No one beats FedGov™ at the mergers and acquisitions game...

  • Rrabbit||

    Fifteen years ago when I moved here, there was just one Italian restaurant in the neighborhood. Then one pizza service opened shop, then another one. One restaurent which had been here for a while closed down, and in moved another Italian restaurant, a pretty good one. Last year, a bakery closed down, and in moved yet another Italian restaurant.

    The Italian restaurant which was here first? It is now doing better business than 15 years ago, even though the population stayed approximately the same.

    There also are 8 motorcycle gear shops right next to each other. They seem to be doing fine, too, despite the heavy competition.

    A government bureaucrat will not understand this, and thus should have no say in what legal business may open where.

  • Snark Plissken||

    Is there an economic term for the way similar businesses will clump together like that? In my neighborhood it is, unfortunately, banks.

  • ||

    When I lived in Korea it was actively encouraged. People would talk about turning left onto cell phone street and then going a block to get to a run of general electronics shops. If you then made a right you were on pet store row.

  • cavalier973||

    Clustering.
    It's why Dalton, GA is the carpet capital of the world. The economies of scale are so good, that it actually makes the supply curve slope downward for a bit (suppliers are willing to supply more product as prices are lowered.)

  • ||

    I've opened several car lots over the years. It always made sense to me to open in a location where people went to shop for cars. It saved a lot on advertising costs. I knew that I could out perform enough of the others to be profitable.

    People selling impulse goods wouldn't find it so attractive.

  • Eduard van Haalen||

    One choicer here used the analogy of siamese twins, and I accept that. Procedures which would be acceptable for one of a pair of siamese twins would be acceptable for a pregnant woman, and not otherwise.

  • Mickey Rat||

    "It might be tempting to view the lawsuit as another attempt by pro-choice activists to force pro-lifers to subsidize or participate in conduct inimical to their moral convictions. But the facts of the case may well point to negligence."

    Then why is the ACLU involved if it is a mere negligence case? Catholic doctrine on abortion is a bit more complicated than "never". I would think that it was not obvious that the child was "nonviable". Also, they are suing the Catholic hospital, not the government making the central planning laws limiting medical options.

  • Ken Shultz||

    "Then why is the ACLU involved if it is a mere negligence case?"

    Because the ACLU's budget is driven by donations, donations that are generated by getting their name in the news and associating it with fighting for causes their likely donors care about.

    It's the same reason why the Sierra Club came out--categorically--against building any new natural gas plants. Why would they do that? Burning gas introduces a fraction of the green houses gases into the atmosphere that coal does--so why would the Sierra Club be against burning natural gas?

    I'll tell you why. It's because fracking is in the news, and they realized that coming out against fracking would generate more in the way of donations. And you think the Sierra Club is gonna a little thing like what's good for the environment get in the way of fundraising?!

    Same thing here. The ACLU's stance on civil rights issues that don't massage their donor's egos reflect the stance of their donors. And if they can attach their name to a controversial abortion case, and that's gonna generate them some donations, then why wouldn't they want to do that?

  • Mickey Rat||

    You are probably right about that, Ken, but that means that Ross's assertion that the case is not about forcing pro-life medical institutions to provide abortions is wrong.

  • Ken Shultz||

    I don't see why.

    If the ACLU is jumping on a negligence case--and making it about denigrating freedom of religion in favor of abortion rights--then that would suggest that Ross' assertion is correct, wouldn't it?

  • Mickey Rat||

    I think what you just wrote is the opposite of what Ross wrote.

  • Ken Shultz||

    I could be misreading this. I've misread stuff before, and I'll be wrong again.

    However, when I read this:

    "It might be tempting to view the lawsuit as another attempt by pro-choice activists to force pro-lifers to subsidize or participate in conduct inimical to their moral convictions. But the facts of the case may well point to negligence."

    I think he's saying that you could buy the ACLU's take on this--or you can see it as negligence.

    Yeah, the ACLU may be trying to make it about one thing--but he's saying the facts may suggest negligence.

  • Mickey Rat||

    But you cannot divorce the intent of the ACLU from what the lawsuit intends to accomplish. The facts may point to negligence, but the suit has larger goals.

  • Ken Shultz||

    "Michigan is one of 28 states that artificially caps the number of hospital beds available in a given region. To open or expand a hospital, health providers must first obtain a “certificate of need” (CON) by convincing state health planners that there is a need for more beds."

    There is a reason for this, and the reason is Medicaid.

    The data you need is here:

    http://usatoday30.usatoday.com.....g-us_n.htm

    From 1990 to 2009, about a third of all the ERs in urban American disappeared. The important reasons are:

    •Serve patients below the poverty level

    •Serve patients with poorer forms of insurance, including Medicaid

    Medicaid pays pennies on the dollar. No hospital can survive only by serving a local population that is dominated by Medicaid patients.

