March 14th, 2017
This is a great story and Trump is to be commended in his selection to run the FDA. Scott Gottlieb is a fine physician who knows this area well and can sharply articulate efforts to alter the problems in this agency.
Scott Gottlieb, Trump pick for FDA, is on the side of the little guy
President Trump’s pick for the Food and Drug Administration, Dr. Scott Gottlieb, is qualified and capable. He will do great work if confirmed, but his nomination provides a great opportunity to lay out a crucial lesson that regulation often serves to protect big business from competition, harming the consumer.
The Democrats’ attack on Gottlieb is easy to predict. Reporters have already provided the template. “He is seen as a strong supporter of [the pharmaceutical] industry and has championed deregulation,” NPR wrote in a story.
NPR also cited Gottlieb’s lucrative consulting for drug companies, and quoted a liberal critic saying, “He has spent most of his career dedicated to promoting the financial interests of the pharmaceutical industry, and the U.S. Senate must reject him.”
This is standard stuff from Democrats and Left-liberal media, of which NPR is a leading member. They always simplistically see arguments against regulation as helping corporate interests.
Gottlieb’s scholarly work, however, shows the truth is different. He is a scholar at the American Enterprise Institute — disclosure: so are Washington Examiner writers Michael Barone and Tim Carney — and has chronicled consolidation in the hospital and insurance industry, and argues that regulation has contributed to the trend. He’s also shown how regulations dampen competition in pharmaceutical industry.
Obamacare regulations, for instance, prevent new entrants into the health insurance markets, thus protecting incumbent insurers from competition, Gottlieb argues. He points out that the law regulations governing how much an insurer may spend on overhead and marketing penalize a new company for its start-up costs. “Spending on things like marketing a new plan to consumers, developing provider networks, and credentialing doctors” are effectively punished by these regulations because they don’t count as “medical” spending.
Further, “new carriers also have a hard time bearing the fixed costs of compliance.” Smarter and lighter regulation would allow more competition. Incumbent insurers might not like this, but customers would.
The same goes for hospitals. Obamacare “favor[s] the consolidation of previously independent doctors into salaried roles inside larger institutions,” Gottlieb wrote in 2014, “usually tied to a central hospital, in effect ending independent medical practices.”
Gottlieb argued against the hospitals’ dominance: “A true legislative alternative to Obamacare would support physician ownership of independent medical practices, and preserve local competition between doctors and choice for patients.”
Obamacare’s regulations and subsidies dampened such competition.
And drugmakers? The largest drug lobby, the Pharmaceutical Research and Manufacturers of America supported Obamacare, as did the American Hospital Association. So Gottlieb and the drug lobby are not of the same mind on major issues.
Second, Gottlieb’s proposed reforms of the drug industry generally aim at getting more competition, often in the form of generic drugs, to drive down prices and profit margins.
In August 2016, Gottlieb wrote in the Wall Street Journal that “a flurry of new regulations is raising production costs and reducing competition for branded drugs. The key to the generic-drug economic model is to keep entry prices low enough to attract multiple competitors.”
Gottlieb’s central goal in policy prescriptions has been more competition in a sector where it is scarce. A major barrier to entry and a major cause of consolidation has been regulation.
This is true not only in the health sector, of course. Banking has consolidated further under Dodd-Frank regulations. Major tax preparers such as H&R Block supported Obama-administration regulations on their industry in order to crowd out smaller practitioners. Mattel supported federal toy regulations and Philip Morris supported regulation of tobacco.
But no sector needs an injection of market competition as badly as healthcare does. Republicans would do well to remember that when fighting for market reform of healthcare, industry is not a reliable ally.
Gottlieb deserves rapid confirmation to head this crucial agency. We hope the Trump administration can learn from this that more regulation often means less competition, protecting the big guys instead of everyone else.
March 4th, 2017
A Chilling Article on the Possible Destruction of France As We Know It. Take It Seriously. It Could Even Happen Here.
