1.
Featured Article:
Privatize the Welfare State By HOWARD HUSOCK, WSJ,
No matter whose priorities
prevail in this year's budget debate, it is a certainty that the federal
government will continue to devote billions to activities known as "social
services." These include support for everything from foster care to drug
abuse prevention; indeed, the Administration for Children and Families alone
supports no less than 60 such programs at an annual cost of nearly $13 billion,
in addition to the cash welfare payments it handles. Billions more are spent on
such purposes by state and local governments, often through contracts with
private "providers." Robust public debate has developed as to whether
other parts of the New Deal legacy still make sense, but the central role of
government in providing or paying for social services appears settled -- with
the only question being how best to achieve efficiency and effectiveness.
But should this role be
considered beyond debate? It is a question worth pondering today because of a
historic confluence of circumstances: an impending wave of charitable giving at
an unprecedented level; long-term projections of federal deficits, undermining
the assumption that social programs can best be funded by government; and a new
generation of so-called social entrepreneurs, looking to try creative
approaches to help those in need, and to do so on a large scale. These
circumstances, moreover, emerge in the context of heightened, post-Katrina
public dissatisfaction with the quality of government-provided public services.
Together, they suggest the possibility of imagining a modern society where
major social service efforts are provided on a large scale outside the
government, through privately funded, not-for-profit charitable organizations.
*
* *
In the era before passage of
the Social Security Act in 1935, whose Title V provided for such spending,
privately funded agencies yielded the bulk of
In any event, greater
government social service spending was certainly achieved. In terms of
quality, however, it is hard to argue that things have worked out the way
reformers intended. Consider services for children. Over the past 10 years, 22
to 36 children have died each year under the watch of
This record of
government-provided services plays out today in a dramatically changing
environment for philanthropy. In recognition of the wealth of soon-to-retire
boomers, the
Meanwhile, a wave of capable
persons has come forward to establish effective new social service
organizations, based on new ideas and with little or no government support.
Indeed, it can be argued that we are now in an unprecedented period for the
emergence of such people, who have started new types of job training, mentoring
and immigrant-assistance efforts. The term "social entrepreneur" --
for those who establish such organizations -- has entered the language and
become current on college campuses, where courses and research centers
(Harvard, Duke, Stanford) on the topic have been established.
Thus the stars are aligned
for nongovernmental organizations to play a much larger role in assisting those
in need. . . .
What's more, service
organizations, which rely on private donations -- whether from individuals or
foundations -- might actually prove to be more accountable for their
performance than their public or publicly funded counterparts. . . .
The transition to a
diminished government role in social services would be complex, as Americans
have been conditioned for several generations to view government as the
provider of first resort. . . .
Such tools might include a
stock market equivalent for major service-providing nonprofits. This is not as
odd as it sounds; serious people are already considering such an idea. . . .
Such a system would, to be
sure, have to emerge gradually -- after all, the general replacement of private
with public sector social services did not occur overnight. But the question of
whether and how to do so should be part of any discussion about the present and
future of the welfare state.
Mr. Husock is director of
the Manhattan Institute's Social Entrepreneurship Initiative and a research
fellow at
To read the entire article (subscription required), go
to http://online.wsj.com/article_print/SB114187355219993355.html
* * * * *
2.
In the News: After Initial Rejection, Scientists Back Work On Cure for Diabetes by Sharon Begley, Science Journal, WSJ,
When Denise Faustman announced
that she had cured mice of diabetes, funders didn't exactly beat a path to her
door, and colleagues didn't shower her with hosannas.
To the contrary. After her
2001 breakthrough, Dr. Faustman, an associate professor of medicine at
When she published a similar
study two years later, reaction from colleagues wasn't much better. Two fellow
Harvard diabetes experts sent a letter to the New York Times, which had run an
article describing Dr. Faustman's work, calling the claim that she was the
first scientist to cure diabetes in mice "patently false." They also
apologized to people with diabetes "on behalf of Dr. Faustman" for
"having their expectations cruelly raised." JDRF, getting flak for
not funding her, circulated the (unpublished) letter to show that the
scientific verdict on her results was far from unanimous, explains spokesman
William Ahearn.
