MEDICAL TUESDAY . NET

NEWSLETTER

Community For Better Health Care

Vol VI, No 21, Feb 12, 2008

 

In This Issue:


1.                  Featured Article: The Future of the American Idea

2.                  In the News: Organ Transplants from an Ill-Informed Malpractice Attorney

3.                  International Medicine: The Election Choice - American Freedom or European Conscription & Force

4.                  Medicare: The Fall Out from Seeing Patients with Payment from the Government

5.                  Medical Gluttony: I Just Love Being in the Hospital and Getting All Those Tests

6.                  Medical Myths: Health Care Reform Will Be Very Expensive

7.                  Overheard in the Medical Staff Lounge: Insurance Companies Practicing Medicine

8.                  Voices of Medicine: Outside the Office: Diving Docs Explore the Deep

9.                  From the Physician Patient Bookshelf: Code Blue: Health Care in Crisis 

10.              Hippocrates & His Kin: Health Care After the November Elections

11.              Related Organizations: Restoring Accountability in HealthCare, Government and Society

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The 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 U.S. health-care system. The extraordinary conference agenda includes compelling keynote panel discussions, authoritative industry speakers, international best practices, and recently released case-study data. The 3rd annual conference was held April 17-19, 2006, in Washington, D.C. One of the regular attendees told me that the first Congress was approximately 90 percent pro-government medicine. This year it was 50 percent, indicating open forums such as these are critically important. The 5th Annual World Health Congress has been scheduled for April 21-23, 2008, also in Washington, D.C. The World Health Care Congress - Asia will be held in Singapore on May 21-23, 2008. The 4th Annual World Health Congress Europe will meet in Berlin on March 10-12, 2008. For more information, visit www.worldcongress.com.

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1.      Featured Article: The Future of the American Idea, November 2007 Atlantic Monthly

With this issue, [The Atlantic Monthly] turns 150 - declining, with respect, the "battered," still aspiring to the magical. What, beyond the patient commitment of its owners, can account for this longevity? Consider The Atlantic's passage: through a permanent revolution in technology, from the telephone, to the practical fountain pen, to the radio, to the note pad, to the television, to the Internet; through financial crises, beginning in 1857 with what The Atlantic called a national "flurry" over credit (or liquidity, to use the present flurry's term); through national arguments over slavery, suffrage, evolution, immigration, prohibition, anticommunism, civil rights, feminism, gay rights, evolution and immigration (again); through the international contests of ideology that defined the last century and into the new contest that so far is shaping this one. How has The Atlantic endured? More to the point, why? To read more, please go to www.medicaltuesday.net/index.asp.

We may be able to spot a clue in the arguments. Unlike other publications, The Atlantic wasn't created to track a particular identity found on a map - Hollywood's glamour, New York's sophistication, Washington's power, Silicon Valley's imagination. It wasn't yoked from birth to a particular industry or technology, like the automobile or the computer. The Atlantic was created in Boston by writers who saw themselves as the country's intellectual leaders, and so its scope from the start was national, if rather theoretical. It was founded on an encompassing abstraction, expressed in the words that appeared in the first issue and that appear again on the cover of this one: In politics, it would "honestly endeavor to be the exponent of what its conductors believe to be the American idea." That sounds pretty good. But those first conductors - among them Lowell, Ralph Waldo Emerson, Oliver Wendell Holmes, Henry Wadsworth Longfellow, and Harriet Beecher Stowe - did not explain what they meant, not exactly. What or which "American idea"? The answer must have seemed obvious to them: In literature, they wanted to provide a platform for an emerging American voice; in politics, they had a cause abolition - that gave granite definition to the American idea as equality, at least among men. One can easily imagine that beyond abolition, agreement would quickly break down. Only reluctantly did Lowell finally agree, in 1859, to publish an essay called "Ought Women to Learn the Alphabet?"

Today, our national facts would seem radically strange to Lowell - machines that can listen in on millions of telephone conversations, city-killing weapons that can fit inside satchels, tools that can pluck cells from embryos and hone them to fight disease - but the reference points for debate would seem quite familiar. What American faction, what American, doesn't embrace both the revolutionary message of the Declaration of Independence and the restraining message of the Constitution? Our endless quarrels are over what these messages mean, over how the ideal should be made real. It is the endlessness of the quarrels - the elusiveness of the American idea, the tantalizing possibility of its full realization - that has sustained The Atlantic. Through the decades, The Atlantic has argued; over time, its writers have been found on both sides of some questions, as, without regard for party or clique or convention, the magazine has struggled with the great perplexities of the day. (This by turns fractious, forceful, and witty history is anthologized in a new collection of Atlantic pieces - called, as it happens, The American Idea - that Doubleday has just published.) Only a magazine devoted to understanding change could have thrived through so much of it. Only a magazine that constantly questions its own assumptions about the American idea could remain true to that idea's potential. That, surely, was the founders' original intent. (The image they selected for The Atlantic's first cover, pictured on the preceding page, is of John Winthrop, he of the "City upon a hill.") While we celebrate the magazine this month with glances back at the archive, we honor it more by continuing to turn our gaze ahead, with pieces like Walter Kirn's romp through the multitaskers' labyrinth, Robert D. Kaplan's report on the decline of American might, and Caitlin Flanagan's essay on Hillary Clinton.

To mark this anniversary, we also invited an eclectic group of thinkers who have had cause to consider the American idea to describe its future and the greatest challenges to it. We provided little more charge than that, beyond asking that they accomplish this feat in 300 words or so. (It should be noted that Judith Martin - Miss Manners - delivered precisely 300, one of them whoops. Her old colleague Tom Wolfe, who happens to differ with Martin on one point of historical interpretation, returned again and again to the library, revising his piece until it reached 2,100 words.) We asked artists to perform the same feat with a drawing or a photograph.

In the pages that follow, George F. Will rings an alarm over the danger inherent in embracing a singular American idea, but many of the contributors agree on a rough definition of the idea itself - the easy part, as John Hope Franklin suggests. Yet has this idea been put into practice or not? Is it more threatened by Americans' faith in God or by their secularism? By Islamic fundamentalism or by our response to it? By poverty, racism, celebrity, the gobbling up of natural resources? Will science and the entrepreneurial spirit carry us through? Should we rejoice on this anniversary, or should we be angry? What follows is a wise, amused, pained, and impassioned cacophony, and, in sum, a statement of the sustaining value of The Atlantic, its commitment to the open mind in pursuit of an idea whose realization was partial and fragile 150 years ago, and still is.

