100th Lucidicus Kit Awarded!

I'm rather late in reposting this January 17th announcement from Jared Rhodes of The Lucidicus Project... but this milestone is fantastic, and I wanted to publicly applaud Jared's work to promote free markets among our future doctors!

I'm proud to announce that today The Lucidicus Project hit a nice milestone: we've awarded our 100th kit! The 100th kit went to Alexander G., a third-year medical student at Boston University.

You can read about Alexander and all the other recipients here.

The Lucidicus Project is a student outreach program that I started in 2005. We give out a "self-defense kit" of books and essays to medical students who are interested in learning about the moral and economic case for capitalism in medicine.

I think it's great that there is a popular movement brewing against Obamacare, but I believe it is absolutely critical to have doctors on board, too. We're cultivating that by reaching out to tomorrow's healthcare leaders--namely, medical students--while they are young and still open to new ideas.

Our next goal is to reach recipient number 200 a lot faster. I'd like to thank everyone who has donated or supported the project in the past in any way. And for anyone interested in doing so now, just go to Support The Center. Or, if you can't help out financially, then just spreading the word online and offline is extremely helpful, too. You never know who is listening!

Cheers,

Jared Rhoads
Center for Objective Health Policy
http://ohpcenter.org

Congratulations, Jared!

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Hsieh PJM OpEd: The Truth About RomneyCare

PJMedia has published my latest piece, "The Truth About RomneyCare".

Here is the opening:

Now that Mitt Romney has shown himself politically vulnerable after Iowa, more people are taking a closer look at his claims about the "RomneyCare" health care plan he helped create as Massachusetts governor. In this interview from April 2010 which recently recirculated last month, Romney attempts to draw some distinctions (as well as acknowledge similarities) between his RomneyCare plan and the national ObamaCare plan.

One of the alleged virtues of RomneyCare over ObamaCare is that Romney's plan does not contain "price controls," whereas ObamaCare does. But how does this stack up against reality?

I then discuss several forms of price controls that have already been (or will soon be) implemented in Massachusetts, and their consequences.

(Read the full text of "The Truth About RomneyCare".)

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Hsieh: Who Will Your Doctor Work For Under ObamaCare?

The 12/30/2011 TownHall.com has published my latest OpEd, "Who Will Your Doctor Work For Under ObamaCare?"

The theme is that ObamaCare will pressure doctors to sacrifice their individual patients' welfare for a collectivist concept of "social justice".

Here is the opening:

Suppose you move to Las Vegas, and you hire a real estate agent to help you buy a house. She returns with several inappropriate choices -- all too expensive and too far from your work. She explains, "I know these aren't what you wanted. But you'd really help the struggling Nevada housing market by purchasing one of these."

Most people would fire her on the spot. Your real estate agent has a professional obligation to look out for your individual interests, not some nebulous "Nevada housing market." Yet under ObamaCare, your doctor will be increasingly pressured into sacrificing your individual medical interests for a nebulous "social justice"...

(Read the full text of "Who Will Your Doctor Work For Under ObamaCare?")

I'd like to thank Diana for her assistance editing an early version of this piece.

I'd also like to thank Dr. Hal Scherz, Dan Rene, and Docs4PatientCare for helping to arrange its publication!

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Real World Effects of ObamaCare

One of my friends posted the following to Facebook, and she has graciously given me her permission to repost it here. She has asked that I refer to her as "Dr. Monica H.":

In Which I Detail How Obamacare Will Work for Me

Currently, I am a college professor at 3 campuses in the Denver area. I prefer not having administrative duties and would rather focus on teaching and research. Until we move (this is complicated), finding a FT job isn't likely, but I'm basically happy. I make what a full time faculty member makes, but that means I don't get healthcare because my work is split at multiple institutions, 2 of them community colleges. So I am responsible for my own healthcare, but I am OK with that, since I don't really use the traditional healthcare system for anything but very serious emergencies. I am not a big fan of medicine as it is practiced in this country, so I do most of my own lab testing and "alternative" treatment.

