24 February 2023

New report paints a grim picture of Portland's future.  Things have gotten so bad that Heathman Hotel had to sell.  The Commonwealth Building downtown defaulted on its mortgage.

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Portland City Council voted down having a watchdog position to enforce transparency.  No surprise.

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The government wants to ban off-label use of approved drugs.  The aim is to target physicians who might prescribe ivermectin to treat COVID-19.  But the unintended consequence is that many physicians, especially oncologists, use drugs off-label, because they can't wait for FDA approval for many applications.  So many patients would be harmed if they couldn't get treated with a drug on an off-label indication.  This is just plain stupid, and politicians should keep their hands out of medical practice.

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Hybrid and electric cars use less or no gasoline, so revenue from the gasoline tax is decreasing.  What to do?  Now Washington state wants to tax cars based on mileage.  This will be an invasion of privacy if they attach GPS units to cars.  Not to mention the extra expense which the taxpayer will ultimately bear.  Speaking of taxes, Washington wants to override the 1% property tax currently in place, and triple the tax to 3%. 

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You can take the person out of India, but I guess you can't take India out of the person.  Expatriates who are Dalit class, still find discrimination in Seattle.  We've seen this before.  As more immigrants come to the USA, eventually they bring to America all the problems of their homeland with them.  Assimilation into American culture takes time. 

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Stanford professors are finding that anonymous reporting of woke "transgressions" threatens free speech.  The East Germans learned this a long time ago.  I've spoken to some at a local large educational institution, who feel that similar policies have changed the nature of their interaction with students and other younger faculty, whom they feel are more likely to register offense.  It's just not worth the trouble.
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Fraud in medical research is increasing.  People in the know have been aware of this for a long time, and there are no easy solutions to this.  Having some level of healthy skepticism is appropriate, as well as being ready to change recommendations and opinion as new data become available.

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The Biden adminstration has discussed banning non-compete agreements for physicians.  Since about 90% of physicians in the U.S. are bound by non-compete clauses, this would likely shake up the employment landscape considerably.  Many young physicians, eager for to get a job somewhere, often take a position in a locale, with a medical group, so that they can start earning money.  Only after they are there and have practiced for a while, can they really determine if they've made the best choice.  And sometimes opportunities for employment elsewhere only arise later on.  Non-competes restrict employment mobility, and force a physician to stick with a less desirable job, and the physician is forced to leave town if the current job is unacceptable.  Techies in Silicon Valley often advance from company to company, as their talents and services are valued.  This opportunity is denied to the physician.  Although I can understand how this must be to a private medical group who wants a stable workforce, physicians should be allowed to go where they are wanted.  Naturally, opposing forces such as hospitals, are against this mobility and freedom.  They would like to maintain control over their employed doctors, but forcing unhappy doctors to uproot and leave town contributes to physician burnout.  We should not be treating our doctors this way.

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