1.
Featured Article: The End Result of
Medicare and Medicaid is happening NOW.
Taking
the Government Out of Health Care
By Avik Roy | September 8, 2014
The
government takeover of our health care system didn't happen with the passage of
the Affordable Care Act in 2010, says Avik Roy, senior fellow at the Manhattan
Institute. It happened in 1965, he writes, with the creation of Medicare and
Medicaid.
Even
without the Affordable Care Act (ACA), the federal government would be spending
trillions of taxpayer dollars on single-payer health care entitlements: Read more . . .
·
Even before the passage of
the ACA, per-capita spending on health care by the U.S. government (at
$3,967) was higher than per- public spending in all but three countries in the
world.
·
In 2022, federal spending
on health entitlements, not including Obamacare, are set to reach $1.5 trillion.
·
The ACA will increase that
spending by 16 percent.
Countries
like Switzerland and Singapore, on the other hand, have the lowest per-capita
public health spending, with Switzerland spending $1,628 per person and
Singapore $813. How do they keep costs so low? According to Roy:
·
Both countries use the
power of private markets.
·
Switzerland has no
government-run insurers, though 20 percent of its population receives government
premium subsidies.
·
Singapore uses health
savings accounts and high-deductible insurance plans to keep costs low.
The
systems are hardly perfect, writes Roy, but they are superior to United States'
government health care programs. Using Singapore and Switzerland as a model,
Roy developed his own plan to replace Obamacare -- as well as Medicare,
Medicaid and the Veterans Health Administration. The plan would:
·
Replace government-run
health care programs with a system of tax credits, allowing individuals to
purchase high-deductible health plans with health savings accounts in the
private market.
·
Reduce federal spending by
$10.5 trillion over three decades.
·
Reduce the cost of
individual health insurance policies by 17 percent.
·
Repeal the Obamacare tax
hikes as well as the individual mandate.
According
to Roy, his model would increase the number of insured Americans by 12 million.
However, his plan has also received criticism, with many labeling it a
refinement of Obamacare rather than a repeal.
Source:
Avik Roy, "Don't
Just Replace Obamacare-Replace the Great Society," Weekly Standard,
September 4, 2014.
http://www.ncpa.org/sub/dpd/index.php?Article_ID=24825
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* * * *
2. In the News: War on Poverty Turns 50: Are We Winning Yet?
by Michael D. Tanner and Charles Hughes
The War on Poverty is 50
years old. Over that time, federal and state governments have spent more than
$19 trillion fighting poverty. But what have we really accomplished?
In a new paper, Cato scholars Michael D. Tanner and Charles Hughes argue
that while the War on Poverty achieved some initial success, the programs it
spawned have long since reached a point of diminishing returns. Read more . . .
Although far from
conclusive, the evidence suggests that we have successfully reduced many of the
deprivations of material poverty, especially in the early years of the War on
Poverty. However, these efforts were more successful among socioeconomically
stable groups such as the elderly than low-income groups facing other social
problems. Moreover, other factors like the passage of the Civil Rights Act, the
expansion of economic opportunities to African Americans and women, increased
private charity, and general economic growth may all have played a role in
whatever poverty reduction occurred.
However, even if the War on Poverty achieved
some initial success, the programs it spawned have long since reached a point
of diminishing returns. In recent years we have spent more and more money on
more and more programs, while realizing few, if any, additional gains. More
important, the War on Poverty has failed to make those living in poverty
independent or increase economic mobility among the poor and children. We may
have made the lives of the poor less uncomfortable, but we have failed to truly
lift people out of poverty.
The failures of the War on Poverty should
serve as an object lesson for policymakers today. Good intentions are not
enough say Tanner and Hughes. We should not continue to throw money at
failed programs in the name of compassion.
Read
the entire article in Cato . . .
Did you know that today there are still 126 separate federal
anti-poverty programs?
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* * * * *
3. International News: Why
Poland Matters
Why Poland Matters:
Do Your
Shopping in Paris, but Back Polish Entrepreneurs
by Julie Meyer CEO, Entrepreneur
Country.
