HDTenEightyP/NetNews huggingface dataset:
From: tjm@netcom.com (Thomas J. Merritt)
Subject: Re: The future of medicine
Organization: Code Generation Technology
Date: Mon, 11 Jan 1993 02:45:53 GMT

In article <1993Jan10.190249.3063@cnsvax.uwec.edu> nyeda@cnsvax.uwec.edu (David Nye) writes:
|[reply to thf2@ellis.uchicago.edu]
...
|>Indeed, it's the AMA that's the greatest bar to quality control at the
|>moment.  There are doctors out there with malpractice rates an order of
|>magnitude or so higher than average -- just try and find out which ones
|>those are.
| 
|I'm in agreement with you here.  I'm not an AMA member.  Many of us
|aren't and don't agree with the way they do things.  It is not the
|official spokesman for physicians, it is a PAC whose primary focus is
|not what is best or most ethical for society but how best to maintain
|physicians' incomes and autonomy.  In that respect it is not much
|different from any other union.

I have to agree with you on this one.  The primary interest of the AMA
is increasing its own power by increasing the number of physicians and
the amount of their incomes.  This flies in the face of curbing health
care costs and maximizing patient care.  It is easy to see that curbing
health care costs in not in the interests of physicians.  However,
providing suboptimal care is not so obvious.

At the extreme if every member of the population was completely healthy
and lived in an environment where the stayed that way there would be no need
for physicians.  Ultimately this should be the goal of a national(global)
health care policy.  The problem with such a goal is that should we actually
make progress in achieving it we would reduce the power and pretige of
physician not increase it since there would be less demand for medical
care.  This goes counter to the interests of the AMA. Although the
AMA doesn't not make a policy of injurying individuals they do so
indirectly by selectively supressing information that would be helpful
to the general population in pursuing more effective and less costly
treatments.

Personaly the only way that I can see to curbing health care costs to 
change the financial incentives that physicains receive.   When and if we
as a society provide a financial incentive for physician to have healthy
patients we will see a decline in health care costs.

Medical economics are a tricky thing and I do not claim to be an expert.
But it is interesting to at the costs of MRI in the USA versus other 
countries.  In locations where the use of MRI is rationed because the
need outstripes the capacity MRI utilization is high the cost is one
seventh that in the USA.  MRI utilization in the USA is about one seventh
our capacity.  What this suggests is that 85% of the cost of an MRI
in the USA is tied up in providing excess capacity.  What we get for
this 85% of the cost is easy access to MRI's in this country.  Conceptually
I like being able to have near immediate access to an MRI should I need
one the other hand I'm not sure that I'm willing to pay the cost.

And on and on and on...

TJ Merritt
tjm@netcom.com
From: nyeda@cnsvax.uwec.edu (David Nye)
Newsgroups: talk.politics.medicine
Subject: Re: The future of medicine
Date: 12 Jan 93 18:24:49 -0600
Organization: University of Wisconsin Eau Claire

[reply to kfl@access.digex.com]
 
>People with habits that have high medical costs should pay those costs.
>There's no reason the rest of us should subsidize smokers, drinkers,
>people who eat meat every day, don't wear seatbelts, have unprotected
>promiscuous sex, get no exercise, have no smoke detector, etc.
 
This already occurs.  Many insurance companies already try to enroll
only the healthiest patients, looking for evidence of bad habits like
these to screen out high-risk patients who then must pay more for
insurance, if they can get it at all.  Most public policy makers think
this practice (called "cherry picking") is a bad idea.  Legislation is
expected to be introduced under the Clinton administration to outlaw
it.
 
>It's wrong to forbid malpractice suits.  If a doctor, licensed or
>otherwise, causes harm through malice, negligence, or incompetence,
>they should be compelled to do whatever they can towards making things
>right again.
 
It is more wrong IMHO that not everyone has access to health care, which
is because it is too expensive, which is because, at least in part, of
the medical malpractice problem.  The question is, how much is it worth
to us to be able to sue?

David Nye
nyeda@cnsvax.uwec.edu
Newsgroups: talk.politics.medicine
From: swf@tools3teradata.com (Stan Friesen)
Newsgroups: talk.politics.medicine,sci.skeptic
Subject: Re: AIDS risk/Duesberg
Date: 5 Jan 93 21:48:49 GMT
Distribution: world
Organization: NCR Teradata Database Business Unit

In article <C012vt.72K@umassd.edu>, pmsc13sg@UMASSD.EDU (Stephen Grossman) writes:
|> 
|>     You have committed the logical fallacy of irrelevant conclusion.
|>     Please provide evidence that the original APA judgement that homosexuality 
|> is psy. illness is _based_ on Christianity. Take care to split _(logically)
|> based_ from _coincidentally consistent with_.

