MEDICAL TUESDAY . NET
Community For Better Health Care
Vol XIII, No 4, July, 2014
Injustice anywhere is a threat to justice everywhere—Martin Luther King
penned from a Birmingham jail in 1963
In This Issue:
11. Restoring Accountability in Medicine, Government and Society
12. Words of Wisdom, Recent Postings, In Memoriam, Today in History . . .
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The Annual World Health Care Congress, a market of ideas, co-sponsored by The Wall Street Journal, is the most prestigious meeting of chief and senior executives from all sectors of health care. Renowned authorities and practitioners assemble to present recent results and to develop innovative strategies that foster the creation of a cost-effective and accountable U.S. health-care system. The extraordinary conference agenda includes compelling keynote panel discussions, authoritative industry speakers, international best practices, and recently released case-study data The 12th Annual World Health Care Congress will be held March 23-25, 2015 at the Marriot Wardman Park Hotel, Washington DC. For more information, visit www.worldcongress.com. The future is occurring NOW.
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1. Featured Article: How Social Security Reform Could Benefit Workers
by Liqun Liu, Andrew J. Rettenmaier and Thomas R. Saving
NCPA |Wednesday, July 16, 2014
Congress is once again considering changes to Social Security in an attempt to "save" the program. Social Security benefit payments have exceeded tax revenues since 2010; the funding deficit is growing and, barring reform, will continue to grow indefinitely. Higher tax revenues are necessary to fund benefits as they are currently calculated.
When workers consider the retirement benefits they expect from Social Security they must also consider the taxes paid during their working years. Average-wage workers retiring today have paid more Social Security taxes than they will receive in retirement benefits, so their net benefits are negative. For future workers, who will have to pay higher taxes to finance the program’s growing expenditures, net benefits will dip even lower. Read more . . .
The system is financed on a pay-as-you-go basis where current tax payments are transferred to current retirees. Changing demographics have resulted in a reduction in the number of workers supporting each retiree and a corresponding need for higher tax rates. The Social Security system cannot escape the ongoing demographic shift, but its share of the economy can be reduced and workers can escape the higher taxes necessary to fund the current program if they are willing to take lower Social Security benefits when they retire.
Balancing Benefits and Taxes. How do current and future workers’ lifetime Social Security benefits and taxes compare under the current benefit structure, with the necessary tax increase to pay for those benefits, and an alternative that scales back benefits such that they can be paid in the long run at the current tax rate?
There is a way to provide a common ground to explore the exchange between accepting lower benefits or paying higher taxes. Retaining the current benefit structure will require an immediate and permanent increase in the Social Security payroll tax of 3.3 percent. In contrast, a long-run balanced budget for Social Security could also be achieved by retaining the current tax rate, but making two benefit reforms: gradually raising the retirement age for workers who become eligible for benefits in 2023 and after, and making the benefit formula less generous for higher earning workers through progressive price indexing. Both political parties have proposed reforms with these attributes.
Comparing the Current Program to a Reformed Social Security. Our estimate illustrates that both the current program with the taxes necessary to close its financing gap (the baseline) and the reformed program produce comparable net results for workers across birth years and across income classes. [See the table.] For example,
· With the baseline program, average-earning men born in 1985 will have to pay 13.5 percent of their lifetime income in taxes and receive benefits equal to 9.6 percent of their income, resulting in a lifetime net tax of 3.8 percent (13.5 – 9.6).
· However, the same workers in the reformed program would pay a lower tax rate of 10.2 percent to receive reformed benefits of 8.2 percent, resulting in a lower net lifetime tax of 2.0 percent (10.2 – 8.2).
For very low-earning men, the reforms retain the current program’s progressivity. Specifically:
· In the baseline program, a very low-earning man born in 1985 will pay taxes equal to 13.5 percent of his lifetime income and receive benefits equal to 15.8 percent of income, resulting in positive net lifetime benefits equal to 2.4 percent of his lifetime earnings.
· In the reformed program, this worker would pay a lower tax rate of 10.2 percent of his income to receive reformed benefits of 14.5 percent, producing net lifetime benefits equal to 4.3 percent of his lifetime earnings.
The reformed and baseline programs produce similar lifetime progressivity due to the combination of policies necessary for each to achieve solvency. Under the reformed program, the gradual rise in the retirement age affects all workers regardless of income. However, most of the reform’s savings come through reduced benefits for higher earning workers.
In contrast, the baseline program retains the current benefit formula, but requires a substantial payroll tax increase to achieve solvency. For lower earning workers, these higher payroll taxes outweigh the lower benefits that are due to the higher retirement age component of the reformed program.
Why Reformed Social Security Is Preferable to the Baseline Program. Finally, if the baseline and reformed programs are comparable in terms of net lifetime tax rates within income classes and birth years, is there a reason to prefer one to the other? The current retirement benefit structure could be fully funded with higher taxes to close the $19.3 trillion shortfall (in present value). The funding gap could also be closed with the alternative. The reformed Old-Age and Survivors portion of the Social Security program would be about 25 percent smaller than projections under the program as currently structured (baseline). We suggest that the smaller reformed program is preferable, primarily for the following reasons:
· Given current debt levels along with ongoing and forecast budget challenges, reducing the size of the federal budget is critical in the long run.
· Collecting the higher tax revenues necessary to retain the current benefit formula inevitably produces welfare losses.
· Reducing the scope of a pay-as-you-go financed retirement program will result in the real prepayment of retirement benefits, leading to greater investment and higher national income.
· The reformed program can be complemented with voluntary, individually directed personal retirement accounts.
Liqun Liu is a research scientist, Andrew J. Rettenmaier is executive associate director and Thomas R. Saving is director at the Private Enterprise Research Center at Texas A&M University.
Read the entire report . . .
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2. In the News: Ebola virus fact sheet for physicians
by: SMCMA Admin
The Dallas County Medical Association and the Texas Medical Association have assembled this information about how physicians can protect themselves from the Ebola virus.
Remember: You can only get Ebola from direct contact with a person who has symptoms.
Signs and Symptoms
Symptoms appear 2 to 21 days after exposure and include:
· Fever greater than 100.4F
· Muscle pain
· Diarrhea, sometimes bloody
· Vomiting, sometimes bloody
· Stomach pain
· Unexplained bleeding or bruising
If You Have Symptoms Read more . . .
· Stay in place to minimize contact with others.
· Contact your doctor for advice.
· Call your doctor immediately if you have symptoms AND have been in direct contact with a person (here or abroad) who has been diagnosed with or is at risk of contracting Ebola.
· If you can’t get in touch with your doctor, call 9-1-1.
Ebola can enter the body through broken skin or unprotected mucous membranes, such as the eyes, nose, and mouth.