I started off the
week with a lot of 'other stuff' on my mind. I boarded the flight to Warsaw on
Monday morning sort of asking myself how it was that I was going to spend my
entire week in Poland. My good friend, Pawel Tomczuk, who is a leading
entrepreneur in Poland, having built a financial communications firm and sold
it to Publicis, had graciously organised for me to speak at the Innovation
Forum in Gdansk and then a series of meetings from Warsaw to Sopot at the
annual financial conference EFNI. . .
But was Poland worth a week?
I didn't expect at all to
have confronted some of the great questions of history in this country of 40
million people, or to be so massively impressed by its people. How did I miss
this before, I was asking myself by Day 2? Read more . . .
As I stood there in the
shipyard where Lech Walesa led the Solidarity movement to bring freedom to
Poland as I awaited giving my keynote on stage at the Innovation Forum in
Gdansk, I met Anna Hejke, a leading venture capitalist, who happens to have
been one of Walesa's interpreters. Now for Americans, Walesa is a hero of
freedom, so I was already intrigued. Anna *did* *not* disappoint.
Anna soon realised I was a
sponge for historical information, and history I got. Poles broke the Enigma
code, and gave it to the Brits. They flew valiantly and to great effect in
WWII, and in many cases, made the difference decisively in battles that
otherwise would have been lost. They helped Jews to survive and get to freedom.
On the 1 of September 1939, the Poles were invaded by Nazi Germany, and 17 days
later by Soviet Russia, but despite being divided by these invading enemies,
the Poles didn't surrender.
In fact, for 50 years, they
didn't surrender. Their government went into exile in the UK for 50 years until
it was returned to Lech Walesa in 1989 (less 1/3 of its treasury that the Brits
took for the Polish use of British aircraft that the Poles had 'used' in
defending Britain)!.. Throughout the entire cold war, the Poles never
surrendered.
But this fighting spirit is
not new. Despite having been wiped off the face of any map, for more than 120
years, the sense that there was a Polish nation and people continued to live
on, only to re-emerge in the 20 century. Talk about living in a reality
distortion field.
Many if not most people will
say that their country has great people, but the Poles can say this with
confidence. I have learned this week that the essence of being Polish is to be
unbelievably persistent and determined: to never give up, never accept no, and
never go away. Despite what the world may say.
That character has been
forged through hardship and tragedy, and it makes a national character worth
backing bigtime. As an investor who believes wholeheartedly that capital
follows ideas and that history is changed only by ideas, and those who execute
them, I will spend a disproportionate amount of my time backing Polish
entrepreneurs as they have grit, ambition and stamina.
Oh, and I learned another
thing too. This week while I would get ready in my hotel room each morning,
there was a backdrop of Hong Kong protestors and French deficit reaching 98% of
its GDP leading to strikes on the streets. The average Polish person loves free
enterprise in a way that the average French person doesn't I am sad to admit. I
lived in France for 7 years, and they don't get it. France manages to sell a
vision of the country as a wealthy European leader despite being essentially
bankrupt. Its people don't understand why it's got the wealth that it has.
Through free enterprise hundreds of years ago, and through its entrepreneurs
today and the ingenuity of its business people, France created wealth. But it
has been sold a lie by its political establishment that government can take the
rough edges off of life, and provide risk-free security. Today, that lie has
been exposed. Instead of creating a national identity where its citizens pull
together for the greater cause of building France, with everyone willing to
sacrifice in order to create a country which works for all, the people squabble
over how to 'protect' their rights, oblivious to how the world is changing
around it, leaving it in the dust.
And this is why Poland
matters.
They have had no silver
spoon. Their freedom started in a shipyard. They were treated abominably in WWII
and its aftermath. I had tears in my eyes, and I haven't even read Norman
Davies and Edward Gibbons yet. Patton tried to march to Moscow, but Roosevelt
wouldn't let him finish the job. They have no accumulated capital, so they must
rely on their human capital. The world enjoys a Polish joke at their expense
occasionally. But they have what Darwin says make you fit: adaptability. The
Poles have had to. They know how to fight. They love their freedom. And they
understand how wealth is created. . .
Poland is open for business.
If we want to be optimistic about the future of Europe, look to Poland.
They are the future – of Europe
and the world.