I do not think this is a cogent reply.

It is fairly obvious, to one who knows something about how these things work,
that the original APA assessment of homosexuality as a disease was based largely
on current *social* *norms*, not scientific eviedence.

This sort of thing is actually quite common in science - some things are considered
so *obviously* *true* that they are accepted without any investigation.  Anyone
with any knowledge of the history of our society would realize that the idea
that homosexuality is abnormal was just such a thing until very recently indeed.

Often times when these 'obvious' things are actually investigated they turn out
to be false. (Whether, given the current social climate, it is possible to have
anything even approaching an objective investigation of homosexuality is a 
different question entirely).

[For a less socially significant example, it was long believed that a certain
microbe entered its cyst stage when food became scarce - it seemed obvious that
this was so. In the mid-1970's I assisted in an investigation that proved that
it was crowding, not lack of food that triggered encystment (eventually it was
shown to be a hormonal thing)].

|>I.e, it could be that religion is
|> accidentally consistent with a concrete scientific judgement.

Yep, that is so.  But so is the converse,
That is why sound scientific judgement must be *independent* of religion.

|>Did APA 
|> explicitly appeal to Christianity or to science?

Probably not, they probably just codified the existing 'common knowledge',
which was based on our long Christian heritage in our culture.

|> Can you cite those studies which APA used (to classify homo.
|> as illness) and which, if I understand you, appeal to Christianity rather than
|> lab, clinic, etc.

I seriously doubt there *were* any well-controlled, double-blind studies on
this issue until recently, since the matter would not even have been considered
a *question*, and thus would not have been felt to *warrent* much research.

-- 
sarima@teradata.com			(formerly tdatirv!sarima)
  or
Stanley.Friesen@ElSegundoCA.ncr.com
From: weemba@sagi.wistar.upenn.edu (Matthew P Wiener)
Newsgroups: talk.politics.medicine
Subject: Re: AIDS risk/Duesberg
Date: 6 Jan 93 18:30:54 GMT
Reply-To: weemba@sagi.wistar.upenn.edu (Matthew P Wiener)
Organization: The Wistar Institute of Anatomy and Biology
In-reply-to: starr@genie.slhs.udel.edu (Tim Starr)

In article <1993Jan6.012008.1059@genie.slhs.udel.edu>, starr@genie (Tim Starr) writes:
>I'm curious about this mutation rate.  It seems to conflict with the stable
>estimates of the US HIV+ population based upon tests of those entering the
>military.  Will you please elaborate on this?

I am baffled at your claim regarding stable estimates.  HIV infection is
still continuing to increase.

>The problem would seem really to be the relatively high number of
>HIV+ people without AIDS, which I've heard is about 1.5 million in
>the USA.  There have been predictions that they'd start contracting
>AIDS in droves, but this hasn't happened, leading Gallo of NIH to
>extend the "dormancy" period to between 12 and 30 years.

The full course and range of HIV infection is still poorly known.  Then
again, there is the possibility is that with the wider spread of safe sex,
clean needles, and so on, the virus is evolving into better host adaption.
-- 
-Matthew P Wiener (weemba@sagi.wistar.upenn.edu)
Xref: sparky talk.politics.medicine:483 alt.politics.homosexuality:9012
From: weemba@sagi.wistar.upenn.edu (Matthew P Wiener)
Newsgroups: talk.politics.medicine,alt.politics.homosexuality
Subject: Re: APA and Homosexuality
Date: 5 Jan 93 22:14:26 GMT
Reply-To: weemba@sagi.wistar.upenn.edu (Matthew P Wiener)
Followup-To: talk.politics.medicine
Organization: The Wistar Institute of Anatomy and Biology
In-reply-to: jbeason@s.psych.uiuc.edu (Joseph E. Beason)

In article <C0E1n9.73z@news.cso.uiuc.edu>, jbeason@s.psych (Joseph E. Beason) writes:
>Psychologists and psychiatrists decided that homosexual behavior was abnormal
>and that homosexuals were sick.  They then went about proving these decsions.
>This is siilar to a charming mental illness they once found in slaves,
>basically, the dislike of their slave state and the desire to be free.  I
>forget the name of this dire mental disease, I'll look it up next time I
>go library hopping.

