Morning Ethics Warm-Up, 4/5/ 2019: An Intersex Revolutionary War Hero! An Unethical Feminist Trailblazer!

Good Morning!

Well, it was nice while it lasted. Thanks to prurient interest in a minor “Naked Teacher Principal” post, traffic on Ethics Alarms this week resembled those heady days of 2016, before ultra-Trump polarization, liberal commenter cowardice and Facebook’s ban took over. Incidentally, despite many thousand of “clicks,” the post in question didn’t get a single comment from the first-time visitors, meaning that said clicks were meaningless and useless.

1. About “Ma” Fergusen. As promised yesterday in my note about “The Highwaymen”, here is the “Ma” Fergusen saga, which is an ethics feast, though not a tasty one. (Source: Texas Politics)

Miriam Amanda Wallace (“Ma”) Ferguson (1875-1961), was the first woman governor of Texas. She served as the first lady of Texas during the gubernatorial terms of her husband James Edward Ferguson,  who was impeached during his second administration for extensive corruption. When James  failed to get his name on the ballot in 1924, Miriam entered the race for the Texas governorship, promising that if elected she would essentially be guided by her husband and that Texas thus would gain “two governors for the price of one.” She defeated the Republican nominee, George C. Butte, and was inaugurated fifteen days after Wyoming’s Nellie Ross, Miriam Ferguson became the second woman governor in United States history. Thus “Ma” helped set the precedent for future examples of wives being elected (irresponsibly) to offices they were not qualified for as substitutes for their husbands. “Ma” wasn’t the feminist pioneer she has sometimes been represented as. She was the opposite–you know, like Hillary Clinton.

Ma Ferguson (the “Ma” comes from her initials) pardoned an average of 100 convicts a month, and there was considerable evidence that she and her puppeteer husband  were taking  bribes of land and cash payments. The Fergusons also appear to have leveraged highway commission  road contracts into  lucrative kickbacks. Though an attempt to impeach Ma failed, these controversies allowed Attorney General Daniel James Moody to defeat her for renomination in 1926 and win the governorship. She (that is,  puppetmaster Pa) was back in  office in 1932, as she won the governorship again on the wave of discontent over the Great Depression.

The portrayal of “Ma” as a strong, independent executive in “The Highwaymen” would have to be judged misleading.

2. Speaking of women, sort of...An intersex  hero and role model may have emerged through the dim fog of history. Scientific researchers at Georgia Southern University claim that after years of study, their examination of skeletal remains of Revolutionary War hero, General Casimir Pulaski, ‘the Father of the American Cavalry’ has revealed that he  was biologically female.

Imagine if these had been George Washington’s remains…

3. Desperately seeking Plan O: As we knew they would, House Democrats have demanded the last six years of President Donald Trump‘s tax returns from the Internal Revenue Service in a letter from the House Ways and Means Committee to IRS Commissioner Charles Rettig, seeking both personal and business tax information from 2013-2018, including individual and corporate tax returns. Democrats have been apoplectic  that candidate Trump  broke decades of tradition by refusing to reveal his taxes during the campaign, and have convinced themselves and “the resistance” that the returns will show criminal activity.

The Committee says it must see Trump’s taxes because  to ensure “the accountability of our government and elected officials. To maintain trust in our democracy, the American people must be assured that their government is operating properly, as laws intend.”  Ha. Translation: Impeachment plots A-N seem to have flopped, so we need a “Plan O.” The Committee also disingenuously claims that the it needs the records to help establish tax policies, unethically trying to use the authority under the tax code granted only to  tax-writing committees in Congress that gives the chairmen of the House Ways and Means Committee and the Senate Finance Committee the power to request tax information on any filer.

This is so obviously a fishing expedition (or witch hunt, if you prefer) and it will be challenged in the courts. I would support a law requiring Presidential candidates to release their taxes, but there currently is no such law. The President can fight this and legitimately claim to be protecting the privacy of all citizens, and I think he’ll win.

4. Not that not being bitter makes one an Ethics Hero, but still: Is there anyone on earth with more reason to be angry and bitter than original Beatles drummer Pete Best, who was dumped by the group in favor of Ringo just before they were launched into fame, fortune, and immortality? Yet in a recent documentary, Best appears to be at peace, without rancor, and untainted by his epic bad luck. From The Spectator:

“Best, it turns out, remains a twinkly-eyed, cheery cove, more than reconciled to his place as a footnote in history, delighted to have spent his recent career — after a 20-year stint in the civil service — as a touring musician playing the kind of raw rock’n’roll the band did in Hamburg….as an exemplar of triumph over adversity, enduring happiness snatched from transient misery, Best does seem a pretty useful role model for all those of us who don’t even have a ‘Yellow Submarine’ in them, let alone an ‘Eleanor Rigby’ or a ‘A Day In the Life’.”

5. Will the truth about Medicare for All ever be made clear to the voting public? Fox had a town hall last night for a group of Democratic candidates, most of whom endorsed Bernie Sanders’ socialist vision of “Medicare For All.” Nobody, including the Fox News moderators, challenged the increasingly popular idea, which can be fairly summed up in the words of “Sidney Wang”:

In addition to being ruinously unaffordable,  — co-sponsored Senator Bernie Sanders’s 2017 “Medicare for All” bill, co-sponsored by  Senators Kirsten Gillibrand, Kamala Harris, and Elizabeth Warren, would abolish private insurance and force  all Americans  into a single government-run plan covering nearly all medical services,including hospital and doctor visits, prescription medication, and dental and vision care. Even Great Britain’s socialized medicine doesn’t ban private insurance. And the results over the pond? From Forbes:

Nearly a quarter of a million British patients have been waiting more than six months to receive planned medical treatment from the National Health Service, according to a recent report from the Royal College of Surgeons. More than 36,000 have been in treatment queues for nine months or more….

Long waits for care are endemic to government-run, single-payer systems like the NHS. Yet some U.S. lawmakers want to import that model from across the pond. That would be a massive blunder.Consider how long it takes to get care at the emergency room in Britain. Government data show that hospitals in England only saw 84.2% of patients within four hours in February. That’s well below the country’s goal of treating 95% of patients within four hours — a target the NHS hasn’t hit since 2015.

Now, instead of cutting wait times, the NHS is looking to scrap the goal.

Wait times for cancer treatment — where timeliness can be a matter of life and death — are also far too lengthy. According to January NHS England data, almost 25% of cancer patients didn’t start treatment on time despite an urgent referral by their primary care doctor. That’s the worst performance since records began in 2009.

And keep in mind that “on time” for the NHS is already 62 days after referral.

Unsurprisingly, British cancer patients fare worse than those in the United States. Only 81% of breast cancer patients in the United Kingdom live at least five years after diagnosis, compared to 89% in the United States. Just 83% of patients in the United Kingdom live five years after a prostate cancer diagnosis, versus 97% here in America.

The NHS also routinely denies patients access to treatment. More than half of NHS Clinical Commissioning Groups, which plan and commission health services within their local regions, are rationing cataract surgery. They call it a procedure of “limited clinical value.”

It’s hard to see how a surgery that can prevent blindness is of limited clinical value. Delaying surgery can cause patients’ vision to worsen — and thus put them at risk of falls or being unable to conduct basic daily activities….





23 thoughts on “Morning Ethics Warm-Up, 4/5/ 2019: An Intersex Revolutionary War Hero! An Unethical Feminist Trailblazer!

  1. The model for the Medicare for All is the IHS and the VA. If you look, those two agencies will remain and be the model for the new agency. How many people have a burning desire to have the VA or IHS as their ONLY possible health care? Also note the ‘Complete Lifes’ philosophy guiding Democratic health care gives almost no value to the life of small children or the elderly. Small children haven’t had much invested in them, so it is cheaper to scrap them and make another, the elderly have had their ‘full life’, so should be given euthanasia or pallative care and allowed to die.

    Click to access huntoon.pdf

      • The Lord continue to bless you. The VA cannot seem to comprehend that I have a job and family. I’ve repeatedly been told at 4pm that I have an appointment at the VA hospital 100 miles away at 8am the next day. Arranging work and basic child care, let alone for a child with special needs, isn’t fun at the last minute. Or, I get snotty messages that I missed an appointment I never had. The arguments that I cannot receive treatment there because a. It’s for veterans; b. I’m a woman, so the appointment must be for my husband.