But JDRF did approve grants
to three competing teams, including one led by an author of the critical
letter, to attempt to replicate Dr. Faustman's work. Now all three are
announcing they have confirmed the aspect of her study that is the basis for a
clinical trial planned at Harvard. By keeping the mice's immune system from
destroying their insulin-making beta cells, the three report in today's issue
of the journal Science, they got beta cells in some (but not all) of the
animals essentially to come back from the dead, curing their diabetes.
In the three studies -- from
the
In the 2003 study that the three
labs tried to confirm, Dr. Faustman and colleagues gave diabetic mice a
compound that destroys killer T-cells. They also transplanted cells from the
spleens of healthy mice into diabetic mice. The transplants bloomed into beta
cells, they reported. . . .
With the T-cells gone, they
hope, surviving or regenerated beta cells will yield enough insulin to reverse
diabetes. . . .
Harvard's Diane Mathis and
her colleagues discovered that even in mice with long-established diabetes,
there is "substantial beta-cell mass, which can be rejuvenated/regenerated
to reverse disease." If so, then cell transplants, from cadavers or
embryonic stem cells, wouldn't be necessary. . . .
"The good news is that
all three groups cured mice as we did," says Dr. Faustman. "They
showed that it was due to regeneration in the pancreas, and that's the beauty
of it: The animals' own pancreas did this."
She still thinks
transplanted cells from the spleen might produce beta cells. "The pancreas
is too smart to cure itself in only one way," she says. "I think
there will be many sources of regeneration, and we're only at the beginning of
understanding what they are."
To read the entire column,
please go to (subscription required) http://online.wsj.com/article_print/SB114315965384906933.html
You can email [Sharon
Begley] at sciencejournal@wsj.com1.
* * * * *
3. International Medicine: Private Health Insurance in Developing Countries
NCPA
Daily Policy Digest: HEALTH
ISSUES,
Private
health insurance may be a good solution for the poor inhabitants of developing
countries, say researchers from the
Government-run
health programs, adopted by most developing nations, have inefficiencies that
force many people to pay over half of their medical expenses out of pocket. For
example:
- In virtually all developing countries,
out-of-pocket expenses exceed the
- Out of pocket expenses paid by poor people
constitute a large share of family income for those who make them.
- Countries' insurance programs -- which profess
to have free, universal and comprehensive provision of medical services --
fail, largely due to poverty.
- From
Private
health insurance could help reduce these burdens and alleviate some of the
health expenses governments experience. Furthermore, poor families would save
money because of the redistributed costs associated with private heath
insurance, say the researchers.
Countries
and regions currently using private insurance include:
- Populations of the
- Zimbabweans and South Africans; these countries
have private insurance that cover more than a quarter of private spending
on medical care.
Despite
the benefits private health insurance offer to families and governments, policy
makers continually opt for social insurance programs and take preventative
measures against private insurance companies, such as passing restrictive laws.
Source:
Mark Pauly et al., "Private Health Insurance In Developing
Countries," Health Affairs, March/April 2006.
To
read more: www.ncpa.org/newdpd/dpdarticle.php?article_id=3154
For
text (subscription required): http://content.healthaffairs.org/cgi/content/abstract/25/2/369
Governments
Restrict Access to Health Care (NCPA Daily Policy
Digest: HEALTH
ISSUES,
Nearly
50 percent of people in parts of
Many
examples of such interventions exist, says IPN:
- Taxes and tariffs of up to 55 percent on
imported medicines price people out of treatment, and costly registration
requirements restrict the approval of American, European and Japanese
medicines in most poor countries because manufacturers cannot justify the
investment in registration.
- Health insurance is hampered by government
regulations, so the poor are unable to obtain insurance and are only able
to pay for treatments if they have sufficient savings, or must rely on
charity or meager government healthcare provision.
- Price controls -- which proponents claim
benefit the poor -- actually reduce the availability of drugs, especially
in distant rural regions, by making it uneconomic for pharmacies to stock
them; even in relatively wealthy South Africa, price controls have led to
the closure of scores of rural pharmacies -- leaving thousands of poor
people without any access to medicines at all.
- Inadequate protection for intellectual property
in poor countries undermines incentives to invest in R&D for the
diseases of poverty by making it more difficult to recover costs.