France’s Fatal Attraction to Islam
by Giulio Meotti
March 4, 2017
Instead of fighting to save what is savable, French opinion-makers are already writing the terms of surrender.
By hybridizing cultures and rejecting Christianity, France will soon end up not even teaching also Arabic, but only Arabic, and marking Ramadan instead of Easter.
Instead of wasting their time trying to organize an “Islam of France”, French political leaders, opinion makers and think tanks should look for ways to counter the creeping Islamization of their country. Otherwise, we may soon be seeing not only a “Grand Imam de France”, but also lashes and stonings on the Champs Élysées.
Two years ago, the rector of the Great Mosque of Paris, Dalil Boubakeur, suggested converting empty churches into mosques, to accommodate the growing Muslim community in abandoned Christian sites. Now, many people in France seem to have taken the idea so seriously that a report released by the foundation Terra Nova, France’s main think tank that provides ideas to the governing Socialist Party, suggests that in order to integrate Muslims better, French authorities should replace the two Catholic holidays — Easter Monday and Pentecost — with Islamic holidays. To be ecumenical, they also included a Jewish holiday.
Written by Alain Christnacht and Marc-Olivier Padis, the study, “The Emancipation of Islam of France,” states: “In order to treat all the denominations equally, it should include two important new holidays, Yom Kippur and Eid el Kebir, with the removal of two Mondays that do not correspond to particular solemnity”.
Thus, Easter and Pentecost can be sacrificed to keep the ever-elusive multicultural “peace”.
Terra Nova’s proposal was rejected by the Episcopal Conference of France, but endorsed by the Union of Islamic Organizations of France, close to the Muslim Brotherhood, which would also like to include the Islamic holidays of Eid al-Fitr and Eid al-Adha in the calendar. The idea of replacing the Christian holidays was also sponsored by the Observatory of Secularism, an organ created by President François Hollande to coordinate secularist policies. The Observatory of Secularism also proposed eliminating some Christian holidays to make way for the Islamic, Jewish and secular holidays. “France must replace two Christian holidays to make way for the Yom Kippur and Eid,” said Dounia Bouzar, a member of the Observatory.
In his recent book, Will the Church Bells Ring Tomorrow?, Philippe de Villiers notes the disappearance of churches in France, and their replacement by mosques. Pictured above: On August 3, 2016, French riot police dragged a priest and his congregation from the church of St Rita in Paris, prior to its scheduled demolition. Front National leader Marine Le Pen said in fury: “And what if they built parking lots in the place of Salafist mosques, and not of our churches?” (Image source: RT video screenshot)
“France is no longer a Catholic country”, wrote Frederic Lenoir, editor-in-chief of Le Monde des Religions. The newspaper Le Figaro wondered if Islam can already be considered “France’s prime religion.” Instead of fighting to save what is savable, French opinion-makers are already writing the terms of surrender. That is the meaning of Terra Nova’s proposal.
A similar shocking idea came from another think tank, the Montaigne Institute, which provides ideas to another presidential candidate, Emmanuel Macron. In its report, written by Hakim El Karoui, the Montaigne Institute proposed the creation of a “Grand Imam of France”, no less, as if Paris and Cairo would have the same historic roots. Macron recently apologized for French colonialism, feeding a defeatist sense of guilt that fuels Islamic extremists in their demands.
The Montaigne Institute has also suggested teaching Arabic in public schools. This idea was also sponsored by Jack Lang, president of the Institute of the Arab world, who stated, “the Arab world is part of us”. By hybridizing cultures and rejecting Christianity, France will soon end up not even teaching also Arabic, but only Arabic, and Ramadan instead of Easter.
If the goal is accommodating Muslims in the French Republic instead of assimilating them, why not ban pork in the schools, avoid sensitive subjects such as the Crusades and the Holocaust, separate men and women in swimming pools, call cartoonists to “responsibility,” and allow Islamic veils in the public administration? In fact, all these things are taking place in France today. And the result is not “emancipation,” but religious segregation.
