1.
Featured
Article: The Bayh-Dole act's 25th birthday of Government
Meddling in Academia
A landmark law has allowed
American universities to profit by patenting their innovations. But the costs
are adding up. by Economist.com
EVERYONE
agrees the reform had the noblest of intentions; yet some now regard it as an
assault on the values of academia. A quarter of a century ago this month, America
passed the Bayh-Dole act, named after its sponsors, Birch Bayh and Bob Dole,
both then members of America's Senate. It was billed as a minor legal
tweak—encouraging universities to patent and license the results of federally
funded research—but it has had huge effects, both good and ill. It is credited
by some with helping pull
The
act enables universities to patent any innovation that springs from
government-funded research, license it and share the spoils with the inventor.
The idea was not to enrich universities, but to give them a reason to propagate
the fruits of research, which had been mouldering unexploited. And it has
worked. In the past 25 years, more than 4,500 firms have been spun out from
non-profit research institutes, based on patents generated as a consequence of
this law.
Scores
of medical advances and technical innovations have resulted, including MRI
body scanning, the vaccine for hepatitis B,
the atomic-force microscope and even the technique behind Google's search
engine. In 2004 alone, American universities and institutes raked in $1.39
billion in licensing revenue, and applied for more than 10,000 new patents.
Impressed with this apparent success, other countries, including
A law of unintended
consequences
Yet
the yelps from critics have grown louder over the years. Many scientists,
economists and lawyers believe the act distorts the mission of universities,
diverting them from the pursuit of basic knowledge, which is freely
disseminated, to a focused search for results that have practical and
industrial purposes. Whether that is a bad thing is a matter of debate. What is
not in dispute is that it makes American academic institutions behave more like
businesses than neutral arbiters of truth. For example, a study published in
2003 by Jerry and Marie Thursby, of Emory University and the Georgia Institute
of Technology respectively, showed that more than a quarter of the licences
[sic] issued by universities and research institutes include clauses allowing
the business partner in the arrangement to delete information from research
papers. Almost half allow them to insist on publication being delayed.
Moreover,
there is ample evidence that scientific research is being delayed, deterred or
abandoned due to the presence of patents and proprietary technologies.
Researchers (and particularly their minders in university patent-licensing
offices) are increasingly reluctant to share materials and knowledge with
others unless such sharing is accompanied by legal agreements about
“reach-through” royalties on potential findings and the right to restrict publication
of results. A study released in October by the American Association for the
Advancement of Science noted that 35% of academic biotechnology researchers
experience difficulties getting hold of patented technologies that they need
for their work, even though non-commercial research is supposed to be exempt
from the normal restrictions of patents. The question is just how
“non-commercial” such research really is. Lawsuits between universities and
researchers over patents and royalties are now common. Indeed, though he was
eventually exonerated, a student from the
Even
industry is starting to complain about a gold-digger mentality among academic
administrators. The most notorious example is
To
read the entire original article including the backlash that has already
developed, go to www.economist.com/displaystory.cfm?story_id=5327661.
[Don’t
miss the larger picture. A flawed law in the
* * * * *
2.
In the News: Literacy of College Graduates Is on Decline by Lois
Survey's Finding of a Drop in Reading Proficiency Is Inexplicable, Experts Say
Literacy
experts and educators say they are stunned by the results of a recent adult
literacy assessment, which shows that the reading proficiency of college
graduates has declined in the past decade, with no obvious explanation.
"It's
appalling -- it's really astounding," said Michael Gorman, president of
the American Library Association and a librarian at
While
more Americans are graduating from college, and more than ever are applying for
admission, far fewer are leaving higher education with the skills needed to
comprehend routine data, such as reading a table about the relationship between
blood pressure and physical activity, according to the federal study conducted
by the
Experts
could not definitively explain the drop.
"The
declining impact of education on our adult population was the biggest surprise
for us, and we just don't have a good explanation," said Mark S.
Schneider, commissioner of education statistics. "It may be that
institutions have not yet figured out how to teach a whole generation of
students who learned to read on the computer and who watch more TV. It's a
different kind of literacy."
"What's
disturbing is that the assessment is not designed to test your understanding of
Proust, but to test your ability to read labels," he added. . .
The
results were based on a sample of more than 19,000 people 16 or older, who were
interviewed in their homes. They were asked to read prose, do math and find
facts in documents. The scores for "intermediate" reading abilities
went up for college students, causing educators to question whether most
college instruction is offered at the intermediate level because students face
reading challenges.
