Author: Jack Marshall

Comment Of The Day: “Comment Of The Day: ‘Comment Of The Day: No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not Discrimination.’”

/ Jack Marshall / 17 Comments

I agree, this is getting ridiculous: our colloquy on the ethical and policy complexities of health care policy has created the first Ethics Alarms Comment of the Day on a Comment of the Day on a Comment of the Day. Nonetheless, John Billingsley’s COTD is deserving, as well as interesting and informative. Here it is, his comment on Comment Of The Day: “Comment Of The Day: ‘No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not Discrimination’”—which in this case you really should read Charlie Green’s post that prompted it.

I have a few comments on specific points.

“New diseases like RLS”

RLS was first described in 1685 and the first detailed clinical description was in 1944 and it was shown in test recordings in 1962. Not really a new disease but a newly publicized disease. Once a medication was developed that was effective at relieving the symptoms, it became profitable for a pharmaceutical company to target it and raise awareness. The company was not being altruistic, but is it wrong to make money by informing someone that there is a way to relieve the distress they are experiencing? If you have ever talked to someone who really has this disorder, you know how much it disrupts their lives. Is it over diagnosed? Possibly, but polysomnography to make a firm diagnosis is expensive and it is a condition where the clinical symptoms are pretty reliable. Probably cheaper to just treat it.

“Because who’s still going to argue with your doc? Especially when he or she gets side benefits from giving in to the latest DTC ads on network news programs?”

I hate DTC ads. I would be good with a spot that just said, do you experience these symptoms (of RLS perhaps)? If you do, tell your doctor. I actually spent quite a bit of time telling patients why they did not need the newest, expensive drug they heard about on TV or in a magazine either because they didn’t meet the criteria for it or because I felt that the cheaper alternatives were just as effective and needed to be tried first. It was a hard sell, particularly when the patient would say, “but my insurance will cover it.” I, and I think most doctors, take being a good steward of the healthcare dollar seriously. In the past there were sometimes substantial “side benefits” from drug companies especially if you used really expensive things like artificial joints or pacemakers. The most I ever received was dinner in a restaurant and things like cheap pens and sticky note pads. These days there are no more cheap ballpoint pens and meals typically are take out from Newks or equivalent in the office during a presentation. Not something I am likely to sell my soul for although I understand the implications. Continue reading →

Ethics Dunce: Marwan Barghouti, The Snacking Hunger Striker

/ Jack Marshall / 9 Comments

See, this is the thing: if you are secretly snacking while leading a hunger strike, you’re doing it all wrong. Gandhi didn’t do this. At least we don’t think he did.

 Over a thousand Palestinian prisoners in Israeli jails are in the third week of a mass hunger strike, demanding better conditions. Now the leader of the strike, terrorist Marwan Barghouti who i being  held in solitary confinement at the Kishon prison, has been caught on camera eating cookies and a candy bar.  Israel released videos of the would-be martyr sneaking snacks in his cell, and naturally  Palestinian leaders called foul, dismissing the videos as fakes aimed at demoralizing his hungry followers. The problem is that Barghouti has cheated before.

In 2004, leading another hunger strike, he was caught on camera eating while his fellow prisoners were refraining from food like good hunger strikers. Not knowing he was being surveilled,  the Palestinian leader covered the door and window of his cell,  washed his hands and chowed down after asking wardens for food.  The Israeali Prison Services spokesman said that cameras were set up to show the fasting prisoners how their leader was behaving. “Barghouti is sitting on a pot of meat and he sends his friends to die,” the spokesman said at the time. Continue reading →

From The Ruddigore Fallacy Files: “60 Minutes” Seeks Sympathy For Another Deported “Good Illegal Immigrant”

/ Jack Marshall / 34 Comments

Earlier installments regarding the deportation of “good” illegal immigrants are here, here, here, and here. We are cursed to hear about these until the stars turn cold.

“60 Minutes” showed viewers the sad story of Roberto Beristain, an illegal immigrant deported to Mexico after being in the U.S. for nearly 20 years. This was part of the news media’s ongoing anti-Trump assault, as well as an effort to pull at the public’s heartstrings while paralyzing its brains.

The CBS news magazine gathered Beristain’s family and friends in Granger, Indiana so they could express their frustration that someone with no criminal record like Roberto could be separated from his wife and children, who are all citizens.

“It just feels wrong,” Kimberly Glowacki said. Michelle Craig said she voted for President Trump, but did so because he promised to deport dangerous criminals. “This is not the person he said he would deport,” she said. “The community is better “for having someone like Beristain in it.

Wrong, wrong and wrong. While the President emphasized that the nation’s passive enforcement of illegal immigration allowed dangerous criminals to enter the nation, he never suggested that “good illegal immigrants” should be allowed to break our immigration laws with impunity, as long as they became law abiding illegal citizens. What did Michelle think the wall was all about? Did she think it would somehow let good illegal immigrants in while stopping the “bad hombres”?

