Dark Brightness

The problem with a market is that people will work rationally. If the business model is untenable, then the business will fold.

What most health planners do not realise that primary care and private practice of medicien (and medicare uses the US private system are small businesses. If they cannot make a profit, the doc will go elsewhere.

In Texas, the docs are thinking of opting out. Me? I’m an academic, on a salary. My private work is limited to consults: I do not live in an insurance driven jurisdiction (which is what the US has become). But… my Dad waited a year for his bypass. On the urgent list. That is the hidden cost of socailising health.

Congress would overturn the cuts, but their short-term fixes didn't keep up with inflation. The Texas Medical Association says the cumulative effect since 2001 already amounts to an inflation-adjusted cut of 20.9 percent. In 2001, doctors receiving a $1,000 Medicare payment made roughly $410, after taking out operating expenses. In 2010, they'll net $290. If the scheduled 21.2 percent cut goes through, they'd net $72, effectively an 83 percent cut since 2001.

The issue caused the Texas Medical Association to break ranks with the American Medical Association and oppose health care reform efforts throughout 2009. Then TMA President Dr. William Fleming said “reform is doomed to failure” without Medicare reform and called Congress' failure to devise a rational payment plan “an insult to seniors, people with disabilities and military families.”

No surprise to senator

U.S. Sen. John Cornyn, R-Texas, said he isn't surprised by the new opt-out numbers, allowing that Congress' inability to reform Medicare is leaving “seniors without access and breaking the promise we made to them.”

“The problem has been how to eliminate the cuts without running up the deficit,” said Cornyn, responding to blame U.S. Rep. Gene Green, D-Houston, placed on the Senate for not passing a House bill that would have provided a longer-term Medicare fix. “There hasn't been the political will, but we really have no choice but to fix it.”

Cornyn acknowledged the task is daunting. The Congressional Budget Office recently estimated that eliminating scheduled Medicare payment cuts through 2020 would cost $276 billion.

The growth in Texas Medicare opt-outs began in earnest in 2007, when 70 doctors notified Trailblazer Health Enterprises, the state's Medicare carrier, they would no longer participate, up from seven in 2006. The numbers jumped to 151 in 2008, fell back to 135 in 2009 and are on pace for 200 in 2010. From 1998 to 2002, by contrast, no more than three a year opted out.

Now, according to a Texas Medical Association new poll, more than four in 10 doctors are considering the move.

“I've been in practice 24 years, and a lot of my patients got old right along with me,” Culpepper said. “It's stressful to tell them you're leaving Medicare and they're responsible for payments if they want to stay with you. You feel like you're abandoning them.”

via Texas doctors fleeing Medicare in droves | Houston & Texas News | Chron.com – Houston Chronicle.

Hat tip to Mish

My teenage children delight in the vulgarity of South Park. The fact I find the show crude, it’s blasphemy far to simplistic, and it not satirical enough to criticize our postmodern hypocrises (of course) encourages them to continue.

They are aware it is satire. I can walk away, as I do to almost all the products of both the disney channel and comedy central. I am dyspeptic, judgmental and of middle years.

But Viacom are inconsistent  If you offend all Christians, most Buddhists, and all scientologists, do a show about Muhammad and Aliesha. Cartman can call him a pervert and pedophile — which is a good description of having sex with a nine year old (at that age,, “marraige” is no excuse). I am aware that the South Park writers would be consistent — but the management are a bunch of cowards.

Voltaire is not in charge of Viacom. So if you're interested in working as a part-time censor for Comedy Central, all you need is a violent temperament, a demented ideology and a poorly constructed website.

The popular animated show “South Park” — gloriously vulgar, sharply satirical and, one suspects, offensive to vast swaths of the viewing public — is, if nothing else, impressive in its evenhandedness.

Yet, in this week's episode, a depiction of the Prophet Muhammad in a bear costume (don't ask) was blocked with the word “censored” so the channel could avoid hurting the feelings of a few virtual New York City Jihadists.

This homegrown radical group called Revolution Muslim (no thanks), warned the show's architects, Matt Stone and Trey Parker, and they would “probably wind up like Theo van Gogh” because of the depiction in the episode.

Van Gogh, for those unaware, was a Dutch filmmaker who documented (along with feminist Ayaan Hirsi Ali) the abuse of women in the Islamic world. Consequently, Ali now lives in hiding and van Gogh was last seen dead in the middle of an Amsterdam street — a thoughtful dissertation on Islamic tolerance affixed to his chest with a knife. (If only the Dutch were less warlike, obviously, this never would have happened.)

Comedy Central initially banned “South Park” from showing any depictions of Muhammad in 2006, as Muslims consider a physical representation of the prophet blasphemous.

There is an appropriate response to this: Watch something else.

via Harsanyi: Next on Cowardly Central – The Denver Post.

Dr. Esolen offers a beautiful affirmation of what ought to be evident, but in our sadly skewed culture must be repeated again and again. I am reminded of a Shakespeare sonnet I often teach in my Intro to Lit classes, one which perhaps tells us why he valued chastity:

The expense of spirit in a waste of shame

Is lust in action; and till action, lust

Is perjured, murderous, bloody, full of blame,

Savage, extreme, rude, cruel, not to trust;

Enjoy'd no sooner but despised straight;

Past reason hunted; and no sooner had,

Past reason hated, as a swallowed bait,

On purpose laid to make the taker mad:

Mad in pursuit, and in possession so;

Had, having, and in quest to have, extreme;

A bliss in proof, and proved, a very woe;

Before, a joy proposed; behind, a dream.

All this the world well knows; yet none knows well

To shun the heaven that leads men to this hell.

I shudder to think of how these plays must be visited at my state university alma mater now that the new wave of relativists and deconstructionists have almost total sway. Thanks for publishing this encouraging essay, the link to which will probably find its way to my students when we visit Shakespeare later this summer.

This is a comment from this essay. Worth reading in full.

ia Desires Run Not Before Honor | First Things.