· Wash your hands often with soap and water or alcohol-based hand sanitizer.
· Avoid contact with the body fluids (blood, vomit, pee, poop, spit, sweat, semen, etc.) of a person with Ebola.
· Avoid contact with items (clothes, linens, needles, syringes) that have come in contact with the blood or body fluid of a person with Ebola.
Ways You CAN’T Get Ebola
· You can’t get Ebola from a person who does not show symptoms.
· You can’t get Ebola through the air.
· You can’t get Ebola though water.
· You can’t get Ebola through food.
Information obtained from the Centers for Disease Control and Prevention and U.S. Department of Health and Human Services.
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3. International News: Democracies Less Likely to Go to War
War has undoubtedly been a fixture throughout human history, and the battles raging in the Middle East today are just one example. But is war necessarily a permanent part of human civilization? In Scientific American, science writer Michael Shermer suggests that democracies are less likely to go to war. Read more . . .
In 1795, philosopher Immanuel Kant first suggested that those in democratic republics were less likely to support wars, and -- despite the War of 1812, the American Civil War, the Israel-Lebanon war and others -- since then, scholars have continued to support the theory. In 2001, political scientists Bruce Russett and John Oneal analyzed 2,300 interstate disputes taking place from 1816 to 2001. For each country involved in a conflict, Russett and Oneal gave them a "democracy score" based on the nation's political process, system of checks and balances, electoral process, and the like. According to their research:
· Disputes would decrease by 50 percent between two countries with high democracy scores.
· The chance of dispute doubled when one of the countries had a low democracy score or was an autocracy.
· Countries more dependent on trade in one year were less likely to have a militarized dispute in the year following.
· The researchers also looked at membership in intergovernmental organizations (IGOs). For any two countries scoring in the top 10 percent in terms of democracy, trade and IGOs, they were 81 percent less likely to have a militarized dispute than a pair of average countries would be.
More recent studies have followed, says Shermer. In 2014, Havard Hegre, political scientist at Uppsala University, made similar findings, concluding that two democratic states were less likely to have conflicts.
Shermer writes that 63 percent of the world's 195 countries are democracies.
Source: Michael Shermer, "Perpetual Peace?" Scientific American
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4. Medicare: Social Security’s missed opportunity of 2000
When I turned 65, I debated whether to apply for Social Security Retirement Benefits. Since, I planned to practice until age 72; I knew that I would lose a major portion of my benefits since I was still working. But I found out that not applying for benefits would cost me far more than the income lost by keeping on with the practice of Medicine. Essentially all of my colleagues who entered practice about the same time as I, had similarly decided to keep on working. Why begin to take retirement benefits at age 65 when 75 is the new life expectancy rather than age 65 which was the life expectancy when Social Security was implemented and lose one dollar for every two dollars earned? Read more . . .
And then President Clinton announced that full benefits would be available to those turning 65 regardless of income. We had all assumed a 2 for 1 reduction in benefits from age 65 to age 72 by staying in the program. Hence, we all began receiving benefits at age 65 even though life expectance was now 75. The average American would now receive an additional 10 years of full benefits that had not been factored in when FD Roosevelt had implemented the program in 1935. But wouldn’t ten years of extra yearly income for every American bankrupt the country? Why couldn’t the Clintons have utilized this information to guarantee the future of Social Security?
Just by delaying the partial benefits of age 62 to age 65 and delaying full benefits from age 65, and now from age 68, to age 72, when all professionals, successful business men, corporate executives and entrepreneurs were expecting they would receive full benefits, the Social Security Armageddon of the 21st century could have been avoided.
In the relative quiet political climate of the mid 1990’s, this could have been feasible. However, in our present political climate it cannot even be mentioned. Social Security has again become the third rail of any politician who even mentions this correction in predictions from the 1930s.
This is another example of a president trying to be kind and to purchase votes, causes far more misery to American’s after he’s dead and gone, rather than become a hero in the annals of American History.
There are only brief interludes in history during which an error of this magnitude can be corrected with the least amount of pain. And Clinton missed it. Had he done nothing, our country would be better off.
Government is not the solution to our problems, government is the problem.
- Ronald Reagan
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5. Medical Gluttony: Medical Penury
New enrollment data for the second quarter of 2014 reveals how Obamacare enrollment shook out among Medicaid and private coverage. In all, the number of insured Americans increased by 8.5 million individuals. However, according to a new study from Edmund Haislmaier and Drew Gonshorowki of the Heritage Foundation, 71 percent of that gain was due to Obamacare's Medicaid expansion. Read more . . .
While Obamacare enrollment officially ran from October 1, 2013, to March 31, 2014, enrollment was extended into April for a number of states. As a result, new data has just become available for the end of the enrollment period, and the results indicate that many insurance gains were offset by losses in other areas, and much of the increase in insurance coverage was due to Medicaid. According to Haislmaier and Gonshorowski:
· Individual market enrollment -- meaning enrollment in health insurance plans both on and off of the exchanges -- rose by more than 6.2 million.
· Employer-sponsored private plan enrollment, however, fell by almost 3.8 million, offsetting 61 percent of the increase in health insurance coverage in the individual market.
· Enrollment in Medicaid grew by more than 5.7 million in the states that expanded Medicaid. In the states that did not, enrollment in the government health care program grew by more than 355,000 individuals.
Thus, while health insurance coverage -- whether in the private market or in Medicaid -- grew by 8.5 million individuals in 2014, the vast majority (71 percent) of that gain was due to increases in Medicaid. According to the authors, "[T]he inescapable conclusion is that, at least when it comes to covering the uninsured, Obamacare so far is mainly a simple expansion of Medicaid."
Medical Gluttony thrives in Government and Health Insurance Programs.
It Disappears with Appropriate Deductibles and Co-payments on Every Service.
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6. Medical Myths from our Inbox: Help for Physicians to do Healthcare Correctly?
Dr. Steven Landers, MPH wrote:
Healthcare reform is shifting the industry away from a fee-for-service model to paying for outcomes through value-based purchasing metrics as well as ACOs, risk-sharing models, shared savings programs, and bundled payments. This calls for a total overhaul in the structure of your business, and as a fellow business leader, I understand how frightening that can be. Read more . . .
But this is your chance to be a part of the conversation. At DecisionHealth's 2014 Healthcare Transformation Leadership Summit, you'll meet leaders on the forefront of these new delivery models who will share how they are meeting regulatory requirements, structuring process design and sustaining reimbursements.
As the head of VNA Health Group, the largest not-for-profit visiting nurse association in New Jersey, I'll be there to talk about the role of home health in accountable care and bundled payment programs, as well as how technology can connect providers, payers and patients to ensure effective care plan oversight.
