MEDICAL TUESDAY . NET
Community For Better Health Care
Vol IV, No 17,
In This Issue:
The 3rd Annual World Health Care Congress, co-sponsored by The Wall Street Journal, is
the most prestigious meeting of chief and senior executives from all sectors of
health care. Renowned authorities and practitioners assemble to present recent
results and to develop innovative strategies that foster the creation of a
cost-effective and accountable
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Paperwork is 21% of health costs - $26
billion goes to administration each year in state By Victoria Colliver, Chronicle Staff Writer,
The study, published in the current issue of the journal Health Affairs, investigated the cost to insurance companies, doctors and hospitals of billing and other administrative tasks, such as referrals and appeals.
That translates into about $26 billion a year in
Many health experts believe that the huge amounts spent on
administration is a major source of inefficiency in the
"If you extrapolate our results nationally, you get about $230 billion a year being spent for these insurance administration expenditures," Kahn said. "This is money that, in my view, would be better spent on health care."
. . . The study concluded that 21 percent was spent on insurance administration and an additional 13 percent was used to cover other administrative tasks, such as maintaining medical records. "What you're left with is that 66 cents (out of every dollar) is spent on health care," Kahn said.
The three-year, $100,000 study was
funded by the California HealthCare Foundation, a philanthropic group based in
Kahn's research bolsters the
conclusion of two
The Harvard study, which compared
health care spending in the
Many physicians are frustrated by the amount of time they have to devote to insurance paperwork.
"If you have 10 different
insurers, you don't know which one covers what. For every medication you give
you have to check the formulary," said an
Guyer said she decided to work for Kaiser Permanente, a membership organization that does not contract with multiple private insurers, to avoid the time and hassle associated with billing.
To read the entire article, please go to www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/11/11/BUGM8FM8I11.DTL&type=printable.
"The Cost of Health Insurance
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Biohazards: Advances in biological science raise
troubling questions about what it means to be human - Wesley J.
"By the end of the 21st century," writes Reason magazine science editor Ronald Bailey in his book "Liberation Biology," http://reason.com/lb/, "the typical American may attend a family reunion in which five generations are playing together. And great-great-great grandma, at 150 years old, will be as vital ... as her 30-year-old great-great grandson with whom she's playing touch football."
UCLA futurist Gregory Stock predicts in "Redesigning Humans" that the genetic engineering of progeny for health, intelligence, physical beauty, even sociability, will be so successful that procreation through intercourse will be deemed "too unpredictable," making "laboratory conception ... obligatory rather than optional."
Princeton biologist Lee Silver believes fervently, as described in "Remaking Eden," that the wonders of human redesign will eventually lead to a "special point" where our posterity will create themselves into a "special group of mental beings who" are as different from humans as humans are from primitive worms. ...'Intelligence' will "not do justice to their cognitive abilities. 'Knowledge' does not explain the depth of their understanding. ...'Power' is not strong enough to describe the control they have over technologies that can be used to shape the universe in which they live."
The prospect of a 150-year-old living human being sounds fantastical. So does pre-designing children or future generations with godlike powers. But many futurists and scientists say we humans are about to seize control of our own evolution.
If the impeders of scientific progress can just be pushed out of the way, they predict, the wonders of science and biotechnology will re-create us into superior beings who will live longer, look better, play harder and think smarter than any of us can even dream of doing today.
Others (including this writer [Wesley Smith]) see such scenarios as more hype than hope.
Some of us also worry that advocates of unfettered research are changing science from a means into an end, a belief system rather than a method. . . .
In place of humanness as the criterion for ultimate value, these advocates offer "personhood theory," in which rights belong to "persons," a status earned by any organism or machine possessing minimal cognitive capacities.
If personhood theory ever governs society, the impact would be incalculable, for as futurist James Hughes writes in "Citizen Cyborg," "Persons don't have to be human, and not all humans are persons."
Opponents of personhood theory warn that it would lead to the most vulnerable humans being exploited as mere objects.
They note that some supporters of personhood theory already advocate infanticide for profoundly disabled babies and organ harvesting from people diagnosed to be in a persistent vegetative state.
The already simmering humanhood versus personhood controversy is going to boil over as our scientific and biotechnological capacities advance.
For example, what if it becomes technologically feasible to create cloned human embryos and gestate them in real or artificial wombs to fetal stage for use in drug testing or for organ procurement? (Such experiments have already been conducted successfully in cows.)