Read the entire article at EntrepreneurCountry
. . .
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* * * * *
4. Medicare: The realities of
government Medicine
Numbers You Need to Know About Medicare Advantage Cuts
Submitted by Randall Clough on Mon, 03/17/2014 - 11:41
1.
$420 to $540: Average
Annual Premium Increase And/Or Benefit Reduction For Medicare Advantage
Enrollee In Florida Due To Proposed Cuts From Obama Administration
2.
78%: Percent Of Seniors In
Swing States That Say Medicare Advantage Cuts Will Be One Of The Most
Significant Issues In Determining Their Vote If Cost Of Plans Rises
Read more. . .
3.
50: Number Of DEMOCRATS In
U.S. House Of Representatives Who Signed Letter To Center Of Medicare Services
Out Of 194 Members Citing Concern Over Cuts To Medicare Advantage
4.
18: Number Of DEMOCRATS In
U.S. Senate Who Signed Letter To Center Of Medicare And Medicaid Services Out
Of 40 Members Citing Concern Over Cuts To Medicare Advantage
5.
74%: Percent Of Seniors In
Swing States Expressing Concern That Medicare Advantage Rate Reduction Will
Increase Cost Seniors Have To Pay
6.
1: Number Of Candidates For
Governor Of Florida Denying That Medicare Advantage Cuts Will Harm Seniors
Ref: http://healthsprocket.com/node/9366
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Government is not the solution to our problems,
government is the problem.
- Ronald Reagan
* * * * *
5. Medical Gluttony: Anything valuable,
but inexpensive or free, will produce gluttony.
Perverse
Incentives
There’s
been a debate in Sacramento for the last 50 years concerning water that is
purchased on the basis of the size of the pipe carrying it to your house. It
was relatively inexpensive for a ¾ inch pipe that would easily take care of
everyone’s water needs. The T-S-R (tax-spend-regulate) folks wanted everyone to
have meters. The costs seemed astronomical. But the T-S-Rs did not think the
cost was important. The law-and- order party fought this as another form of
taxation. They knew that once a tax is imposed, there is no limit as to how
high the tax can rise. Co-incidentally, that’s how the T-S-Rs looked at it.
There has never been a tax that the T-S-Rs didn’t like. They do not believe in
limits. Limits will always be exceeded. Read more . . .
I was
having a debate with one of the Tax-Spend-Regulate folks and the income tax issue
came up which reached about 90% under President Jimmy Carter. When President
Reagan took over, he was able to reduce this to about half. My friend saw this
as taking money from the poor and allowing the rich to keep it. So I suggested
that perhaps he would like to see a 100% income tax. He said, “Yes, Absolutely.
The rich can well afford it.” I thought I had a basic T-S-R fallacy going, so I
asked, “Perhaps you would like to see the income tax go higher, maybe to 150 or
even 200 percent?” He again responded, “Certainly. The rich can well afford
that.” This suggested he did not comprehend basic high school economics. I didn’t
want to pursue this any further.
The water
meters are being installed and ours was installed about three years ago. The
total conversion will take another seven years. Our cost of water tripled
immediately. We have some majestic red woods, deodars, oak, pines, cedars, camphor,
as well as Monterey pines lining our redwood fences that we’ve had for 35 years.
They were starting to die in midsummer. So we had to soak a number of trees
several times this summer until they started greening again. Our water bill in
Sept was $555. Extremely high. But the cost was allocated on the bases of use
and we’re in the second year of a major drought. Without the water meters, our
water district would have had to pump the Carmichael wells dry. The previous
socialized water program, like socialized medicine, allows unlimited use
without regard to costs. But there was a 30% drop in water usage in September
indicating that free enterprise is the most efficient conservation mechanism
with everyone allowing their trees to be drier, but still keeping them alive.
Please
note that this was a voluntary reduction in use without further regulation or
policing.
The same
thing happens with socialized medicine. Healthcare is touted as being much more
important than water care. With such a valuable product being free at the point
of use or service, it makes essentially all patients gluttonous users of
healthcare which increases much faster than the price of water.