But never fear. My healthcare "problem" will be solved in 2014 when Obamacare kicks in. That's because the college has been told by the Feds that they must provide community college instructors who work more than 3/4 time (that's me) with health insurance. That would be me. I'm going to get health insurance! Yay, right?

How will the college respond to this? Likely by hiring more very part time instructors and taking work away from current instructors that teach nearly a full-time load. This is not speculation: I expect this to gradually be implemented over the coming 2 years, as detailed in an email I just received from the administration. This will be so they don't have to pay the insurance mandated by the federal government. I won't simply be able to spread out my work over 4-5 community colleges in response, because the new regulations apply to all community colleges in Colorado as a whole. In other words, the state won't view, say, Front Range CC and CC of Denver as two separate institutions when it comes to health insurance. It will view them as one. That means instead of teaching 4-5 classes per semester, I'll be limited to 1. The number of instructors will probably triple, depending on the department.

Yep, I'm sure on a salary 1/4 to 1/5 what I make now, I'll be ever so capable of paying for mandated insurance! Thanks, Obama!

A very practical example of the types of unanticipated effects of such legislation. For those of you who wonder why I'm no longer all that excited about the government thinking it knows best for me and every aspect of my life, this is why.

First, I very much appreciate this sort of "in the trenches" real-world report of how ObamaCare is hurting Americans. I hope more of our elected officials take heed of what their policies are doing to their constituents.

Second, many on the Left actively want Americans to be frustrated with private insurance industry under ObamaCare. That way they can say, "See, we tried it the 'free market' way and it failed; that's why we need a government 'single-payer' system". (Of course, the failure would be due to government policies that destroyed the free market, not the free market itself.)

Finally, these perverse effects of ObamaCare will affect many people all across the economic spectrum by making it harder for employers to offer full-time jobs to willing employees. For more details, see the following from James Sherk of The Heritage Foundation: "Obamacare Will Price Less Skilled Workers Out of Full-Time Jobs".

Here's a critical image:

[Crossposted from FIRM blog.]

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Hsieh PJM OpEd: Screening For Cancer vs. Screening For Terrorists

The November 30, 2011 edition of PJMedia has published my latest OpEd, "Screening For Terrorists vs. Screening For Cancer".

My theme is that the seemingly contradictory policies of the government of terrorist screening vs. cancer screening actually demonstrate a common theme.

Here is the opening:

As the holiday travel season approaches, millions of American air passengers will become painfully reacquainted with Transportation Security Agency (TSA) screening measures. Passengers must submit to either medically unnecessary X-rays or intrusive gropings.

Yet in the realm of health care the federal government has adopted a new policy of discouraging routine screening tests for many cancers. Although these two policies may seem superficially contradictory, they demonstrate an underlying common theme of the government seeking ever-greater control over our bodies and our freedom.

In particular:

Our government currently tells air travelers, "Submit to our screening despite the dubious effectiveness, bodily invasion, and needless emotional distress" while simultaneously telling patients, "Don't undergo cancer screening because it might lead to further bodily invasion and emotional distress."

Despite this seeming contradiction, in both cases the government is really saying, "We'll decide who can do what with your body." The American founding fathers would never have imagined that the federal government would someday presume to restrict citizens' medical or travel freedoms in such a fashion.

(Read the full text of "Screening For Terrorists vs. Screening For Cancer".)

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Upcoming Rationing of Neurosurgery Services?

Update: The Snopes.com website states that the American Association of Neurological Surgeons has investigated this issue and determined that anonymous caller was likely not a neurosurgeon and that the call "contained several factual inaccuracies". More here.

Original Post

An Illinois neurosurgeon discusses upcoming new guidelines from the Obama administration restricting how doctors can deliver medical care.

A few key points with respect to neurosurgery procedures:

Patients over age 70 with government insurance will receive "comfort care", but not the full range of aneurysm treatment, stroke therapy, etc.