Gorman
said that he has been shocked by how few entering freshmen understand how to
use a basic library system, or enjoy reading for pleasure. "There is a
failure in the core values of education," he said. "They're told to
go to college in order to get a better job -- and that's okay. But the real
task is to produce educated people."
Other
experts noted that the slip in scores could be attributed to most state schools
not being particularly selective, accepting most high school graduates to
bolster enrollment. In addition, Schneider said schools may not be taking into
account a more diverse population, and the language and cultural barriers that
come with shifting demographics . . .
Dolores
Perin, a reading expert at
On
average, adult literacy is virtually unchanged since 1992, with 30 million people
struggling with basic reading tasks. While adults made some progress in
quantitative literacy, such as the ability to calculate taxes, the study showed
that from 1992 to 2003 adults made no improvement in their ability read
newspapers or books, or comprehend basic forms.
One
bright spot is that blacks are making significant gains in reading and math and
are reaching higher levels of education. For instance, the report showed that
the average rate of prose literacy, or reading, among blacks rose six percentage
points since 1992. Prose and document reading scores for whites remained the
same.
To
read the entire article, please go to
www.washingtonpost.com/wp-dyn/content/article/2005/12/24/AR2005122400701_pf.html.
[The
Finding of a “Drop in Reading Proficiency Is Inexplicable” is only because
these are all government funded or government controlled schools. No such drop
is seen in private or parochial schools where students and their parents pay
for the education. If the student doesn’t learn to read, the parents will not
enroll the child the following year and the school will go out of business and
the teachers become unemployed. Therefore, the teachers will make sure their
students learn the course work. The answer to our education problem, which is
similar to the answer to our health care problem, is to get the government out
of education.
[School
vouchers do not get the government out of education. They just open the door to
allow the government to also destroy private and parochial education. Witness
the Hillsdale experience of never accepting any funds forcibly extracted from
To
Paraphrase Paul Revere: The Socialists Are Coming. The Socialists Are Coming.
* * * * *
3.
International
Medicine: Nationalism And Science Don't Mix by Economist.com
THE
twisted tale of Hwang Woo-suk, a once-feted but now-disgraced South Korean
stem-cell researcher, is salutary at many levels. It shows, first, that you
can't cut corners in science—at least, not in any meaningful way. The
occasional dud result in a low-profile field of endeavour[sic] may escape
critical scrutiny, but if you report inaccurate work in an area as
controversial and important as human cloning, your slips will catch up with you
pretty quickly. Second, it shows the risks to scientists of becoming
celebrities. An artistic celebrity's audience may prove fickle, but ultimately
it is only that artist's talent that is being judged. A scientific celebrity's
success, by contrast, relies both on his talent and on nature delivering the
goods to him in a timely fashion—and nature does not bend to a scientist's
will, however much he or his audience may wish it might.
Hubris
and vanity are all too human vices and, despite occasional propaganda to the
contrary, scientists are, indeed, only human. But the third salutary lesson of
this episode, though related to the other two, is deeper. It is that
nationalism and science are uneasy bedfellows. Dr Hwang's downfall was set in
train by his elevation by the South Korean government into an emblem of his
country's emergence as a scientific power. That both flattered him and demanded
the next great breakthrough from his laboratory. In the end, he came up with a fatally
flawed piece of research that has now been disowned by collaborators (see article).
The
most famous example of deluded scientific nationalism was Trofim Lysenko, a
Soviet geneticist. Or, rather, a non-geneticist. Lysenko was flattered and
financed by Stalin because he claimed that an organism could pass on to its
offspring characteristics it acquired in its lifetime. That fitted well with
Marxist ideology about the mutability of nature, but wrecked the
The
reverse phenomenon, of discounting something because of its source, applies
too. Before the second world war, many of
In
spite of the success of the
The truth will out
Compared
with these dire examples of waste and destruction, Dr Hwang's mistake looks
relatively modest. Those opposed to human cloning may raise a cheer or two that
a great leap forward which they had feared seems not to have happened. But, as
the Nazis discovered, denying reality just because you don't like it is equally
foolish. Eventually, somebody probably will clone a human being. Just not,
perhaps, in
www.economist.com/displaystory.cfm?story_id=5327612
* * * * *
4.