Those who believe that humanhood provides intrinsic value argue that such "fetal farming" should be prohibited because it reduces nascent human life to the status of a mere harvestable commodity.
Personhood theorists, on the other hand, would tend to support using cloned fetal nonpersons to save the lives of persons and to reduce the suffering of animals currently used in medical research, which are seen as having greater moral value because they possess higher cognitive capacities.
Another issue touching on the meaning and importance of human life is the creation of animals called chimeras that have been genetically engineered to contain some human DNA. . . .
Once having children was generally conducted in a simple way: Men and women got married, made love, and had babies -- although not always in that order. . . .
Infertile couples now conceive through in vitro fertilization. Women who can't carry a child can arrange to have their baby gestated by a surrogate birth mother. . . .
But critics worry that our growing mastery over reproduction could slide from liberty into license and even into reproductive anarchy. Look for these issues to cut through the body politic like a laser in the coming decades:
-- Is there a right to reproduce?
This issue strikes at core beliefs about the importance of natural limits, age, gender, sexual orientation, feminism, traditionalism, normality and the purposes of becoming a parent. . . .
How all of this will turn out, nobody knows. But as Leon Kass, former chairman of the President's Council on Bioethics, has said: "All of the natural boundaries are up for grabs. All of the boundaries that have defined us as human beings, boundaries between a human being and an animal on one side and between a human being and a super human being or a god on the other. The boundaries of life, the boundaries of death. These are the questions of the 21st century, and nothing could be more important."
Wesley J. Smith is a senior fellow at the Discovery Institute and a special consultant to the Center for Bioethics and Culture. His current book is "Consumer's Guide to a Brave New World." Contact us at firstname.lastname@example.org.
Read the whole article at
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When conversations turn to health care, I am always reminded of my grandfather. He was 91 when he died. He had never been ill. He had never needed medical treatment in his whole life. Upon reaching his nineties, however, he required prostate surgery.
Like all Belgians, my grandfather had paid wage-related contributions to cover health insurance throughout his entire professional life. The Belgian health care system is a so-called pay-as-you-go system. Today's young and healthy do not set money aside for their own future needs, but are compelled to pay for today's sick and elderly. As my grandfather had never needed much health care, he had been a net contributor to the system. Now was the first time he was going to claim something back.
He had his operation in May. In November he was dead. The prostate operation had gone fine, but afterwards the hospital had given him an antibiotic drug that caused complete deafness. Though there were other, but costlier, drugs available, the hospital gave the old man the cheapest one. They knew about the side-effects, but it did not strike them as an unreasonable and unjust thing to do. Why should it? A man who has already had 90 healthy years of life surely has no right to complain about deafness when some people get more seriously ill or die at a far younger age. When my grandfather left the hospital he was completely deaf. He lost his will to live. Six months later, he was dead.
In many Western European countries, health care is the fastest growing segment of government spending. Over the past forty years there has been a significant increase in health-care spending. According to the latest OECD figures (2003), Western European countries spend between 7.3 and 11.5% of their gross domestic product on health care. Ten years ago it was between 6.9 and 9.9%. In 1960 it was only around 4%.
Much of the rise in
There are only two ways to keep the present government-run European health-care systems going. One can either drastically increase the financial burden on those at the paying end of the system the young and healthy of today or one can drastically limit the quality and the availability of health care for those at the receiving end the sick and the elderly.
For decades governments increased the financial burden on
the working population. When this burden became intolerable, they shifted their
policies towards cutting back quality. In
Other ways in which many governments in
For almost a decade now, governments have been stifling
medical innovation in
As is often the case, many of continental
While these measures were successful in the field of cost
control, they had devastating consequences for the pharmaceutical industry. The
German pharmaceutical companies, no longer keen on developing new drugs, saw
their world-wide share of drug patents drop to 8% from 16%. Doctors, afraid
that they would have to pay the pharmaceutical bills out of their own pockets,
started to refer their patients to specialists and hospitals. Patients with
minor illnesses, requiring common and cheaper medicines were helped, but the
doctors would "dump" their more serious cases instead of treating
them in more costly ways. As a result, in 1993
"Money is being saved even if it costs lives to do so. Whenever possible many hospitals are turning away expensive patients covered by the sickness funds. The only good patient is a cheap patient."
