Editore"s Note
Tilting at Windmills

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August 10, 2009

STEPHEN HAWKING IS ALIVE AND WELL.... The estimable Jay Bookman discovered this unintentionally-hilarious item in the Investor's Business Daily on health care reform. The headline reads, "How House Bill Runs Over Grandma."

The U.K.'s National Institute for Health and Clinical Excellence (NICE) basically figures out who deserves treatment by using a cost-utility analysis based on the "quality adjusted life year."

One year in perfect health gets you one point. Deductions are taken for blindness, for being in a wheelchair and so on.

The more points you have, the more your life is considered worth saving, and the likelier you are to get care.

People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.

Human Events, the right-wing magazine, lauded this IBD piece for having "exposed the Achilles' heel of Obamacare."

Now, it might be tempting to respond to the IBD piece by noting that the health care reform proposal backed by Democrats is in no way similar to the British health care system, so these mind-numbing comparisons don't make any sense. That, of course, would be a fair response.

But let's not overlook the punch-line here. As Bookman noted, "Of course, that same Stephen Hawking who wouldn't have a chance in the United Kingdom was in fact born in the United Kingdom, has lived his entire life in the United Kingdom and lives there still today, at the ripe old age of 67. (He was in fact hospitalized earlier this month.) Hawking is, you might say, living, breathing proof that these people are first-class fools."

Ever wonder what the reform debate would be like if conservatives approached it with a shred of intellectual seriousness?

Steve Benen 2:45 PM Permalink | Trackbacks | Comments (77)

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Nah, Hawking is famous and white. That makes him
an honorary American, like Jim Carrey, Pamela Anderson, and Jesus Christ.

Posted by: Richard Cownie on August 10, 2009 at 2:50 PM | PERMALINK

Steve Benen wrote: "Ever wonder what the reform debate would be like if conservatives approached it with a shred of intellectual seriousness?"

If Republicans and "moderate" Democrats approached the health care reform debate with intellectual honesty, they would be openly and forthrightly telling the American people that the USA has the most profitable health care system in the world and that their goal is to keep it that way -- that the primary purpose of the US health care system is not to provide health care to human beings, but to provide profits to corporations.

Gosh, I wonder why they don't do that.

Posted by: SecularAnimist on August 10, 2009 at 2:51 PM | PERMALINK

Given that Stephen Hawking has been under NHS care since being diagnosed over 40 years ago, this argument is even stupider than it first seems. The NHS would have let Hawking die, except that it has had 40 years to do it and never bothered?

Posted by: Mnemosyne on August 10, 2009 at 2:53 PM | PERMALINK

Ever wonder what the reform debate would be like if conservatives approached it with a shred of intellectual seriousness?

Ever wonder what the reform debate would be like if conservatives approached it with a shred of intellectual capability?

There, fixed it.


Posted by: TCinLA on August 10, 2009 at 2:54 PM | PERMALINK

Ever wonder what the reform debate would be like if conservatives approached it with a shred of intellectual seriousness?

Ever wonder what the reform debate would be like if conservatives had or could even recognize a shred of intellectual seriousness?

Posted by: Cap'n Chucky on August 10, 2009 at 2:55 PM | PERMALINK

There's a joke about two hikers fleeing an angry bear that ends with the punchline "I don't need outrace the bear, I just need to outrace you!"

There's something like that happening in the conservative punditry ecosystem.

Guys like Bookman don't have to fool us, they just need to fool . . . well, folks like Sarah Palin, or a Tea Party organizer. The Stephen Hawking factoid will get used in a speech or put on a poster and convince a few more specimens of Bear Bait. The idiot factoid will live on, forever, because there are no lack of gullible soreheads.

Posted by: Stefan Jones on August 10, 2009 at 2:56 PM | PERMALINK

@Mnemosyne - They're still waiting on the paperwork from his death panel. Durned inefficient bureaucracies!

Posted by: Jamobey on August 10, 2009 at 2:56 PM | PERMALINK

Book him

I suspect Stephen Hawking would be happy to make pro-public healthcare ads for Team Obamacare:

"If it wasn't for the national health care we have in the UK...
I would have had to rely on private insurance companies...
And my illness would have been declared a pre-existing condition.
I wouldn't be alive right now..."