Come be a part of the transformation in healthcare and together we'll make sure our collective voices are heard. Register at www.healthcaretransformationsummit.com.
I hope to see you in Las Vegas on Nov. 17-18, 2014.
Dr. Steven Landers, MPH
President and CEO
Visiting Nurse Association Health Group
you for your views on our health care problem.
The very idea that physicians need oversight by underlings is absolutely frightening.
Many best practice protocols even makes life saving measures that don't fall inside the protocol as too risky to pursue. It is sometimes more appropriate to allow a patient in whom the next stage of his illness is to die to then allow nature and time take their course rather do some heroic lifesaving treatment that the protocol demands which would cause more suffering in the final stages of life.
And conversely paying for outcomes designed by non-physician bureaucrats, even if followed by medical specialists, may not be in either the patient’s best interest or in a cost effective healthcare interest.
Recently a 90-year-old male I'd been seeing for 20+ years came with his arms wrapped up having had shunts inserted surgically for treatment of his kidney failure with hemodialysis while on vacation. He hadn't understood that he would be lying in a hemodialysis center three half days a week.
We reviewed his chart concerning his long standing kidney function. On pointing out that his kidneys had reduced function for about 15 years as is common in a 90-year-old man. We then pointed out that had I sent him to a kidney specialist 10 years ago, they would have recommended dialysis. His family would have insisted that it be done immediately without the agreement of his personal physician. I could not have changed that course without being an ogre. Hence, in view of his age and being a free spirit, I elected to manage his mild kidney failure medically. I pointed out to him that he also had mild respiratory failure (his P02 was 90) as we had discussed before but with the activity of a person in the tenth decade of life, he did not have significant breathlessness for the activities of his age. He did not require oxygen and less likely than not would he require oxygen treatment in the foreseeable future. He had also had a mild degree of congestive heart failure, but this could still be managed with the usual diuretics and with the usual activities of his age he did not suffer from breathlessness. Hence he had multi-organ failure for the past decade. He was grateful that I had not followed the usual protocols and he immediately reduced his dialysis days to twice a week. He told his daughters not to agree with anything any consultant recommended in the future without checking with his personal physician whom he had grown to trust over the past 20 years. He was doing well when I last saw him three months later.
Physicians since the time of Hippocrates have always served the patient first. They shouldn't have to worry about meeting regulatory requirements, and structure their treatment process designed to sustain reimbursements rather than helping those we serve. This has caused our profession to lose its prestige and sense of excellence as every bureaucrat and other medical illiterates want to help us out. They can only hurt the health care system, the patients, their doctors and nurses by their meddling.
Have you tried to socialize Legal-Care? Why should those that have been unfairly targeted by an Attorney have to spend several years of our income defending ourselves? Shouldn't this suffering be spread out across our society? Wouldn't that be fairer? Keep me posted concerning this more worthwhile effort. Thank you for your letter.
Please give Ann my best. Was she your mother? I always admired her advice. But she never got the toilet paper procedure correct. Of course, Dr. Brizendine had not done her research of the Female Brain at that time, either.
Del Meyer, MD
Medical Myths originate when someone else pays the medical bills.
Myths disappear when Patients pay Appropriate Deductibles and Co-payments on Every Service.
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7. Overheard in the Medical Staff Lounge: How to survive Obamacare.
Dr. Rosen: The elections are upon us and we have doctors running for office.
Dr. Dave: But they are all running in the wrong political party.
Dr. Yancy: It’s hard to understand why former colleagues in this room are now running on the Tax & Spend & Regulate party? We have traditionally been in the freedom party. Read more . . .
Dr. Sam: Physicians have come over into the T & S & R party for a number of years. What makes us think we have so much power that we can gain more by this force than in the free market?
Dr. Rosen: Do you think physicians still have the prestige that most of us think we have lost by this fringe group. I'm not sure that we've retained any of it.
Dr. Edwards: I agree. I still frequently see physicians make such embarrassing statements as don't you give doctors a discount?
Dr. Dave: Now that's just as bad as I saw overseas when I over heard, "Don't you give us Americans a discount?"
Dr. Yancy: Now that we've discounted all of healthcare in this country, are the T S R's happy?
Dr. Paul: I guess you're putting me in the T S R group. Let's face it there are a lot of poor people in whom having Medicaid is appreciated. We have had a Medicaid practice and that hasn't changed. What's your problem?
Dr. Milton: Now that Obama has solved the health care conundrum in this country, by over filling the Medicaid folks, has he really made health care available as was advertised?
Dr. Paul: My Medicaid practice is as full as ever. I have to see 8-12 patients an hour to fit them all in.
Dr. Rosen: Let's see. At 8 patients per hour or two every 15 minutes or a patient every 7-1/2 minutes, how can you deliver any good Quality of Care? If it takes you two minutes to record your visit, can you even get the chief complaint and good vital signs in 5 1/2 minutes?
Dr. Paul: Remember these are poor folks, some are destitute, they are happy with any attention they get and even one prescription is a treasure for them.
Dr. Edwards: I guess I've heard of the physician who had no exam table, no writing desk, and only one wall writing area for the chart. The nurse brought the patient in, the doctor started talking as the patient walked towards him, he started writing the prescription which he handed to the patient as he walked past him with his stethoscope out to catch one or possibly two breaths and then shake hands as he escorted him out the second door.
Dr. Paul: I have an advanced EMR program. I just need three words and the program types up the entire history and physical exam in a logical format.
Dr. Rosen: You've got to be kidding.
Dr. Paul: I just have to mention the organ system, such as "heart" and then one symptom, such as "can't sleep flat" and then one drug for the prescription that I've already written like "diuretic" and my favorite diuretic is already programmed into the system and, voila, the chart is completed, I sign it, and walk to the other door to greet my next patient. Five minutes max. I've gotten up to 10 or 12 patients an hour.
Dr. Rosen: What if you have a CMS (Center for Medicare and Medicaid Services) review?
Dr. Paul: I've already had a review. They thought for a family doctor I had one of the most complete records they had seen.
Dr. Rosen: So if you can maintain the pace of 10-12 patients an hour at $150, you're making $1500 to $1800 an hour or $15,000 to $18,000 a day.
Dr. Paul: Why do you think Medicaid reviews me? You just have to run a tight ship.
Dr. Rosen: If your schedule were made public, CMS would cut the re-imbursements drastically. And the internists among us that see four patients an hour would have to get another job.
Dr. Paul: That's your problem. As you can see, I'm making a lot of money on Obamacare.
Dr. Edwards: I don't think any patient of mine would come back after a 5 minute appt as you describe it.
Dr. Paul: So all doctors with sophisticated care as you have as an internist would go under. My practice with minimalist care that follows the letter of the regulation to a "T" would survive.
