How American Healthcare Killed My Father: Q&A with David Goldhill

 

David Goldhill is the head of the Game Show Network – and one of
the most-lucid analysts and unforgiving critics of the American
health care system.

In this interview, produced by Reason TV’s Jim Esptein and
conducted by Kmele Foster, Goldhill talks about his must-read new
book,
Catastrophic Care: How American Health Care Killed My Father–and
How We Can Fix It
,
what’s wrong with Obamacare, and much
more. If you care about the future of medicine and insurance in
this country, watch this interview.

Released on Friday, November 1. Read the original writeup and
get more info by clicking below.

In 2007, David Goldhill’s father was admitted to a New York City
hospital with pneumonia, and five weeks later he died there from
multiple hospital-acquired infections. “I probably would have been
like any other family member dealing with the grief and disbelief,”
says Goldhill, a self-described liberal Democrat who is currently
the CEO of the Game Show Network. “But,” as Goldhill recounts,

A month later there was a
profile
 in The New Yorker of physician
Peter Provonost, who was running around the country with fairly
simple steps for cleanliness and hygiene that could significantly
reduce the hospital-acquired infection rate, but he was having a
hard time getting hospitals to sign up for this. I had helped run a
movie chain, and we had a rule that if a soda spilled, it had to be
cleaned up in five minutes or someone got in trouble. And I thought
to myself, if we can do that to get you not to go to the theater
across the street, why are hospitals having such a hard time doing
simple cost-free things to save lives?

That’s how Goldhill first got interested in the economics of the
American health care system. In 2009, he published a
much-discussed article in The
Atlantic
, which he has now expanded into a book,
titled Catastrophic
Care: How American Health Care Killed My Father–and How We Can Fix
It
.

Goldhill argues that the major problem in health care is a
system of incentives that puts most of the purchasing power in the
hands of insurance companies and the government, while cutting
patients out of the equation. This system isn’t just costing us a
lot of money, it’s killing us. As Goldhill explains, there’s a
direct link between the way we pay for health care and the
estimated 100,000 patients in the U.S. who die every year from
infections they picked up in hospital.

Reason TV Contributor Kmele Foster sat down with Goldhill to
discuss the problems in our health care system and why turning
patients back into customers will go a long way towards solving
them.

Produced, shot, and edited by Jim Epstein. Additional camera by
Anthony Fisher.

About 30 minutes.

Scroll down for downloadable versions and subscribe
to Reason TV’s
YouTube Channel
to receive automatic updates when new material
goes live.

from Hit & Run http://reason.com/blog/2013/11/02/how-american-healthcare-killed-my-father
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The Government’s Cheap, Dishonest Campaign Against the Chinatown Bus Industry: Jim Epstein in The Daily Beast

Customers line up in NYC's Chinatown to board a Lucky Star bus. |||

I have an article up at The Daily Beast looking at how
the government’s forced shut down of
two Chinatown bus companies was based on fabricated evidence.
Here’s how it 
begins:

On May 20, 2013, a passenger motor coach run by a Chinatown bus
company called Lucky Star departed New York City for Boston’s
SouthStation. Shortly after hitting the road, the driver heard
a strange bang come from under the bus. The bus seemed to be
functioningnormally, so he kept going.

Upon arriving in Boston, the driver was shocked to find a New
York City manhole cover lodged in the vehicle’s luggage
compartment. Apparently, the bus struck the loose cover in the
streets of Manhattan, sending it darting up into the vehicle’s
undercarriage. Lucky Star immediately took the bus out of service
and sent it to the garage for repairs.

The following month, the Federal Motor Carrier Safety
Administration (FMCSA) ordered Lucky Star to cease operating
on the grounds that its buses and drivers posed “an imminent hazard
to public safety.” One of the primary reasons the FMCSA gave for
the shutdown was the manhole cover incident. But the out-of-service
order, which is the official document revoking the company’s
operating license, incorrectly states that after discovering the
damage, Lucky Star’s dispatcher kept the vehicle out of the garage
and continued sending it on passenger trips in an act of willful
negligence.

The false account of the manhole cover incident is just one of
many distortions and inaccuracies that appear in the out-of-service
order, according to multiple sources familiar with the
investigation. (FMCSA spokesperson Duane DeBruyne declined to
comment for this article.) The case of Lucky Star, a well-run
company with a nearly spotless accident record, is the latest
example of how the government’s stepped-up safety regime is
destroying small bus companies to the benefit of large,
politically-connected corporate carriers, and in the process making
American travelers less safe.


Read the whole thing.

And watch my recent Reason TV collaboration with Naomi
Brockwell, The
Feds vs. The Chinatown Bus
:

from Hit & Run http://reason.com/blog/2013/11/02/the-governments-cheap-dishonest-campaign
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James Poulos Writes In Defense of Guerrilla Street Art

To be a brand name in guerilla street art is to
be in exclusive company. And no one has built a bigger brand
imposing his stencils, spray paintings, and sculptures on the world
than Banksy. Despite the grumbling critiques from both nannyesque
Bloombergians and the kinds of property rights advocates who
sometimes cross swords with the Mayor, James Poulos argues that
unauthorized art invites us to think anew about the place of street
art in our lives.

View this article.

from Hit & Run http://reason.com/blog/2013/11/02/james-poulos-writes-in-defense-of-guerri
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Open Thead: Why the Hell Not? Plus: Subscibe or Die!

It’s been a long
time since we had an open thread. So here’s one. Have at it.

And as long as you’re hanging out here, why not:

Related:
Reason’s founders discuss 45 years of the magazine
.

from Hit & Run http://reason.com/blog/2013/11/02/open-thead-why-the-hell-not-plus-subscib
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Administration Officials Worried Obama's Promise that People Could Keep Their Plans Wasn't Right, and Let Him Make It Anyway

We already know that administration policymakers
were aware that President Obama’s promise that people who like
their plans can keep them under Obamacare was not true, because
estimates built into early regulations indicated that many plans
would lose their grandfathered, protected status.

A
report
in today’s Wall Street Journal indicates that
senior White House advisers were also concerned that the promise
could not be fulfilled, but decided to let the president make it
anyway: 

When the question arose, Mr. Obama’s advisers decided that the
assertion was fair, interviews with more than a dozen people
involved in crafting and explaining the president’s health-care
plan show.

But at times, there was second-guessing. At one point, aides
discussed whether Mr. Obama might use more in-depth discussions,
such as media interviews, to explain the nuances of the succinct
line in his stump speeches, a former aide said. Officials worried,
though, that delving into details such as the small number of
people who might lose insurance could be confusing and would
clutter the president’s message.

“You try to talk about health care in broad, intelligible points
that cut through, and you inevitably lose some accuracy when you do
that,” the former official said.

The former official added that in the midst of a hard-fought
political debate “if you like your plan, you can probably keep it”
isn’t a salable point.

So they apparently decided the president should repeatedly make
a promise that wasn’t true, and whose impacts would be felt by
millions of Americans, simply because they hoped that would make it
easier to sell the legislation they wanted to pass. 

from Hit & Run http://reason.com/blog/2013/11/02/administration-officials-worried-obamas
via IFTTT

Administration Officials Worried Obama’s Promise that People Could Keep Their Plans Wasn’t Right, and Let Him Make It Anyway

We already know that administration policymakers
were aware that President Obama’s promise that people who like
their plans can keep them under Obamacare was not true, because
estimates built into early regulations indicated that many plans
would lose their grandfathered, protected status.

A
report
in today’s Wall Street Journal indicates that
senior White House advisers were also concerned that the promise
could not be fulfilled, but decided to let the president make it
anyway: 

When the question arose, Mr. Obama’s advisers decided that the
assertion was fair, interviews with more than a dozen people
involved in crafting and explaining the president’s health-care
plan show.