Winning the health care debate really is too easy.
You just have to be willing to be as vicious about winning as the opposing side.
Then... it all just falls into visceral place.


Posted by: koreyel on August 10, 2009 at 2:58 PM | PERMALINK

That's the second major howler committed by IBD on this issue. Hilzoy described the first in a wonderful post shortly before she left.

What will they come up with to top this, I wonder?

Posted by: Peter on August 10, 2009 at 2:59 PM | PERMALINK

Stephen Hawking is NOT British! Have you ever listened to him? He definitely doesn't have a British accent.

Posted by: Al on August 10, 2009 at 3:00 PM | PERMALINK

Al, you just won the internet. Bravo.

And, huzzah for Dr. Hawking. May he continue in good health for decades to come.

Posted by: doubtful on August 10, 2009 at 3:07 PM | PERMALINK

You are confused by the term republican or conservative. I assure you they are not the same.

Posted by: EC Sedgwick on August 10, 2009 at 3:10 PM | PERMALINK

Stephen Hawking is NOT British! Have you ever listened to him? He definitely doesn't have a British accent.

LOL! Makes perfect sense to me as a criterion!

What a remarkable individual Stephen Hawking is!

Posted by: msmolly on August 10, 2009 at 3:12 PM | PERMALINK

It's just taking a long time for the paperwork to get through the British bureaucracy. Once it does, he'll be finished.

Posted by: Conservatroll on August 10, 2009 at 3:22 PM | PERMALINK

Professor Stephen Hawking is a prestigious multi-millionaire; he can afford the very best medical care for himself and his family.

In other words, Hawking is not dependent on the indisputably broken and corrupt National Health Service (NHS), which is why he's still breathing rather than being forcibly persuaded to shuffle off this mortal coil by some government bureaucrat who is part of an indifferent, socialized medicine regime.

Posted by: Urban Matrix on August 10, 2009 at 3:26 PM | PERMALINK

I'm sure IBD will now blame Hawking for its mistake. His synthesized voice doesn't have a British accent so how were they to know Hawking lived in the UK.

Posted by: 3reddogs on August 10, 2009 at 3:28 PM | PERMALINK

What the White House ought to do is send out an emmisary to personally visit with each of these RePub gas bags who tell these lies publicly. Imagine Virginia Fox being visited by Howard Dean and then having to admit she lied. Would make for great promo.

Posted by: fillphil on August 10, 2009 at 3:30 PM | PERMALINK

"Professor Stephen Hawking is a prestigious multi-millionaire; he can afford the very best medical care for himself and his family."

LOL, that certainly does bolster the argument. Not only would National Health Care have killed him in the country where he was born and lives, but he actually became so rich that he doesn't even need the healthcare anymore, despite the fact that it would have killed him.

Brilliant, just brilliant.

Posted by: ashton on August 10, 2009 at 3:33 PM | PERMALINK

@ Stefan Jones You said it . You and I both know it will be repeatd by the MSM without question or they will repeat it without correctly framing it as "Republican rag erroniously identifies Steven Hawkings makes stupid statement. We will hear Steven Hawking British subject - you decide could have been killed if he was.
Earth Round or Flat? Some say no - you decide.

Posted by: John R on August 10, 2009 at 3:44 PM | PERMALINK

Urban Matrix,
So if people in England can still buy the best medical care money can buy, what is the problem?

Posted by: DR on August 10, 2009 at 3:48 PM | PERMALINK

Actually, Hawking was treated at Addenbrook's Hospital in Cambridge, which is an NHS hospital.

http://www.cuh.org.uk/addenbrookes/addenbrookes_index.html

Posted by: KathyF on August 10, 2009 at 3:51 PM | PERMALINK

I don't think he's British. Has anyone seen his birth certificate?

Posted by: Saturated Fathead on August 10, 2009 at 3:51 PM | PERMALINK

If Stephen Hawking was an American, he'd be running the five-minute mile and singing opera instead of being confined to a wheel chair and tonguing a keyboard. Hawking is a perfect example of what sub-standard government health care leads to.

Posted by: Al on August 10, 2009 at 3:54 PM | PERMALINK

The British death panel missed one and there's going to be Hell to pay!

Posted by: John McCain on August 10, 2009 at 3:54 PM | PERMALINK

Yes, but would they take care of Trig, or Track, or whatever the fuck it's name is?!