Health
insurance companies still give totally free access to many types of procedures
to increase sales of the product. Even when preventive care, such as
immunizations, papaniculau cancer smears, mammograms, are fully covered, the
patient never understands the cost. Therefore the value of these procedures approach
zero over time. We see this every day in the number of people that have not had
a flu shot, a pap smear, or mammogram in 10 years. Many see this only as an
inconvenience and not as a cost or health item.
We also
see many patients who demand expensive but unneeded tests such as yearly lipid
panels, chest x-rays, electrocardiograms, when the last two have been normal
and screening every five is more than adequate. In the current hostile health
care environment, the patient evaluates the doctors, and a complaint can go up
to the level of state review. Just the time to review the record and write a
report to the HMO and insurance company can be up to 5 or 10 hours of the
physician’s time. This is a cost that is not reimbursable. There is a similar
cost in loss of income during the same 5 to 10 hours of patient appointment
time given up with an equal loss of income. If this includes a Quality of Care
(QOC) or a possible legal issue, the cost of each complaint will require an
attorney review and cost can be an extra $2,000 to $5,000 per complaint even if
they are without substance as 90% of them are.
Hence
much of medical gluttony is allowed by physicians since the alternative can be
very expensive for the physician in the current hostile health care
environment.
We have
done studies on our patients which indicate that welfare patients paying $5 an
office call and $10 per day on hospital admissions, reduced costs by more than
80%. We found many cases were a $10,000 hospital stay would have been avoided
with a $10 per day copay. They would have come to the office to avoid that $10
a day copayment for a $5 office one time copayment.
Why don’t
the T-S-R folks want to save such significant healthcare costs, with a rather
small copay? They say that some folks can’t afford the $5 or $10. But they are
seen with a smart phone or are smoking a $4 pack of cigarettes per day ($120
per month). Hence the $5 or $10 copays are really affordable which would reduce
healthcare costs by more than half. This is a very simple and workable solution
to health care costs and doesn’t require any further regulation or oversight
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Medical Gluttony thrives in Government and Health
Insurance Programs.
It Disappears with Appropriate Deductibles and
Co-payments on Every Service.
* * * * *
6. Medical Myths: Pharmaceutical
Management Companies improve the QOC
Pharmacies
programs are now making direct contact with our patients causing confusion and
questions their personal physician’s (frequently referred to with the
derogatory PCP designation) competence. Although these letters, which are
shared with the patients, do state that they obviously do not have the entire
patient’s record, and the “PCP” is in a better position to determine if the
pharmaceutical management company’s recommendations are valid, they do cause
questioning of their “PCP’s” competence. This becomes obvious when the patient
becomes irate on the phone, states that we’ve made a mistake and please order
what the “pharmacy” recommends. Read more . . .
This
may cause a serious disruption in the physicians work flow. He may be involved
in direct patient care and it creates an unkind problem with the patient he’s
currently seeing if he reviews the pharmaceutical letter, the patient’s medical
record, gets on the phone to explain that he had an adverse reaction of another
ACE inhibitor and to use the recommended pharmaceutical that was recommended by
a reviewing agency would more likely than not produce the same adverse
reaction.
The constant policing of physicians does not improve
the Quality of Care (QOC).
But it does diminish physicians, and destroys much of the doctor/patient
relationship,
which in turn decreases the QOC.
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Medical Myths originate when someone else pays the
medical bills.
Myths disappear when Patients pay Appropriate
Deductibles and Co-payments on Every Service.
* * * * *
7. Overheard in the Medical Staff Lounge: How can we
control health care costs?
Dr.
Rosen: Last week we discussed
how dangerous “Repeal and Replace” would be. No one has really
outlined a simple replacement for the thousands of pages of Obamacare. What changes
would you make? Read more . . .
Dr.
Sam: I think our system was
actually rather good. We had Medicare for the seniors over 65 and those
that are disabled. We have Medicaid for the poor who can’t afford private care.
Everyone else should be working and thus are
covered through standard insurance.
Dr.
Yancy: I think we have the level
of what constitutes the poor set too high. It should never include more
than the bottom 12% to 15% of society. I’m sure that income follows a bell
curve. One could make a case that those that are
more than 2 standard deviations out from the mean
are truly poor.
Dr.
