• Dr. Anthony Youn, a plastic surgeon in Detroit, comments on a recent report that found many doctors unsatisfied with their level of income, offering a personal experience to illustrate one reason why doctors are frustrated with their salaries. If Dr. Youn’s experience is commonplace, it’s a profound injustice–doctors save our lives and just like anyone else who performs a service for us, we owe them payment in return.
• Sarah Kiff of the Washington Post describes a new online service by which patients can comparison shop for health care—the site allows you to compare the prices doctors are charging and lets you see how patients have rated their doctors.
• A recent study found that two drugs—Avastin and Lucentis—do an equally good job of treating those with age-related macular degeneration (AMD), an eye disease in the elderly that can lead to blindness. The study was requested by the government because a dosage of Avastin costs far less than a dosage of Lucentis, so if the drugs are equally effective, requiring physicians to prescribe Avastin for AMD can save Medicare a lot of money. The article notes, however, that Avastin users in the study suffered more complications than Lucentis users, and manufacturers of the drugs maintain that the two compounds are different enough that some patients may benefit from one while others may benefit more from the other. If you are an AMD patient who might fare better with Lucentis, you’re out of luck if the government mandates only Avastin can be used to treat the ailment. This kind of conflict inevitably occurs when the government is paying for your health care and so it gets to decide which treatments it will pay for. If seniors were responsible for funding their own care, they could purchase whichever treatment that, in consultation with their physician, looks the most promising for them.
• A fascinating article in the New England Journal of Medicine about how surgical techniques have evolved and improved in the last 200 years.

• Freedom, Dependency, and the Avengers
• Yaron Answers: Is Apple Exploiting Chinese Workers?
• Why Making Altruism Voluntary Can’t End the Entitlement State

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• Why We’re Born Poor and Why Some Become Rich
• A Desperate Defense of Capitalism?
• The Soul of Occupy Wall Street: Part 1 and Part 2

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• Legislators and health care leaders are trying to figure out what to do about the shortage of physicians in Arizona. Whenever I hear about a lasting shortage, I suspect government interference in the marketplace because shortages don’t last very long on a free market (check out my post from earlier this year about how government controls in the drug market are contributing to the severe shortage of critical drugs). When it comes to physician supply, as this article points out, the government is very much involved—for example, the federal government funds most residency slots and has capped the number of slots for the last fifteen years.
• Businesses are learning that ObamaCare will substantially increase their health care costs and some may consequently drop coverage for their employees (at least 30% of employers are expected to do this ).
• Grace-Marie Turner of the Galen Institute details some of the latest concerns with ObamaCare, including how it is contributing to the student loans crisis making headlines recently.
• It’s widely recognized that Medicare, Medicaid and Social Security are in fiscal crisis. This New York Times article highlights another, lesser known entitlement program that is on the verge of collapse: disability insurance.

During the Iraq war — especially during the “surge”– battalion commanders were “were allocated packets of $100 bills and authorized to use them for anything from repairing a schoolhouse to paying off ex-rebels and paying blood money to the families of innocents killed by U.S. forces.” Washington poured as much as $4b into this kind of effort to “improve relations” with Iraq. There’s a lot wrong, in my view, with paying off “ex-rebels” to stop killing Americans, and in my book I criticized this tactic at length. At the time it was hailed as a stroke of military genius. From a new audit of the Commanders Emergency Response Program (CERP), we learn that: “the report is detailed evidence that at least a portion of CERP in Iraq may have fed the insurgency these funds were aimed at stopping.”

Here’s another angle on what our policy bought us in Iraq.

img: flickr/U.S. Army

But the problem is the FDA itself, not its current budget.

The FDA has no business coercively keeping drugs, devices and other therapies off the market before it deems them worthy. By what right does the FDA force innovative companies like Regenerative Sciences to take a “time out” on the procedure they spent years developing and testing so that the FDA can play catch-up to the new technology? By what right does the FDA make it illegal for Americans to use their own cells until bureaucrats give permission?

The FDA, by its nature, treats innovators as guilty until proven innocent—what’s a bigger extinguisher of innovation, in terms of the costs and time involved for gaining regulatory approval, than that? And the FDA forces the rest of us to abide by its collective edicts, rather than our own doctors’ assessment of risks and benefits in our own, individual medical circumstances.

According to Eschenbach, “Regulatory approval is the only bridge between miracles in the laboratory and lifesaving treatments.” It’s time to dismantle that bridge and establish a system by which the government puts on trial only cases of demonstrable fraud, not all promising therapies.

• Don’t Mess With Prices
• What To Do About Social Security
• It’s the Spending, Stupid

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A court found Egypt’s most popular comic actor guilty on Tuesday of insulting Islam in roles in films mocking religious hypocrisy. . . . Mr. Imam [the actor] was convicted for performances in the blockbuster films “The Terrorist,” in which he plays a radical Islamist hiding among a moderate, middle-class family, and “Terrorism and Kabab,” in which his character becomes enraged at a lazy civil servant pretending to pray to avoid work. [NYT]

First, for context, let’s recall that Egypt was far from a bastion of freedom of speech. But it’s the political ascendancy of Islamist parties there that makes this story particularly notable. Likely the Islamists will crack down (even more severely than Mubarak did) on speech; one faction has signaled as much. Since the actor was seen as “a Mubarak friend,” however, it’s also possible this was payback: a settling of some old score by a faction of the interim military regime against a loyalist of the former ruler. These, then, are the depressingly limited political alternatives in Egypt: Islamists hostile to freedom, or  a dictatorial military clique hostile to freedom. Neither bodes well for U.S. interests.  (For more on the political culture of Egypt, you may be interested in a new interview that Yaron Brook and I did for the Whitehead Journal.)

• The individual mandate is already in effect in Massachusetts, as part of its 2006 health care reform legislation (upon which ObamaCare is based). Everyone must carry a policy, and most employers must pay for their employee’s coverage. If an individual does not have insurance, he is fined. If an employee does not accept the coverage his employer is offering, the employer is also fined. This New York Times article explores the consequences of these policies on Massachusetts residents and employers.
• Greg Scandlen of NCPA considers whether the fee-for-service system in health care, by which health care professionals are paid for each service they perform, inherently raises health care costs—an argument made by many.
• Veterinary medicine has seen rapid innovation in the last few years. This article describes some of the amazing advances that have been made and then considers whether the costs are worth it. In my view, the beauty of veterinary medicine is that each pet parent is in the position to decide for himself whether a particular treatment is worth doing for his pet. The American health care system is the opposite. Whether a treatment for your child is worth the cost is determined mostly by third parties, like insurers and the government. This is because they, not you, are footing most of the bills.
• More and more hospitals are developing secondary emergency rooms that serve only senior citizens, in order to better accommodate aging baby boomers and to comply with ObamaCare regulations. These ERs are often lavish, with one offering the option to communicate with your nurse via a hospital-provided iPad.

Dr. Brook and Mr. Journo discussed, among other things, why Iran is a significant enemy to America and how we should respond to its threat, whether, as some insist, Saudi Arabia is really America’s ally, and if our use of oil serves to enrich our enemies.

The full text of the interview is here (PDF).

At the launch event for this issue in March, Elan Journo took part in a panel discussion at Seton Hall University in which he discussed how the U.S. should respond to “Arab Spring.” Mr. Journo’s fellow panelists were Alon Ben-Meir of New York University and Paul Sullivan of Georgetown University. The event was moderated by David A. Andelman, who is the editor of World Policy Journal.

image: flickr/cc