Posted by: The Galloping Trollop/Sarah Palin on August 10, 2009 at 3:56 PM | PERMALINK

You know, once this gets inserted into the email circuit, it will become certifiable truth, and never be debunked, no matter how many times you produce a valid birth certificate, utility bill, and recorded hospital stays for Mr. Hawking.

Posted by: Rook on August 10, 2009 at 3:57 PM | PERMALINK

Just because it's a complete utter lie, that doesn't mean it won't make it into the talking points of Faux News, Rush Lameball, and the entire ReThuglican Noise Machine.

Falsity isn't a bug to these folks, it's a feature, because it gets rational people talking about SUBSTANCE (Hawking in British) rather than MEME (Obamacare will kill the elderly and disabled).

Always attack the MEME.

It's under AMERICAN health care that Hawking would have been institutionalized because our health INSURANCE companies wouldn't pay for his care at home, like socialized medicine actually does.

Posted by: Cal Gal on August 10, 2009 at 4:05 PM | PERMALINK

Is Urban Matrix a real troll or a faux troll? It sure is hard to tell sometimes but just in case, was Hawking born into a rich family?

Posted by: Sarah Barracuda on August 10, 2009 at 4:11 PM | PERMALINK

Well, hey, that just shows the inefficiency of public health care right there. If the system was more efficient those death panels would have gotten around to killing Hawking by now, surely...

This is why health care reform seems likely to lose in the U.S. this time around. By co-opting all the good pro-reform arguments (fear of death due to rationing, lack of poor care for the unfortunate, inefficiency of the public system, overefficiency of the public system, etc.) the opposition has got reformers coming and going so much at this point that they have no idea which way is ahead anymore. Pity.

Posted by: BruceR on August 10, 2009 at 4:13 PM | PERMALINK

"Oh yeah? I happen to have Professor Stephen Hawking right here.
"What makes you qualified to write newspaper editorials? You know nothing of my health care history."

Posted by: Art Hackett on August 10, 2009 at 4:21 PM | PERMALINK

I've heard him speak. That accent is not English.

Posted by: Rolla on August 10, 2009 at 4:33 PM | PERMALINK

Stephen Hawking is NOT British! Have you ever listened to him? He definitely doesn't have a British accent.

OMG! Al is right! Hawking is a Dalek!!!!

Posted by: Martin on August 10, 2009 at 4:35 PM | PERMALINK

Check out the second picture here. Seems odd for Hawking to support a president whose healthcare policy is modeled after the UK death panels that would have euthanized him decades ago if not for his wealth and celebrity. Either that, or some nasty liberal has played a cruel trick on him.

Posted by: ibid on August 10, 2009 at 4:36 PM | PERMALINK

Sarah Palin has now dropped to 2nd place in the contest for the single stupidest thing said about health care reform.

BTW I don't get republican opposition to these "death panels". Serving on one would give Dick Cheney and his pals some retirement income.

Posted by: lgerard on August 10, 2009 at 4:38 PM | PERMALINK

Remember, IBD is the paper for those who think the Wall Street Journal is too liberal.

Posted by: Chris L. on August 10, 2009 at 4:43 PM | PERMALINK

"Is Urban Matrix a real troll or a faux troll? It sure is hard to tell sometimes but just in case, was Hawking born into a rich family?"

I really can't say; however I have seen that "point" made in several places today. If it was a faux troll, there was certainly nothing tongue-in-cheek about the comment. It showed all of the signs of simply repeating something without actually thinking about it first.

Posted by: ashton on August 10, 2009 at 4:44 PM | PERMALINK

When I hear arguments like this that are just so BLAZINGLY STUPID & WRONG, I begin to wonder if the originators of these arguments aren't just pro-reform trolls trying to sabotage the right under the weight of Onion-like irony.

How else do you explain people screaming about the Feds wanting to take over Medicare?

Posted by: Husker Blue on August 10, 2009 at 4:45 PM | PERMALINK

When I hear arguments like this that are just so BLAZINGLY STUPID & WRONG, I begin to wonder if the originators of these arguments aren't just pro-reform trolls trying to sabotage the right under the weight of Onion-like irony.

How else do you explain people screaming about the Feds wanting to take over Medicare?

