Patterico's Pontifications

1/18/2011

Obama Announces “Smart” Regulation

Filed under: General — Aaron Worthing @ 8:40 am



[Guest post by Aaron Worthing; if you have tips, please send them here.]

Mind you, he is not fool enough to call it “smart regulation” because it sounds too much like “smart diplomacy.  But that is what it is and he all but calls it that.  From his op-ed today:

From child labor laws to the Clean Air Act to our most recent strictures against hidden fees and penalties by credit card companies, we have, from time to time, embraced common sense rules of the road that strengthen our country without unduly interfering with the pursuit of progress and the growth of our economy.

Sometimes, those rules have gotten out of balance, placing unreasonable burdens on business—burdens that have stifled innovation and have had a chilling effect on growth and jobs. At other times, we have failed to meet our basic responsibility to protect the public interest, leading to disastrous consequences. Such was the case in the run-up to the financial crisis from which we are still recovering. There, a lack of proper oversight and transparency nearly led to the collapse of the financial markets and a full-scale Depression.

Over the past two years, the goal of my administration has been to strike the right balance. And today, I am signing an executive order that makes clear that this is the operating principle of our government.

This order requires that federal agencies ensure that regulations protect our safety, health and environment while promoting economic growth. And it orders a government-wide review of the rules already on the books to remove outdated regulations that stifle job creation and make our economy less competitive. It’s a review that will help bring order to regulations that have become a patchwork of overlapping rules, the result of tinkering by administrations and legislators of both parties and the influence of special interests in Washington over decades.

Yeah, that sounds good in theory.  But bear in mind, this is the same administration that advocated an interpretation of the law that declared pretty much everyone to be a creditor, requiring everyone—employees, contractors, corporations, etc.—to form plans for catching identity theft.  But hey, maybe he just didn’t know what was happening.  Maybe he is just a really sh-tty administrator.  But even when he discusses what he envisions with simple examples, a chill runs down my back:

Where necessary, we won’t shy away from addressing obvious gaps: new safety rules for infant formula; procedures to stop preventable infections in hospitals; efforts to target chronic violators of workplace safety laws.

That all sounds nice, but particularly in the bolded example I am creeped out.  I work for a health care company.  You don’t think we work really hard to prevent the spread of infection?  Of course we do.  Now the main reason we do is is because our company is filled with people who really are dedicated to improving the health of our patients.  This is not just a job to them, but a profession.  But even if you are skeptical of moral influence, we have another reason for doing so: because if we don’t then we can be held liable.  So federal regulations requiring certain procedures to be followed will be at best a waste of time—every company that wants to avoid an avalanche of lawsuits is already doing that—and at worst will introduce inappropriate rigidity into the system.  All of which seems to contradict this later assurance:

As the executive order I am signing makes clear, we are seeking more affordable, less intrusive means to achieve the same ends—giving careful consideration to benefits and costs.

Except that coming up with specific procedures, rather than a simple liability rule, is more intrusive, and is unlikely to further that end.

Oh, and he can’t possibly get through it all without an attempt to smother criticism with the label of incivility:

Despite a lot of heated rhetoric, our efforts over the past two years to modernize our regulations have led to smarter—and in some cases tougher—rules to protect our health, safety and environment.

(emphasis added)  Oh, and notice he does use a phrase that is very close to “smart regulation”—“smarter… rules.”  Of course there is nothing wrong with a regulatory regime that is actually smarter.  The problem is that I have zero confidence that this will be the result.

But hey, Mr. President, why don’t you surprise me?

Btw, I don’t know who put this in, but at the bottom someone actually thought there were people stupid enough not to know who he was, so someone added:

Mr. Obama is president of the United States.

Thanks for the info, guys!  But then again considering the state of knowledge in this country, we might be unsure if anyone, politicians included, know that.

Update: You can read the executive order, here.  This is a parody, right?  Maybe the guys at the Onion?

[Posted and authored by Aaron Worthing.]

132 Responses to “Obama Announces “Smart” Regulation”

  1. “So federal regulations requiring certain procedures to be followed will be at best a waste of time — every company that wants to avoid an avalanche of lawsuits is already doing that…”

    Well, with more than 2 million preventable hospital infections acquired, resulting in over 100,000 deaths annually, clearly some hospitals AREN’T already doing that. Or perhaps procedures in place aren’t working that well.

    In other words, your workplace notwithstanding, the self-regulation of the health care community ain’t a-working. If it was, there would be no preventable infection issue at all to regulate, much less a significant body count.

    Kman (d30fc3)

  2. Typical kmarty asshattery.

    These smart unintrusive regulations will be things like regulating the internet, banning offshore drilling by not issuing permits, revoking EPA approval like they did in WV, regulating exhalation of breath by the EPA, etc … Now that they do not control the House, they will do by regulation that which they cannot do by legislation. They are actually doing the unitary executive that they wailed about Bush doing. Projection.

    JD (d48c3b)

  3. Kman, did you ever read the breakdown on the CDC study in question to see how many of those were at government-run hospitals?

    No, of course you didn’t bother to. Wouldn’t fit your narrative.

    SPQR (26be8b)

  4. The alpha and the omega:

    Obama has poisoned the well, I don’t much care what he says or writes, if he’s fer it, I’m agin it.

    ropelight (8cc49c)

  5. Kman

    > with more than 2 million preventable hospital infections acquired

    based on your word, i suppose.

    > . If it was, there would be no preventable infection issue at all to regulate, much less a significant body count.

    lol, so perfection is our standard? be perfect or we will regulate the sh-t out of you?

    Aaron Worthing (e7d72e)

  6. Btw, I don’t know who put this in, but at the bottom someone actually thought there were people stupid enough not to know who he was, so someone added:

    Mr. Obama is president of the United States.

    Aaron, I am afraid I must correct your snark here. It is completely inappropriate, I’m afraid. Given how often that Obama blames President Bush for the world’s ills, reminding the audience that Obama is actually President is upholding their journalistic responsibility in a refreshing way.

    😉

    SPQR (26be8b)

  7. Why don’t we call this what it really is – a smokescreen to allow the Obama administration to legislate through agencies and regulations rather than through Congress.

    aub (eb805c)

  8. …and in summary, don’t…like…pay attention to what we are..you know…DOING…just listen to what I am SAYING and everything will be just fine…for me.