    Hospitals in relatively affluent suburbs survive by gouging insurance companies to make up for what they lose on Medicaid patients.

    But in a city like Detroit?

    A hospital cannot serve that demographic if other hospitals in the suburbs are siphoning off insurance patients; i.e., if it weren't for these--indeed--stupid anti-competition laws, the last of the inner city ERs would disappear.

    So, the solution isn't to get rid of the stupid anti-competition laws. The solution is to get rid of Medicaid--because Medicaid is the ultimate cause of the problem.

  • Gozer the Gozerian||

    But if hospitals could turn down those Medicaid patients, ER free-riders, etc....

    The issue really does come down to anti-competition laws, although that must be understood broadly.

  • Ken Shultz||

    "But if hospitals could turn down those Medicaid patients, ER free-riders, etc...."

    Bingo!

    I'm gonna sound a little bit like Milton Friedman here talkin' about the Fed--I don't think you should have a Fed, but if you're gonna have one over my objections anyway, then here's what I think you should do...

    Well, I don't think we should give away free healthcare, but if we're gonna do it anyway, the first thing to do is to stop forcing private providers to take public patients.

    Start a series of inner city--government owned--ERs and clinics. All the services there could be free! Or maybe they charge $20 a visit or some nominal fee. And then that's where the poor people go. They get a minimum quality of care--and they don't break the private system in the process.

    Meanwhile, the private providers and insurers get to compete in a free market---one where they're not burdened by sometimes the overwhelming majority of their patients being, essentially, deadbeats (like now on Medicaid). Might be surprised how many poor people will suddenly be able to afford their own insurance.

    The biggest problem with our system is that it makes private providers give free care to people on the government programs. If the government isn't going to pay the market rate for those people's care, then they need to provide that care themselves--not force private providers to give away free care and gouge private pay patients to make up the difference.

  • Ken Shultz||

    "Might be surprised how many poor people will suddenly be able to afford their own insurance."

    It is also interesting--and somebody really should mention this--the way the left keeps demonizing the uninsured.

    I'm sick of seeing the working poor demonized for being too poor to afford insurance. I remember when ObamaCare was supposed to help them--how did it ever get so we "help" the working poor by siccing the IRS on them unless they buy something they can't afford?

    Meanwhile, if there were government clinics that gave care to all comers, it would not be necessary for private hospitals to turn away the uninsured from their ERs. And it wouldn't be necessary to have a gigantic Medicaid bureaucracy devoted to determining eligibility for Medicaid.

    And if the government wanted to use private contractors to operate the government's "free" clinics and ERs, there wouldn't be anything wrong with that, either.

  • VG Zaytsev||

    It is also interesting--and somebody really should mention this--the way the left keeps demonizing the uninsured.

    I'm sick of seeing the working poor demonized for being too poor to afford insurance. I remember when ObamaCare was supposed to help them--how did it ever get so we "help" the working poor by siccing the IRS on them unless they buy something they can't afford?

    It's not just the poor.

    I haven't had insurance for several years now, despite having a 6 figure income because it is a complete effing rip off. I'd buy a true catastrophic policy if one were available but none are, nore ever have been. By true catastrophic I mean one with a $50,000 ro higher deductible.

  • Ken Shultz||

    It's not just the poor.

    Ostensibly, the purpose of ObamaCare was supposed to be to help the poor.

    That's garbage.

    Now, the supporters of ObamaCare are demonizing the poor.

    Anybody who cares about the poor should be totally pissed off about that. That makes the bait and switch on Iraq look like nothing.

    Anybody who wants to create a system that will help the poor--can do a hell of a lot better than Medicaid. Medicaid sucks!

    I know we libertarians aren't used to arguing from that perspective--but maybe that's why we keep getting our clocks cleaned on these issues...

    We should be saying to swing voters and marginal Democrats--you wanna help the poor? Then why the fuck would you support ObamaCare?! We can do much, much better than Medicaid and ObamaCare. Have a little imagination!

  • Gozer the Gozerian||

    At the core, it isn't so different from government using labour law to "help the poor": Make employers pay for that shit!

    Of course, those of us with a basic knowledge of economics...

  • Ted S.||

    Start a series of inner city--government owned--ERs and clinics. All the services there could be free! Or maybe they charge $20 a visit or some nominal fee. And then that's where the poor people go. They get a minimum quality of care--and they don't break the private system in the process.

    How many nanoseconds until there are calls that that "minimum quality" needs to be raised, becuase it's just not fair?

  • Francisco d Anconia||

    This.

  • Ken Shultz||

    So let them argue that!

    We can spend all the money we're spending on Medicaid now--and have the benefit of not completely screwing up the healthcare system for everybody. ...and not having a bunch of bullshit about how I owe it to the government to buy health insurance--'cause I was born.