Medicare: Part D
(Disaster)
We are only into the second week of the new Pharmacy
Benefit Program now called Medicare Part D. Most of my patients are having
difficulty navigating the federal waters, to put it mildly. Many still don’t
have any idea whether their conventional insurance, their HMO or Medicare is
paying for their medications. One thing they all seem to expect is that they
are not paying and someone else should. So after the first round of
prescriptions with a trip to the pharmacy, and a denial, the federal waterfall
turns back to the doctor’s office to get something that is covered. The
pharmacists aren’t sure yet what’s covered. They just want another round of
prescriptions, which they will run through their computer. If you ask, “Just
tell me which one is covered?” the response is that they can’t tell until they
have the new prescription with the patient’s ID in front of them as they scroll
their computer. Then if it isn’t covered, they will just send another fax.
So what’s the economics of this government bureaucracy?
After the office visit which includes a minute or two of amenities, a review of
the patient’s chart, a brief review of the current problem or status of the
prior medical problems, a brief examination, an assessment of the findings, a
brief discussion with the patient of the possible treatments, the prescriptions
or requisitions are then written and the medical record is completed in case
the government reviews the chart to police the actions that occurred. These
twenty minutes are paid by the carrier or Medicare at about half the usual
rate. The writing of the prescriptions is a huge unknown. We know that there
will be numerous faxes from the pharmacists for alternatives.
Before all the faxes have come and gone, before a new
treatment program can be implemented, it may be necessary to have another
review of the patient’s record, an assessment of the medical problem to see if
the requested alternative medication will work, rewriting the prescriptions,
faxing them back to the pharmacists, and revising the medical record to reflect
the changes. In short, this is another office call essentially in cyberspace.
Only this one is not even reimbursed at half rate. So now there have been
essentially two office calls for one-half the price of one. Not only don’t the
bureaucrats understand the drag on the system, one’s own employees,
pharmacists, and patients do not understand this doubling of costs. It cannot
go on indefinitely.
The pharmaceutical industry and pharmacists have come
to the partial rescue with many large chains giving out a few days supplies to
allow the federal government’s incompetence to ameliorate. One of the local
pharmacists says he doesn’t have the financial resources to give out free
medications. He’s been kept on hold for two hours and then has his phone go
dead in an attempt to sort this out for his patients. He says the “D” in
Medicare Part D stands for “Disaster” and it’s of Biblical Proportions. (See
“Confusion reigns over drug plans” at www.sacbee.com/content/news/v-print/story/14046778p-14878200c.html.)
No wonder there is this huge exodus away from Medicare
and also from private insurers. How sad for patients. Even worse, why are doctors
tolerating this?
What’s even more tragic is that this hyperbolic
increase in government entitlement has come under the watch of a business
president with an MBA who should have known better, rather than a lawyer who
sees legal complications as an increase in his professional security.
To read about the Medicare Pharmacy Benefit Plan that should
have been implemented to allow Medicare to continue for our grandchildren,
please to go to http://www.delmeyer.net/hmc2005.htm.
Government
is not the solution to our problems, government is the problem.
- Ronald Reagan
* * * * *
5.
Medical Gluttony:
Not Limited to Patients, but Also Includes Doctors and Hospitals
A reader of MedicalTuesday writes that Medical
Gluttony is not limited to patients. Physicians also practice it; to which we
would add hospitals also practice it. The interests of consumers (patients),
producers and the payer are well aligned in the free market. That’s because the
consumer and the payer are the same person. However, in healthcare, the
consumer and the payer are not the same person and this creates conflict, loss
of accountability, excessive utilizations and total corruption of the Medical
MarketPlace. In a free and open Medical MarketPlace, there can be no Medical
Gluttony, not by patients, not by physicians and other providers, and not by
hospitals. (Please see Cannon and Tanner in Section 9 below.
* * * * *
6.
Medical Myths:
Technology Increases the Price of Healthcare
Remember
when? Consumer electronics used to have bigger price tags and smaller memory
chips. By Clint Swett -- Bee Staff Writer Friday,
December 23, 2005 .
“I
remember a few years ago, DVD recorders were $2,000. Now they are just a couple
of hundred bucks," said Jim Babb, a spokesman for electronics retailer
"Falling prices is
just one of the essential truths of consumer electronics," he said. That's
borne out in a segment of the Consumer Price Index that charts price changes
for personal computers and peripherals, and adjusts for advances in technology
such as processing power, memory and storage.
According to the index,
technology prices have plunged 88 percent since December 1997, while the CPI as
a whole is up 22.5 percent over the same period.