Edwards: That certainly would make
more economic sense than just taking items that a group think are
necessities. The cost of food is easily calculated. Clothes are more difficult.
Some will “need” clothes that are twice as
expensive as others. There are many factors of taste. Having
a committee like approach will exceed what is absolutely necessary. There will never
be agreement as to what is necessary.
Dr.
Milton: Drinking, smoking and
gambling habits are really variable. I have people of welfare smoking
two or three packs per day. Some that drink a fifth of Vodka a week.
Dr.
Ruth: I have one welfare
family that spends one entire welfare check a month on a trip to Reno to
gamble. I think we have to call that a disease. We had dinner with one couple
there and they were dropping quarters in the slots as we were in
line for a buffet. When we got to the food he
had won one small handful of coins and bragged about his winnings. He totally
discounted the money he lost and chalked that up to pleasure and vacation spending.
Dr.
Kaleb: Remember when President
Clinton said welfare should be limited to couple of years. We saw
many of our Medicaid patients obtain a job rather quickly rather than wait out
the two years.
Dr.
Patricia: I see many of my
patients go to the ER rather than come to my office for routine complaints
because of evening conveniences.
Dr.
Michelle: That’s a significant
excessive or glutinous cost since ERs are never less than $1500 when office
calls are about $150.
Dr.
Rosen: What if we had a $50 ER
copay and a $5 office copay? How would that change the equation?
Dr.
Milton: I don’t think any of my
Medicaid patients would pay $50 to go to the ER. They would see
me the following day.
Dr.
Edwards: I second that.
Dr.
Rosen: It seems like we could
save about 80% in this segment of society with just a reasonable and
affordable copayment. If we just keep adding up all these savings, health care
costs would plummet. At least in the Medicaid
portion of society.
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The Staff Lounge Is Where Unfiltered Opinions Are
Heard.
* * * * *
8. Voices of Medicine: A Review of Regional
Medical Journals: Sonoma Medicine
The magazine of the Sonoma
County Medical Association
EDITORIAL: MEDICINE &
POLITICS
Rob Nied, MD
Has the current morass
in Washington DC inspired you to
run for Congress? According to the New York Times, 26 physicians are
running for Congress this year, and Kentucky senator Rand Paul, an
ophthalmologist, is considered a likely presidential candidate. Compare that
with a total of 25 physicians who served in Congress between 1960 and 2004.
Commoditizing physicians and
patient care, declining reimbursement, the Affordable Care Act, and increasing
bureaucratic regulation have made the business of medicine increasingly unpalatable,
so it is understandable that we physicians want to stand up and fight for our
profession. Our country’s founding fathers would be proud—more than 10% of the
signers of the Declaration of Independence were physicians. Read more . . .
A few years ago, The Daily
Beast published an entertaining article by Dr. Kent Sepkowitz about physician
politicians (“Why physicians make crazy politicians,” May 26, 2010). He
postulates that physicians are used to taking charge and have a sense of
personal responsibility for the world around them. We also share a sometimes
outsized belief in our own ability to “fix things.”
Having more physicians in
Congress might seem like a good idea, but the ones who are already there don’t
necessarily represent the views of physicians in general . . .
The reality is that
physicians across the United States have the same disparate views and biases as
any group of 600,000 people. Considering that most of a physician
Congressperson’s time is spent advocating and deciding on policy matters far
removed from their medical training, it may not be in our collective best
interest to elect more of them.
Of course, physicians don’t
need to hold political office to influence the most important public policy
decisions, even at the national level. Politicians know that one thoughtful
letter or call from a constituent represents the views of tens or even hundreds
of peers who did not bother to publicize their opinions. Personal relationships
between physicians and key legislators, forged over a decade of interaction,
ultimately led to the “GPCI fix.” The adjustment in the Medicare Geographic
Practice Cost Index—which only happened in California—will increase payments to
physicians in 14 California counties by $50 million annually and over $400
million in the next decade. Sonoma County physicians will see a 4–9% increase
in payments. For other national policy issues, such as repealing the Medicare
SGR, personally lobbying our elected representatives is the single most
powerful thing we can do.