Unfortunately, the German system has become the European
model. Politicians in neighbouring (sic) welfare states, noticing the drop in
German health expenditure, started to follow the German example. The only thing
that mattered in their eyes was cost control. Many adopted the policy of adding
drug volume control to price control and finally to prescription control.
the root of these decisions is the understandable desire of governments to
control health-care costs. But rationing is clearly not the answer. What many
the larger and more fundamental problem of how to finance the health-care
systems is not adressed. Instead of funding the provisions of today's sick with
taxes from today's healthy and young, people should be building up reserves for
their own future liabilities. What
To read the entire report, please go to www.canadafreepress.com/2005/brussels112305.htm.
Paul Belien is the editor of the Flemish quarterly Secessie and the editor-in-chief of The BrusselsJournal. He is a columnist at the Flemish weekly Pallieterke and at the Flemish monthly Doorbraak and a regular contributor to the Flemish conservative monthly Nucleus, which he co-founded in 1990.
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My homeless patient came in last week for his annual exam. I have been seeing him since 2002. Some may recall that he lived in boxes behind a bar when he was out of jail for substance abuse. In 2003, he started living in his car and obtained drinking water, showered and shaved at the YMCA. Low and behold, people started being friendly with him. In 2004, he obtained a job driving a truck and was able to keep body and cell phone together in an apartment.
Last week, he came in well dressed, his beard neatly trimmed, and could have passed for a mid-level executive. He announced that he was now driving an 18-wheeler, sometimes a 30-wheeler, truck interstate. He said the money was good, real good. After checking his pulmonary function and finding that his asthma was improved, partly due to living in a clean environment, he stated that he had been taking his standard bronchodilators and had not suffered from asthma attacks in the past year. He also decreased his cigarette smoking. After writing his prescriptions for the next year and escorting him to the door, I noted that he was still covered by Medicaid insurance, government healthcare for the poor and destitute. I looked surprised. He said he still had two more years to go before his next review of the disability he obtained for being on drugs.
Government is not the solution to our problems, government is the problem.
- Ronald Reagan
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One of my patients, a 72-year-old lady, came in for an office visit to obtain a health statement so she could continue substitute teaching in her school district. In reviewing her medical history since her last visit three months earlier, I found she had gone to the hospital Emergency Room because of elevated blood pressure. On the previous Saturday it was elevate to 210/112 at . When asked why she didn't take one of her two blood pressure medications, she said it wasn't time until to take them. Why didn't you take them early? She said, "I didn't know I could."
Her emergency record noted that no medications or treatment was given. She stated that she took her pill bottles with her and when the nurse interviewed her, she was advised that she should take her medications even though it was an hour early. She was then allowed to occupy an expensive ER bed for two hours, after which her blood pressure returned to the usual 130/80 range. When reminded of the ER cost, and the daily newspaper reports concerning excessive health care costs, she said she had no idea that ERs are so expensive. If she had to pay a portion of the ER costs, say what an average physician office visit cost (about $100) and the rest of the ER cost would be paid by Medicare (about $600), would she have gone to the ER? She acknowledged that she would have either called me or taken her high blood pressure medications on her own.
How can this gluttonous behavior be stopped? Was Medicare able to stop it with their massive restrictive and oversight programs? No, this happened under Medicare's watch. Would health insurance carriers or managed care companies have been able to stop this with their massive restrictive and oversight programs? No, this happened under health plan co-insurance managed care watch.
This type of gluttonous behavior can only be controlled through patient responsibility. It is not a classroom learnable experience not even by this teacher after 50 years of teaching. This behavior can only be corrected through financial responsibility. Patients with no health insurance shop wisely and reduce their costs to about half. Patients with a percentage co-payment also shop wisely and reduce their health care costs, by estimates of 30 percent to 50 percent. Patients with a fixed or no co-payment, simply use their health plan financed by taxpayers or the pool of insured premium payers with no regard for its cost. This lady increased her health care costs by 600 percent because it was there. There was actually a disincentive to save costs since the $100 office call would have cost her a $10 co-payment, while the $600 ER visits had no co-payment because it was construed as an emergency, which it wasn't.
Single-payer or socialized medicine by any other name has never worked and will never work. Human gluttony will always exceed human need. Medical responsibility will never occur with third-party health care with no or fixed co-payment plans. It will only occur with a graduated deductible and graduated co-payment system. To think that non-economic incentives or a police state can control one of the largest items in a family's budget is unrealistic thinking.
To paraphrase the warning of Paul Revere:
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The City Council that pressured Thomas to step down earlier this month quietly gave him an even nicer send-off Tuesday - a 10 percent pay raise and potentially a higher pension for life.
The decision boosts Thomas' salary to $208,900 from $189,901. The council made the increase retroactive to July 1, the beginning of its fiscal year.
The council was generous to its other top administrators as well, giving them identical retroactive 10 percent salary increases. City Attorney Sam Jackson's salary rose to $182,800 from $166,148, City Treasurer Tom Friery's to $169,900 from $154,502 and City Clerk Shirley Concolino's to $122,000 from $110,946.
The timing and the substantial amount of the pay increases could trigger a review by the California Public Employees Retirement System, according to spokeswoman Pat Macht. . . .
If a pay raise was given as part of a final settlement, was listed as special compensation or would not be used to calculate the pay range for the city manager in the future, Macht said, it might not be allowed in a pension calculation.
"It would raise a red flag - the compensation experts would take a look at it," she said.
However, Macht said, if the raise was given to other key managers, was recommended after a compensation survey, or would be used to set the salary for a replacement candidate, the pension increase would be more in line with CalPERS requirements.
In a written report to the council,
Dee Contreras, director of the city's labor relations office, said the
recommended raises were based on performance and in comparison with several
other cities in
Contreras said the raises will place
On Tuesday, the council unanimously approved the salary increases with no discussion. It was included as part of the consent agenda, usually reserved for noncontroversial items. . . .
Theis Finlev, policy advocate for California Common Cause, said salary discussions such as these should always be discussed in public on the regular agenda.
"Sacramentans were not given enough opportunity to weigh in on this," Finlev said.
Read the entire article at www.sacbee.com/content/politics/local_government/v-print/story/13895924p-14734780c.html.
Reality: No Branch of
Government Can Control Costs or Make Accurate Financial Projections. They Use
Myths Justify Their Gluttonous Behavior.
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"Though unsavory, it is not unusual for members of Congress on powerful defense committees and subcommittees to receive campaign donations from defense contractors or to be recruited for lucrative lobbying and defense industry jobs after they leave elected office. From Congress to the school board, proving that contributions are made with the specific intent to influence an official act or received because of an official act is what's difficult to pin down.
"But that wasn't the case for Cunningham, R-Rancho Santa Fe, and his quid pro quo. Cunningham blatantly and shamelessly took private favors in exchange for steering contracts to his benefactor. Cunningham admitted in U.S. District Court that he used his position on the House Appropriations Defense Subcommittee to steer government contracts to a defense contractor in exchange for personal favors. . . . All told, Cunningham admitted in court to receiving at least $2.4 million in bribes."
Dr Rosen: But won't investigating bribes decimate Congress?
Dr Milton: Hopefully. And wouldn't that be the biggest step in restoring freedom in our country?
* * * * *
White Paper For Patient Safety: In Search Of The "Black Box" For Reliable And Cost-Effective Quality Control Of The Delivery Of Medical Care. By Gil N. Mileikowsky, MD
The reason airline transportation is the safest of all transports is due to the famous "black box" that provides the necessary first step, i.e. the accurate "diagnosis." Without that reliable "forensic" analysis, the "blind lead the blind."
The reason the Federal Aviation Agency (FAA) is effective is because it has jurisdiction over every aspect of the airline industry, including pilots, mechanics, flight attendants, management and manufacturers. It can prevent disasters because it has the power to act immediately, without the intervention of any other agency, e.g. the U.S. Department of Justice and its lengthy process. The FAA can ground, at once, a particular type of plane or an entire airline company, with good cause. Without it, planes would crash daily.
There is no such equivalent
in the healthcare industry, however the taxpayer is spending billions of
dollars on multiple layers of county, state, federal and not-for-profit
agencies that are defective by design. On
Is it possible to have a "black box" in the health care industry?
In clinical research, to evaluate new treatments we use randomized "double-blind" studies, where neither the physicians nor the patients know which pill is a placebo and which pill actually contains the drug. We can do the same when evaluating any error or complication in the health care industry, whether it's in the hospital, the doctor's office, the pharmacy, the manufacturer of a medical device, etc.
We have about 900,000
licensed physicians in the
Whenever any error or complication is reported, it could be submitted anonymously, i.e. without the patient's name, the physician's name, the hospital's name, the city or state, to an odd number (7 to 11) licensed individuals who will also remain anonymous to the patient, physician and hospital. This anonymity will assure an unbiased, impartial opinion, void of any possible conflict of interest. Such an approach also eliminates any concern of "immunity," as the identity of those individuals will never be known.