Patients are referred to as "units", not patients.

Various devices currently approved by the FDA for "humanitarian use" and widely regarded by surgeons as medically safe and appropriate for clinical use will likely have that approval withdrawn to save money.

According to this surgeon, this information is straight from Obama administration HHS officials, although not yet published.

The physician summarizes the issue quite nicely:

You know, we always joke around -- 'it's not brain surgery' -- but I did nine years after medical school, I've been in training ten years, and now I have people who don't know a thing about what I'm doing telling me when I can and can't operate.

(Read the full blog post, "Neurosurgeon Briefed by HHS". Link via @SonoDoc99.)

Anyone who's read Atlas Shrugged will recognize the similarity between this surgeon's observations and this quote from the fictional Dr. Hendricks (also a neurosurgeon):

Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I could not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward...

Many Americans (including my own and Diana's parents) are over 70 years old yet in reasonably good health. They'd likely be denied life-saving neurosurgical care in the near future if these guidelines take effect.

But just don't call it rationing.

[Crossposted from the FIRM blog.]

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Hsieh TU OpEd: Don't Blame Capitalism For High Health Insurance Costs

On 10/4/2011, The Undercurrent published my latest OpEd, "Don't Blame Capitalism for High Health Insurance Costs".

My theme is that rising health insurance costs are due to statism, not the free market. Here is the opening:

Suppose Congress passed a law requiring that all restaurant meals include broccoli and okra, whether the customer wanted them or not. Restaurants must also charge the same price for all meals, regardless of whether the customer ordered a small salad or a large steak. And they must serve free meals to children up to age 26 whenever their parents purchased a meal.

As meal prices rose, most Americans would understand that this was caused by the government regulations, not the free market. Today, similar laws are driving up the price of health insurance -- and it's equally important not to unfairly blame capitalism for the problems caused by the government.

(Read the full text of "Don't Blame Capitalism for High Health Insurance Costs".)

I'm glad The Undercurrent published this to coincide with their Capitalism Awareness Week project. You can still watch some of their earlier lectures and debates held this past week at college campuses across the country.

Many thanks to Noah Stahl and Ben Bayer for their helpful editorial suggestions. For more on The Undercurrent, check out their website.

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Armstrong on Health Insurance and Personal Responsibility

The 9/24/2011 edition of PajamasMedia published Ari Armstrong's OpEd, "Health Insurance and Personal Responsibility".

Armstrong discusses the question asked by Wolf Blitzer to candidate Ron Paul in a recent GOP debate on who should pay for the health care of "a healthy 30-year-old young man [who] has a good job, makes a good living" but deliberately decides not to carry health insurance.

Although Blitzer framed the question as a false alternative between "society" paying for his care vs. "letting him die", Armstrong digs more deeply into issues of personal responsibility. In essence, if someone is able to pay for his own health insurance but chooses not to and instead "goes bare" on the risk, he should be help responsible for the bill (even if it might require a payment plan over time).

Armstrong then makes an important point:

But what about somebody who develops expensive health problems and truly cannot afford to pay? In those cases, hospitals and voluntary charity organizations remain free to step in and cover some or all of the costs.

Blitzer talks about "society" letting someone die, but whom does he mean? Each individual is part of society, so isn't the real question, "What are YOU going to do about it?" Treating "society" as some super-entity above and beyond the individuals who compose it causes two problems. First, it gives individuals an excuse to do nothing by their own initiative; second, it encourages many to ignore the actual victims of politicians' forced wealth transfer schemes.

This is a critical observation. Too much of current politics mistakenly reifies "society" as something above and beyond the individuals that compose it. This makes it too easy for politicians to propose policies which sacrifice individuals to a nebulous "collective good". Our numerous current political and economic problems are the consequence of this error.

The only way out of this trap is to recognize the primacy of the individual as the proper unit of political thinking, and to recognize that the proper function of government is to protect individual rights. Fortunately, more and more Americans are become aware that this is the critical issue.