It is in this Apartheid that Islamic extremists grow and permeate hearts and minds. France’s director-general of intelligence, Patrick Calvar, has been clear: “The confrontation is inevitable,” he said. There are an estimated 15,000 Salafists among France’s seven million Muslims, “whose radical-fundamentalist creed dominates many of the predominantly Muslim housing projects at the edges of cities such as Paris, Nice or Lyon. Their preachers call for a civil war, with all Muslims tasked to wipe out the infidels down the street”.
The Socialist front-runner for the Presidential elections, Benoit Hamon, to whom the Terra Nova’s report was directed, even justified the disappearance of French women from the cafés in Muslim-majority areas: “Historically, in the workers’ cafes, there were no women,” he said.
Instead of wasting their time trying to organize an “Islam of France”, French political leaders, opinion-makers and think tanks should look for ways to counter the creeping Islamization of their country. Otherwise we may soon be seeing not only a “Grand Imam de France”, but also lashes and stonings on the Champs Élysées.
Giulio Meotti, Cultural Editor for Il Foglio, is an Italian journalist and author.
February 28th, 2017
An interesting article.One can only hope he is right
Washington Examiner 2/28/2017
Eight Reasons for optimism in the Trump Era
I said some hard things about President Trump during the primaries, and I’m sure I will again. Nothing he has done in office has alleviated my chief concern about him: that he regards himself as bigger than the presidency.
Still, I remain sanguine about America’s prospects. Oddly enough, my optimism contrasts vividly with the continuing fury of some of Trump’s supporters. You’d have thought that, with their guy in office, they’d be delighted. But a great many of them have simply transferred their rage from Hillary Clinton to the media. Perhaps that rage is a character trait rather than a response to specific circumstances.
Be that as it may, there are solid reasons for conservatives to be optimistic. Not since 1928 has the GOP controlled both chambers and the White House. Ninety years is a long time for a system to be clogged up with useless laws. If that great and underrated New Englander Calvin Coolidge could be transported from 1928 to our own era, he would be so horrified by the size of the state that he might manage to squawk out more than three or four consecutive words.
Opportunities like this don’t come often, and Republicans know it. Here are eight reasons why right-of-center Americans should look forward to the current session.
1.) Scrapping Obamacare
As his opponents predicted, Barack Obama’s healthcare reforms have proved byzantine, cumbersome and costly. They suck money from the private sector and discourage businesses from growing. Firms are reluctant to take on more than 49 employees. Bosses hesitate before offering a contract of more than 30 hours a week.
Replacing Obamacare with a cheaper, simpler system — ideally one based on individual healthcare accounts — will do far more to stimulate the economy than all the TARP boondoggles put together.
2.) Sacking regulators
Talking of stimulating the economy, how about getting rid of federal bureaucracies? Not just getting rid of expensive regulations; getting rid of expensive regulators. Let the 50 states set their own standards, so as to encourage benign competition. Ronald Reagan dreamed of scrapping the education and environment departments. Although total abolition is unlikely, these agencies may well face their first serious reduction in personnel since their founding.
3.) States’ rights
The principle of competition among states goes much further than regulation. The key to America’s success, down the ages, was the diversity of its constituent states. Ideas could be piloted; good practice could spread. The only truly successful reform of welfare was the one drafted by Newt Gingrich’s Congress and signed into law by Bill Clinton. Its secret? To return responsibility to the states.
That same principle should apply across the board — in healthcare, education, law enforcement, taxation and the rest.
4.) Cheap energy
The United States is blessed with ample energy reserves, yet the Obama administration went out of its way to discourage their exploitation. Let people get at the treasures in America’s earth and prices will fall. Factories will become immediately more productive, transportation cheaper. More jobs will come into existence and revenues will rise as the economy grows.