    Let the taxpayers foot the bill! ...instead of forcing it onto health insurers and buyers of health insurance.

    And I don't think it would be long before entrepreneurs were offering better healthcare than the working poor could get at the "free" clinics--cheap, too.

    We're talking about removing the primary reason why the healthcare market is so thoroughly distorted.

    Medicare and Medicaid are also a big reason why healthcare is so thoroughly regulated. The reason they can't reject patients with Medicaid--as I recall--is because they need a Medicaid contract for accreditation.

    Anyway, we are never going to get a market based healthcare system without taking this first step--gotta get the people on the government programs out of the private hospitals. It's like running a store with half the customers shoplifting every purchase. It's unsustainable. There's no chance of it succeeding in the long run.

    Oh, and we're never going to get people to go along with ending Medicaid unless we do something to provide basic healthcare for the poor. Not initially, anyway. But the better the healthcare markets function, the less need there will be for "free" healthcare.

    I guarantee that.

  • VG Zaytsev||

    And I don't think it would be long before entrepreneurs were offering better healthcare than the working poor could get at the "free" clinics--cheap, too.

    Actually, they already are.

    Go to any clinica in an immigrant are and you can get basic healthcare services ridiculously cheap.

  • Ken Shultz||

    I'm talking about getting people off of Medicaid. I'm talking about eliminating Medicaid and using the money to build "free" clinics so there is no more Medicaid. Medicaid is the problem.

    This isn't *just* about people who aren't paying anything for care now; although that creates distortions, too, it's nowhere near as bad--in quantity--as the people on Medicaid.

    I think a lot of Americans just don't understand. They think that because there's a government program, that means the government pays those hospital bills. But the government does not pay their bill--they pay, on average, 12.5 percent.

    Illegal immigrants getting "free" healthcare through an ER without paying and native born Americans getting "free" healthcare through an ER by way of Medicaid--there's no substantive difference between illegal aliens not paying and Medicaid patients not paying.

    Actually, native born Americans on Medicaid are much worse--since they make up a much larger percentage of all the unpaid hospital bills.

    You go to downtown Detroit, and the reason the ERs would have to close if it weren't for the anti-competition laws isn't because of illegal aliens. It's because so few people have private health insurance in a one, three, five, and ten mile radius--that there aren't enough of them to make up for all the money the hospital loses on Medicaid patients.

    Illegal aliens are a drop in the bucket compared to all the Medicaid patients.

  • JeremyR||

    Insurance companies pay pennies on the dollar as well.

    Medicaid is lower, I think only 18 cents on a dollar. But insurance companies are only about twice that.

    And if you look at hospital bills, they make up for things by charging 5x as much for their services.

    The only people paying full price are people without insurance.

  • Ken Shultz||

    12.5 cents on the dollar is what Medicaid pays on average.

    Last I checked, Aetna pays over 85 cents on average. And there are good reasons why they want to restrict which providers you go to willingly...

    And the guys in the accounts receivable department are all giving each other high fives if you're admitted through their ER--and they don't have a contract with Aetna. Cha-CHING!

    It used to take one private insurance patient for every eight Medicaid and/or Medicare patients to break even.

    ...and if they were all Medicaid patients, the ratio would be even worse.

  • Ken Shultz||

    "It used to take one private insurance patient for every eight Medicaid and/or Medicare patients to break even."

    So what we should be asking is about how much insurance would cost if that one private insurance patient were only paying to insure himself--and not the other eight Medi-Medi patients, too.

    ObamaCare was an attempt to rescue (and expand) Medicaid. They don't want the taxpayers to have to pay for all those Medi-Medi patients becasue it would raise taxes so high there would be a backlash.

    So they dump all those costs on private insurers by forcing private providers to care for people on the government programs--and they blame the evil corporations for charging so much for insurance premiums.

    ...and they blame the pharmaceutical companies.

    ...and they blame the racists in the Tea Party.

    ...and they have to put anti-competition laws in place to try to keep the inner-city ERs open.

    Meanwhile, people are suffering needlessly.

    Sometimes I really do wish there were a God and that he'd come someday and put all those vile politicians out of our misery.

    http://www.youtube.com/watch?v=mcwyyFOeu5E

  • VG Zaytsev||

    There is a reason for this, and the reason is Medicaid.

    Nope.

    Certificates of Need Laws began gaining approval in the 60s before Medicaid was established and reached a peak under Nixon when federal policy pushed all states to enact them - before the EMTALA was passed. States began eliminating them in the early 1980s; which is the sale time that medicaid usage took off.

  • The Rt. Hon. Serious Man, Visc||

    OT: Newlywed couple allegedly murder man for a thrill

    A couple married just three weeks lured a Pennsylvania man to his death with a Craigslist ad because they wanted to kill someone together, police said.