Moreover,
low pay and poor conditions at government run hospitals and clinics mean that a
large number of trained medical professionals have immigrated to wealthier
countries with better healthcare systems, says IPN.
Furthermore,
governments in
To
read the original article, go to www.ncpa.org/newdpd/dpdarticle.php?article_id=3156.
Source:
Editorial, "Governments Restrict Access to Healthcare and Prevent Medicine
Development: major new report," International Policy Network,
For
text: www.policynetwork.net/main/press_release.php?pr_id=89
For
study text: www.policynetwork.net/uploaded/pdf/Civil_Society_text_web.pdf
For
more on Health: www.ncpa.org/iss/hea/
Governments are not the
solution to healthcare problems; governments decrease access, worsen quality,
and destroy personalized healthcare for purely fiscal reasons.
* * * * *
4. Medicare: The Long Arm of Government Medicine in
Big
Health In
A plan introduced this week
in the Massachusetts state legislature would impose tax penalties, expand
government-insurance programs and impose unfunded mandates to achieve universal
health coverage, says the Washington Times.
Although
Gov. Mitt Romney (R) had a dream of universal consumer-driven health care, this
bill isn't "consumer-driven" at all, says the Times. It relies on third-party
payers and employers and existing government-insurance programs. Furthermore:
- The plan would impose "fees" --
actually, giving up existing tax breaks -- in the amount of $295 (per
employee) for employers and $150 for individuals who fail to comply.
- Companies that employ insurance-less "free
riders" who run up big hospital bills must pay anywhere between 10
percent and 100 percent of bills over $50,000.
- These fees -- sure to make
people and employers take the law seriously -- will distort the state's
economy and do little or nothing to harness market forces, says the Times.
Equally
bad, it imposes an unfunded mandate. One health specialist speaking to the Wall
Street Journal predicted that the plan would require a subsidy of about $700
million -- about four times what the plan provides.
According
to Regina Herzlinger, a professor at the
- The plan will hurt businesses, especially small
ones; it will force employers to favor capital improvements over labor,
and compel outsourcing of jobs overseas.
- In
Source:
Editorial, "Big health in
For
text (subscription required): www.washingtontimes.com/op-ed/20060405-091810-8649r.htm
To
read more: www.ncpa.org/newdpd/dpdarticle.php?article_id=3151
Government
is not the solution to our problems, government is the problem.
- Ronald Reagan
* * * * *
5.
Medical Gluttony:
We Haven't Seen Anything Yet - Just Wait for P4P
According
to recent reports, Adults receive about half of recommended care:
54.9%
= Overall care
54.9%
= Preventive care
53.5%
= Acute care
56.1% = Chronic care
It looks like if everyone received the recommended care,
Payment for Performance (or Quality of Care) would double adult health care
costs in this country.
Are we really ready to accept a $3 trillion health care bill in this country? The rest of the world already thinks our $1.8 trillion is excessive.
How would it improve healthcare quality in a patient
with known cholesterol and triglycerides twice normal for the past three years,
to proceed with another lipid profile to determine LDL cholesterol when he has
no intention to change his diet or take statin drugs?
How would it improve healthcare quality in an elderly
noncompliant adult onset type II diabetic who has never been in ketosis, who
takes his medications sporadically, doesn't measure his glucose regularly, and
states he's not going to do so in the future, to obtain a glycohemoglobin when
all the previous year's determinations have been high?
How would it improve healthcare quality in an
80-year-old man with cancer of the prostate, who declined surgery, radiation
and hormonal therapy, to obtain another PSA when the last one was four times
normal and the previous one was five times normal?
How would it improve healthcare quality to obtain a
yearly pap smear on a 60-year-old virginal nun when the incidence of cancer of
the uterus approaches zero?
These are the type of grading systems that the Pay for
Performance (P4P) advocates are using to reduce payment to physicians.
What's wrong with just letting the physicians work
these things out with patients and their families so everyone gets the quality
and type of personalized healthcare that he or she desires? We've spent the
first 32 years of our lives getting the training for this challenge.
To read another perspective on what P4P really means
(payment for compliance or punishment for noncompliance) and how it trivializes
and corrupts the medical profession, please review Robert P Gervais, MD's,
article: Payment for Performance in Perspective, www.jpands.org/vol11no1/gervais.pdf. (With Bob being an ophthalmologist, please excuse
his calculations of physicians income by inadvertently adding three zeros.)
