More Ignorant Doctor Bashing From Matthew Yglesias

The liberal blogosphere provides tremendous benefit, but also includes bloggers who post their solutions to problems when they don’t have the slightest bit of understanding of the subject. Last June I chastised Matthew Yglesias for his advocacy of “doctor-crushing” as a solution to problems in health care. He had another ignorant and irrational attack on the medical profession a couple of days ago. He wrote:

Ezra Klein points to a study with this striking conclusion:

[A] year after surgical teams at eight hospitals adopted a 19-item checklist, the average patient death rate fell more than 40 percent and the rate of complications fell by about a third, the researchers reported.

He finds reason in this to once again bash doctors, mistakenly believing that doctors were opposed to such progress. Fortunately, as in the case of his earlier post, many of his blog readers are far more intelligent than Yglesias.

Check lists such as that which Yglesias and Klein find of value are already in place in many hospitals. Measures such as this are being proposed and implemented by the very doctors which Yglesias loves to demonize.

It make for an easy blog post to attack doctors for doing something wrong whenever the medical literature provides recommendations for doing things better. The irrationality of this mind set is rather obvious.

As in every other field, there are likely doctors who resist change but contrary to the claims made by Yglesias, the medical profession in general would prefer to make changes which reduce patient deaths and complications.

Yglesias makes the claim, without any evidence to support his misconceptions, that professional organizations are analogous to unions and that they are opposed to progress which improves patient care. Neither of his assumptions are correct. Again, the studies which show the benefits of of changes demonstrate that searching out improvements is being done by the medical profession itself.

Ezra Klein writes, “Hospitals are dangerous. Surgery is dangerous.” Klein and Yglesias seem to think that hospitals are only made up of doctors when they consider such dangers. As I discussed in December, there are many sources for problems in hospitals beyond doctors, with outdated and counterproductive hospital policies often persisting despite the wishes of individual physicians.

Retreating on Card Check For The Bigger Victory

Like many of Obama’s supporters, I do not share the traditional Democratic Party ties to labor, and like George McGovern, I see no reason to allow the Republicans to take the high ground on an issue as fundamental as the secret ballot. While Democrats will continue to support the legitimate rights of workers to voluntarily organize and seek to improve their living conditions, the day might be over when the Democratic Party is in the pocket of organized labor.

Card check has allowed Republicans to disguise their opposition to voluntary organization by workers as support for democracy. I suspect that Obama, who often manages to transcend the traditional left-right divides, is beginning to question the wisdom of making card check the key point of the debate. The Washington Post described their interview with Obama:

On the Employee Free Choice Act, which would allow unions to organize by obtaining a majority of signatures from employees in a workplace rather than having to win secret-ballot elections, Mr. Obama signaled willingness to consider other mechanisms to address the concern that employers unfairly use the current process to intimidate workers not to join unions. And he seemed in no hurry to have Congress bring it up. “If we’re losing half a million jobs a month, then there are no jobs to unionize, so my focus first is on those key economic priority items,” Mr. Obama said, declining to state whether he wanted to see the issue debated during his first year in office.

Others on the left are beginning to realize that card check should not be where the battle lines are drawn. Via Steve Benen, T.A. Frank raises such concerns in The Washington Monthly:

The question, then, is how much of a fight the card check provision merits. And the answer is probably a little, but not a lot. What most undermines the secret-ballot process is that employers can violate the law in numerous ways without consequences. Under EFCA, however, every illegal action has the potential to be costly, so firings, spying, threats, or other forms of intimidation would be less likely. Also, there is an alternative way to preserve the secret ballot while guarding against company malfeasance: expedited elections. Under current law, months can go by between when NLRB announces the results of a card check vote and when a secret-ballot election is held. If, however, this campaign window were reduced to just a few days, employers would have less opportunity to intimidate union supporters into changing their minds. Workers I spoke to in Lancaster seemed content with this alternative. And some savvy people in the labor movement I spoke to feel the same way — provided that employers either refrain from captive-audience campaigning or else grant union members equal access to the workplace during a campaign.