Posted by: Husker Blue on August 10, 2009 at 4:48 PM | PERMALINK

Some Dr. Stephen Hawking information, from Wikipedia:
"Stephen William Hawking, CH, CBE, FRS, FRSA (born 8 January 1942) is a British theoretical physicist"
"During a visit to the research centre CERN in Geneva in 1985, Hawking contracted pneumonia, which in his condition was life-threatening as it further restricted his already limited respiratory capacity. He had an emergency tracheotomy, and as a result lost what remained of his ability to speak. He has since used an electronic voice synthesizer to communicate.

The DECtalk DTC01 voice synthesizer he uses, which has an American accent, is no longer being produced. Asked why he has still kept it after so many years, Hawking mentioned that he has not heard a voice he likes better and that he identifies with it. Hawking is said to be looking for a replacement since, aside from being obsolete, the synthesizer is both large and fragile by current standards."

So, he is a British physicist and has an American accent.

Posted by: st john on August 10, 2009 at 4:49 PM | PERMALINK

At least Hawking's nurse married him instead of golddigging for a handsome, wealthy, highly respected doctor husband the way American nurses do.

Trust me, I know something about this.

Posted by: Myke K on August 10, 2009 at 4:49 PM | PERMALINK

... some government bureaucrat who is part of an indifferent, socialized medicine regime.

As a commentor at MattY's once put it: "I would rather have my healthcare decisions be made by a government bureaucrat who doesn't care if I lived or died than by an insurance-company bureaucrat who would prefer I died."

Posted by: Thlayli on August 10, 2009 at 4:53 PM | PERMALINK

According to his website, Hawking's 24 hour nursing care is provided by "grants from several foundations," not to mention housing accommodations provided by the college. I have no idea how much of his care is paid for by the NHS, and how much is paid for by himself or other sources.

Posted by: TB on August 10, 2009 at 4:56 PM | PERMALINK

Professor Stephen Hawking is a prestigious multi-millionaire; he can afford the very best medical care for himself and his family.

He's currently a prestigious multi-millionaire. He was not one when he was diagnosed with ALS 40 years ago. Are you guys using your Time Machine Theorem again?

I guess this time the time machine is being used to go back in time to make college undergraduate Hawking a famous multi-millionaire instead of planting fake birth announcements in the two Honolulu newspapers. Damn those Time Lords! Damn them!

Posted by: Mnemosyne on August 10, 2009 at 4:57 PM | PERMALINK

Mnemosyne,

I have it on good authority that Obama and Hawking are planning to go back in time, learn to play the guitar, and then save the world with the music of Wyld Stallyons!

Posted by: doubtful on August 10, 2009 at 5:15 PM | PERMALINK

Actually, Mnemosyne, what makes Professor Stephen Hawking's life story and success so compelling is that he triumphed despite the rationed care of the NHS.

Without question, he survived and prospered despite the heavy odds stacked against someone who would be discarded as an "unproductive member" of society, as as socialized medicine regime would otherwise have judged someone like Hawking.

Posted by: Urban Matrix on August 10, 2009 at 5:21 PM | PERMALINK

Hawking is a British citizen, but he did spend some time at Cal Tech back in the 1970s. He was already badly disabled and had a caretaker at the time. This was long before his "Short History of Time" or his gaining the profits from his book.

Posted by: Bob G on August 10, 2009 at 5:23 PM | PERMALINK

@ EC Sedgwick: You are confused by the term republican or conservative. I assure you they are not the same.
OK, we've heard this many times and I can accept it as a viable thesis in the abstract. Now, how come there aren't more "conservatives" who despise the GOP for being phony, corrupt, stupid, etc. - and get up and complain and demand change, third party, to stop voting for them, to stop giving approval in polls to people like GW Bush?

Yes, there are some of you and some of them do a good job making the relevant points etc. I asked, why so little a presence ...

Posted by: Neil B ♪ on August 10, 2009 at 5:29 PM | PERMALINK

@Al
I've said it before, and I'll say it again.

You are an idiot.

Posted by: FreeThinkingRedneck on August 10, 2009 at 5:39 PM | PERMALINK

The Right likes to complain that national care will "lead to rationing." Well ... The current private system has to ration of course, based on health and money. What the Right means: they want the rationing to be based on $$$ first, cost (to insurers) second, and need last.