Falling prices are one
manifestation of Moore's Law, the 1965 prediction by Intel co-founder Gordon
Moore that the number of transistors on a computer chip would double every two
years. That phenomenon has contributed to more powerful but less expensive
devices, ranging from cellular phones to microwave ovens and laptop computers.
www.sacbee.com/content/business/tech/v-print/story/14009948p-14842766c.html
[The fall in technology prices was not allowed to
decrease the technology of medicine. During the same period above, as Medical
Director of the Pulmonary Function Laboratory and Respiratory Therapy Services
of American River Hospital, I purchased a new Arterial Blood Gas Analyzer.
Although the price was about $2,000, it reduced my technician’s time from 30
minutes to three minutes to perform one ABG. The capital cost could be amortized
to about one dollar per blood gas. Hence, the savings in technical labor was
huge. I suggested a measly $5 decrease in the price of an ABG from $25 to $20
after demonstrating that my department would more than triple its profits
despite this decrease; however, it would be a small step in reducing health
care costs. I was overruled by the administrator who immediately increased the
charge to $30. He notified me about three months later that Medicare, Medicaid,
Blue Cross-Blue Shield and Foundation Health Plan were paying the new rate
without discount, thus indicating that his decision was correct. Therefore, he
increased the charge further to $35. He said he would continue to increase the
charge until he found the maximum that Medicare and insurance carriers would
pay. I tried to have an ethics discussion concerning the immorality of gouging
the sick patients with obscene prices; he simply turned around and walked away
shaking his head.
[The hospital is a major
cause of the health care inflation after the advent in the 1960s of Medicare,
government medicine and third-party insurance, which removed the patient from
the financial interface with their doctors and hospitals. Had physicians been
allowed to be an effective voice in medical care, the technological advances of
medicine would have brought considerable savings to health care. Free market,
competition-oriented physicians are continuing to be sidelined by the
Medical-Hospital Complex. Only the open and free Medical MarketPlace can still
correct the problems of health-care costs.]
* * * * *
7.
Overheard in the
Medical Staff Lounge: Doctors Discussing Medical Journals
THOMAS P. STOSSEL:
Mere Magazines
“The Journal of the American
Medical Association has declared industry-sponsored research categorically untrustworthy,
and, to publish it, demands that an academic researcher be an author and take
responsibility for its integrity, and also that an independent academic
statistician analyze its data. This and other journals rail obsessively against
'financial conflicts of interest' of academic researchers working with
companies and conduct inquisitions to identify every possible financial motive
that might corrupt researchers' objectivity. . . .
“If reporters understood
that journals are magazines, not Holy Scripture, we might not be witnessing
ever more onerous regulations inhibiting interactions between academic and
industry science. Prestigious biomedical journals are good for our health --
provided they stick to their core business of facilitating imperfect communication
between researchers. Leave drug and device monitoring to the FDA -- and
theology to theologians.”
Mere Magazines: http://online.wsj.com/article_print/SB113590672017634344.html (Subscription required.)
Termites Ate the Research
Data: The British Medical Journal
In 1992, the British Medical
Association's flagship journal published a study led by Indian doctor Ram B.
Singh with a striking finding: Heart-attack victims who ate more fiber, fruits
and vegetables for a year cut their risk of death during that period by almost
half.
A year later, Richard Smith,
the journal's editor, received two letters questioning the findings. What
followed was an extraordinary inquiry stretching over a dozen years and 5,000
miles. Along the way, Dr. Singh contended that termites had eaten crucial data
and Dr. Smith spent four years begging a busy statistician to deliver a report
. . .
Even Dr. Smith, who stepped
down from BMJ last year to take a position at UnitedHealth Group Inc., now says
that journals "are not really set up to administer justice in these kinds
of cases."
http://online.wsj.com/article/SB113565052512831921.html?mod=todays_us_page_one (Subscription required.)
* * * * *
8.
Voices of
Medicine: Competition Fuels the Market - Part II
by Charles B. Clark, M.D.
So how does competition fuel the market? And how does all this apply to our present status and our future as medical doctors? It is a process called negotiation. Let’s see how it works.
One of our hospitals recently decided that they were not going to contract any longer with one of the larger managed care plans. This was all about reimbursement. We physicians were advised that we would not be able to admit those patients after a certain date. Managed Care had the alternative of admitting their patients to another hospital chain. After a period of negotiation, we were informed that we could admit those patients to our hospital once again. This type of negotiation explains why the hospitals accept such horrific reductions in the fees they submit to their contracted managed care organizations. However, it places an intolerable burden on the uninsured patient who does not have the advantage of a “negotiated contract.”