    Elytte Barbour told officers before his arrest Friday night that he and his wife, Miranda, had planned to kill before but their plans never worked out until last month when Troy LaFerrara responded to an online posting that promised companionship in return for money.

    Elytte Barbour, 22, and Miranda Barbour, 18, both face criminal homicide charges in LaFerrara's death. His body was found Nov. 12 in an alley in Sunbury, a small city northwest of Philadelphia. The couple recently moved to nearby Selinsgrove from North Carolina.

    According to Sunbury police, Elytte Barbour told investigators he hid in the backseat of the couple's SUV as his wife picked up LaFerrara at a mall on Nov. 11. He told police that, on his wife's signal, he wrapped a cord around LaFerrara's neck, restraining him while Miranda Barbour stabbed him.

    The 42-year-old man was stabbed 20 times, police said.

    How do such people find each other?

  • Gozer the Gozerian||

    I dare say that they are Natural Born Killers...

  • The Rt. Hon. Serious Man, Visc||

    But did they ever make it to the Badlands?

  • Death Rock and Skull||

    Craigslist.

  • lap83||

    That's fucked up. But I thought the worst part of the story was finding out at the end that she had a kid.

  • The Rt. Hon. Serious Man, Visc||

    Yeah, but it's certainly in that kid's best interests to be raised by someone else. Hopefully he/she finds a good adoptive family that aren't sociopaths.

  • Eduard van Haalen||

    The family that slays together, stays together? Or is thay joke taken?

  • ||

    No, but it's criminal that it wasn't the headline.

  • Death Rock and Skull||

    It is definitely true that people like us- I mean them- can never, ever leave each other.

  • Dweebston||

    I think the federal penal system begs to differ.

  • Death Rock and Skull||

    If murder fetish couples want to stay out of the federal penal system, they can never, ever leave each other. Unless they are already on the run. At that point, it doesn't really matter if they want to kill each other.

  • Ken Shultz||

    "He told police that, on his wife's signal, he wrapped a cord around LaFerrara's neck, restraining him while Miranda Barbour stabbed him."

    Obviously, we need to ban assault weapons.

  • Acosmist||

    I would not describe Sunbury as "northwest of Philadelphia." It's true, but to a person ignorant of the geography, it makes it sound like it's anywhere near Philly.

  • pan fried wylie||

    To save me the trouble of reading the article, can anyone explain the difference between an "nonviable pregnancy" and a "miscarriage"?

  • Dweebston||

    Apparently a nonviable pregnancy is a pending miscarriage? I didn't read any further, too nice a day.

  • Stoic||

    A nonviable pregnancy is when the baby has no chance of survival, but it's still inside the womb. Once it exits the womb, it is a miscarriage.

    This case makes no sense to me. If a woman's water breaks, it is standard practice to induce labor if it hasn't already started (or deliver by C-section). It is true that this baby was too immature to survive outside the womb, but a baby also cannot survive in the womb with no amniotic fluid. The woman should never have been sent home. At the very least, she should have been kept in the hospital until the baby came out on it's own. A pregnant woman is NEVER sent home after her water has broken, so why should it be different in this case just because the baby had no chance of survival? There is risk of infection if the baby stays in too long after the water breaks, so there was risk to the mother, and the baby was going to die regardless, so even if you consider the unborn baby and the mother to be equal, it still makes sense to minimize risk to the mother's health since the baby is going to die anyway.

  • Death Rock and Skull||

    Like I said, Catlicks are bad at economics. And customer satisfaction and retention, and other things related to economics.

  • Dweebston||

    Assuming the plaintiff is telling the truth.

  • Eduard van Haalen||

    And assuming the bishops' ethical statement had a secret clause saying to send a pregnant patient home when her wster breaks - since she sued the bishops, not the hospital.

  • Stoic||

    True. They could have just kept her in the hospital under observation, and maybe even given some antibiotics, without breaking the "don't stop a beating heart" rule. And if they had done that, maybe none of the patients would have bothered to call the ACLU.

  • RishJoMo||

    Sounds like some serious business to me dude.

    www.Anon-VPN.com

  • Jayburd||

    Cops seize medical records outside scope of warrant. http://articles.ktuu.com/2010-.....d_24127903

  • thorax232||

    Yes, because static mathematical models should design and rule a dynamic and impossible to predict society...

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  • MSimon||

    For Jews the life of the mother comes first. Abortion - even very late stage - is no sin if there is medical necessity. And that even includes the mental health of the mother.

  • MSimon||

    It is in the Talmud. I know. I studied it with my Rabi.

  • Brooke King||

    Proponents of CON (certificate of need) claim limiting the supply of hospital beds is necessary to restrain healthcare costs. They should all take Economics 101. Thinking cynically, maybe they have but conduct this charade for reasons of personal benefit.

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