    Mr. Obama, President of the United States.

    MJN1957 (d1de05)

  9. Oh, Aaron, Kman was refering to a nine year old CDC study that did receive a fair amount of criticism given its claims. Some of their assumptions in categorizing deaths caused “by” infection versus the infections resulting from compromised immune systems, organ failure etc. were debatable.

    SPQR (26be8b)

  10. spqr

    are you suggesting that kman was less than honest?

    Aaron Worthing (e7d72e)

  11. SPQR:

    Kman, did you ever read the breakdown on the CDC study in question to see how many of those were at government-run hospitals?

    Um, I’m not sure how that hurts my narrative. If the problem lies with government-run hospitals, then I would think that calls more strongly for government regulation.

    Next thing you know, you’ll be complaining about government regulation of the military.

    AW:

    lol, so perfection is our standard? be perfect or we will regulate the sh-t out of you?

    That’s not what I said. I don’t think anyone said that.

    But if preventable infections kills 100K per year, it certainly requires action. And hospitals aren’t doing the job.

    Kman (d30fc3)

  12. Some of their assumptions in categorizing deaths caused “by” infection versus the infections resulting from compromised immune systems, organ failure etc. were debatable.

    By whom?

    Kman (d30fc3)

  13. Kman thinks that a failure of government requires more government!

    SPQR (26be8b)

  14. Kman, you don’t even know that the CDC study had critics? This isn’t the first time that you’ve opined on a topic you were actually ignorant of, you know. Not the first time.

    Aaron, suggesting? Would I suggest such a thing?

    SPQR (26be8b)

  15. Kman, you don’t even know that the CDC study had critics?

    I’m asking who. Why can’t you tell me who?

    Kman (d30fc3)

  16. SPQR – give kmarty points for admitting it is its narrative, as opposed to anything resembling honesty.

    JD (822109)

  17. I didn’t say that I couldn’t tell you. I can.

    SPQR (26be8b)

  18. I didn’t say that I couldn’t tell you. I can.

    Okay, SPQR. I guess your inability to back up what you say makes me dishonest. (*snort*)

    Kman (d30fc3)

  19. Kman, I have not stated that you are dishonest in this thread. I stated you were ignorant. Do pay attention.

    And you’ve not established my inability to back up what I say.

    You really aren’t very good at this debate thing are you?

    SPQR (26be8b)

  20. Kman

    > [me] lol, so perfection is our standard? be perfect or we will regulate the sh-t out of you?

    > [you] That’s not what I said

    Except that is what you said. Let me quote you again.

    > In other words, your workplace notwithstanding, the self-regulation of the health care community ain’t a-working. If it was, there would be no preventable infection issue at all to regulate.

    (emphasis added)

    > But if preventable infections

    A claim you have yet to prove.

    By the way, in theory ALL infections are preventable. We just put every single man, woman and child into plastic bubbles. We can go to work in space suits. See, no germs, except maybe occasionally transmitted via sex, given that we have to do that for the species to survive. Oh, no, wait, we don’t even have to do that. we can simply create the babies in a Petri dish with all genetic material pre-screened for germs.

    Of course most of us would recognize that would be a pretty sh-tty world to live in. so what we talk about in law is not “preventable” but “reasonably preventable.” If your supposed study exists and it is at all valid (SPQR, whom I trust disputes the latter point), it is fatally flawed as evidence of the need for regulation if it doesn’t consider the reasonability of prevention.

    Aaron Worthing (e7d72e)

  21. Oh, Aaron, Kman was refering to a nine year old CDC study that did receive a fair amount of criticism given its claims

    And the study, by the way, is from 2010. Not that being honest matters to you….

    Kman (d30fc3)

  22. kman

    you mean this study you never proved to exist?

    Aaron Worthing (e7d72e)

  23. 100,000 people die every year in hospitals from “preventable” infections. The govt should jus ban infections. Or hospitals.

    JD (6e25b4)

  24. Um, I’m not sure how that hurts my narrative. If the problem lies with government-run hospitals, then I would think that calls more strongly for government regulation.

    Really? I think it might call for more government regulation of government-run hospitals, but if the problem doesn’t lie in private hospitals, how would more government regulation of them help?

    Some chump (4c6c0c)

  25. you mean this study you never proved to exist?

    It’s a little disconcerting that a lawyer who works in the health care industry isn’t aware of the frequency with which people contract preventable infections while in hospitals, nursing homes, etc.

    All the more reason for the need for government regulation.

    Kman (d30fc3)

  26. Increase hospital regulations and overhead so they need to hire more lawyers, accountants, and clerical staff; lower reimbursements; let states go indeterminant periods without reimbursing for Medicaid care; do the same for medical practices, all of the time making less and less funds available for actually taking care of the patient: then- watch the staffing levels decrease to dangerous levels and force haste in doing what should be careful and routine care; then- increase hospital regulations…

    Either he is arrogant enough to really think no one can do a job correctly unless he is in charge, even on things he knows nothing about, or he is that crazed to concentrate power, or both. No matter what the case, it’s insane. How long before, “Big Brother will be watching you.”

    MD in Philly (3d3f72)

  27. All the more reason for the need for government regulation.
    Comment by Kman

    Ummmm, there is already plenty of governmental regulation, and if it isn’t working, perhaps more of the same while expecting a different result is…insane.

    Now, back to the regularly scheduled ignoring.

    MD in Philly (3d3f72)

  28. The CDC article based on a 2002 National Nosocomial Infections
    Surveillance study that Kman claims I dishonestly referred to
    . Which we discussed on Debunkers nearly four years ago. When it was published.

    Kman, you are only showing your ignorance in this topic.

    SPQR (26be8b)

  29. Ummmm, there is already plenty of governmental regulation

    Not in this area. That’s because the extent of the problem has only recently become known (hospitals typically haven’t been required to report incidents of healthcare-associated preventable infections, until recently).

    As a result, most states merely have plans to regulate certain aspects of heathcare-associated infections and/or are in the process of implementing those plans.

    Kman (d30fc3)

  30. I’m trying to recall the discussion we had four years ago about this study without bothering to go reread the thread. But I think indicative of the exaggeration of the study can be seen in the fact that more than a third of the deaths claimed as “hospital acquired infection” in the study came from … pneumonia.