Dr. Edwards: But do you think your minimalist care is good Quality of Care, the Hall Mark of what is proposed by CMS?
Dr. Paul: That's not the issue in Obamacare. Your care has to pass Obamacare schedule of rapidity of care to meet the deluge of patients enrolling and still meet the CMS guidelines of their QOC. You're meeting the CMS guidelines of care which may yield higher QOC. But you will only be able to see about one-fifth the number of patients, and unless you get rid of most of your support staff, you won't be able to meet your mortgage and practice obligations, much less have anything left over for you and your family.
Dr. Edwards: So in reality you're saying that I have to lower the quality of care.
Dr. Paul: Would you like for me to spell that out for you?
Dr. Edwards: No thanks. You come across loud and clear. No one in Washington has ever made it any clearer.
Dr. Paul: Why should they?
The Staff Lounge Is Where Unfiltered Opinions Are Heard.
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8. Voices of Medicine: A Call from the San Mateo County Medical Association.
Dear Physician Colleagues,
We need your help in protecting California’s Medical Injury Compensation Reform Act (MICRA). On November 4, 2014, voters will go to the ballot to vote on Prop 46. The importance of MICRA to physicians in the state of California is significant. We're not asking you to assemble and march on Sacramento as more than 800 physicians, nurses, lab technicians and hospital personnel did in a grass root effort lead by the California Medical Association on May 13, 1975. Read more . . .
Trial lawyers have sponsored Prop 46. If Prop 46 passes, the current MICRA cap will quadruple from $250,000 to $1.2 million on non-economic damages in medical malpractice lawsuits. If Prop 46 passes, it will result in higher health care cost for everyone and threaten patient’s access to care with his or her providers. If Prop 46 passes, California will be flooded with new lawsuits and big payouts to trial lawyers.
The California Medical Association and county medical associations across the state have been working tirelessly to defeat this measure, but we still need your help. The next two weeks are crucial if we are to defeat Prop 46.
Please make a voluntary contribution ($25, $50, $100, $500) to help us preserve MICRA.
You can also mail your check to:SMCMA – Prop 46, 777 Mariners Island Blvd., #100, San Mateo, CA 94404
When November 4 arrives, we hope we will be able to celebrate the defeat of Prop 46 and return to the practice of medicine without increasing threats of malpractice "pain and suffering" awards to increase to $1.2 million blue sky in addition to all the medical injury without limit.
VOM Is an Insider's View of What Doctors are Thinking, Saying and Writing about
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9. Book Review: WHO OWNS YOUR BODY?
WHO OWNS YOUR BODY?: Doctors and Patients Behind Bars
by Madeleine Pelner Cosman, PhD, Esq.,
Praeger Publishing, (www.praeger.com)Westport, Connecticut ISBN: 0‑313-0327‑2
In 1993, Dr Madeleine Pelner Cosman, a health care attorney, reviewed Medicare and Medicaid litigation and legislation from their beginnings. She was startled to discover that the law most of us accepted as primarily gentle civil law had altered incrementally to brutal criminal law. Physicians are held to vague, arbitrary standards that provide accused doctors fewer rights and defenses than accused murderers, rapists and arsonists. If convicted, physicians were punished more harshly than the vilest criminals. Read more . . .
Cosman's thesis for this volume implies that medical criminal law now poses a clear and present danger both to physicians and to patients. This new type of law aims to eliminate fraud in the government medical system, but lurches wildly into the personal rights of each American doctor and patient. It also collectivizes patients under "capitation" formulas (paying health care providers a certain amount per patient without regard to how many or how few services are provided) and bureaucratic decisions of "medical necessity," placing at risk patients' privacy, confidentiality of medical records, individual medical choices, personal liberty, and bodily integrity.
She warns that members of Congress and public health experts who favor a single standard of medical care for all, regardless of individual patient requirements, use the criminalization of the physicians and collectivization of patients to propel America to a government-controlled, single-payer national health care system.
Cosman contends that American Medicine is manacled with so many regulations that she's calling Americans to alarmed a1ert. Physicians must obey 132,720 pages of government medical directives, laws, rules and regulations, including 111,000 pages of rules specifically controlling Medicare. The law governing medicine has shifted since 1965 from civil law to criminal law. The law was temperate civil law when Medicare and Medicaid were implemented. It was not coercive. It did not meddle in physicians' decisions. It did not intrude in medical offices or hospitals. Section 1872 of the Social Security Act was thought to be strong enough to prevent, curb and catch potential frauds and abuses. Fraud required intent. No doctor could be prosecuted for medical fraud unless he knew a particular act was wrong and he did it willingly and intentionally.
But legal intentions and social suppositions changed as medical costs rose meteorically. Incrementally major laws have become more restrictive, oppressive and punitive. They incorporate increasingly sterner reporting standards and more vindictive criminal punishments. In chapter one, Attorney Cosman lists the eight laws and discusses what is forbidden, defining what is progressively more arbitrary and, therefore, more likely to entrap the innocent. The ordinary street thug must intend his vicious crime and actually do it. A doctor need not intend to defraud and need not perform the criminal act to be liable and jailed. Medicare fraud can be accidental. Fewer and less certain criminal procedures protect the constitutional rights of physicians than those of the professional thug, arsonist, rapist or murderer.
Cosman discusses the six white-coat crime hazards and the dubious nature of Medicare fraud. The Office of the Inspector General had previously estimated Medicaid fraud at 2 percent. The Health Care Financing Administration had estimated medical crime even lower, or 0.44 percent. An Assistant Inspector General admitted that he got a call from the Health and Human Services Secretary's Office saying that he would be giving a speech in nine days and wanted an estimate of waste, fraud and abuse. A number of people sent in figures because they had to. He guessed the Secretary's people just added up all the guesses and came up with an illusory 10 percent fraud idea. So the 10 percent is only a political proportion, not a statistical certainty. Some of the estimates were 1 percent, 0.1 percent and 0.01 percent. But it was an effective political statistic with no empirical foundation. It was so effective that 72 percent of retirees in an opinion poll of the American Association of Retired Persons (AARP) believed that if medical fraud were eliminated, Medicare would not go broke.