Some political issues,
however, require a more organized, collective effort, such as the current
effort to defeat Proposition 46. Organizing a statewide public-relations
campaign is too large of a project for one person, one county medical society,
or even the largest medical group. The California Medical Association—the
collective voice of almost 40,000 physicians—represents our common interests at
the state level. The physicians and medical students standing on the California
State Capitol steps in support of universal access formed the most lasting
image of this year’s Legislative Leadership Conference, which is organized by
CMA. To do that work requires people and money. It is important that each of us
contribute our share.
Unfortunately, public opinion
of organized medicine is not much higher than public opinion of Congress.
Corporate medicine has often been guilty of protectionism and favoring special
interests. Most people, however, still have a great deal of admiration for
individual physicians. A 2011 poll found that 77% of the respondents trust
physicians in general and 93% trust their personal physician, a number that is
rare in today’s society.
Ultimately, the most
effective advocacy for the issues we hold most dear is the clout and respect we
have in our own community. We shouldn’t underestimate that. Sonoma County
physicians, almost uniquely in California, are embedded in our community. We
live and play here. Simply being present and active in our community influences
public opinion, effects change and helps educate.
The real question is not
whether you should run for Congress. Instead, it’s what are you passionate
about? Over the coming year, SCMA will be launching an effort to better connect
our members with organizations in Sonoma County that share our common interest
in the health and vibrancy of our community. What inspires you? ::
Read
the entire editorial in Sonoma
Medicine . . .
Dr. Nied, a Santa Rosa family physician,
is president of SCMA.
Email: robert.j.nied@kp.org
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VOM
Is an Insider's View of What Doctors are Thinking, Saying and Writing.
* * * * *
9. Book Review: In Search of a New Health Care Model: The Healing of America
The Healing of America: A Global Quest for Better, Cheaper, and
Fairer Health Care,
Marin Medicine –
The magazine of the Marin Medical Society
|
|
TR Reid, 304 pages, Penguin (2010).
This book review is found at http://www.nbcms.org/en-us/about-us/marin-medical-society/magazine/summer-2014-sleep-departments-current-books-in-search-of-a-new-health-care-model.aspx?pageid=340&tabid=759
.
ED: We had to do a cross check to make sure this
wasn’t Harry Reid. This book is out dated and the reviewer is biased. When we
go to international meetings, we do not find the physicians from afore mention
countries happy with her government regulated or socialize programs. Breton
states that Reid dispels many myths about the WHO being too liberal. But we
have not found anyone that would even consider going to Columbia, as I recall,
for heart surgery which is ranked above the United States. I’m sure this
reviewer wouldn’t either. Breton does get the wait times essentially correct.
But he highlights the wrong orthopedic procedure. The orthopedic patient wait
that went to the Canadian Supreme court was the ruling that determined that
Canadians did not have access to health care. They only had access to a waiting
list. That certainly turns everything on its head that Canadian Medicare delivers
good healthcare. Prejudices hardly ever die. They don’t even fade away after
all these years. Some of these don’t even fade away before the history books
are written.
Canadian
Medicare does not give timely access to healthcare, it only gives access to a
waiting list.
--Canadian
Supreme Court Decision 2005 SCC 35, [2005] 1 S.C.R. 791
http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html
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reviews . . .
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reviews topically . . .
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The Book Review Section Is an Insider’s View
of What Doctors are Reading.
* * * * *
10. Hippocrates & His Kin: Giving up
smoking is the easiest thing in the world.
Giving
up smoking is the easiest thing in the world. I know, because I’ve done it
thousands of times. –Mark Twain.
Thomas,
a patient told me that he gave up smoking every evening when he went to bed. He
didn’t have another cigarette until breakfast.
Richard,
another patient told me that he smoked three packs every day, two packs during
the day and one pack during the night. He would wake up about every hour, open
up his night shirt, and light up. Why open the night shirt? So if I accidently
fall asleep before I finish, it falls on my chest and wakes me up. Doesn’t that
burn you? Not that much. That’s better than burning up the bed. Especially
since you’re still in it. But that’s only a half pack at night. So you smoke
only a ½ pack per night? I guess you’re right. So I must smoke 2 ½ packs during
the day since I purchase three packs a day. . . When I examined him, I did
confirm several small burn spots and several “loss of hair spots” on his chest.
