RUTHFULLY YOURS

https://www.nationalreview.com/2024/10/advocates-of-woke-medicine-play-victim-while-still-pushing-their-agenda/?utm_source=recirc-desktop&utm_

It’s pretty brazen to pretend to be on the defensive when your effort is having real-world consequences for doctors and patients.

The forces driving the politicization of medicine have a complaint: People are starting to notice what they’re doing.

Their effort to view health care through a DEI lens, which has proceeded almost unabated for years, has only recently begun to have genuine opposition. And this is supposedly threatening their cause’s very existence. “It’s very taxing,” Chandra L. Ford, a professor at Emory University and founding director of the Center for the Study of Racism, Social Justice & Health, recently lamented to the Washington Post. “This anti-DEI movement creates a climate of fear.”

Sheldon Rubenfeld would be surprised to learn that Ford and those like her are on the defensive. Rubenfeld had been clinical professor of general medicine at Baylor College of Medicine. But this past summer, the medical school officially ended its relationship with him. It’s just the latest chapter in a story that demonstrates both the extent of the problem and the need to confront it.

Rubenfeld’s service at Baylor went back decades. It encountered a major stumbling block last year, however. The medical school abruptly canceled Healing by Killing: Medicine during the Third Reich, an elective course he had been teaching for 20 years. Rubenfeld, also the author of Medicine after the Holocaust: From the Master Race to the Human Genome and Beyond, believes the course was an effective way to warn aspiring doctors against letting their prejudices influence how they treat their patients. Doing so ultimately “leads to all sorts of nastiness,” he says, “and Jews are always the first ones to experience it.”

One student, however, thought the course itself was a source of nastiness and filed an “anonymous grievance” after a lecture in which Rubenfeld pressed his students about their own potential biases. As he wrote in National Review earlier this year, all he learned about the nature of the complaint is that the student objected to his use of the word “Palestinian” — somehow now a charged term after the campus convulsions surrounding Hamas’s October 7 attack on Israel and Israel’s response. Despite the filing of no further anonymous grievances, Baylor canceled the course.

https://www.americanthinker.com/articles/2024/10/doctors_have_responsibility_but_no_authority.html

Nothing proves the title better than the recent reinstatement of a mask mandate in San Francisco hospitals. Every clinical doctor knows the data overwhelmingly proves they don’t work “to prevent the spread of the flu, COVID and other seasonal illnesses,” the ostensible, official reason for re-masking.

Note the adjective “clinical” doctor to contrast MDs in the trenches caring for sick people with bureaucrat MDs who, like Fauci, have never cared for patients in the real world but who dictate how the clinicians must practice medicine.

For most viruses, a cloth surgical mask is as effective as a screen door on a submarine. When (not if) patients get sick with the flu despite healthcare workers wearing masks, who will be responsible to care for them? When patients complain that masks did not prevent illness, who will they blame?

For decades, federal regulations and bureaucratic doctors have been chipping away at doctors’ independence, authority, and valuation. The heart surgeon with the best results can charge more than the surgeon with poor results, yet both are paid the same: an amount much less than their charges and what Medicare determines as “allowable reimbursements.” These are not reimbursements — they are government-pre-determined, low-ball payments.

As an interventional pediatric cardiologist, this author’s charges for a cardiac catheterization in a critically ill newborn baby ranged from $1,500 to as much as $9,000 if a device were implanted. Medicaid paid the maximum allowable reimbursement: $387.

In the past, general physicians would refer their patients to surgeons with the best results for the operation the patient needed. Now they must send the patient to whatever institution (not even who) the insurance company has a contract with.

A personal physician is no longer chosen by the patient. The enrollee, not patient, is assigned a provider on a health plan panel. People wait months to get in for a 15-minute appointment during which the doctor spends most of the time looking at a computer screen and filling out forms. No one takes a history or does a physical exam anymore.

https://www.city-journal.org/article/lipstick-on-a-pig

The American College of Surgeons is trying to expunge the term DEI from antiracism and critical race theory initiatives. An attempted rebranding was inevitable, given how rapidly the term and its associated programs have fallen out of favor. Universities, corporations, and institutions of all kinds are eagerly rechristening, if not dismantling, their DEI departments and laying off their DEI administrators.