Finally, Armstrong notes the following:

The deeper problem, the real reason a healthy 30 year old grows tempted to forgo health insurance, is that politicians have made the costs of health care and insurance ludicrously expensive.

Through destructive tax policies, the federal government linked health insurance to employment and encouraged the use of "insurance" for routine, every-day costs rather than for true emergencies. As a consequence, consumers have almost no incentive to seek economical care, and a considerable portion of each health dollar goes to insurance paperwork rather than actual care.

Today's politicians have taken dramatic action to turn health insurance into a gigantic wealth transfer scheme. That, indeed, is the entire premise behind the ObamaCare "mandate"; people must be forced to buy insurance because its artificially high costs subsidize the care of others. Consider, for example, the recent mandate from Health and Human Services that forces the insured who don't need birth control to pay for the birth control of others.

If we dismantled the federal controls over health care and moved toward a free market, that would put patients back in control of their health care, help contain costs, make insurance affordable again, empower more people to manage their health care costs, and ease the burdens on voluntary charity.

Armstrong's analysis is spot-on. It's not too late to reverse course, repeal ObamaCare, and move in the direction of genuine free-market health care reforms.

(Read the full text of "Health Insurance and Personal Responsibility".)

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Hsieh/Minton OpEd: Durbin's Dietary Paternalism

The September 13, 2011 edition of HumanEvents.com has just published an OpEd co-authored by myself and Michelle Minton of the Competitive Enterprise Institute, "Durbin's Bill Is Dietary Paternalism".

Here is the opening:

"You can't have that. It's not good for you."

We've all heard parents say that to their children at the grocery store checkout line countless times. While it may be appropriate for a mother to say to her 10-year-old, it's simply the wrong way to treat adults. Yet that would be the effect of new restrictions on dietary supplements proposed by Sen. Richard Durbin (D.-Ill.)...

(Read the full text of "Durbin's Bill Is Dietary Paternalism".)

We discuss the dangers of the proposed new restrictions on dietary supplements, which would require many supplement manufacturers to submit proofs of safety to the FDA before they could be marketed -- including many that are already freely available in drugstores and supermarkets without a prescription. The new regulations would raise the prices of many supplements and force others off the shelves entirely.

On a personal level, I am taking some dietary supplements (in consultation with physician colleagues) to help with my hip fracture healing. So anything that would restrict my ability to purchase such supplements to promote my health greatly alarms me.

Many thanks to my co-author Michelle Minton and her colleagues at CEI for her excellent work and for facilitating the publication of this piece!

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Hsieh PJM OpEd: Let's Model ObamaJobs After ObamaCare!

The 9/7/2011 edition of PajamasMedia has published my latest OpEd, "Let's Model ObamaJobs After ObamaCare!"

In this satirical piece, I discuss how President Obama could easily modify elements from his "universal" health plan to guarantee "universal" employment. Here's an excerpt:

1) Impose a "job mandate" requiring all companies with greater than 50 employees to add 10% new employees to their payrolls. So if a company currently has 50 employees, they would need to hire 5 new workers. If a company has 100 employees, they must hire 10 new workers, etc.

3) Of course, the government would have to closely specify what sorts of salaries, benefits, and job responsibilities must be included in any of these new government-created jobs, both within and outside the exchanges. We can't have those "millionaire and billionaire" employers exploiting their new employees. If a company needs, say, a Linux programmer, but the new worker has a "pre-existing condition" of not actually knowing Linux, the company should deal with it the best they can -- either by training him in Linux or finding him another job that he can do.

5) Of course, this idea of a "jobs mandate" is constitutional. Some old-fashioned pundits might mistakenly think that employers -- not the government -- should be free to decide whether and when to hire new workers, based on their own individual circumstances and requirements. But more enlightened scholars realize that "not hiring someone" is a form of "economic activity" that could affect commerce and economics across the country, especially when such individual "not hiring" decisions are considered in aggregate. Hence, by the Commerce Clause of the U.S. Constitution, Congress has the authority to limit or outlaw this widespread practice of "not hiring someone."