    SPQR (26be8b)

  31. The CDC article based on a 2002 National Nosocomial Infections…

    Yeah. That was an estimate from 2002.

    Just because there IS old data doesn’t mean I’m referring to or relying on it.

    Kman (d30fc3)

  32. As I said, kmarty is just performance art. It sure as hell is not good faithed discussion.

    JD (2da347)

  33. ‘Obama Announces “Smart” Regulation’

    Oh joy.

    Any time a lefty starts saying that crap, you can count on having a brand new brood of useless bureaucrats you have to feed, soon after.

    Dave Surls (07a487)

  34. But it is hilarious, JD, to watch him struggle to master this debate thing.

    Not a passing grade yet, but by the time he graduates from high school, anything is possible.

    SPQR (26be8b)

  35. More generally, back to the topic, the whole thing smacks of the usual Obama hypocrisy, given that a Federal court found that the Obama administration had fraudulently ginned up the “study” that justified the Gulf drilling moratorium.

    SPQR (26be8b)

  36. Was regulating the financial services industry but ignoring the primary role of Fannie and Freddie “smart” regulation? The idea that increased regulation wiLl likely be a net positive on the business climate is laughable.

    These are the same people that are going to go all penal on CO2. Better quit exhaling.

    JD (822109)

  37. SPQR – Look what their “smart regulation” by the EPA just did to West Virginia.

    JD (822109)

  38. JD, or the regulation by the Consumer Product Safety Commission ( abetted by Congress’ incompetence ) in destroying hundreds of small toy manufacturers.

    But just think of the stupidity of this initiative when the government is the major investor in the US automobile industry?

    Outrageous hypocrisy.

    SPQR (26be8b)

  39. Can we forget Cass Sunstein, who just wants to ‘nudge’ us in the right direction through regulation, the Fin Reg bill, helmed by an Warren,who came to notice, through that bogus
    study that health care was responsible for the majority of bankrupcy, she was placed there by
    recess appointment

    narciso (6075d0)

  40. As I said in the second part of #26 and others elsewhere, “the forest” is the fact that for Obama to claim for himself (or his direct proxies) power to change all regulations of the fed govt. to his liking is ridiculous, arrogant, and foolhardy at best, cumbersome, costly, and a “black box” of tinkering at the worst. (Why yes, I really think it is a bad idea, if you really want to know how I feel about it.)

    The specific “tree”: Not in this area. That’s because the extent of the problem has only recently become known (hospitals typically haven’t been required to report incidents of healthcare-associated preventable infections, until recently). As a result, most states merely have plans to regulate certain aspects of heathcare-associated infections and/or are in the process of implementing those plans.
    Comment by Kman

    If the extent of this problem has only recently become known to governmental authorities, that shows how unnecessary they are. Dennis Maki, MD at Wisconsin was seriously monitoring this in the early 80’s when I was a medical student. The hospital where I did my residency monitored this in the mid-late 80’s. A local colleague was studying this here in Philly at the hospital where I had admitting privileges from 89-95. I knew the people in charge of this at the university hospital I was at from 95-05.

    Whether the government was looking at it or not, every dept of medicine and surgery has periodic morbidity and mortality conferences where they discuss what went wrong. You don’t need more than personal pride and the risk of professional humiliation to try to minimize complications under your service. I am sure Mike K. can tell you what it’s like to be a resident on the surgery service with the most nosocomial infections that month, kind of like standing in front of a pack of snarling Dobermanns.

    Returning to ignore mode.

    MD in Philly (3d3f72)

  41. I would like to see elected and bureaucratic officials be held to MD standards of practice. What is that unemployment rate again? What is the budget deficit again? I could run a pretty nice hospital, knowing nothing about it, if I could throw money at it like the feds do.

    MD in Philly (3d3f72)

  42. Kman

    > It’s a little disconcerting that a lawyer who works in the health care industry

    I pay attention to my own company. and you’re dodging. Can you prove it or not?

    And notice you ignored

    1) when I proved you did in fact say that any imperfection means we should regulate.

    2) when I showed that saying that an infection is preventable is useless information, because all infections are preventable, but not all are REASONABLY preventable.

    Aaron Worthing (e7d72e)

  43. MD in Philly, one of the ways in which one avoids “preventable” HAI’s is to avoid hospitalizing someone unnecessarily … recall when the Federal govt decided that it should legislate whether or not women had to be hospitalized for a set number of days post partum?

    SPQR (26be8b)

  44. Is there a difference between the troll and Obama, the former might actually believe the idiocy that the President wants to free us from
    regulation, Obama certainly doesn’t, he thinks we’re too stupid to make our choices. That phony thimerosal study that RFK jr, hawked for 5 years, how many have either died or been put in danger
    of serious illness, because of it,

    narciso (6075d0)

  45. I have a gut feeling that regulations rushed through Congress before any lawmakers have had the opportunity to read them have absolutely got to be smarter, more conducive to the pursuit of progress and economic growth than regulations which see the light of day before votes, but that’s just me.

    daleyrocks (e7bc4f)

  46. AW:

    I pay attention to my own company.

    Ah. So your initial argument basically boils down to “Well, MY company is a good corporate citizen; therefore, the government shouldn’t regulate ANYBODY.” Color me unpersuaded.

    and you’re dodging. Can you prove it or not?

    I’ve linked to various sources throughout this thread. Please do try to keep up.

    And notice you ignored

    1) when I proved you did in fact say that any imperfection means we should regulate.

    No, AW. Spinning what I say doesn’t prove what I actually said. It’s just a dishonest way to debate.

    And notice you ignored

    2) when I showed that saying that an infection is preventable is useless information, because all infections are preventable, but not all are REASONABLY preventable.

    I ignored it because I basically agree with it. It is, unfortunately, irrelevant to the discussion, unless you are assuming that the regulations are going to be unreasonable and onerous (e.g., every patient must be immersed in a plastic bubble). I don’t think the Obama administration is going to propose things like that — hence his call for “smart” regulation.

    In any event, any discussion of the exact nature of the regulations is premature. You can be dickish about it, and I understand that you feel compelled to (because it is Obama and you can’t let 24 hours pass without an attack on Obama). But you’re only guessing about the “reasonableness” (or lack thereof) of future regulations.

