Donald's Blog

  This old house was only a few blocks from the state Capitol in Madison, Wisconsin. All the neighborhood cats lived in the basement during the winter. The house has long since been torn down, but in 1972 there were AR2ax speakers in the front room, and a lot of good music was heard there.

«May 2012»
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In the 21st century I am just as opinionated as ever, and I now have an outlet. I shall pontificate here about anything that catches my fancy; I hope I will not make too great a fool of myself. You may comment yea or nay about anything on the site; I may quote you here, or I may not. Send brickbats etc. to: dmclarke78@icloud.com.

 

May 31, 2012

Commonplace book

Is God’s being incomprehensible the weightiest reason we can advance for his existence?

The Journal of Jules Renard August 1909

 

May 31, 2012

The latest filler in the news

If we are to have any sort of national health-care service, and if employers are to be involved, then all employers will have to allow the same access, including churches. No individual Catholic will be required to accept advice about contraceptives or anything else of which that church disapproves; hence the worry of the bishops and of Daniel Henninger (in today's Wall Street Journal) about religious freedom is merely yet another phony hot-button issue.
  
      Of course this non-problem would disappear if we could get what most of us want, which is a national single-payer system (Medicare for all) with the employers (and the insurance companies) out of it. This is what most other modern nations have; it would be good for the job-creators, it would be cheaper, and it would provide adequate health care for the largest possible number of people. The problem is Congress, which is ignorant and cowardly where it is not corrupt, and which bends over as far as possible to accommodate each special interest. This resemblance to the Weimar Republic frightens me far more than any threat to religious freedom.

 

May 31, 2012

Prostates, death panels and so forth

Tom Perkins is a founding director of a venture capital partnership, and a retired director of Rupert Murdoch’s News Corporation, which owns the Wall Street Journal. Years ago Kleiner & Perkins backed Hybritech, who developed the PSA test, which middle-aged men are now encouraged to get annually. “Life is full of ironies”, Perkins wrote in the Wall Street Journal the other day. It certainly is.

A recent announcement by the U.S. Preventative Health Service can rather simply be summed up: Most men eventually get prostate cancer, but most don’t die from it; those who do are mostly over 75 years of age, so that ends their continuing burden on the public purse. Further, early and prolonged testing is expensive, and can lead to medical complications from biopsy examination.
      Happily I can report that I have successfully completed my 80th trio around the sun. A few years ago my prostate cancer was detected by my annual prostate-specific antigen test: it was of a particularly aggressive type, as revealed by a routine biopsy.

Perkins had surgery, radiation and hormone treatment, and the cancer returned, but has been kept under control, so he is happily scuba diving in Fiji every day, and concludes:

A healthy market-driven free economy leads to innovation and the development of breakthroughs, like the PSA test. A highly taxed and highly regulated economy leads to “Death Panels”, like the U.S. Preventative Health Service.

It’s hard to know where to begin with this farrago of impertinance, but to begin with, Perkins’s cancer was not detected by a PSA test. At least one of the now elderly scientists who isolated PSA many years ago has protested against its use as an indicator of anything at all; a high PSA result can be caused by any number of things.
      A year or so ago my PSA was thought to be slightly elevated, so my very nice young doctor, not a specialist, wanted me to see a urologist, and randomly sent me to someone who had his own clinic ten miles out in a rural suburb, and who immediately wanted me to have a biopsy, but couldn’t tell me why. Ethne and I got the hell out of there in a hurry, passing through a waiting room full of glum-looking middle-aged men, most of whom (I am willing to bet) have a prostate biopsy in their future, no doubt a nice little earner for this particular specialist. We did some research and sought another opinion from a highly regarded doctor attached to the urology department of a large and well-known hospital, who examined me, talked to me, looked at my blood tests and concluded, as we thought he would, that there was no particular reason why I should have a biopsy.
      I am happy that Perkins had a doctor who could take his PSA reading and other factors into account, and who decided that he should have a biopsy, so that he is still alive several years later. I am also happy that he is wealthy enough so that he (or his insurance company) could afford surgery, radiation and hormone treatment, and so that he could spend his declining years scuba diving in Fiji. None of this means however that the U.S. Preventative Health Service would wish to wash its hands of any man with an aggressive prostate cancer, no matter how old he is. (Frank Zappa was not quite 53: his wasn’t caught soon enough.)
      Meanwhile, I have a loved one who lives in the southwestern Unites States, where the public services are low and unemployment is high; she has reached the age where she has her aches and pains, her husband spends a lot of time in a wheelchair, and her grown son has been diabetic since he was about 12. They are underemployed and have no health insurance. I don't know how much scuba diving there is in their trailor park, but I'm sure they wish they had a government agency looking after them.