* * * * *
6.
Medical Myths:
Everyone Should Retire at Age 65?
A fixed retirement age rejects a young
spirit and old skill By
John Browne, Published:
Several decades ago, Michael Young [the British thinker and social
entrepreneur] coined the term "chronologism" for society's tendency
to pigeon-hole people according to their physical age. He wrote about the
bureaucratisation of age which ignores ability and choice, and creates a linear
process driven by the ticking of the clock.
I want to approach the same subject from a different perspective -
that of a businessman running an international company that is based in
When first Bismarck in
The nature of the economy has also changed. More than 70 per cent
of the European economy is now based on services rather than manufacturing.
Many of the jobs in both private and public services are based on knowledge
gathered through experience. How can we afford to say to someone, just
because they have reached 60 or 65: "You are too old to make a
contribution any more"?
In the
These are the practical, economic reasons why we need to rethink
the idea of a rigid age of retirement. But there is another reason: the need
for a civilised society to overcome prejudice. Slowly and imperfectly we have
stopped judging people simply on the basis of their gender, religion or skin colour.
As with many forms of prejudice, attitudes to age run very deep. And they are
reinforced by a culture in which the word "young" is synonymous with
vitality and the future, and "old" is synonymous with the past - the
slow and the failed . . .
Business cannot change social attitudes alone but we can show what
can be done. The key must be flexibility. People should have the chance to stay
on, either on a full-time basis or, where practicable, to work part time,
combining paid income with some income from their pension. They should be able
to phase out of work or to change their role, becoming advisers rather than
managers, for instance . . .
Lord Browne of Madingley is group chief executive of BP; this is an
edited extract of his Young Foundation lecture "Beyond Retirement",
delivered yesterday in
To read the entire edited extract, please go to (Subscription
required) http://news.ft.com/cms/s/1801db4e-c598-11da-b675-0000779e2340.html.
Medical Truth: Retirement Age Should Be Flexible and Consistent
with Mental and Physical Capabilities
* * * * *
7.
Overheard in the Medical
Staff Lounge: Has the Geography of the Female Chest Changed?
Last week, after I went through the buffet line in the
medical staff lounge, I joined a table with a cardiologist, radiation
oncologist, and plastic surgeon. The cardiologist was pointing out some of the
modern challenges in obtaining routine electrocardiograms and echocardiograms
in an increasing number of women - especially in the age group in which cardiac
disease begins to occur. Technicians can easily map out the chest of women in the
sixth and seventh decade of life. This is when they begin to have heart disease
that plagues men a decade earlier. The breasts are beginning to atrophy and are
freely mobile so that ECG leads and ultrasound sensors can be placed with great
accuracy. With more women having implants, the accuracy of lead placement is
more elusive as saline water bags raised an atrophic breast into the adolescent
conical shape.
The radiation oncologist mentioned that they had a
couple of patients with lung cancer receiving radiation therapy to the hilum of
the lung. The radiation oncologist places black marks on the chest to either
side of the sternum to delineate the radiation field, on which the radiation
technician can focus the cancer-killing beam with great accuracy. These black
marks stay on for the entire multi-month treatment period and can't be washed
off. The oncologists also normally deal with elderly women, the age when lung
cancer normally occurs, with atrophic breasts that could be easily moved so
that these indelible marks were placed directly on the chest wall. He's had two
female patients with lung cancer where it was difficult to accurately place the
radiation field. In fact, now that he had a chance to think about it, he began
to wonder if the delivered dose of radiation might be diminished enough going
through a water interface so that the calculated lethal dose did not reach the
cancer and thus there might be a greater recurrence rate.
The plastic surgeon was asked if the size of the
saline water bags inserted was getting larger in recent years. He had the
impression that the usual size of the implants (240 to 300 cc or the equivalent
of an eight to 10 ounce water glass) was indeed increasing as seen on the
breast implant website www.breastimplants411.com/ba_photos.htm, which shows the before and after photos with the
size of the implant listed. There now
are more women opting for the 360 cc to more than 600 cc (12 to 20 ounces)
implants. He said that he was still using the eight-ounce to ten-ounce implants
most frequently, these being the type that the more mature women would want.