But at times, there was second-guessing. At one point, aides
discussed whether Mr. Obama might use more in-depth discussions,
such as media interviews, to explain the nuances of the succinct
line in his stump speeches, a former aide said. Officials worried,
though, that delving into details such as the small number of
people who might lose insurance could be confusing and would
clutter the president’s message.

“You try to talk about health care in broad, intelligible points
that cut through, and you inevitably lose some accuracy when you do
that,” the former official said.

The former official added that in the midst of a hard-fought
political debate “if you like your plan, you can probably keep it”
isn’t a salable point.

So they apparently decided the president should repeatedly make
a promise that wasn’t true, and whose impacts would be felt by
millions of Americans, simply because they hoped that would make it
easier to sell the legislation they wanted to pass. 

from Hit & Run http://reason.com/blog/2013/11/02/administration-officials-worried-obamas
via IFTTT

The Truth About E-Cigarettes: Safe, Effective, and…Fun?

 

Electronic cigarettes are a safe, effective, and fun way to
prevent cancer among smokers of tobacco prodcuts – or people who
want to suck down flavored water vapor that often doesn’t even
include nicotine.

So why are so many people – including folks at the FDA – so
hell-bent on banning or heavily regulating e-cigarettes?

Reason TV’s Tracy Oppenheimer cuts through the fog with the
video documentary, originally released on Tuesday, October 29.

Here’s the original write-up:

Electronic cigarettes are creating a frenzy among politicians,
health experts, and the media. Local bans on
using e-cigarettes indoors are popping up all over the country,
andmany interest
groups are clamoring for top-down FDA regulations, which are
expected to be released in the coming weeks.

“E-Cigarettes currently exist in a complete no-man’s land,” says
Heather Wipfli, associate director for the USC Institute for Global Health.
Skeptics such as Wipfli worry about the lack of long-term data
available because the product is so new.

But according to the Consumer
Advocates for Smoke-Free Alternatives Association
’s Greg
Conley, calls for regulation are “a perverse interpretation of the
precautionary principle.” The precautionary principle holds that
until all possible risks are assessed, new technologies shouldn’t
be allowed to move forward.

Conley points to preliminary studies, like this one from
Drexel University, which confirm these smokeless, tobacco-less,
tar-less products are not a cause for concern – or at least not a
cause for the same concerns that accompany traditional cigarettes
and second-hand smoke.

“That [Drexel University] professor concluded that there was
absolutely no worry about risks to bystanders from e-cigarette
vapor,” says Conley.

The ingredients of e-cigarettes certainly have very little in
common with tobacco cigarettes. Nicotine, the only ingredient found
in both products, is mainly used to wean smokers off traditional
cigarettes and is not one of the harm-inducing ingredients
associated with lung cancer in smokers. The other ingredients in
the “e-juice” at the core of e-cigarettes are propylene glycol,
vegetable glycerin, and food flavorings— all of which are used in
other food products.

“All we are doing is steaming up food ingredients to create a
vapor,” says Ed Refuerzo, co-owner of The Vape Studio in West Los
Angeles. The Vape Studio is one of the many boutique
e-cigarette shops popping up that might be significantly affected
or even shut down by both local legislation and FDA
regulations.

Conley says it’s the currently unregulated customizability of
the e-juice that allows these small businesses to thrive. “The
availability of liquids is what is allowing a lot of these small
stores to open and prosper because they are able to mix their own
liquid and sell it to consumers without having to go through a big
manufacturing process,” says Conley.

The higher costs of complying with regulations would most likely
be passed on to consumers, which would impact people who are
looking towards e-cigarettes as an effective way to quit
smoking. 

“We’re using technology, and that’s what we do in America, we
use technology to solve really complicated problems,” says Craig
Weiss, president and CEO of NJOY. NJOY
is a leading manufacturer of electronic cigarettes  - and a
donor to Reason Foundation, the nonprofit that publishes Reason TV.
Weiss says that despite regulations, the potential of the industry
is only just starting to be realized.  

“The electronic industry is growing at quite a dramatic pace.
It’s more than doubled each of the last four or five years,” says
Weiss. “This piece of technology could have such an potential
impact on the world.”  

For more on the industry and NJOY, watch this
ReasonTV interview with
Weiss:

 

from Hit & Run http://reason.com/blog/2013/11/02/the-truth-about-e-cigarettes-safe-effect
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Virginia Governor’s Race: Can Cuccinelli Beat McAuliffe – and What About Libertarian Sarvis?

The Virginia governor’s race is being widely
viewed as a bellwether about…something. It pits the ultimate FOB
(does anyone still remember what that means?) Terry McAuliffe (D)
against the conservative Attorney General Ken Cuccinelli (R), with
a suprisingly popular Libertarian candidate, Robert Sarvis, polling
near on in double digits (read Reason’s
inteview with him
).


The latest poll
, from Emerson College, has McAuliffe at 42
percent, Cuccinelli at 40 percent, and Sarvis at 13 percent. Not
long ago, McAuliffe was winning in a total rout. Other polls show
the race tightening before the election Tuesday, though nothing as
tight as Emerson’s.
RealClearPolitics’ average
has McAuliffe up by about 8 points
and Sarvis just over 10 percent (important because cracking double
digits would guarantee the LP ballot access through 2016).

Depending on who you ask, it’s about how awful the GOP is
overall and their foolhardiness in shutting down the federal
government (which is hugely important to the Old Dominion’s
economy). Or it’s about just how disastrous the Obamacare debacle
really is, or how inexperienced and dirty McAuliffe really is; how
brave and stand-up Cuccinelli is (he was a leader in bringing legal
action against Obamacare) or how insanely socially conservative he
is; or how reckless the Libertarian Party is (depending on whom you
ask, the LP is either gifting the election to McAuliffe or showing
the deepening appetite for a third-party to the Dems and Reps.

I suspect that there’s a mix of all of the above at play in the
race. But this is certainly worth hammering home: The notion that a
third-party candidate, in this case a Libertarian, in any way,
shape, or form “costs” a Democrat or Republican an election is a
category error.

This type of argument was made most famously to
explain the outcome of the 2000 election, which was supposedly
thrown to George W. Bush by Green Party candidate Ralph Nader. The
methodology to prove this is simple: You take the spread between
the major party players and then see if a third-party candidate
more votes than that, and blame them. Don’t you see that Nader
obviously tossed the election to Bush, because all of Nader’s
voters would have turned out even if he wasn’t running and would
have voted for Gore…?

There’s a basic logic that seems persuasive, but it glosses over
too many things to really be convincing. In the 2000 election, it
skims over the fact that if Al Gore had been a semi-decent
candidate, he should have won in a rout. He was the VP of a flawed
but effective administration that had overseen a massive and
general increase in wealth (even despite the tech bubble bust at
the very end of the 1990s). This was a guy who had various scandals
of his own on top of Bill Clinton’s and then made the bizarre
decision to show up in orange-face for a
presidential debate
 and also vaguely physically threaten
Bush at the end of one too. However close – and ultimately
arbitrary – the final vote tally was, Al Gore lost the election
because he was a rotten candidate that voters (and yes, ultimately
the Supreme Court) rejected.

The whole “third party are spoilers” presupposes that the
two major parties have a prior claim on votes and voters, which is
simply wrong. This sort of logic typically get
trotted out by conservatives
around election time, when they
suddenly realize that small-L libertarians exist and vote on issues
that go beyond patently unconvincing promises to reduce the size,
scope, and spending of government at any given level. Candidates
such as Cuccinelli, who is by all accounts extremely socially
conservative, are a tough sell to libertarian-minded voters
(45
percent
of whom say they identify with the Republican
Party). 

Which is another way of saying: If GOP candidates aren’t
convincing to libertarians, don’t blame libertarians. Don’t
conservatives believe in personal responsibility? Take a look at
the man in the mirror then. Blame a party that has never lived up
to its limited government rhetoric or its insistence that
government should leave people alone as much as possible (in
Virginia, this meant among other things, having Republican
legislators vote against a plan to get the government out
of the liquor business. Really).

Libertarians are incredibly consistent in what they
believe and getting their vote is pretty easy: All you have to do
is present a credible plan to cut the role of government across the
board. As leading libertarian Republican Sen. Rand Paul (R-Ky.)

has concisely put it
, you have to “embrace liberty in both the
economic and personal spheres.” As I noted in a recent
Time.com column
, this isn’t complicated, but it has often
proved a bridge too far for Republicans. That’s their problem and
it may well spell their doom going forward, as libertarian-minded
voters gain numbers and influence:

If the Republicans can’t figure out a way to accommodate broadly
popular, socially tolerant libertarian policies on gay rights, drug
legalization, and more, they will not just lose the race for the
White House in 2016, but quite possibly their status as a major
party.


More here.

Related and highly relevant: Scott Shackford on
which candidate is “losing”
more votes to Sarvis
.

from Hit & Run http://reason.com/blog/2013/11/02/virginia-governors-race-can-cuccinelli-b
via IFTTT

Virginia Governor's Race: Can Cuccinelli Beat McAuliffe – and What About Libertarian Sarvis?

The Virginia governor’s race is being widely
viewed as a bellwether about…something. It pits the ultimate FOB
(does anyone still remember what that means?) Terry McAuliffe (D)
against the conservative Attorney General Ken Cuccinelli (R), with
a suprisingly popular Libertarian candidate, Robert Sarvis, polling
near on in double digits (read Reason’s
inteview with him
).


The latest poll
, from Emerson College, has McAuliffe at 42
percent, Cuccinelli at 40 percent, and Sarvis at 13 percent. Not
long ago, McAuliffe was winning in a total rout. Other polls show
the race tightening before the election Tuesday, though nothing as
tight as Emerson’s.
RealClearPolitics’ average
has McAuliffe up by about 8 points
and Sarvis just over 10 percent (important because cracking double
digits would guarantee the LP ballot access through 2016).

Depending on who you ask, it’s about how awful the GOP is
overall and their foolhardiness in shutting down the federal
government (which is hugely important to the Old Dominion’s
economy). Or it’s about just how disastrous the Obamacare debacle
really is, or how inexperienced and dirty McAuliffe really is; how
brave and stand-up Cuccinelli is (he was a leader in bringing legal
action against Obamacare) or how insanely socially conservative he
is; or how reckless the Libertarian Party is (depending on whom you
ask, the LP is either gifting the election to McAuliffe or showing
the deepening appetite for a third-party to the Dems and Reps.

I suspect that there’s a mix of all of the above at play in the
race. But this is certainly worth hammering home: The notion that a
third-party candidate, in this case a Libertarian, in any way,
shape, or form “costs” a Democrat or Republican an election is a
category error.

This type of argument was made most famously to
explain the outcome of the 2000 election, which was supposedly
thrown to George W. Bush by Green Party candidate Ralph Nader. The
methodology to prove this is simple: You take the spread between
the major party players and then see if a third-party candidate
more votes than that, and blame them. Don’t you see that Nader
obviously tossed the election to Bush, because all of Nader’s
voters would have turned out even if he wasn’t running and would
have voted for Gore…?

There’s a basic logic that seems persuasive, but it glosses over
too many things to really be convincing. In the 2000 election, it
skims over the fact that if Al Gore had been a semi-decent
candidate, he should have won in a rout. He was the VP of a flawed
but effective administration that had overseen a massive and
general increase in wealth (even despite the tech bubble bust at
the very end of the 1990s). This was a guy who had various scandals
of his own on top of Bill Clinton’s and then made the bizarre
decision to show up in orange-face for a
presidential debate
 and also vaguely physically threaten
Bush at the end of one too. However close – and ultimately
arbitrary – the final vote tally was, Al Gore lost the election
because he was a rotten candidate that voters (and yes, ultimately
the Supreme Court) rejected.

The whole “third party are spoilers” presupposes that the
two major parties have a prior claim on votes and voters, which is
simply wrong. This sort of logic typically get
trotted out by conservatives
around election time, when they
suddenly realize that small-L libertarians exist and vote on issues
that go beyond patently unconvincing promises to reduce the size,
scope, and spending of government at any given level. Candidates
such as Cuccinelli, who is by all accounts extremely socially
conservative, are a tough sell to libertarian-minded voters
(45
percent
of whom say they identify with the Republican
Party). 

Which is another way of saying: If GOP candidates aren’t
convincing to libertarians, don’t blame libertarians. Don’t
conservatives believe in personal responsibility? Take a look at
the man in the mirror then. Blame a party that has never lived up
to its limited government rhetoric or its insistence that
government should leave people alone as much as possible (in
Virginia, this meant among other things, having Republican
legislators vote against a plan to get the government out
of the liquor business. Really).

Libertarians are incredibly consistent in what they
believe and getting their vote is pretty easy: All you have to do
is present a credible plan to cut the role of government across the
board. As leading libertarian Republican Sen. Rand Paul (R-Ky.)

has concisely put it
, you have to “embrace liberty in both the
economic and personal spheres.” As I noted in a recent
Time.com column
, this isn’t complicated, but it has often
proved a bridge too far for Republicans. That’s their problem and
it may well spell their doom going forward, as libertarian-minded
voters gain numbers and influence:

If the Republicans can’t figure out a way to accommodate broadly
popular, socially tolerant libertarian policies on gay rights, drug
legalization, and more, they will not just lose the race for the
White House in 2016, but quite possibly their status as a major
party.


More here.

Related and highly relevant: Scott Shackford on
which candidate is “losing”
more votes to Sarvis
.

from Hit & Run http://reason.com/blog/2013/11/02/virginia-governors-race-can-cuccinelli-b
via IFTTT

Remy: The Healthcare Mash (It Was a Keyboard Smash!)

 

Watch the latest Reason TV collaboration with Remy!

Originally released on October 30, this video is now over the
100,000-view mark at YouTube, a testament to Remy and producer Sean
Malone’s talents – and the ongoing trainwreck that is
Obamacare.

More links, videos, and downloadable versions at Reason.tv.

Here’s the original writeup for the vid:

Remy channels Bobby “Boris”
Pickett
 for this Healthcare.gov-Halloween
mash-up. 

Written and performed by Remy. Video by Sean Malone. 

About 1.50 minutes. Scroll below for lyrics and and downloadable
versions.

Subscribe to Reason
TV’s YouTube channel
 to get automatic notifications when
new material go live. Follow Reason on Twitter at @reason.

Follow Remy on Twitter at @goremy and on You Tube here.

For all of Remy and Reason’s collaborations, go
here
.

Lyrics:

He was working on his laptop late one night
when his eyes beheld a ghoulish site
He could not log in despite several tries
then suddenly to no one’s surprise

(he did the Mash)
He did the Healthcare Mash
(the Healthcare Mash)
it was a keyboard smash
(he did the Mash)
the website was trash
(he did the Mash)
He did the Healthcare mash

Who could design such a site so flawed and so sloppy?
The code is so ancient, perhaps it was Hammurabi
He’d try to apply but the site would suspend
I’ve seen a eunuch with a more functional front end

(he did the Mash)
He did the Healthcare Mash
(the Healthcare Mash)
it was a keyboard smash
(he did the Mash)
He tried to clear his cache
(he did the Mash)
He did the Healthcare mash

Hundreds of millions of dollars were spent
for a website that has trouble loading
How could the government’s web designers
create a site with such awful coding?

(they did the Mash)
Ahh, they did the Healthcare Mash
(the Healthcare Mash)
it was a keyboard smash
(they did the Mash)
they spent all of our cash
(they did the Mash)
They did the Healthcare Mash

from Hit & Run http://reason.com/blog/2013/11/02/remy-the-healthcare-mash-it-was-a-keyboa
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