Cosman proceeds to give us a well-referenced report on a large number of actual instances of what passed as Medicare Fraud, such as inadequate or improper recording of information or codes, or providing uncovered services even if appropriate and helped patients. What Medicare considers lack of necessity often means only that Medicare does not want to pay for that medical or surgical procedure. Medical fraud under current medical law can be unintentional and trivial, not material, and not harm–can actually help--the patient, if the crime hurts the medical program by charging for the patient's care.[baf1]
Medical fraud holds triple terror for a medical professional. First is the ease of conviction for alleged frauds that are not intentional. Second, many honest acts can be misinterpreted as medical fraud. Third, medical fraud under certain laws such as the False Claims Act has high, pre-established, statutory penalties "per incident" plus triple damages. Therefore, a small alleged fraud is punished harshly. A doctor who accidentally uses the wrong reimbursement code 100 times for a simple medical procedure costing $100 suddenly is worth a lot to prosecutors. Triple damages for each incident, $300 + $10,000 penalty = $10,300 per patient x l00 patients, escalates the fraud to $1,030,000. The more money involved in a fraud, the more severe the punishment after conviction. The more money involved in an alleged medical fraud, the better the press elevates the stature of the prosecutor. The more money involved, the more newsworthy the crime.
This volume is a veritable repository of essentially all the challenges in health care we face today and why. There is a chapter in which Cosman answers the frequently asked question, "Is Health Care a Basic Right?" Another important chapter on how health insurance shackles your employer discusses the cause of the colossal national deception that employers rather than employees actually pay for health insurance. And in her ninth and final chapter, Cosman gives numerous examples of how the return to choice in health care has unshackled American Medicine with Patient-Centered affordable health care.
Who Owns Your Body?: The Shackling of American Medicine is dedicated to helping the excellent, ethical physicians and surgeons who are caught by laws that are vague, arbitrary, illogical, capricious and vicious. Also at risk for accidentally violating medical criminal law are psychologists, pharmacists, chiropractors, podiatrists, audiologists, and physical, speech and occupational therapists.
Cosman asks if a physician does not own his or her own medical mind, who owns it? If a medical patient does not own his or her body, who owns it? Who should decide whether or how much money should be spent to save a patient's life? Should a patient have the right to spend personal cash to protect the body he or she owns? These are not irrelevant questions. Medicare patients in both the United States and Canada do not have this option.
Americans merit the best medicine of a free society. It charts a path to medical abundance, medical integrity, and medical excellence. We have the courage, the intelligence and the rights to buy it. Who Owns Your Body?: Doctors and Patients Behind Bars reveals deceptions and misconceptions in modern American medicine. It should be read by every physician and health-care provider. Not to be aware of the issues in this volume, with actual examples of physicians in jail who have never given improper care, could cause you to lose your license, home, family and also place you behind bars.
We have come to a crossroads in America, both in education and medicine. Baylor sold its religious heritage to acquire federal funds. Hillsdale College, which avoided all federal funding, found even accepting veterans on a GI bill constituted government largess. They raised enough donations to fund every student that wanted to enroll to replace any government loan, scholarship, or any government program the student had acquired to keep the federal government from meddling into their educational affairs. Now health care has found that federal involvement can be a lethal arrangement. It is critical that all professions extricate themselves from government control. Physicians and all health care workers will want to seriously consider opting out of all federal health care programs as soon as they can safely do so without abandoning or harming their patients. Keeping 10 percent of their Medicare patients as charity cases may be less expensive in the long run than staying in Medicare.
Del Meyer, MD
The Book Review Section Is an Insider’s View of What Doctors are Reading about.
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10. Hippocrates & His Kin: Notes from Planet Hollywood and from Planet Mars.
My Twilight Years ~ /P Clint Eastwood
As I enjoy my twilight years, I am often struck by the inevitability that the party must end. There will be a clear, cold morning when there isn't any "more." No more hugs, no more special moments to celebrate together, no more phone calls just to chat.
It seems to me that one of the important things to do before that morning comes, is to let every one of your family and friends know that you care for them by finding simple ways to let them know your heartfelt beliefs and the guiding principles of your life so they can always say, "He was my friend, and I know where he stood."
So, just in case I'm gone tomorrow, please know this:
I voted against that incompetent, lying, flip-flopping, insincere, double-talking, radical socialist, terrorist excusing, bleeding heart, narcissistic, scientific and economic moron currently in the White House!
Participating in a gun buy-back program because you think that criminals have too many guns is like having yourself castrated because you think your neighbors have too many kids.
Or to fight a war from the air without any soldiers to maintain the peace over territory won for lack of military experience.
Or to fight a war with Ebola without placing travel restrictions or a full quarantine on all passenger leaving Africa for lack of Public Health experience or not using your Public Health Officer that freedom to exert a quarantine?
Or to impose a nation-wide health plan with no understanding of the Doctor-Patient interface?
Or to take over the White House with no CEO or administrative experience?
Or to place Czars in every corner of America just in case the opportunity arises.
What's with the American public giving a 'fail' to the chief?
by Willie Brown, SF Chronicle, former speaker if the California Assembly
In 2008, when Obama was elected, our country was in the tank. Now we've got universal health care, an unemployment rate so low it never comes up on the Sunday chat shows, and a stock market that's nearly doubled in value since Inauguration Day 2009.
Obama is intellectually gifted and a man of great integrity. What he lacks is conniving and treachery skills, which is not the case with many of the politicians he has to deal with in Washington. On a scale of 1 to 10 for honesty and principle, the Washington crowd ranks below 3 and Obama scores a 10.
We Americans have a great president, and sharing ratings with the younger Bush and Tricky Dick is the ultimate insult.
Before you scream, know that I'm not objective. I'm a dyed-in-the-wool admirer of superior talent.
So as we celebrate the founding of this great nation and the 50th anniversary of the Civil Rights Act, which gave us the opportunity to elect an Obama, let's congratulate ourselves and celebrate together.
Did you happen to notice if Willie Brown’s mouth was moving when he said that?
Have a Happy 238th Independence Day celebration.
and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Yesterday, Today & Tomorrow
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• The National Center for Policy Analysis, John C Goodman, PhD, President, who along with Gerald L. Musgrave, and Devon M. Herrick wrote Lives at Risk, issues a weekly Health Policy Digest, a health summary of the full NCPA daily report. You may log on at www.ncpa.org and register to receive one or more of these reports.
• Pacific Research Institute, (www.pacificresearch.org) Sally C Pipes, President and CEO, John R Graham, Director of Health Care Studies, publish a monthly Health Policy Prescription newsletter, which is very timely to our current health care situation. You may signup to receive their newsletters via email by clicking on the email tab or directly access their health care blog.
• The Mercatus Center at George Mason University (www.mercatus.org) is a strong advocate for accountability in government. Maurice McTigue, QSO, a Distinguished Visiting Scholar, a former member of Parliament and cabinet minister in New Zealand, is now director of the Mercatus Center's Government Accountability Project. Join the Mercatus Center for Excellence in Government.
• To read the rest of this column, please go to www.medicaltuesday.net/org.asp.