As the chest physician at the table, I remarked that
it has had little effect on our practice, although I've seen physicians in the
chest conference setting who missed the double contour breast shadow and were
criticized by the chief for not reading a CXR thoroughly.
Looking around as to who was listening in on our lunch
table talk, a family doctor at the next table looked surprised and said,
"Gosh with two to three pounds of water weight outside of the center of
gravity on these women, maybe that's why some of my patients seem to be running
after their center of gravity, much like a Parkinson's patient. Has anybody assessed
the risk of falling and broken hips in such patients?"
Another doctor who always feels that the government is
the answer to all medical challenges stated that he would alert his congressman
to get a law passed. What kind of law? He didn't know, but he did know that
there should be a law.
On discussing this with my
Socialized Medicine Gets Right to the Source of the
Problem in a Hurry, Doesn't It!
But then again, the NHS may
not be entirely successful. This week, I had a 68-year-old lady who, while I
was bringing her annual medical history up-to-date, remarked that the only
medical occurrence in the previous year was that she finally had her
"breast lift." She had wanted one since age 22 after her second child
when the hormonal surge after her first child was flattening out. She was happy
that she could finally afford to have this done even after a 46-year wait. The
result was not apparent on examination in the recumbent position except for
retracting scars. But then she had no intimate relationship going and didn't
think she ever would again. The result was apparently for her own self-image
and the public in full attire.
Looks Like Some Patients
Could Out Wait Socialized Medicine, Should Such a Catastrophe Occur.
* * * * *
8.
Voices of
Medicine: From Local and Regional Medical Journals
Current
Books: Sonoma Sonoma
County
Sex, Time, and Power: How
Women's Sexuality Shaped Human Evolution,
by Leonard Shlain, MD
Is That All There Is? A review by
Allen Gruber, MD
Dr.
Leonard Shlain, a
Shlain takes a middle ground. Although Sex, Time, and Power is not a
scientific work, Shlain does bring the benefits of scientific training and
rigorous analysis when formulating his hypotheses and conclusions. His book is
encyclopedic in its development of a theory of human sexual adaptations as
predecessors to certain traits that set us apart from all other species. In his
effort to understand archaic processes that cannot be tested by controlled
scientific investigation, Shlain integrates diverse fields of knowledge,
including anthropology, linguistics, paleobiology, evolutionary theory,
ethology, archaeology, anatomy, physiology, and medicine. By doing so, he
creates an impressive (but not unassailable) set of explanations for
understanding the bio-psycho-social constructs that are male and female human
beings.
Shlain's analysis has one unifying methodology. All the evidence and rationales
that he brings to the plate are tested against the known rules of natural
selection. He makes genuine and intellectually honest efforts to ground his
logic in this genetic winnowing process, although some readers may take him to
task for stretching concepts at crucial points and for a sprinkling of factual
errors and a few instances of perspective bias.
Throughout the book, Shlain uses evolutionary principles to
explain misogyny and patriarchy, bipedalism, menstruation, linear time-sense,
foresight, iron-deficiency anemia, rampant encephalization, the bio-selective
perils of childbirth, sexual power imbalances, pornography, the social
evolution of crones, and the helpless neoteny of human infants. He dubs the
primordial female and her descendents Gyna sapiens both to underscore how close
the human sexes are to being different subspecies and to honor females' crucial
evolutionary role in developing the unique and powerful traits that make the
human species so dominant . . .
According to Shlain, women developed the potential for
continuous sexual receptivity and, in the interest of self-preservation,
simultaneously evolved the ability to remain sexually unavailable unless men
met certain requirements. Central to these was the need for continuous dietary
iron replenishment and for protection and support during pregnancy and
child-rearing. Thus was born women's power to say "No!" to sex and,
with it, the birth of a continuous tension between the sexes that continues to
the present.
One of Shlain's most important insights is that human females spend the bulk of
their lives slowly bleeding to death. With a few minor exceptions, this is a
uniquely human trait and, in Shlain's view, must have an evolutionary purpose.
