Born-Alive

Last week the British Nuffield Council on Bioethics published a report including step-by-step recommendations regarding the proper care of premature infants.  The Council recommended that infants born earlier than 22 weeks of gestation not be resuscitated and that infants between 22 and 23 weeks of gestation only receive intensive care if their parents request such care and the infant’s doctors agree.

There has been a flurry of commentaries in U.S. papers and blogs about the Nuffield Council’s recommendations, but not a single one that I have seen mentions the fact that in the U.S., it would be illegal to follow the Council’s recommendations.   In 2002 President Bush signed into law the federal Born-Alive Infant Protection Act and in 2005 DHHS Secretary Mike Leavitt stated “[w]e aggressively enforce federal laws that protect born-alive infants.  We issued clear guidance that withholding medical care from an infant born alive may constitute a violation of the federal Emergency Medical Treatment and Labor Act and the Medicare Conditions of Participation.”

It is nevertheless worth considering what the Nuffield Council has said to help put the Born-Alive Infant protection Act into perspective.   The Council’s report makes it clear that there is no realistic chance that a baby born under 22 weeks of gestation will survive and that infants born between 22 and 23 weeks have only a 1% chance of survival.  Furthermore, those few that do survive at 22-23 weeks are highly likely to suffer from severe handicaps.  (None of this information is limited to Britain.  U.S. statistics confirm these conclusions).  The Born-Alive Infant Protection Act requires health care professionals to try to save such babies. They must tape them down, stick them with needles and tubes, and resuscitate them – essentially, they are required to torture such babies until they die.  As a mother of four children and a Christian, I would want to hold and rock my little infant as it dies.  I wouldn’t want its precious few hours of life to be filled with pain and fear and never a mother’s warm embrace or soft voice.  It is a very cruel world indeed if the drafters of the Born-Alive Infant Protection Act knew they were going to require health care professionals to torture dying infants and deny parents the only realistic succor they have to offer – the physical affection that would tell such infants that, while their stay on earth is short, they are nevertheless loved.

“No Child” Not Working? Unbelievable!

The New York Times today reports the unthinkable: The vaunted No Child Left Behind Act (NCLB) has done almost nothing to shrink the black-white achievement gap, and the credit the Bush administration has given the law for overall achievement gains is – get ready – unfounded! Writes the Times:

The 2005 National Assessment of Educational Progress, a battery of reading and math tests administered to thousands of students in every state, showed some rising scores for all ethnic groups, and the black-white score gap narrowed in a statistically significant way for fourth-grade math. But on fourth-grade reading, and on eighth-grade reading and math, the black-white and Hispanic-white gaps were statistically unchanged from the early 1990s.

Over the past three decades, the gaps narrowed steadily from the 1970s through the late 1980s but then leveled out through 1999. Since then, some have narrowed again, but at a rate that would allow them to persist for decades. That picture showed up in a separate National Assessment test devised to measure long-term trends, administered in late 2003 and early 2004.

That test showed that regardless of race, scores increased a bit over three decades for 9- and 13-year-old students, with the best gains coming between 1999 and 2004.

Test administrators warned against attributing those gains to the federal law, because it had been in effect for about only a year when the 2004 test was given…..But Bush administration officials have routinely credited the law for the improved scores on that test.

Many Democrats who originally supported NCLB, as you can imagine, have put the blame for its failure squarely on Bush. Unfortunately, their own solutions feel distinctly like old times are here again:

The findings pose a challenge not only for Mr. Bush but also for the Democratic lawmakers who joined him in negotiating the original law…and who will control education policy in Congress next year.

Senator Edward M. Kennedy of Massachusetts and Representative George Miller of California, who are expected to be the chairmen of the Senate and House education committees, will promote giving more resources to schools and researching strategies to improve minority performance, according to aides.

Of course! More resources and “researching strategies” are the keys to real change. Why didn’t anyone else think of that?

Oh wait. They did: Federal spending on elementary and secondary education leapt from $43.8 billion in FY 2000 to $68.0 billion in FY 2005, a 55 percent increase, and NCLB imposed a whole new strategy of unprecedented federal control onto the schools. Yet, somehow, nothing changed.

Thankfully, there is a strategy that really could help struggling students get the education they need, but it would require embracing real change. First, the federal government would have to get out of education, ending more than 40 years of demonstrated failure and pulling some of the worst politics out of America’s classrooms. That, however, would not be enough, because while federal politicians are the most shameless about claiming victory in the face of abject failure, state and local politicians aren’t much better. There must, therefore, be a second phase: All states must offer universal school choice, finally putting parents in charge of education, and ending the era of strategies hopelessly built on politicians’ empty rhetoric and broken promises.

