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MEDICAL TUESDAY . NET |
NEWSLETTER |
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Community For Better Health Care |
Vol VIII, No
10, Aug 25, 2009 |
In This Issue:
1.
Featured Article:
The
End of Medical Miracles
2.
In
the News: Tasting the
Light: Device Lets the Blind "See" with Their Tongues
3.
International Medicine: Shooting for Targets in Healthcare can be Deadly
4.
Medicare: Can Health
Reform Save Money?
5.
Medical Gluttony:
Motorized Wheelchairs? And then it happened . . .
6.
Medical Myths:
Infant mortality is lower in countries with “universal medical care.”
7.
Overheard in the CMA (Certified Medical Assistant) Meeting: Are offices getting hostile?
8.
Voices of Medicine:
Obama's Health Plan Will Succeed . . .
9.
The Bookshelf: Code Blue:
Reviving Canada's Health Care System
10.
Hippocrates
& His Kin: Human Rights
In Health Care
11.
Related Organizations: Restoring Accountability in Medical Practice and Society
Words of Wisdom,
Recent Postings, In Memoriam . . .
* * * * *
MOVIE
EXPLAINING SOCIALIZED MEDICINE TO COUNTER MICHAEL MOORE's SiCKO
Logan Clements, a pro-liberty filmmaker in Los Angeles, seeks
funding for a movie exposing the truth about socialized medicine. Clements is
the former publisher of "American Venture" magazine who made news in
2005 for a property rights project against eminent domain called the "Lost
Liberty Hotel."
For more information visit www.sickandsickermovie.com or
email logan@freestarmovie.com.
* * * * *
1. Featured
Article: The End of Medical Miracles - Commentary Magazine
The End of
Medical Miracles? By June 2009
Americans have, at best, a love-hate relationship with
the life-sciences industry—the term for the sector of the economy that produces
pharmaceuticals, biologics (like vaccines), and medical devices. These days,
the mere mention of a pharmaceutical manufacturer seems to elicit gut-level
hostility. Journalists, operating from a bias against industry that goes as far
back as the work of Upton Sinclair in the early years of the 20th century,
treat companies from AstraZeneca to Wyeth as rapacious factories billowing
forth nothing but profit. At the same time, Americans are adamant about the
need for access to the newest cures and therapies and expect new cures and
therapies to emerge for their every ailment—all of which result from work done
primarily by these very same companies whose profits make possible the research
that allows for such breakthroughs.
Liberals and conservatives appear to agree on the need
to unleash the possibilities in medical discovery for the benefit of all. But it
cannot be ordered up at will. It takes approximately ten years and $1 billion
to get a new product approved for use in the United States. Furthermore, only
one in every 10,000 newly discovered molecules will lead to a medication that
will be viewed favorably by the Food and Drug Administration (FDA). Only three
out of every ten new medications earn back their research-and-development
costs. The approval success rates are low, and may even be getting lower—30.2
percent for biotech drugs and 21.5 percent for small-molecule pharmaceuticals.
It is the very nature of scientific discovery that
makes this process so cumbersome. New developments do not appear as
straight-line extrapolations. A dollar in research does not lead inexorably to
a return of $1.50. Researchers will spend years in a specific area to no avail,
while other areas will benefit from a happy concatenation of discoveries in a
short period. It is impossible to tell which area will be fruitless; so many
factors figure into the equation, including dumb luck. Alexander Fleming did
not mean to leave his lab in such disarray that he would discover that an
extract from moldy bread killed bacteria, yet that is how it happened.
Conversely, if effort and resources were all it took, then we would have an HIV/AIDS
vaccine by now; as it stands, the solution to that problem continues to elude
the grasp of some of the most talented and heavily funded researchers.
Scientific discoveries are neither inevitable nor
predictable. What is more, they are affected, especially in our time, by forces
outside the laboratory—in particular, the actions of politicians and government
bureaucracies. The past quarter-century has offered several meaningful object
lessons in this regard. For example, in the 1980s, the Reagan administration
undertook a number of actions, both general and specific, that had a positive
effect on the pace of discovery. On the general front, low taxes and a
preference for free trade helped generate a positive economic climate for
private investment, including in the rapidly growing health-care sector. More
specifically, the Reagan administration engaged in new technology transfer
policies to promote joint ventures, encouraged and passed the Orphan Drug Act
to encourage work on products with relatively small markets, and accelerated
approval and use of certain data from clinical trials in order to hasten the
approval of new products. All of these initiatives helped foster discovery.
That which the government gives, it can also take
away. . .
A leading critic of Big Pharma, Greg Critser, wrote in
his 2007 Generation Rx that President Clinton picked up on a public discomfort
with drug prices and “began hinting at price controls” during his first term in
office. These hints had a real impact. As former FDA official Scott Gottlieb
has written, “Shortly after President Bill Clinton unveiled his proposal for
nationalizing the health-insurance market in the 1990s (with similar limits on
access to medical care as in the [current] Obama plan), biotech venture capital
fell by more than a third in a single year, and the value of biotech stocks
fell 40 percent. It took three years for the ‘Biocentury’ stock index to
recover. Not surprisingly, many companies went out of business.”
The conduct of the businesses that had been
responsible for almost every medical innovation from which Americans and the
world had benefited for decades became intensely controversial in the 1990s. An
odd inversion came into play. Since the work they did was life-saving or
life-enhancing, it was not deemed by a certain liberal mindset to be of special
value, worth the expense. Rather, medical treatment came to be considered a
human right to which universal access was required without regard to cost.
Because people needed these goods so much, it was unscrupulous or greedy to
involve the profit principle in them. What mattered most was equity. Consumers
of health care should not have to be subject to market forces.
And not only that. Since pharmaceuticals and biologics
are powerful things that can do great harm if they are misused or misapplied,
the companies that made them found themselves under assault for injuries they
might have caused. It was little considered that the drugs had been approved
for use by a federal agency that imposed the world’s most rigorous standards,
and was often criticized for holding up promising treatments (especially for
AIDS). Juries were convinced that companies had behaved with reckless disregard
for the health of consumers, and hit them with enormous punitive damages claims.
. .
. . . An oft-cited 1999 study by the National
Institute for Health Care Management (NIHCM) claimed that the newest and
costliest products were only offering “modest improvements on earlier therapies
at considerably greater expense.”
The NIHCM study opened fresh lines of attack. The
first came from the managed-care industry, which used it as a means of arguing
that drugs had simply grown too expensive. Managed care is extremely
price-sensitive, and its business model is built on cutting costs; executives
of the industry were well represented on the board of the institute that put
out the report. They were, in effect, fighting with the pharmaceutical
companies over who should get more of the consumer’s health-care dollars.
The second came in response to the approval by the FDA
in 1997 of direct consumer advertising of pharmaceuticals. The marketing
explosion that followed it gave people the sense that these companies were not
doing life-saving work but were rather engaged in the sale of relative trivialities,
like Viagra and Rogaine, on which they had advertising dollars to burn that
would be better spent on lowering the cost of drugs. And the third element of
this mix was the rise of the Internet, which gave Americans a level of price
transparency that they had not had before regarding cost differentials between
drugs sold in the U.S. versus Canada and other Western countries. . .
A cultural shift had taken place. Pharmaceutical
manufacturers, once the leading lights of American industry, had become a
collective national villain.
_____________
The life sciences are among the most regulated areas
of our economy, and are constantly subjected to significant policy upheaval
from Washington. Because these products are so expensive to develop, the
regulatory and policy whims of Washington tend to have a disproportionate
impact on investment in the industry. Without investment, there is no research,
and without research, there are no products. According to Ken Kaitin of the
Center for the Study of Drug Development at Tufts, new drug approvals from the
Food and Drug Administration are not keeping pace with rising
research-and-development spending, which means that recent spending has not
been leading to results. This raises the question of how long such investments
will be sustainable if they do not provide sufficient return for investors.
FDA approval is not the only hurdle for products
making their way to market. Manufacturers and investors need to deal with the
Department of Health and Human Services at four levels in order to get a
product to market and reimbursed. Basic research begins at the National
Institutes of Health (NIH), a $30-billion agency that often partners with the
private sector on promising new areas of research and that has just received a
$10-billion boost from the stimulus package. The FDA then handles approvals of
products. Once a product has been approved, someone must pay for it in order
for the product to be used. The Centers for Medicare & Medicaid Services
(CMS) determines which products will be paid for by Medicare. Because CMS is
the largest single payer in the health-care system, its decisions often help to
determine which products will eventually be covered by private insurance
companies as well. Finally, the Agency for Healthcare Research and Quality is
in the process of increasing its role in conducting post-market product
evaluations. These bureaucratic and evaluative hurdles have injected far too
much uncertainty into the process and have dried up investment capital for the
industry as a whole. . .
At the same time, as Sally Pipes of the Pacific
Research Institute has shown, the American system also lets its consumers
obtain many products far more cheaply than consumers in other nations. This is
because our competitive system allows for low-cost generic drugs that drive
down prices. Brand-name products are more expensive here, but generics, which
are available after patent protections expire, are cheaper and more widely
available in the United States than elsewhere.
Another factor that reduces the availability of
research-and-development investment is the growth of lawsuits. According to a
Pacific Research Institute study, “American companies suffer over $367 billion
per year in lost product sales because spending on litigation curtails
investment in research and development.” A recent analysis by the Washington
Post found that “courts have been flooded with product liability lawsuits in
recent years, and statistics show about a third are against drug companies.”
. . . Most
famously, perhaps, Dow Corning was forced to declare bankruptcy after being
flooded with over 20,000 lawsuits and 400,000 claimants over its silicon breast
implants, despite the fact that the evidence has finally demonstrated
definitively that they are not harmful.
The results are unmistakable. Dow Corning was forced
to remain in bankruptcy for nine years. . .
_____________
The situation as it stands now is bad enough. But it
would be made worse by the proposed elimination of an FDA policy called
preemption, which holds that when federal laws come into conflict with state or
local laws on drug matters, federal laws prevail. This is particularly
important for the FDA, which sets federal safety standards. Preemption makes
the FDA standards supreme as long as the manufacturers adhere to FDA
guidelines. This policy prohibits trial lawyers from suing manufacturers in
circumstances where the manufacturer adhered to the federal guidelines but
where state law differs. A recent Supreme Court case, Wyeth v. Levine, opened
up this issue by ruling that the FDA’s approval of a medication does not
protect the drug’s maker from state-level lawsuits, thereby limiting
preemption’s scope. . .
Then there is the looming shadow of health reform. One
of the great requirements of a systemic overhaul is controlling costs, which
were $2.5 trillion last year and growing at a rate triple that of inflation. It
is clear that Congress and the administration will have to cut costs in order
to come close to paying for an ambitious plan. How they do so could have a
devastating impact on medical innovation.
Attempts to universalize our system and pay for it
with cost controls that could stifle innovation contradict their own goal,
which is, presumably, better health. It also embraces the notion that you can
get something for nothing—namely, that you can get innovative new discoveries
and better health outcomes somehow without paying for these discoveries to come
into being.
_____________
We forget the power of the single-celled organism. For
most of man’s existence on earth, the power of a single-celled animal to snuff
out life was an accepted—and tragic—way of the world. Human beings could be
wiped out in vast communicable plagues or simple through ingesting food or
water. In the last century, the advent of the antibiotic has changed all that.
For millennia, the only cure for an infection in humans was hope. Today,
antibiotic use is so common that public health officials struggle to get people
not to overuse antibiotics and thereby diminish their effectiveness.
Just as there is potential danger from the way in
which Americans take the power of the antibiotic for granted, so, too, one of
the greatest threats to our health and continued welfare is that Americans in
the present day, and particularly their leaders, are taking for granted the
power, potency, and progress flowing from life-saving medical innovations. And
in so doing, they may unknowingly prevent the kind of advance that could
contribute as vitally to the welfare of the 21st century as the discovery
altered the course of human history for the better in the century just
concluded.
Read the entire treatise . . .
www.commentarymagazine.com/viewarticle.cfm/the-end-of-medical-miracles--15162?page=all
About the
Author: Tevi Troy, deputy secretary of the United States
Department of Health and Human Services from 2007 to 2009, is a visiting senior
fellow at the Hudson Institute.
* * * * *
2.
In the News:
Tasting Light Scientific American, Sept 2009 Issue
Tasting
the Light: Device Lets the Blind "See" with Their Tongues By Mandy Kendrick,
A pair of sunglasses wired to an electric "lollipop"
helps the visually impaired regain optical sensations via a different pathway
Neuroscientist Paul Bach-y-Rita
hypothesized in the 1960s that "we see with our brains not our eyes."
Now, a new device trades on that thinking and aims to partially restore the
experience of vision for the blind and visually impaired by relying on the
nerves on the tongue's surface to send light signals to the brain.
Legal blindness is defined by U.S. law as vision that is 20/200 or worse, or
has a field of view that is less than 20 degrees in diameter. The condition
afflicts more than one million Americans over the age of 40, according
to the National Institutes of Health. Adult vision loss costs the country about
$51.4 billion per year. . .
From the CPU, the signals are sent to the tongue via a
"lollipop," an electrode array about nine square centimeters that
sits directly on the tongue. Each electrode corresponds to a set of pixels.
White pixels yield a strong electrical pulse, whereas black pixels translate
into no signal. Densely packed nerves at the tongue surface receive the
incoming electrical signals, which feel a little like Pop Rocks or champagne
bubbles to the user. . .
Like learning to ride a bike
In any case, within 15 minutes of using the device, blind people can begin
interpreting spatial information via the BrainPort, says William Seiple,
research director at the nonprofit vision healthcare and research organization Lighthouse International. The electrodes
spatially correlate with the pixels so that if the camera detects light
fixtures in the middle of a dark hallway, electrical stimulations will occur
along the center of the tongue.
"It becomes a task of learning, no different than learning to ride a
bike," Arnoldussen says, adding that the "process is similar to how a
baby learns to see. Things may be strange at first, but over time they become
familiar."
Seiple works with four patients who train with the BrainPort once a week and
notes that his patients have learned how to quickly find doorways and elevator
buttons, read letters and numbers, and pick out cups and forks at the dinner
table without having to fumble around. "At first, I was amazed at what the
device could do," he said. "One guy started to cry when he saw his
first letter."
Wicab will submit BrainPort to the U.S. Food and Drug Administration for
approval at the end of the month, says Robert Beckman, president and chief
executive officer of the company. He notes that the device could be approved
for market by the end of 2009 at a cost of about $10,000 per machine. . .
2 b. In The News Continued: Gene Therapy for
Blindness Scientific American, Sept 2009 Issue
Gene Therapy Treatment for Blindness Proves Safe--and
Effective--One Year In
By Katherine Harmon
Three subjects with a rare form of visual impairment found
their sight still better a year after gene therapy, and their immune systems
seemed happy with the treatment, too
Gene
therapy has been rhapsodized and vilified in its nearly two decades of
human testing, helping some and making others sicker. But a new 12-month
clinical trial has shown that, at least in one ocular disease, it appears safe
and—perhaps even more impressive—effective.
The research, part of a phase I clinical trial to test the safety of the
treatment, was published as a letter to the editor in The New England
Journal of Medicine earlier this week and will be in the September
issue of Human
Gene Therapy. (The paper was co-authored by about a dozen researchers,
two of whom own equity in a company that could profit from a commercialized
version of this procedure.)
The researchers report that three young adults with severe vision impairment
from a hereditary disease maintained improved eyesight a year after gene
therapy was administered—and didn't suffer any health side effects in the
meantime. Gene therapy, which often employs viruses to deliver the good genes
to a body's target cells, has been known to trigger severe
immune responses and was blamed for the death of an 18-year-old in 1999,
who was receiving gene therapy for a hereditary metabolic disorder.
The test subjects suffer from Leber congenital amaurosis (LCA), a form of
hereditary retinal degeneration that occurs in infants and young children and
is relatively rare. Most people who have lost vision due to hereditary retinal
degeneration have either no photoreceptors with which to perceive light or
photoreceptors that don't work. "This disease has a little bit of
both," explains lead study author Artur
Cideciyan, an associate research professor at the Scheie Eye Institute at
the University of Pennsylvania. "It's a complex disease."
The participants, ages 22 to 25, all had a mutation on the RPE65 gene, the
signature of LCA. Doctors administered normal RPE65 (delivered via an rAAV2
vector) into a site on one of the retinas that had the most photoreceptors
left. And, Cideciyan says, "Within weeks of the procedure there was a
substantial, very significant improvement in sensitivity to see dim lights. . .
Read the entire article at www.scientificamerican.com/article.cfm?id=ocular-gene-therapy-treatment
* * * * *
3.
International
Medicine: Shooting for Targets in Healthcare can be Deadly
NHS managers were . . . accused of putting targets and cost-cutting ahead of patients as
a report into at Mid-Staffordshire Hospitals trust found up to 1,200 people may
have died needlessly due to “appalling standards of care” at a single hospital by Rebecca Smith, Medical
Editor, 18 Mar 2009
A litany of failings at
the trust was uncovered by the Healthcare Commission in one of the most
critical reports of NHS treatment ever published.
. . . patient groups voiced concern that managers
who should have spotted failings at the trust but did not raise the alarm have
been promoted to key jobs in the NHS and health care regulation.
The investigation into
care between 2005 and 2008 found overstretched and poorly trained nurses who
turned off equipment because they did not know how to work it, newly qualified
doctors left to care for patients recovering from surgery at night, patients
left for hours in soiled bedclothes and reception staff expected to judge the
seriousness of the condition of patients arriving at Accident and Emergency.
Doctors were diverted
from seriously ill patients to treat ones with minor problems to make the trust
look better because it was in danger of breaching the Government’s four-hour
waiting time target.
The trust – which was
under pressure to save £10 million from its annual
budget – was more concerned with hitting targets, gaining foundation trust
status and PR marketing and had “lost sight” of its responsibilities for
patient care, the report said. . .
It is not clear how many
patients died as a direct result of the failures, but the commission found that
mortality rates in emergency care were between 27 per cent and 45 per cent
higher than would be expected, equating to between 400 and 1,200 “excess”
deaths. . .
The trust is spread
across two hospital sites, one in Stafford and one in Cannock. Most of the
problems occurred at Stafford. Patients described one ward as a “war zone” and
said people were often left in Stafford’s A&E for hours covered in blood
and without pain relief, even though they had serious injuries. Others were
left without food or drink, leading some to reportedly drink from vases when
thirsty.
Some patients also
received the wrong medication – or none at all.
Martin Yeates, the trust
chief executive, and Toni Brisby, its chairman, stepped down two weeks ago. Mr
Yeates, who is paid a salary of £160,000 a year, is suspended on full pay while
an independent investigation is carried out.
But patient groups were
angered that Cynthia Bower who, from July 2006, was chief executive of the West
Midlands Strategic Health Authority — which had responsibility for checking
standards at the hospital — is to become the head of the health
super-regulator, the Care Quality Commission.
David Nicholson, her
predecessor at the authority’s forerunner, the Shropshire and Staffordshire
SHA, left in 2006 and is now the chief executive of the NHS. Sir Ian Kennedy,
the chairman of the Healthcare Commission, said the report was a “shocking
story” and that there were failures at almost every stage of care of emergency
patients.
“There is no doubt that
patients will have suffered and some of them will have died as a result,” he
said. “Trusts must always put the safety of patients first. Targets or an
application for foundation trust status do not lessen a board’s responsibility
to its patients’ safety.”
The problems emerged
after the hospital was reported in 2007 to have high mortality rates among
patients. But the trust’s board of directors “fobbed off” NHS investigators by
saying the rates were a result of statistical errors.
. . . the Healthcare Commission concluded this was
not the case.
Its report stated that
staff members claimed care of patients had become secondary to
government-imposed targets. The report said there was a “reluctance to
acknowledge or even consider that the care of patients was poor”.
Nurses were threatened
with the sack because of the number of breaches of the target to treat A&E
patients within four hours and felt they were “in the firing line”.
Patients in danger of
breaching the target were put in a “clinical decision unit”, a “dumping ground”
for patients in order to “stop the clock” on the waiting time.
Relatives reported nurses
shouting at patients and a survey found two thirds of doctors would not be
happy to have a family member treated at the hospital.
Eric Morton, the new
chief executive of the Mid Staffordshire NHS Foundation Trust, said: “We would
like to offer our very sincere apology. We would like to reassure the local
community that our focus is, and will remain, on providing high quality,
efficient and safe healthcare.”
The NHS does
not give timely access to healthcare, it only gives access to targets.
* * * * *
4.
Medicare: Can Health
Reform Save Money? by Andrew J.
Rettenmaier and Thomas R. Saving
Health care spending per person varies widely across
the country, but greater spending does not appear to produce better
quality. A natural inference is that some areas of the country are less
efficient in the use of health care resources.
Thus, it is argued that health spending could be cut
substantially if the high-spending areas practiced medicine in the same way as
the low-spending areas. Office of Management and Budget Director Peter Orszag,
for example, argues that health care spending for the country as a whole could
be reduced by $700 billion a year. But how can these savings be realized?
Medicare Spending Variation. A number of studies have found that Medicare spending
varies substantially from one state, county or hospital region to another. For
example:
·
In 2004, average
Medicare spending in Louisiana (the highest spending state) was $8,659 while
spending in South Dakota (the lowest spending state) was $5,640, almost 35
percent less.
·
Taken as a group,
Louisiana, Maryland, New Jersey, Florida and Texas averaged more than $8,200 in
2004, or about $800 above the national average for Medicare spending.
·
By contrast, South Dakota,
Montana, New Mexico, Hawaii and Idaho all spent less than $5,800 - about 40
percent less than the states at the top of the distribution.
·
Overall, if every state
were as "efficient" as the fifth lowest spending state, Medicare
spending could be reduced by about 25 percent.
These numbers appear to confirm Orszag's claim without
answering the question of how we could dramatically change the practice of
medicine in 45 states. However, before concluding that there are large
potential savings, there are two important factors that need to be considered.
Spending on Other Patient Groups by State. News stories often imply that doctors in
high-spending Medicare states are practicing medicine in a way different from
doctors in low-spending states. One is left to infer that this must also be
true for Medicaid patients and private patients as well. But this inference is
not entirely true.
For example, although Louisiana is the highest
spending Medicare state and South Dakota is the lowest, average per capita
health care spending for the whole population is actually lower in Louisiana
($5,040) than it is in South Dakota ($5,327). This is not an isolated case:
·
Although Texas is fifth
highest in Medicare spending per capita, it is 43rd in per capita spending for
the state's entire population.
·
California is 11th in
Medicare spending, but 42nd overall.
·
North Dakota is 43rd for
Medicare, but 11th overall.
It appears that high Medicare spending is often
associated with lower spending on the non-Medicare/Medicaid population and
vice-versa. This observation is consistent with cost shifting between
public and private payers, although there may be other explanations as
well.
Read the entire article at www.ncpa.org/pub/ba668.
Government is not the solution to our problems, government is
the problem.
- Ronald Reagan
* * * * *
5.
Medical Gluttony:
Motorized Wheelchairs? And then it happened . . .
When returning to my office on Fair Oaks
Blvd last week, the traffic came to a halt. Ahead at the corner of FOB and
Stanley, there had been an accident. Two motorized wheelchairs had collided in
the intersection. As I started to get out of the car expecting to help two disabled
persons, I noted that both were already up and laughing as they helped each
other upright their MWC. They then proceeded to shake hands as they climbed
aboard and took off again. The traffic resumed and I arrived at my office on
time for my afternoon patients.
Requests for motorized wheelchairs are
becoming almost a daily occurrence. The requests are seldom based on
substantiation of disability, but rather that their neighbor or friend or
someone else at the senior residence has one and they don’t seem to be as ill
as my patient, or that it would be nice to tour the neighborhood in one.
I have a number of patients who live
within a mile or two of my office that drive their wheelchairs to my office
building and up the ramp. They park their motorized wheelchair in the hallway
and stride into my office. Some use a cane. The patient last week said he would
stop by the grocery store on his way home to buy his groceries for the week.
Does he still own a car? He said he did but would probably convert that to cash
since he now had an alternate form of transportation, with thanks to Medicare.
He felt he was deserving since he paid for it with his Medicare premiums over
the year.
Today, I had two requests for motorized
wheelchairs from a 98-year-old woman and her 76-year-old daughter on a visit I
made to their homes, which were in the same block. Both were rather weak. The
younger one was suffering from fibromyalgia and could sit for no more than 30
minutes. How could she sit in a wheelchair and travel up the street to see her
mother? She was too weak to even squeeze my hand. How could she manage the arm
and lever to drive the wheelchair? What would she do if she overturned on the
hilly area where she lived? I felt it was far too hazardous for her to have a
motorized vehicle and that her grandson and great-grandson that lived with her
should continue to help her about.
The older one was obviously too weak to
even consider one and, furthermore, she was essentially blind. She put her hand
to my face to help locate where I was at her bedside. I didn’t write a
prescription for either.
When
people get entitlements, they always feel they are entitled to even more. There
is no limit.
With
the proposed healthcare reforms, our medical costs will at least double until
they are contained by denial of service and a waiting list, which worsen access
to healthcare.
To keep up with health care reform, be sure to subscribe to
HealthPlanUSA.net by entering your email address at www.healthplanusa.net/newsletter.asp.
Medical Gluttony thrives in Government and Health Insurance Programs.
Gluttony Disappears with Appropriate Deductibles and Co-payments on
Every Service.
* * * * *
6.
Medical Myths:
Infant mortality is lower in countries with “universal medical care.”
Myth 4: Infant mortality is lower in other countries because they have
“universal” tax-funded medical care, and the U.S. does not.
July
3rd, 2009
A number of countries report lower infant mortality than the U.S., but it has
nothing to do with the source of payment for medical care.
In Japan, which has the best statistics (3.3 die per
1,000 live births), the national system does
not cover normal childbirth—or prenatal, postnatal, and postpartum
care (Your Health Matters by
Gregory Dattilo and David Racer, Alethos Press, 2006).
In the U.S., mortality is only 3.0 per 1,000 for
full-term babies weighing at least 5.5 lbs (ibid.). Premature, low-birth-weight
babies, who have a much higher risk of early death, have a better chance of
survival in the U.S. than anywhere else, because of the excellent medical care
they receive here.
The incidence of prematurity and low birth weight is
relatively high in the U.S.; one reason is ethnic composition. Black American
mothers give birth before 37 weeks twice as often as whites, and 3.8 times as
often before 28 weeks (Future of Children,
Spring 1995).
Predictors of premature birth include socioeconomic
factors such as age under 20, single marital status, being on welfare, and not
having graduated high school (Lieberman E, et
al. N Engl J Med
1987;317:743-748); chronic health problems such as diabetes, hypertension,
or clotting disorders; certain infections during pregnancy; use of cigarettes,
alcohol, or illicit drugs (CDC);
and prior abortions (Rooney
B, Calhoun BC, J Am Phys Surg
2003;8:46-49). Increasing Medicaid coverage for pregnant women had no
effect on birth outcomes (Ray WA, et al. JAMA 1998;279:314-316).
Many nations do not count very small babies as live
births. Hence, they don’t count as deaths either. In France and Belgium, for
example, babies born before 26 weeks are automatically considered stillborn, states
Bernardine Healy.
In the U.S., all our babies count, even if they make
our statistics look worse. The tiny ones we now save could be the first
casualties of “reform.”
“[A question] that assumes even greater significance
as we contemplate the finances of health care reform [is] how much capital are
we willing to invest to save the lives of the most extremely preterm infants?”
(Future of Children, op. cit.)
Additional information and references at www.aapsonline.org/newsoftheday/00307.
Medical Myths Originate When Statistics are Manipulated for Political
Reasons.
Medical Myths Disappear With Honesty in Calling a Breathing Baby a Live
Baby.
* * * * *
7.
Overheard at the
CMA (Certified Medical Assistant) Meeting: Are offices getting hostile?
Mabel: Have you noticed how impatient offices are getting
with each other?
Ann: It seems like most of the consultant’s offices are
rather short.
Nancy: Well, I have an angry doctor who’s upset because the
referral and records aren’t here and the patient is here.
Ann: Don’t you check your fax inbox before you get angry
with the referring physician who needs your doctor’s opinion? I’m sure your
doctor is grateful for having his expert opinion sought.
Nancy: We get so many faxes every day. I don’t have time to
go through all of them.
Mabel: Well, Good Grief. Is that any excuse to make a
hostile phone call to the physician who is referring the patient whose fees pay
your salary?
Ann: Don’t you think you should at least look through the
fax “holding pen” or whatever you might call it before you cause further work
for the referring physician’s office?
Jane: It shouldn’t be too much trouble to have them fax it
again, should it?
Ann: When we fax the referral, we dismantle our chart to
make sure the last complete exam is faxed along with recent and relevant x-rays
and lab reports. We also include face sheets and insurance information so your
doctor and office is efficient with time and can write a good report.
Jane: My doctor just dictates his consultation with the
available information and then adds that additional reports will be sent when
the information is complete.
Mabel: If your doctor has to give an additional report,
because of your inefficiency, doesn’t that cause inefficiency through the whole
chain?
Nancy: I don’t understand. Through the whole chain?
Mabel: If your doctor has to see the patient a second time
to give a report, it no longer is timely.
Ann: Meanwhile, the referring office has to send the
entire record again; the patient is inconvenienced and has to wait to benefit
from the second opinion. Doesn’t that essentially double all costs?
Nancy: How so?
Mabel: If your doctor has to pay you twice to do the work
that should have been done correctly the first time, doesn’t that double his
cost of paying you?
Nancy: How does that affect my salary?
Mabel: If everything you do is doubled or takes twice as
long, then you’re getting paid twice what you’re worth or what a more efficient
CMA would cost.
Nancy: Just let my doctor try to cut my salary in half.
Ann: As his overhead goes up and he makes less and less,
it won’t take him long to realize that it would be more cost efficient to pay a
good CMA that does twice as much work as you do for about the same salary. Your
job will be in jeopardy.
Susan: Mabel, listening to you and Ann has certainly put my
job in perspective. I must confess that on several occasions, Ann has asked me
to take another look for previously faxed records. And sure enough, they were
already in our office two weeks prior, just as she had documented.
Ann: I think the key is getting everything taken care of,
whether it’s messages or filing or acting on reports, before going home every
night. The phone starts ringing within 30 seconds after I reach the office, so
there is never any time the next day to catch up.
Mabel: You would be even further behind by the end of the
next day.
Susan: I’m certainly sorry I’ve caused you extra work. I’ll
make sure the faxes are filed immediately in the appropriate charts. If it’s a
new referral, I’ll make up a temporary folder until the patient arrives for his
or her appointment.
To keep up with what’s new, be sure to subscribe to HealthPlanUSA.net
by entering your email address at www.healthplanusa.net/newsletter.asp.
The Staff Lounge Is Where Unfiltered Medical Opinions Are Heard.
* * * * *
8.
Voices of
Medicine: A Review of Local and Regional Medical Journals and Related
Articles
Obama's Health Plan Will Succeed . . . By: Mark Schiller, Front Page, Thursday, August 06, 2009
.
. . At getting people to die faster.
Many
critics are busy complaining that President Obama's healthcare reform plans are
doomed to failure. It would be nice if they would just quit their whining and
get back to caring for their polo ponies or something, because it's clear that
the plan will be successful. Think about it -- as severely
ill people die more quickly, costs will inevitably be cut.
It's
really quite simple. Take cancer treatment. If we can just make sure to treat cancer
patients with older, cheaper, more ineffective treatments, then treatment will
actually be more effective -- at cutting costs as more cancer patients die. We
not only save the cost of more expensive medication -- we also save by relying
on less expensive stays in hospices instead of more extended active treatments.
More
importantly, if we can help patients die quickly now, then we can save on the
cost of any future major illnesses they would've had that would have cost
society a whole boatload of money. Basically, one severe potentially terminal
illness is cheaper than two. Some cancer patients may try to demand more
up-to-date, effective treatments, but society must obviously ignore their
selfish desires to live.
The
Obama plan is going to accomplish this with its billion-dollar investment in
"comparative-effectiveness research." This is a coup, because it
sounds so rational and scientific. A sophisticated observer can see that it
will be "comparatively effective" at reducing the rate at which new,
more effective treatments are utilized. The kind of large, expensive studies
required to prove that newer treatments are less effective at killing off
patients will be so difficult to conduct that the newly created
"Federal Coordinating Council for Comparative Effectiveness Research"
(or FCCCER, pronounced faux care) will have cover for many years before it's
compelled to approve any new treatment.
Such
is the excellent model provided by Great Britain's National Institute for
Clinical Excellence, known by the wonderful acronym NICE. Indeed it was
"NICE" how the agency "regrettably" found last summer that
four admittedly "clinically effective" lifesaving medications for
kidney cancer were not "cost-effective uses of NHS resources." NICE
has been wildly successful in shortening the overall amount of time that the
British medical system is forced to treat cancer patients. In Great Britain,
survival rates after a cancer diagnosis range from 40.2 to 48.1 percent for men
and 48 to 54.1 percent for women. The United States currently boasts an
inefficiently high rate of 66 percent for men and 63 percent for women.
Of
necessity, part of Obama's plan is to get physicians focused on purchasing,
integrating, and pulling their hair out over how to use fully computerized, government-approved
medical records systems. Many physicians complain that these systems don't work
well in their practices, that they're time consuming, and that they take time
away from patient care. But these computer systems are absolutely essential in ensuring
that physicians don't try to practice medicine themselves and instead comply
with the FCCCER's dictates to use outdated treatments. Computer records will
permit minute, constant scrutiny of physicians, who will be penalized for
trying to use independent judgment in prescribing unapproved treatments.
An
underappreciated part of the plan is the expected savings on Social Security
benefit payments, if we can be more effective in not prolonging the suffering
of those that could be terminally ill. It would be nice to see White House
economists include such assumptions in their calculations to help bolster their
argument for adoption of the President's plans. That is the type of forward
thinking that we need to sell this bill of goods to an American public so
unsophisticated that they are worried about having the government fully take
over one-seventh of the national economy during this time of economic distress
and multi-trillion-dollar federal debt.
www.frontpagemag.com/readArticle.aspx?ARTID=35840
Mark
Schiller, M.D., is a Senior Fellow at the Pacific Research Institute and a
board member of the Benjamin Rush Society, a medical society that is dedicated
to serving patients, not the government.
VOM is Where Doctors' Thinking is Crystallized into Writing.
* * * * *
9.
Book Review: Code Blue:
Reviving Canada's Health Care System by David Gratzer, MD
Greg Scandlen reviewed Gratzer's Code Blue, the story
of the Canadian Health Care System, for Medical Sentinel, the Official Journal
of the Association of American Physicians and Surgeons. We think this message
needs to be read by every American during the health care reform debate.
Long the shining beacon for the American Left, the
grand example of successful socialism on North American soil, the Canadian
health care system is falling apart, or so says David Gratzer in Code Blue:
Revising Canada’s Health Care System. Gratzer was a medical student at the
University of Manitoba when he wrote the book and now practices psychiatry in
Toronto.
Canada’s system, known as “medicare,” is run by
provincial governments and paid for by a combination of provincial and national
funds. Copayments are not allowed, nor are people allowed to go outside the
system and pay for services directly (unless one leaves the country). The
system is plagued, Gratzer writes, by long waiting lists of sick patients,
overcrowded hospitals, second-rate equipment, and a stream of doctors, nurses
and patients fleeing to the United States. He documents these woes not only
with a host of health care horror stories from Canadian newspapers, but with a
long list of studies, both official and private.
Gratzer says, “Waiting lists are the biggest concern
that Canadians have with their health care system. The lists are not a medical
but an economic problem. Because patients have no incentive to think twice
about using health care services, policy makers are forced to find ways to
ration health care.”
Gratzer agrees that the Canadian system is less costly
than the American one, but says the difference is overstated in a number of
ways. Total American spending is inflated, and Canadian spending lowered, by
the Canadians who cross the border to receive services in the States. He also
points out that raw comparisons don't account for differences in spending on
research, or differences in demographics or accounting procedures. He notes
that, “Canada’s entire research budget is smaller than the R&D budget of
the University of Texas’ M.D. Anderson Cancer Center.”
Even after adjusting for these differences, Canadian
medicine may still be cheaper, but you fail to get what you fail to pay for –
in this case, modern equipment, adequate facilities, and motivated physicians.
Gratzer’s most withering analysis is aimed at Canada’s
“gutless” political establishment that relies on bromides and cliches in place
of serious efforts to address the problems in Canadian medicine: “The badly
needed national debate isn’t taking place. There is only the sound of silence
as partisans of every political stripe advocate the intellectually vacant
position of maintaining the status quo in an ideal system that doesn’t really
exist.”
He maintains that the early success of medicare – back
when the population was young and costs were low – became hard-wired in the
Canadian psyche as a source of national pride. Now that the system is failing,
no political leader wants to be the first to tell the truth. As with “The
Emperor’s New Clothes,” denial reigns supreme.
Gratzer doesn’t stop at documenting the problems in
Canadian medicine, nor at laying the responsibility at a political class that
prefers to look the other way. He also examines possible solutions and
their consequences, including simply spending more money, applying user fees,
or creating a parallel privatized system to supplement the public program. Any
of these reforms would be an improvement, he says, but “the most important step
toward renewing health care in [Canada] is to accept that medicare is
fundamentally flawed.” He notes that medicare currently “consumes 21 cents of
every dollar earned by working Canadians,” and the Office of the Superintendent
of Financial Services projects a tax rate of 94.5 percent will be needed to
support the program in 2040 without fundamental reform.
Instead, Dr. Gratzer would like to see patients making
their own decisions about how to best spend their health care resources,
whether those resources come through the government or directly out-of-pocket.
And the best way to do this, he proposes, is through a national system of
medical savings accounts (MSAs), combined with high-deductible indemnity
insurance plans. He examines several alternative MSA designs, including the
possibility of government-provided high deductible insurance and tax-payer
funded “allowances” for MSA deposits. He prefers self-funded MSAs using
tax-free deposits. He argues that the poor and persons with “special needs”
could be granted extra assistance.
He concludes that “Medical savings accounts aren’t a
miracle solution. But an MSA system has the potential to address many of the
problems with the present health care system in Canada.” They could fix the
problems of waiting lists, second-rate equipment and fleeing physicians, while
maintaining accessibility and timeliness of care.
To read more book
reviews . . .
To read book reviews topically
. . .
* * * * *
10. Hippocrates
& His Kin: Human Rights In Health
Care
Hillary Rodham Clinton has been stomping through a
number of South African Countries extolling human rights. William Jefferson
Clinton has been meeting with the Dictators of the Most Unfree Country in the
world, North Korea, for the human rights of two reporters in prison. Barack
Hussein Obama has been stomping the United States to eliminate Human Rights in
Health Care.
Can’t Politicians Ever Get Things Straight?
God Save Our Country
A noted psychiatrist was a guest Speaker
at an academic function where Nancy Pelosi happened to appear. Ms Pelosi took
the opportunity to schmooze the good doctor a bit and asked him a question with
which he was most at ease.
“Would you mind telling me,
Doctor,” she asked, “how you detect a mental deficiency in somebody who appears
completely normal?” ”Nothing is easier,” he replied. “You ask a
simple question which anyone should answer with no trouble. If the person
hesitates, that puts you on the track.” ''What sort of question?” asked
Pelosi. Well, you might ask, ”Captain Cook made three trips
around the world and died during one of them. Which
one?” Pelosi thought a moment, and then said with a nervous laugh,
“You wouldn't happen to have another example would you? I must confess I
don't know much about history.”
There has been no double-blind study on a treatment
for “STUPID.”
The Father
of Socialized Medicine
Always remember that Chancellor Otto von Bismarck,
the father of socialized medicine in Germany, recognized in 1861
that a government gained loyalty by making its citizens dependent on the state
by social insurance. Thus socialized medicine, or any single-payer
initiative, was born for the benefit of the state and of a contemptuous
disregard for people’s welfare.
Will Barack Hussein Obama become as famous as
Bismarck?
* * * * *
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.
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,” “single-payer,” 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.
•
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 . . . 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.
* * * * *
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Del Meyer
Del Meyer, MD, Editor & Founder
6945 Fair Oaks Blvd, Ste A-2, Carmichael, CA 95608
"Those who know what's best for us must rise and save
us from ourselves." -Neil Peart
"The nine most terrifying words in the
English language are 'I'm from the government, and I'm here to help.'
"-Ronald Reagan
"Not everything that counts can be counted, and
not everything that can be counted counts." -Albert Einstein
Some Recent
Postings
Why Government
Doesn't Work, By Harry Browne
A Disingenuous Debate on Health Care Policy by David Gibson, MD
The Recession and its Effect on
Healthcare by David Gibson, MD and Jennifer Shaw Gibson
In Memoriam
Robert Novak, 1931-2009
A Conservative Columnist and Pundit Who
Looked for Scoops and Trouble
Robert D. Novak, who died Tuesday at age 78, parlayed shoe-leather
reporting and a dour worldview into a prime spot among the Washington
commentariat.
He was universally known as "The Prince of Darkness" for his
bleak take on human nature, and he wore the sobriquet proudly, using it as the
title to his 2007 memoir of a half-century reporting from Washington. It helped
nurture his gloomy persona on display on shows such as "Crossfire"
and "The Capital Gang."
"I am a pessimist by nature, which is why I have spent my life as a
journalist instead of trying to be a leader, which requires optimism," he
wrote in his memoir.
But Mr. Novak's persona -- including his title as "The Prince of
Darkness" -- was only a public one. Friends, who describe him as tough,
are also quick to call him kind and generous.
"He was given that as a nickname as a very young reporter," says
Geraldine Novak, his wife of nearly 50 years. "But everybody who knew him
knew that it was nonsense. He was really very cheerful and fun to be
with."
Al Hunt, Mr. Novak's longtime sparring pundit partner on television, spoke
highly of him as a mentor during earlier years in the Washington press corps.
"He was supportive and kind," says Mr. Hunt. "There was
pessimism unless you cut the capital gains tax, and then he was an incredible
optimist." . . .
A reporter from his student days at the University of Illinois, he later
worked for The Wall Street Journal, where he was a Washington correspondent
from 1958 to 1963. He left to team with Rowland Evans on "Inside Report,"
a column of Washington gossip and news that initially appeared six days a week
for the New York Herald Tribune Syndicate. . .
Mr. Novak continued his column after Mr. Evans died in 2001, and in 2003
published perhaps his most incendiary column ever, identifying Valerie Plame as
a Central Intelligence Agency operative. . .
Because naming a CIA agent can be a crime, questions soon arose as to
whether Ms. Plame was in the CIA and who had told Mr. Novak. In the resulting
imbroglio, Mr. Novak divulged his sources before a grand jury. A federal
investigation ended with the 2007 conviction of a top vice-presidential aide,
I. Lewis "Scooter" Libby for perjury and obstruction of justice.
Although a registered Democrat, Mr. Novak identified himself as a conservative.
He wrote that his conservatism deepened as his TV persona grew. But his main
role continued to be as an "obstreperous reporter looking for
trouble." He wrote in his memoir about the heavy drinking that accompanied
his hard reporting.
But in the early 1980s, partly because of a bout of spinal meningitis, Mr.
Novak curtailed his drinking. That was one of several health setbacks that
partly inspired his conversion to Catholicism late in life, at the age of 67.
Mr. Novak said he also took part of his inspiration from Whittaker Chambers's
book Witness, about Mr. Chambers's conversion from Communism to Christianity.
The Judaism he was raised with, he said, was not inspiring at all.
With an all-star group of Washington politicians looking on and Ms. O'Beirne
as his godmother, Mr. Novak converted to Catholicism in a 1998 ceremony at St.
Patick's Church in Washington.
Presiding at the ceremony was Monsignor Peter Vaghi, who had been a staffer
for Sen. Pete Domenici and a source for Evans & Novak before entering the
priesthood. Just before Mr. Novak bowed his head to receive the sacramental
waters of baptism, Msgr. Vaghi told the onlookers they were about to witness
the transformation of a "prince of darkness" into a "child of
light."
His friend Sen. Daniel Patrick Moynihan joked, "Well, we've now made
Bob a Catholic. The question is, can we make him a Christian."
Years later, Mr. Novak told the Washingtonian magazine that "it was an
exhilarating experience, one of the great moments of my life."
In 2008, he seemed in a daze after leaving the scene of an accident after
his Corvette hit a Washington pedestrian. Days later, he was diagnosed with the
brain tumor that would eventually kill him.
http://online.wsj.com/article/SB125061255230640357.html#mod=todays_us_opinion
![[Political Columnist Robert Novak Dies at 78]](./Aug2509_files/image002.jpg)
Robert Novak at a taping of 'Meet the Press'
in 2007
On This Date in
History - August 25
On this date in 1930, Sean Connery was
born in Edinburgh, Scotland, the son of a truck driver. He worked the
morning milk route before heading off to school. He introduced the role of
British superspy James Bond to the silver screen in the 1962 film Dr. No. He recreated the James Bond
role five more times before he moved on to other projects after 1971.
On this date in 1918, Leonard Bernstein
was born in Lawrence, Massachusetts. He was a famous conductor by the age of
25, and composer of the symphony, “Jeremiah.” He moved with
ease from the classical to the popular side of composing, meanwhile bringing
the New York Philharmonic new glory as its conductor.
On this date in 1836, Bret Harte, the writer,
was born in Albany New York. It was Bret Harte who gave the public
its first exciting and grubbily humorous accounts of Western life, including
such classics as “The Luck of Roaring Camp” and “The Outcasts of Poker Flat.”
Within ten years he had burned himself out as an author, while friends and
colleagues like Mark Twain not only kept on going, but kept on getting better
all the time. Some people rise like meteors and fall the same way, while others
seem to keep on going, shining brighter all the time. Sometimes it’s difficult
to know when you’re at the brightest and it’s time to stop. If you don’t,
tragedy may happen on your descent.
After Leonard and
Thelma Spinrad
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