These kind of demented diagnoses continue to this day.  I quoted in
sci.psychology the abstract to a paper straightfacedly arguing for the
classification of happiness as a mental illness.  I received some
pretty shocking e-mail of a case where this has happened.  A man's
ex-wife has gotten psychiatrists to report that

    The children suffer SEVERE EMOTIONAL OUTBURSTS prior to visits
    with their father. A second and third opinion said the same.
    SEVERE EMOTIONAL REACTION: SEVERE EMOTIONAL DISTURBANCE. In
    talking to the last therapist to see the children, I found out
    the children jumped out of their chairs, danced around and sang
    daddy's coming when asked if they wanted to do therapy with dad.

As a consequence, the man cannot visit his children.
-- 
-Matthew P Wiener (weemba@sagi.wistar.upenn.edu)
Xref: sparky talk.politics.medicine:476 talk.origins:16045
From: starr@genie.slhs.udel.edu (Tim Starr)
Subject: Re: APA and Homosexuality
Organization: UDel, School of Life & Health Sciences
Date: Wed, 6 Jan 1993 02:08:25 GMT

In article <C0Aww2.M6q@umassd.edu> pmsc13sg@UMASSD.EDU writes:
}In article <1993Jan3.055056.8747@msc.cornell.edu>, maynard@leah.msc.cornell.edu (Maynard J. Handley) writes:
}	"Inventing the Homosexual"-Marjorie Rosenberg, _Commentary_, Dec. 1987; 
}excellent account; p.36. However, she doesn't give reasons why APA previously 
}opposed homo. Her point is merely that the later APA acceptance of homo. was 
}neither good nor bad science but "The psyciatric concept of homo.had been an 
}integral part of a theoretical system elaborated throughout his century; it was 
}overturned in a two-year period by committees of the APA responding to a 
}general political climate and to specific political manipulation and 
}intimidation."

If you think this pschiatric judgement was scientific, you haven't read enough
of Thomas Szazs' works to gain skepticism that this science is any more
advanced, as Ted so nicely put it, than phrenology.

}	I think one must get very basic, perhaps even philosophical, to 
}understand homo. Human nature is the key here. Humans are bio. hetero.

It isn't clear what you mean.  If you mean that sexual reproduction requires
heterosexual intercourse, then you're correct, but too close to the claim
that all sex must be for the purpose of procreation for my comfort.

}As far as i know, even 
}anti-reason societies oppose, to varying degrees, homosexuality.

This is false.  The ancient Greeks practiced homosexuality.  I'd think that
the society of Socrates and Aristotle was one of the more pro-reason ones,
wouldn't you?

Tim Starr - Renaissance Now! - Think Universally, Act Selfishly
starr@genie.slhs.udel.edu

"True greatness consists in the use of a powerful understanding to enlighten
oneself and others." - Francois Marie Arouet Voltaire
From: starr@genie.slhs.udel.edu (Tim Starr)
Subject: Re: AIDS risk/Duesberg
Organization: UDel, School of Life & Health Sciences
Date: Thu, 7 Jan 1993 07:57:36 GMT

In article <103852@netnews.upenn.edu> weemba@sagi.wistar.upenn.edu (Matthew P Wiener) writes:
}In article <1993Jan6.012008.1059@genie.slhs.udel.edu>, starr@genie (Tim Starr) writes:
}>I'm curious about this mutation rate.  It seems to conflict with the stable
}>estimates of the US HIV+ population based upon tests of those entering the
}>military.  Will you please elaborate on this?
}
}I am baffled at your claim regarding stable estimates.  HIV infection is
}still continuing to increase.

My understanding is that the estimates for the HIV+ population in the USA
based upon tests of those entering the military have remained stable at about
1.5 million.  I keep hearing of increases, but never above that figure in
the USA.

Tim Starr - Renaissance Now! - Think Universally, Act Selfishly
starr@genie.slhs.udel.edu

"True greatness consists in the use of a powerful understanding to enlighten
oneself and others." - Francois Marie Arouet Voltaire
Newsgroups: talk.politics.medicine
From: starr@genie.slhs.udel.edu (Tim Starr)
Subject: Re: AIDS risk/Duesberg
Organization: UDel, School of Life & Health Sciences
Date: Wed, 6 Jan 1993 01:50:36 GMT

In article <17983@pitt.UUCP> geb@cs.pitt.edu (Gordon Banks) writes:
}In article <1992Dec23.064508.12019@genie.slhs.udel.edu> starr@genie.slhs.udel.edu (Tim Starr) writes:
}>In article <1992Dec23.005116.29281@midway.uchicago.edu> thf2@midway.uch
}>}
}>}Of course this alternative theory doesn't explain why hemophiliacs and
}>}infants and blood transfusion recipients get AIDS.  Or why it's so
}>}prevalent in Africa.  My first guess would be to reject Duesberg's
}>}theory as having less explanatory power than the current theory.
}>
}>Blood transfusions in themselves are immunosuppressive, as is malnutrition.
}>
}
}But hemophiliacs got transfusions for many years before AIDS and never
}got it.  They get transfusions now and don't get it.  What is the difference?
}We now don't give them blood from HIV+ donors.  Anyone who doesn't
}admit the connection between HIV and AIDS needs to join the flat
}earth society.