Proceed to the collection of essays. Proceed to the Atlantic www.theatlantic.com/doc/200711/intro.

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2.      In the News: Organ Transplants from an Ill-Informed Malpractice Attorney

Edwards and Organ Transplants By SCOTT GOTTLIEB, WSJ, January 11, 2008

Campaigning in the primaries, former Sen. John Edwards is leveraging the tragic story of Nataline Sarkisyan -- the 17-year-old California woman who recently died awaiting a liver transplant -- to press his political attack on insurance companies and argue for European-style, single-payer health care. But the former trial lawyer, accustomed to using anecdotes of human suffering to frame his rhetoric, is twisting the facts. Organ transplantation, like many areas of medicine, provides a poor basis for his political thesis that single-payer health care offers a more equitable allocation of scarce resources, or better clinical outcomes.

Late last year, Ms. Sarkisyan developed liver failure, apparently a result of blood clotting that stemmed from the high doses of chemotherapy and a bone marrow transplant she had received to treat relapsed leukemia. She was put on life support as her doctors at the University of California-Los Angeles tried to get her a new liver, and asked CIGNA, the insurer that was acting as administrator to her father's employer-provided, self-insured health plan, to pay for the transplant. CIGNA deemed the transplant unproven in its medical benefit and ineffective as a treatment. It recommended that her father's employer not cover the procedure.

After an appeal, CIGNA hired an oncologist and transplant surgeon to review the case. According to CIGNA, these experts agreed that the transplant exceeded appropriate risk-taking, with little support from existing medical literature. . . . To read more, please go to www.medicaltuesday.net/news.asp.

CIGNA never reversed its administrative decision. But after significant pressure from the California Nurses Association, a powerful union lobby -- and legal threats -- it made a clumsily-announced concession, a one time "exception" to pay for the transplant itself, despite sticking to its judgment that the procedure constituted an experimental use of a scarce organ. But CIGNA's concession came too late. The same day it was made Ms. Sarkisyan was taken off life support and died. . .

Mr. Edwards seized on the case. "We're gonna take their power away and we're not gonna have this kind of problem again," he said on Dec. 21. "These are living and breathing examples of what I'm talking about and there are millions more just like them," Mr. Edwards told reporters on Jan. 6. An edited video of his attacks on CIGNA has posted on YouTube.

Research provides little support to Mr. Edward's underlying premise that single-payer health-care systems would do better. On balance, data suggests that in the U.S. transplant patients do quite well compared to their European counterparts, with significantly more opportunities to undergo transplant procedures, survive the surgery, and benefit from new organs.

Some of the best data pits the U.S. against the U.K. and its National Health Service. A study published in 2004 in the journal Liver Transplantation compared the relative severity of liver disease in transplant recipients in the U.S. and U.K. The results were striking. No patient in the U.K. was in intensive care before transplantation, one marker for how sick patients are, compared with 19.3% of recipients in the U.S. Additionally, the median for a score used to assess how advanced someone's liver disease is, the "MELD" score, was 10.9 in the U.K. compared with 16.1 in the U.S. -- a marked gap, with higher scores for more severe conditions. Both facts suggest even the sickest patients are getting access to new organs in the U.S.

On the whole, the U.S. also performs more transplants per capita, giving patients better odds of getting new organs. Doctors here do far more partial liver transplants from living, related donors, but also more cadaveric transplants (where the organ comes from a deceased donor). In 2002 -- a year comparative data is available -- U.S. doctors performed 18.5 liver transplants per one million Americans. This is significantly more than in the U.K. or in single-payer France, which performed 4.6 per million citizens, or in Canada, which performed 10 per million. . .

These findings aren't confined to transplanted livers. A study in the Journal of Heart and Lung Transplantation compared statistics on heart transplants over the mid 1990s. It found patients were more likely to receive hearts in the U.S., even when they were older and sicker. The rate was 8.8 transplants per one million people, compared to 5.4 in the U.K. Over the same period, about 15% of patients died while waiting for new hearts in the U.K. compared to 12% in the U.S. In 2006, there were 28,931 transplants of all organ types in the U.S., 96.8 transplants for every one million Americans. There were 2,999 total organ transplants in the U.K., 49.5 transplants for every one million British citizens.

What about Mr. Edwards's implicit thesis, that U.S. organ allocation is dictated by someone's ability to pay? When it comes to livers, the majority of U.S. transplants are for chronic liver disease, usually resulting from hepatitis C or alcoholism. These are diseases disproportionately affecting lower-income Americans who predictably comprise a comparatively higher number of people getting new organs.

Ideally, everyone who can benefit from an organ transplant would receive one, especially a young patient like Ms. Sarkisyan. But with more patients than available organs, some form of allocation procedure involving administrative judgments is inevitable. In Ms. Sarkisyan's case, that judgment was made by CIGNA, in an advisory capacity to her father's employer, interpreting the terms of the employer's health-insurance contract. In the U.K. and other European systems -- and in the U.S. single-payer system favored by Mr. Edwards -- those judgments are made solely by a government agency. The available data suggests that the government allocation procedures do a somewhat worse job, as far as health outcomes are concerned, than private allocation procedures in the U.S.

As in all events, the inevitable trade-offs and ethical dilemmas cannot be wished away. Our system in the U.S. for allocating scarce resources remains imperfect. But taken as a whole, statistics show that organ access, our willingness to transplant the sickest patients, and our medical outcomes are among the best in the world. Probably superior to the single-payer systems that Mr. Edwards would have Americans emulate -- and certainly better than the facts that Mr. Edwards wants us to believe.

http://online.wsj.com/article_print/SB120001235968882563.html

Dr. Gottlieb is a practicing physician and resident fellow at the American Enterprise Institute.

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3.      International Medicine: The Election Choice - American Freedom & Choice or European Conscription & Force

The GOP's Prescription for Health Care By GRACE-MARIE TURNER January 29, 2008

Health care has been a sleeper issue in the Republican presidential primaries. But as we heard in President Bush's State of the Union address last night, the GOP does have ideas -- big and transformative ideas designed to energize the free market to target many of the problems that plague our health sector.