Posted by: N e i l B on August 10, 2009 at 5:48 PM | PERMALINK

My head hurts. Urban Matrix just did another double back flip 360 twist that totally refutes what he's trying to say.

OH, the HORROR!

Let me see if I can untie this knot. Stephen Hawking is a genius who managed to survive the socialized medicine of his country which would have (but apparently didn't, or tried and didn't succeed, or just didn't get around to it) killed him at birth and so he's an example of why NOT to have socialized medicine because here he'd never have been able to get insurance (talk about pre-existing condition) so he'd never have been killed by our system because without health care insurance there would be no bureaucrat here to deny him health care, so he would have received treatment for his chronic (!!!) condition at the emergency room free of charge. Is that it?

Posted by: Cal Gal on August 10, 2009 at 5:55 PM | PERMALINK

Urban Matrix writes: "...what makes Professor Stephen Hawking's life story and success so compelling is that he triumphed despite the rationed care of the NHS.

Without question, he survived and prospered despite the heavy odds stacked against someone who would be discarded as an "unproductive member" of society, as as socialized medicine regime would otherwise have judged someone like Hawking."

How so?

In fact, Hawkings was born and raised in the United Kingdom, within a system that you claim would have discarded him.

He was not discarded.

So which is wrong -- you, or the facts? I don't see a third option.

Hawkings was already afflicted with his disease long before his books made money, and his treatments were very expensive: moreover, his scholarships, grants, and scholarly income were all largely dependent on governments -- through what most folks would recognize as "socialist" institutions, e.g., government-run universities in the UK, and schools primarily funded by government (generally DOD) research grants in the US, particularly in physics.

It is unlikely that Hawking could have made a living as a blacksmith or a carpenter, so I suppose if you wanted to create a parallel universe you could argue that he issn't a productive guy but in THIS universe he was doing quite well as a scholar long before his books started to sell -- and the NHS paid for his health care during all the years he was being educated and trained for the marvelous success he has had as a physicist.

So where is your evidence that socialized medicine would discard a Hawking -- since, yanno, it HAD the real Hawking, and helped him thrive?

Posted by: theAmericanist on August 10, 2009 at 5:58 PM | PERMALINK

I think Urban Matrix was trying a parody.

Posted by: here to help on August 10, 2009 at 6:00 PM | PERMALINK

That's the point: with the state of the wingnuts these days, how could you tell?

Posted by: theAmericanist on August 10, 2009 at 6:07 PM | PERMALINK

I think the most likely explanation here is that Steven Hawking was euthanized as a young man by the eeevil NHS and what we have now running around giving lectures is some sort of robot they produced to cover for their eeevil NHS deeds. I mean, the IBD can't be wrong. Occam's razor and all that.

/wingnut>

Posted by: Jeff S. on August 10, 2009 at 6:46 PM | PERMALINK

theAmericanist, of course Professor Stephen Hawking wasn't discarded by the NHS. He obviously wouldn't be with us today, sharing the contents of his amazing intellect if some government-approved socialist bureaucrat had sidled up to wheelchair and quietly snapped his neck.

The point missed by everyone here is that Hawking beat the odds in the socialized medicine system. Just imagine, if there were no NHS, how many more Stephen Hawkings would be with us today, living and breathing, and helping to advance the cause of scientific progress for the betterment of all mankind.

And now liberals wish to assail American society with a similar system like NHS. Sure, it's only a "public option" now. That'll just be the first step toward full-blown, socialist single-payer medical rationing and care.

No one is fooled.

Posted by: Urban Matrix on August 10, 2009 at 6:49 PM | PERMALINK

So Matrix, what you're saying is that the typical response of the NHS is to exterminate handicapped people?

Then why did I see a bus full of handicapped people today, near the A40 outside London?

Oh wait. I bet they were on the way to the extermination centre in High Wycombe!

Seriously. You're nuts.

Posted by: KathyF on August 10, 2009 at 6:58 PM | PERMALINK

Huh?

UM, you seem sorta confused about the distinction between fact and opinion, which evidently baffles your efforts to construct an argument based on evidence.

For example, you say that Hawking "beat the odds'. No doubt -- there aren't that many brilliant physicists even among the large majority of people who are born and grow up physically healthy, so the incidence of people like him surely decrease when you factor in his ALS, diagnosed by the socialized medicine you object to on ideological grounds, when Hawking was in his 20s.

