Category Archives: Health Policy

Colorado Capitol

Vaccinations and the Misreporting of the “Parent’s Bill of Rights”

If there’s one thing I hate more than faulty reporting of a political issue, it’s when the faulty reporting is mine. Earlier today on Twitter I wrongly accused Progress Now Colorado of misstating the text of a bill, Colorado Senate Bill 15-077 (the “Parent’s Bill of Rights”). I apologized for that, and I here apologize again. The basic issue is whether and in what respect the bill touches on parental choice with respect to vaccinations.

Unfortunately, some of the other reporting of the bill significantly mischaracterizes it—including that by Progress Now Colorado. Here I’d like to clarify what the bill actually says, correct my own factual error, and comment on other reporting about the bill.

Some preliminary remarks: I have no position on the bill in question, because I have not researched it adequately to reach a position on it. Offhand, it seems like an overly ambitious, overly broad bill. (It will almost certainly fail, so I see little need to look more closely into it at this time.)

As a matter of political strategy, the bill represents a massive failure for the Colorado GOP. The state senate is definitely in play next year, and Democrats will almost certainly use this bill to scare parents about outbreaks of horrific diseases. My state senator, Laura Woods, a cosponsor of the bill, likely will suffer hit pieces on the matter—we live in an extremely competitive district that until recently was held by Democrats. (In an email about the bill, Progress Now Colorado explicitly named Woods and only her, even though she is not the bill’s primary sponsor.) The bill, introduced January 14 (see the legislature’s web page), winds through the legislature just when national debate rages about vaccinations. So why stir that pot for a bill that doesn’t even have a chance to pass, especially using the names of at-risk legislators? Strategically, the bill is idiotic.

Cleverly taking advantage of the media storm surrounding vaccinations, Progress Now Colorado described SB-77 this way in an email this morning:

One of the worst attacks we’re seeing right now is on public health and education. News reports this week show that Colorado has the lowest rate of childhood vaccinations in America. Right-wing politicians like Rand Paul have come under fire for suggesting that vaccines might be responsible for mental health problems in children, even though that theory has been totally discredited by scientific research.

Right on cue, Colorado conservatives in the Senate have introduced a bill reaffirming the “right” of parents to not have their children vaccinated. With outbreaks of preventable diseases like measles and whooping cough making nationwide headlines, is there a worse message we could send to Colorado parents?

The email’s description is technically accurate but incomplete. The nine-page bill includes a single line about immunization. Here’s what the relevant section of the bill states:

The board of education of a school district, in consultation with parents, teachers, and administrators, shall develop and adopt a policy to promote the involvement of parents of children enrolled in the schools within the school district. The policy must include . . . [p]rocedures by which a parent can learn about the parental rights and responsibilities under the laws of the this state, including the right to . . . [b]e exempt from any immunization laws of this state.

In other words, the bill doesn’t do anything to alter current immunization laws; it merely directs school boards to help parents better “learn” about existing statutes. (Why parents might need the help of school boards to learn about statutes they can easily look up for themselves is beyond me.)

Again, the bit about immunization takes up a single line of a nine-page bill—yet not only Progress Now Colorado but various news outlets made it seem as though vaccinations was the primary issue of the bill.

An article by CBS4 carries the title, “Bill Would Support Parents Opting Out Of Child Vaccinations.” Although the article is technically accurate, it is misleading in that it doesn’t even mention any aspect of the bill besides vaccinations until the fourth paragraph.

The headline of a 9News article states, “‘Parents Bill of Rights’ proposal underlines vaccines, sex education opt-outs.” Again, the article (by Eli Stokols) is technically correct, yet it wrongly implies that the bill is predominantly about vaccinations and sex education. (The bill mentions sex several times, but that too is only a minor aspect of the bill.)

Stokols’s article also wrongly claims the bill “authoriz[es] Colorado parents to make all medical decisions for their children until they’re 18.”  Actually, the bill expressly allows government to intervene when there is a “compelling governmental interest” in doing so, if that interest “is of the highest order, is narrowly tailored, and cannot be accomplished in a less restrictive manner.” The bill also offers exceptions “as otherwise provided by law.”

Notably, the bill mentions neither vaccinations nor sex in its summary; instead, the summary states, “The bill establishes a parent’s bill of rights that sets forth specific parental rights related to education, health care, and mental health care of minor children.”