In terms of Dr. Average Physician, he has a practice whose reimbursement is largely controlled by managed care plans. From the beginning, the effect of managed care was to reduce the reimbursement to physicians. Most physicians passively watched this happen because so many patients were insured by these plans. “A Piece of the Pie”
Then we began to see various specialists forming groups. Gastroenterologists and cardiologists, for example, were banding together. The stated purpose of this joining forces was to be able to compete more effectively for managed care contracts.
So the negotiations began. Group A contracts with Managed Care Plan for x dollars a unit. Group B wants a bigger share of the action so they contract with Managed Care Plan for x minus one dollar a unit. Now Group B is getting the business. Group A agrees to contract with Managed Care Plan for x minus two dollars. And so it goes on. Where will it stop? Will it stop? Why should it stop? Virtually all of us have submitted quite passively to this competitive struggle for the patients. Yes, competition fuels the market but the market may be becoming stressed to the brink of extinction in its present form.
As we float quietly down the river into the misty fog of oblivion, who is to blame for our demise? We need look no farther than the mirror.
To review Dr Clark’s earlier posting, please go to www.healthcarecom.net/CBCCompetitionFuelsMarket.htm.
To read additional Voices of Medicine, go to www.healthcarecom.net/vom1999.htm.
* * * * *
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 III –Underlying Diseases, Strong Medicine: Chapter 4 - Too
Much of a Good Thing Can Be Very Bad.
“What can policymakers do to make health
care of ever-increasing quality available to an ever-increasing number of
consumers? The answer begins with an accurate diagnosis of the problem. As
discussed in the Introduction, producers in an open market must compete to meet
consumers’ needs at the lowest possible cost. Consumers who must weigh
different options against one another tend to focus on getting the highest
value per dollar spent, and they reward producers who provide it. Consumers and
efficient producers both gain. Inefficient ways of doing things are driven from
the market. Competition constantly pushes producers to reduce prices and
improve quality. However, this process does not describe
“Why does health care lack the vigorous
competition that produces wonders in other sectors of the economy? As we survey
the scene, we see that many of the necessary conditions of healthy competition
have been disabled. On the consumer side, government promotes excessive levels
of health coverage. On the producer side, it imposes excessive regulation,
which dampens competition. In each instance, government usually has a stated
goal of making health care more affordable, protecting consumers, or even
increasing market competition. However, its interventions often produce the
opposite effect. When it limits experimentation and learning in the marketplace,
government inhibits the competitive discovery process and most often leaves
consumers worse off.
The Trouble with Too Much Health Coverage
“Health insurance plays a crucial role in
financing health care. But Americans rely on health coverage beyond its
usefulness. Like auto, fire, and homeowner’s insurance, health insurance is
supposed to protect against unlikely but high-cost events. Ordinarily, it would
not cover regular checkups for the same reason that auto insurance does not
cover oil changes: such expenses are neither unlikely nor high-cost. It is
easier to pay for smaller, predictable expenses directly rather than through
insurance. Of course, there is no reason why someone should not be able to
purchase coverage for regular checkups—as long as she is willing to pay the
added cost.
“Health insurance works differently in the
Creating Conflict
“Most fundamentally,
“Deductibles and co-payments give the patients an
interest in eliminating wasteful expenditures and utilizing only medical care
that they expect will provide value. These cost-sharing measures realign the
interests of patients, payers, and providers. Having patients choose the terms
of their health insurance in advance further harmonizes the parties’ interests.
This allows insurers to convey the costs of different ways of dealing with the
problems of third-party payment (i.e., different
deductibles, co-payments, and other features) and requires consumers to weigh
those costs.
“When government hides the full cost of
coverage from consumers, however, it makes the problem of conflicting interests
worse . . .
“One result is unnecessary conflict
between patients and payers. Since
patients pay an average of only 14 cents for each dollar of care, they utilize
more care than they would if they had to shoulder more of the cost. The added utilization
imposes costs on the people who ultimately pay for the other 86 percent—workers
and taxpayers. They perceive no benefit
from a stranger’s overuse of the health care system. Through their agents
(insurers, employers, and governments), they push back by refusing to pay for
care that patients want. Excessive coverage also creates conflict between
patients and payers by encouraging 'moral hazard.' By reducing the (apparent)
costs to consumers of risky behaviors (e.g., obesity, smoking, reckless driving),
it encourages consumers to do less than they otherwise would to safeguard their
health.