A "black box" method of investigation should combine multiple disciplines, i.e. physicians, pharmacists, nurses, administrators, medical device manufacturers, laboratory technicians, etc., because errors and complications in the health care sector can result from various sources in a hospital, a laboratory, a pharmacy, a doctor's office, etc. "It's the system stupid," as R.M. Wachter, M.D. and K.W. Shojania, M.D., point out in Internal Bleeding the truth behind America's terrifying epidemic of medical mistakes.3
Such a "black box" could be consulted in lieu of "experts" by state medical boards, hospitals' peer review, medical malpractice cases, Medicare investigations, etc., since their "experts" are at times the weak link or "Achilles tendon" of the system.
Such a "black box" could also prevent future errors and complications because the opinions of each member of such a "black box" could be reviewed and a physician, a pharmacist, a nurse, or an administrator whose professional opinion may fall below the acceptable standard of practice could be identified and educated in such a proactive "two way" analysis. Isn't the whole purpose of peer review to learn from our colleagues' mistakes so that we can reduce errors and complications in our industry by not repeating them.
Such a "black box" participation should be mandatory as a part of maintaining and renewing the licenses' of physicians, nurses, pharmacists, hospitals, etc., in the same way that participation in peer review is mandatory under the bylaws of hospitals for members in order to maintain their "active" status. We could save the taxpayer a lot of money by merging all state boards - medical, nursing, pharmacists, tissue bank, laboratory, hospitals -, into a single state and federal oversight agencies. Thus, their investigative capabilities would be merged into one single comprehensive unit, much like our multiple intelligence agencies are coordinated through the "Homeland Security" Department. This is the only way to achieve a uniform quality control across the country. See articles in the Washington Post regarding the disparate effectiveness of various state medical boards.4
To read the entire article, please scroll down at http://www.delmeyer.net/HMCPeerRev.htm.
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9. Book Review: HEALTHY COMPETITION - What's Holding Back Health Care and How to Free It by Michael F Cannon & Michael D Tanner, Cato Institute, Washington, DC © 2005, ISBN 1-930865-81-3, 173 pp, $10. Part II Misdiagnosis: Chapter 3: How Not to Reform Health Care
The authors begin with a
popular subject of the "Right" to Health Care as claimed by Physicians
for a National Health Program, a group that claims to represent more than
10,000 doctors and medical students. (about one percent of physicians) Sen.
Edward M. Kennedy (D-Mass.) has remarked, "We have it in our power to make
the fundamental human right to health care a reality for all Americans. His
colleague Sen. John F. Kerry (D-Mass.) has said, "I'm committed to
universal health care coverage because, in
respond: "Medical care can be as essential to survival as food. But does
it follow that people have a right to medical care? Would recognizing a right
to health care solve
"Whoever has the power to make these decisions will exercise enormous power over who does and does not receive medical care. Who should have that power? In most nations that have tried to guarantee universal access to medical care, politicians allocate specified funds to local bureaucracies, which in turn decide how medical care will be rationed. This is typically achieved by making even seriously ill patients wait for care.
"A second and related difficulty is the question of who pays. A right to health care by definition would not be conditioned on one's ability to pay. Enforcing the right would require increasing taxes in proportion to how generously one defines the ''right.''
"A third difficulty is the incentives such a system creates. Patients would have little reason to constrain their consumption because additional consumption would cost them little. Higher tax rates would discourage work and productivity, yielding less economic growth and wealth. Pushing down the compensation of medical professionals would discourage many (and many of the brightest) candidates from entering the field of medicine. Divorcing their compensation from the satisfaction of their patients would reduce the quality of care. Since innovations that increase medical productivity also increase spending, policymakers would discourage innovation because every new discovery puts them in the uncomfortable position of either increasing taxes or saying ''no'' to patients. The paradox of a ''right to health care'' is that it discourages the very activities that help deliver on that ''right.''
"A final difficulty is how to deliver the medical care to which all are now entitled. Declaring health care to be a right does nothing to solve the problem of getting the right resources to the right place at the right time. Where are doctors most needed? Where will we place hospitals? Who will produce surgical tools? How much will they be paid? These decisions must be made through the political process. Not only has the political process proven slow and imprecise at meeting shifting needs, but those with political power would enjoy a greater ''right'' to health care than others by virtue of their ability to affect the allocation of health resources. That has largely been the experience of countries that have tried to enforce a right to health care. . . .
"Fundamentally, creating a legal 'right' to health care is incompatible with the idea of individual rights. People cannot legitimately claim a right to something if that claim infringes on the rights of another. Smith's right to free speech takes nothing away from Jones. The only obligation Jones owes to Smith is not to interfere with Smith's exercise of her rights. The same is not true of a right to health care, which would turn the concept of rights from a shield into a sword by imposing an obligation on Jones to provide health care to Smith.
"The underlying goal of creating a legal right to health care is to provide medical care to the greatest number possible. The fact that this approach would reduce the amount of medical care available to most or all Americans suggests that we should look for other ways of achieving this goal."
Health Care . . . as is done in
government-run health care system would come at enormous cost to American
taxpayers. One proposal championed by Representative and former Democratic
presidential candidate Dennis Kucinich was estimated to cost as much as $6
trillion over 10 years. Supporters argue
that some of this cost would be offset by savings from reduced administrative
costs and insurance company profits. However, research suggests that government
provision of health care leads to higher administrative costs. Patricia Danzon
has estimated that administrative costs under
"Whatever its powers, government cannot repeal the laws of economics. When individuals perceive health care to be free, the quantity demanded increases. Faced with the choice of bankrupting their economy to pay for the virtually unlimited demand, or reducing the amount of health care provided, these countries opt for the latter.
"Even with rationing, however, government-run health
care systems do a poor job of controlling the rising cost of health care. When
such factors as population growth, general inflation, exchange rates, growth in
elderly populations, investment in research and development, and rates of
crime, poverty, AIDS, and teen pregnancy are taken into account, Canadian health spending is much closer
to that of the
"Universal health care is not free. Citizens of countries
with national health care systems pay a heavy price in taxes.
"One step removed from government management of the
health care marketplace is the concept of 'Managed Competition'"
That idea would leave the provision of health care in private hands, but would
create an artificial marketplace run under strict government control. Managed
competition saw its fullest rendering in the failed
To read the rest of Part II, Chapter 3 How Not to Reform Health Care, please go to the Cato Bookstore: www.catostore.org/index.asp?fa=ProductDetails&method=cats&scid=33&pid=1441272. The price is only $10. At that rate, consider purchasing two or three and do your friends, who don't understand the ideas above, a favor with a gift that keeps on giving. There are also excellent other recent titles you may want to consider.
Next month, Part III: Underlying Diseases, Strong Medicine, Chapter 4: Too Much of a Good Thing Can Be Very Bad
To read some of
the other book reviews that are available, please go to www.delmeyer.net/PhysicianPatientBookshelf.htm.
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10. Hippocrates & His Kin: Government Is a Way Of Not Having to Think
Harry Browne: Out of the mouths of nurses: During a recent hospital stay, I had an interesting conversation about government with a nurse, Kathleen Brazil. In the middle of the dialogue, she suddenly said, "Government is a way of not having to think." And in those eight words, she wrapped up neatly the seduction of government for so many people. www.harrybrowne.org/
Goodness, I hope she thinks when she's taking care of the sick and dying.
Vioxx Verdict: In the battle between sound
science and the trial bar, it was probably too much to hope that Merck would
win the lawsuit whose verdict came down Friday [August 19]. There was no direct
causal link between Vioxx and the arrhythmia that the autopsy showed had caused
the death of a
How can you have a heart attack that can't be confirmed on the autopsy? So now attorneys, judges, and juries can hand down verdicts based on speculation rather than evidence?
A MedicalTuesday member writes about a college friend diagnosed as mentally ill by the psychologists at the euphemistically named student-counseling center. Ended up locked up in mental institution for some months. Finally her advisor heard about it. She was a chem major and had been working with selenium. Symptoms of excessive selenium exposure are, well, apparently similar to those of mental illness. They were so tuned to seeing everything as a psychological problem that they never even considered a physical cause until the professor started raising Cain.
It's always hazardous to allow allied medical fields to make a medical diagnosis. Before long, we might even hear of administrators of insurance carriers or even government practicing medicine by telling doctors how to diagnose and treat.
George Washington's Thanksgiving Prayer "Whereas it is the duty of all nations to acknowledge the providence of Almighty God, to obey His will, to be grateful for His benefits, and humbly to implore His protection and favor . . .that great and glorious Being who is the beneficent author of all the good that was, that is, or that will be." http://online.wsj.com/article_print/SB113287973488606161.html
If George Washington were alive today, he may never have become president.
Joshua Wolf Shenk, author of Lincoln's
Melancholy: How Depression Challenged a President and Fueled his
Greatness states: Modern clinicians agree that
Had Abraham Lincoln lived today in our current milieu of political correctness, he could never have been elected president and slavery may have lasted another generation or more.
To read more HHK columns,
please go to www.healthcarecom.net/hhk2000.htm.
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Pacific Research Institute, (www.pacificresearch.org) Sally C Pipes, President and CEO, John R Graham, Director of Health Care Studies, publish a monthly Health Policy Prescription newsletter, which is very timely to our current health care situation. You may subscribe at www.pacificresearch.org/pub/hpp/index.html or access their health page at www.pacificresearch.org/centers/hcs/index.html. This month, be sure to read The Acute Nature of Chronic Problems: Why the AARP drumbeat on costs won't help cure a single patient. www.pacificresearch.org/press/opd/2005/Medical_Progress_10-05.pdf.
The Mercatus Center at
The Galen Institute, Grace-Marie Turner President and Founder, has a weekly Health Policy Newsletter sent every Friday to which you may subscribe by logging on at www.galen.org. Be sure to read her current report on Too Many Choices at www.galen.org/medicare.asp?docID=846.
Greg Scandlen, an expert in Health Savings Accounts (HSAs) has embarked on a new mission: Consumers for Health Care Choices (CHCC). To read the initial series of his newsletter, Consumers Power Reports, go to www.chcchoices.org/publications.html. To join, go to www.chcchoices.org/join.html. To read the current issue, go to www.chcchoices.org/publications/cpr6.pdf.
Institute, www.heartland.org, publishes the Health Care News founded and edited by
Conrad F Meier in 2001. Conrad passed on unexpectedly earlier this year. Be
sure to get his latest book at the CAHI site below. This month, read Why
Government Failed in
The Foundation for Economic Education, www.fee.org, has been publishing The Freeman - Ideas on Liberty, Freedom's Magazine, for over 50 years, with Richard M Ebeling, PhD, President, and Sheldon Richman as editor. Having bound copies of this running treatise on free-market economics for over 40 years, I still take pleasure in the relevant articles by Leonard Read and others who have devoted their lives to the cause of liberty. I have a patient who has read this journal since it was a mimeographed newsletter fifty years ago. This month, be sure to read another classic on Political Accounting by James Bovard who is the author of Freedom in Chains: The Rise of the State and the Demise of the Citizen, www.fee.org/publications/the-freeman/article.asp?aid=4854. "Since government is coercion, politics is largely the exercise of deception regarding the intended use of coercion. . . . If a politician camouflages his plans, people may fail to resist the increased power until it is too late. This is the thumbnail history of Social Security, a program that illustrates the natural combination of paternalism and political fraud."
The Council for
Affordable Health Insurance, www.cahi.org/index.asp, founded by Greg Scandlen in 1991, where he served as
CEO for five years, is an association of insurance companies, actuarial firms,
legislative consultants, physicians and insurance agents. Their mission is to
develop and promote free-market solutions to
The Health Policy Fact Checkers is a great resource to check the facts for accuracy in reporting and can be accessed from the preceding CAHI site or directly at www.factcheckers.org/. This week, read the Daily Medical Follies: "Woeful Tales from the World of Nationalized Health Care" at www.factcheckers.org/showArticleSection.php?section=follies or just review the list of common myths and what is reality.
Independence Institute, www.i2i.org, is a free-market think-tank in Golden,
The National Association of Health Underwriters, www.NAHU.org. The NAHU's Vision Statement: Every American will have access to private sector solutions for health, financial and retirement security and the services of insurance professionals. There are numerous important issues listed and accessible on the opening page. Make this your guide to insurance, whether Individual, Group, Long Term Care or information on HSAs. www.nahu.org/consumer/HSAGuide.htm.
Martin Masse, Director of Publications at the Montreal Economic Institute, is the publisher of the webzine: Le Quιbιcois Libre. Please log on at www.quebecoislibre.org/apmasse.htm to review his free-market based articles, some of which will allow you to brush up on your French. You may also register to receive copies of their webzine on a regular basis. This month, read Bradley Doucet's "Native Poverty: Why Relying On Government Is A Poor Solution" at www.quebecoislibre.org/05/051115-8.htm.
Fraser Institute, an independent public policy organization,
focuses on the role competitive markets play in providing for the economic and
social well being of all Canadians. Canadians celebrated Tax Freedom Day on
June 28, the date they stopped paying taxes and started working for themselves.
Log on at www.fraserinstitute.ca for an overview of the extensive research
articles that are available. You may want to go directly to their health
research section at www.fraserinstitute.ca/health/index.asp?snav=he. Be sure to read some good news from the
The Heritage Foundation, www.heritage.org/, founded in 1973, is a research and educational institute whose mission is to formulate and promote public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values and a strong national defense. The Center for Health Policy Studies supports and does extensive research on health care policy that is readily available at their site. The Medicare Maladies at www.heritage.org/research/healthcare/mm.cfm and Bitter Pill series at www.heritage.org/Research/HealthCare/bp18.cfm contain a wealth of basic health care information. This month, be sure to read Ed Feulner, PhD's, latest commentary on Medicare and Social Security "Entitlement Fix Not an Option for Uncle Sam" at www.heritage.org/Press/Commentary/ed120505a.cfm.
The Ludwig von Mises Institute, Lew Rockwell, President, is a rich source of free-market materials, probably the best daily course in economics we've seen. If you read these essays on a daily basis, it would probably be equivalent to taking Economics 11 and 51 in college. Please log on at www.mises.org to obtain the foundation's daily reports. You might want to read this month on "The Rise and Fall of the City" by Hans-Hermann Hoppe at www.mises.org/story/1959. You may also log on to Lew's premier free-market site at www.lewrockwell.com to read some of his lectures to medical groups. To learn how state medicine subsidizes illness, see www.lewrockwell.com/rockwell/sickness.html; or to find out why anyone would want to be an MD today, see www.lewrockwell.com/klassen/klassen46.html.
CATO. The Cato Institute (www.cato.org) was founded in 1977 by Edward H. Crane,
with Charles Koch of Koch Industries. It is a nonprofit public policy research
foundation headquartered in
The Ethan Allen Institute, www.ethanallen.org/index2.html, is one of some 41 similar but independent state organizations associated with the State Policy Network (SPN). The mission is to put into practice the fundamentals of a free society: individual liberty, private property, competitive free enterprise, limited and frugal government, strong local communities, personal responsibility, and expanded opportunity for human endeavor. The Heartland Institute is featured by clicking on "Links."
The Free State Project, http://freestateproject.org/ is an agreement among 20,000 pro-liberty activists to move to New Hampshire, where they will exert the fullest practical effort toward the creation of a society in which the maximum role of government is the protection of life, liberty, and property. You may obtain copies of The Quill, the Free State Project's monthly newsletter at http://freestateproject.org/news/thequill/. The success of the Project would likely entail reductions in taxation and regulation, reforms at all levels of government to expand individual rights and free markets, and a restoration of constitutional federalism, demonstrating the benefits of liberty to the rest of the nation and the world. [It is indeed a tragedy that the burden of government in the U.S., a freedom society for its first 150 years, is so great that people want to escape to a state solely for the purpose of reducing that oppression. We hope this gives each of us an impetus to restore freedom in our own state.]
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Stay Tuned to the MedicalTuesday.Network
and Have Your Friends Do the Same.
Please note: Articles that appear in
MedicalTuesday may not reflect the opinion of the editorial staff.
Del Meyer, MD, Editor & Founder
Words of Wisdom
George Orwell: Political language . . . is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind.
Ruth Grant: Hypocrisy and politics are inextricably connected on account of the peculiar character of political relationships.
Social Security Commissioner Stanford Ross, 1979: The mythology of Social Security contributed greatly to its success.
P. J. O'Rourke: When buying and selling are controlled by legislation, the first things to be bought and sold are legislatures.
Mark Twain, (1866): No man's life, liberty, or property are safe while the legislature is in session.
Unknown Author: Talk is cheap except when Congress does
Some Recent or Relevant Postings
Medicare Reform: Pharmacy Benefit ProgramWhat Must Be Done A Clinician's Point of View www.delmeyer.net/hmc2005.htm
The Tipping Point - How Little Things Can Make a Big Difference - by Malcolm Gladwell www.delmeyer.net/bkrev_TheTippingPoint.htm
THE TYRANNY OF GOOD INTENTIONS - How Prosecutors and
Bureaucrats are Trampling the Constitution in the Name of Justice, Paul Craig Roberts & Lawrence M Stratton http://healthcarecom.net/bkrev_TyrannyofGoodIntentions.htm
On This Date in History December 13
Sir Francis Drake set out to sail the world on this date in 1577.
Abel Tasman discovered
Robert E Lee spoke a few wise words on this date in 1862: It is well that war is so terrible, or we should grow too fond of it.