|
MEDICAL TUESDAY . NET |
NEWSLETTER |
|
Community For Better Health Care |
Vol IX, No 10,
Aug 24, 2010 |
In This Issue:
1.
Featured Article:
Hereditary Acquisitions
2.
In
the News: German Hospitals
Can Ill Afford End to Draft
3.
International Medicine: A case study in the "fatal conceit" of
central planning
4.
Medicare: How painful will reform have to be?
5.
Medical Gluttony:
Excessive health care spending is frequently caused by family members.
6.
Medical Myths:
Illegal Aliens not covered? Wanna Bet?
7.
Overheard in the Medical Staff Lounge: Electronic Medical Records
8.
Voices
of Medicine: Physician
Invictus
9.
The Bookshelf:
Physicians almost persuaded again that Socialized Medicine is inevitable
10.
Hippocrates
& His Kin: More
people without life insurance than without health insurance
11.
Related Organizations: Restoring Accountability in Medical Practice and Society
Words of Wisdom,
Recent Postings, In Memoriam . . .
* * * * *
MOVIE BLASTS OBAMACARE, DOCTORS
NEEDED TO SCREEN LOCALLY
A new movie has Canadian doctors, patients, journalists and others
warning Americans about the final destination of ObamaCare. The producer, Logan
Darrow Clements hopes people will understand that ObamaCare isn't about
reforming health insurance but a complete government take-over of the medical
system. Clements is hoping doctors across American can help him screen
the movie through a revolutionary new distribution system whereby doctors can become
instant distributors. Read more . . .
For a flat fee of $500 they can buy a screening license and show the movie in
their community keeping all ticket revenues. The process is simple. A doctor
downloads a high resolution version the movie overnight onto their laptop
computer. They can then take their laptop anywhere and connect it to a
projector or purchase one at a local office supply store. Whenever possible the
producer plans to be available for question and answer sessions after screening
by phone or webcam. A personal version of the movie can be instantly
downloaded right now for only $4.95 at www.sickandsickermovie.com/.
Mr. Clements can be reached in Los Angeles through his production company
Freestar Movie, LLC at 310-795-2509.
* * * * *
1. Featured Article: Hereditary Acquisitions
Hereditary
Acquisitions; August 2010; Scientific
American Magazine; by JR Minkel
One of the primary goals of genetics over the past
decade has been to understand human health and disease in terms of differences
in DNA from person to person. But even a relatively straightforward trait such
as height has resisted attempts to reduce it to a particular combination of
genes. In light of this shortcoming, some investigators see room for an
increased focus on an alternative explanation for heritable traits:
epigenetics, the molecular processes that control a gene's potential to act.
Evidence now suggests that epigenetics can lead to inherited forms of obesity
and cancer.
The best-studied form of epigenetic regulation is
methylation, the addition of clusters of atoms made of carbon and hydrogen
(methyl groups) to DNA. Depending on where they are placed, methyl groups
direct the cell to ignore any genes present in a stretch of DNA. During
embryonic development, undifferentiated stem cells accumulate methyl groups and
other epigenetic marks that funnel them into one of the three germ layers, each
of which gives rise to a different set of adult tissues. In 2008 the National
Institutes of Health launched the $190-million Roadmap Epigenomics Project with
the goal of cataloguing the epigenetic marks in the major human cell types and
tissues. The first results could come out later this year and confirm that
different laboratories can get the same results from the same cells, says
Arthur L. Beaudet of the Baylor College of Medicine, the project's data hub.
"One couldn't automatically assume it would be so nice," he says.
Up to this
point, the best way to study epigenetic effects has been a strain of mice known
as agouti viable yellow. In these mice, a retrotransposon—a bit of mobile DNA—has inserted itself in a gene that controls
fur color. Mice bearing the identical gene can be yellow or brown depending on
the number of methyl groups along the retrotransposon. Such methylation marks
would normally be erased in the reproductive cells of an animal. But in 1999 a
group led by geneticists at the University of Sydney in Australia discovered
that methylation of the fur color genes persists in the female germ line,
allowing it to be passed down to offspring like a change in the DNA.
Agouti viable yellow mice might have
something to say about the human obesity epidemic. The animals have a tendency
to overeat and become obese. In 2008 Robert A. Waterland, also at Baylor,
discovered that this trait gets passed down and amplified from one generation
of agouti to the next, so that "fatter mothers have fatter
offspring," he says. He is investigating whether the effect can be
explained in terms of methylation patterns in the hypothalamus, the part of
the brain that regulates appetite.
Retrotransposons could lead to other
epigenetic effects. In the early 2000s geneticist David Martin of Children's
Hospital Oakland Research Institute in California reasoned that the silencing
mechanism that keeps retrotransposons inactive might randomly shut down genes
that are supposed to be left on. If the silencing occurred in a gene
responsible for suppressing tumor formation, the result would appear the same
as genetic mutations that predispose people to cancer.
To read more about
this innovative research in Scientific American . . . (Subscription required)
Feedback
. . .
Subscribe MedicalTuesday .
. .
Subscribe HealthPlanUSA .
. .
* * * * *
2. In the News: German Hospitals Can Ill Afford End to
Draft – WSJ – 7-19-10
Public-Service
Providers rely on Conscientious Objectors' work say conscription would hurt
programs.
A proposal in Germany to abolish compulsory military
service is drawing major opposition from unlikely quarters—the thousands of
hospitals and other public-service providers where most young German men end up
fulfilling their draft duties.
Germany is one of the last European countries with a
draft, which many of its neighbors have abandoned since the end of the Cold
War. But amid pressure to cut defense spending and modernize German's armed
forces, Defense Minister Karl Theodor zu Guttenberg has amplified a
longstanding debate about military conscription by calling for it to be
scrapped. . .
Increasingly, though, conscription's main impact has
little to do with military training at all> As attitudes toward mandatory
service have changed over the decades, the draft's biggest beneficiaries have
become Germany's hospitals, nursing homes and other social programs, where for
the past 20 years more than half of draftees have opted to carry out
alternative, nonmilitary service.
Abolishing the draft would leave a large hole in
Germany's public services. More than 150,000 men out of 226,000 deemed fit to
serve in 2009 filed as conscious objectors, slating them for civilian-servant
jobs. . . .
Losing the
steady flow of civilian servants would be the latest blow to Germany's
health-care system, beleaguered by the spiraling cost of caring for an aging
population. Earlier this month, Chancellor Angela Merkel's government announced
further increases in premiums and cuts in medical spending to help plug an €11
billion ($14 billion) deficit in the country's public health-insurance system
next year. . .
Feedback
. . .
Subscribe MedicalTuesday .
. .
Subscribe HealthPlanUSA .
. .
* * * * *
3. International Medicine: eHealth Ontario: A case study in the
"fatal conceit" of central planning, by Brett J. Skinner
Ontario's
health minister recently resigned due to a public spending scandal revealed by
the provincial Auditor General. The incident raises serious political concerns
about the corruption of government procurement processes. It also provides an
opportunity for Canadians to discuss one of the many economic pitfalls
associated with government-run health care: the futility of central planning.
The details of
the scandal are found in the Auditor's report (Auditor General of Ontario,
2009), which charges that since 2003 more than a billion dollars in public
spending has been wasted on eHealth Ontario and its predecessor, Smart Systems
for Health Agency. Both agencies of the Ministry of Health were responsible for
developing centralized electronic medical records for the province's Medicare
system, but have failed to produce anything useful for the money spent.
Yet, on a more fundamental
level, the failure of eHealth Ontario is beside the point. Even if eHealth had
successfully delivered a working health information system, the basic economic
premise of the project was wrong from the beginning.
Spontaneous market order in health care
The
establishment of a government-controlled health information system was
justified on the grounds that it would save the province money by giving
authorities the information they need to improve the efficiency of the health care system. The eHealth project was
based implicitly on the belief that, with enough information, government
bureaucrats could manage the allocation of medical care better than market
forces, and that this would reduce public health expenditures.
But Nobel
Prize-winning economist Frederic Hayek would have characterized the implied
rationale for the creation of eHealth as the "fatal conceit" of
central planning. Hayek (1945) showed
that central planners cannot possibly satisfy all of the individual needs and
preferences of consumers (or patients) as efficiently as the market. The
allocation of resources in a market is spontaneously ordered by countless
individual choices. These choices are determined by needs and preferences that
are unique to individuals and informed by various bits of information. It is absurd (and, in Hayek's view, somewhat
arrogant) to believe that a single person, or even a group of experts, could
set prices or determine the supply of goods and services and their allocation
to individuals better than the spontaneous ordering of the market. Even if
theoretically possible, the practical cost and technical barriers to obtaining
the information necessary to allow central planners to be as efficient as the
market would vastly outweigh the benefits.
Yet, with
eHealth, Ontario was spending vast sums of taxpayers' money on an information
system designed, essentially, to make central planning more efficient. This is
a wasteful, unnecessary, and ultimately futile exercise because the market does
a better job of allocating resources, without a centralized information system
and the enormous additional cost to taxpayers.
Of course,
information technology has the potential to make the delivery of health care goods
and services more efficient. But as with other sectors of the economy,
market-driven adoption of technology is a more efficient approach to allocation
than centralized government planning. In a market, the value of information
technology would be apparent from its reputation for reducing costs and
improving quality, and its allocation within the health care system would be
determined by cost-benefit choices about its value among medical providers.
If Ontario
wants to make its health care system more efficient, all that is needed is the
dispersion of information in the form of market-based price signals, and
market-based competition for the delivery of medical goods and services.
For example,
Ontario could simply expose consumers to prices for their personal use of
publicly insured health care. If governments reimbursed patients directly for
only 75% of the cost of the health care they consumed, then there simply
wouldn't be any need for centrally planned allocation. The 25% out-of-pocket
co-payment would act as a price signal that would give consumers (following the
expert advice of their physicians) the information needed to make appropriate
use and substitution choices on their own. Structuring copayments as a
percentage of the cost of consuming medical goods and services effectively
creates a price that is proportional and directly relative to the total cost.
For non-emergency treatment decisions, even a small price gives patients the
economic incentive to weigh the value of medical treatment against alternative
uses of their money, and consider the relative value of various types of
treatments. . .
[This
is an excellent rationale of why Medicare became insolvent in the United
States.]
Download
the rest of this article from the Frasier Institute . . .
Feedback
. . .
Subscribe MedicalTuesday . . .
Subscribe HealthPlanUSA . . .
Health
care may be awakening to market forces one country at a time.
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
* * * * *
4. Medicare: How painful will reform have to be?
The most important
domestic policy problem this country faces is health care. The most important
component of that problem is Medicare. Forecasts by every federal agency that
produces such simulations - the Congressional Budget Office (CBO), the Social
Security/Medicare Trustees, the General Accounting Office (GAO) - show that we
are on a dangerous and unsustainable path. Indeed, the question is not: Will
reform take place? The question is: How painful will reform have to be?
by John C. Goodman, Ph.D, President, NCPA
Health care is the most
serious domestic policy problem we have, and Medicare is the most important
component of that problem. Every federal agency that has examined the issue has
affirmed that we are on a dangerous, unsustainable spending path:
·
According to
the Medicare Trustees, by 2012 the deficits in Social Security and Medicare will
require one out of every 10 income tax dollars.
·
They will
claim one in every four general revenue dollars by 2020 and almost one in two
by 2030.
·
Of the two
programs, Medicare is by far the most burdensome — with an unfunded liability
five times that of Social Security.
Nor is this forecast the worst
that can happen:
·
The
Congressional Budget Office notes that health care costs overall have been
rising for many years at twice the rate of growth of our incomes.
·
On the
current path, health care spending (mainly Medicare and Medicaid) will crowd
out every other activity of the federal government by midcentury.
There are three underlying
reasons for this dilemma:
·
Since
Medicare beneficiaries are participating in a use-it-or-lose-it system,
patients can realize benefits only by consuming more care; they receive no
personal benefit from consuming care prudently and they bear no personal cost
if they are wasteful.
·
Since
Medicare providers are trapped in a system in which they are paid predetermined
fees for prescribed tasks, they have no financial incentives to improve
outcomes, and physicians often receive less take-home pay if they provide
low-cost, high-quality care.
Since Medicare is funded on a
pay-as-you-go basis, many of today's taxpayers are not saving and investing to
fund their own post-retirement care; thus, today's young workers will receive
benefits only if future workers are willing to pay exorbitantly high tax rates.
. .
To address these three defects in the
current system, we propose three fundamental Medicare reforms . . .
With
assistance from Andrew J. Rettenmaier, an NCPA senior fellow, we have been able
to simulate the long-term impact of some of these reforms. The bottom line:
Under reasonable assumptions, we can reach the mid-21st century with seniors
paying no more (as a share of the cost of the program) than the premiums they
pay today and with a taxpayer burden (relative to national income) no greater
than the burden today. Along the way, the structure of Medicare financing will be
totally transformed:
·
Whereas
today, 86 percent of all Medicare spending is funded
through taxes, by 2080, taxes will be needed for only one out of every four
dollars of spending.
Whereas there is no prefunding of Medicare
today, 60 percent of all Medicare spending will eventually be funded through
savings generated by beneficiaries during their working years.
In terms of the
impact of Medicare on the economy as a whole:
·
With no
reform, the size of the Medicare program will more than
triple (relative to national income) over the next 75 years.
·
With
reform, Medicare will take no more of national income
than it does today.
Read the
entire policy report 315 . . .
Feedback
. . .
Subscribe MedicalTuesday .
. .
Subscribe HealthPlanUSA .
. .
Government is not the solution to our problems, government is
the problem.
- Ronald Reagan
* * * * *
5. Medical Gluttony: Excessive health care spending is
frequently caused by family members.
We received a call from the wife of a long
time patient. She stated that her husband had injured his elbow and she was
sending him. She wanted to alert us ahead of time so that we could obtain an
MRI and Orthopedic Consult with all dispatch. It always is somewhat amusing how
a lay person can chart the entire diagnostic program and demand it being
accomplished without so much as input from the physician who is the only one
that can authorize the risk and expense.
When he came in, he had a fluid filled
bursa over his left elbow for about two weeks. He had already been to the
hospital emergency room ten days earlier where it was drained and he was given
a Rocephin (Ceftriaxone)
injection and placed on Cephalexin for ten days. Since there was
no trauma, the ER physician did not do an x-ray. It was improving but the fluid
returned after about a week when his wife got very excited and demanding of
consults and MRIs.
Since it was painless, it did not
interfere with his activities or work, he decline further drainage and agreed
no x-ray was indicated and certainly no MRI. Neither would he consider seeing
an orthopedist for this. Since there were some residuals of the cellulitis, the
Cephalexin was continued for another week.
Then the question came up about his
anxious wife. Since, neither he nor I wanted to face a very irate wife, we
agreed that an x-ray may be of some therapeutic benefit, if not to him,
certainly to his wife. Since he had returned to smoking cigarettes at two packs
per day, this was also an excellent way of obtaining a Chest X-ray, which he
otherwise would not be inclined to do. As an entrepreneur he was much too busy.
Neither could he ever imagine being sick with cancer - even though he had lost
his first wife two years earlier to a five-year ovarian cancer struggle.
When seen a week later, the cellulitis was
resolved, the fluid filled bursa was smaller, the elbow had a normal bony
architecture, and the chest x-ray was clear of any suggestion of cancer.
Was this excessive testing? With all the
information in the media about CT of the chest is the best screening test.
However, this did allay the wife's concern before the more expensive CT was
demanded again.
Feedback
. . .
Subscribe MedicalTuesday .
. .
Subscribe HealthPlanUSA .
. .
Medical Gluttony thrives in Government and Health Insurance Programs.
Gluttony Disappears with Percentage Co-payments and Appropriate
Deductibles on Every Service.
* * * * *
6. Medical Myths: Illegal Aliens not covered? Wanna Bet?
Myth 28. Healthcare reform
bills will not cover illegal aliens.
The
growing number of "48 million uninsured" includes perhaps 15 million
illegal aliens (Phoenix Business Journal 7/22/09).
Obama's
statement that " the reforms I'm proposing would not apply to those who
are here illegally" elicited the notorious "You lie" outburst from Rep. Joe Wilson
(R-SC).
Currently
proposed legislation does not explicitly extend coverage to illegal aliens,
only to legal non-citizen residents. Of course, illegals could be made legal
through other legislation. Some say that amnesty is on the legislative agenda
immediately after "healthcare reform" and energy taxes ("cap and
trade"), writes James R. Edwards, Jr. (Center for Immigration studies 10/2/09).
All
four bills that had passed committees as of September would allow illegal
aliens to take part in Health Insurance Exchanges (Charles Krauthammer,
Ariz Daily Star 9/19/09) . . .
If all
uninsured illegal aliens with incomes below 400% of poverty accessed the
credits, it would cost federal taxpayers $30.5 billion annually. The current
cost to all levels of government for treating uninsured illegals is estimated
to be $4.3 billion, primarily at emergency rooms and free clinics (Newsmax.com
9/8/09). . .
Medicaid also
does not require identity verification for those claiming U.S. birth. Illegals
would also likely benefit from proposed expansion of eligibility to 133% of
poverty (ibid.).
Illegals might
not sign up for benefits, especially if it required filing a tax form. It is
not clear that the private sector, especially hospitals, would see any relief
from the enormous unfunded mandate (www.youtube.com/watch?v=bLJxmJZXgNI)
to treat indigent illegals not covered by government programs.
Additional information:
§
Congressional Research Service. Treatment of Noncitizens
in H.R. 3200, Aug 25, 2009.
Feedback
. . .
Subscribe MedicalTuesday .
. .
Subscribe HealthPlanUSA .
. .
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: Electronic Medical Records
Dr. Edwards: We had an excellent
presentation at the Independent Practice Association (IPA) last week. It really
explained the difference between an Actually Integrated system such as Kaiser
Permanente (KP) and the Virtually Integrated system like our IPA.
Dr. Milton: Wasn't that impressively
and professionally done?
Dr. Thomas: It was also enlightening
how it was understood that ObamaCare was simply the first step in moving toward
universal coverage.
Dr. Rosen: Yes, wasn't it smooth how
they never mentioned Socialized Medicine?
Dr. Milton: In the Liberal Left
instructions on how to win the war by taking over and implementing universal
health care, it mentions never using such words as Socialized Medicine, which
still has a negative connotation in the public eye.
Dr. Rosen: That just points out that
it really is not an "above the board" dialogue but an underhanded
subterfuge - a war, if you will, to hoodwink the public.
Dr. Milton: It should be obvious to any
clear-thinking, freedom-loving American that this is the system our
grandfathers left in Europe.
Dr. Edwards: Why would anyone want to go
back to an oppressive government, especially in matters relating to our personal
health?
Dr. Paul: Big business is just as
oppressive as any government.
Dr. Rosen: Big business is poorly
understood. They are apolitical. They can be radical left, radical right, or
any place in between that serves their business purpose. In general, big
business likes big government that they feel they can manipulate to their
advantage. But they can never knock on your door at night and arrest you. Only
Big Government can do that.
Dr. Edwards: And that is what government
throughout all the ages has done. And the United States was the first attempt
to change that forever. As our forefathers have stated, we have given you a
Republic, if you can keep it. It seems to take a lot of effort to keep it. Big
government is like a slowly growing incurable cancer. If we don't cut it out
while its operable, it will eventually take over out entire system.
Dr. Milton: Getting back to your IPA
meeting, don't you think the EMR is the vice that will force all of us into
submission? It's really surveillance, isn't it? It's like having a camera on
you at all times. If you vary even slightly from government protocol, they will
warn you the first time, haul you in front of a bureaucratic board the second
time, and prosecute you the third time - that may mean jail time.
Dr. Paul: Come on, you guys; you're
all getting paranoid. The government is just trying to help us.
Dr. Rosen: Isn't that what medical
school, internship, residencies, fellowships, grand rounds and specialty
meetings do to keep us current on the latest? The government is the last one
that can even measure quality.
Dr. Edwards: Isn't that the truth. Have
you ever had a visit from a stranger and he says, "We're from the
government and we're here to help you." Did you smile and offer him a
beer? Or did you feel queasy, uneasy and sweaty?
Dr. Paul: Well, I wouldn't offer him
beer, but I'd poor a cup of coffee or a coke and cooperate fully.
Dr. Edwards: And if he told you how to
handle your case the next time, what would you do?
Dr. Paul: I'd handle the patient just
as he wanted me to.
Dr. Edwards: And if you thought that was
not in the best interest of the patient, would you still do it?
Dr. Paul: Certainly. He's the boss.
Dr. Edwards: So you immediately
acquiesce to the government boss to the detriment of your patient?
Dr. Paul: Hey, I want to survive. The
patient can die. That's no sign that I want to die professionally.
Dr. Edwards: I think we have just
confirmed how bad government medicine, AKA as ObamaCare, really is. It's
professional servitude, like the world has never witnessed in health care
before, even in a totalitarian state before the Nazi era. ObamaCare may
actually equal NaziCare.
Dr. Rosen: It's hard to realize after
six generations of Rosen's in America, first coming during the time of
Bismarck, that America may revert to a time more than two centuries earlier in
Europe. Goodness, how civilization can regress.
Ref: How
long does it take to read a 243 page EMR?
Ref: Information Technology . . .
Feedback
. . .
Subscribe MedicalTuesday .
. .
Subscribe HealthPlanUSA .
. .
The Staff Lounge Is Where Unfiltered Medical Opinions Are Heard.
* * * * *
8. Voices of Medicine: A Review of Local and Regional
Medical Journals and Articles
Physician
Invictus – From Heroin Addict to Addiction Physician By Don Kurth, AAD
April 5, 1969.
The red and white ambulance races through the early morning hours of the dark
North Jersey night. Sirens are
screaming and red lights are flashing, casting revolving shadows against the
trees and houses as the medics race through the darkened suburban
neighborhoods. The rain has just stopped falling and a hazy mist rises from the
black pavement. In the back of the
ambulance lies a young man, barely out of his teens. His lips are blue and his
skin is pale gray, but the paramedics continue to pump on his chest and force
oxygen in to his lungs with the plastic face mask and ambu-bag. Bloody vomit
drips out of the mask and down his cheek. There are no signs of life, no
respirations, no pulse. His dark blood is filled with drugs and alcohol and his
lungs are filled with vomit and beer. Behind the ambulance the young man's
parents are following, trying to keep up with the racing van. Neither speaks.
They are remembering all the hopes and dreams they had had for their firstborn,
their only son. His mom thinks about when she dropped him off for his first day
of kindergarten, when he cried and called for his mother not to leave him. His
dad remembers the first time his boy caught a trout by himself and how proud he
was of his son and the photos they took of the speckled fish before they
slipped him back into the creek. They both remember their dreams of college and
a profession for their son, and maybe grandchildren of their own someday. And
another round of siren screams fills the night air as they race to follow the
ambulance through the night.
Finally they arrive at the
hospital and their son is whisked into the treatment area, the paramedics still
trying to pump life back into his dying body. The parents park to the side and
are directed to the reception clerk to fill out the forms and paperwork Then
they are asked to take a seat and wait As they sit, silent in the empty waiting
area, neither speaks; neither lifts their eyes to look at the other; each is
lost in private thoughts. Quietly both pray to their own God, isolated in their
grief over the loss of their son, wondering if they should have done something
differently, wishing they could do something more now.
Finally, the young ER
doctor walks through the swinging double doors from the treatment area, looks
around the waiting room, and walks toward the grieving pair.
"I am so sorry,"
he says slowly, deliberately. "I don't think he is going to make it. He
was dead by the time he arrived. There just wasn't anything more we could do.
He didn't have oxygen to his brain. I am sorry."
The doctor feels the grip
of both sets of eyes on his own. He feels the sorrow of their loss in his own
heart. Then, after a quick moment, he turns on his heel and hurries back
through the double doors into the treatment area of the emergency room. An
agonizing twenty more minutes pass before he returns with a different look on
his face.
"I think he is going
to make it!" he exclaims. "We've got a pulse and he is starting to
breathe on his own. I think he might be OK!"
That young man was me, and
I did not die of that overdose in 1969. But I was not done yet, either. I still
had more overdoses to survive and jails to visit. And I still had to stumble my
way into drug rehab and have a chance to turn my life around. On August 12, 1969—three days before
Woodstock—I slammed my last speedball just before the police surrounded my parent's
home and a new phase of my life began.
Later that year I entered
drug treatment at Daytop Village in New York and started to get my life back on
track I had already flunked out of college twice by the time I overdosed in
1969. In fact, I had actually achieved a perfect GPA at my first college—0.00.
I had split for California to visit the Haight and neglected to inform my
registrar that I might not be returning to complete my final exams. Apparently,
my professors were not listening as intently as I was to the "Turn on,
tune in, and drop out," call of Dr. Timothy Leary. They failed to
recognize the value of my desire to join in the "Summer of Love" and
manifested their misunderstanding by awarding me F's in every single class.
But by the summer of 1972,
I had completed drug rehab and begged my way back into college. Without drugs
in my bloodstream, my grades improved dramatically and by 1975 1 had snagged an
academic scholarship to Columbia University in New York City. I worked as a
gardener to pay for my living expenses and scrimped every penny I could. I
couldn't afford a car, so I bought a used Suzuki motorcycle to get around. I
managed to save $200 over my next month's rent, so I bought a chain saw and a
hundred feet of rope and became a tree cutter. After each hurricane or
blizzard, I would tie the chain saw and rope to the back of my motorcycle and
ride around looking for fallen trees to cut. There was always somebody who
needed my help, and eventually I found a partner and bought a pickup truck to
expand the business. It was hard work, but I enjoyed what I did and made enough
money to get through school. I eventually graduated, Phi Beta Kappa and cum
laude, and went on to medical school at Columbia. I had to work hard to get good grades. I had a lot of remedial
work to do just to catch up with the other students. And I had to make the
sacrifices that we all have had to make to dedicate our lives to medicine and
patient care.
I trained at Hopkins and
UCLA and found myself seduced by the California sunshine. I opened an urgent
care practice in Rancho Cucamonga, California. But I have always had a soft
spot in my heart for those who suffer from addictive disease, and eventually I
found myself on the faculty of Loma Linda University, where I have run the
addiction treatment program since the mid-nineties. I got involved with the Rancho Cucamonga Chamber of Commerce,
really just to get to know people in my community and to build up my own
practice. . .
The more I got involved,
though, the more I began to realize the importance of being involved on a
political level. It became more and more clear to me that many of the
challenges we face, not just in addiction medicine but throughout medicine, are
challenges that can only be met on a public policy level.
Scope of practice,
corporate bar, and MICRA are all issues that must be defended on a public
policy level. But our political responsibility as physicians goes far beyond
that. Who but physicians can better fight the battle to ensure greater access
to care for our patients? Who but physicians can articulate the importance of
our physician-patient relationship remaining unfettered by burdensome
government interference and regulations? If we cannot or will not advocate for
ourselves, who do we expect to speak for us? The questions we must ask ourselves
are these: If not us, then who? If not now, then when? As in the poem
"Invictus," by William Ernest Henley, we must be the masters of our
fates; we must be the captains of our souls.
I suppose my career path
has been one of unlikely twists and turns. But believe me, I did not plan it
this way. Following my chamber involvement I was elected to the local water
district board. After eight years of elected office, I moved on to the city
council in Rancho Cucamonga (population 180,000} and was then elected mayor in
2006. Concurrently though, as my skills have sharpened in this world of public
policy, I have done my best to pull my physician colleagues along with me, and
together we have achieved some degree of success. I helped create our Addiction
Treatment Legislative Days, first in California and then in Washington, D.C.
Working together, we greatly improved access to care and our Addiction
Treatment Parity Bill was signed into law by then-President George Bush on
October 5, 2008. Greater access to medical care for those suffering from
addiction is now the law of the land in the United States of America. I was
honored by my colleagues to be elected president of the California Society of
Addiction Medicine and now serve as president-elect of the American Society of
Addiction Medicine. . .
Donald J. Kurth, MD, MBA, MPA, FASAM, is
an associate professor at Loma Linda University and president-elect of the
American Society of Addiction Medicine. He is also mayor of the City of Rancho
Cucamonga, California, and a candidate for the 63rd Assembly
District in southern California. His website is at www.DonKurth.com.
www.smcma.org/bulletin/issues/June2010.pdf
Feedback
. . .
Subscribe MedicalTuesday .
. .
Subscribe HealthPlanUSA .
. .
VOM
Is an Insider's View of What Doctors are Thinking, Saying and Writing about.
* * * * *
9. Book Review: Are Physicians almost persuaded again
that Socialized Medicine is Inevitable?
Almost Persuaded, American Physicians and Compulsory
Health Insurance, 1912-1920
by Ronald L. Numbers. The Johns
Hopkins University press, Baltimore & London. 1978.
Numbers
points out in his preface: "In 1911 the British parliament passed a
National Insurance Act making health insurance mandatory for most employees
between the ages of 16 and 70. The following year the American Association of
Labor Legislation created a Committee on Social Insurance to prepare a model
health-insurance bill for the United States, and by 1916 several state
legislatures were actively considering bills that would have covered virtually
all manual laborers earning $100 or less a month. No such law ever passed, but
between 1916 and 1920 compulsory health insurance was a real possibility in a
number of industrial states."
In
this study of America's first debate over compulsory health insurance, Numbers
focuses on the changing attitudes of the medical profession. The initial
response of physicians to compulsory health insurance was surprisingly
positive. From the AMA to various state and sectarian medical societies, the
feel prevailed that this method of paying medical bills was both inevitable and
desirable. By 1917, however, medical opinion was beginning to shift, and,
before long, scarcely a physician could be found willing to endorse such a
"socialistic" proposal.
In
an era prior to opinion polls, Numbers relies on medical society minutes,
unpublished correspondence, and the numerous national, state, and local
publications to present what he feels is a reasonably accurate reading of the
prevailing view of the medical profession. As the public debate continues, it
behooves as many of us as possible to become conversant with how health care
evolved to our present dilemma.
Review by Del Meyer, MD
This book review is found at . . .
http://healthcarecom.net/Denial_of_the_Soul.htmTo read more book
reviews . . .
To read book reviews
topically . . .
Feedback
. . .
Subscribe MedicalTuesday .
. .
Subscribe HealthPlanUSA .
. .
The
Book Review Section Is an Insider's View of What Doctors are Reading and
Writing about.
* * * * *
10. Hippocrates & His Kin:
More people without life insurance than without health insurance
There
are 35 million U.S. households that neither own their own life-insurance
policies nor are covered under employer-sponsored plans, up from the 24 million,
or 22% of households, without coverage in 2004, according to the study this
year by Limra, of Windsor, Conn.
Limra is an
industry-funded research organization that has conducted periodic surveys of
ownership trends since 1960. The percentage without life insurance is a sign of
the financial pressures on middle-income families as the economy struggles. The
rise reflects tight household budgets, loss of employer-provided coverage as a
result of layoffs, and cutbacks by some employers in their benefits packages,
Limra said. Half of the respondents in the latest survey said they needed more
life insurance, but many haven't bought it because their financial priorities
include paying off debt.
Among
households with children under 18, four in 10 respondents said they would
immediately have trouble meeting living expenses if a primary wage earner died,
and another three in 10 would have trouble keeping up with expenses after
several months.
"Clearly,
more American families are living on the edge, surviving paycheck to paycheck,
and, as our new study suggests, too many are without the safety net that life
insurance provides," said Robert Kerzner, president of Limra. . .
Life-insurance
coverage provided through benefits packages at work has played a significant
role in protecting families in recent decades, but it may be lost if the wage
earner loses his job or reduces work hours. Employers scaling back or
eliminating coverage is another factor in the declining percentage of
households with insurance, Limra noted. The number of households relying solely
on life insurance provided through an employer shrank to one in four, from
about one in three in 2004, when the previous survey was conducted. --By LESLIE SCISM
I'm sure President Obama will have the
insurance industry in his sights shortly and force us to buy coverage.
The US ranked
87th in Economic Stability as it's viewed as a wasteful spender by
the world. Its Index of Financial Marked Developoment fell from ninth to 31st.
The U.S.
fell from second, a year after losing the No. 1 position for the first time
since the Geneva-based organization began its current index in 2004. A
budget shortfall of more than $1 trillion and public distrust of politicians
were among the weaknesses in the world's largest economy.
I'm sure Obama can get us into the last or
139th place before he's impeached?
Vietnamese Americans show the path out of welfare
One broiling Saturday 15 years ago, 345
Vietnamese American kids attended a celebration at Florin High School,
where they each were awarded cool backpacks for getting straight A's.
Students from first grade through college
shared their secrets for getting 4.0 GPAs, and underscored Southeast Asian
immigrants' drive to climb out of poverty.
In 1990, half the Sacramento region's Southeast Asians were
poor. Today, 52 percent own homes, according to a Bee analysis of census data. They enjoy a
median household income of $50,000 annually, up from $17,350 in 1990 – about
$28,500, adjusted for inflation. The regional average is $61,000.
Many fled Vietnam or Laos by boat after the Communist
victory in 1975, arriving here with post-traumatic stress disorder and little
else. Vietnamese, Hmong, Lao, Iu
Mien and Cambodian refugees had lost their land, their freedom, and often their
closest relatives.
Most started at the bottom – without
English or job skills – but through teamwork and the will to succeed have gone
from roach-infested apartments in gang-controlled neighborhoods to suburban
homes.
Their children – including those at Florin
High that hot August morning – have gone to America's top universities and become
doctors, lawyers, engineers and teachers.
Read more: http://www.sacbee.com/2010/10/18/3111515/southeast-asians-make-strides.html#ixzz12oMEDKCa
American
parents should take note since recent statistics indicate that half of
America's children have no aspirations beyond high school. Many join the
physical labor pool where one injury can take them back to the welfare slums.
To read more HHK . . .
Feedback
. . .
To read more HMC . . .
Subscribe MedicalTuesday .
. .
Subscribe HealthPlanUSA .
. .
Hippocrates
and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Today & Tomorrow
* * * * *
11.
Professionals Restoring Accountability in Medical Practice, Government
and Society:
•
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.
•
Medi-Share Medi-Share is based on the biblical principles of
caring for and sharing in one another's burdens (as outlined in Galatians 6:2).
And as such, adhering to biblical principles of health and lifestyle are
important requirements for membership in Medi-Share.
This is not insurance. Read more . . .
•
PATMOS EmergiClinic - where Robert Berry, MD, an emergency
physician and internist, practices. To read his story and the background for
naming his clinic PATMOS EmergiClinic - the island where John was exiled and an
acronym for "payment at time of service," go to www.patmosemergiclinic.com/ To
read more on Dr Berry, please click on the various topics at his website. To
review How
to Start a Third-Party Free Medical Practice . . .
•
PRIVATE
NEUROLOGY is a Third-Party-Free
Practice in Derby, NY with
Larry Huntoon, MD, PhD, FANN. (http://home.earthlink.net/~doctorlrhuntoon/)
Dr Huntoon does not allow any HMO or government interference in your medical
care. "Since I am not forced to use CPT codes and ICD-9 codes (coding
numbers required on claim forms) in our practice, I have been able to keep our
fee structure very simple." I have no interest in "playing
games" so as to "run up the bill." My goal is to provide
competent, compassionate, ethical care at a price that patients can afford. I
also believe in an honest day's pay for an honest day's work. Please Note that PAYMENT IS EXPECTED AT
THE TIME OF SERVICE. 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."
•
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 25–50 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 Liberty high-deductible model, go
to www.libertyhealthgroup.com/Liberty_Solutions.htm.
There is extensive data available for your study. Dr Dave is available to speak
to your group on a consultative basis.
•
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.
•
ReflectiveMedical Information Systems
(RMIS), delivering
information that empowers patients, is a new venture by Dr. Gibson, one of our
regular contributors, and his research group which will go far in making health
care costs transparent. This site
provides access to information related to medical costs as an informational and
educational service to users of the website. This site contains general
information regarding the historical, estimates, actual and Medicare range of
amounts paid to providers and billed by providers to treat the procedures
listed. These amounts were calculated based on actual claims paid. These
amounts are not estimates of costs that may be incurred in the future. Although
national or regional representations and estimates may be displayed, data from
certain areas may not be included. You may want to
follow this development at www.ReflectiveMedical.com.
During your visit you may wish to enroll your own data to attract patients to
your practice. This is truly innovative and has been needed for a long time.
Congratulations to Dr. Gibson and staff for being at the cutting edge of
healthcare reform with transparency.
•
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.
•
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.
•
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, who wrote an
informative Medicine Men column at NewsMax, have now retired. Please log
on to review the archives.
He now has a new column with Richard Dolinar, MD, worth reading at www.thenewstribune.com/opinion/othervoices/story/835508.html.
•
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. This month, be sure to read the new rules .
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.
* * * * *
Thank you for joining the
MedicalTuesday.Network and Have Your Friends Do the Same. If you receive this
as an invitation, please go to www.medicaltuesday.net/Newsletter.asp,
enter you email address and join the 10,000 members who receive this
newsletter. If you are one of the 80,000 guests that surf our web sites, we
thank you and invite you to join the email network on a regular basis by subscribing
at the website above. To subscribe to our companion publication
concerning health plans and our pending national challenges, please go to www.healthplanusa.net/newsletter.asp
and enter your email address. Then go to the archives to scan the last several
important HPUSA newsletters and current issues in healthcare.
Please note that sections 1-4, 6, 8-9 are
entirely attributable quotes and editorial comments are in brackets. Permission
to reprint portions has been requested and may be pending with the
understanding that the reader is referred back to the author's original site.
We respect copyright as exemplified by George
Helprin who is the author, most recently, of "Digital Barbarism,"
just published by HarperCollins. We hope our highlighting articles leads to
greater exposure of their work and brings more viewers to their page. Please also
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 research
and 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.
Spammator Note: MedicalTuesday uses many
standard medical terms considered forbidden by many spammators. We are not
always able to avoid appropriate medical terminology in the abbreviated edition
sent by e-newsletter. (The Web Edition is always complete.) As readers use new
spammators with an increasing rejection rate, we are not always able to
navigate around these palace guards. If you miss some editions of
MedicalTuesday, you may want to check your spammator settings and make
appropriate adjustments. To assure uninterrupted delivery, subscribe directly
from the website rather than personal communication: www.medicaltuesday.net/newsletter.asp.
Also subscribe to our companion newsletter concerning current and future health
care plans: www.healthplanusa.net/newsletter.asp
Del Meyer
Del Meyer, MD, Editor & Founder
6945 Fair Oaks Blvd, Ste A-2, Carmichael, CA 95608
Feedback
. . .
Subscribe MedicalTuesday .
. .
Subscribe HealthPlanUSA .
. .
Life is what happens while you are making
other plans. -John Lennon
"Suppose one of you wants to build a
tower. Will he not first sit down and estimate the cost to see if he has enough
money to complete it?" - Jesus of Nazareth, Luke 15:28
Sounds like good advice also for government towers, such as
health care.
If the government will get out of the way,
there's no limit to what the American people can achieve. - Ronald Reagan.
Sounds like the road to freedom should be obvious.
Some Relevant
Postings
FALSE HOPES - Why
America's Quest for Perfect Health Is a Recipe for Failure by Daniel Callahan . . .
Health
Care: A Two-Decade Blunder Tevi Troy . . .
Sorting Fact From
Fiction on Health Care Jerome Groopman, MD and Pamela Hartzband, MD
In Memoriam
Alex "Hurricane" Higgins, transformer of
snooker, died on July 24th, aged 61
THE game of snooker is a curious
one. Professional players wear black waistcoats and bow ties, as if they have
been waylaid on their way to a funeral. The referees, similarly attired, also
wear white gloves with which to replace the balls upon the table. The green
baize cloth, much like the smooth lawn of a bowling green, enforces quiet,
concentration, care. Only the odd nervous cough, soon suppressed, breaks the
glacial atmosphere.
But snooker grew up in Britain's
working men's clubs as something rough, rude and rambunctious. Beer fuelled it,
cash betting underpinned it, and scores were settled with fists in the street
outside. Speed was a virtue; safety, beyond a certain point, just sissy. The
good player took on all comers and dispatched them, mercilessly, one by one.
Most professionals learned to
establish a prudent distance from that world. Alex Higgins never did. The man
who reached the heights of snooker in the 1970s, and turned it into a global
phenomenon in the 1980s, was always the edgy, jigging teenager who haunted the
Jampot Billiard Hall off the Donegall Road in Belfast's Shankill. There he
would keep the score for pocket money and, little by little, start to play
himself, a scrawny creature with fast, feline grace who would prowl around the
table and seem to know at once how to build a break or make a clearance, always
three balls ahead of himself. He'd play for anything: Mars Bars, fizzy drinks,
a packet of Player's, a smooth pint of Guinness down the throat. He was a
Protestant boy who would even take on a Taig if there was money in it. He would
take on anyone, because he knew within a short time that he could beat them
all.
This was the world he brought
with him like a gale into the sacred halls of the sport, such as the Selly Park
British Legion Hall in Birmingham, where in 1972 he won his first world
championship at 22, then the youngest winner ever. At the time he was homeless,
moving from squat to squat through condemned streets in Blackburn. He appeared
for the final, fingers stained with nicotine, in white trousers and a tank top.
The World Professional Billiards and Snooker Association ruled these
"clothes unbecoming to a professional" and, after his victory, fined
him. . .
Read the entire
obituary . . .
On This Date in
History – August 24
On this date in 79 A.D., a volcano named
Vesuvius began a tremendous eruption; before it was over, two Roman cities,
Herculaneum and Pompeii, were wiped out. The ruins of Pompeii remain to this day
as a reminder of how suddenly and how thoroughly a living city can cease to
exist. Today, cities must change or they run the risk of falling apart and
deteriorating.
On this date in 1814, by odd coincidence,
the British burned Washington during the war of 1812. The British
were infinitely more selective. They didn't burn the whole city; they
concentrated on the White House and other government buildings. They went on to
try to capture Baltimore, where they were repulsed by the Battle of Fort
McHenry and Francis Scott Key was inspired to write "The Star Spangled
Banner." Washington was, of course, rebuilt, and the British and the
Americans, after a suitable lapse of time, became the best of friends. The only
real thing separating the British and the Americans is their mutual illusion
that they speak the same language.
After Leonard and
Thelma Spinrad
The 7th Annual World
Health Care Congress
Advancing solutions for business and health care CEOs to
implement new models for health care affordability, coverage and quality.
The 7th
Annual World Health Care Congress was held April 12-14, 2010
Washington, DC
www.worldhealthcarecongress.com
Toll Free: 800-767-9499
In partnership with MedicalTuesday.net, the 7th
Annual World Health Care Congress is the most prestigious meeting of
chief and senior executives from all sectors of health care. The 2010
conference convened 2,000 CEOs, senior executives and government officials from
the nation's largest employers, hospitals, health systems, health plans,
pharmaceutical and biotech companies, and leading government agencies. Please
watch this section for further reports in the future as well as www.HealthPlanUSA.net.