To read more HHK
. . .
To
read more HMC . . .
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Hippocrates and His Kin / Hippocrates Modern
Colleagues
The Challenges of Yesteryear, Yesterday, Today & Tomorrow
* * * * *
11. Restoring Accountability in Medical Practice, HealthCare,
Government and Society:
•
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
•
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."
* * * * *
12. Words
of Wisdom, Recent Postings, In Memoriam, Today in History . . .
Words of Wisdom
Sir William Osler: Aphorisms, from his
bedside teachings and writings.
Collected by Robert Bennett Bean, MD
(1874-1944)
“He was a keen observer, a brilliant
clinician. His contributions to medicine and medical education were important.
He was a great teacher. But his main strength lay in the singular and unique
charm of his presence, in the sparkling brilliancy of his mind, in the rare
beauty of his character and of his life, and in the example that he set to his
fellows and to his students. He was a quickening spirit . . . He taught us that
the treatment of the patient was the most important element in the treatment of
disease, that the patient not the disease was the entity.” –Thayer
The great republic of medicine knows and has known no national boundaries.
In science the credit goes to the man who convinces the world, not to the man
to whom the idea first occurs.
It is strange how the memory of man may float to posterity on what he would have himself regarded as
the most trifling of his works.
There is no more potent antidote to the corroding influence of mammon than the presence in
the community of a body of men devoted to science.
Modern science
has made to almost every one of you the present of a few years.
Thucydides it was who said of the Greeks that they possessed “the power of thinking
before they acted, and of acting, too.”
Some Recent Postings
In The August Issue:
1.
Featured
Article: A Tale of two Bridges
2.
In the News: A Tax-limiting Amendment
3.
International
Medicine: The Republic of
Georgia chose to outsource regulation.
4.
Medicare: The Patient Friendly
Medicare Program may Not be so Patient Friendly
5.
Medical
Gluttony: HMOs practicing
parallel medicine and interfering with patient care
6.
Medical Myths: You can keep your
insurance and doctor and save money with Obamacare
7.
Overheard in the
Medical Staff Lounge: Repeal &
Replaced are two dangerous words
8.
Voices of Medicine: The Dilemma of
Speaking Up
9.
The Bookshelf: Extreme Medicine: by Kevin
Fong, MD
10.
Hippocrates & His Kin: Doctors Continue
to become more irrelevant
11.
Restoring Accountability in
Medicine,
Government and Society
12.
Words of Wisdom,
Recent Postings, In Memoriam, Today in History .
In Memoriam
Eduard Shevardnadze, Soviet foreign minister and then
president of Georgia, died on July 7th aged 86 The Economist |Jul 12th 2014 | From the print edition
THE obscure provincial leader
was at first sight an unlikely choice to be foreign minister of the world’s
largest country. Eduard Shevardnadze did not even want the job: he spoke only
his native Georgian and heavily accented Russian, had no important foreign
contacts, and had barely travelled abroad. But Mikhail Gorbachev was immovable.
The new Soviet leader wanted big changes—and the “Silver Fox”, his friend since
the 1950s, to make them. . . Read more . . .
Deeds matched the words. He
ended the Soviet Union’s proxy wars in Africa, Latin America and Asia, hurrying
the Red Army home from its futile and bloody mission in Afghanistan. At arms-control
talks with America knotty negotiating problems unraveled overnight. The danger
of nuclear war abated. He buried most of the Soviet empire in Europe, and
played midwife to a united Germany, saying allies were better than subjects:
“It is time to realise that neither socialism, nor friendship, nor
good-neighbourliness, nor respect, can be produced by bayonets, tanks or
blood.”
Even hawkish Americans realised
that the Soviet Union truly wanted to end the cold war. Mr Shevardnadze forged
notable friendships with his American and German counterparts. The hardliners
back home, with their grumbling jargon and rigid mindsets, were a greater
obstacle.