Given that SB-77 does not alter existing vaccination laws, but only creates new guidelines for educating parents about those laws, what do existing state laws say about vaccinations? Revised Statute 25-4-903, pertaining to “school entry,” states, “It is the responsibility of the parent or legal guardian to have his or her child immunized.” It offers exemptions for health reasons, on the basis of “a religious belief whose teachings are opposed to immunizations,” and on the basis of “a personal belief that is opposed to immunizations.” I’m not sure, but I’m guessing the statutes apply to homeschoolers and to students in private schools as well as to students in government schools. I’m also guessing that, because of the compulsory attendance laws, all parents of school-age children legally must comply with these statutes, ether getting the immunizations or filing for an exemption. Those points merit further research.

Obviously, neither Progress Now Colorado nor any Colorado Democrat is likely to come out publicly in favor of repealing the existing exemptions. So they support, at least tacitly, the exact same vaccination policy that the Republicans they’re demonizing support.

But, for some reason, neither reporters nor political hacktivists see the percentage in running the headline, “Democrats Support the Exact Same Vaccination Laws that Republicans Support, Quibble Over Providing Information”—even though that is the essential truth here.

So where did I go wrong in my initial reporting? In my initial hasty reading of the bill, I looked for the term “vaccination” and missed the related term “immunization.” That was simply an oversight. I thought Progress Now Colorado was reading an implication into the bill that it didn’t explicitly cover. I hastily Tweeted my erroneous conclusion.

Thankfully, Eli Sokols corrected me, pointing me to the relevant line in question, at which point I thanked him and apologized to Progress Now Colorado and to Alan Franklin (a supporter of that group) for my error. I again apologize to those parties, and I again express my appreciation to Stokols for taking the time to point out my error. This serves at a good reminder not to come out swinging without firmly nailing down the relevant facts.

I take solace in the fact that, with this report, I feel I’ve done the matter justice.

Update: Alan Franklin reports that “anti-vaxxers”—people opposed to vaccinations—testified today in favor of the bill. This underlines my point that, strategically, the bill is a disaster for Republicans. I bet the Democrats on the committee can barely contain their glee at witnessing the farce; it’s as though Republicans are writing the attack ads against themselves. I do find it interesting that both the opponents of vaccinations and Democratic operatives are trying to paint the bill as something that it is not: a measure altering vaccination exemptions. At any rate, in case my position was not clear by implication: Vaccines are a wonderful, life-saving medical advance, and parents generally should get their children vaccinated against the relevant diseases.

Second Update: I made yet another error in the original version of this report, and I rewrote it just before 6 pm local time to correct the mistake. (This time Alan Franklin corrected me, which I again appreciate.) Originally I saw the religious exemption in state statutes but missed the exemption for “personal belief.” Originally, I remarked that having only a religious exemption is wrong; however, because there’s not only a religious exemption, that remark was misplaced. Again, I do not have a well-developed policy position on such issues.

Third Update: In an article time-stamped 5:31 pm (but that I read some hours later), ABC7 reports that SB-77 passed out of committee on a party-line vote. The article contains this remarkable passage:

The measure also mentions the controversial topic of immunizations, underscoring current Colorado law that allows parents to opt out of vaccinating their kids for medical, religious or personal beliefs by signing a waiver. 7NEWS asked if the bill would get rid of the waiver process.

“Yes, I mean, I would assume so,” [bill sponsor Tim] Neville said.

But I see no language in the bill that would remove the waiver process for vaccination exemption; the language quoted above certainly doesn’t do that. So I must conclude either that Neville had no idea what the reporter (Lindsay Watts) was asking, or he doesn’t fully understand his own bill. (That would not come as much of a surprise; legislators have a staff to write the language of bills.)

The article also summarizes: “Opponents argued at Thursday’s Senate Education Committee hearing that the measure would prevent children being physically or sexually abused from getting help, especially if a parent was the abuser.” Although I think the fear is exaggerated, I am concerned about language in the bill such as the following: “Except as otherwise provided by law, no [party] . . . may . . . perform a physical examination upon a minor child . . . without first obtaining written consent from the minor child’s parent.” What does “as otherwise provided by law” cover, exactly? Obviously, it would be a horrible outcome if, even in some cases, abusive parents could use the law to shield themselves from scrutiny. I am, to say the least, extremely skeptical that the bill is well written and narrowly tailored to address real problems.

Latest Updates | Image: Greg O’Beirne

Watkins on How to Repeal ObamaCare

Image: Pete Souza

Image: Pete Souza

In his recent op-ed for Politix, Don Watkins paints potentially grim future for those wanting to repeal ObamaCare. He compares its history with that of Social Security, in which opposition from the right started with superficial objections and soon withered away almost entirely, such that now almost all Republicans openly endorse Social Security.

But repealing ObamaCare is not hopeless, Watkins writes, if those fighting for its repeal follow three main strategies: First, defend “the free market against those who would blame it for problems” caused by government. Second, distinguish “between an individual’s voluntary decision to support people and causes he cares about” from the moral premise “that a person’s need entitles him to support by others.” Third, “offer an inspiring moral alternative” of free markets and voluntary interactions between patients, doctors, and insurers.

Incidentally, the pdf of Watkins’s new book, Rooseveltcare: How Social Security is Sabotaging the Land of Self-Reliance, is available for free online.

How Doctors Can Improve Care, Lower Costs, and Earn More

In a recent interview with Concierge Medicine Radio, family physician Brian Forrest of Apex, North Carolina discusses his concierge practice (hat tip to Paul Hsieh). CMR summarizes the topics covered:

  • The shockingly simple math behind how reducing overhead and eliminating collections allows primary care physicians to spend more time providing better care while improving their take home pay.
  • How Brian kept his total operating expenses to $50k in the first year and how you can too.
  • The rule of thumb Brian uses to make all his purchasing decisions.
  • The two most effective forms of advertising for Brian’s direct pay practices.
  • How to choose your billing software and Brian’s recommendations.

For more on this innovative approach to health care, see my interview with Dr. Josh Umbehr for the Objective Standard, or see a set of collected articles about Forrest. For regular updates about health care and health policy, see the Hsieh’s blog at Freedom and Individual Rights in Medicine.

Insurance Rates Politicized under Colorado ObamaCare Regs

“In April, 2014, emails from Insurance Commissioner Marguerite Salazar to various Colorado officials discussed what to do about the high Obamacare premiums in Colorado’s resort counties,” as Linda Gorman discusses for Complete Colorado. At issue is the regulatory manipulation of rates in different regions. Gorman concludes, “In Colorado, Obamacare is such bad policy that it encourages politicians to take from the relatively poor and give to the relatively rich.” When politicians give bureaucrats the power to regulate insurance premiums, is anyone surprised that regulatory process becomes political and influenced by special interests?

University of Kansas Cuts Student Work Hours over ObamaCare

Here’s the latest from the University of Kansas: Because of “potential fiscal liabilities with ACA,” aka ObamaCare, the “Student Employee Eligibility Requirements and Appointment Limits will reduce the hours that undergraduate students will be able to work during the semester to 20 hours per week except during breaks and summer. Previously, undergraduates could clock up to 30 hours during the academic year,” reports the University Daily Kansan. Hat tip to Campus Reform. This is just the latest illustration of ObamaCare’s impacts on employers—who became involved in health insurance in the first place almost entirely because of government.

Coffman Introduces Insurance Regulation Bill

Colorado Congressman Mike Coffman introduced the “Guaranteed Health Coverage for Pre-Existing Conditions Act of 2014” to “prohibit the ability of an insurance company to deny coverage based on a pre-existing medical condition in the event that the Affordable Care Act (ACA), better known as Obamacare, is repealed,” according to a July 31 media release from Coffman’s office.

In other words, Coffman wants to make sure that government smothers insurers with rights-violating regulations, whether or not ObamaCare exists. But the problem regarding pre-existing conditions is almost entirely a creation of government, which pushed most people from long-term personal insurance to (typically short-term) employer-based insurance. Is there any prominent Republican, anywhere, willing to stand up and say that government should protect rather than violate the rights of patients, insurers, and doctors?

Under Government Force CA Health Premiums Increase “Only” 4.2 Percent

“California officials said the more than 1.2 million consumers in the state-run Obamacare insurance exchange can expect modest price increases of 4.2% on average next year,” reports the Los Angeles Times. Of course, the fact that government can “negotiate” with insurers using brute force may have something to do with the lower-than-average increases. But starving insurance companies of premiums won’t keep the costs of health care from going up; it will only cause insurance companies to offer worse coverage or worse service. And if government artificially forces down the costs of health care, that will cause doctors to offer worse care or less service. Government can control prices (to some extent), but it can’t escape the inevitable economic consequences. If we want better services and lower prices, we must demand a free market in medicine.