(Read the full text of "Let's Model ObamaJobs After ObamaCare!".)

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Open Letter to Apple: My iPad and My Hip Fracture

Dear Apple:

I've been a happy iPad2 owner since March 2011, but I never fully appreciated its value until I recently broke my hip in a bad fall and required subsequent hospitalization.

I am a physician, so I had already been using my iPad for my work, reading PDFs of medical articles, communicating with my colleagues via e-mail, etc. But when I broke my hip in an accident a few days ago, the iPad became my lifeline to the outside world:

Because I had my iPad with me at the time of the accident, I was able to immediately notify my friends and family of what had happened once I arrived in the ER.

In the ER, the iPad also helped keep my spirits up as I checked e-mail, followed my friends on Twitter and Facebook, and followed the regular world news. When my orthopedic surgeon presented my treatment options to me, he also e-mailed me some relevant medical literature in the form of PDF files which I could digest at my own pace on the iPad. And of course, I was also able to perform Google searches on my various surgery options, the complication rates, postoperative care requirements, etc.

Because of the specific nature of my fracture, I had to choose between two treatment options, each with its own pros and cons. I found it enormously helpful to be able to gather the relevant medical information literally "at my fingertips". Because of the iPad, I was able to more quickly make an informed treatment decision that I was comfortable with.

I did briefly leave my iPad with my wife during the surgery itself, but she gave it back to me immediately after the surgery. Other than that, it did not leave my side while in the hospital.

While in the hospital after my surgery, I used the iPad to read eBooks, check my e-mail, surf the internet, and keep up my regular blogging. It was a real morale booster to be able to continue as much of my regular online routine as possible, despite my impaired physical condition.

My wife also had her own iPad with her while I was hospitalized, which allowed her to update our friends and family in real time on my condition, as well as keep her occupied while I was asleep or in surgery.

And now that I'm at home recovering, my iPad is still at my side!

For someone such as myself with limited physical mobility, the iPad2 with its light weight and long battery life was perfect. A laptop computer simply would not have worked while in the hospital. The iPad was literally an emotional, medical, and physical lifeline for me during a difficult time in my life.

I know Apple has been in the news lately because of Steve Jobs' decision to step down as CEO. I just wanted to take this opportunity to publicly thank Mr. Jobs and Apple for creating such a wonderful, life-enhancing product.

In your advertisements, Apple has touted the iPad as "magical" and "revolutionary". To that, I would add the term "life-saver".

-- Paul Hsieh, MD

[Crossposted from GeekPress.]

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Hip Injury Aftermath

After my earlier left hip fracture, I underwent successful surgery to repair the broken femur head. The surgeon was able to get a good repair, and here's a post-op image:



For comparison, here's a matching pre-operative CT image:



For the record, those were definitely the three most expensive titanium screws I have ever purchased! But of course, I wasn't just paying for the screws but for the highly customized, personalized, urgent delivery method as well.

I'm now home for a few days of Medical Leave before I return to work. Fortunately, I should still be able function pretty well at my job at a computer work-station, although I won't be able to perform invasive procedures (or anything that involves prolonged standing) for a little while.

I do have a few observations in this immediate post-operative period:

1) American medical care is really really good. My care at all steps from the ambulance to the ER to the pre-op to surgery to the surgical aftercare was superb. Again, I want to give my kudos to the Level 1 Trauma Center where I was treated.

2) It's very easy to think that this superb medical care "just happens" and grows magically on trees. But knowing how bad care can be in other countries with socialized medical systems, I appreciate the current semi-free American system even more than ever. And I want to continue to fight to keep it as free as possible.

3) Some of the various personnel at the hospital knew I was a physician on staff there, but many did not. For those who didn't, I deliberately didn't mention the fact that I was a doctor just to see how they treated a "regular" patient. They were consistently competent, courteous, and professional -- and that makes me feel much prouder about where I work.

4) It's amazing how much one's life changes when one has restricted mobility on a single hip. Even simple ADLs (activities of daily living) such as sitting in chair, taking a shower, going to the bathroom, etc., become much more challenging. Fortunately, part of my patient education included some extremely helpful training sessions with the Physical Therapy and Occupational Therapy teams to prepare me for functioning at home.

5) The first shower at home after surgery feels really, really nice!

6) Some of the postop physical therapy exercises are a real b*tch!

7) Having an iPad was a huge boon throughout the entire process, staring in the ER, then at home prior to surgery, then in the hospital immediately postop, and now at home. Being able to reply to e-mails, keep up on the news, interact with friends via Twitter/Facebook, look up medical literature, read my Kindle books, etc., was an enormous morale boost. A laptop would not have been as convenient or portable for someone like me with limited physical mobility.

Finally, Diana has been a tremendous help during this challenge. She's been unfailingly cheerful despite now having to do twice as much work around the house as before. Certainly, if you value her work on NoodleFood or the Rationally Selfish webcasts, please feel free to be extra-generous with the tip jars!

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Hsieh PJM OpEd: How ObamaCare Plays Games With Your Life

My latest OpEd is now up at PajamasMedia: "How ObamaCare Plays Games with Your Life" (9/1/2011).

My theme is that under ObamaCare, people will succeed through cronyism, pull, and "gaming the system". In contrast, doctors who adopt the old fashioned approach of working for their patients' best medical interests will be punished for their virtues.

Here is the opening:

Whenever Congress attempts to "reform" the tax system by passing new laws, they inevitably create new winners and losers. But one group always wins -- the consultants and special interest groups best able to "game" the system to their advantage. The same is happening now with Obama's health care "reform," except this time the stakes won't just be money, but Americans' lives...

I also discuss Dr. Stewart Segal's related concept of the "ACO leper".

Will you be an "ACO leper" under the new system?

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Hsieh PJM OpEd: Don't Shoot the Downgrade Messenger

The 8/10/2011 PajamasMedia has just published my latest OpEd, "Don't Shoot the Downgrade Messenger".

My theme is that attacking S&P for the U.S. credit downgrade is like criticizing your doctor for diagnosing your cancer. Here is the opening:

Suppose you saw your doctor for a persistent headache. After performing a full battery of tests, he told you that your MRI scan showed a malignant brain tumor. Would you (1) work with him on a plan to treat your cancer, or (2) threaten the MRI manufacturer with a government investigation? Although most normal people would choose option 1, our government is responding to the news of the S&P credit downgrade with option 2.

The Senate Banking Committee has responded to S&P's downgrading of the U.S. government's credit rating by "gathering information" in preparation for possible formal hearings on S&P's action. Committee Chairman Tim Johnson (D-S.D.) called S&P’s move "irresponsible" because it would make it more difficult for cash-strapped state and local governments to borrow more money. In other words, the problem wasn't the fact that the federal, state, and local governments were borrowing money that might not ever get paid back. Rather, the problem was that S&P was pointing out that fact to the rest of the world.

Unfortunately, our government's tactic of blaming the messenger has been all too common these past few years...

(Read the full text of "Don't Shoot the Downgrade Messenger".)

The unrest in Great Britain and Greece are a wakeup call to America as to what to expect if we continue on our current unsustainable welfare-state spending spree. Let's hope Americans take heed before it's too late.

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Claeys on ObamaCare, Constitutionality, and Politics

George Mason University law professor Eric R. Claeys has a nice detailed article on the constitutional issues related to ObamaCare and their political implications.

His article appears in the Summer 2011 issue of National Affairs and is entitled, "Obamacare and the Limits of Judicial Conservatism".

I'm still digesting Claeys' piece, but one of the many interesting points he makes pertains to the conventional wisdom that when the "individual mandate" is eventually decided by the US Supreme Court (SCOTUS), there will be 4 conservative votes against and 4 liberal votes for, with the "swing vote" being Justice Kennedy.