The leading Republican candidates all have announced plans that would give more power and control to individuals over their health care and health insurance, breaking the employment-based coverage lock. That's a far cry from the proposals of the Democratic presidential candidates. While they talk about patient choice and private insurance options, their remedies rely on a much bigger dose of government. . . . To read more, please go to www.medicaltuesday.net/intlnews.asp.

 

The GOP candidates want to boost options for individually-owned health insurance, and they would change federal tax policy to create new deductions and/or tax credits for health insurance. Lower income people, especially the uninsured, would get new subsidies to purchase private insurance.

The candidates would allow people to purchase health insurance across state lines, and they would give states new incentives to fix problems, especially regulations and mandates, that have helped make health insurance so expensive in the first place. They believe that bringing millions of new buyers into the health care marketplace will expand competition and force insurers and providers to offer more affordable options.

The similarity among Republican candidates' health-care principles is such that they often sound like they have the same speechwriter:

- Rudy Giuliani: "I believe we can reduce costs, expand access to, and improve the quality of health care by increasing competition. We can do it by increasing health-care choices and affordability, and by empowering patients and their doctors, not government bureaucrats."

- Mike Huckabee: "I advocate policies that will encourage the private sector to seek innovative ways to bring down costs and improve the free market for health-care services. We can make health care more affordable by making health insurance more portable from one job to another, and making health insurance tax deductible for individuals and families as it now is for businesses."

- John McCain: "It is good tax policy to take away the bias toward giving workers benefits instead of wages. It is good health policy to reward having insurance no matter where your policy comes from. To use their money effectively, Americans need more choices."

- Even Mitt Romney, who led the enactment of a universal health plan for Massachusetts that expanded the role of government in the health sector, now says: "The federal government needs to loosen regulations on the nation's health-insurance providers, increasing competition and thereby lowering patient costs. The right answer is less government, less regulation, more individual responsibility, and more of the market dynamics that propel the rest of our economy."

While there are differences in implementation, Messrs. Giuliani, Huckabee, McCain and Romney all start with proposals to reform the generous but invisible tax provision that ties health insurance to the workplace. The U.S. offers a generous tax break worth more than $200 billion a year to those who get health insurance through the workplace. Any amount of income that workers receive in the form of health insurance is excluded from federal and state income and payroll taxes.

This provision, which dates back to World War II, has cascaded through the economy for 65 years to create a system in which more than 160 million people get health insurance through the workplace.

But today, when four in 10 workers change jobs every year, tying health insurance to the workplace isn't working for tens of millions of Americans. Further, because the full cost of job-based health insurance is invisible to most workers, they have incentives to over-consume health services and to demand more expensive health insurance, driving up costs for those trying to buy coverage on their own.

While the Republican presidential candidates don't want to blow up the employment-based system, they all want to give people the same tax benefit when they purchase a policy on their own as when they get it at work. This was also central to the health-reform proposals President Bush outlined last night.

The Democratic candidates would lock in the employment-based system with requirements for most employers to pay for coverage. In addition, Hillary Clinton and John Edwards would impose an "individual mandate" in which the federal government would require everyone to have health insurance.

None of the Republican candidates supports an individual mandate. Barack Obama is the outlier among the Democrats -- a major point of contention among them -- because he supports a mandate for children to get health insurance but not everyone. "The reason Americans don't have health insurance isn't because they don't want it, it's because they can't afford it," Sen. Obama says.

Sen. Clinton says that the key vision of the Democrats is to achieve universal health coverage. But that takes her down a rocky road of mandates on individuals, employers and insurers that squeeze genuine competition out of the health sector. . .

. . . the contrast between the Republican and Democratic candidates is stark. Ultimately they break down over whether individuals or government will be in control of health care in the future. The choice this election year is real.

Ms. Turner is president of the Galen Institute and editor of "Empowering Health Care Consumers through Tax Reform" (University of Michigan Press, 1999). She has advised the Giuliani, McCain and Thompson campaigns on health care.

See all of today's editorials and op-eds, plus video commentary, on The Editorial Page1.

http://online.wsj.com/article_print/SB120156877726923875.html

Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.

--Canadian Supreme Court Decision 2005 SCC 35, [2005] 1 S.C.R. 791

http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html

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4.      Medicare: To Every Doctor that Sees Patients with Payment from the Government

PARK CITY MEDICAL CENTER, PARK CITY, KANSAS 67219

Dear Doctor: To every practicing physician in Kansas: January 18, 2008

After all the news coverage of Haysville Doctor Stephen Schneider, we all have probably thought, "Boy, I'm glad it's not me!" Not only are the feds after him, but the trial lawyers, too.

But, what about you and me? With 3,000 pages of Medicare regs and 2,000 pages of HIPAA, ANY ONE of us seeing Medicare or Medicaid patients could be GUILTY of healthcare fraud (even though it was UNINTENTIONAL). And the government is out to collect FINES! . . . To read more, please go to www.medicaltuesday.net/medicare.asp. !

What is a federal prosecutor? Answer: an attorney with the full backing of the federal BUDGET and 5,000 pages of laws that are impossible to follow without numerous unwitting infractions, which the federal prosecutor can build into a FEDERAL case. And like the gunslingers of old, each BAD DOCTOR prosecuted becomes a notch on the gun, bringing publicity to the prosecutor so they can run for office and write more regulations to entrap you and me. The federal prosecutor is also a COWARD. Rather than get the real drug dealers (who threaten to kill the prosecutor or their family), the prosecutor goes for the easy (safer) mark, the doctor who keeps enough records to make a case for the prosecutor.

What has Dr Schneider done? He sees the rejects of medicine that WE won't see. The Medicaid folks don't have doctors standing in line to see people with "the CARD", do they? He sees the people who have had all the surgeries and epidural steroid injections that insurance would buy, before it ran out, AND they still have pain. And he gets duped by the "actors" who have called all of our offices at one time or another. And the federal prosecutors have probably sent in some of their own "actors" to entrap him.

Why does he prescribe so much to so many of these patients? What would knock you or me OUT, barely touches the pain of some of these patients.