A Suit? How about Repeal ObamaCare?

The Objective Standard just published my blog post, “What Congress Should Do Rather than Sue.” I write, “Congress has the power to repeal ObamaCare and to begin rolling back government controls of health care. For example, Congress could not only repeal the rights-violating mandates that force individuals to purchase insurance and employers to provide it; Congress could also put an end to the use of the tax code to punish people for purchasing insurance directly.” In his post on the subject, Erick Erickson offers a great quote by Madison explaining how and why Congress controls the purse; it begins, “The House of Representatives cannot only refuse, but they alone can propose, the supplies requisite for the support of government.”

“Sierra Leone Bans Public Meetings” over Ebola Outbreak

Sierra Leone’s president declared a state of emergency in his west African country, banning all public meetings and mobilizing troops to quarantine the homes of Ebola victims, as the World Health Organization reports that the death toll from the latest outbreak of the virus has jumped to 729,” USA Today reports. But how dangerous is the disease even for those in the most-affected areas? According to the Telegraph, the recent outbreak has led to “1200 suspected cases so far across Guinea, Liberia, and Sierra Leone.” Sierra Leone has a population of some six million people (Colorado has around 5.3 million, by comparison). No doubt if hundreds of people died of a viral infection in Colorado, people would be freaking out. The outbreak leads to two important questions: What should governments do about this and other outbreaks, and what should individuals do? Prudence counsels that families keep on hand at least a short-term store of emergency supplies (including water and food), just in case. Meanwhile, those who want to learn more about the ebola virus may see WHO’s fact sheet.

So Now ObamaCare Is a “Tax” But Not One to Raise Revenues

You may recall the Supreme Court ruled ObamaCare constitutional on the basis that it’s a tax—see Dave Kopel’s discussion of that ruling. But now the D.C Circuit Court has ruled that, although ObamaCare is a tax for purposes of its Constitutionality, it is not a revenue-generating tax for purposes of the Origination Clause. Article I, Section 7 of the Constitution states, “All Bills for raising Revenue shall originate in the House of Representatives”; ObamaCare originated in the Senate. So not only is ObamaCare a “Seinfeld tax on nothing,” as Kopel says, it’s a tax that’s not really a tax. The courts in these matters are completely failing to uphold the letter and spirit of the Constitution. See Heritage’s report, Timothy Sandefur’s blog post on the recent ruling (Sandefur pursued the case), and Sandefur’s video about the same.

An Open Reply to a Pharmacist Regarding Prescription Drug Monitoring

600px-Ritalin-SR-20mg-1000x1000Last month I wrote an op-ed and a follow-up blog post critical of a proposal to expand Colorado’s prescription drug monitoring program. I pointed out (among other things) that the program was promoted and financed largely by federal law enforcement; that law enforcement agents can access the information in the database (by warrant) for purposes of pursuing criminal investigations; that the program does little to curb drug abuse, in part because drug abusers easily can switch to different drugs, and in part because some drug abusers steal their drugs (or, I’ll add here, buy them on the black market); and that the proposal seeks to force doctors (and other prescribers) to register with the database.

My main point was that it is not the government’s proper role to save drug addicts from their own dangerous behavior—particularly given the government’s actions in this area inevitably make it harder for some people to obtain the drugs they desperately need to manage their excruciating pain.

On March 31, someone who identified himself only as “John” replied to my web page:

Ari, hello. My name is John and I am a retail pharmacist. I rely heavily on our prescription monitoring program here in Nevada. As pharmacists, we use it to make sure people are not filling multiple controlled substance prescriptions at different pharmacies, using multiple doctors for controlled substances, and that they are not misusing or abusing controlled substances. This tool has prevented abuse and diversion in our state and is a very useful tool. Also, to stress an important point, a good pharmacist understands true pain (cancer) and always strives to take compassionate care of the patient.

Following is my open reply:

Dear John,

As a pharmacist, you are undoubtedly a smart fellow; you must realize, therefore, that you have not actually responded to any of the observations or arguments I make in my op-ed and related post.

I have no doubt that the monitoring programs set up by the governments of various states prevent some drug addicts from obtaining certain drugs from certain sources. (Whether it substantially prevents drug addicts from abusing drugs, on the other hand, is extremely doubtful.) My primary philosophical objection is that it is not the government’s proper role to address or prevent the problem of drug abuse; rather, it is to protect people’s rights, including the rights of consenting adults to contract freely. Although a full defense of that position lies outside the scope of this short letter, I will note here that there are other—and much better—ways to help drug addicts with their problems.

I will also note here that my criticisms of government-run drug prescription drug monitoring programs (run largely at the behest of federal law enforcement agents) do not constitute reasons to prohibit doctors and pharmacists from independently sharing certain information about potentially dangerous situations. And of course nothing in my position implies that reckless doctors should be free from civil and even (if circumstances warrant) criminal liability.

As a pharmacist, your ability to “take compassionate care of the patient” is inherently limited. After all, you are not legally authorized to diagnose any disease or to write drug prescriptions. Thus, there is no case in which you can actually expand the delivery of pain medications to the patients who desperately need them. Your actions can have one and only one effect in this regard: to block or delay such delivery.

Of course, your actions might also have the effect of subjecting the doctors and other medical professionals, who are legally authorized to write drug prescriptions, to the actions of federal and state law enforcement agents. Those agents, in turn, have the power in some cases to arrest doctors and to help other government agents prosecute doctors or strip them of their ability to practice medicine.

As a pharmacist, John, you are not in any danger of having your power stripped to write drug prescriptions (as you have no such power) or of being prosecuted for writing drug prescriptions (as you do not write any). You are, however, quite capable of assisting federal and state drug enforcement agents create a climate of fear and intimidation among those who do write drug prescriptions, such that, on balance, those who prescribe drugs tend to err on the side of legal precaution and not help people coping with excruciating pain obtain the drugs they desperately need. Such a result is possible—and I think likely—even assuming (as I’m sure is the case) that most uses of the monitoring program do not involve law enforcement. And the more the program is expanded, the more substantial will be its effects in this regard.

In using the monitoring program, you act primarily on guesswork and speculation. Consider the activities that you regard as inherently suspicious: people “filling multiple controlled substance prescriptions at different pharmacies” and “using multiple doctors for controlled substances.”

Again, I do not doubt that such behavior describes some drug addicts. But I also do not doubt that such behavior also describes some people coping with excruciating pain due to cancer or other serious diseases.

Consider that cancer patients and others coping with serious illnesses typically see multiple doctors in multiple locations to manage their diseases. They also typically use different types of pain medications concurrently to cope with their diseases. Moreover, cancer patients often end up leaving their jobs, moving to a different location, and switching their insurance companies—developments that can result in them seeing more doctors in more locations. Add to this the fact that people suffering from a variety of diseases often require supplemental surgeries—surgeries that initially cause enormous pain and that involve yet more medical facilities. For all these reasons, people coping with such diseases very often get multiple drug prescriptions, written by multiple doctors, filled at multiple pharmacies—the very behaviors that you claim to “make sure” to treat as suspicious.

As a pharmacist, John, you typically lack access to the pertinent information about such patients, and when you lack such information you cannot possibly “take compassionate care” of them. With respect to such patients, your actions can have one and only one result: to make it harder for them to obtain the pain medications they so desperately need.

I will thus repeat here what I wrote at the outset: “the answer is not for the government to monitor and harass people who suffer from devastating pain—and make it harder for them to manage their pain—in a misguided attempt to save drug abusers from themselves.”

Sincerely, Ari Armstrong

Image: Wikimedia Commons

The Problems with Prescription Drug Monitoring

Yesterday the Greeley Tribune published my article, “Prescription Drug Monitoring Punishes the Responsible for the Sake of the Irresponsible,” written for the Independence Institute. That article begins:

Prescription drug abuse is a serious problem, sometimes a fatal one. But the answer is not for the government to monitor and harass people who suffer from devastating pain — and make it harder for them to manage their pain — in a misguided attempt to save drug abusers from themselves. Unfortunately, that is precisely the effect of House Bill 1283, sponsored by Rep. Beth McCann of Denver.

Here I thought I’d take the opportunity to offer more details about the program and my research of it.

Health Information Designs

One interesting fact about the Colorado database that tracks (some) prescription drug use is that it is operated by a limited-liability corporation, Health Information Designs (HID).

Colorado’s Department of Regulatory Agencies (DORA) links users directly to HID for information about the Electronic Prescription Drug Monitoring Program (PDMP). Interestingly (or perhaps disturbingly), HID originally went into business producing “data mining software” for prescription drugs.

So let us clarify what’s going on here. The Colorado government encourages doctors and pharmacies to enter patients’ personal medical information into a central database, run by a for-profit corporation, and this information is available to a wide range of medical professionals—whether or not patients wish their records to be so distributed—and to law enforcement agents who obtain a warrant to see the records.

One thing McCann wants to do is force all prescribing doctors and pharmacies to register with the database. McCann’s bill would not force prescribing doctors and pharmacies to actually use the register, but does anyone seriously doubt that’s the Drug Enforcement Administration’s eventual aim? The goal here is for Big Brother to be able to monitor every individual’s use of prescription drugs, every doctor’s prescriptions, and every pharmacy’s drug sales. And, of course, the government wants to subject violators of the (ambiguous) prescription laws to penalties, including the penalty of getting locked in a metal cage.

The Funding for the PDMP

Tellingly, the Colorado PDMP, launched in 2005, got its primary funding from the U.S. Department of Justice—of which the DEA is an agency.

The legislator’s fiscal note for 2005 House Bill 1130 states the following:

The bill is assessed at having a conditional fiscal impact of $547,156 . . . in its first year of implementation and $271,484 . . . in its second year of implementation. . . . During the current fiscal year, the Department of Regulatory Agencies has received a $50,000 U.S. Department of Justice grant in support of the Harold Rogers Prescription Drug Monitoring Program. . . . Additionally, the federal government will make a $350,000 grant available to implement the program once statutorily authorized.

I do not have complete funding details about the program. However, it is apparent that the program is driven primarily by federal law enforcement.

News Sources

I relied on several news reports in conducting my research. 9News published a story about McCann’s current bill. Eli Stokol’s pathetic excuse for journalism on this matter essentially uncritically relates McCann’s talking points, without bothering to raise a single critical question. Hopefully in the future Stokol will take his role as a journalist more seriously and set a higher bar for himself than legislative lapdog.

Over at the Denver Post, I found Felisa Cardona’s 2011 story about the legislature’s renewal of the PDMP that year as well as Michael Booth’s 2012 story about DEA complains of low registry use.

Drug Substitution

As I point out in my op-ed, drug abusers who have a harder time getting one type of drug often switch to another type. My claim is supported by a recent news story from the Washington Post (republished by the Denver Post).

[T]he U.S. government’s decade-long crackdown on abuse of prescription drugs has run an unsettling risk: that arresting doctors and shuttering “pill mills” would inadvertently fuel a new epidemic of heroin use. . . . [A]t the same time that some pain medications have become less available on the street and pricier, many users have switched to cheaper heroin, since prescription pills and heroin are in the same class of drugs and provide a comparable euphoric high.

It should go without saying—but, in today’s political climate not even the most obvious facts may go without saying—that substituting street heroin addictions and deaths for prescription drug addictions and deaths is no great victory.

Drug Thefts

I cut the following line from my op-ed due to space restraints, but it’s an interesting detail: “In testifying in favor of McCann’s bill, Robert Valuck from the University of Colorado offered the example of a woman who robbed a pharmacy at gunpoint—but the expanded registry would promote rather than deter thefts of prescription drugs.” Valuck’s claim is included in 9News’s video, not in Stokol’s written account.

The Magnitude of Prescription Drug Deaths

In my op-ed, I claim that McCann apparently overstated the magnitude of deaths related to prescription drugs. Specifically, she said, ““More people actually die from prescription drug overdose than from traffic accidents.”

I have an email out to McCann asking for her sources, so perhaps she’ll send me something I have not yet considered. However, based on the sources I’ve been able to find so far, McCann’s claim seems not to have support.

This past October, an outfit called Trust for America’s Health published a report, “Prescription Drug Abuse: Strategies to Stop the Epidemic.” (Likening a volitional behavior—drug abuse—to an infectious disease is epistemologically and morally offensive, but I’ll leave that topic for another day.)

That report does not state that prescription drugs are responsible for more deaths than are traffic accidents. Instead, the report claims that “[p]rescription painkillers are responsible for more than 16,000 deaths” per year. The number of motor vehicle deaths exceed 30,000 each year.

Regarding traffic fatalities, the report makes a different claim: “Drug poisoning deaths—the majority of which are related to prescription drugs—surpassed traffic-related crashes as the leading cause of injury death in the United States in 2009.”

My guess is that McCann misstated this report’s (or a derivative report’s) findings.

(I also saw that Dr. Joseph Mercola makes a broad statement about prescription drug deaths surpassing auto deaths, but, if you trace back his links, you find that the statistic pertains only to Ohio. I have not traced the claim beyond a 2011 New York Times story.)

The best statistics I’ve found about the problem of prescription drug abuse are provided by the Centers for Disease Control, which report, “In 2008, drug overdoses in the United States caused 36,450 deaths. OPR [opioid pain relievers] were involved in 14,800 deaths (73.8%) of the 20,044 prescription drug overdose deaths.” (In many cases a death involves the mixing of various types of drugs.)

Of course, as the CDC also report, most people who intentionally kill themselves by overdosing on drugs use prescription drugs for the purpose. But the monitoring program will not pick up one-time drug purchases among suicidal people, nor will it prevent suicidal people from substituting one method of suicide for another.

Conclusions

I have known people who have died from terminal cancer. I know people now dealing with the agonizing pain caused by late-stage cancer and other diseases. The simple fact is that more people with serious injuries and diseases will suffer more pain because of the government’s crackdown on prescription drugs—all to save irresponsible drug abusers from their own poor choices. That policy is morally wrong.

Image of Beth McCann: Wikimedia Commons

Dr. Hsieh Makes the Case Against Medical Licensing

In a July 31 talk hosted by Liberty On the Rocks, Dr. Paul Hsieh made the case against medical licensing. The event was held on what would have been Milton Friedman’s 100th birthday, and Hsieh drew on Friedman’s work on licensing. (Hsieh noted that he does not agree with all of Friedman’s other positions.)

Hsieh argued that, far from guaranteeing the competency of doctors, medical licenses tend to lull patients into a false sense of security.

Moreover, Hsieh argued, licenses put doctors under the thumb of politicians, who in some cases have already tried to use threats of license revocation to force doctors to behave in ways that politicians deem best.

Watch the entire, 20-minute talk:

Kopel on ObamaCare SCOTUS Ruling

Constitutional scholar Dave Kopel discussed the ObamaCare SCOTUS ruling July 9 at Liberty On the Rocks, Flatirons. He argued that, despite the court’s troubling ruling on the taxing power, in other ways the ruling provides important Constitutional protections of our liberties.

Kopel spoke for about an hour to a crowd of around fifty people; I extracted a series of ten videos encompassing most of his remarks.

Kopel began by discussing the commerce clause, noting that the ruling offers a relatively restrained reading of that clause more consistent with original understanding:

Next Kopel addressed the meaning of the “necessary and proper” clause, noting that the court’s ruling moved interpretation of that clause closer to original understanding:

What about Medicaid spending? Kopel points out that the Court’s ruling has profound implications for states’ ability to manage their own budgets.

Of course, the Court dramatically expanded the Congressional taxing authority, and that part of the ruling is the most problematic. Kopel discusses ObamaCare’s “Seinfeld tax on nothing.”

Did Justice Roberts make a “switch in time” because of political pressure? Kopel discusses the possibility:

What is the state of legal academia? Kopel argues that it was bad but that it is getting much better.

Is the Tenth Amendment meaningless? Hardly, argues Kopel.

Ultimately, the Constitution lives in the hearts and minds of the American people. “It is up to the American people to maintain our political system of constitutional liberty,” Kopel argues.

Judicial review is proper, Kopel argues, but not sufficient to maintain liberty.

Finally, Kopel discusses other possible legal challenges to ObamaCare.

See also Randy Barnett’s op-ed and interview about the decision.

Coloradans Rally Against ObamaCare, SCOTUS Ruling

Today around two hundred Coloradans rallied at the state capitol in Denver to protest ObamaCare and the Supreme Court decision upholding the individual mandate under the Congressional taxing authority.

Read Tim Hoover’s article over at the Denver Post—then check back here for the most important information (which Hoover ignored). I refer to the talks by Dr. Jill Vecchio (shown in the photo) and constitutional scholar Rob Natelson, the video of which is embedded below.