But that is simply your opinion -- and insofar as you offer it with any reference to reality, the facts show you're wrong: Hawking's ALS was diagnosed by socialized medicine, and treated by it, and YET he was still encouraged to pursue his studies, at which he has been very successful AFTER his ALS was diagnosed and treated, without which he WOULD be dead... so a person reasoning from evidence would have to conclude that socialized medicine CAUSED Hawking's valuable career.

The way this 'thinking' process works, if you want to dispute that, you need to cite what are called "facts" and connect them in what is known as an "argument" to demonstrate that, as you claim, there would be "more" Stephen Hawkings, except...

See, the only evidence you have of a connection between socialized medicine and Hawking's existence, is that his ALS was diagnosed and treated by socialized medicine: quite literally, UM, you have nothing behind your opinion but your opinion. The known facts go a different way, and you have no other facts to offer, do you?

So this proves you wrong in another particular: there is, indeed, someone who is fooled -- you.

Posted by: theAmericanist on August 10, 2009 at 7:04 PM | PERMALINK

If the private system is so great, why did Lou Gehrig only live four years with ALS? He was treated at the Mayo Clinic, one America's best hospitals, and he still died quickly. Obviously, two data points don't make a trend, but it's hard to argue that the private system is better if it can't produce better results.

Posted by: fostert on August 10, 2009 at 7:35 PM | PERMALINK

Actually, there is some disagreement whether what Dr. Hawking has is, in fact, ALS. If you Google Dr. Stephen Hawking and go to the Wikipedia citation, you will see a discussion of an alternative diagnosis of a condition with similar symptoms. This is not to discount the care and treatment provided by the NHS; just another factoid to enter the mix.

Enjoy the ride...

Posted by: st john on August 10, 2009 at 7:55 PM | PERMALINK

Fostert, perhaps Lou Gehrig died 4 years after his diagnosis of ALS was made because they didn't have portable ventilators back in 1941. Oh, Lou Gehrig also didn't have a portable speech synthesizer like Steven Hawking's, because they didn't have portable computers back in 1941. I guess you've proved that the UK's public healthcare system in 2009 is better than the US's private system in the 1930's and 40's.
Although the IBD's article is easily refutable, I suspect the Lucasian professor of physics and the greatest British mind in physics since Newton might get slightly better care in the NHS than the average soccer houligan.

Posted by: gyp on August 10, 2009 at 8:09 PM | PERMALINK

The sneering dismissal in place of a civil rebuttal is to be expected from pro-Obamacare advocates like theAmericanist, but the condescending lecture on just how to make an argument in order to please liberal sensibilities is rather grating.

My response is thus: no, the NHS is not seeking to snuff out all handicapped people (lame strawman, KathyF), but the fact is that Professor Stephen Hawking has thrived and he's contributed immensely to mankind despite the rationed medical care that Brits are forced to endure.

That in itself is a miracle worth praising. That was -- and still is -- my clear-as-day point.

Thank you.

Posted by: Urban Matrix on August 10, 2009 at 8:10 PM | PERMALINK

@Urban Matrix,

Simple probability theory explains that Professor Hawking survived because of the "rationed" -- but apparently highly effective -- health care available to him in the UK.

There is no evidence, none, other than the kind of third-hand hearsay that any sane person would sneer at that "rationing" affects the length of a person's life in the UK.

Posted by: Charles on August 10, 2009 at 8:17 PM | PERMALINK

I think Steve's final line was written just for UM:

Ever wonder what the reform debate would be like if conservatives approached it with a shred of intellectual seriousness?

Yes. Yes, I do wonder. And I will never find out.

Posted by: Mnemosyne on August 10, 2009 at 8:25 PM | PERMALINK

"I guess you've proved that the UK's public healthcare system in 2009 is better than the US's private system in the 1930's and 40's."

Well, I haven't proven anything. As I noted, two data points don't make a trend. But here's some real stats: "The life expectancy of ALS patients usually ranges from about 3 to 5 years after diagnosis." (http://www.neurologychannel.com/als/index.shtml). In other words, Lou Gehrig lived as long as a typical patient with the disease in modern times. Or more bluntly, the private system has yet to improve outcomes for this disease (nor has socialized medicine). It's an incurable disease, so it's not like socialized medicine could possibly result in worse outcomes. The outcome is death at some point.