So, why do WE CRITICIZE OR REMAIN SILENT while the federal prosecutor CASUALLY goes about her work while a fellow physician is held like a POW? Yes, it is war. If you take any money from the federal health programs, YOU are a target. "But I don't do what he does." Are you certain you have complied with all 5,000 pages of the minefield we have allowed or legislators and bureaucrats to place into law?

Should the Healing Arts Board do something? Yes! In the current environment, I am sure that YOU are as afraid to prescribe CONTROLLED medications for your patients as I am for my patients. I was glad that Dr Schneider had THE BALLS to help the people that were OUT OF OPTIONS. The Board should read and reread this letter, then ask "What can we do to provide pain relief for the people who have no other place to turn?

How can we work WITH our physicians to provide that care, KNOWING that some of the "patients" are addicts and dealers, and how can we COMMUNICATE with one another to IDENTIFY the addicts and dealers and CUT THEM off?" Let's stop demonizing physicians, and demand individual RESPONSIBILITY of doctors, patients, and lawyers.

SURGEONS, how many of your patients, despite your best efforts, STILL HAD PAIN and you were afraid to prescribe narcotics to control the pain that surgery did NOT resolve? YOU should be the most vocal supporters of Dr Schneider, because he was taking care of many of them (probably most of them).

PRIMARY CARE doctors, Dr Schneider took care of our patients that we were afraid to give narcotics. We should not criticize him for taking care of the people who CHOSE to go to a clinic where they COULD get medication. WE should be very vocal supporters of Dr Schneider.

TRIAL LAWYERS love what the feds are doing. One question. If Dr Schneider is responsible for Jeff Hambleton's overdose death in Jeff's office, does that mean that the Hambelton agency is responsible for every drunk who buys a Ford vehicle and dies in a car crash in the car that Hambleton provided him?

Do YOU, DOCTOR, have any patients with severe, intractable PAIN?

Of course, we ALL do! Have any of our patients ever chosen suicide instead of living in constant pain? YES! And many of the patients seeing Dr Schneider were depressed and probably suicidal. We, and he, can not control what our patients do, no matter how hard we try. And all of us, despite our best efforts, have had patients die from their illnesses, some shockingly sooner than expected.

INSURANCE companies want to control everything. "Send the money to us and we will decide what we will cover."

LEGISLATORS, your constituents demand more benefits from government and the insurance companies. The SMARTEST mandate would be that no insurance policy could be written with LESS than $1,000 deductible AND a 20% co-pay on everything else. That makes the patient responsible for ENOUGH of their health care costs that the whole system will become self regulating, AND the cost of health care will DECREASE!

I do not participate with any insurance company, not Medicare, not Medicaid. But I see patients who HAVE those insurance plans, AND they pay cash, check or credit card for the FAIRLY PRICED services I provide that insurance frequently does NOT cover anyway. AND, every Tuesday night I provide FREE medical care through Good Samaritan Clinic, giving three hours of my time (Many of these patients do not take their FREE CARE seriously and accept any personal responsibility to improve their own health.). This is what I dreamed of when I applied to medical school - I am responsible to my patients and they are responsible to me, with no "third party" dictating what I can or can not do for my patients. But I don't prescribe narcotics for chronic pain, because I don't trust the Healing Arts Board or the federal regulators.

I would be happy to talk with any of you, and I pray God's blessings upon you.

George R Watson, D.O.

P.S. We all worked very hard to graduate from medical school. We all had the freedom to choose in what area we wanted to specialize. If we have NOT had specialized training in a particular procedure or treatment, let us NOT criticize a procedure that we have not studied, performed or experienced. Let us respect one another's expertise and training.

Government is not the solution to our problems, government is the problem.

- Ronald Reagan

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5.      Medical Gluttony: I Just Love Being in the Hospital and Getting All Those Tests.

A 73-year-old white male came into the office today in exuberant spirits stating he was just in the hospital. He said he had little experience with hospitals before but this was really a plush hotel. He said he had more tests than he could have imagined in just one day. When he left, the ER doctor said, "We don't know what you have, but we ruled out all the important things."

The diagnosis was obvious and required no tests. It just required a doctor or a family member or a friend to spend five or ten minutes with the patient, give him a Proton Pump inhibitor, such as Prilosec, the $5 pill which is now OTC at 50 cents and a Gaviscon tablet, which is OTC at one cent, see another patient and come back in 20 or 30 minutes to re-evaluate him to see if he still had a problem. He would have been well. However, the ER doctor convinced him that his severe substernal burning could be life threatening and all serious illnesses should be ruled out as possibilities.

My front desk was able to obtain the eleven pages of testing before his appointment. She also told me that on the phone it sounded like he just had some severe heart burns. . . To read more, please go to www.medicaltuesday.net/gluttony.asp..

The eleven pages included two pages of laboratory reports, all essentially normal. There was a chest x-ray, which was negative. There were a series of cardiac enzymes all of which were normal. There was a treadmill stress electrocardiogram, which revealed he was functioning at 7 METs, which is a healthy level. There was a myocardial perfusion study, which revealed a normal Left Ventricular ejection fraction and normal cardiac function with normal wall motion, without any evidence that any heart muscle was ischemic or at risk. The costs were at $thousands.

The reason all these unnecessary tests are done in the ER is that if the patient is admitted to the hospital they fall under Medicare Regulations and price controls. The hospitals can, as I understand it, allegedly get several times as much money by doing these tests in the ER than if the same studies are done on an inpatient basis.

How can we avoid this 10,000 percent increase in unnecessary health care costs? As we saw elsewhere in this newsletter, one party's candidates want to implement controls. However, there is no control that would prevent this. No reviewer would actively interfere with an Emergency Doctor's evaluation of heartburns even if camouflaged as chest pain. Retrospective reviews are regressive, costly, and further reduce health care quality.

What is the answer? The other party's candidates, as we saw elsewhere in this newsletter in the article written by Grace-Marie Turner of the Galen Institute, want to put the decision under the patient's control. Our colleague from Kansas, also elsewhere in this newsletter, would increase patient responsibility with a significant deductible and a co-payment on everything else. He feels this would make health care self-regulating. In other words, this patient would know from the grapevine that the basic charge for an Emergency Room visit is $600 or so. With a 20 percent co-payment as suggested, he would understand it costs $120 to walk in the door. After the first thousand dollar test, since he is bright enough to understand that 20 percent of the test would be $200 out of his pocket, he would figure out that he should try a glass of milk or a PPI such as Omeprazole to block the acid production, and an antacid to neutralize the acid that is burning his esophagus. The co-payment makes the patient wake up and self evaluate the burn, makes him more knowledgeable about health care costs, thus saving health care dollars. In this case, thousands of dollars or an eliminated 10,000 percent excess cost.

What is Mr Edwards' and his party's answer? More regulations. Eliminate co-payments. Make it free for all. At least until we get it passed. Thereafter, we can eliminate the rich, decrease payments for the poor, eliminate certain procedures, just as Massachusetts is already doing for Romney's socialistic implementation. This is following Canadian, UK, and European health care restrictions. Why? They are not interested in a freedom loving independent medical profession judiciously working for the patient. This would eliminate their populist programs that control the patient and make a police state with the physician as the scapegoat.

The answer is obvious. Just as we changed political freedom in this country in 1776 escaping the European way of feudal states and nobility, we can change the health care of the world by charting a new course of self-regulating freedom in health care instead of regressing to the Canadian, British and European deteriorating health care system of controls.

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6.      Medical Myths: Health Care Reform Will Be Very Expensive

Health Alert: Subject: Paying for Health Reform 
Real health reform does not cost money. It saves money. 
Conservatively, I would guess we could reduce health spending by one-third and raise quality and increase access to care at the same time. That's $7,000 for every U.S. household. Since government spends almost half the money, we could all get an annual economic stimulus check for $3,000 - leaving $50 billion behind for government to mop up any remaining problems. 
Alas, hardly anyone is in favor of real reform. For a lot of people, reform doesn't even count as reform without sacrifice and atonement. 
Think of California liberals and global warming. Nothing they do will have any perceptible impact on the climate. But they don't feel good about themselves unless they are enduring pain and discomfort. 
Anyway, suppose we did need more money to add to our annual $2.1 trillion health care spending spree. Where could it come from? To read more, please go to www.medicaltuesday.net/myths.asp. 
In the Democratic primaries, here is the standard mantra: tax cuts for the rich are depriving government of revenue which we desperately need for health reform. All of this is exclaimed with almost religious fervor and a level of hysteria that is hard to top, unless you count this morsel from Paul Krugman in The New York Times: "for 30 years 
American politics has been dominated by . . .Robin Hood in reverse, giving unto those that hath, while taking from those who don't." 
Now for an uncomfortable look at the facts. For the past 30 years, there has been no lasting tax cut for the rich. And far from being deprived of revenue, the federal government's share of national income today is exactly where it has been, on the average, for the past 60 years. 
The penultimate sentence in the preceding paragraph deserves repetition and emphasis: 
There has been no lasting tax cut for the rich. 
What we have done, beginning in the Reagan administration 25 years ago, is cut tax rates for the rich. But every time we cut rates, total taxes paid by the rich went up, not down. As Art Laffer explained in The Wall Street Journal the other day, the top 1% of taxpayers are on the wrong side of the Laffer curve, and they have been there for almost the entire sorry history of the income tax. 
Every Republican tax rate reduction for the wealthiest taxpayers as well as every Democratic one (both Kennedy and Clinton) has led to more revenue for the Treasury. In Clinton's case, approving a Republican capital gains rate reduction (from 28% to 20%) in 1996 is what produced surpluses at the end of his presidency - surpluses that Clinton's own Treasury Department never predicted! 
Unlike ordinary mortals, the rich have enormous discretion over how they receive their income - as wages, as dividends, as realized capital gains or even as unrealized (untaxed) capital gains. So the way to get the most money out of them is not to push rates up to 70% or 90% (where they once were), but to lower them in order to coax the wealthy into realizing more taxable income. 
Furthermore, almost every time tax rates for the wealthiest have been reduced, millions of low-income taxpayers have been removed from the tax rolls. So that today almost half the population pays no income tax. 
The upshot is that virtually every tax change in recent history - whether Democrat or Republican - has made the tax code more progressive. 
Since noneconomists often wonder whether they are being statistically hoodwinked in these discussions, let us be clear: 
Over the past two decades the income tax system has become increasing more progressive, no matter how progressivity is measured. 
So here are the takeaways: (1) government revenues today as a fraction of national income are equal to their historic average, (2) we are collecting more income taxes - both in total dollars and as a percent of the total - from the wealthy than ever, (3) the tax system today is more progressive by far than at any time in modern history and (4) repealing the Bush rate reductions for high-income taxpayers is unlikely to produce any extra revenue for health reform. 
For Michael Stroup's demonstration that Republican tax cuts have made the income tax system more progressive than otherwise, go to www.ncpa.org/pub/ba/ba606/. 
For Steven Moore's demonstration that capital gains rate cuts always produce more capital gains tax revenues go to www.ncpa.org/pub/st/st307/st307.pdf. 
For Art Laffer's explanation of all of this, go to www.freerepublic.com/focus/f-news/1959323/posts. 
Have a good day, 
John Goodman, President 
National Center for Policy Analysis
12770 Coit Rd., Suite 800
Dallas, Texas 75251
www.ncpa.org

* * * * *

7.      Overheard in the Medical Staff Lounge: Insurance Companies Practicing Medicine

Dr. Sam: How is the insurance company's practice of medicine coming along?

Dr. Rosen: Medicare, the worlds largest, started to pay in December and gave us a notice that after December 18 all payments would be electronic.

Dr. Ruth: I can't wait to hear?

Dr. Rosen: You're right. It's now February and we haven't got paper or electronic checks. We did get a notice to fill out form 855 again.

Dr. Michelle: Isn't that the one that's about 17 pages long?

Dr. Rosen: At least. But we've completed it at least three times in the last six months.

Dr. Sam: Unbelievable bureaucratic drag.

Dr. Edwards: How can anyone even think of having the government put that kind of drag in all of health care? . . . To read more, please go to www.medicaltuesday.net/lounge.asp.