The new name of the game is “Inclusive Excellence.” Like “diversity, equity, and inclusion,” it has a nice ring to it and even seems to signal a return to a focus on merit. This is not the case. Search the ACS website for the Office of Diversity, and you’ll be redirected to the Office of Inclusive Excellence. The ACS has renamed its DEI Toolkit, introduced in December 2023, the ACS Inclusive Excellence Resource and Implementation Toolkit.

A perusal of the materials reveals that little if anything has changed in the program’s content and focus. It continues to promote the discredited Implicit Association Test as a measure of one’s implicit bias. It still claims that achieving proportionate representation of identity groups somehow makes organizations better. It adopts the same underlying DEI premise: that disparities of representation always indicate discrimination.

https://amgreatness.com/2024/10/14/poll-majority-favors-federal-ban-on-transgender-surgeries-for-minors/

A new poll shows that nearly two-thirds of voters support a federal ban on so-called “sex change” operations for minors, as Democrats continue pushing transgenderism on children across the country.

As reported by Just The News, the new survey from the Center Square Voters’ Voice Poll found that 59% support the ban, including 82% of Republican respondents and 56% of independents. Only Democrats were against the ban, with just 36% of Democratic respondents favoring it.

Along gender lines, men were more likely to support such a ban than women, with 63% of men favoring it while 56% of women voiced their support for it. When broken down by ethnicity, a total of 61% of White respondents favored the ban, while 46% of black respondents favored it, compared to 32% who opposed it and 22% who remained unsure.

The age groups which most favored the ban were the 45-54 and 54-65 demographics, both at 61% support. Meanwhile, the 18-34 bloc supported such a ban by a narrow majority, at 52%.

Lastly, 55% of voters with a college degree supported such a proposal compared to 61% of voters without a college degree, while 61% of voters with children supported a ban, compared to 52% of voters without children.

Transgenderism, the false and scientifically-debunked belief that there are more than two genders, and that anyone can simply change their gender at any time, has been promoted by Democrats for the last several years; the ideology has only recently begun facing serious pushback from conservatives, with laws banning such treatments for minors in 25 different states.

https://getpocket.com/explore/item/why-therapy-is-broken?utm_source=pocket-newtab-en-us

An hour a week in a shrink’s office is increasingly treated as a prerequisite for a healthy, happy life. There, we imagine, friends learn new coping skills and enemies realize the errors of their ways. Everyone is “healed.” Therapy has been marketed as a panacea for all kinds of issues, from fixing a bad personality to ending racism. Refusing to seek treatment becomes a red flag, while fluency in “therapy-speak” is all but mandatory. Professional help has even infiltrated our leisure hours: Reality TV shows like Couples Therapy, podcasts from This Is Dating to Where Should We Begin?, and “therapy in a box” card games, some actually designed by psychoanalysts, abound.

Unfortunately, as anyone who’s actually tried it can tell you, therapy often sucks.

Anywhere from 50 to 75 percent of people who go to therapy report some benefit—but at least 5 percent of clients get worse as a result of treatment. (For people from marginalized groups, harmful outcomes may be even more common.) The remainder report no clear benefit at all. Plenty of would-be clients go once and, feeling alienated, never return. Others keep trying, even as it becomes clear they aren’t really getting what they need, whatever that is.

But the American mental health care system has hardly acknowledged the existence of bad therapy, let alone taken steps to fix the problem. Instead, in the wake of the Covid-19 pandemic, which sent the demand for therapy soaring, the American Psychological Association and other organizations seemed to prioritize the quantity of available appointments over the quality of any resulting therapy. The rise of app-based mental health care, like BetterHelp and Talkspace, has only made this landscape harder to navigate.

The result is that everyone is telling everyone else to go to therapy, but “nobody really creates space to have dialog about, ‘OK, if it doesn’t work, let’s talk about why,’” says psychotherapist Ben Fineman, cohost of the Very Bad Therapy podcast with Carrie Wiita. That’s partly out of fear of uncertainty, which therapists dislike as much as anyone, and partly because reforming mental health care is complicated. But ignoring these shortcomings is only perpetuating the suffering therapy promises to heal.

https://www.nationalreview.com/2024/10/how-to-fight-the-lefts-politicization-of-medicine/

A new study challenges one of the more popular reasons cited for introducing left-wing ideology into medicine, and it outlines an agenda for making health care apolitical.

‘A sick society must think much about politics, as a sick man must think much about his digestion,” C. S. Lewis wrote. “To ignore the subject may be fatal cowardice for the one as for the other.” In the national delirium of a presidential election, the maladies of politics impose themselves on our minds to an even greater degree.