And that's what makes Urban Matrix's ramblings so absurd. This is a disease where treatment doesn't affect the outcome. And of course, he seems to ignore the fact that there is much more rationing in our system than England's. Our system is run by the Insurance Nazi. No coverage for you!

Posted by: fostert on August 10, 2009 at 8:30 PM | PERMALINK

I unfortunately know far more about ALS than I would care to. Yes, the life-expectancy is very short because the muscles that support breathing eventually deteriorate to the point that the person can't breathe at all. The reason that some people progress "faster" than others is that ALS does not behave the same in every patient--some patients see deterioration of the limbs first, while the respiratory muscles are the first to go in other patients (and then there is something called bulbar-onset, describing where the motor neurons start do deteriorate, and affects the tongue and emotional lability). As for Stephen Hawking's official diagnosis, the UK uses the term "Motor Neurone Disease," which is actually more accurate than our American ALS label (varieties of the disease include lower motor neuron and upper motor neuron involvement--there are some "subset" diagnoses, such as Progressive Muscular Atrophy, but then you have the joy of trying to convince insurance to pay for things--it's all about the diagnosis code, and subsets sometimes get excluded in the numbers game).

Those who choose not to be vented are typically going to die faster because respiratory failure is usually the end-stage of the disease. Those who opt for a vent (and undergo a tracheotomy) can live far longer, but then the cause of death is going to be something else, such as pneumonia or another infection, heart failure, organ failure, etc. Stephen Hawking is alive because he is on a ventilator. He would not be alive otherwise. This same technology is available in the US for those who can afford it (and by "affording it," I am referring to the insanely expensive cost of private duty nursing care--Medicare does not pay for in-home "shift" care, just scheduled visits, and Medicaid varies based on where you live--Medicare does pay for the vent rental and other equipment/supplies, though, and the expensive hospital stays [think: $135,000 a visit for the ICU]).

As for Sarah Palin's death squad, I can only assume that when President Obama wrote my mother (who has ALS) a personal letter encouraging her brave choice to live on a ventilator (which she has been on for almost two years), it was a subversive attempt to trick her into thinking that he actually believes she should be alive...so that he can come back later and yank her off the machine.

And as for Lou Gehrig, prognosis in general, and the future of this disease, we firmly believe that stem cell research has the best promises for an eventual cure (also for the other neurological diseases, namely Parkinson's, Alzheimer's, and MS--these diseases might have more in common than we realize). Funding for research is essential. Unfortunately, researchers have to compete for funds, and given that these diseases affect so few people (ALS is 1 in 100,000, or about 1 person in a mid-sized city), money usually goes to other diseases. I don't mean to begrudge cancer research--we all benefit enormously from the strides to cure cancer--but research physicians shouldn't have to compete for funding based on how high-profile a disease is--and neurological diseases like ALS seem to get marginalized because patients go through such a horrible process that it's hard to talk about their daily life (things that most people reading this can't begin to imagine) in public. Same goes for Christopher Reeve and spinal cord injuries.

In dealing with this disease, I must admit that my frustration with the current health care debate is that very little attention is being paid to improvements in critical care management and research. I want everyone to have access to affordable health care, but if most doctors are going to continue the "pills are the cure" approach to medicine, we are ignoring the fundamental problem with how health care treatments are approached in this country. I say this knowing that my mother takes fewer pills each day than lots of people who are up walking around (and breathing) on their own.

Posted by: Cindy McCant on August 10, 2009 at 9:32 PM | PERMALINK

Postscript: The one medication that can be used to "treat" ALS is Rilutek/Riluzole. It's unbelievably expensive (over $7,000 a year), due to the French manufacturer's aggressive attempts to block any generic alternative, and it increases life-expectancy by a mere 3 months (and given the wide span of the disease prognosis, it's hard to assess what that even means for the patient, unless there is a specific event, such as a wedding or birth of a grandchild, that is motivating someone to stay alive). For what it's worth, I think that Rilutek is an example of an unethical pill--the cost far outweighs the benefits--and given that it doesn't "cure" the disease--just prolongs it ever so slightly--I wonder if it would be better to hand every ALS patient $5,000 for a nice vacation that they can enjoy while they are still mobile, or at least give them that option. But that's just me...

Posted by: Cindy McCant on August 10, 2009 at 9:40 PM | PERMALINK

Urban Matrix, are you one of these paid trolls?:

http://www.politicsandtechnology.com/2007/07/make-no-mistake.html

We have so much authentic talent here, your kind can't prevail.

Posted by: N e i l B on August 10, 2009 at 9:47 PM | PERMALINK

Gyp at 8:09: greatest British mind in physics since Newton.

Sorry, Hawking is brilliant, but he is no P. A. M. Dirac, perhaps not even a Freeman Dyson (even if Dyson has become a bit of a reactionary foil on global warming in his old age). As long as we are ripping on British physicists, the way Newton stole all the credit for inventing differential calculus from Liepniz was a complete disgrace.

Posted by: J. Frank Parnell on August 11, 2009 at 12:01 AM | PERMALINK

Nice comments, Cindy. Thanks.

Posted by: matt on August 11, 2009 at 2:18 AM | PERMALINK

I visited Applied Math and Theoretical PHysics in Cambridge, UK in 1971, and Hawking was already deep in the grip of his disease-in a wheelchair and unable to speak intelligibly.

That the UK health service has for 40 years kept him in such good shape that he has continued his work is a real testament to them.

Posted by: bob h on August 11, 2009 at 10:42 AM | PERMALINK

"My response is thus: no, the NHS is not seeking to snuff out all handicapped people (lame strawman, KathyF), but the fact is that Professor Stephen Hawking has thrived and he's contributed immensely to mankind despite the rationed medical care that Brits are forced to endure."

Only just come back over the weekend to read this. It's utterly barking and (unsurprisingly from an American right-winger) completely wrong.

NICE don't decide whether people live or die. They allocate drugs to the NHS based on clinical effectiveness and the fact that there's a finite pot. Many people in the UK (myself included) also have private health insurance, which is very reasonably priced and lets us have non-essential ops a little quicker than the NHS would have - in my case, a non-critical hernia which I'd have had to wait a few months to have fixed. If the private sector wasn't competitively priced, they'd be out of business.

What's interesting about this debate is not that I think American right-wingers are spectacularly badly informed, because I don't actually believe many of them (Urban Matrix included) are educationally subnormal enough to actually believe them. I think it's clear that sorting healthcare would be such an almighty triumph for Obama, particularly after 8 years of extraordinary incompetence by his predecessor, that it would see the end of Republicans in power for a generation, so the only option left is lying.

The NHS leaves no-one to die. The broken American system does exactly that - and that's why Obama's trying to fix it. Good luck to him.

Posted by: ally on August 11, 2009 at 1:12 PM | PERMALINK

Agreed with ally 100%. Were it not for the good old NHS I'd be bankrupt and my partner would be dead. My parents - pushing 90 - can remember how it felt when the NHS came in, after the 1945 election. One of my mother's friends was lying in bed with TB, waiting for death. The election happened and, suddenly, the antibiotics she needed were available to save her life. It was like the sun streaming in through a previously shuttered window.

Posted by: legionseagle on August 11, 2009 at 5:09 PM | PERMALINK

Hawking responds in a telephone interview with The Guardian:
"I wouldnt be here today if it were not for the NHS...I have received a large amount of high-quality treatment without which I would not have survived."

http://www.guardian.co.uk/politics/2009/aug/12/birthers-stephen-hawking-paul-rowen

Any comment, U.M.?

Posted by: Portmanteau on August 11, 2009 at 8:07 PM | PERMALINK

J. Frank Parnell, Newton invented calculus first but Leibniz beat him to the publishers.

Posted by: Neil B ♪ on August 11, 2009 at 9:56 PM | PERMALINK

Here's an inconvenient fact: When Hawking contracted pneumonia, the doctors in Switzerland wanted to pull the plug.

From A Brief History of Time:
"I was in Geneva, at CERN, the big particle accelerator, in the summer of 1985. ... I caught pneumonia and was rushed to hospital. The hospital in Geneva suggested to my wife that it was not worth keeping the life support machine on. But she was having none of that. I was flown back to Addenbrooke's Hospital in Cambridge, where a surgeon called Roger Grey carried out a tracheotomy. That operation saved my life but took away my voice."

Everything Hawking has done since 1985 would have been lost because a hospital thought his quality of life wasn't promising. IBD was wrong, but Palin was right.

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