Dr. Milton: HMOs aren't much better. I had a patient with an acute appendix. The kind that we're use to operating on the same day? It took my HMO three days to approve the emergency surgery.

Dr. Yancy: Well, did it rupture?

Dr. Milton: Amazingly, it did not.

Dr. Yancy: Too bad. Sorry for the patient but that would have shaped up the HMO.

Dr. Rosen: I don't think so. HMOs seem to survive almost all lawsuits that would destroy private doctors.

Dr. Michelle: So there you see the protection that HMOs gives us.

Dr. Yancy: At the expense of patients' health and maybe their lives?

Dr. Rosen: They even seem immune to the loss of life. Remember the Linda Peeno story. She had a stamp: DENIED. And then a patient died which made her think beyond her job.

Dr. Patricia: What about the pharmacies practicing medicine. Those "Dr. don't you know - " faxes that question most of my prescriptions.

Dr. Dave: Are you taking the time to educate the pharmacists?

Dr. Patricia: I've tried. But some of them don't have enough of a command of the English language to understand what I'm discussing.

Dr. Rosen: Don't you think that they are being forced to do that by their mandates and their insurance carriers?

Dr. Milton: I'm steering more patients to the Wall-Mart, Costco, and Sam's club pharmacies now that they have more than 300 generic drugs for $4 a month. They are just super pleased that for $12 they can pick up a three-month supply and not return to the pharmacy every 30 days.

Dr. Rosen: Since the patients are paying, they can go early to pick up the refills instead of a 7-day window.

Dr. Ruth: You mean they can pick up refills early?

Dr. Rosen: Certainly. They are paying cash and, therefore, the pharmacies aren't controlled by the insurance carriers to be watchdogs over what insurance will cover and pay. That's an easy way to eliminate one mandate.

Dr. Ruth: Why don't politicians understand that the costs of drugs seem to be decreasing in the free market environment?

Dr. Rosen: They have a political agenda of control because health care involves every American. What a sly way to put a noose around every Americans' neck. And they won't know what's strangling them until it's too late. Then they will all be at the mercy of their congressman and senators and no longer have any voice in restoring their freedom from state-controlled doctors.

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8.      Voices of Medicine: A Review of Local and Regional Medical Journals

SONOMA MEDICINE, the Magazine of the Sonoma County Medical Association

Outside the Office: Diving Docs Explore the Deep, By Paul Johnson, MD

You may have noticed that practicing medicine these days has become a mighty intense occupation. Fortunately, dealing with the rigors of the profession becomes easier when I participate in activities outside the office that engage my full attention and enthusiasm and that provide different sorts of challenges and opportunities. I am lucky to have found all of that and more in scuba diving. . . To read more, please go to www.medicaltuesday.net/voicesofmedicine.asp.

I became a certified scuba diver more than a decade ago. My training began with a short "resort course" during a vacation. From my first moments at the bottom of the pool, I realized that scuba diving was something I wanted to keep doing. As luck would have it, my friend and colleague, cardiologist Steve Werlin, had just become certified as an open-water scuba instructor through PADI (the Professional Association of Dive Instructors).

I was among the three students in Steve's first diving class, and in October of 1996 - after completing the last of four open-water checkout dives in Tomales Bay - I became a certified diver. I was 49 years old, firmly in the grip of middle age. Incidentally, the two other students in Steve's class, proving they were considerably smarter than me, did their four checkout dives in the Cayman Islands.

The ocean covers more than two-thirds of the surface of the earth. My explorations beneath the waves have led me to a beautiful and fascinating realm, quite unlike what we observe on land. They have also taken me to far-flung locations of the planet that I might not have otherwise considered visiting, such as Indonesia and Papua New Guinea. But even without the majestic sights and exotic locales, something about diving itself exhilarates me. Maybe it's the feeling of weightlessness when I hover in the water column with perfect buoyancy control. Maybe it's the rhythmic, Zen-like sound of my own breathing, amplified by the regulator and the water. And maybe it's my sense of gratitude that I have been allowed into such a special and different world, experienced by such a small fraction of my fellow human beings.

Over the years, Steve and another colleague, general and thoracic surgeon Vince Frantz, organized Diving Docs, a loose network of people passionate about diving, the ocean, and travel. Many of the group's members are people we work with at Kaiser. The network includes physicians, nurses, pharmacists, psychologists, and our local non-medical friends - but we also number people like "Jillie" from New Zealand, whom we met on a dive trip. . .

If you are interested in taking a break from the hectic world of medicine and joining us beneath the waves, feel free to contact me at pajkotwf@aol.com or Steve Werlin at (what else?) divingdoc@hughes.net.

To read more about Dr. Johnson's Diving Docs, their schedules and destinations, go to www.scma.org/magazine/scp/Fall07/johnson.html.

Dr. Johnson is an internist at Kaiser Permanente Medical Center in Rohnert Park.

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9.      Book Review: Code Blue: Health Care in Crisis by Edward R. Annis. Regnery Gateway Press, Washington, D.C. 1993, 278 pages.

Doctor Annis opens his introduction describing the two worlds that physicians live in: The wonderland of modern medicine, a gratifying and challenging world of achievement in research, education, and clinical practice; and the faltering American health care world, which is on the verge of collapse. Not unlike Charles Dickens in the opening to this Tale of Two Cities: "It was the best of times. It was the worst of times."

Annis gives us many anecdotal insights into the history of American medicine: Fleming's discovery of penicillin in England in 1928, that sat on the shelf until American drug companies developed methods of production in 1943, making it available to patients; sick England in the postwar era to healthy America; the high death rate of Europe to increased life expectancy to 68 years in America in 1949. The high cost of living is only exceeded by the higher cost of dying. His chapter on health insurance ("Call the Plumber, We're Insured!") is a parody on why health insurance is not insurance and, therefore, cannot work in its current format. To read more, please go to www.medicaltuesday.net/bookreviews.asp.

Edward Annis, who never chaired a meeting or held an organized medicine office, was elected president of the AMA at a young age in an attempt to counter a cunning band of political sophists in Washington, D.C. He champions the fight to head off government intrusion between doctor and patient and dispels the myth that a "managed" health care system would solve America's problems. He feels the problems in health care have a "Made in Washington" label. Health care already is the most regulated industry in America, strangling doctors and hospitals by senseless paper work, counterproductive bureaucracy, an abusive civil court system, and price controls that are actually driving prices up. He feels it should be labeled a crisis in government that can only be solved by less government interference.

In his final chapter, "What's the Solution?," Annis gives us his analysis of why third-party systems aren't working. Clinton's health plan; and two well-thought-out plans which he feels put the patient back in the driver's seat in charge of his or her own money. He favors "An Agenda for Solving America's Health Care Crisis," by the National Center for Policy Analysis. . .

Dr. Annis quotes Tom Paine's 1976 Revolutionary Era treatise, Common Sense, decrying excessive government, Time makes more converts than reason. . .

To read the entire review, please go to www.delmeyer.net/bkrev_CodeBlue.htm.

To read other reviews, please go to www.delmeyer.net/PhysicianPatientBookshelf.htm.

To peruse reviews by topics, please go to www.healthcarecom.net/bookrevs.htm.

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10.  Hippocrates & His Kin: Health Care After the November Elections

Mrs. Clinton has promised to force nationalized health care down our throats with mandates if elected. She wasn't able to cram it down in 1992, because she was only a spouse at that time.

Fellow Americans: What is it about government medicine that you don't understand?


Mr. Romney implemented government health care in Massachusetts while governor. Now that state is facing insolvency within two years and decreasing coverage already. This is even worse than the Medicare cost projections of 1966.

Fellow Americans: What is it about state medicine that you don't understand?

To read more, please go to www.medicaltuesday.net/hhk.asp.


Mr. Edwards had promised real police state medicine before he left the campaign. Doesn't it frighten you that someone of national prominence has this degree of disregard for individual American Freedom? Much of the huge cost of defensive medicine is due to trial malpractice lawyers like Mr. Edwards.

Fellow Americans: This kind of luck on the campaign trail is only temporary.


We have had two pictures of Hillary Clinton in tears in preparation for Super Tuesday this month. Won't that put a new dimension into politics?

Fellow Americans: Do you really think that tears will affect Iran or N Korea?


John Kerry has blamed the tornadoes in the south on global warming. Come on, John, do you really think the planet is so fragile that a fraction of a degree can upset the cosmos? Have you read Unstoppable Global Warming by Fred Singer, founding dean of the School of Environmental and Planetary Sciences at the University of Miami? He states that the earth's current warming trend is a largely natural occurrence that we can't do anything to stop, which is not only harmless, but potentially beneficial, and is part of a 1,500-year solar-driven cycle.

By the time he and Al Gore figure this one out, we'll be another 15 generations down the road into the next warming cycle.

To read more vignettes, please go to www.healthcarecom.net/hhkintro.htm.

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11.  Organizations Restoring Accountability in HealthCare, Government and Society:


 

                      The National Center for Policy Analysis, John C Goodman, PhD, President, who along with Gerald L. Musgrave, and Devon M. Herrick wrote Lives at Risk issues a weekly Health Policy Digest, a health summary of the full NCPA daily report. You may log on at www.ncpa.org and register to receive one or more of these reports. This month, be sure to read about how HillaryCare II isn't about "choice," but would require financial penalties for people to comply, including garnishing wages.

                      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. Be sure to read John R Graham's article about how Massachusetts "reform" is costing 85% more than originally budgeted.

                      The Mercatus Center at George Mason University (www.mercatus.org) is a strong advocate for accountability in government. Maurice McTigue, QSO, a Distinguished Visiting Scholar, a former member of Parliament and cabinet minister in New Zealand, is now director of the Mercatus Center's Government Accountability Project. Join the Mercatus Center for Excellence in Government. This month, be sure to peruse the articles and publications in the section on Accountability and Government Oversight.

                      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 on the opening page. Be sure to scan their professional journal, Health Insurance Underwriters (HIU), for articles of importance in the Health Insurance MarketPlace. www.nahu.org/publications/hiu/index.htm. The HIU magazine, with Jim Hostetler as the executive editor, covers technology, legislation and product news - everything that affects how health insurance professionals do business. Be sure to review the current articles listed in their table of contents. To see my recent column, go to http://hiu.nahu.org/article.asp?article=1660&paper=0&cat=137.

                      To read the rest of this column, please go to www.medicaltuesday.net/org.asp.

                      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. A new study of purchasers of Health Savings Accounts shows that the new health care financing arrangements are appealing to those who previously were shut out of the insurance market, to families, to older Americans, and to workers of all income levels. This month, be sure to read Grace-Marie's guide for educators teaching courses on health policy.

                      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. Be sure to read Prescription for change: Employers, insurers, providers, and the government have all taken their turn at trying to fix American Health Care. Now it's the Consumers turn at www.chcchoices.org/publications/cpr9.pdf. This month, read Ralph Weber's article on how California employers are being deprived of one of the best tools available for lowering the cost of coverage and offering health benefits to their employees.

                      The Heartland Institute, www.heartland.org, publishes the Health Care News. Read the late Conrad F Meier on What is Free-Market Health Care? at www.heartland.org/Article.cfm?artId=10333. You may sign up for their health care email newsletter at www.heartland.org/Article.cfm?artId=10478. All global warming enthusiasts should read the heart-warming story about a global drop in temperature of 0.63 degrees Centigrade in the past 12 months with California experiencing the second coldest January ever.

                      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, treat yourself to an excellent piece on the Casualties of the War On Poverty and why there are more poor people after $10 trillion dollar welfare program.

                      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 America's health-care challenges by enabling a robust and competitive health insurance market that will achieve and maintain access to affordable, high-quality health care for all Americans. "The belief that more medical care means better medical care is deeply entrenched . . . Our study suggests that perhaps a third of medical spending is now devoted to services that don't appear to improve health or the quality of care - and may even make things worse." A must read is their annual report of Health Mandates.

                      The Independence Institute, www.i2i.org, is a free-market think-tank in Golden, Colorado, that has a Health Care Policy Center, with Linda Gorman as Director. Be sure to sign up for the monthly Health Care Policy Center Newsletter at www.i2i.org/healthcarecenter.aspx. This month, be sure to read the article on Compulsory Insurance is Collective Punishment.

                      Martin Masse, Director of Publications at the Montreal Economic Institute, is the publisher of the webzine: Le Quebecois 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 the article on Private Property and Collective Ownership.

                      The 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. This month, be sure to read Nadeem Esmail's article on Why Canadians are still waiting for Health Care.

                      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. This month, peruse their strategy on Health Care.

                      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. To read about the current US financial crises, go to www.mises.org/story/2863. 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. Or enjoy the Cretinous Clowns of the Washington DC Beltway.

                      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 Washington, D.C. The Institute is named for Cato's Letters, a series of pamphlets that helped lay the philosophical foundation for the American Revolution. The Mission: The Cato Institute seeks to broaden the parameters of public policy debate to allow consideration of the traditional American principles of limited government, individual liberty, free markets and peace. Ed Crane reminds us that the framers of the Constitution designed to protect our liberty through a system of federalism and divided powers so that most of the governance would be at the state level where abuse of power would be limited by the citizens' ability to choose among 13 (and now 50) different systems of state government. Thus, we could all seek our favorite moral turpitude and live in our comfort zone recognizing our differences and still be proud of our unity as Americans. Michael F. Cannon is the Cato Institute's Director of Health Policy Studies. Read his bio at www.cato.org/people/cannon.html. Read about Social Security Choice at www.cato.org/pub_cat_display.php?pub_cat=19.

                      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. Click on LINKS to access all the organizations.

                      The Free State Project, with a goal of Liberty in Our Lifetime, 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. 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 from government intrusion in our own state.] To keep up with the Liberty Forum, go to http://freestateproject.org/libertyforum.

                      The St. Croix Review, a bimonthly journal of ideas, recognizes that the world is very dangerous. Conservatives are staunch defenders of the homeland. But as Russell Kirk believed, wartime allows the federal government grow at a frightful pace. We expect government to win the wars we engage, and we expect that our borders be guarded. But St Croix feels the impulses of the Administration and Congress are often misguided. The politicians of both parties in Washington overreach so that we see with disgust the explosion of earmarks and perpetually increasing spending on programs that have nothing to do with winning the war. There is too much power given to Washington. Even in wartime, we have to push for limited government - while giving the government the necessary tools to win the war. To read a variety of articles in this arena, meet their authors, including yours truly, please go to www.stcroixreview.com.

                      Hillsdale College, the premier small liberal arts college in southern Michigan with about 1,200 students, was founded in 1844 with the mission of "educating for liberty." It is proud of its principled refusal to accept any federal funds, even in the form of student grants and loans, and of its historic policy of non-discrimination and equal opportunity. The price of freedom is never cheap. While schools throughout the nation are bowing to an unconstitutional federal mandate that schools must adopt a Constitution Day curriculum each September 17th or lose federal funds, Hillsdale students take a semester-long course on the Constitution restoring civics education and developing a civics textbook, a Constitution Reader. You may log on at www.hillsdale.edu to register for their Seminars and Programs. Congratulations to Hillsdale for its national rankings in the US News College rankings. Changes in the Carnegie classifications, along with Hillsdale's continuing rise to national prominence, prompted the Foundation to move the College from the regional to the national liberal arts college classification. Please log on and register to receive Imprimis, their national speech digest that reaches more than one million readers each month. This month, read Mark Steyn on Is Canada's Economy a Model for America. The last ten years of Imprimis are archived at www.hillsdale.edu/news/imprimis/archive.asp.

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Del Meyer

Del Meyer, MD, Editor & Founder

DelMeyer@MedicalTuesday.net

www.MedicalTuesday.net

6945 Fair Oaks Blvd, Ste A-2, Carmichael, CA 95608

Words of Wisdom

Above all, we must realize that no arsenal, or no weapon in the arsenals of the world, is so formidable as the will and moral courage of free men and women. -Ronald Reagan.

Let every nation know, whether it wishes us well or ill, that we shall pay any price, bear any burden, meet any hardship, support any friend, oppose any foe to assure the survival and the success of liberty. -John F. Kennedy.

Make patients the center of care and give them a larger role in both prevention and care, putting more decisions and responsibility in their hands. -John McCain

Families should be able to purchase health insurance nationwide, across state lines, to maximize their choices, and heighten competition for their business that will eliminate excess overhead, administrative, and excessive compensation costs from the system. -John McCain

Some Recent Postings

HIU OpEd Articles at www.healthplanusa.net/OpEd.htm.

Offshore Hospitals Take on the U.S. Health Care Market by David Gibson, MD www.ssvms.org/articles/0711gibson.asp

In Memoriam

TAMPA, Fla. -- Harry Richard Landis, who enlisted in the Army in 1918 and was one of only two known surviving U.S. veterans of World War I, has died. He was 108.

Landis, who lived at a Sun City Center nursing home, died Monday, according to Donna Riley, his caregiver for the past five years. He had recently been in the hospital with a fever and low blood pressure, she said.

"He only took vitamins and eye drops, no other medication," Riley said Wednesday. "He was 108 and a healthy man. That's why all of this was sudden and unexpected. He was so full of life."

The remaining U.S. veteran is Frank Buckles, 107, of Charles Town, W.Va., according the U.S. Department of Veterans Affairs. In addition, John Babcock of Spokane, Wash., 107, served in the Canadian army and is the last known Canadian veteran of the war.

Another World War I vet, Ohioan J. Russell Coffey, died in December at 109. The last known German World War I veteran, Erich Kaestner, died New Year's Day at 107.

Landis trained as a U.S. Army recruit for 60 days at the end of the war and never went overseas. But the VA counts him among the 4.7 million men and woman who served during the Great War.

The last time all known U.S. veterans of a war died was Sept. 10, 1992, when Spanish-American War veteran Nathan E. Cook passed away at age 106.

Read the entire obituary at www.sacbee.com/833/v-print/story/692712.html.

On This Date in History - February 12

On this date in 1809, Abraham Lincoln, was born in Kentucky. He was known as Honest Abe, was elected the Sixteenth President of the United States, began the Civil War, Freed the Slaves and was assassinated at the Ford Theater while in office.

On this date in 1893, General Omar N. Bradley was born in Missouri. He was the G.I.'s general in World War II and became one of the nation's most loved as well as longest lived top generals, and a plain and gentle man.

After Leonard and Thelma Spinrad


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.

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