It's been a while, but I read of some flaws with studies of hemophiliacs.
Construing "connection" as "correlation," I'd agree with you.  However, there's
simply too much left unexplained for me to lose doubt about any causal
hypothesis for AIDS.

I'd also like to point out that there are other differences between hemo-
philiacs who got HIV+ transfusions and ones now who don't: concern over
immunosuppression seems much higher, and would tend to lead people who are
more aware that they're at risk of it to take better care of themselves.
This might not be highly significant, but it is another factor.

Tim Starr - Renaissance Now! - Think Universally, Act Selfishly
starr@genie.slhs.udel.edu

"True greatness consists in the use of a powerful understanding to enlighten
oneself and others." - Francois Marie Arouet Voltaire
Newsgroups: talk.politics.medicine
From: thf2@ellis.uchicago.edu (Ted Frank)
Subject: Re: AIDS risk/Duesberg
Reply-To: thf2@midway.uchicago.edu
Organization: University of Chicago
Date: Wed, 6 Jan 1993 03:57:30 GMT

In article <1993Jan6.013651.1695@genie.slhs.udel.edu> starr@genie.slhs.udel.edu (Tim Starr) writes:
>In article <-tsrq8b@lynx.unm.edu> bhjelle@carina.unm.edu () writes:
>}The 3 back-to-back Science papers by Gallo's lab in 1984 proved
>}that HIV causes AIDS.
>
>I thought they'd been discredited.

No.  Gallo got in trouble for taking credit for the work of French
researchers, but the publications, to my knowledge, are still valid.
-- 
ted frank                     | thf2@ellis.uchicago.edu 
standard disclaimers          | void where prohibited
the university of chicago law school, chicago, illinois 60637
Newsgroups: talk.politics.medicine
From: starr@genie.slhs.udel.edu (Tim Starr)
Subject: Re: AIDS risk/Duesberg
Organization: UDel, School of Life & Health Sciences
Date: Wed, 6 Jan 1993 01:43:15 GMT

In article <103726@netnews.upenn.edu> weemba@sagi.wistar.upenn.edu (Matthew P Wiener) writes:
}>The 3 back-to-back Science papers by Gallo's lab in 1984 proved
}>that HIV causes AIDS.
}
}A creationist once asked in talk.origins when was the "fact of evolution"
}considered proven.  He got numerous answers, and thought that this range
}of answers clinched the case that scientists don't know what they're
}talking about.  Of course this is ridiculous--there simply are no uniform
}standards of proof in science.  Each individual scientist has his turning
}point regarding when the mass of accumulating evidence is convincing.  And
}usually a somewhat higher point that is considered incontrovertible proof.

No uniform standards?  That seems too wide for me.  I thought that controlled
studies were the standard for all theories with predictive potential.

}Which brings us to the end of the diversion.  I'd disagree that the 1984
}NCI papers were _proof_, although I agree they were damned convincing.
}Proof, in my mathematical eyes, has been more recent.  Two stand out
}in particular.  The restriction of the overwhelming majority of blood
}transfusion AIDS cases to recipients of unscreened blood 1977-1985, and
}the ability to track more recent cases to donors who seroconverted after
}their donation, puts a bullseye on HIV.  As does the ability of AZT, a
}reverse transcriptase inhibitor, to delay the onset of AIDS.  By a not
}so surprising coincidence, HIV evolves to be AZT resistant, and AIDS
}follows.  And this ability of AZT to delay AIDS is voided if the initial
}HIV infection is AZT resistant.  Which makes perfects sense if HIV causes
}AIDS, but which makes absolutely no sense if HIV does not cause AIDS.

One thing about AZT: there are no long-term AIDS survivors on it, according
to the makers of AZT, Burroughs-Wellcome (if I recall the spelling correctly).