        I won’t begin with the safety issues I’ve encountered.

  2. In discussing Medicare-For-All, no one ever seems to ask why it has not been enacted by any individual states.

    Also, what is it with abolishing private health insurance. Should not a woman be able to choose between medicare-For-all and private health insurance?

    Or does a woman’s right to choose end at her cervix?

  3. 1. Thanks for this. I had never heard of her.

    As an aside, I am in the middle of a book on Nellie Taft, wife of President William Taft, and just finished the story of the torn loyalties of aide Archibald Butt who had also served the Roosevelts. Pressured to choose between Taft and TR in the 1912 campaign, he became ill and went to Europe for a badly-needed vacation, sailed home on the “Titanic” and drowned. Witnesses report him helping women into lifeboats, including women from steerage. I quickly checked IMDB to see if there was a representation of Butt in the 1997 movie and found nothing. Unfortunate. Perhaps, it didn’t jibe with the narrative of snobby upper-class passengers leaving the unwashed masses to die.

    Just as “The Highwaymen” needed to show Kathy Bates playing another fictionalized version of a strong, independent woman (Having played “Molly” Brown in “Titanic”).

    2. I had not heard about this at all. While not impossible that Pulaski was a woman posing as a man, I find it more likely that the bones got mixed up. That’s not an unusual occurrence in history when notable people get buried & reburied. I believe there is nothing left of Mad Anthony Wayne after his numerous post-mortem trips.

    3. The Democrats have demonstrated that they have no problem with using suspicions about taxes to target politicians they don’t like. After all, Romney lost, didn’t he?

    4. Good for Best. Living a happy life outside of the fame, wealth and influence of the Entertainment Industry is not a bad thing.

    5. Around the time that the ACA was being bandied about as the solution to all of our medical problems, a member of a message board to which I belonged argued that Americans don’t get to go to the doctor as often as they should because they don’t have the money. Single-payer or another similar program would change that.

    No sooner had the President signed the ACA bill and people began finding out “what was in it” (as opposed to finding out before it was passed), the member began arguing that Americans go to the doctor too much and need to learn to handle discomfort better the way the Europeans do.

    Who thinks like that? What kind of a person or Party or government appeals to the masses, telling them how much better and easier and free(!) a program will be to get it passed, only to tell them to get over delays and discomfort after the fact?

    • AM on #5 I suspect that the folks thinking like that are the same folks who don’t walk out when at a “We the People” event, the words of convicted murderer and Marxist Assata Shakur (who fled to Cuba after escaping prison) are chanted without reservation. At this same event the last lines of the Communist Manifesto “The proletarians have nothing to lose but their chains. They have a world to win. Proletarians of All Countries, Unite!” were also repeated. Bernie Sanders, Beto O’Rourke, Elizabeth Warren, Cory Booker, Amy Klobuchar, Jay Inslee, and Kirsten Gillibrand all spoke at the same event.

      I’m sure any concerns about eugenics and socialized medicine are nothing to worry about with such life affirming attitudes.

  4. 1. “Ma” Ferguson

    I guess in the #MeToo era, corruption is less important than the fetish of a “strong” woman leader.

    2. Casimir Pulaski

    You’d think the doctor, midwife or others assisting in his birth would know. Hard to imagine they stayed silent all their lives, but then again, in those times they could’ve told everyone around them and it would never have reached 50 miles.

    So I guess, assuming the remains are in fact his, we’ll have to speculate based on the available evidence. I find it curious that that intersex disorder implicitly works only one way…

    3. Plan O

    Well, this has been the plan since the 2018 election campaign. I think the President should win, and if the law permitting this disclosure goes before the Supreme Court, I think they will declare it unconstitutional. — and I firmly believe it is. If a woman’s right to privacy supersedes the state interest in protecting life, there’s no way congressional fishing expeditions are sufficient justification, even for a president.

    4. Pete Best

    Good for him. There is nothing to be angry about having lived a full life, even if opportunity left him in a ditch.

    5. “Medicare for all”

    Will the truth about Medicare for All ever be made clear to the voting public?

    Not by the Democrats.

    As far as the quality of care, the race to the bottom is a hallmark of nearly all Democrat policies. They are convinced it is better for everyone to have poor quality, indifferent care than to have most people with good to excellent care and some without.

    I suspect the next step will be making it a crime to travel abroad for better care, or at least a significant monetary penalty for doing so. After all, we have to stop those nasty rich people from unfairly taking advantage of their ill-gotten gains.

    The definition of insanity once again seems monotonously apropos.

  5. There’s no good reason to use the UK for the comparible to America’s healthcare system when directly to the North is Canada, a more geographically, culturally, and politically similar nation to American that happens to ban Insurance-based healthcare options…. Unless the point of the comparison is to highlight wait times, because Canada’s are better.

    America’s healthcare system is absurd. And I think that Americans have been swimming in that absurdity for so long, they can’t even consider sanity, opting instead to focus narrowly on relatively insignificant markers like relative wait times.

    Epinephrine shots, otherwise known as the EpiPen, attached about 800% more expensive in America than they are in Canada. Why? Because insurers generally pay for them, and insurers have no incentive to negotiate for lower prices because they make their money as percentages on the margin, and any increased marginal costs get spun into the insurance pools. America has the highest per-proceedure and per-deviceedical costs on Earth because it is collectively too stupid to leverage it’s own buying power over concerns that granny might wait a few months for a hip replacement.

    • HT
      I fully understand your point. However, wait times are not an insignificant issue in cases where disease progression can lead to lower expectations for the prognosis. I don’t know if Mick Jagger decided to come to the US for a minimally invasive heart valve replacement was due to a wait time or lack of ability to perform the procedure but one thing is obvious he could get it done in the US on his timetable.

      No doubt decoupling pricing from the consumer has led to much higher prices for a variety of drugs and procedures. When the pain of cost is not felt there is no reason to be concerned with the price. It does not matter to the buyer if a third party picks up the tab and if the third party can shift the cost to another they have no incentive to negotiate either. When the insurers are on the hook they do have an incentive to negotiate or not cover a procedure or drug. You cannot pass on costs indefinitely. Ultimately, the payer runs out of moneym

      If health care is deemed a right as most progressives claim how will you tell patient x they are ineligible for a procedure when others are eligible? Why should one get treated sooner and the other have to wait if both are eligible. Someone, a human being, will make these determinations just like the human beings who makeup the health care industry corporations.

      What exactly will the US have to stop doing in order to have funds available to offer health care en masse to everyone living within the borders of the US? What if we cut our percentage to that of Germany in NATO. That could pay for a great deal. Will other countries fill the void in world politics when the US retreats on the world stage devoting its limited resources on domestic issues?

      Given that Canada’s population is about a 10th of the US can a Canadian method be scaled to address a significantly larger population? Perhaps we should let California try this out on their dime before we make it universal.

      For the life of me I cannot understand why construction of health care facilities is not discussed as an infrastructure project and our student aid dollars should be directed first to essential national employment needs . This would increase supply driving price pressures downwards. You cannot get more services at lower prices if you fail to address the supply side.

      • “However, wait times are not an insignificant issue in cases where disease progression can lead to lower expectations for the prognosis.”

        This is kind of exactly what I was talking about. I’ll use oncology (cancer care) as an example of time-sensitive care. First off, oncology costs are so expensive that the wait time for people that aren’t insured is literally forever. Second, Oncology services in Canada are given priority, we get service along the same timeframes as you would. I understand why you might think that isn’t true, whenever you hear about Canadian medical wait times, they’ll average oncology services with hip replacements and come out around 4 months. You are being scared with misleading statistics to argue against something you are misinformed about, triage has existed basically since forever, and it’s done and done well, even in a universal system.

        “When the insurers are on the hook they do have an incentive to negotiate or not cover a procedure or drug. You cannot pass on costs indefinitely. Ultimately, the payer runs out of moneym”

        And THAT’s the math they do. They want to increase costs so their marginal percentage is a higher dollar amount without pricing themselves out of the market. Insurance agencies have you over a barrel, they have entire accounting departments dedicated to figuring out what your tolerance is, and you need your chemotherapy. There is no competition, there is no meaningful regulation, there is no justification for $800 Epinephrine shots. Zero. They cost $20 to make and the patents have amortized.

        “What exactly will the US have to stop doing in order to have funds available to offer health care en masse to everyone living within the borders of the US?”

        How do you think Canada did it? What part of America’s economy do you think is so fundamentally inferior to Canada’s that it precludes this? Or what Miracle did Canada pull of in order to pull this off?

        The fact of the matter is that the majority of America’s health costs are already paid for through the government via medicare and medicaid. If you could reduce medicare and medicaid costs by actually leveraging America’s volumes, you might actually save money. I mean…

        “Given that Canada’s population is about a 10th of the US can a Canadian method be scaled to address a significantly larger population?”

        It should work BETTER. Universal medicine relies on economies of scale. America has fractured it’s scales. It is ABSURD! It is INSANE! That a market ten times bigger than Canada cannot negotiate costs to even the same level as that of Canada. Your AVERAGE service costs 300% more than the Canadian equivalent.

      • … What if we cut our percentage to that of Germany in NATO. That could pay for a great deal. Will other countries fill the void in world politics when the US retreats on the world stage devoting its limited resources on domestic issues?

        No, not if the U.S.A. still prevents that, as it has done ever since the Suez Crisis in 1956. In this area, the cost to the U.S.A. is the price of ownership. Really give it up, and others would be just as willing to pay for their own – but not if they don’t get that.

    • I won’t argue that America’s health care system has some very big problems, but I’d say if you’re the person with an advanced-stage cancer diagnosis or in need of emergency medical care, wait times for care probably seem like a quite significant measurement.

      One of the reasons that medicines can be cheaper in other countries is because the profits the companies make off the higher prices they charge Americans helps to subsidize those countries that refuse to pay more. If America adopts a single-payer system and forces lower prices here, prices will go up elsewhere, or innovation will have to slow considerably. I’m not making a judgement either way on that (there’s quite a good argument to be made that everyone should pay the same price for the same product, and as an American I’d be fine if I could pay less even if it meant that English or Canadian people had to pay more), but it’s an inescapable fact of the current system.

      • I would LOVE to see the math on this, because I think it’s propaganda. I want to personally guarantee you that pharmacological companies make money even in Canada. Americans are just being completely and utterly soaked.

        Even if that were true “We cannot leverage our buying power because if we don’t pay more than everyone else, everyone else might have to pay their fair share” is asinine.

        • I’d like to see some $ breakdown as well, but it does make sense. If the companies can cover their development and initial costs of production by what they charge in the U.S., they only have to have a slight profit over the incremental cost of producing each pill they sell in Canada or elsewhere.

          This could possibly be tested by the U.S. having a regulation requiring the drug producers to charge the same in the States as they do in Canada. If the resulting prices equalized at some point between the two current prices, that would tend to support the theory that the U.S. is subsidizing others countries.

        • I have no doubt that the pharma companies are making some profit in Canada and in other places with nationalized health care systems. But they’re not making the kind of money needed to support their massive research and development costs. Developing new drugs and medical treatments is expensive, and U.S. companies shoulder a disproportionate amount of the cost of that, largely because there’s much more potential to profit on a new breakthrough in the U.S. market. The pharmaceutical industry has the highest rate of reinvestment into R&D of any industry in America, and the majority of medical innovation is coming from the United States: almost 60% of global medical R&D spending is American (and 70% of those dollars come from for-profit companies), while only 1% is Canadian. A whole lot of the drugs you get for so much cheaper wouldn’t even exist without the billions of dollars U.S. companies spend to discover and develop them.

          I’m not normally in the habit of defending the pharmaceutical industry, so my hastily-researched numbers may be off a bit, but I don’t think there’s much debate that a free-market system (even a “free market” as wildly distorted by government involvement as ours is), although it may be inferior in other ways, produces more innovation than a government-run system. Lower profits necessarily means less investment in research. Higher profits means higher prices. The trick is to balance the two, which I don’t think any country is doing a very good job of at the moment.

  6. I get to share a proud Connecticut moment for once!

    Ella T. Grasso
    First female governor elected in “her own right”

    Starting off as a businesswomen, she joined the League of Women voters, and eventually run for the state legislature. She was a key player in restructuring local government and in drafting the 1960 state constitution. She served four years in Congress, before running for governor.

    As governor, she navigated the fiscal crisis of day, even donating back a $7000 raise she could not refuse. She skillfully navigated a true crisis, the Blizzard of 1978. She resigned at the end of the first year of her second term due to a cancer diagnosis, and died a month later at age 61.


  7. I suppose the superiority of socialized medicine was why Mick Jagger chose to have his heart surgery in the United States.

    The cost of healthcare is so high for the same reason college tuition is so high–there’s a big bag of money (i.e, insurance companies and student loan availabiity) out there and the providers all want a chunk of it

  8. Growing up in Canada I was always told and I have always believed that we have the best health care health care in the world. Now I know that there is but one caveat to that statement. We do have one of the best until you actually need it. Then the reality of the system start to set in.

    Wait times for emergency care can be in excess of 12 hours unless you have a major trauma requiring immediate care. I once sat an entire night into the morning hours with my wife waiting for her to be seen by a doctor in emerg. While listening to two separate couples who had arrived before us and were still waiting to be seen after both having apparent miscarriages. That particular visit we gave up and went home before my wife was seen because her symptoms subsided enough that she wasn’t in pain anymore. I have a dozen other stories like that.

    The plus side to our system is that you don’t have to go bankrupt or suffer severe financial hardship while dealing with serious illnesses. But, it’s a trade off. You do wait inordinate amounts of time to see specialists and more often than not you get minimal time and attention from one as they’re trying to see as many patients as possible to. One reason is a shortage of specialists especially in lower populated areas. Also the government decides how much they’ll cover per patient visit. So the only way to increase their income is to turn their offices into a patient mill.

    Socialized medicine ensures that everyone gets treated the same. It also mean we all wait our turn. Unfortunately most people also know that if you do have enough money you don’t have to wait your turn. There’s always a way to jump the queue and you see it all the time. Also don’t forget it’s not free healthcare for all. While the governments do determine maximum billing and do their best to control health costs. It comes at a personal cost of way higher tax rates than most Americans would accept. There is still a lot that isn’t covered including dental and eye care. Those are still covered by private insurance or user pay.

    It’s a balancing act. You trade off the financial aspects for wait times and the maximum amount of hospital beds that are financed by the government. As an example I live in a smaller city with roughly about 300,000 population and our region only has less than 500 acute care beds. I’m not sure a lot of Americans would be willing to accept a system like that.

  9. Re: Casimir Pulaski, it really sounds like they’re stretching. There were doubts in 1854 that the remains were actually Pulaski’s, and having determined that the skeleton is that of a female, the simplest and likeliest explanation is that there was a mix-up. The notion that Pulaski was an intersex person is exactly the least likely explanation. I guess we’ll see in time whether the theory bears out.

  10. #5
    My own anecdote:
    I have a close young relative who, a few years ago, discovered he had unilateral testicular cancer. He was able to see a doctor the first day he realized something was really wrong, got a second confirming opinion a day later and surgery within a week, along with arranging chemo treatments scheduled for afterwards. He has been clear for several years now, has one child and another on the way.

    When he first began to deal with his situation, he spent a lot of time online in various informational websites and support forums, with considerable international participation. In trying to find out as much as possible about the disease, treatment, best doctors, etc., etc., there were two repeated themes that stood out to him. One was “GET TO THE U.S. IF YOU CAN!”; the other was the laments from those (or their relatives) who had to wait so long to be diagnosed and treated that it was too late to save them…and these were not from third-world countries.

    Forgive me if I’m not yet all that keen on having only one government source of medical service.

  11. ‘Wait times for emergency care can be in excess of 12 hours unless you have a major trauma requiring immediate care. I once sat an entire night into the morning hours with my wife waiting for her to be seen by a doctor in emerg.’

    I have had the same experience in the US. My father’s visiting nurse came to see him with a hacking cough, and didn’t have a mask to put on. He had Stage IVb esophageal cancer, and three days later we were in an ambulance at 11pm, poor Dad had a 103 fever, and was eventually diagnosed with pneumonia. We waited in the ER until 7am when he was finally seen, and it was 11 am before a bed was opened up. They say that America has some of the most advanced care in the world, but it is most certainly not universally available. His treatment and the attitudes of the people who cared for him were poor.

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