Seemingly, he was cut from the
same cloth. He had joined the party at the height of the Stalin era. A ferocious
local official, he brought even the sybaritic Georgians to follow Party
discipline. A possibly apocryphal story relates how he called a show of hands
on some anodyne motion at a meeting of senior officials, on his first day as
anti-corruption chief there. As the grey-clad arms went up, he inspected every
wrist—and remarked caustically how strange it was that the servants of the
proletariat could afford pricey Western watches. Other tactics were tougher:
mass arrests, beatings, torture and executions. He jailed dissidents and
cracked down on those trying to defend Georgian language and culture from
Russification.
It worked well, for him. Having
shown the Kremlin the extent of corruption in Georgia, he was given the
republic to run. Control of the best food, wine, scenery and hospitality in the
Soviet Union proved a fine way to forge important friendships.
But behind the outward
appearance of sycophantic loyalty to a brutal system was a different man. Yes,
he had been a true believer, but he also knew that his father had narrowly
escaped death in Stalin’s purges. His beloved Nanuli was the daughter of an
enemy of the people, but he risked his career and married her anyway—declining
to “sacrifice love to hatred”, he wrote later. He secretly shared his despair over
the Soviet Union’s failures with the young Mr Gorbachev, his counterpart in the
nearby Russian province of Stavropol. Both men saw that only radical change
could avert catastrophic collapse.
Outfoxed
But unlike Mr Gorbachev, the Georgian went
further. Back home he had allowed the making of “Repentance”, an explosive
allegorical film (banned by censors) about the crimes of Stalinism. His
experiments in economic liberalisation in Soviet Georgia had been successful,
but they made him conclude that socialism was unworkable, not reformable. He
saw far more clearly than his boss the danger of a hardline backlash. Their
friendship frayed. As the shadows darkened over Moscow in the winter of 1990,
he spectacularly resigned, with an emotional speech warning of looming
dictatorship. For many, that marked the real end of the era of glasnost and
perestroika.
After the Soviet collapse in 1991 Mr
Shevardnadze headed home to Georgia, where independence had brought bloody
strife and economic collapse. Though he became the only politician to have been
foreign minister of one country and head of state of another, his record was at
best mixed. He eventually ended the fighting, jailing two of the warlords who
had put him in power, sidelining the third, and escaping several assassination
attempts. . .
There were some successes. New east-west oil
and gas pipelines across Georgian territory helped break Russia’s export
monopoly, and put the country on America’s map. He encouraged bright young
Georgians to study abroad; one of them was his later nemesis, a brash, polygot
lawyer called Mikheil Saakashvili. Egregious election-rigging in 2003 sparked
the “Rose revolution”, in which an indignant mob, led by the glitzy young
English-speakers, hustled a bewildered and indignant “Silver Fox” into
retirement. Too much democracy, he said crossly, was a mistake.
http://www.economist.com/news/obituary/21606711-eduard-shevardnadze-soviet-foreign-minister-and-then-president-georgia-died-july-7th
On This Month in History - September
On September 1, The Labor Day Season begins. As we approach the end of the rites of
summer, we celebrate the big Labor Day Week-end ending on the first Monday of September;
we salute the working people of America. But what it has become principally is
a celebration of the end of the formal vacation season and a signal that it’s
time to go back to work. It has also been a traditional occasion for the kind
of oratory that goes with bunting, flags, parades and picnics. Read more . . .
On September 1, 1939, World War II began when Germany invaded
Poland. The world of Sept
1, 1939 fell apart and had to be put back together again with blood, sweat, toil
and tears. What does that have to do with our world today? That’s a broad
question which future historians will have to put together for the next
generation since we are unable to understand the present world in real time.
On September 1, 1910, Nan Aspinwall became the first woman to ride across the United states on
Horseback, making it from San Francisco to New York City.
On September 1, 1958, a U.S. spy plane was shot down for violating
Soviet airspace. George
P. Petrochilos and sixteen other crewmen were downed by Soviet MIGs as the
plane skimmed the Soviet border.
On the same day in 1983, a Soviet jet fighter shot down a Korean
Air Lines Boeing 747
passenger jet over the Sea of Japan. The plane had violated Soviet airspace,
which cost 269 passengers and crew their lives.
On September 1, 1969, Colonel Moammar Ghadafi overthrew the Libyan government in a
bloodless coup.
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.