Tim Starr - Renaissance Now! - Think Universally, Act Selfishly
starr@genie.slhs.udel.edu

"True greatness consists in the use of a powerful understanding to enlighten
oneself and others." - Francois Marie Arouet Voltaire
Newsgroups: talk.politics.medicine
From: starr@genie.slhs.udel.edu (Tim Starr)
Subject: Re: AIDS risk/Duesberg
Organization: UDel, School of Life & Health Sciences
Date: Sat, 9 Jan 1993 07:59:42 GMT

In article <C0Krq0.Bwu@watserv1.uwaterloo.ca> dmcanzi@watserv1.uwaterloo.ca (David Canzi) writes:
}In article <1993Jan8.082406.4296@genie.slhs.udel.edu> starr@genie.slhs.udel.edu (Tim Starr) writes:
})In article <C0II6D.Iwr@watserv1.uwaterloo.ca> dmcanzi@watserv1.uwaterloo.ca (David Canzi) writes:
})}Firstly, this is a *small* set of
})}people.
})
})How is this known?  I've heard that half of all AIDS cases were presumed by
})the CDC to have HIV without testing.  Have I been misinformed?
}
}A serious question, though it may not look serious:  Which half?
}Also, where did you get this information?

I don't know which half or where I heard it, sorry.

})It all depends on this, of course.  If non-HIV AIDS is rare, then mutation
})could easily account for the failure to detect HIV in those PWAs.  If it's
})too common, then the mutation rate would have to be too high to square with
})the other info.
}
}Since you don't know if the number of HIV-negative patients with
}AIDS-like illness is large enough to cause the statistical effects you
}expect, the lack of such effects does not support your argument.

True.  The basic facts are the issue.

Tim Starr - Renaissance Now! - Think Universally, Act Selfishly
starr@genie.slhs.udel.edu

"True greatness consists in the use of a powerful understanding to enlighten
oneself and others." - Francois Marie Arouet Voltaire
Newsgroups: talk.politics.medicine
From: bhjelle@carina.unm.edu ()
Subject: Re: AIDS risk/Duesberg
Date: Thu, 07 Jan 93 15:10:38 GMT
Organization: University of New Mexico, Albuquerque

In article <1993Jan7.080346.5725@genie.slhs.udel.edu> starr@genie.slhs.udel.edu (Tim Starr) writes:
>}>
>
>
>}>have been predictions that they'd start contracting AIDS in droves, but
>}>this hasn't happened, leading Gallo of NIH to extend the "dormancy" period
>}>to between 12 and 30 years.
>}
>}Gallo has said no such thing. Furthermore, making estimates like
>}that would be far removed from Gallo's scientific interests.
>
>I'm sorry, but he has said such things, and I have the references to prove it
>if necessary.  The remove from his scientific interests is beyond me to
>judge - hell, figuring out that his scientific interests are is beyond me!
>
>
They are not hard to judge if you actually read his papers.
I will summarize them here: basic science of HIV and other
viruses; basic science of carcinogenesis, such as Kaposi's
sarcoma. I would like to see your reference to the 12-30 year
quote. 12 years is not far removed from the usual latency
estimates, but 30 years is  *way*  off.

Brian




Newsgroups: talk.politics.medicine
From: gld@cunixb.cc.columbia.edu (Gary L Dare)
Subject: Re: The future of medicine
Reply-To: gld@cunixb.cc.columbia.edu (Gary L Dare)
Organization: The Bates Motel
Date: Wed, 13 Jan 1993 02:33:30 GMT

jlove@ivrit.ra.itd.umich.edu (Jack Love) writes:
>
>In a system where all people are covered under some form of national
>health insurance, the victim does not need to worry about receiving
>whatever care is necessary to repair damage caused by malpractice. In
>the event that such damage cannot be repaired, or there is substantial
>loss of wages, the victim is awarded compensation via binding
>arbitration. The victim benefits because there is never any doubt that
>the bills will be paid, and payment is immediate.  In return, people
>give up their right to sue.

Hmmm ... in Canada, where we have the various provincial public plans
(but not national -- that's a policy with guidelines), doctors still
pay for malpractice insurance albeit an order of magnitude less ...
having a more traditional British-style (French in Quebec) civil law
system, our bars prohibit speculative percentage fees (as in America,
we have a lawyers' monopoly as well as a doctors' monopoly) so when
you are suing, you and your attorneys are pretty cocksure about your
case and if you're the offending doctor, it is indeed time to sweat.
Loss of wages, pain and suffering plus medical costs (reimbursing the
insurance fund -- it's not free, after all!) can be exacted from the
losing party.

gld
--
~~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare
> gld@cunixb.cc.columbia.EDU 		President Bush should
> gld@cunixc.BITNET			pardon Amy Fisher NOW!