“Encouraging excessive coverage also
creates conflict between payers and providers. Providers often see the payers’
coverage decisions as an intrusion on the doctor-patient relationship and an
affront to their professional judgment. One result is that providers (and
presumably patients) often deceive payers to obtain coverage. Researchers from
'Tactics reported by
physicians have included exaggerating
the severity of the
patient’s condition, changing the patient’s
diagnosis for billing, or
reporting signs or symptoms that the
patient did not have.
Deceptions may involve brief change
in wording, as when physicians
rule out cancer as the indication
for a test rather than
screening. . . (e.g., inventing findings such as breast
lumps to obtain a referral
for screening mammography). . .'
“The RAND Health Insurance Experiment
confirms that people with excessive coverage utilize care that does nothing to
improve health. Families who had to weigh the cost of the first few thousand dollars
of medical expenses saw 'little to no net adverse effect on health for the
average person,' compared with families with 100 percent coverage. 'Indeed,
restricted activity days fell.'
“It may be impossible to estimate the
total amount of waste in
Dampened Competition
“Discouraging patients from
shopping for value and distracting physicians from pursuing higher quality care
at lower prices cannot help but stifle competition. Michael Porter and
Elizabeth Teisberg write,
'The most fundamental and
unrecognized problem in
Undermining the Doctor-Patient Relationship
“Most physicians now rely extensively on
third-party payers. More than 95 percent of physicians accept Medicare
patients. In 2001, about 90 percent of physicians
had at least one managed-care contract, and on average physicians received
roughly 40 percent of their income from managed care. Only about a quarter of
physicians practiced independently, compared with 41 percent in 1983.
“This trend has had a
negative impact on the way physicians practice medicine and the doctor-patient
relationship. Swiss medical ethicist Ernest Truffer argues that the increasing
interjection of 'gate keepers,' 'case managers,' and other forms of bureaucracy
between doctors and patients 'amounts to a rejection of the medical ethic—
which is to care for a patient according to his specific medical
requirements—in favor of a veterinary ethic, which consists of caring
for the sick animal not in accordance with its specific medical needs, but
according to the requirements of its master and owner, the person responsible
for paying any costs incurred.'
“When doctors
are paid a set amount per office visit, as they often are, it leads to less
time to meet with patients, which can have an impact on effective diagnoses and
treatment. After receiving a second opinion that corrected a serious
misdiagnosis (which missed three blocked coronary arteries), author Jay
Neugeboren observed,
'the way the health care
system is now run [has] undermined the traditional doctor-patient relationship.
Not only do doctors have less and less time to meet with us, but, given the
vagaries of health insurance, the doctor we see one time may not be the same
doctor we see the next time, and so we often remain strangers to one another .
. . [I]n the words of Dr. Bernard Lown, inventor of the defibrillator, listening
to the patient and taking a careful history remains 'the most effective,
quickest and least costly way to get to the bottom of most medical problems.'
"A growing movement
among some physicians to reject third-party coverage attests to the impact it
has had on the practice of medicine and the physician-patient relationship. . .
.”
To read the rest of Part III, Chapter 4 –
Too Much of a Good Thing Can Be Very Bad, 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 surprise your friends, who don't
understand that government involvement in health care is destroying affordable
health care, with a gift that keeps on giving. There are other excellent recent
titles you may want to consider.
For Next month, read Part III: Chapter
5 – Tax Policy and Health Care
To read some of
the other book reviews that are available, please go to www.delmeyer.net/PhysicianPatientBookshelf.htm.
* * * * *
10. Hippocrates & His Kin: Medicare Part D: Drug
Benefit Program
The Medicare Drug Benefit Program (MDBP) has gotten
off to a rocky start and appears to be very complicated. Patients aren’t sure
if they want to join. One patient came up with a recipe for success: Take your
age, divide by your height, multiply times your weight, divide by your lipids,
multiply times your blood pressure, subtract the number of donuts you eat per
day, and add in your income, and subtract the square root of your taxes. If you
come up with a number, any number, you qualify.
Just as we thought: It doesn’t help the current
generation but eliminates income for our children.
Hospital Chief Of Staff
Which Formerly Was a Sought After Position But Now Is a “No Win” Position
Psychiatrist to the patient
on his couch: You must get over this
fear of doctors.
Patient: But why?
Psychiatrist: Because you’re the
hospital’s chief of staff. (after Benita Epstein)
To read more HHK Vignettes,
go to www.healthcarecom.net/hhk1998.htm
- July/August%201998.
* * * * *
11. Organizations for Restoring Accountability in
HealthCare, Government and Society: