MEDICAL TUESDAY . NET
Community For Better HealthCare
Vol V, No 2,
In This Issue:
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
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
To read the entire article (subscription required), go to http://online.wsj.com/article_print/SB114187355219993355.html
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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
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 firstname.lastname@example.org.
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3. International Medicine: Private Health Insurance in Developing Countries
Daily Policy Digest: HEALTH
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:
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:
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
Restrict Access to Health Care (NCPA Daily Policy
50 percent of people in parts of
Many examples of such interventions exist, says IPN:
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.
To read the original article, go to www.ncpa.org/newdpd/dpdarticle.php?article_id=3156.
Editorial, "Governments Restrict Access to Healthcare and Prevent Medicine
Development: major new report," International Policy Network,
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.
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4. Medicare: The Long Arm of Government Medicine 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:
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.
to Regina Herzlinger, a professor at the
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
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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.)
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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"?
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
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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.
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Sex, Time, and Power: How Women's Sexuality Shaped Human Evolution, by Leonard Shlain, MD
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.
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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
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
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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.
[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.]
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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. For their article, "Are you really insured?," go to www.healthplanusa.net/AE-AreYouReallyInsured.htm. "On March 3, 2006, we got word that the Prime Minister of Antigua and Barbuda has signed our letter giving us 90 days to come up with the means to utilize their brand new 200+ bed hospital. He has indicated that he recognizes our compassionate and comprehensive approach to health care and our desire to see the healthcare of the people of Antigua & Barbuda enhance in the process. Our mission will be to bring uninsured people to the island for high quality, low cost surgery utilizing US physicians who are willing to live there for travel there for 2-4 weeks stays. Physicians will be paid a fair price for their services, and enjoy a beautiful resort environment at the same time." You may want to start planning to take a month each year to practice in this resort environment, or even buy a medical timeshare. Their medical board includes John and Alieta Eck, MDs. To read the rest of the proposal, please go to www.zhcenter.org/custom.asp?id=188800&page=3.
PRIVATE NEUROLOGY is a Third-Party-Free Practice in
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" at www.northernurology.com/articles/healthcarereform/administrativectomy.html.
Dr Vern Cherewatenko concerning success in restoring private-based medical practice which has grown internationally through the SimpleCare model network. Dr Vern calls his practice PIFATOS - Pay In Full At Time Of Service, the "Cash-Based Revolution." The patient pays in full before leaving. Because doctor charges are anywhere from 2550 percent inflated due to administrative costs caused by the health insurance industry, you'll be paying drastically reduced rates for your medical expenses. In conjunction with a regular catastrophic health insurance policy to cover extremely costly procedures, PIFATOS can save the average healthy adult and/or family up to $5000/year! To read the rest of the story, go to www.simplecare.com.
Dr David MacDonald started Liberty Health Group. To compare the
traditional health insurance model with the
Madeleine Pelner Cosman, JD, PhD, Esq, who has made important efforts in restoring accountability in health care, has died (1937-2006). Her obituary is at www.signonsandiego.com/news/obituaries/20060311-9999-1m11cosman.html. She will be remembered for her important work, Who Owns Your Body, which is reviewed at www.delmeyer.net/bkrev_WhoOwnsYourBody.htm. Please go to www.healthplanusa.net/MPCosman.htm to view some of her articles that highlight the government's efforts in criminalizing medicine. For other OpEd articles that are important to the practice of medicine and health care in general, click on her name at www.healthcarecom.net/OpEd.htm.
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. To read his latest article on When the Public Loses Confidence in Physicians, go to www.ssvms.org/articles/0601gibson.asp.
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, who 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.
Society International, Verner S. Waite MD, FACS, Founder; Henry Butler MD,
FACS, President; Ralph Bard MD, JD, Vice President; W. Hinnant MD, JD,
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
To attend the annual meeting of the Semmelweis Society in Washington, DC, May 7-9, 2006, go to www.semmelweissociety.net/ and click on May Meeting. To read the entire agenda on Where is it Safe to Practice, go to www.semmelweis.org/meeting agenda 2006.pdf.
Dennis Gabos, MD, President of the Society for the Education of Physicians and Patients (SEPP), is making efforts in Protecting, Preserving, and Promoting the Rights, Freedoms and Responsibilities of Patients and Health Care Professionals. For more information, go to www.sepp.net.
Robert J Cihak, MD, former president of the AAPS, and Michael Arnold Glueck, M.D,
write an informative Medicine Men column at NewsMax. Please log on to
review the last five weeks' topics or click on archives to see the last two
years' topics at www.newsmax.com/pundits/Medicine_Men.shtml.
This week the Medicine Men discuss: For
all the talking about "the uninsured" and "access to health
Association of American Physicians & Surgeons, 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. Please go to www.AAPSonline.org to see the latest news release and action alerts. Be sure
to scroll down on the left to departments and click on News of the Day to
review the latest topics. The "AAPS News," written by Jane
Orient, MD, and archived on this site www.aapsonline.org/news.htm,
provides valuable information on a monthly basis. Scroll further to the
official organ, the Journal of American Physicians and Surgeons, www.jpands.org/, with Larry Huntoon, MD, PhD,
a neurologist in
the 63d Annual Meeting of the AAPS, in
* * * * *
Stay Tuned to the MedicalTuesday.Network and Have Your Friends Do the Same.
Please note: Articles that appear in MedicalTuesday may not reflect the opinion of the editorial staff.
ALSO NOTE: MedicalTuesday receives no government, foundation or private funds. The entire cost of the website URLs, website posting, distribution, managing editor, email editor, and the twenty hours per week of writing is solely paid for and donated by the Founding Editor, while continuing his Pulmonary Practice, as a service to his patients, his profession and in the public interest for his country.
Del Meyer, MD, Editor & Founder
Words of Wisdom
Albert Einstein: Not everything that can be counted counts and not everything that counts can be counted. (How did Einstein know we would be battling P4P?)
Earl Nightingale: Creativity is a natural extension of our enthusiasm.
Edward Langley, Artist 1928-1995: What this country needs are more unemployed politicians.
Some Recent Postings
HealthPlanUSA Quarterly for January 2006: www.healthplanusa.net/January06.htm
HealthPlanUSA Quarterly for April 2006: www.healthplanusa.net/April06.htm
OpEd/Cinematic Reviews: www.delmeyer.net/CinematicOpEdReviews.htm
Medicare Reform: Pharmacy Benefit Program - What Must be Done - A Clinician's Point of View: www.delmeyer.net/hmc2005.htm
Michael Joyce: The architect. A conservative every Democrat should study carefully.
JOYCE, who died on February 24th at age 63, was hardly a household name, unless
you happen to be called Kristol or Podhoretz. The New York Times has not
yet even bothered to accord him an obituary. Yet, Mr Joyce was one of the
leading architects of the conservative renaissance that reshaped
A blue-collar Catholic Democrat by background, Mr Joyce more or less invented a new industry: conservative intellectual philanthropy. He ran two of the right's biggest treasure troves -- the John Olin Foundation (1979-85) and the Lynde and Harry Bradley Foundation (1985-2001) -- and dispensed millions to conservative thinkers.
To read the entire obituary, please go to www.economist.com/research/articlesBySubject/displayStory.cfm?story_id=5578832&subjectid=348996.
On This Date in History April 25
On this date in 1864, Guglielmo Marconi,
the father of wireless radio, which revolutionized worldwide communications,
was born in
On this date in 1945, The
Also on this date in 1945, a group of
international dignitaries met in
At this magical moment in history, the east and west joined forces on two separate fronts, despite the language barrier.
Today is Tax Freedom Day. So far this year, every dollar youve
earned has gone for taxes and today you start working for yourself. In