• The National Association of Health Underwriters, www.NAHU.org. The NAHU's Vision Statement: Every American will have access to private sector solutions for health, financial and retirement security and the services of insurance professionals. There are numerous important issues listed on the opening page. Be sure to scan their professional journal, Health Insurance Underwriters (HIU), for articles of importance in the Health Insurance MarketPlace. The HIU magazine, with Jim Hostetler as the executive editor, covers technology, legislation and product news - everything that affects how health insurance professionals do business.
• The Galen Institute, Grace-Marie Turner President and Founder, has a weekly Health Policy Newsletter sent every Friday to which you may subscribe by logging on at www.galen.org. A study of purchasers of Health Savings Accounts shows that the new health care financing arrangements are appealing to those who previously were shut out of the insurance market, to families, to older Americans, and to workers of all income levels.
• Greg Scandlen, an expert in Health Savings Accounts (HSAs), has embarked on a new mission: Consumers for Health Care Choices (CHCC). Read the initial series of his newsletter, Consumers Power Reports. Become a member of CHCC, The voice of the health care consumer. Be sure to read Prescription for change: Employers, insurers, providers, and the government have all taken their turn at trying to fix American Health Care. Now it's the Consumers turn. Greg has joined the Heartland Institute, where current newsletters can be found.
• The Heartland Institute, www.heartland.org, Joseph Bast, President, publishes the Health Care News and the Heartlander. You may sign up for their health care email newsletter. Read the late Conrad F Meier on What is Free-Market Health Care?. This month, be sure to read ?
• The Foundation for Economic Education, www.fee.org, has been publishing The Freeman - Ideas On Liberty, Freedom's Magazine, for over 50 years, with Lawrence W Reed, President, and Sheldon Richman as editor. Having bound copies of this running treatise on free-market economics for over 40 years, I still take pleasure in the relevant articles by Leonard Read and others who have devoted their lives to the cause of liberty. I have a patient who has read this journal since it was a mimeographed newsletter fifty years ago. Be sure to read the current lesson on Economic Education.
• The Council for Affordable Health Insurance, www.cahi.org/index.asp, founded by Greg Scandlen in 1991, where he served as CEO for five years, is an association of insurance companies, actuarial firms, legislative consultants, physicians and insurance agents. Their mission is to develop and promote free-market solutions to America's health-care challenges by enabling a robust and competitive health insurance market that will achieve and maintain access to affordable, high-quality health care for all Americans. "The belief that more medical care means better medical care is deeply entrenched . . . Our study suggests that perhaps a third of medical spending is now devoted to services that don't appear to improve health or the quality of care–and may even make things worse."
• The Independence Institute, www.i2i.org, is a free-market think-tank in Golden, Colorado, that has a Health Care Policy Center, with Linda Gorman as Director. Be sure to sign up for the monthly Health Care Policy Center Newsletter.
• Martin Masse, Director of Publications at the Montreal Economic Institute, is the publisher of the webzine: Le Quebecois Libre. Please log on at www.quebecoislibre.org/apmasse.htm to review his free-market based articles, some of which will allow you to brush up on your French. You may also register to receive copies of their webzine on a regular basis.
• The Fraser Institute, an independent public policy organization, focuses on the role competitive markets play in providing for the economic and social well being of all Canadians. Canadians celebrated Tax Freedom Day on June 28, the date they stopped paying taxes and started working for themselves. Log on at www.fraserinstitute.ca for an overview of the extensive research articles that are available. You may want to go directly to their health research section.
• The Heritage Foundation, www.heritage.org/, founded in 1973, is a research and educational institute whose mission was to formulate and promote public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values and a strong national defense. -- However, since they supported the socialistic health plan instituted by Mitt Romney in Massachusetts, which is replaying the Medicare excessive increases in its first two years, and was used by some as a justification for the Obama plan, they have lost sight of their mission and we will no longer feature them as a freedom loving institution and have canceled our contributions.
• The Ludwig von Mises Institute, Lew Rockwell, President, is a rich source of free-market materials, probably the best daily course in economics we've seen. If you read these essays on a daily basis, it would probably be equivalent to taking Economics 11 and 51 in college. Please log on at www.mises.org to obtain the foundation's daily reports. You may also log on to Lew's premier free-market site to read some of his lectures to medical groups. Learn how state medicine subsidizes illness or to find out why anyone would want to be an MD today.
• CATO. The Cato Institute (www.cato.org) was founded in 1977, by Edward H. Crane, with Charles Koch of Koch Industries. It is a nonprofit public policy research foundation headquartered in Washington, D.C. The Institute is named for Cato's Letters, a series of pamphlets that helped lay the philosophical foundation for the American Revolution. The Mission: The Cato Institute seeks to broaden the parameters of public policy debate to allow consideration of the traditional American principles of limited government, individual liberty, free markets and peace. Ed Crane reminds us that the framers of the Constitution designed to protect our liberty through a system of federalism and divided powers so that most of the governance would be at the state level where abuse of power would be limited by the citizens' ability to choose among 13 (and now 50) different systems of state government. Thus, we could all seek our favorite moral turpitude and live in our comfort zone recognizing our differences and still be proud of our unity as Americans. Michael F. Cannon is the Cato Institute's Director of Health Policy Studies. Read his bio, articles and books at www.cato.org/people/cannon.html.
• The Ethan Allen Institute, www.ethanallen.org/index2.html, is one of some 41 similar but independent state organizations associated with the State Policy Network (SPN). The mission is to put into practice the fundamentals of a free society: individual liberty, private property, competitive free enterprise, limited and frugal government, strong local communities, personal responsibility, and expanded opportunity for human endeavor.
• The Free State Project, with a goal of Liberty in Our Lifetime, http://freestateproject.org/, is an agreement among 20,000 pro-liberty activists to move to New Hampshire, where they will exert the fullest practical effort toward the creation of a society in which the maximum role of government is the protection of life, liberty, and property. The success of the Project would likely entail reductions in taxation and regulation, reforms at all levels of government to expand individual rights and free markets, and a restoration of constitutional federalism, demonstrating the benefits of liberty to the rest of the nation and the world. [It is indeed a tragedy that the burden of government in the U.S., a freedom society for its first 150 years, is so great that people want to escape to a state solely for the purpose of reducing that oppression. We hope this gives each of us an impetus to restore freedom from government intrusion in our own state.]
• The St. Croix Review, a bimonthly journal of ideas, recognizes that the world is very dangerous. Conservatives are staunch defenders of the homeland. But as Russell Kirk believed, wartime allows the federal government to grow at a frightful pace. We expect government to win the wars we engage, and we expect that our borders be guarded. But St. Croix feels the impulses of the Administration and Congress are often misguided. The politicians of both parties in Washington overreach so that we see with disgust the explosion of earmarks and perpetually increasing spending on programs that have nothing to do with winning the war. There is too much power given to Washington. Even in wartime, we have to push for limited government - while giving the government the necessary tools to win the war. To read a variety of articles in this arena, please go to www.stcroixreview.com.