Given that card check is substantively minor, why has it come to define the entire debate about EFCA in Washington? Because it is the one element of the bill that its opponents can object to and still seem principled — it’s easier to stand up for “democracy” than for the right of companies to break labor laws without consequence. And all of this factors into the gamesmanship that’s likely to take place on Capitol Hill over EFCA. Commentators like Marc Ambinder have called the fight “a quandary” for Democrats, one that carries a risk of disastrous failure. But must it come to that? Deploying political capital wisely means fighting over what matters most, not what matters least. Perhaps the bill’s proponents in Congress intend to stand firm in their defense of the card check provision of EFCA. But if they strategically retreat, at just the right moment, like a matador lifting his red cape, will liberals accuse Democrats of selling out labor? Or will they realize that, with or without card check, EFCA will still accomplish what’s most needed — finally, at long last, restoring the rights of workers who seek to organize?

A Modest Libertarian Proposal

The Wall Street Journal has multiple writers from both the left and right discussing their hopes from the Obama administration. Via Megan McArdle I came across this proposal from Glenn Reynolds:

I will make one policy proposal. Some of my fellow libertarians hope that the Obama administration will put an end to the drug war. I hope so too, but I’m not too optimistic. Instead, I propose a smaller step toward freedom — eliminating the federally mandated drinking age of 21. This mandate was a creature of Elizabeth Dole (who is no longer in the Senate to complain at its abolition), and it has unnecessarily limited the freedom of legal adults, old enough to fight for their country, to drink adult beverages.

What’s more, as the 130 college presidents of the Amethyst Initiative have noted, rather than promoting safety, it has largely created furtive and less-safe drinking on campus. As a former professor of constitutional law, President Obama knows that the Constitution gives the federal government no legitimate role in setting drinking ages. Returning this decision to the states would be a step for freedom, a step toward honoring the Constitution, and a step away from nannyism. It would also be a particularly fitting act for this administration. Barack Obama received enormous support from voters aged 18-21. Who better to treat people that age as full adults again?

Like Glenn Reynolds I have not been too optimistic that Obama will put an end to the drug war, but I do anticipate improvements over some Republicans policies such as stopping the raids on those who use medicinal marijuana, even in states where it is legal.

Megan considers the politics of the current drinking age:

A drinking age of 21 is an embarassment to a supposedly liberty-loving nation.  If you are old enough to enlist, and old enough to vote, you are old enough to swill cheap beer in the company of your peers.

The problem is, the main constituency of this initiative is small.  I remember sitting through the  alcohol education class that the Commonwealth of Pennsylvania required me to sit through in exchange for clearing my sentence.  The lawyer teaching it allowed that the drinking age might well be–indeed, probably was–unconstitutional in various ways.  So why did the law still stand?

“Because when people turn 21,” he explained patiently, “they stop caring.”

It strikes me that this might be a golden opportunity for the Republicans, though.  The news post-election was filled with commentators pointing out that the first few times a person votes tend to seal their political identity.  Well, a president coming out strongly against the drinking age could put the next generation in Republican pockets for decades.

With all their unpopular views, I doubt that supporting a lower drinking age would be enough to get young voters to back Republicans for life. It would also be counter to the mind set of most people remaining in the Republican Party to back an issue which gives  people more freedom of choice, along with upsetting their supporters in the religious right.

If Republicans could overcome their overwhelming tendency towards telling others how to live their lives, I doubt the Democrats would be so foolish as to allow them make such easy in roads with the youth vote. What such an attempt by Republicans might do is force Democrats to enact such a change, neutralizing it as a political issue. From that perspective, I do hope that the few remaining libertarian-minded Republicans are successful in getting Republicans to adopt such an idea.

Restoring The America We Remember


While one theme of the day has  been change, the irony is that the most important change is that the nation is returning to American values after the aberration of the last eight years. As Colin Powell said, “The America we remember is back again.”

Instead of a president who ignored the Constitution he swore to protect, the new president is a Constitutional scholar who understands and respects the restrictions upon government power devised by the founding fathers.

Instead of a president who undermined our national security we have a president who understands the challenges we face and is prepared to take sensible action, without sacrificing our freedoms.

Instead of a president who championed anti-intellectualism and hostility towards science we have a president who respects science,  has studied many viewpoints, and who can speak and write coherently.

Of course some in the authoritarian right were fighting the modern world and a return to the America we remember on inauguration day, when even most Republicans realized it was not a day for such petty partisan attacks. They showed once again that they despise America and the values America was founded upon, preferring to see the country suffer from yet another failed presidency rather than having a member of the opposing party succeed. Rush Limbaugh said ” I hope Obama fails.” Joseph Farah, founder and CEO of Worldnet Daily, ran an op-ed entitled Pray Obama Fails.

Limbaugh and Farah justified this extreme position by distorting Obama’s positions as well as ignoring the actual record under Republican rule. Farah accused Obama of desiring to “change our country from one anchored on self-governance and constitutional republicanism to one based on the raw and unlimited power of the central state.” In reality it was the Bush administration which ignored the Constitution and expanded the power of government over our lives while liberals such as Obama have protested. Such distortions of reality worked for conservatives for a while, but after eight years the reality of conservative beliefs have become clear to the vast majority of American people.

American who support freedom, government limited by the Constitution, science and reason have rejected the conservative ideas which are hostile to the principles this nation was founded upon.

Obama’s inaugural address might not be one which is remembered by history but few are. More importantly he had important messages for today.

It is only after the hostility towards science under Republican rule that such a speech would include a line such as, “We will restore science to its rightful place.”

The speech laid the groundwork for Obama to move beyond the distortions which Republicans have used in framing issues:

What the cynics fail to understand is that the ground has shifted beneath them – that the stale political arguments that have consumed us for so long no longer apply.  The question we ask today is not whether our government is too big or too small, but whether it works – whether it helps families find jobs at a decent wage, care they can afford, a retirement that is dignified.  Where the answer is yes, we intend to move forward.  Where the answer is no, programs will end.  And those of us who manage the public’s dollars will be held to account – to spend wisely, reform bad habits, and do our business in the light of day – because only then can we restore the vital trust between a people and their government.

Republicans have tried to portray themselves as defenders of liberty by making the argument that they are supporters of smaller government and this is what makes us free. In reality, Republicans did not provide smaller government as even Willam Kristol recently admitted,  and size of government is a poor measure of freedom compared to looking at what government actually does.

Obama continued to debunk the false choices offered by Republicans :

Nor is the question before us whether the market is a force for good or ill.  Its power to generate wealth and expand freedom is unmatched, but this crisis has reminded us that without a watchful eye, the market can spin out of control – and that a nation cannot prosper long when it favors only the prosperous.

He also debunked the false choice of security or liberty which the Republicans have  used to justify their actions which ultimately made us less secure and less free:

As for our common defense, we reject as false the choice between our safety and our ideals.  Our Founding Fathers, faced with perils we can scarcely imagine, drafted a charter to assure the rule of law and the rights of man, a charter expanded by the blood of generations.  Those ideals still light the world, and we will not give them up for expedience’s sake…

Recall that earlier generations faced down fascism and communism not just with missiles and tanks, but with sturdy alliances and enduring convictions.  They understood that our power alone cannot protect us, nor does it entitle us to do as we please.  Instead, they knew that our power grows through its prudent use; our security emanates from the justness of our cause, the force of our example, the tempering qualities of humility and restraint.

Obama rejected the belief of many on the right that this is a Christian nation and that the power of government can be used to impose their views upon all:

For we know that our patchwork heritage is a strength, not a weakness.  We are a nation of Christians and Muslims, Jews and Hindus – and non-believers.

Obama defended the rights not only of those of different religions, but of non-believers, recognizing that under the secular government developed by our founding fathers, religious views must not be used alone to form public policy.

Obama managed to avoid sounding confrontational or controversial while quickly demolishing the bogus arguments used by conservatives to justify their attempts to destroy the American we remember.