Beristain was as much of a border-jumper success story as the there is, a former cook and new owner of a popular Granger restaurant , “Eddie’s Steak Shed,” that employs about 20 people.  He had no criminal record in the U.S.. He entered the U.S. in 1998 illegally but had been issued a temporary work permit, Social Security number and drivers license under the Obama administration, an irresponsible policy that sent a “Illegals Welcome!” message to the world. The Trump administration, to its credit, has ended this cynical nonsense. If you are here illegally, you are subject to deportation at any time, and should be. The argument that by being a “good” illegal after you get here somehow erases the fact that you shouldn’t be here is what has been named “The Ruddigore Fallacy.” To refresh your memory: Continue reading →

Ethics Observations On Bill Maher’s Incest Joke About Ivanka Trump

/ Jack Marshall / 28 Comments

This is my favorite photo of Bill Maher. It captures the essence of his charm, his manners and his wit so perfectly…

Following the (much deserved and still not sufficient) criticism of Fox News’ Jesse Watters’ leering “joke” about Ivanka Trump’s handling of a microphone, HBO’s Bill Maher gave conservative critics an opportunity to trot out the  “we have standards, where are yours?” accusation against liberals when the host of “Real Time” made suggestive gestures while talking about how the First Daughter “helps” President Trump.

“What do you make of Ivanka and her efforts to sort of humanize her father?”, the comic asked guest Gabe Sherman ( a writer, book author, Fox News critic and a vocal one regarding Watters’ incivility). “We see all this misogyny at Fox News [ KABOOM!, incidentally. If there is anyone on earth other than the President more ethically estopped from accusing someone else of misogyny, it’s Maher, who flings “cunt” and “twat” at women he disagrees with and who cheered Bill Clinton’s exploitation of Monica Lewinsky on the grounds that “he works hard, and he deserves it”); we see it in Donald Trump himself. A lot of us thought, Ivanka is gonna be our saving grace.” Then, as he mimed Ivanka masturbating her father, Maher continued, “When he’s about to nuke Finland or something, she’s gonna walk into the bedroom and—”Daddy, Daddy…’Don’t do it, Daddy!”‘

This most recent vulgarity by Maher as his audience of hateful left-wing boors hooted on cue even moved the progressive tool Daily Beast to complain that “if liberals are going to castigate Donald Trump for his boorish, sexist behavior, they shouldn’t behave in a similar fashion” —a point that is too little and far too late in the case of proudly boorish, sexist Bill Maher.

Ethics Observations: Continue reading →

Comment Of The Day: “Comment Of The Day: ‘No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not Discrimination.’”

/ Jack Marshall / 33 Comments

The health care/ACA/AHCA commentary from readers continues to be uniformly excellent. (It was originally spurred by the post, No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not “Discrimination.”)  Spartan’s Comment of the Day on the topic has itself sparked its own Comment Of The Day, this one authored by Charles Green.

By fortune’s smiles, I was able to finally meet Charlie last week face to face, as he kindly alerted me that he would be passing through my neighborhood. Finally having personal contact with an Ethics Alarms reader is always a revealing and enjoyable experience, and this time especially so. I think you would all enjoy Charlie; I certainly did. Maybe I need to hold an Ethics Alarms convention.

Here is his Comment of the Day on the post, Comment Of The Day: “No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not ‘Discrimination’.”

…The claim that “a free market system” and “freedom of choice” is the solution to all that ails us is a mindless mantra that is only occasionally true, but not always.

It’s important to be clear about when free market solutions are good, and when they are not. It’s not all that hard to sort out. Basically:

Free market solutions ought to be the presumptive default. Unless there is good reason to the contrary, they ought to be the rule.

1. Exception Number 1: Natural monopolies. It makes no sense to have competition for municipal water supplies; airports; multiple-gauge railroads; fishing grounds; groundwater; or police departments. The basic reason is the putative economic benefit is either simply not there, or is absurdly overwhelmed by the social confusion engendered by multiple suppliers.
In these cases, a form of regulated monopoly is desirable. (By the way, the airline industry at a national level is precisely this kind of market; we do not have too little competition there, but too little regulation).

2. Exception Number 2a: Wallet-driven market power monopolies. It’s strategy 101 in business schools that the way to be successful is to be #1 or #2, and the best way to do that is to get more market share than your competition, so you can drive them out of business. The one guaranteed way to do that is to cut prices so low that no one else can compete. Think Walmart. Think Amazon. Think Japanese in the 60s and 70s in any industry.
The reason we have anti-monopoly laws is to reset the playing field when a competitor dominates the market too strongly.