• Hillsdale College, the premier small liberal arts college in southern Michigan with about 1,200 students, was founded in 1844 with the mission of "educating for liberty." It is proud of its principled refusal to accept any federal funds, even in the form of student grants and loans, and of its historic policy of non-discrimination and equal opportunity. The price of freedom is never cheap. While schools throughout the nation are bowing to an unconstitutional federal mandate that schools must adopt a Constitution Day curriculum each September 17th or lose federal funds, Hillsdale students take a semester-long course on the Constitution restoring civics education and developing a civics textbook, a Constitution Reader. You may log on at www.hillsdale.edu to register for the annual weeklong von Mises Seminars, held every February, or their famous Shavano Institute. Congratulations to Hillsdale for its national rankings in the USNews College rankings. Changes in the Carnegie classifications, along with Hillsdale's continuing rise to national prominence, prompted the Foundation to move the College from the regional to the national liberal arts college classification. Please log on and register to receive Imprimis, their national speech digest that reaches more than one million readers each month. This month, read ? Choose recent issues. The last ten years of Imprimis are archived.
• John and Alieta Eck, MDs, for their first-century solution to twenty-first century needs. With 46 million people in this country uninsured, we need an innovative solution apart from the place of employment and apart from the government. To read the rest of the story, go to www.zhcenter.org and check out their history, mission statement, newsletter, and a host of other information
• Medi-Share Medi-Share is based on the biblical principles of caring for and sharing in one another's burdens (as outlined in Galatians 6:2). And as such, adhering to biblical principles of health and lifestyle are important requirements for membership in Medi-Share. This is not insurance. Read more . . .
• PATMOS EmergiClinic - where Robert Berry, MD, an emergency physician and internist, practices. To read his story and the background for naming his clinic PATMOS EmergiClinic - the island where John was exiled and an acronym for "payment at time of service," go to www.patmosemergiclinic.com/ To read more on Dr Berry, please click on the various topics at his website. To review How to Start a Third-Party Free Medical Practice . . .
• PRIVATE NEUROLOGY is a Third-Party-Free Practice in Derby, NY with Larry Huntoon, MD, PhD, FANN. (http://home.earthlink.net/~doctorlrhuntoon/) Dr Huntoon does not allow any HMO or government interference in your medical care. "Since I am not forced to use CPT codes and ICD-9 codes (coding numbers required on claim forms) in our practice, I have been able to keep our fee structure very simple." I have no interest in "playing games" so as to "run up the bill." My goal is to provide competent, compassionate, ethical care at a price that patients can afford. Private Neurology also guarantees that medical records in our office are kept totally private and confidential - in accordance with the Oath of Hippocrates. Since I am a non-covered entity under HIPAA, your medical records are safe from the increased risk of disclosure under HIPAA law.
• FIRM: Freedom and Individual Rights in Medicine, Lin Zinser, JD, Founder, www.westandfirm.org, researches and studies the work of scholars and policy experts in the areas of health care, law, philosophy, and economics to inform and to foster public debate on the causes and potential solutions of rising costs of health care and health insurance. Read Lin Zinser’s view on today’s health care problem: In today’s proposals for sweeping changes in the field of medicine, the term “socialized medicine” is never used. Instead we hear demands for “universal,” “mandatory,” “singlepayer,” and/or “comprehensive” systems. These demands aim to force one healthcare plan (sometimes with options) onto all Americans; it is a plan under which all medical services are paid for, and thus controlled, by government agencies. Sometimes, proponents call this “nationalized financing” or “nationalized health insurance.” In a more honest day, it was called socialized medicine.
• Michael J. Harris, MD - www.northernurology.com - an active member in the American Urological Association, Association of American Physicians and Surgeons, Societe' Internationale D'Urologie, has an active cash'n carry practice in urology in Traverse City, Michigan. He has no contracts, no Medicare, Medicaid, no HIPAA, just patient care. Dr Harris is nationally recognized for his medical care system reform initiatives. To understand that Medical Bureaucrats and Administrators are basically Medical Illiterates telling the experts how to practice medicine, be sure to savor his article on "Administrativectomy: The Cure For Toxic Bureaucratosis."
• David J Gibson, MD, Consulting Partner of Illumination Medical, Inc. has made important contributions to the free Medical MarketPlace in speeches and writings. His series of articles in Sacramento Medicine can be found at www.ssvms.org. To read his "Lessons from the Past," go to www.ssvms.org/articles/0403gibson.asp. For additional articles, such as the cost of Single Payer, go to www.healthplanusa.net/DGSinglePayer.htm; for Health Care Inflation, go to www.healthplanusa.net/DGHealthCareInflation.htm.
• Dr Richard B Willner, President, Center Peer Review Justice Inc, states: We are a group of healthcare doctors -- physicians, podiatrists, dentists, osteopaths -- who have experienced and/or witnessed the tragedy of the perversion of medical peer review by malice and bad faith. We have seen the statutory immunity, which is provided to our "peers" for the purposes of quality assurance and credentialing, used as cover to allow those "peers" to ruin careers and reputations to further their own, usually monetary agenda of destroying the competition. We are dedicated to the exposure, conviction, and sanction of any and all doctors, and affiliated hospitals, HMOs, medical boards, and other such institutions, which would use peer review as a weapon to unfairly destroy other professionals. Read the rest of the story, as well as a wealth of information, at www.peerreview.org.
• Semmelweis Society International, Verner S. Waite MD, FACS, Founder; Henry Butler MD, FACS, President; Ralph Bard MD, JD, Vice President; W. Hinnant MD, JD, Secretary-Treasurer; is named after Ignaz Philipp Semmelweis, MD (1818-1865), an obstetrician who has been hailed as the savior of mothers. He noted maternal mortality of 25-30 percent in the obstetrical clinic in Vienna. He also noted that the first division of the clinic run by medical students had a death rate 2-3 times as high as the second division run by midwives. He also noticed that medical students came from the dissecting room to the maternity ward. He ordered the students to wash their hands in a solution of chlorinated lime before each examination. The maternal mortality dropped, and by 1848, no women died in childbirth in his division. He lost his appointment the following year and was unable to obtain a teaching appointment. Although ahead of his peers, he was not accepted by them. When Dr Verner Waite received similar treatment from a hospital, he organized the Semmelweis Society with his own funds using Dr Semmelweis as a model: To read the article he wrote at my request for Sacramento Medicine when I was editor in 1994, see www.delmeyer.net/HMCPeerRev.htm. To see Attorney Sharon Kime's response, as well as the California Medical Board response, see www.delmeyer.net/HMCPeerRev.htm. Scroll down to read some very interesting letters to the editor from the Medical Board of California, from a member of the MBC, and from Deane Hillsman, MD. To view some horror stories of atrocities against physicians and how organized medicine still treats this problem, please go to www.semmelweissociety.net.