    Kman (d30fc3)

  47. Oh, heaven forbid we be “dickish” to a troll.

    SPQR (26be8b)

  48. “when I showed that saying that an infection is preventable is useless information”

    A.W. – I am not a doctor, but I think most of those hospital associated infections are preventable. If you notice the stats, most of the infections are curiously associated with the most invasive procedures or injuries. For example, burns, different major surgeries, trauma. You don’t see the infections in the psych units for some reason.

    So the simple solution to reduce the preventable infections and make people like Sebelius and kman happy is for hospitals to stop accepting burn and trauma patients and stop performing major surgeries. The Dems are all for rationing anyway, so they should have no objections.

    daleyrocks (e7bc4f)

  49. “I ignored it because I basically agree with it”

    So you do admit you ignored it.

    daleyrocks (e7bc4f)

  50. So you do admit you ignored it

    Yes, Daley. If I addressed every moronic point that AW raises, I wouldn’t have time to eat, sleep, bathe, etc.

    So if he wants to do pick out some irrelevant point like “I just proved that when you said X, you really meant Y”, I let him have his little victory dance in the end zone. It’s kind of like when I let my toddler nephews and nieces win at Chutes and Ladders; some things are simply not worth challenging.

    Kman (d30fc3)

  51. Oh, my, lefty favorite Seymour Hersh on Obama yesterday in Doha:

    “”Just when we needed an angry black man,” he began, his arm perched jauntily on the podium, “we didn’t get one.”

    It quickly went downhill from there.”

    http://blog.foreignpolicy.com/posts/2011/01/18/seymour_hersh_unleashed

    Why is it ALWAYS about race with the left?

    daleyrocks (e7bc4f)

  52. daleyrocks, that’s not the worst part of Hersh’s looney speech. He makes our butter substitute spam troll look sane.

    SPQR (26be8b)

  53. Kman

    > So your initial argument basically boils down to “Well, MY company is a good corporate citizen;

    Nope, I am talking about incentives, you moron. Well, either you are a moron, or a liar. Take your pick.

    > I’ve linked to various sources throughout this thread.

    Yes, finally after being asked several times. And the links you provided show no evidence of negligence. They only note infection rates. So… fail. Yes, they are preventable, in some sense of the word, but you have not shown they were reasonably preventable.

    > No, AW. Spinning what I say

    I don’t expect you to admit it, but as usual, your dishonesty is showing.

    > I ignored it because I basically agree with it. It is, unfortunately, irrelevant to the discussion

    Not when all you can cite are studies of infection, and not studies of reasonably preventable infection. If it is shown that hospitals are in fact doing as much as is reasonable to prevent infection then there is no problem justifying regulation ON TOP OF the regulation imposed by our tort system. Our tort system is bad enough. Edicts from Washington will only make things worse.

    > unless you are assuming that the regulations are going to be unreasonable and onerous (e.g., every patient must be immersed in a plastic bubble). I don’t think the Obama administration is going to propose things like that

    I don’t think they will propose that we all be in plastic bubbles (why did you have to go and kill that innocent straw man? He done did nothin’ to you!), but yes, I AM CERTAIN THEY WILL BE UNREASONABLY ONEROUS AND INFLEXIBLE. Because everything they have done so far is exactly that. This man has no track record of SMART regulation. He has a history of massive, intrusive, unreasonable regulation resulting in years of costly regulation.

    Or do you think you should be seen in the law as a creditor? Do you think THAT is reasonable? Because the American Bar Association didn’t think so and neither did two levels of federal courts.

    Daley

    > I think most of those hospital associated infections are preventable

    Every infection is preventable. See above at 10:00 am

    http://patterico.com/2011/01/18/obama-announces-%e2%80%9csmart%e2%80%9d-regulation/#comment-743811

    This issue isn’t whether it is possible to prevent them, but whether it is reasonably possible to prevent them. and that is a question the CDC doesn’t even attempt to answer.

    Aaron Worthing (e7d72e)

  54. Daley

    btw, thanks for that seymour hersh link. i will be using it later.

    Aaron Worthing (e7d72e)

  55. A.W. – He is nuts as you can when you read the rest. Bill Maher wanted a gangsta Obama, didn’t he?

    daleyrocks (e7bc4f)

  56. “Every infection is preventable. See above at 10:00 am”

    A.W. – You know the intended recipient of my comment.

    daleyrocks (e7bc4f)

  57. Returning to ignore mode.

    Comment by MD in Philly

    Welcome back to the ignore silly trolls club!

    Sadly, there’s not much else to say here. Obama’s regulatory trend so far has been abusive at best. Cap and Tax via EPA, FCC shoving race hustling onto mergers, IG firings and smearings, racist DOJ practices.

    I’m sure, in a very crass sense, it was smart to do all that, short term, for democrat electoral prospects.

    I wonder what color he’ll die his hair for the next regulation push? I think gray. Matches well with a blue tie, I think.

    Dustin (b54cdc)

  58. This issue isn’t whether it is possible to prevent them, but whether it is reasonably possible to prevent them. and that is a question the CDC doesn’t even attempt to answer.

    Wow, are you wrong.

    Kman (d30fc3)

  59. kman

    that link wholly fails to relate to your point. they did not even purport to discuss whether negligence was involved in any of those infections.

    so… did you not read it, or did you read it and misrepresent it?

    Aaron Worthing (e7d72e)

  60. Daley

    > Bill Maher wanted a gangsta Obama, didn’t he?

    Inevitably, most of the people who call those who oppose obama’s policies “racist” are themselves racist.

    Aaron Worthing (e7d72e)

  61. But, but…Manchin was for it before he was against it.

    Dmac (498ece)

  62. they did not even purport to discuss whether negligence was involved in any of those infections.

    Nobody has raised the issue of negligence except you.

    If the government chooses, through regulation, to limit the amount of rat feces in hot dogs, does it have to show that rat feces always gets in hot dogs through negligence? Of course not.

    If the number of healthcare-associated infections can be reduced by simply requiring hospitals (nursing homes, etc) to perform some reasonable prevention techniques, then what’s the problem? Negligence doesn’t enter into it. Maybe it’s simply ignorance that doesn’t rise to that level.

    Talk about a straw man.

    Kman (d30fc3)

  63. Semantics, Kman, through which you attempt to evade the point.

    And fail.

    Not really very good at this debate thing, are you?

    SPQR (26be8b)

  64. over 100,000 deaths annually

    Deplorable. Obviously, that number needs to be increased dramatically if we’re going to make Obamacare work.

    As far as the “smart regulation” goes… who will be the first to be given an “Overcharge” button by the Obama administration?

    malclave (4f3ec1)

  65. Semantics, Kman, through which you attempt to evade the point.

    My point (which I made in comment #1) doesn’t “fail” because I haven’t proved that negligence was behind all or even most healthcare-associated infections. AW can raise negligence all he wants, but it’s a red herring because the concept of negligence has nothing to do with what I was saying there.

    And I think you know that, SPQR.

    Kman (d30fc3)

  66. Nobody has raised the issue of negligence except you.

    Except that, you thundering moron, to say that regulation would improve those numbers is to implicitly suggest that it is through either neglect or incompetence that they occur.

    If neither is the cause then what, exactly, do you think further regulation will do? Do you think the words themselves will cause infections to not occur?

    Scott Jacobs (9b5ed3)

  67. No, Kman, I don’t know that because it isn’t a red herring. If the infections are not the result of negligence, then you are saying that they can’t be prevented.

    This is inherent in the definition of the term, both in lay terms and legal terms.

    SPQR (26be8b)

  68. Kman

    > Nobody has raised the issue of negligence except you.

    Yes, god forbid we discuss whether this is actually a problem or a solution in search of a problem! Everyone else here understands the issue. You are the only person who thinks that if there is even one “preventable” infection we must have onerous federal regulation.

    > If the government chooses, through regulation, to limit the amount of rat feces in hot dogs, does it have to show that rat feces always gets in hot dogs through negligence? Of course not.

    Well, I don’t know, it depends on a lot of facts specific to that example. For instance, can you removed the rat feces after the fact—meaning after it gets in, in the first place? if not, then it becomes an issue of prevention, and yes, if reasonableness of preventative measures comes into it.

    You shallow silly person.

    > If the number of healthcare-associated infections can be reduced by simply requiring hospitals (nursing homes, etc) to perform some reasonable prevention techniques, then what’s the problem?

    Nothing. But your date doesn’t show that, now does it?

    And notice you can’t even dispute my point that so far obama’s regulations have been unreasonably onerous.

    Aaron Worthing (e7d72e)

  69. Mr. Obama is president of the United States

    Does anyone else see visions of Edward VI of England, in this proclamation? Hell, Edward VI’s England actually does bear some economic resemblance to Obama’s USA, too.

    Scott, Kman isn’t a lawyer and doesn’t know what the word ‘negligence’ implies. He doesn’t realize that when he talked about infections people could prevent, if only they did things the proper way, he’s talking about negligence. His only purpose in this thread is to insist Aaron is wrong, over and over again. He has been doing this for seven years. He could care less what his links say. He tried informing Aaron about his sex life, and now he’s obsessed and stalking Aaron, often exploding if Aaron mentions that he’s not gay.

    Let’s do the math.

    Dustin (b54cdc)

  70. Kmart’s interpretive dance about New Guinean basket weaving is quite entertaining.

    JD (822109)

  71. Except that, you thundering moron, to say that regulation would improve those numbers is to implicitly suggest that it is through either neglect or incompetence that they occur.

    Of course not. It could be sheer ignorance.

    If, for example, studies showed that washing a ventilator tube twice a day (instead of the industry standard of once a day) could reduce the number of ventilator-related infections by 80%, the hospital that does the once-a-day cleaning procedure isn’t necessarily being negligent or incompetent.

    I think you’re all stuck on the notion that a regulation is punishment for wrongdoing or something.

    Kman (d30fc3)

  72. Can we design regulations to prevent or cure liberal brain infections? Those are not necessarily health care related.

    daleyrocks (e7bc4f)

  73. Scott

    actually thanks, you said that better than i did.

    Dustin

    > often exploding if Aaron mentions that he’s not gay.

    must… scrub… image… from… head.

    Aaron Worthing (e7d72e)

  74. btw, I’m not suggesting non-lawyers are less able to intelligently discuss how over-the-top Obama’s regulation promises appear to be.

    Just Kman, the fake lawyer.

    Dustin (b54cdc)

  75. And notice you can’t even dispute my point that so far obama’s regulations have been unreasonably onerous.

    I don’t which of “Obama’s” regulations you’re referring to.

    Kman (d30fc3)

  76. Kman

    > If, for example, studies showed that washing a ventilator tube twice a day (instead of the industry standard of once a day) could reduce the number of ventilator-related infections by 80%, the hospital that does the once-a-day cleaning procedure isn’t necessarily being negligent or incompetent.

    Actually not being up on the latest info about your profession is negligence.

    And that certainly doesn’t explain why we need a federal regulation, in your hypothetical, to force hospitals to do it more often. if you feel it is just ignorance, then the simpler, dare i say, “smarter” solution would be an information campaign. duh.

    Aaron Worthing (e7d72e)

  77. “Obama’s” regulations

    Scare quotes because… ?

    Maybe because you’re saying Aaron’s wrong to associate all the executive branch with the President? I guess they didn’t offer Administrative Law at Cooley Law Schooley.

    Dustin (b54cdc)

  78. Kman

    > I don’t which of “Obama’s” regulations you’re referring to.

    Proving you didn’t read my post.

    Not that anyone is surprised when i point that out anymore.

    Aaron Worthing (e7d72e)

  79. And that certainly doesn’t explain why we need a federal regulation, in your hypothetical, to force hospitals to do it more often. if you feel it is just ignorance, then the simpler, dare i say, “smarter” solution would be an information campaign. duh.

    You answered your own question. We need a regulation because an information campaign doesn’t “force” anybody to do anything.

    And sometimes we want DO want to force businesses to do certain things. Otherwise, they might not do it. They’ll simply go ahead with dangerous (yes, even neglectful) practices even after they are informed of the danger, by simply factoring in any negative repercussions as a cost of doing business.

    Kman (d30fc3)

  80. Dustin

    > I’m not suggesting non-lawyers are less able to intelligently discuss

    right, its not elitism, because you are looking down on only one person, who purports to be a lawyer, but knows nothing of the law.

    Aaron Worthing (e7d72e)

  81. Is ignorance of professional standards of care a defense to negligence? If cleaning tubes twice a day is good, why not 20 times a day? Why not every time they are touched? I say we ban infections altogether.

    JD (109425)

  82. Kman

    > We need a regulation because an information campaign doesn’t “force” anybody to do anything.

    But you just alleged that this was not negligence, but merely ignorance.

    Which is it?

    > They’ll simply go ahead with dangerous (yes, even neglectful) practices even after they are informed of the danger, by simply factoring in any negative repercussions as a cost of doing business.

    That is a heavy accusation. But you have NEVER PROVEN THAT. You have never shown that any of these infections are reasonably preventable.

    Your analysis is fact immune. you know that hospitals are just risking patient’s lives in service of the almighty dollar because… um… you are really, really sure they are.

    I thought liberals liked science.

    Aaron Worthing (e7d72e)

  83. If cleaning tubes twice a day is good, why not 20 times a day? Why not every time they are touched?

    But that’s my point, JD. Everyone here is operating under the assumption that there is a clear bright line between negligent practices and non-negligent practices. Unfortunately, in medicine (like much of real life), there are — shall we say — variable degrees of care that a provider can give.

    So washing a ventilator tube once a day may not be negligent, but washing it twice a day, or three times a day, is better and can, in the aggregate, save thousands of lives.

    All regulation does is SET those professional standards. I can’t understand why people object to the principle of that. I mean, it’s one thing if you don’t trust Obama, or you fear the regulations might be too onerous. But people here are objecting to the idea of regulation in hospitals where there is a clear — and preventable — problem that can be addressed.

    Kman (d30fc3)

  84. factoring in any negative repercussions as a cost of doing business.

    huh…

    That’s not a very nice thing to say. I guess these are the people stealing tonsils that Obama was wetting the bed over?

    They probably planned 9/11. Kman’s a medical truther, unless he has hard proof of his hysterical claim.

    Dustin (b54cdc)

  85. I was freaking mocking you, and you are too pig ignert to know any different.

    JD (d56362)

  86. You have never shown that any of these infections are reasonably preventable.

    Your analysis is fact immune.

    Only an idiot (or a very bad lawyer) would ask for “proof” of reasonableness. Obviously, I can (and indeed, have) linked to various prevention techniques that the CDC has listed (depending on the type of infection). If you think any of the proposed preventative techniques are unreasonable, then say so. But mostly, they appear to consist of rather common-sense procedures of disinfecting and sterilization.

    But no, I can’t “prove” the reasonableness of these prevention techniques because “reasonableness” is subjective. I know you can’t understand that, so do your victory dance. You know you want to.

    Kman (d30fc3)

  87. I also like how kmart noted that states are already looking at this, and haven’t yet had the chance to fully implement their plans. Therefore, the Feds must regulate it. Still waiting on examples of their non-instrusive common-sense regulations that have encouraged business.

    JD (6e25b4)

  88. Kman

    > So washing a ventilator tube once a day may not be negligent, but washing it twice a day, or three times a day, is better and can, in the aggregate, save thousands of lives.

    Or twenty times a day. Or a thousand? Talk about missing the point, slowpoke.

    > I mean, it’s one thing if you don’t trust Obama, or you fear the regulations might be too onerous.

    Wow, you finally get it.

    And but then you lose it again.

    > But people here are objecting to the idea of regulation

    I am not opposed to regulation when it is proven to be necessary.

    > where there is a clear — and preventable — problem that can be addressed.

    Lol, notice you keep leaving out that word “reasonably.” Because you don’t care about being at all reasonable in the steps to prevent it. so… I guess everyone goes in the bubble, right?

    Aaron Worthing (e7d72e)

  89. HEY PEOPLE!!!!

    I gave the definitive answer up at #41 which Kman didn’t respond to while talkin’ to the rest of y’all.
    If you people don’t stop pretending you know about medicine, I’m going have to start talking about Constitutional Law and Habes corpse

    I think you’re all stuck on the notion that a regulation is punishment for wrongdoing or something.
    Comment by Kman
    Yup. For example, hospital “X” overcharges Medicare by $500,000 one year because of errors in procedure codes. That same year they also undercharge Medicare by $650,000 also because of errors in procedure codes. So, in that year the hospital undercharged a net of $150,000 in part due to confusing Medicare regulations. Do you know what the Feds call that? Medicare Fraud for $500,000, so the hospital is out of $650,000 (because they will not pay the difference for underbilling) plus a fine and additional administrative costs.

    MD in Philly (3d3f72)

  90. Is ignorance of a professional standard of acre a defense against negligence, kmart?

    JD (822109)

  91. I was gonna comment on this thread, but I was totally bored after comment #1, so — nah.

    Icy Texan (441ab5)

  92. Is ignorance of a professional standard of acre [sic] a defense against negligence, kmart?

    Generally not, but we’re not talking about an established “standard”, are we?

    Do you think all hospitals and nursing homes follow the same standard and practice when it comes to, say, cleaning ventilation tubes (i.e., how often, how to clean, what solution to use)?

    Kman (d30fc3)

  93. Kman

    > Obviously, I can (and indeed, have) linked to various prevention techniques that the CDC has listed (depending on the type of infection).

    But you fail to prove that failure to follow those techniques relate to any deaths. Indeed, why should we think those suggested techniques are the best? Call me crazy but some egghead in Washington is unlikely to come up with the best solution. And the other problem is that is in imposing those as regulations, they lock us in. this is an area where technology is changing all the time, and innovations arise. Tomorrow a smart guy might have an idea for a better technique that might either 1) prevent the same number of infections but with less cost or effort or 2) prevent more infections. But hospitals would be slow to adopt those ideas precisely because regulation is involved requiring them to do things a certain way. central planning is typically idiocy.

    Something you would know if you were not a socialist.

    > Only an idiot (or a very bad lawyer) would ask for “proof” of reasonableness.

    > But no, I can’t “prove” the reasonableness of these prevention techniques because “reasonableness” is subjective.

    Only an idiot or a very bad lawyer would think that reasonability is not susceptible to proof. Let’s review the elements of a typical tort of legal malpractice, since this might come in handy for you:

    • The existence of an attorney-client relationship;
    • Negligence in the legal representation of the plaintiff;
    • That the negligence was a proximate cause of an injury;
    • The fact and extent of the injury alleged.

    And of course what is negligence? “Conduct that falls below the standards of behavior established by law for the protection of others against unreasonable risk of harm. A person has acted negligently if he or she has departed from the conduct expected of a reasonably prudent person acting under similar circumstances.” I mean you don’t have to be a good lawyer, but just a good googler, to know that. See how that word, “reasonable” keeps popping up in various forms.

    Of course in the context of legal malpractice it’s a reasonably prudent lawyer, not just a reasonably prudent person.

    And this is typical of all negligence issues, including medical malpractice. Only a person profoundly ignorant of the law doesn’t know that reasonableness of conduct is questioned, proved and disproved every day in our courts. I mean seriously, this is first semester law school stuff.

    Aaron Worthing (e7d72e)

  94. It’s too bad that the individual states don’t have regulations, and that the federal guvmint has to step in and control everything.

    What’s that? The states DO have this power, and already have regulations in place?

    Huh.

    Icy Texan (441ab5)

  95. Kman

    > Do you think all hospitals and nursing homes follow the same standard and practice when it comes to, say, cleaning ventilation tubes (i.e., how often, how to clean, what solution to use)?

    um, you did:

    > If, for example, studies showed that washing a ventilator tube twice a day (instead of the industry standard of once a day) could reduce the number of ventilator-related infections by 80%[.]

    Omg, does this mean that you are not even reading or comprehending your own comments? Are you really a million monkeys at a million typewriters?

    Aaron Worthing (e7d72e)

  96. OK, I’m lookin’ for my law book….

    MD in Philly (3d3f72)

  97. Call me crazy but some egghead in Washington is unlikely to come up with the best solution. And the other problem is that is in imposing those as regulations, they lock us in.

    Well, with the prevalence of HAIs, the free market doesn’t seem to be working. So I’d rather have some “eggheads” at the CDC come up with a solution, rather than some hospital administrator looking at the balance sheets and fretting about how much it will cost the hospital to NOT infect the people under its care.

    And this is typical of all negligence issues, including medical malpractice. Only a person profoundly ignorant of the law doesn’t know that reasonableness of conduct is questioned, proved and disproved every day in our courts. I mean seriously, this is first semester law school stuff.

    Yeah. Thanks for the refresher on med mal.

    Unfortunately, your post isn’t about medical malpractice and lawsuits. It’s about the regulatory scheme. I know you WANT to move into a realm about which you (in theory) have more schooling, but you need to resist the urge to try to see everything through a lawyer’s eyes. It’s why people dislike our profession so much.

    It’s okay. You’re young.

    Kman (d30fc3)

  98. “Well, with the prevalence of HAIs, the free market doesn’t seem to be working”

    Kman – When you say the free market is not working, what is the trending on HAI’s in terms of prevalence? That first study you linked presented only combined year data.

    daleyrocks (e7bc4f)

  99. Kman

    > Well, with the prevalence of HAIs, the free market doesn’t seem to be working

    Seem? Well, sorry, but prove it or shut up.

    > Unfortunately, your post isn’t about medical malpractice and lawsuits. It’s about the regulatory scheme.

    Actually it is. It is about the use of the tort system as a regulatory device, rather than a regulatory scheme. So once again, you prove you didn’t read the post.

    I mean a minute ago you wrote about administrators checking balance sheets. Well what the f— do you think is on the other side of the balance sheet when there are no regulations? What are they weighing the cost of a preventative procedure against? THE DANGER OF A LAWSUIT, YOU IDIOT.

    Seriously, are you THIS IGNORANT of the basics of law and economics?

    Aaron Worthing (e7d72e)

  100. “Seriously, are you THIS IGNORANT of the basics of law and economics?”

    A.W. – That’s a rhetorical question for Kman, right?

    daleyrocks (e7bc4f)

  101. Kman

    And i let this one go too easy.

    > Yeah. Thanks for the refresher on med mal.

    That isn’t just med mal. that the tort of basic negligence. you cannot go a month into law school without knowing this. so you said an ignorant thing, that the reasonableness of preventative measures cannot be proven, despite the fact that it is proven EVERY SINGLE DAY in our courts. You said something that contradicted what every first year law student knows.

    you called me young? apparently you are senile, because you don’t even remember what you were taught in your first semester of law school.

    Aaron Worthing (e7d72e)

  102. Kmart will now do a contemporary dance entitled “I shove my head in my rectum”, accompanied by William Yelverton, head lubricator and Professor of the Skin Flute.

    JD (d48c3b)

  103. He has been doing this for seven years.

    Am I hearing this correctly, AW? Is Dustin accurate in this timeline of heavy – breathing/stalking odyssey? If so, then that’s beyond pathetic; it’s full – on, mouth – breathing creepatoid.

    Kmart, is this is true, please go fling your poo and random idiocies somewhere else – Balloon Juice, for example. They just lurve them some illogical fallacies over there.

    Dmac (498ece)

  104. don’t even remember what you were taught in your first semester of law school.

    But doesn’t watching the first season of Matlock count just as much?

    Dmac (498ece)

  105. dmac

    going on like 8 or 9. since 2002 or 2003, and this is 2011. i admit to being fuzzy about when i first came in contact with his stupidity.

    Aaron Worthing (e7d72e)

  106. That’s patently ridiculous, AW. No one should have to put up with that kind of mental illness.

    Dmac (498ece)

  107. I stand corrected.

    Kman, what kind of glass cleaner do you find best for cleaning off saliva? My dog just loves to ambush me when I’m playing on the old PS3, and sometimes my glasses get smudged with her kisses before I can react.

    Dustin (b54cdc)

  108. One monkey, one typewriter. And he nails it every time.

    Icy Texan (441ab5)

  109. I like the idea of outlawing infections, on the theory that if we outlaw infections, only outlaws will have infections–sort of a wild west form of justice, maybe.