3. Exception Number 2b: Product-driven market power monopolies. Where the product is so obscure, expensive, infinitely variable, and difficult to understand that the producers are de facto in control, because it is too confusing and too dangerous to challenge them.
Drug prescriptions are an interesting example. The ‘free market solution’ to high drug prices was (partly) to let drug companies advertise, and to loosen up the definition of what constituted a ‘new’ drug. What did we get? New diseases like RLS, new definitions of ‘new’ (moving ‘off label’ to ‘on label’) and even higher drug company profits. Because who’s still going to argue with your doc? Especially when he or she gets side benefits from giving in to the latest DTC ads on network news programs?

Continue reading →

Say Hello To Rationalization # 65, “The Pest’s Justification.”

/ Jack Marshall / 10 Comments

The Pest’s Justification or “He/She/They can take care of themselves,” the latest addition to the apparently bottomless pit of self-deception known in these parts as the Ethics Alarms Rationalizations List, is a distant cousin of Rationalization 2A, Sicilian Ethics, which holds that  wrongdoing toward a party isn’t wrong when the abused party has aggrieved the abuser.  2A boils down to “He deserves it.” #65 boils down to “There’s no need to be ethical to someone more powerful than me.”

The newest addition takes its name from periodic playground accounts in the news, where a larger child is endlessly tormented by a smaller one who assumes that he is immune from harsh judgment  by virtue of being perceived as relatively harmless compared to his target. These stories often end badly, with the larger child finally deciding that he can take no more, clobbering his tormenter, and being called a bully for doing so. Spousal abuse where women beat up their larger husbands are especially ugly extensions of  this rationalization. It can take the form of bullying. Continue reading →

The Flint Water Bills: Is This The Most Outrageous Ethics Story Of The Year?

/ Jack Marshall / 29 Comments

“What do you mean it’s brown and poisonous? Water is water! Pay up.”

This story out of Flint, Michigan is so wrong, so astoundingly and obviously unethical, such a satire of government ineptitude at its worst and bureaucratic soullessness at its most damning, that I literally didn’t believe that it could be anything but a momentary hiccup, and that it would be resolved by the state, the city, an elected leader with guts and the sense God gave a mollusk, within a day or two, after the voices of millions were heard screaming. “WHAT????”

I was wrong. You want to know why it is insane to place your freedom, health, livelihood and survival and that of your families in the hands of government? THIS is why. Exactly this.

Thousands of Flint, Michigan residents risk losing their homes if they don’t pay their overdue water bills  less than three years since the start of a prolonged, botched, water safety crisis that led to extremely dangerous levels of lead in the city’s water pipes. In a move that will stand through the ages as the epitome of shamelessness and gall,  the Flint government sent threatening letters to more than 8,000 residents warning them they will face a tax lien if they do not pay water and sewage bills they have avoided for six months or more. Residents have until May 19 to pay the delinquent bills, and after that, a process begins that could end with foreclosure on their homes. Flint sends these letters annually to property owners whose payments are at least six months late, but skipped this process in 2016, given that the water the residents weren’t paying for was only technically water at all. The better label was “poison.” This year’s letters cover two years of past-due balances. Continue reading →

Comment Of The Day: “No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not ‘Discrimination’.”

/ Jack Marshall / 71 Comments

There have been a lot of lively and articulate debates on Ethics Alarms since it began in late 2009, but I don’t know if any post has generated more thoughtful, informed and enlightening comments than this one. Many of them, and I mean ten or more, are Comment of the Day worthy. I would post them all, but it’s more efficient to just send you to the post. I’m very proud of Ethics Alarms readers on this one. It’s an honor to have followers so astute and diverse.

I chose Spartan‘s comment over the others in part because it was the most overtly about ethics, balancing and altruism. Plus the fact that she gets a lot of flack here, and yet perseveres with provocative comments that are well-reasoned and expressed. She is an excellent representative of all the commenters that add so much to this blog.

Here is Spartan’s Comment of the Day on the post, No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not “Discrimination.”

The biggest problem — single payer is a jobs killer. I’ll admit that. Tens of thousands of people will have to find new jobs. Of course, there’s a flip side to this issue. Is it moral to sustain an industry that only benefits the rich and those who have access to employer-sponsored health care?

If we are going to get anywhere in this political debate, we have to be honest. Single payor is not sunshine and rainbows for all. Many people will have to find new jobs. Not everybody will love the care that they are provided. Medical students might decide to become stockbrokers instead because they will not make as much money. (On the plus side, the risk for med mal will go down so maybe there will not be a mass exodus.)

Another truth: a single payer plan will hurt the upper middle class the most. People like me. Because under single payer, I undoubtedly will have to pay more in taxes (the only way it could work), but I most likely will get a lower standard of care down the road. So, I imagine many people like me will go out and buy private insurance to sit on top of government provided medical care. So now I am even out more money. (Similarly, I don’t like my government provided education, so I pay money out of pocket for my kids’ school.)