Vecchio explained that ObamaCare forces doctors to violate the Hippocratic Oath:

Natelson, one of the leading experts on the original meaning of the Constitution, argued that the Supreme Court’s ruling constitutes sophistry:

Below are a few additional images from the rally; see my Picasa album for more. (You’ll notice that I posted the photos as Creative Commons.)

Bob Beauprez meets Vecchio:

Bill Faulkner and Jason Letman:

Felix Diawuoh, an immigrant from Ghana:

Jeff Crank, Colorado director for Americans for Prosperity (the group hosting the rally):

More soon!

Coloradans Lead the Fight for Liberty in Medicine

Yes, I’m disappointed by today’s ObamaCare ruling by the Supreme Court. (You can find my further remarks over at The Objective Standard blog.) I am not terribly surprised by the ruling; John Roberts was merely following today’s common conservative legal theory to the effect that the Supreme Court should do whatever backflips are necessary to jam congressional legislation into the framework of the Constitution. (I’ll have more to say about this later.)

Here, I wanted to first point out that this is hardly the end of the fight, and second thank those Coloradans who have played such an important part in the fight to establish liberty in healthy care.

This is not the time for defeatism, for disillusionment, for pessimism, or for sulking. This is the time to stoke one’s motivation and help rally the lovers of liberty to the cause of freedom in medicine.

I think the Supreme Court erred in its judgment today. But the Supreme Court defines the limits of Congressional action, not its ideal state. Just because the Court allows it, doesn’t mean Congress must enact it.

Now the battle must move to the cultural arena—where it has always been fought at the most fundamental level. In a way, today’s ruling brings a certain clarity to the issue, for who can deny that we face a basic choice between liberty in medicine and government-controlled medicine? Either the individual is in control of his own life, his own health, his own choices, his own body, or the government is.

The fight to bring about liberty and free markets in medicine is just beginning.

And the side of liberty already has tremendous momentum, thanks in large part to the work of scholars and activists here in Colorado. I want to take this opportunity to thank some of them and link to some of their work.

Dave Kopel and Rob Natelson

Legal scholars Kopel (shown in the photo) and Natelson did tremendous work explaining the limits of the “necessary and proper clause.” Notably, the Supreme Court ruled that ObamaCare is not permissible under that clause (but rather under Congress’s taxing authority).

Kopel has also written extensively about the implications of ObamaCare, as in an article for the Volokh Conspiracy.

Earlier this year I interviewed Kopel about the mandate.

Paul Hsieh

Radiologist Paul Hsieh cofounded Freedom and Individual Rights in Medicine. He coauthored an article chronicling the history of government intervention in medicine, and he continually writes blog posts and articles on health policy.

Hsieh wrote an article for today’s PJ Media in which he argues:

Ultimately, the political fight against ObamaCare must be part of a broader fight for limited government that respects our freedoms. The proper function of government is to protect individual rights, such as our rights to free speech, property, and contract. Only those who initiate physical force or fraud can violate our rights. A properly limited government protects us from criminals who steal, murder, etc., as well as from foreign aggressors. But it should otherwise leave honest people alone to live peacefully, not deprive us of our freedoms in the name of “universal health care.”

Jill Vecchio

Vecchio, another medical doctor, has delivered numerous talks on health policy. She recorded a multi-part video commentary on ObamaCare.

Linda Gorman

Gorman, an economist with the Independence Institute, has written about health policy for many years. I have benefited enormously from her detailed and technical understanding of health laws and their implications.

Brian Schwartz

Schwartz writes for the Institute’s Patient Power Now blog. He keeps abreast of the latest news related to health care, and he shares this news with the wider community.

Thanks to the amazing work of these scholars, doctors, and activists—and many other Coloradans who have made the case for liberty in medicine—much of the public is aware of the dangers posed by ObamaCare and open to serious discussions about replacing today’s government-controlled health care with a free market.

That is the cause for which we must continue to fight.

Kopel: ObamaCare Mandates Unconstitutional

I caught up with Constitutional scholar Dave Kopel at the Independence Institute’s annual banquet February 16. In these two short videos, he explains why the Medicaid mandate as the individual mandate (to purchase health insurance) under ObamaCare are unconstitutional.

First Kopel argues that the Medicaid mandate violates the principles of federalism:

Next he argues that the Constitution never granted Congress the power to compel people to purchase products.

See also the complete briefs against the Medicaid mandate and the individual mandate.