From all causes combined, the proclivity of human females to lose blood runs
into the impressive total of 15 gallons of iron-rich fluid during the course of
a woman's reproductive years. Shlain exhaustively details the many routes of
female iron loss. Leading the list in terms of short-term loss are labor,
delivery, and the hemoglobin content of the placenta. (The human female is
thought to be the only mammal that does not routinely eat the placenta
following labor.) The bulk of female blood loss, however, occurs during
menstruation: typically 10 gallons of iron-rich blood through the completion of
menopause . . .
Shlain is impressively erudite when he expounds upon subjects
that fall within his expertise as a physician, and he is an excellent
storyteller. Having directed his book primarily to an educated lay audience,
and having blithely admitted to his lack of credentials in many of the fields
he draws from (evolutionary biology, anthropology, ethology, sociology), he
goes to frequently overlong length in explaining phenomena familiar to
physicians. For this reason, doctors may find much of his book somewhat tedious
in its basic medical detail, even though those details are important in the
building of Shlain's arguments.
An Internet search reveals many reviews of Sex, Time and Power. A
preponderance of the reviewers are female, often with a feminist orientation.
Their reception of Shlain's book is clearly divided. Some critiques are of the
damned-both-ways variety, in which Shlain's condemnation of misogyny is viewed
as "condescending" while his elevation of females' key role in human
evolution is labeled as "demeaning" and "baseless flattery that
[he] uses to worm into the good graces of his female audience." Others
comment with delight or dismay that the book has been incorporated into many
women's studies courses. One reviewer writes that Shlain represents a threat to
feminist progress in that "while patting women on the head, he employs the
facade of empowering language to codify women's oppression as natural,
inevitable, and, most of all, a product of our very efforts to exert control
over our sexuality."
My own reading is that Shlain has done as good a job as possible to present an
encyclopedic and thoughtful treatise on the evolutionary sociobiology of
humankind . . .
For all its good points, I have to confess to experiencing some negative
feelings from Shlain's book, mainly from the repeated subtextual message that
humans are the product of an oppressively mechanical evolutionary process.
While I can intellectually accept the evolutionary mechanisms that promote
species adaptation, reproduction, and survival, it can be horrifying to
contemplate how little the individual person amounts to in all of this. As
individual men and women, we are left with biologically programmed
sexual-emotional needs that are not especially "user-friendly" in
terms of inter-sex compatibility or individual fulfillment. Having the sexual
evolutionary process meticulously explained runs the risk of arriving at a
cynical and mechanistic view of male-female relations. It is dispiriting to
contemplate that, at the level of the lone individual, our sexuality is
basically an elaborate system of bartering meat (or the modern equivalent of
meat) for sex. The cultural and emotional part of me feels there has to be more
to male-female relations than that. Perhaps Dr. Shlain should be challenged to
take up this thread as the nucleus of his next book.
Dr. Gruber, an
anesthesiologist and pain medicine specialist, serves on the SCMA Editorial
Board. To read the entire review, go to www.scma.org/magazine/scp/wn06/gruber.html.
* * * * *
9.
Book/Cinematic Op-Ed Review: "Tsotsi"
Is Free Will
Possible Even in Cycle of Global Gang Violence? By James J
Murtagh, M.D.
Warning: movie
spoiler alert. If you have not seen "Tsotsi", consider seeing the
film before reading further.
[Note: James
Murtagh has spent 20 years as an Intensive Care Unit physician at a major
Southeast hospital.]
At first, the
South African film "Tsotsi", looks like a re-shoot of the Brazilian
masterpiece, the "City of
But then I realized. "Tsotsi" is the answer to all of these films,
not the extension.
Tsotsi, like "City of
Except in "Tsotsi," where the bath of blood is stopped, and the
gangland leader reforms, transformed by the innocence of a child. The hardened
criminal surrenders himself, arms spread wide and high, as if he were forming a
kind of cross, tears of remorse and redemption streaming down his cheeks. The
power of the heart and his empathy for a helpless child reformed even one of
the most hardened killers in film history.
Free will entering into an International gangland story is shocking and exhilarating.
In all other mobster movie in memory, the Killers, Godfathers and Macbeths were
pawns of fate. Fate tricks each gangster-leader into believing he
is supremely powerful and wise, an Uberman above the laws of good or evil,
the Master of the Universe, holding all power and all the puppet strings. But
ultimately, each realized he was deluded. In fact, each supposed villain puppet
master was in fact himself only a puppet, dangling ironically on the strings of
the corrupt violent system. Those that lived by the gun die by the gun, and
those who put heads on pikes end up with their own head on a pike.
Macbeth and Brutus showed how conditions turn good men into villains, as surely
as fate turned Darth Vader from the good side to the evil side of the force.
But for the grace of God, in the theme of these stories, any of us could be
born or made into killing machines.
Vito Corleone's criminal fate appeared sealed as he stepped as an orphan
refugee child, into the shadow of the statute of liberty, stripped of his
name, and thrown friendless into quarantine. Later, fate made his son Michael
reluctantly into the next criminal genius. Neither father or son apologized, as
crime appeared as the least bad choice option. Even the police were conniving
with rival gangs to finish both Corleones off. Who could the Corleones have
turned to, even if they wanted to go straight? Not the police. Not the media.
Not the church.
"The woman made me do it," was Adam's excuse. "The serpent made
me do it" Eve replied. "I am not my brother's keeper," Cain
continued. "The weird sisters made me," continued Macbeth. Venus
"forced"
But Tsotsi breaks this mold. Beginning as a killer more heartless than Luca Brasi, Tsotsi discovers his heart is bigger than violence.
Unlike any other mob movie character, (possible excepting Samuel Jackson's
"Pulp Fiction" character), Tsotsi actually breaks through his
environment, and takes responsibility, to find redemption. To read the entire
review, please go to www.delmeyer.net/JM_TsotsiReview.htm.
To read other
movie reviews, go to www.delmeyer.net/CinematicOpEdReviews.htm.
James J. Murtagh
Jr.,
* * * * *
10. Hippocrates & His Kin: A
Scheme to Kill Off 5.8 Billion Humans
A
popular professor at the
Pianka
was named the 2006 Distinguished Texas Scientist by the Texas Academy of
Science. He is a specialist in herpetology and evolutionary ecology.
"The
Earth's population is growing," he said. "We will see a point when we
reach the carrying capacity--there aren't enough resources." He thinks the
current 6.5 billion human beings are too many, and 0.7 billion would be about
the right number. Human life, he thinks, is no more valuable than other life,
such as lizards or bison.
Pianka
tells his student audiences, cheerfully, that each one of them will get to bury
nine others. "This is really an exciting time."
The
prime candidate for achieving this massive genocide is the Ebola virus, as soon
as it evolves the capacity for airborne transmission, states Pianka. . . .
"The biggest enemy we face is
anthropocentrism," he said, describing the belief system in which humans
are the central element of the universe. "This is that common attitude
that everything on this Earth was put here for [human] use."
To Pianka, a human life is no more
valuable than any other -- a lizard, a bison, a rhino.
To read the entire article, and the
professors who disagree, please go to (Jamie
Mobley, Seguin Gazette 4/2/06).
To
read more, go to www.aapsonline.org/nod/newsofday280.php.
Was
Hitler's Holocaust Just A Warm Up Maneuver To The Real One?
Managed Care Organizations Treating Physicians as
School Kids
The Managed Care Organization (MCO) requested a review
of 44 charts and substantiation that LDL, Glycohemoglobin, Mammograms and PSAs
were done on the selected patients to determine the next payment for quality,
which has now been re-invented as performance. Since these were rather detailed
reviews, contingent on several factors, they required about as much time as an
office call. Hence, after the office closed, this required the equivalent time
of 44 short office visits or follow-ups. Many were repeats from the previous
year that had declined to obtain the requested lab or procedure. This, of
course, required making copies of the documentation that the patient had been
requested to obtain the test. If a test was obtained, the measure of distrust
for physicians in the 21st century was seen in that the results of
the test had to be forwarded to the MCO. The fact that the physician was going
to be held strictly accountable was seen on the envelope and in the cover
letter to the forms to be completed addressed that it was confidential to the
physician and not his staff.
The
Revolt Of Managed Care Is Eminent
[Please note: When MCO or
HMO are used in MedicalTuesday, we are referring to the For Profit HMOs and
MCOs, and not to Kaiser or The Permanente Medical Group, which are a unique and
totally integrative health care system.]
* * * * *
11. Restoring Accountability in HealthCare, Government and
Society: