“The sum of statistical lives saved vastly exceeds the number of actual lives.
Think of all the things that have saved your life. Every breath you take, every heartbeat, every car and lightning bolt that didn’t hit you. Yet, you’re only alive once. Even if we restrict ourselves to the effects of government programs, the total statistical lives saved by all programs is far greater than the population.
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Wyse and Meyer only show one side of the ledger—the reduction in mortality among people who gain Medicare eligibility. On the other side are the statistical lives lost from the people the money is taken from, or the programs cut.
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Counting statistical lives saved or lost is a debased currency, because it counts each actual life multiple times. And citing only the good side of the ledger makes it impossible to evaluate.
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after the Medicaid expansion, total expenditures increased by more than $1 trillion. That spending also costs statistical lives
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the money could have remained in taxpayers’ bank accounts, which also could promote good health. Mortality declines with income. Even if the Medicaid expansion were a cost-effective way to improve mortality, you have to consider the other side of the ledger.
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The lifesaving medical measures with the biggest impact, such as vaccinations and antibiotics, are relatively cheap. The Medicaid expansion may have relieved financial stress and made the program’s beneficiaries more physically comfortable, which are better criteria for evaluating its impact.
Now consider the 2013 NEJM study trumpeted by conservatives, which examined various health measures. It found that Medicaid enrollment resulted in large and statistically significant improvements in patients’ subjective estimates of their health and quality of life, as well as significant reductions in their financial stress. But it did not find a statistically significant impact on mortality.
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The two studies are more valuable in combination than individually. The NEJM study had the advantage of random assignment and detailed individual data. The NBER paper had a much larger sample size and time interval. Both found significant benefits to Medicaid recipients, although they did not establish that these benefits were any greater than could have been obtained by simply giving each recipient several thousand dollars per year. Neither study convincingly answered whether Medicaid improved health or saved statistical lives.”
Work requirements on Medicaid will rob many people of health insurance because many will fail to do the burdensome paperwork to prove they are working.
Doctor has seen people die from preventable ailments because the people couldn’t afford to get care.
“Tillis — who voted against the bill in a key procedural vote Saturday night and announced Sunday he would not run for reelection — delivered a scathing rebuke of the president’s agenda-setting bill in a Senate floor speech, explaining his position and pledging to withhold his vote unless his concerns about drastic cuts to Medicaid are addressed.
“What do I tell 663,000 people in two years or three years, when President Trump breaks his promise by pushing them off of Medicaid because the funding’s not there anymore, guys? I think the people in the White House … advising the president are not telling him that the effect of this bill is to break a promise,” Tillis said in his floor speech.”
The Republican claim that their bill’s Medicaid cuts won’t take away people’s health insurance because people will get employer health insurance is either spoken out of dishonesty or ignorance. Many people on Medicaid will not be able to get a full time job that supplies benefits like health insurance. They will be paid little and not receive health insurance. Medicaid expansion has not shown to increase unemployment.
Medicare Advantage private health insurance companies have a strong say in whether someone gets elevated medical care. They have the incentive to see you as healthier than you are so they don’t have to pay for Medical care. Whistleblowers say that United Healthcare has said something like ‘they are old anyways, so maybe no one will notice’.
United Healthcare apparently illegally incentivized nursing homes to give United Healthcare leads so the insurance company can sell old people products. Families have complained that their loved ones were sold products when the elderly family member was not capable of making such a decision.
“If enacted across the board, Trump’s order would mean pharmaceutical companies must sell drugs to Americans at the lowest prices they were offering anybody else in the world.”
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“Americans do pay significantly more for prescription drugs than people in other developed nations, but the reasons for that are more complicated than Trump suggests.
“There are many good reasons why we should pay more for earlier access to new medications than our trading partners,” wrote Darius Lakdawalla and Dana Goldman of the University of Southern California’s Schaeffer Institute for Public Policy & Government Service. “As the world’s largest market for pharmaceuticals, America finds itself in the unique position of accruing the lion’s share of the benefits from new medicines. We often recoup these additional costs in the form of longer and healthier lives.””