5.) Lower taxes
Devolving taxation to state level, as the founders envisioned, will lead to jurisdictional competition and, in turn, downward pressure on rates. The U.S. badly needs to lower corporate taxes. There’s a global race out there, and it makes no sense to handicap yourself with the heaviest business taxes in the industrialized world.
6.) Anglosphere trade
Regular readers will know that I loathe Trump’s protectionism. Threatening a 20 percent tariff on Mexican imports won’t “pay for the wall.” It won’t pay for anything. It will drive up prices, reduce economic activity and cut Treasury income. Then again, the Donald does seem serious about a free trade deal with the U.K. If this can be done quickly and cleanly, the benefits will be palpable and, with luck, the appetite for protectionism vis-a-vis Mexico and China will dissipate.
7.) Straightforward judges
How odd to watch Democrats howl with fury because Trump wants to appoint a Supreme Court judge who will interpret the law as it is written rather than seeking to advance leftist causes from the bench. A few more such appointments and America may again have judges who rule on the basis of what the law says rather than what they wish it said.
8.) Mike Pence
The vice president is a good and humble man, in politics from the best of motives. As long as his health is good, conservatives should sleep soundly.
Dan Hannan is a British Conservative MEP.
February 12th, 2017
This essay is a response to the hand wringing of many academic and corporate medical workers lamenting the potential effect of the recent travel ban, which was blocked in a most absurd and unconstitutional manner by a 3-judge panel of the 9th circuit court of appeals.
Travel Ban is Revealing ––––but Does Not Threaten American Medicine
Jane Orient, M.D.
A 90-day ban on travel from seven countries has sparked tremendous outpourings of “worry” or outright opposition by some 33 medical organizations.
“The community is reeling over the order, fearing that it will have devastating repercussions for research and advances in science and medicine,” states an article in Modern Healthcare.
Certainly the order is disrupting the lives of individual physicians who have won coveted positions in American medical institutions and were not already in the U.S. when the order was issued. Also their employers have a gap in the work schedule to fill. War tears people’s lives apart, however innocent they may be. And countries that sponsor terrorism have effectively declared war on the U.S.
But is American medicine so fragile that it can’t survive a 90-day delay in the arrival of physicians, most of them trainees, from Iran, Iraq, Libya, Syria, Yemen, Somalia, and Sudan? After all, every year more than a thousand seniors in U.S. medical schools do not land a position in a post-graduate training program through the annual computerized “Match” of graduates with internships. After another chance through the Supplemental Offer and Acceptance Program, or SOAP, hundreds of seniors are still without a job. This means that they cannot get a license to practice in the U.S., however desperate rural communities or inner-city hospitals are to find a physician, and their four years of rigorous, costly post-college education are wasted. Yet James Madara, CEO of the American Medical Association (AMA), is worried about vacant residency slots, according to a Feb 3 article in MedScape by Robert Lowes.
Entry to medical school is highly competitive, so presumably all the students are well-qualified. Can it be that graduates from Sudan are better trained? Does the U.S. have so few young people capable of and interested in a medical career that we have to depend on a brain drain from countries that are themselves desperately short of physicians?
For all the emphasis on “cultural competence” in American medical schools, and onerous regulations regarding interpreters for non-English speakers, what about familiarity with American culture and ability to communicate effectively with American English speakers? Some foreign-born graduates are doubtless excellent, but many American patients do complain about a communication gap. So why do some big institutions seem to prefer foreigners? Could it be that they want cheap, and above all compliant labor? Physicians here on an employment-related visa dare not object to hospital policy.
Whatever the reasons for them, here are some facts about the American medical work force:
- One-fourth of practicing physicians in this country are international medical graduates (IMGs), who are more likely to work in underserved areas, especially in primary care, according to Madara.
- According to the Accreditation Council for Graduate Medical Education (ACGME), 10,000 IMGs licensed in the United States graduated from medical schools in the seven countries affected by the ban.