Claeys warns:

[T]his conventional wisdom is wrong -- and adhering to it could prove highly counterproductive for Obamacare's opponents. It is wrong largely because it assumes that the Roberts Court's 'judicial conservatives' are members of a monolithic bloc.

In the final section of the paper, he also discusses 4 principles that ObamaCare opponents should keep in mind as the SCOTUS decision draws here:

1. There should be no irrational exuberance about the Virginia and Florida decisions.

2. Obamacare opponents should not despair if the Supreme Court votes not to declare the individual mandate unconstitutional.

3. Opponents of Obamacare must anticipate what to say if the Supreme Court votes not to declare the individual mandate unconstitutional.

4. If legislators and candidates will need to argue against Obamacare's constitutionality later, they might as well start now. And they should consult the opinions of Justice Thomas.

(He discusses each of these points in greater depth in the paper.)

As I mentioned above, I'm still digesting this piece. But it's a thought-provoking read. The full text is available at "Obamacare and the Limits of Judicial Conservatism".

Disclaimer: Professor Claeys was on my wife's PhD dissertation committee. (Note from the wife: He was super-helpful!)

(Link via GMU law professor Adam Mossoff.)

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Crowdsourcing Benefits of Personal Genetic Testing

At FuturePundit, Randall Parker described how "Crowd Sourcing Identifies 2 Parkinsons Disease Genes".

Here's an extended excerpt from his post:

The folks at personal genetic testing company 23andme.com recruited Parkinson's Disease (PD) patients from mailing lists and other means and compared their genetic variants with a group of 23andMe customers who also got their genetic variants tested by 23andMe.

They used the resulting data to discover 2 more genetic variants associated with Parkinson's Disease. The results demonstrate the speed, low cost, and power of web-based recruiting to do genetic research outside the traditional academic framework.

We conducted a large genome-wide association study (GWAS) of Parkinson's disease (PD) with over 3,400 cases and 29,000 controls (the largest single PD GWAS cohort to date). We report two novel genetic associations and replicate a total of twenty previously described associations, showing that there are now many solid genetic factors underlying PD. We also estimate that genetic factors explain at least one-fourth of the variation in PD liability, of which currently discovered factors only explain a small fraction (6%–7%). Together, these results expand the set of genetic factors discovered to date and imply that many more associations remain to be found.

Unlike traditional studies, participation in this study took place completely online, using a collection of cases recruited primarily via PD mailing lists and controls derived from the customer base of the personal genetics company 23andMe.

Our study thus illustrates the ability of web-based methods for enrollment and data collection to yield new scientific insights into the etiology of disease, and it demonstrates the power and reliability of self-reported data for studying the genetics of Parkinson's disease.

You can read the whole open access Plos Genetics research report at that link.

What's cool about this: Using a web site and cheap genetic testing services people can volunteer themselves as research subjects on a scale that historically has taken far more effort to organize. This approach can scale into the hundreds of thousands, and even hundreds of millions of people. There's a big network effect where the more people who get tested the more useful genetic testing becomes.

Direct-To-Consumer (DTC) genetic testing is what made the study above possible. Whether we will be able to continue to get our DNA tested without paying for a doctor's visit and additional testing mark-ups remains to be seen. In the United States the Food and Drug Administration (FDA) is taking a dim view of DTC genetic testing.

(Read the rest of Parker's post: "Crowd Sourcing Identifies 2 Parkinsons Disease Genes".)

Here's the full PLOS Genetics paper: "Web-Based Genome-Wide Association Study Identifies Two Novel Loci and a Substantial Genetic Component for Parkinson's Disease".

I completely agree with Parker. Proposed FDA controls over the growing consumer genetic testing market not only deprive individuals of the right to learn the content of their DNA, but could also stifle the growth of new discoveries (and downstream therapies) made possible only by this sort of innovative free-market "crowdsourcing".

The FDA has no business stopping people from voluntarily sharing their genetic information with others in hopes that they might reap life-saving benefits.

(See also my July 2010 PajamasMedia piece, "Should You Be Allowed To Know What's In Your DNA?")

Note from Diana: I got my 23andMe genetic test results back last week... with some useful but worrisome results. I'll blog about that soon-ish.

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Hsieh PJM OpEd: The Coming Collectivization of American Health Care

The 7/11/2011 edition of PajamasMedia has just published my latest OpEd, "The Coming Collectivization of American Health Care".

Here is the opening:

In the 1930s, the USSR forced independent farmers into large state-run collective farms. Despite possessing some of the richest farmland in the world, these collective farms could not feed the country. By the end of the Cold War, the USSR survived only by importing Western grain. Unfortunately, the United States is about to make the same mistake in health care by collectivizing doctors and hospitals into government-supervised accountable care organizations (ACOs)...

(Read the full text of "The Coming Collectivization of American Health Care")

Note that this government-drive consolidation of doctors and hospitals into a few large provider groups is not some "bug", but rather a desired "feature", because it allows the government to more easily control what kind of medicine will (and will not) be practiced in the US.

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Hsieh PJM OpEd: Why the 'Unexpected' Keeps Happening

The 6/29/2011 edition of PajamasMedia has just published my latest OpEd, "Why the 'Unexpected' Keeps Happening".

Here is the opening:

If an irresponsible teenager repeatedly crashed his car into a tree whenever he had a few beers, we would never say his accidents were "unexpected." Rather, they would be foreseeable consequences of driving while drinking. Similarly, we shouldn’t let journalists get away with describing as "unexpected" the foreseeable negative consequences of bad government policies.

Blogger Glenn Reynolds recently highlighted numerous examples of the media’s increasingly frequent use of "unexpected" to describe bad economic news. Unemployment "unexpectedly" rose despite federal "stimulus." Home sales "unexpectedly" fell despite taxpayer bailouts. ER visits unexpectedly rose in Massachusetts despite RomneyCare. Similarly, the Pundit Press blog has rounded-up dozens of examples of such "unexpected" developments since January 2011...

Read the full text of "Why the 'Unexpected' Keeps Happening" for the answer!

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Hsieh TownHall OpEd: Central Planner Fallacy in Health Care

The 6/20/2011 TownHall.com has published my latest OpEd, "A Doctor Exposes Obama's Health Care Fallacy".

My theme is that Accountable Care Organizations (ACOs) represent the latest incarnation of the failed "central planner fallacy" as applied to American health care. Here is the opening:

Suppose President Obama proposed reviving the faltering American economy by creating a federal "Department of Technology" to encourage Silicon Valley technology companies to merge into large consortiums. Bureaucrats would then tell these companies what products they should produce and sell.

Most Americans would consider that approach ridiculous. They know that innovations such as iPads and smartphones were created by entrepreneurs competing in a free market, not by government central planners. Yet the Obama administration is committing the same error by pushing doctors and hospitals into government-supervised "Accountable Care Organizations"...

(Read the full text of "A Doctor Exposes Obama's Health Care Fallacy".)

Thanks to Dr. Hal Scherz and to Dan Rene of Docs4PatientCare for helping to arrange this!

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Hsieh PJM OpEd: "Dude, Where's My Freedom?"

The 6/11/2011 PajamasMedia has published my latest OpEd, "Dude, Where's My Freedom?"

My theme is that ongoing forms of "gun control", "health control", and "travel control" are just examples of a broader "freedom control".

Here is the opening:

Benjamin Franklin once warned Americans that “they who would give up an essential liberty for temporary security, deserve neither liberty or security.” Yet in the seemingly unrelated areas of health care and physical security, our political leaders are embracing this folly with predictably bad results...

(Read the full text of "Dude, Where's My Freedom?")

I'd like to thank Jared R. and Vicky G. for pointing me to some of the links I used. And thank you, Glenn Reynolds, for the Instapundit link!

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