• The Association of American Physicians & Surgeons (www.AAPSonline.org), The Voice for Private Physicians Since 1943, representing physicians in their struggles against bureaucratic medicine, loss of medical privacy, and intrusion by the government into the personal and confidential relationship between patients and their physicians. Be sure to read News of the Day in Perspective: Don't miss the "AAPS News," written by Jane Orient, MD, and archived on this site which provides valuable information on a monthly basis. Browse the archives of their official organ, the Journal of American Physicians and Surgeons, with Larry Huntoon, MD, PhD, a neurologist in New York, as the Editor-in-Chief. There are a number of important articles that can be accessed from the Table of Contents.
The AAPS California
Chapter is an unincorporated
association made up of members. The Goal of the AAPS California Chapter is to
carry on the activities of the Association of American Physicians and Surgeons
(AAPS) on a statewide basis. This is accomplished by having meetings and
providing communications that support the medical professional needs and
interests of independent physicians in private practice. To join the AAPS
California Chapter, all you need to do is join national AAPS and be a physician
licensed to practice in the State of California. There is no additional cost or
fee to be a member of the AAPS California State Chapter.
Go to California Chapter Web Page . . .
Bottom line: "We are the best deal Physicians can get from a statewide physician based organization!"
• PA-AAPS is the Pennsylvania Chapter of the Association of American Physicians and Surgeons (AAPS), a non-partisan professional association of physicians in all types of practices and specialties across the country. Since 1943, AAPS has been dedicated to the highest ethical standards of the Oath of Hippocrates and to preserving the sanctity of the patient-physician relationship and the practice of private medicine. We welcome all physicians (M.D. and D.O.) as members. Podiatrists, dentists, chiropractors and other medical professionals are welcome to join as professional associate members. Staff members and the public are welcome as associate members. Medical students are welcome to join free of charge.
Our motto, "omnia pro aegroto" means "all for the patient."
* * * * *
Words of Wisdom & Aphorisms
Washington, D.C. was named for the only President who didn’t have to live there.
Washington, where the buck starts.
Washington, where the lame ducks are on the pond.
When Congress is in session, the city is so crowded that D.C. stands for Don’t Come.
When you work in Washington a few years, you are apt to stay.
Some Recent Postings
In The June Issue:
Richard Mellon Scaife, who has died aged 82
Heir who relented after muckraking
By Jurek Martin, Financial Times
There was something almost biblical about the life and times of Richard Mellon Scaife, who has died aged 82. He was a man of many passions, even hatred, yet able to achieve a reconciliation with the president whom he had sought to bring down by means more foul than fair. Or perhaps Hollywood had already invented him 75 years ago in Citizen Kane, as the press baron left howling in the wilderness of his own frustrated dreams. Read more . . .
Born into the Mellon banking, oil and steel fortune, he poured his inheritance into conservative causes, a precursor to the Koch brothers of similar political persuasion today.
Not for nothing was he known as the “funding father of the right”, with many US think-tanks and activist organisations – the American Enterprise Institute, Cato, the Federalist Society, the Heritage Foundation, Judicial Watch and more besides – the beneficiaries of his largesse. Yet he also contributed to education and the arts and to causes generally seen as on the other side of the political divide: Planned Parenthood, which provides abortion services, and public broadcasting – both anathema to the right. . .
But he was most defined by his attempts to discredit Bill Clinton, starting even before the Arkansas governor assumed the presidency. He was the money behind what Hillary Clinton called “the vast rightwing conspiracy” intent on bringing her husband down (it was not vast but it did conspire to some effect). He set up the Arkansas Project to dredge up whatever dirt, including sexual liaisons and the failed Whitewater property investment scheme, could be found in the couple’s background.
There were few depths to which he would not sink, most notoriously by hiring people to write that Vince Foster, Mr Clinton’s old Arkansas friend and a White House aide, had not committed suicide in 1993 but had been murdered – by inference on Hillary’s orders. Even if that smear went nowhere, Scaife generated enough of a miasma of scandal around the Clintons that special prosecutors ended up investigating whatever they did, almost all to no avail. But the administration, it seemed, was always on the defensive.
The president did not help his own cause by his dalliance with Monica Lewinsky, the White House intern, which led to his impeachment for lying under oath (he was acquitted by the Senate). Scaife was close to Kenneth Starr, the special prosecutor in the matter, even offering him a job at Pepperdine University in California as dean of the public policy school he had endowed. The obvious conflict of interest meant Mr Starr took it up only later.
Given this history, eyebrows went skywards in 2008 when Scaife in effect endorsed Mrs Clinton for the Democratic presidential nomination, after sitting down with her at the offices of his newspaper, the Pittsburgh Tribune-Review. Cynics believed this was because he was more scared of Barack Obama, for his politics and/or the colour of his skin, but he went on to be most complimentary about the good works of the Clinton Foundation. They all may not have ended up as bosom friends, but mortal enemies they were no longer. . .
In 1970 he bought the Tribune-Review, a small suburban newspaper. But along with his local radio station it served as a vehicle for his political views and crusades. In May he revealed on its front page that he had cancer.
Rather like the Citizen Kane portrayed by Orson Welles, he almost never gave interviews. The real motivation for his various stances thus remains at least as elusive as the Rosebud utterance of Kane’s cinematic deathbed.
Read the entire obituary in The Financial Times . . .
On This Month in History - July
On July 4, 1776, the United States declared its Freedom with the Declaration of Independence.
On July 4, 1826, 50 years later two presidents that signed the Declaration, Thomas Jefferson and John Adams, died.
On July 4, 1831, another President, James Monroe, died.
On July 4, 1872, another president, Calvin Coolidge, was born in Plymouth, Vermont.
On July 4, 1807, Giuseppe Garibaldi, the father of Italian independence and unity was born.
After Leonard and Thelma Spinrad
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Chancellor Otto von Bismarck, the father of socialized medicine in Germany, recognized in 1861 that a government gained loyalty by making its citizens dependent on the state by social insurance. Thus socialized medicine, any single payer initiative, Social Security was born for the benefit of the state and of a contemptuous disregard for people’s welfare.
We must also remember that ObamaCare has nothing to do with appropriate healthcare; it was similarly projected to gain loyalty by making American citizens dependent on the government and eliminating their choice and chance in improving their welfare or quality of healthcare. Socialists know that once people are enslaved, freedom seems too risky to pursue.