- Immigrants account for 28% of U.S. physicians and surgeons, 40% of medical scientists in manufacturing research and development, and 15% of registered nurses, according to the Institute for Immigration Research at George Mason University. More than 60,000 of the 14 million workers in health-related fields were from the seven countries affected by the ban.
Is medicine, like agriculture, now filled with “jobs that Americans won’t do”? Actually, we have more than enough Americans who love medical work. But some of best doctors are being driven out by endless bureaucratic requirements, including costly “Maintenance of Certification™” programs that line the pockets of self-accredited “experts” but contribute nothing to patient care. They are being replaced (substituted for) by “mid-levels” with far less training. Then there are thousands of independent physicians having to retire or become employees because they can’t afford the regulatory requirements—soon to be greatly worsened by MACRA, the new Medicare payment system. Physician “burnout” is becoming so bad that we lose up to 400 physicians—the equivalent of a large medical school class—to suicide every year.
The U.S. should be a beacon to attract the best and brightest, and it should welcome those who want to become Americans. Unfortunately, the lives of Americans, as well as the opportunities of aspiring foreign-born doctors, are threatened by those who desire to kill Americans and destroy our culture. These must be screened out.
Meanwhile, the reaction of organized medical groups to the travel ban is spotlighting serious problems in American medicine.
Jane M. Orient, M.D.obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989. Dr. Orient is the 2017 recipient of The Edward Annis award for medical leadership.
February 6th, 2017
For those who read my blog and who are writers, this short article should be quite helpful. Sent to me by my good friend, Stephen Dubel.
Should You Angle for Anglo-Saxon, or Enlighten with Latin?
By Mark Nichol
Arguments for and against favoring Latinate words over Germanic ones, or vice versa (or, if you prefer a non-Latinate phrase, the other way around), have been heard over the years. What’s best? How about the status quo?
The vocabulary of Modern English is the result of a unique admixture of words (and phrases) from a variety of languages. But only about one-fourth derive directly from Old English, or Anglo-Saxon, and other Germanic languages. More than that come from Latin — and Latin’s progeny (mostly Spanish and French) account for as many more words. Admittedly, many Latin words are used primarily in legal, scientific, and medical contexts, whereas Germanic words tend to be more practical for everyday life, but the Latinate contribution is still predominant over native words, and the language is richer for the widespread borrowings.
Given the choice between words from the Germanic root and those of Latin origin, which should one choose? How about one or the other, on an ad hoc basis, or as your mood strikes you? Various movements have attempted to eradicate non-Germanic vocabulary from the English word-hoard, or at least minimize it, but these absurd endeavors, which have sometimes included efforts to create or calque (translate) new words, have been prompted by nationalism, not by any sensible motive.
To communicate plainly, Germanic words, which tend to be shorter, are often preferable, but the Latinate pain, for example, is as simple as the Germanic ache, and Germanic anger and wrath are slightly more complicated than ire and rage, both of which are of Latin provenance but could easily be misidentified as Germanic words.
If you do want to introduce more Germanic words into your writing, it’s easy, for instance, to target classes of words with specific suffixes: For example, words that end in the Latinate suffix -age have more concise synonyms: Think of advantage (gain), marriage (wedlock), savage (wild), and voyage (trip). But where would we be without parentage? “Mother and father” may be more concrete, but the Latinate term is more concise, more precise, and more flexible when it comes to nontraditional families.
For another example, words ending in -ity are often more complicated; why not, for example, write selfhood instead of identity? Unfortunately, identity often refers to a collective, rather than individual, impression. (And often, when one considers alternatives for Latinate words, the first synonym that comes to mind is non-Germanic, too: Quick, what’s another word for fidelity? Loyalty? That’s from French. Allegiance? French.) For yet another example, though words ending in -ology are of Latin origin, there’s no suitable Germanic equivalent for the suffix.
Ultimately, word choice depends on various factors, but the ground a word sprang up in shouldn’t be one of them.
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