    Rochf (ae9c58)

  110. Kman,

    why wash the tubing at all? Replace hourly with new, sterile tubing. Wouldn’t that reduce infections further?

    malclave (4f3ec1)

  111. Actually, now that I think about it, maybe we do need more regulation.

    Case in point: in our last FDA inspection, our Blood Bank was criticized (though it was not entered on the report) because the inspector thought the lids on our sharps containers looked more pink than red.

    The federal government needs to provide specific guidelines as to the wavelengths of light reflected by sharps container lids, and the means to measure them.

    Your tax dollars at work.

    (Personally, I think the lids are red, but because they’re clear they’re not the deep red of the rest of the container. But then, I’m not an FDA inspector.)

    malclave (4f3ec1)

  112. Oh, good allah. Al Gore is back. Linking the Austrailian and Brazilian floods to global warming.

    http://thehill.com/blogs/e2-wire/677-e2-wire/138539-al-gore-lauds-abc-news-for-climate-flooding-link

    elissa (2e9154)

  113. Comment by elissa — 1/18/2011 @ 4:55 pm

    Never let a crisis… oh never mind.

    Dana (8ba2fb)

  114. Saying that the “free market” isn’t working with respect to HAI’s is pretty hilarious since (1) there is no evidence that the supposed frequency of HAI’s is actually at a particular rate because of some profit incentive and (2)given that the bulk of hospitals are in fact non profit enterprises.

    SPQR (26be8b)

  115. Let me see if I have this right. Despite the fact that doctors swear an oath to do no harm and despite the fact that they can get the holy crap sued out of them for making a mistake, we are supposed to believe that the government can kill germs?

    Can we have a regulation that makes good, old Ag80 immortal – and attractive. For the missus, I mean.

    Ag80 (e03e7a)

  116. Ag80, notice that my example of a specific IRS regulation proposed without statutory authority and in direct derogation of the US’ desireability as a place to invest was completely ignored by Kman.

    SPQR (26be8b)

  117. we are supposed to believe that the government can kill germs?

    You know that if Bush (or any Republican) had tried this, the leftists would all be screaming about germ warfare…

    malclave (4f3ec1)

  118. Or unitary executive. Iamadimwit is back.

    JD (d4bbf1)

  119. NoYou

    Yes, its the same administration. Its the obama administration. he is responsible for all of it, and this overregulation, rigging of the “science,” of open defiance of federal decisions is a trademark of it, across all agencies.

    Aaron Worthing (73a7ea)

  120. Civics is hard.

    Ag80 (e03e7a)

  121. That’s because the extent of the problem has only recently become known (hospitals typically haven’t been required to report incidents of healthcare-associated preventable infections, until recently).

    Md in Philly, he doesn’t know about hospital infection control departments that have existed at least since 1972 and probably well before. I suspect he has never heard of Amory Codman who began the systematic study of results of surgery in 1914.

    Kman is a lawyer with all that implies about his ethics and knowledge. Sorry Patrick.

    Mike K (8f3f19)

  122. “we are supposed to believe that the government can kill germs?”

    Just remember what Obama did for Gabby Giffords last week. He is a healer!

    daleyrocks (e7bc4f)

  123. Hush, dimwit.

    JD (d4bbf1)

  124. Indeed, Mike K. I spoke of my first hand experience and you bring a more extended history (I’m assuming 1914 is not first hand knowledge 😉 )

    Government inspections are about as useful as malclave describes at #114.

    It is relatively easy to do quality control on the manufacture of inanaimate objects. If you want to know if the IV fluid is sterile, you test one out of every so-many bags, along with looking at the manufacturing equipment. But as soon as you talk about a complicated process that involves people, the best that can be done are measurements that are meant to correlate with a desired outcome. The main problem is that such systems are not “controlled” in the classic sense, and other info is needed if the numbers are to mean anything. This is the big problem if you compare morbidity/mortality rates for the “same procedure” at two different hospitals. One hospital does heart surgery on the healthiest and easiest cases, and another is a university referral center that handles all of the high risk cases the first hospital won’t touch, and then some reporter or lawyer wants to make a big to do over differences in “the numbers”. Or, look at total HAI from 2 different hospitals. Guess what, the hospital that does Bone-Marrow and other transplants will have higher numbers.

    Government health-care facility inspections are opportunities for administrators and clinical supervisors to panic and make those under them panic for a short period of time preparing for an inspection- like ordering darker red tops for sharps container. Meanwhile there are more important things people could be devoting their energies on.

    MD in Philly (3d3f72)

  125. “he is responsible for all of it”

    Why do you think they call it an “independent” agency then?

    Comment by NoYouDidnt

    Just to be clear, are you saying the IRS is independent of the Executive branch?

    The word independent does not mean “not in an executive branch”. It means it’s separate from others. Just as the DOE is independent of the DOD.

    The IRS is simply the Secretary of Treasury’s department for bringing revenue to the government. It’s blatantly part of the executive branch.

    If you’re not talking about the IRS, what are you talking about? Not even Inspector Generals are independent of the executive anymore, since Obama plays Chicago thug politics.

    Dustin (b54cdc)

  126. NYD:

    I’ll tell you what, if under the next GOP administration it does something you don’t like, we’ll call it square.

    Seriously, someone here is playing dumb and it’s not me.

    Ag80 (e03e7a)

  127. mike K

    hey! as a lawyer i resemble resent your remarks.

    Aaron Worthing (73a7ea)

  128. “We’re also getting rid of absurd and unnecessary paperwork requirements that waste time and money.”

    Mr. President, may I point out that absurd, unnecessary and just plain dumb new Form 1099 requirement included as part of ObamaCare as a glaring example of what you are talking about?

    How about a snitch line direct to the White House where ordinary citizens can submit their favorite unnecessary regulations?

    daleyrocks (e7bc4f)

  129. You don’t think we work really hard to prevent the spread of infection?

    There are people in the food service industry that work really hard to prevent contamination. But somehow, food gets contaminated and people get salmonella poisoning.

    That’s why we have a USDA and FDA. No industry can be trusted to regulate itself. Even if most firms do their best, there are always some who cut corners or screw up.

    Getting 100% compliance with finicky procedures from a large and heavily worked staff is hard. Getting middle managers to enforce 100% compliance while trying to meet financial and productivity goals is hard.

    I’m no Obama fan or lover of regulation, but trusting to good intentions is not sufficient here.

    Rich Rostrom (f7aeae)


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