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“”facing a choice between deep cuts in their U.S. pricing or the loss of weakly profitable overseas markets,” the companies may simply exit foreign markets altogether, “leaving U.S. consumers with the same prices, pharmaceutical manufacturers with lower profits, and future generations with less innovation.””
Twenty-six U.S. states have banned certain medical interventions for children with gender dysphoria. In a free country, the barrier for straight up banning a medical intervention needs to be very high. The evidence needs to be overwhelming that such interventions are bad—that they do far more harm than good. That is not the case for puberty suppressing drugs, hormone replacement therapy, or even surgery. Such bans are an insult to liberty and should be removed.
If a doctor, parent, and child, all agree that a particular medical intervention is the best solution for their problem, then who the Hell is the government to stop them? Who the Hell are you to stop them? It doesn’t matter how you feel about transgenders, unless such interventions are clearly net bad for patients to the point where no reasonable person would perform them, they should not be banned.
There are lots of studies on transgender interventions, and there is some evidence that puberty suppression, hormones, and/or surgery help children and adolescents with their gender dysphoria, their quality of life, depression, and even lessens their chance of suicide. Unfortunately, that evidence is mixed and the studies are far from conclusive. Researchers on both sides seem biased and exaggerate the quality of evidence for their positions while undervaluing the evidence in favor of other positions.
The evidence is mixed enough that doctors and parents need to approach such decisions with a heavy dose of caution. The burden of evidence for stopping, and especially changing, a child’s natural puberty needs to fall on the intervention. If doctors are negligently transitioning kids who should not be transitioned, then those doctors should be charged and sued under normal medical malpractice or negligence laws. We don’t need to ban procedures to enforce basic medical law.
I strongly encourage parents and medical professionals to be careful about transitioning children, and for parents to get second opinions from different-thinking doctors. The evidence in favor of such interventions is quite modest, and it’s hard to tell which children are more likely to benefit from them. Nevertheless, such decisions should be in the hands of the parents, doctors, and the children, not the government. We are not truly a free country if medical interventions can be banned on such weak justifications.
What the Science on Gender-Affirming Care for Transgender Kids Really Shows Heather Boerner. 2022 5 12. Scientific American. https://www.scientificamerican.com/article/what-the-science-on-gender-affirming-care-for-transgender-kids-really-shows Mastectomy John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/breast-cancer/mastectomy#:~:text=A%20mastectomy%20is%20surgery%20to,a%20high%20risk%20for%20it. Correction: Access to gender-affirming hormones during adolescence and mental health outcomes among transgender adults Jack L. Turban et
“Five months later, federal health officials, industry executives and the public health community say they’re more worried than ever.
Kennedy in his first seven weeks atop the Department and Health and Human Services has dramatically reshaped the U.S. health apparatus, eliminating entire agency divisions, abruptly shifting policy priorities and leaving the sprawling department in what six current and former employees described as an unprecedented state of upheaval.
The health secretary and his team forced out top scientists in charge of developing new vaccines and evaluating the safety of medicines, stripping away centuries of collective expertise and institutional knowledge. Government offices that manage key functions like ensuring safe drinking water and alerting Americans to contaminated drugs have been decimated.
In the meantime, Kennedy appointees have sought greater control over scientific decision-making in agencies such as the Centers for Disease Control and Prevention and Food and Drug Administration — going against longstanding norms and roiling a health sector that accounts for nearly one-fifth of the U.S. economy.
“It’s a mess,” said one former senior HHS official granted anonymity to discuss internal matters. “What was once a very robust place to work, that was trying to lead on innovation, is gone. It’s just gone.”
The rapid overhaul, punctuated by last week’s mass firing of 10,000 employees, has left the HHS workforce traumatized and the broader health community in deep distress, according to interviews with nine current and former health officials, as well as five other public health experts and industry officials, most of whom were granted anonymity for fear of retribution.”
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““They got rid of all the people who made the place work,” said one health official. “It doesn’t seem to be achieving their aims. Unless their aim was just to cause chaos and torpedo morale.””