Monday, July 13, 2009

Liberal Values

Liberal Values

Profitability And Private Insurance

Posted: 13 Jul 2009 08:54 AM PDT

Medicare Advantage programs receive 13% to 19% more to take care of Medicare patients than is paid through the government program. I just had a patient come in saying that their Medicare Advantage plan will stop operating as of January as they no longer find it profitable despite these higher payments. There was also another plan which I had patients in which stopped operating as of January of this year. I’m glad to hear that they are going away as a few times they have refused to pay for lab tests which were needed, and which Medicare would pay for. Most likely their denials were motivated  purely by financial considerations as opposed to medical need.

So much for the greater efficiency of the free market, alon g with the idea that it is government, and not private plans, which “ration” health care.

SciFi Weekend: “Torchwood: Children of Earth”

Posted: 12 Jul 2009 05:34 PM PDT

Instead of a usual thirteen episode season, Torchwood was presented as a five part miniseries for five constructive evenings. Torchwood: Children of Earth was broadcast on the BBC last week and will appear on BBC America later this month as well as becoming available on DVD. The miniseries was a tremendous success both creatively and in terms of ratings and can be enjoyed by those who have not followed the first two seasons. After this recommendation, I must warn that this review contains major spoilers and I recommend that it not be read if you plan to watch the miniseries at a later date.

The miniseries was stronger by having to come up with only one alien menace and having time to both tell the story and develop the back stories of the characters. The romance between Jack and Ianto was further developed, making Ianto’s death in the fourth installment even more shocking. We also saw relatives of both, including Jack’s daughter who appeared older than the immortal Captain Jack, and a grandson. Gwen’s story was advanced as she learned she is pregnant.

The story began with aliens speaking through the children of earth and it came as no surprise to find that the conflict was over the alien desire to take ten percent of the children. As with many science fiction shows it is necessary to enjoy the story without giving too much thought to all the specifics, but such thoughts cannot be helped after wards. If the alien 456 could control the children, it would have been much simpler to have them march off to rendezvous points as opposed to forcing the governments to round them up.

The story had the feeling of The X-Files in dealing with government involvement with the aliens and attempts to cover up their past dealings with them. The decision of the government to kill those with knowledge of their previous deal with the 456  showed questionable judgement but it was easy to believe they would make such a choice. It would have been far smarter to enlist Torchwood to help find a way to fight the 456 as opposed to trying to kill an immortal such as Jack. We saw the members of Torchwood on the run from the authorities, also similar to portions of several seasons of 24.

Torchwood has always been a far darker series than Doctor Who, and this was even more the case with Children of Earth. Sacrifice and loss was a major theme. First Jack watched Ianto die.  Much of the show was seen from the perspective of Frobisher, a civil servant placed on the front lines in dealing with the 456 (primarily as this placed him as opposed to the Prime Minister at risk). The Prime Minister told Forbisher he must publicly turn his children over to the 456 so that others will see this as safe. The cover story was that the children were to receive inoculations to protect them, but actually the 456 use children to extract drugs which bring them pleasure.

Like the decision to try to destroy Torchwood, this was a poor choice as, knowing their fate Forbisher was unlikely to comply and might have jeopardized the transfer by going public with is knowledge. It is also questionable if seeing a  single civil servant send his children for the inoculations would have calmed any parents who were skeptical. While a poor choice, this was foreshadowed by the attitude of the Prime Minister towards Forbisher in previous meetings.  Instead of  going along, Forbisher killed his children, his wife, and then himself to spare his children the horrible fate. His decision was also ultimately the wrong one as the transfer of the children was stopped.

Stopping the transfer and defeating the children called for yet another sacrifice as a child was needed to beat the 456 by using the children of earth to transmit a reverse of the frequency that the 456 used to control the children. Jack knew the primary child used would die and the only child available at the base where he was working was his own grandson. This sacrifice meant the loss of his grandson, and probably the loss of any chance at reconciling with his daughter.

While this defeated the 456 for the moment, we do not really know whether they remain a threat. We only saw those already on earth be defeated, but we do not know if more will be coming. Perhaps this is just a renegade group after drugs and there are no more to threaten earth. It is also possible that there are other planets where they obtain similar children and, having been defeated on earth, will stick to easier targets. It is also questionable if the deal with the 456 would have turned out well. The 456 first came in 1965 and settled for twelve children. This time they said they would destroy all life on earth unless they received ten percent of the children. If they broke their promise and returned a second time, it is likely they would return again for more.

The miniseries leaves open the future of Torchwood. The series started with only three surviving members after the events of last season. This year Ianto died, Gwen may or may not continue working after having a child, and the final episode ended with Jack leaving earth. Even their headquarters was blown up. Some see this as the end of Torchwood but, considering the high ratings, I suspect there will be another series.

Most likely Jack will return, perhaps just as a new danger to earth is revealed, and  Gwen will join him. Lois Habiba, who assisted Torchwood during this episode, could easily join the team. Early on I thought that Dr. Rupesh Patanjali (seen in the above video clip) was going to be an addition to Torchwood but he did not survive. Martha Jones could  return if Freema Agyeman is available. They used the excuse of her honeymoon to explain her absence from this episode. If they return with a full season as opposed to a miniseries they could also develop new characters.

While the miniseries worked very well this year, it might be best to return to a regular thirteen episode format to rebuild both their facilities and a new team. If this does turn out to be the end of Torchwood, it was an excellent way to end the series.

Blinded By Hysteria About “Socialized Medicine”

Posted: 12 Jul 2009 10:13 AM PDT

Glenn Reynolds presents the usual conservative hysteria against health care reform.  He brings up the usual nonsense lines that reform will bring about “socialized medicine” as he writes about the benefits of modern health care while ignoring the problem that our system denies such care to tens of millions. He ignores the frustration of  those of us who practice medicine who realize how far we are falling behind the rest of the industrialized world in so many ways.

As I’ve stated many times in the past, you can tell that an article on health care reform is not worth reading when they bring up scare stories about Great Britain as a government run system of this type is not on the table here. The British system is opposed by virtually all supporters of health care reform. His arguments against “socialized medicine” and the British system may or may not be true, but they have no relevance with regards to the current health care debate. Those who rely on scare stories about “socialized medicine” are just avoiding a discussion of the real issues under consideration.

Of particular absurdity is his argument against preventive medicine because of examples where receiving preventive medicine might not have mattered. This has no bearing on the many cases we see of people who do die because they did not receive routine preventive medicine, or did not have coverage for routine treatment of chronic medical diseases.

I had seen this op-ed as not being worth any time commenting on after writing about the absurdity of equating health care reform with socialized medicine so many times in the past. Then I reached the last paragraph:

It’s ironic that the same Democrats who were pushing the medical prospects for stem-cell research during the last election are now pushing a program that will make such progress far less likely.

While the right claims that it is health care reform which will limit health care, this shows just one example how it has really been Democrats who in many ways have been pushing to expand health care choices and reduce interference from restrictive government regulations. Besides stem-cell research, we have also seen this as conservatives have tried to limit or ban abortion and birth control, and their interference in end of life decisions such as with Terri Schiavo.

Reynolds, with his hysteria about “socialized medicine” and lack of understanding of the harm caused by corporate medicine and practices of the insurance industry, sees irony in Democratic support for eliminating the restrictions on embryonic stem-cell research. While his view that health care reform will make such progress any less likely are based upon his irrational views on the health care system, perhaps at least some readers will see his conclusion and question which side is really the one which is responsible for reducing health care choices in this country.
Posted by Ricky at 10:04 AM

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