Liberal doctors, healthcare crackdown

Two related stories on a deeper level, though not on the surface.

First, new doctors are more politically liberal than their seniors.

Doctors were once overwhelmingly male and usually owned their own practices. They generally favored lower taxes and regularly fought lawyers to restrict patient lawsuits. Ronald Reagan came to national political prominence in part by railing against "socialized medicine" on doctors' behalf.

But doctors are changing. They are abandoning their own practices and taking salaried jobs in hospitals, particularly in the North, but increasingly in the South as well. Half of all younger doctors are women, and that share is likely to grow.

Nobody's asking doctors to take vows of poverty, even after paying off med school loans. But, the idea that being a doctor is a great way to be your own small businessman? I hope that's falling by the boards with these changes, and doctors like this are becoming fewer:

“People who are conservative by nature are not going to go into the profession,” said (Dr. Kevin S. Flanigan, a former president of the Maine Medical Association), “because medicine is not about running your own shop anymore.”

As Dr. Atul Gawande just told Harvard Medical School graduates, medicine is becoming more and more a team-based enterprise.

Everyone has just a piece of patient care. We’re all specialists now—even primary-care doctors. A structure that prioritizes the independence of all those specialists will have enormous difficulty achieving great care.

All we need now is for med schools to stop charging tuition as though an MD were a super-MBA.

===

The other, related issue?

The feds are looking at cracking down on healthcare company CEOs for negligence that fails to detect fraud by underlings.

Now, on top of fines paid by a company, senior executives can face criminal charges even if they weren't involved in the scheme but could have stopped it had they known. Furthermore, they can also be banned from doing business with government health programs, a career-ending consequence.

This, too, says that medicine needs to become more about medicine, and about team-based medicine, not big business.

That's why some libertarians, and many of us liberals, see healthcare as like a utility, and single-payer national healthcare as the best way of meeting that.

That said, the utility privatization wave of the past decade has undermined that analogy.

Liberal doctors, crackdown

Type your summary here Type rest of the post here

2012 for home prices to hit bottom?

Housing analysts who talked to the Associated Press many not be quite as gloomy as those who talked to the New York Times yesterday, but they're not a load of joy.

The AP has says it may be 2012 until the housing market bottoms out, in a good story that looks at the broader effects of the housing bubble. It also mentions the foreclosure fraud committed by mortgage signing services, a fraud the banksters don't want to accept any responsibility.

Also worth noting is the spread of problem to new areas:

(T)he damage is now spreading to areas that had long escaped the worst of the crisis. They include Dallas, Denver, Minneapolis and Cleveland. Economists regard them as housing bellwethers — metro areas that are reliable indicators of where national prices are headed.

Denver and Dallas are on pace to hit post-housing bust lows in the next few months.

Yet more reason why we should look askance at Rick Perry's boastful talk of Texas' economic miracle.

Non-Gang Green enviros: #CBD at least has down side

While I applaud a group like the Center for Biological Diversity for not sucking up to the Democratic Party, and for playing hardball as needed, some of its tactics do fuel pushes for tort reform, and give environmentalism a black eye.

Losing a $600K suit for defaming a rancher by claiming photos of a dirt parking lot were allegedly his denuded grazing allotment? And, the legal fees CBD gets undercutting Interior Department's funds for endangered species protection?
Amos Eno runs the hugely successful Yarmouth, Maine-based Resources First Foundation, an outfit that, among other things, assists ranchers who want to restore native ecosystems. Earlier, he worked at Interior's Endangered Species Office, crafting amendments to strengthen the law, then went on to direct the National Fish and Wildlife Foundation. Eno figures the feds could "recover and delist three dozen species" with the resources they spend responding to the Center for Biological Diversity's litigation.

"The amount of money CBD makes suing is just obscene," he told me. "They're one of the reasons the Endangered Species Act has become so dysfunctional. They deserve the designation of eco-criminals."

A senior Obama official had this to say: "CBD has probably sued Interior more than all other groups combined. They've divested that agency of any control over Endangered Species Act priorities and caused a huge drain on resources. In April, for instance, CBD petitioned to list 404 species, knowing full well that biologists can't make the required findings in 90 days."
Hmm. I might have to rethink clicking on all those CBD email action alerts.

Michael Lind, off base on peak oil

Sometimes Michael Lind is great; sometimes he's thought provoking. Occasionally he's irritating. This time, he's all three. He may be right on the abundance of natural gas, but he's "out there" on oil.

In sounding like Daniel Yergin, and in making claims for both crude oil and natural gas that even Exxon won't, he's sounding like a utopian, or Kurzweil, or Michael Shermer.

It's clear that he's overstating the case for future oil reserves. He also, while perhaps quite right on natural gas reserves, overlooks the difficulty of converting an entire infrastructure, and not just an occasional filling station, to natural gas pumping. Finally, he ignores the costs of that, and how much more quickly running cars on natural gas would draw down those reserves.

That said, he is right that hyper-abundant natural gas will put the use of renewables for electricity in doubt. But, if so, especially post-Fukushima, why is he touting nuclear power in the story? He comes off perilously close to being an anti-environmentalist.

Finally, he ignores global warming entirely in this whole long piece. Big fail.

Andrew Leonard, his Salon colleague, has the right reaction today; WTF?

Lind now weakly claims he's "not a global warming denialist." No, just a pooh-pooher of how bad it's going to get.

Right here:

If there were really a clear and present danger of catastrophic overheating ...

Now, "present" isn't in the next 5 years, perhaps. But, a 3F rise by 2050, in the lifetimes of many of us here right now? I'd call that "present" enough. And, catastrophic enough.

Michael Lind, put down the shovel.

Oh, and STOP LYING. Andrew Leonard never called you a global warming denialist, despite your claim in your second column.

California: running out of water as seen from space

California water districts appear (for "good" selfish reasons) loth to accept what a pair of satellites is showing: the state is running low on groundwater.

How bad is it? Over the 2003-2010 period, California drew down nearly enough groundwater to fill Lake Mead, and I'll assume that's full-capacity, pre-bathtub-ring Lake Mead.

Looking at the map, some areas in the southwestern part of the Central Valley, around Tulare, look like they don't have a lot of life left.

That said, I wish the Times had produced a similar map for the Ogallala Aquifer. I doubt West Texans would totally wake up, even then, to the severity of water issues, but maybe some would.

Where data has been presented, though, and not just in California, it's been resisted:

In other areas of the world, like northern India, the novelty of the gravitational measurements — and perhaps the story they tell — has led to pushback, scientists say. ...

John Wahr, a geophysicist at the University of Colorado and his colleague Sean Swenson faced opposition for a study on aquifer depletion in northern India. As Dr. Swenson explained, “When in a place like India you say, ‘We’re doing something that is unsustainable and needs to change,’ well, people resist change. Change is expensive.”

In places on high-tension, water-focused borders, like India-Pakistan, Israel-Palestine-Jordan-Syria and such, this is understandable in a way, but still lamentable.

An interesting sidebar is that the satellites were launched from Russia and some of their data would have been considered classified before the end of the Cold War. A peace dividend!