Unfortunately, the current state of the medical field is not much of an analgesic. In recent years, left-wing ideology has thoroughly penetrated medicine. But new research undercuts one of the more popular academic buttresses of this blatant politicization. It’s more than enough to make one wonder if a movement that bills itself as pro-health might actually be iatrogenic.

Health care has not been immune from the whole-of-society effort by the Left to take control of institutions and subordinate them to its aims. Medical schools, journals, professional societies, continuing-education courses, and other institutions of the medical field now tilt left, as I documented last year.

Examples abound. The official publication of the American College of Emergency Physicians recently published a case for DEI in medicine. Harvard’s School of Public Health is offering a “Settler Colonialism” course. The Cleveland Clinic is currently being investigated for possible discrimination against white patients. The important roles academia and the government play in the medical field make this reality sadly unsurprising.

It still may have been a surprise to some when a related research paper became fodder for the Supreme Court. In her dissent from the Supreme Court’s majority opinion that overturned affirmative action last year, Justice Ketanji Brown Jackson wrote that the practice “saves lives” (indirectly), citing a 2020 study to claim that high-risk black newborns are twice as likely to live if they have a black physician. What the study actually found was that half as many black newborns died while being treated by a black physician as when treated by a white physician, while the survival rate was above 99 percent in either case.

https://issuesinsights.com/2024/09/25/women-children-disabled-pay-the-price-for-obamacares-medicaid-expansion/

Obamacare greatly expanded Medicaid eligibility. As a result, about 20 million able-bodied, working-age adults who were previously ineligible are now enrolled in the program. 

But as a new report from the Paragon Health Institute makes clear, their gains have come at the expense of the pregnant women, children, and people with disabilities that Medicaid was established for. 

The harm to these legacy beneficiaries, and to taxpayers, will only mount unless Congress fixes the perverse incentives that Obamacare created for the nation’s flagship health program for the poor.

Obamacare directed states to expand Medicaid eligibility to able-bodied adults earning up to 138% of the federal poverty line. Forty states and the District of Columbia have complied.

Previously, eligibility had been restricted to vulnerable people — like nursing home residents with virtually no assets, or minor children, or pregnant women who lacked other health coverage. 

Obamacare incentivized states to enroll able-bodied adults by having the federal government cover most of the cost. 

For the legacy Medicaid population, the feds normally pick up between half and three-quarters of enrollees’ health care costs; states foot the rest of the bill. For the expansion population, Washington initially picked up 100% of the cost. Now the federal government covers 90%. 

https://www.city-journal.org/article/hhs-has-misled-on-gender-medicine

In 2015, the Centers for Medicare & Medicaid Services (CMS) accepted a formal request to initiate a national coverage analysis for “gender-reassignment surgery.” When making these coverage determinations, CMS is legally obligated to evaluate relevant clinical evidence and answer the question: Is the evidence sufficient to conclude that the application of the item or service under study will improve health outcomes for Medicare patients? In June 2016, CMS released its 109-page analysis, which it made open for public comment. The agency published its final decision memo two months later. The differences between the two documents were revealing—and disturbing.

At first sight, the summaries of both memos seemed similar. Each mentioned that the CMS was not issuing a national coverage determination on “gender-reassignment surgery” for Medicare beneficiaries with gender dysphoria. Such determinations, the CMS said, would continue to be made by local contractors on a case-by-case basis. On closer examination, however, the final document included substantial changes. These were not corrections. They amounted to a systematic effort to scrub any reference to the evidence of the harms associated with these surgeries.

The agency’s shifting analysis of gender surgery is glaring enough. But it is just one of several examples, between 2016 and the present day, of how key figures and agencies within the U.S. Department of Health and Human Services have misled the American public about the evidence for “gender-affirming care.”

Start with the tale of two memos. To conduct a proper analysis of the clinical evidence, CMS identified a large number of publications related to “gender-reassignment surgery.” As CMS explained:

Studies with robust study designs and larger, defined patient populations assessed with objective endpoints or validated test instruments were given greater weight than small, pilot studies. Reduced consideration was given to studies that were underpowered for the assessment of differences or changes known to be clinically important. Studies with fewer than 30 patients were reviewed and delineated, but excluded from the major analytic framework. Oral presentations, unpublished white papers, and case reports were excluded. Publications in languages other than English were excluded.

Thirty-three publications, ranging from 1979 to 2015, were eventually identified and included.