Obama’s Doctor Discusses How Insurance Companies Interfere With Medical Decisions


Dr. David Scheiner, Barack Obama’s personal physician for twenty-two years (and an advocate of a single-payer system) was interviewed by CNN. He discussed ways in which insurance companies make it difficult for doctors:

You’ve said in interviews that insurers are making it increasingly difficult for doctors to do their jobs. Can you give some examples?

I’ll give you two. I have a patient with bipolar disorder whose psychiatrist is no longer in her insurance company’s panel. She is heartbroken that the insurance company won’t pay to let her see the doctor.

I have another patient with obvious sleep apnea. I ordered a sleep study on him. The insurance company knows he needs it but has made life miserable for him. They are making him wait to get their approval, hoping he won’t bother with it.

Insurance companies are making it more difficult for doctors to get preauthorization for treatments because they are hoping it will discourage people from getting expensive treatments.

Insurers also tell us what hospitals we can admit patients to and what subspecialists we can refer our patients to. They are telling me how to do my job.

As a doctor, how do you get around these challenges and ensure that your patient still gets the treatment they need?

Well, if you know that an insurance company is going to deny coverage, you word your request in such a way that will be more medically acceptable to them. I try to use certain buzz words that I think will help the patient get approval for a treatment. Insurers have no reason to question what I need for my patient, but they do.

Bureaucrats, in this case from the insurance companies, interfere with the decisions made by doctors and there are unnecessary delays in having tests and treatment. Many of the scare stories from the right are true, except the problem is often the insurance industry, not “socialized medicine” in their attempts to “ration” care to save money.

Posted in Health Care. Tags: . 8 Comments »

Richard Dawkins Explains the Evidence for Evolution

51U7X4lEa4L._SL500_AA240_P.Z. Myers has reviewed Richard Dawkins’ new book, The Greatest Show on Earth, for Seed Magazine:

While our public schools are failing to educate people about the science of biology, the barrier to picking up the basic information has never been lower. These books are wonderfully written, easy to absorb, and great at communicating the basic principles; an interested person can pick up one and in a few evenings of pleasant reading get a good idea of why evolution has been such a powerful idea in biology.

Ah, if only the problem of creationism could be solved as easily as simply handing out copies of Richard Dawkins’ latest book…but it’s a necessary preliminary. Most of the critics of evolution don’t have the slightest idea of the principles of the theory (I’m always being told that it’s entirely about chance conjuring complex organisms into existence, the old “tornado in a junk yard” canard) and certainly have no knowledge of the multiple lines of detailed evidence that support evolution. Creationists assert that there are no transitional fossils, for instance, so we have to show them a few hundred. They don’t understand how the sequence data is only comprehensible if organisms are related, so we have to explain genes and genomes.

Richard Dawkins talks about reaching the fence-sitters, and education is an important first step. When I get into an argument with a confirmed creationist, someone who is clearly not sitting on the fence, I’m not trying to convince that person—I’m trying to reach all the others who are listening in. If an opponent throws out a claim that is patently a product of abysmal ignorance—such as, “If evolution is true, then why are there still monkeys?” or “The Cambrian explosion was a sudden event that can only be explained by the work of a designer”—it’s very helpful if the audience is already aware of how silly those arguments are; it spares me time that otherwise has to be spent addressing the most elementary basics, and suddenly, the creationist is looking very, very ill-informed. It’s great!

Seed previously interviewed Dawkins about the book here. A portion of the interview:

Seed: This book provides evidence for evolution. What’s the best way to make a case to someone who is undecided?
RD: I try to speak about it in terms of history, of a kind of detective story where you have to decipher from clues what has happened—but on a timescale that is far longer than we can observe. People can see how a white moth can become a black moth—that’s not a problem. It happens on a human timescale. But seeing how a fish can become a mammal, that’s something else entirely. The sheer length of time involved is a great barrier, so couching it in terms of a historical puzzle helps.

Seed: What’s a frequent mistake people make in arguing against evolution?
RD: You often find people who say, well, evolution is a theory of chance, in the absence of a designer. If it really were a theory of chance, of course they would be right to dismiss it as nonsense. No chance process could give rise to the prodigy of organized complexity that is the living world. But it’s not random chance. Natural selection is the exact opposite of a chance process. I’ve dedicated a number of my other books to showing that it is not.

Seed: Making this detective analogy, where one convinces by force of evidence, where do the strongest facts come from?
RD: Comparative molecular genetics. It is a remarkable fact that all living creatures that have ever been looked at have the same genetic code. The machine code of life is the same, wherever we look. And when we look at particular genes in any one animal, we can find the same genes in other animals—almost the same, but with a few differences, which we can actually count.

And the wonderful thing is that you can find genes that are shared not just among very similar animals like humans and chimpanzees, but also among more distant animals like humans and fish, or humans and snails. And again, we can count the differences—literally count—just as you can count the number of letters by which two versions of the same written text differ. This gives you a measure of the similarity/difference between any one species and any other.

When you examine the pattern of resemblances between pairs of animals and plants, you find that it makes a perfect hierarchical tree. The only sensible interpretation of this tree is that it is a family tree: The tree of evolutionary relationships. This is, in my opinion, the most compelling evidence there is—especially given that different genes give the same tree.

Posted in Evolution. Tags: , . 1 Comment »

Mixed Assessment On Preventive Detention

The Obama administration has announced it will use current law to justify the indefinite detention of about 50 terrorism suspects being held without charges as opposed to seeking a new law.  Putting this in perspective, Glenn Greenwald calls this an incremental, perhaps only cosmetic, improvement. He does find some positives in this:

Regardless of what motivated this, and no matter how bad the current detention scheme is, this development is very positive, and should be considered a victory for those who spent the last four months loudly protesting Obama’s proposal.  Here’s why:

A new preventive detention law would have permanently institutionalized that power, almost certainly applying not only to the “war on Terror” but all future conflicts.  It would have endowed preventive detention with the legitimizing force of explicit statutory authority, which it currently lacks.  It would have caused preventive detention to ascend to the cherished status of official bipartisan consensus — and thus, for all practical purposes, been placed off limits from meaningful debate — as not only the Bush administration and the GOP Congress, but also Obama and the Democratic Congress, would have formally embraced it.  It would have created new and far more permissive standards for when an individual could be detained without charges and without trials.  And it would have forced Constitutional challenges to begin from scratch, ensuring that current detainees would suffer years and years more imprisonment with no due process.

Beyond that, as a purely practical matter, nothing good — and plenty of bad — could come from having Congress write a new detention law.  As bad as the Obama administration is on detention issues, the Congress is far worse.  Any time the words “Terrorism” or “Al Qaeda” are uttered, they leap to the most extreme and authoritarian measures.  Congress is intended to be a check on presidential powers, but each time Terrorism is the issue, the ironic opposite occurs:  when the Obama administration and Congress are at odds, it is Congress demanding greater powers of executive detention (as happened when Congress blocked Obama from transferring Guantanamo detainees to the U.S.).  Any process that lets Lindsey Graham, Joe Lieberman and Dianne Feinstein anywhere near presidential detention powers is one that is to be avoided at all costs.  Whatever else is true, anyone who believes in the Far Left doctrines known as the Constitution, due process and what Thomas Jefferson called “the only anchor ever yet imagined by man, by which a government can be held to the principles of its constitution” (i.e., jury trials) should consider it a very good thing that the Congress is not going to write a new law authorizing presidential preventive detentions.  However bad things are now, that would have made everything much worse.

This assessment comes a day after Greenwald called yesterday’s announced changes to the state secrets policy a “farce.”