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Paul Hsieh, M.D.

Paul Hsieh, M.D. is a member of the Colorado chapter of Docs4PatientCare (www.Docs4PatientCare.org) and co-founder of Freedom and Individual Rights in Medicine (www.WeStandFIRM.org).
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In Praise of the Market Economy

Monday, July 27th, 2015 - by Paul Hsieh, M.D.

While in Los Angeles for a recent vacation trip, I had the pleasure of walking (!) around the streets of West L.A.

I love the feel of a bustling shopping district. I know it’s fashionable to decry the shallowness and materialism of American consumer culture. On the other hand, I prefer a more positive “glass half full” perspective. I love that a modern market economy makes such a wide variety of goods and services so easily available to ordinary people for such relatively little money.

For less than the price of an hour of labor, an average person in California can enjoy a filling lunch of authentic cuisine from India or Thailand. This would have been impossible to all but the richest of Americans 200 years ago.

Through most of human history, the average person had to spend hours each day in backbreaking farm labor to grow barely enough to feed themselves and their families. Today, our market economy creates such enormous surpluses that people can become artists and scientists and writers and computer programmers and baristas and specialty chefs, etc.

Of course, the economic freedom of a market economy puts the onus on individuals to figure out for themselves what careers they will find most personally and professionally fulfilling. But this is analogous to how the social freedom created by eliminating old school “arranged marriages” in traditional societies places the onus on individuals to figure out what sort of romantic partners they actually want.

Freedom doesn’t automatically guarantee success for any given person. But it does give people an opportunity — provided they are willing to think and plan for their own happiness. Such freedom can be daunting — but it’s far better than having no real choices at all.

It’s true that markets and material goods cannot provide meaning to someone with an empty spiritual life. But a market economy can give people their best chance of seeking and finding their own life purpose and meaning.

And to the extent that modern free-market capitalism has been allowed to function, it has lifted millions of people from poverty who in centuries past would have remained stuck in the rural or urban underclasses. Had I been born 200 years ago, I’d probably be a poor peasant picking rice somewhere in Taiwan, rather than enjoying a fulfilling career as an advanced professional here in the United States.

So the next time you’re sipping on a latte at your neighborhood coffee shop, browsing for a new smart phone at the local Apple Store, or enjoying the aroma coming from the all-you-can-eat lunch buffet at the local Indian restaurant, savor the experience. And savor the market economy that makes it all possible.

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VA Scandal Has Nothing to Do with Single-Payer, Say Single-Payer Advocates

Saturday, May 24th, 2014 - by Paul Hsieh, M.D.

The Veterans Administration health care scandal is now mainstream news. For good discussions of how corruption within the government-run health system has harmed American veterans (and potentially led to scores of patient deaths), see these summaries by David Catron, Michael Tanner, and Mark Tapscott.

Yet this has not fazed advocates of a government “single-payer” system. According to Kaiser Health News, the VA health scandal isn’t relevant to their cause because “the VA system is fully government-run, and not the same as single-payer, where doctors and hospitals would remain private, with payment from the government.”

But this is a distinction without a difference.

The federal government sets the budget for the VA, determines which doctors can work for them, and ultimately controls what care patients may receive. Except for cosmetic differences, the same applies to any single-payer system. Even if doctors remain nominally private under single-payer, he who pays the piper calls the tune.

If American veterans can’t trust the federal government with their medical care, why should the rest of us?


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Federalizing Medical Conversations?

Tuesday, January 21st, 2014 - by Paul Hsieh, M.D.

Will the federal government be taking a closer look at conversations between doctors and patients, in the name of protecting privacy?Here is an excerpt from a recent e-mail sent by a hospital administrator to physicians I know.  (I’ve deleted the name of the sender and the hospital).

Please protect yourself while protecting our patients. Make it part of your practice to ask every patient for permission to speak in front of others when others are present.

It is preferred that others are asked to step out of the room before asking for permission to allow the patient to freely respond, if this is not an option, the question must be asked regardless.  Never assume that it is “o.k.” to speak in front of others, i.e; husband, wife, mother, father, friends without asking for permission before speaking.  If a patient initiates a conversation in front of others, take a moment to ask permission before responding.  THIS IS IMPORTANT.

Privacy complaints are being reported to The Office of Civil Rights, (the OCR is the agency who investigate alleged Privacy violations)  with much more frequency than years past.  Fines for privacy violations can range from $100 to $50,000 for each violation for accidental violations up-to and including $50,000 for each violation for willful neglect.   Willful neglect violations, (involving monetary gain), often include criminal penalties…

Should doctors protect patient privacy? Yes, of course.

Should doctors take steps to make sure patients are free to discuss sensitive information (by requesting family members step out if necessary)?  Yes.

Should it literally become a “federal case” if doctors fail to follow proper protocol before each medical discussion with patients and their families?  I don’t think so.

Federalizing these relatively minor offenses has tremendous potential for misuse and selective enforcement.  We’ve seen this in other areas, as in this 2011 Wall Street Journal piece, “As Criminal Laws Proliferate, More Are Ensnared“.

It looks like we may be seeing more of this in health care as well.

Also read Vodkapundit: Care versus Coverage

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What if the NFL Changed Its Rules Like the White House Did with ObamaCare?

Monday, December 30th, 2013 - by Paul Hsieh, M.D.

The Washington Redskins finished the 2013 NFL season a disappointing 3-13, in a year when many fans expected them to make the playoffs.

But their record could have been much better if the NFL referees had shown the same “flexibility” towards the rules as the White House has taken towards its own health care law.

For instance, the White House unilaterally delayed the mandate requiring employers of at least 50 people to provide insurance to workers (or face a fine).

The White House also delayed twice the Small Business Health Options Program (SHOP) exchanges for small businesses employing fewer than 50 people.

Similarly, after angry public outcry over cancelled insurance policies, the President declared that insurance companies could keep offering plans he had previously declared “substandard.”

And the President has also magnanimously granted some Americans a “hardship waiver” from the individual mandate if their new government-compliant plans were too expensive.

Think of how much better the Redskins’ season could have been if the refs gave them a first down after only advancing the ball a “substandard” 7 or 8 yards, rather than the standard 10 yards. Or if they were given a hardship waiver of 5 downs for each possession, rather than 4 downs like everyone else. Or if the coach had a few extra timeouts to use whenever he needed. Or if the refs moved the goalposts to give them a shorter field to score.

Arbitrarily changing the rules to favor the Washington Redskins would certainly have helped their season. But of course, it would have also made a mockery of football as a sport governed by objective rules.

Fortunately, the NFL has higher standards than the White House. It doesn’t “move the goalposts” to favor Washington’s preferred team. It’s too bad the White House doesn’t take the same approach towards its preferred law

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Did the White House Try to Get a Conservative Columnist Canned?

Wednesday, May 15th, 2013 - by Paul Hsieh, M.D.

According to Dr. Milton Wolf, the answer is “yes.” And he should know, because the columnist was him.

Milton Wolf is a physician practicing in Kansas City, and he’s also President Barack Obama’s second cousin. During the health care debates of 2010, Dr. Wolf began speaking out against the ObamaCare proposal. Because he is an articulate, knowledgeable, passionate conservative, he began getting national attention, appearing on outlets including PJTV and Fox News. He also became a regular columnist for the Washington Times.

During the 5/14/2013 White House press conference, Dr. Wolf tweeted:

The same year the #IRS held up my tax refund for months w/o ever saying why, the WH urged the @WashTimes to drop me.

I asked him for more details. He explained what happened back in 2010 (quoted with his permission):

They called my editor and feigned concern that the Washington Times was taking advantage of me… by publishing my op-eds critical of Barack Obama. Around the same time the IRS put a hold on our tax refund that required an arbitrator and several months to resolve. We finally received our refund (and interest) but never an explanation. The local IRS office and the arbitrator seemed genuinely confused by the ordeal using terms like “very strange” and “unusual” but never could explain why it happened. One wonders.

With respect to the IRS issue, he noted:

I wondered at the time if the White House could possibly be behind it but I just couldn’t make that leap. It seemed so stupid and hamhanded. But what before seemed implausible today seems possible.

Of course, he may never know the full truth. Another interesting observation from Wolf:

[I]t wasn’t just a politician complaining about a particular column or supposedly incorrect facts. They weren’t requesting a correction or even an opportunity to respond. They wanted someone canned.

Fortunately, the Washington Times stood by Dr. Wolf. He’s now written over 80 pieces for them in the past three years (which is pretty damned impressive for someone with a full-time job in a busy medical practice).

At Tuesday’s press conference, White House press secretary Jay Carney repeatedly claimed that President Obama was deeply committed to freedom of the press and “unfettered” media scrutiny of his administration. Trying to get a conservative columnist canned from a newspaper sure is a funny way of showing it.

Also read: 

Add Me to the List of IRS Targets


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The War On Men: Embryo Edition

Sunday, September 16th, 2012 - by Paul Hsieh, M.D.

The idea of a “war on women” is now a liberal cliche. But a recent article in Slate describes a much less publicized “war on men” by American women engaging in sex-selection of embryos.

From the article, “Women Are Paying Huge Sums To Have a Daughter Rather Than a Son”:

The conventional wisdom has always been this: Given a choice, couples would prefer sons. That has certainly been the case in places like China and India, where couples have used pregnancy screening to abort female fetuses. But in the United States, a different kind of sex selection is taking place: Mothers like Simpson are using expensive reproductive procedures so they can select girls…

For Jennifer Merrill Thompson, the reasons were simple. “I’m not into sports. I’m not into violent games. I’m not into a lot of things boys represent and boys do,” she said. Thompson is the author of Chasing the Gender Dream, a self-published book that documents her use of gender-selection technology to conceive her daughter.

Interviews with several women from the forums at in-gender.com and genderdreaming.com yielded the same stories: a yearning for female bonding. Relationships with their own mothers that defined what kind of mother they wanted to be to a daughter. A desire to engage in stereotypical female activities that they thought would be impossible with a baby boy.

Imagine the outrage if fathers were selecting baby boys over girls, citing reasons like:

I’m not into dollhouses and tea parties. I’m not into a lot of things girls represent and girls do. I’d like to be able play catch with my son just like I did with my old man. And we all know that girls can’t throw. I yearn for some male bonding with a son that would be impossible with a baby girl…

I guess gender stereotyping is ok if it’s done by affluent American women.



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Why Should Government Pay For What Goes On Inside The Bedroom?

Thursday, August 9th, 2012 - by Paul Hsieh, M.D.

At the August 8, 2012 rally in Denver featuring Sandra Fluke and President Obama, many women came out to hear Obama’s support for government-mandated birth control coverage.

Caleb Bonham interviewed a few attendees, asking the question: “Why should government pay for what goes on inside the bedroom?”

Some of the answers are shocking and hilarious.

Here’s one typical exchange (starting at 0:33):

Woman: I’m, like, all for abortion and I’m all for birth control.

Bonham: So you don’t think the government should be involved in what goes on inside the bedroom, correct?

Woman: Oh, exactly.  Not even close.

Bonham: So then why do you expect the government to pay for what goes on inside the bedroom?

Woman: [Long pause] Uh, because….

Welcome to Flukonomics!

(Note: Even though I support abortion rights, I oppose government funding of birth control or abortion.)

H/T: Ari Armstrong.

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Will More Doctors ‘Go Galt’ Because of Obamacare?

Monday, July 2nd, 2012 - by Paul Hsieh, M.D.

At the June 29, 2012 anti-Obamacare rally hosted by American For Prosperity, blogger Ari Armstrong captured this short video of Dr. Jill Vecchio explaining how Obamacare will force her to practice substandard medicine.

Pay close attention to her words, starting at 1:00:

According to the government, I can only recommend a screening mammogram for women over 50 every other year until 74, then never again. That violates the American Cancer Society guidelines … The American Cancer Society says every year after the age of 40 until the woman no longer wants to have a mammogram.

Screening mammography has been proven to decrease the number of women who die by breast cancer by 30-40% — just screening mammography. These government rules that I will have to abide by will cause me to violate my Hippocratic Oath. And I won’t do it. I will violate their guidelines every day, many times a day. As a result of that … I will be fined, I won’t be paid …

I will not be practicing medicine when this law takes effect. Neither will thousands of other physicians.

Dr. Vecchio also alluded to possible jail sentences, which could be imposed for failing to follow guidelines on the use of mandatory electronic medical records.


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Obamacare will force doctors to choose between their patients and their government paymasters. If Obamacare is not repealed, many doctors will “go Galt” and quit medicine, rather than violate their medical consciences and betray their patients’ trust.

Ask yourself: When the doctors who are willing to practice in their patients’ best interests quit medicine, what kind of doctors will remain?

And will you want them taking care of you?

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