While acknowledging all of this, I would still vote for single payer. In my view, it’s not ethical to let people die so other people can have jobs. That’s my position. If it means we can never go on another vacation or eat out again, it is more important to me that everyone have access to basic health care.

France And Ireland Remind Us Of Two More Reasons To Be Proud And Grateful To Be An American…

/ Jack Marshall / 23 Comments

News Item:

France sought to keep a computer hack of frontrunner Emmanuel Macron’s campaign emails from influencing the outcome of the presidential election, with the electoral commission warning on Saturday that it may be a criminal offence to republish the data. Macron’s team said a “massive” hack had dumped emails, documents and campaign financing information online just before campaigning ended on Friday and France entered a quiet period, effectively forbidding politicians from commenting on the leak.

Polls have been predicting that Macron, a former investment banker and economy minister, is on course for a comfortable win over far-right leader Marine Le Pen in Sunday’s election, with the last surveys showing his lead widening to around 62 percent to 38.

…The election commission, which supervises the electoral process, warned social and traditional media not to publish the hacked emails lest they influence the vote outcome…

“On the eve of the most important election for our institutions, the commission calls on everyone present on internet sites and social networks, primarily the media, but also all citizens, to show responsibility and not to pass on this content, so as not to distort the sincerity of the ballot,” the commission said in a statement on Saturday.

“The commission stresses that publication or republication of these data…could be a criminal offence,” it said.

That’s right: withholding information from the voters because they can’t be trusted to be fair and discerning about what is relevant to their vote and what isn’t is to preserve “the sincerity of the ballot.” This is how they reason in countries without guaranteed freedom of speech, and freedom of the press. Florian Philippot, deputy leader of Le Pen’s National Front party, tweeted “Will Macronleaks teach us something that investigative journalism has deliberately kept silent?” Good question. Continue reading →

Well, Waddya Know! Both President Trump And Barack Obama Are Interfering With The French Election!

/ Jack Marshall / 65 Comments

See. when we do it, it’s ethical.

It’s small wonder that the rest of the world sees the United States as the most arrogant nation imaginable. Hot on the heals of  elected officials from both parties declaiming the outrageous conduct of Russia to “interfere in an American election,” with Democrats, depending on which excuse has been chalked on the blackboard as Hillary’s excuse du jour, even claiming that Vladamir Putin’s e-machinations stole the election, President Trump endorsed far-right French presidential candidate Marine Le Pen. Oh, as usual with this President, it was a confusing endorsement with a touch of deceit: in an interview with The Associated Press, Trump said although he was not offering an endorsement,  Le Pen is “strongest on borders, and she’s the strongest on what’s been going on in France.” In other words, he endorsed her by saying she was the best candidate. The translation of Trump’s statement: “I won’t endorse her, but I’m endorsing her.”

Typical. Unfortunately.

Two weeks later, ex-President Obama directly and formally endorsed Le Pen’s opponent, Emmanuel Macron, saying  a video announcing his support..

“I know that you face many challenges, and I want all of my friends in France to know how much I am rooting for your success.Because of how important this election is, I also want you to know I am supporting Emmanuel Macron to lead you forward. En March! Vive la France!”

Also typical, also unfortunate.

Obama’s latest exploits should be called his Hypocrisy Tour: first the man who led the party that condemned the corruption of big money in politics immediately cashes in witb a staggering post-presidency book deal and two $400,000 speaking fees, and now the icon of the party that has been shaking its fist at the skies about foreign interference in U.S. elections openly interferes in the election of an American ally. …because, you see, when we do it, it’s a good thing.

This shouldn’t be hard to grasp. Any efforts by a foreign country, government, official, leaders, former leaders, corporations, organizations or media organs to influence the results of another nation’s elections are wrong, per se and always, no exceptions.

Some forms of outside and illicit influence are worse than others, but they all are wrong: endorsements, contributions, fake news, hacking…all of it. This should be obvious, and it is not a partisan observation. The refusal to admit it, however, IS partisan. The United States cannot protest credibly when its elections are messed with as long as its leaders and others persist in interfering with the democracy of other nations themselves. It doesn’t matter if the meddler is a former President who has been anointed with an unearned, permanent presumption of virtue regardless of reality, or a current President whose conduct is automatically assumed to be sinister by those unalterably biased against him. It is wrong in either case, or any other.

This embodies an international application of the Golden Rule. Democratic elections are nobody’s business but the citizens of the nation holding them. The United States resents outside interference with our elections—some Democrats called the Russian involvement with letting us know just how corrupt the Clinton campaign was the equivalent of an act of war—so we should understand why for us to do the same is similarly wrong.

I admit it: I trolled my Angry Left Facebook friends with this post a couple of days ago:

Barack Obama just endorsed Macron in the French election. Boy, don’t you just hate it when foreign governments and officials try to influence elections?

Continue reading →