Weinstein & #metoo & Bret Boes, MD

Weinstein, Rose, Lauer, Spacey, and Trump- these are reprobates for sure. But the complaints are all workplace related. I don’t want this sound like I’m unsympathetic, or that their behavior was OK.

I can’t understand the lack of outrage at a worse case of #metoo. There are predatory physicians all over the United States. These physicians have “consensual” sex with patients. But make no mistake- they’re predators. They’re rapists. Consent is rarely valid when the power differential is as great as the doctor patient relationship.

Yet, no one is addressing this. Take a look at the worst state in the country, Mississippi. Mississippi Medical Board has a nationally-recognized, and justly earned, reputation for for failing in it’s most basic task- protecting patients. Yet, there is no outrage. Why?

Look at 3 recent cases before the medical board:

Bret A Boes, MD- You can read his summons Boes summons and his consent order Boes order. The summons contains 29 pages of charges. It includes approximately 100 counts of distribution of controlled drugs- most amphetamines. It also contains a charge of sex with patients. His consent agreement is essentially an admission to all of the charges. Yet, and here’s the part where  there should be outrage, he received essentially no discipline from the Mississippi Medical Board. He stll has a license. In fact, he’s in practice in Meridian, MS at some place called Anderson Regional Health System. It claims to be a “family values” system- makes me wonder about Mississippi families- and their values.

I’ll talk about some of the others later. Mississippi deserves to be last.

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Sex, Teens, and Indiana

In Indiana, it’s legal for adults to have consensual sex with minors aged 16 and 17. But it’s illegal to sext those same minors, the Indiana Supreme Court ruled this week.

Yes, you read that right. In Indiana the state supreme court has just issued that very ruling. Now, lest you think it’s just dumb judges, the court noted that this was a problem of legislation not the judiciary. One justice wrote:

Whether this inconsistent statutory treatment of minors aged 16 and 17 is advisable with respect to sexually-related activity is a matter for the legislature, and whether Thakar’s alleged conduct violated the Dissemination Statute is a matter for the jury.

Yes, the judges know this is an absurd outcome but they can only scratch their collective heads and enforce the laws the legislature creates and the governor signs (hey, wasn’t Pence the governor there- that explains a lot).

Maybe Indiana just wants to suck as much as Mississippi? A similar case was reported in Texas last year.

Neither runs much risk of overtaking Mississippi though, where it’s still OK for doctors to have sex with patients in exchange for drugs.

“Preservation of a Natural childhood”

Yes that’s really the name (also known as Initiative # 29) of an innocuous sounding, yet insanely stupid idea from Colorado legislators.

The initiative states, in relevant part:

Beginning January 1, 2019, Initiative 29 prohibits retailers from selling or permitting the sale of a smartphone to a person under the age of 13, or to any person who indicates that the smartphone will be wholly or partially owned by a person under the age of 13. Retailers must verbally inquire about the age of the intended primary owner of the smartphone prior to the sale, document the response, and file a monthly report to the Department of Revenue (DOR) that lists the type of phone sold (smartphone or cellular) and the age of the intended primary owner at the time of purchase.

Seriously? The Initiative prompted Greg Pulscher over at FEE.org to comment and his words are insightful and spot on.

Again, seriously? Is there nothing more threatening to the health safety, and welfare of Colorado children than cell phones?

How about obesity? Colorado doesn’t seem to be sure whether it’s children are really getting fatter. One state website notes:

According to the Colorado Child Health Survey, the state’s childhood obesity rate was 14.8 percent in 2004 and 14.6 percent in 2014.
“If Colorado wants to remain the leanest state in the nation and become the healthiest, we need to start with our youngest residents,” said Dr. Larry Wolk, chief medical officer and executive director of the Colorado Department of Public Health and Environment. “Fortunately, we have dedicated parents and partners across Colorado who are working with us to make sure Colorado kids can get the nutritious food and physical activity they need.”
But, as usual, when we dive into the data we see why Colorado might be getting concerned:
Screen Shot 2017-07-16 at 5.26.34 PM
As is the usual case- governments begin to care when a disease threatens white people. Here we can see the number of overweight/obese white, non-hispanic children at 22.7%. If this number grows then this will be a “state calamity.”
Similarly, rich people don’t see this as a problem, yet:
Screen Shot 2017-07-16 at 5.31.25 PM
As we might guess, all of the markers for economic success show a negative correlation with weight.
Yet, another state website seems to indicate Colorado children are getting fatter.
Obesity is a complex, serious and costly public health problem that’s on the rise everywhere in the United States, and Colorado is no exception. Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death.
Yes, there are far more important things Colorado could do. But it won’t, not yet.

People will die!

Check out this video:

Hyperbolic but you get the picture.

Reprinted from another blog:

This is a common cry from politicians, the press, and consumers- especially in relation to the Affordable Care Act. The simple fact is that all of the “expected deaths” associated with losing “Obamacare” are going to happen anyway. Sorry but there’s nothing magic about having health insurance that endows an individual with immortality. Each and every one of those patients will die.

The better question, and the on no one wishes to address, is how much will an average person’s life be shortened by the loss of health insurance. It is absolutely true that health insurance is not the same as healthcare. Having an insurance you cannot afford to use is the same as not having insurance. Further, having an insurance that no provider will accept is essentially the same as having no insurance at all. In many ways an insurance policy no one accepts is worse than no insurance at all. If saddled with such a policy an individual has paid premiums but no may be subjected to uncontrolled out of pocket expenses to see a “non-participating” provider.

It’s time to move away from the rhetoric and start addressing the real issues of healthcare not the pseudo-issue of insurance. Insurance is merely doctor-speak for “pay me.”

This is a common cry from politicians, the press, and consumers- especially in relation to the Affordable Care Act. The simple fact is that all of the “expected deaths” associated with losing “Obamacare” are going to happen anyway. Sorry but there’s nothing magic about having health insurance that endows an individual with immortality. Each and every one of those patients will die.

The better question, and the on no one wishes to address, is how much will an average person’s life be shortened by the loss of health insurance. It is absolutely true that health insurance is not the same as healthcare. Having an insurance you cannot afford to use is the same as not having insurance. Further, having an insurance that no provider will accept is essentially the same as having no insurance at all. In many ways an insurance policy no one accepts is worse than no insurance at all. If saddled with such a policy an individual has paid premiums but no may be subjected to uncontrolled out of pocket expenses to see a “non-participating” provider.

It’s time to move away from the rhetoric and start addressing the real issues of healthcare not the pseudo-issue of insurance. Insurance is merely doctor-speak for “pay me.”

In most cases, vast majority of lifetime healthcare spending occurs in the last 6-12 months of life. As near as I can tell everyone has to live through those terrible months. Thus everyone will have large expenditures at some point.  

In many respects MIT economist Jonathan Gruber was exactly correct. Without including the healthy, at substantially inflated premiums, there is no way to keep premiums down for those who are sick. But isn’t that the nature of insurance? Isn’t insurance risk-based premiums? When organizations lobby for limited premium differentials, in spite of clear cut risk differentials, insurance companies oblige and raise all the rates.

Washington needs to wise up and realize legislators are fixing the wrong problem. Insurance isn’t the problem. Access is the problem. Cost is the problem.