My Afternoon with Milton & Rose

I had the fortune to work for the Republican leadership of the U.S. Senate from 1999 to 2003.  I got to run around on the Senate floor, act important, give senators advice, and watch them routinely reject that advice.  It was great fun. 

The highlight of my tenure as a Senate staffer was easily the the afternoon that I shuttled Milton and Rose Friedman from their hotel to the Senate and back again. 

It was May 9, 2002, the day that Milton was honored both at the White House and at the Cato Institute’s 25th anniversary gala for his lifetime of service to the cause of human freedom.  When I learned he would be in D.C., I opportunistically arranged a meeting between him and half a dozen senators so that Milton could share his ideas about health care

Some cute memories stand out.  I had to ask my two passengers to buckle up.  When we arrived at the Senate, Milton and Rose – each standing about 5’2” tall – practically got stuck when they tried to step through the metal detector at the same time.  I tried not to laugh as an enormous Capitol policeman repeatedly patted down the diminutive, apologetic, and 90-year-old Nobel laureate to find whatever deadly weapon Milton was trying to smuggle into the Capitol. 

After Milton and the senators discussed health care, Sen. Don Nickles (R-OK) brought up the farm bill that the Senate had just passed.  He and Milton had a lengthy exchange wherein Milton denounced the bill as a throwback to Soviet-style economic planning.  On our way back to the hotel, I explained that Sen. Nickles had raised the issue to needle another senator, who sat right next to Milton at the meeting, had voted for the farm bill, and who uncomfortably stared at his hands throughout the entire exchange.  Milton was unconcerned about the senator’s discomfort, asking only, “Why did he vote for that??”

That day in 2002 was the only face time I got with Milton and Rose.  (Another highlight of my career came in 2005, when Milton wrote a blurb for a book that I co-authored.) Nevertheless, ever since he passed on Thursday, I can’t help feeling that I lost a great friend.  Just another one of his gifts, I suppose.

Rest in peace.

An Update on Health Care Trends

The Washington (state) Alliance for a Competitive Economy announces a new briefing paper on health care trends.

In 2005, an estimated 54.6 percent of health care was funded by private sector spending, a slight increase from the 54.3 percent reported in 1995. In 2015, private sector spending is projected todecrease to 52.5 percent. While the percent of funding from the private sector remains relatively stable, the source of private sector funds has shifted from out-of-pocket payments to private health insurance. In 1970 out-of-pocket payments made up 33.2 percent of health care spending, decreasing to 12.3 percent ofspending by 2005.

The paper refers frequently to Crisis of Abundance.

The Cause That Dare Not Speak Its Name

The New York Times writes that Ho Chi Minh City (formerly Saigon) is beginning to develop after being “held back by a half-century of war and privation.”

A slightly more accurate statement would be that economic development in Vietnam has been held back by “a half-century of war and socialism.” The privation was a result of the socialism, not a cause.

Topics:

Hoyer’s a Liberal

In at least two stories today (here’s one), the Washington Post described new House Majority Leader Steny Hoyer (D-MD) a “moderate.”

Nonsense. National Journal scores for votes on economic issues show that Hoyer is a consistent liberal. His percentile rank in the House for favoring conservative economic policies was toward the bottom end at 26 percent, 20 percent, and 26 percent for 2003, 2004, and 2005, respectively. His voting record also shows a strong preference for “liberal” social and foreign policy positions.

In his latest Almanac, Michael Barone calls him “fairly liberal,” but does note the exception of Hoyer’s votes in favor of free trade agreements.

To Milton What Belongs to Milton

When I was 18 years old in 1966, I read this paragraph in Milton Friedman’s Capitalism and Freedom:

The “social security” program is one of those things on which the tyranny of the status quo is beginning to work its magic…. [I]t has come to be so much taken for granted that its desirability is hardly questioned any longer. Yet it involves a large-scale invasion into the personal lives of a large fraction of the nation….

These words, and the brilliant Chapter 11 of that book, changed my life and the future of my long and narrow country.

Many years later, after we had fully privatized Social Security in Chile in 1980, I was honored to become an intellectual friend with this giant of liberty. We met at his beautiful San Francisco apartment, we interacted at many Cato events, and we even rode together in a very long black limousine with his wife Rose and Ed Crane from San Francisco to San Jose to a joint appearance in front of Sillicon Valley entrepreneurs. I saw him for the last time when he was honored at the White House on May 9, 2002, during an event appropriately called “A Lifetime of Achievement: Milton Friedman at 90.”

A great leader has left us. He was a man who understood the wisdom in T.S. Eliot’s words: “Only those who risk going too far can possibly find out how far one can go.”

Because Milton dared to “risk going too far,” he advanced decisively the frontiers of liberty.