1.
Featured Article: Rising Health-Care Costs: Who's the
Villain? By Charles Van Eaton
Dr. Van Eaton is McCabe/UPS Professor of Economics at Hillsdale
College, Hillsdale, Michigan.
Why is the level of health-care spending what it is?
Why does the rate of growth in health-care spending tend to rise faster than
spending on other things? Can anything be done to control the rate of growth,
if not the level, of health-care costs, short of having government take control
of what now constitutes almost 14 percent of our entire Gross Domestic Product?
What can be done to decrease the number of persons who are without some form of
private health-care insurance?
As the political debate about health-care unfolded,
it became clear that virtually no one in the federal establishment thought that
trying to get answers to these questions made any difference in what the
politicians were trying to do to move government even more heavily into the
health-care-services production system than it is now.
It does make a difference. There are strong
differences of opinion on why the level of U.S. health-care costs are what they
are, why these costs have been rising faster than the cost of other goods and
services, and what government can do both to reduce the level of costs and to
arrest the rate of cost growth.
On one side is the view that if the level of
spending on health care is the product of forces over which government can, at
best, have little control, there is no reason to give government more control.
However, if part of the reason health-care spending tends to rise faster than
other streams of spending is the product of policies generated by government
programs, and if the goal is to reduce this rate of spending growth, the
obvious place to start would be to do away with those government policies which
contribute to spending growth.
Why are costs what they are and why do they tend to
rise as fast as they do?
"Villain Theories"
On one side of the debate one hears what may be
called "villain theories" of healthcare costs. These theories focus
on the production side of services and conclude that both the level and rate of
growth in costs are the product of greed on the part of insurers,
pharmaceutical companies, hospitals, and physicians.[1] Until these
parts of the health-care-services production and financing system are brought
under control, this argument goes, nothing can be done to reduce health-care
spending. . .
Against the villain theory of health-care costs lies
the view that the level of healthcare costs is a product of six factors, none
of which involves villains of any stripe.
1. The level of health-care costs relative to Gross
Domestic Product is higher in the United States than it is in other countries
because the American health-care system has been so successful in treating
conditions which, in past times, would have been untreatable.[2]
Consequently, good medicine increases rather than reduces the proportion of
people in our population who have illnesses requiring continued treatment. . .
(Put another way, while the dead are no longer a cost burden to the health-care
system, survivors are.)
2. The technological superiority of the American
health-care-services production system has resulted in an increase in the
quantity of health-care services demanded. The technical diagnostic capacity to
test for that additional one percent of information, which might provide
answers to a medical puzzle, results in a demand for additional testing and
additional treatment-at additional cost, of course. . . Consequently there are
many who argue that American medical technology is a major reason for the high
level of health-care costs. [Note: While medical technology may be expensive, these advances
almost always lead to more cost-effective total care and better quality of
life. It is interesting that in no other industry is less technology considered
progress.]
3. What is all too often overlooked when the level
of American health-care spending is unfavorably compared to spending in other
nations is that the United States, in many ways . . . is not like other
nations. Therefore comparing the level of health-care spending in the United
States relative to spending in other nations is not particularly useful unless
all those distinguishing factors are addressed and statistically held constant
before cost comparisons are made.
. . . As former Secretary of Health and Human
Services Louis W. Sullivan noted, "It cannot be overemphasized that the
top ten causes of illness and premature death in our nation are significantly
influenced by personal behavior and lifestyle choices.". . .
4. . . . A nation with high income is going to spend
more on everything, especially health care, because health care is, to use
economists' jargon, highly income elastic. When income levels rise by some
given percent, the demand for health care rises proportionately more. . .
[George J. Schieber and Jean-Pierre Poullier found that each 10 percent
difference in per-capita Gross Domestic Product is associated with a 14 percent
difference in per-capita health-care spending.]
What can government do to change these cost factors?
Virtually nothing.
The rate of growth in American healthcare costs
relative to the cost of other things Americans buy, New York University
economist William Baumol argues, is due to the relative difficulty of expanding
productivity in services production compared to goods production. In Baumol's
view, there are no villains.
Baumol, long considered one of America's foremost
scholars in the field of productivity analysis, argues that "There is no
advanced country in which complaints about rates of cost increase are not
heard." In fact, "in fourteen of eighteen countries in the years 1960
through 1990, health-care prices rose more rapidly than prices in general. The
U.S. rate of increase was exceeded by that in seven countries-Australia,
Austria, Canada, the Netherlands, New Zealand, Norway, and Switzerland. . .
Those inclined to see the rise in healthcare costs
in terms of villains who must be managed by direct government intervention into
the health-care-services production system may be failing to grasp the nature
of services production relative to goods production. Both data and theory
compel serious observers to acknowledge that it is far more difficult to
increase productivity in services such as health care, law, welfare programs,
mail, police, sanitation, repairs, and the performing arts, compared to
manufacturing, because in the latter the continual development of new tools and
management techniques makes it possible to expand output with fewer units of
labor input.
By contrast, services—particularly health-care services—all
have a "hand-craft" attribute in their supply process. Consequently,
when productivity rates differ across different sectors of an economy, say,
manufacturing compared to health care, the money price of health care will rise
relative to the money price of outputs in those sectors where productivity
gains are real and substantial. Therefore, Baumol concludes, rising health-care
costs are "an inevitable and ineradicable part of a developed economy and
the attempt to do anything about it may be as foolhardy as it is
impossible.". . . Consequently,
the rise in the dollar price of health-care services is not evidence of a
system in despair, but only of a broad difference in relative productivity
rates between services and goods.
But, Baumol rightly notes, "This happy
conclusion is just a bit too simplistic…. it will not be easy to convince the
layperson that, even though the prices of personal services appear to be rising
at a phenomenal rate, in fact the costs of these services (in terms of their labor
time equivalent) are really declining because of increases in labor
productivity generally.". . .
For example, even though the German insurance system
is bankrupt despite premiums that come to 13 percent of payroll, after paying
the tax, Germans "graze themselves to obesity on medical services because
the price of care, as perceived by individuals, is essentially zero."
A new econometric model developed by Gary and Aldona
Robbins of Fiscal Associates, Inc., which looks at how America finances health care,
provides insight into why our current system for subsidizing health care
distorts demand and adds costs that increase the probability that some people
will be priced out of the market for affordable health insurance coverage. The
Robbinses note the following:
• Prices matter. People are not
price sensitive in the market for health care as they are in the market for
other goods and services because some third-party (Medicare or a private
insurer) pays most of the cost of health services. . .
• Health spending has been
rising because prices paid by patients have been falling. When we are using
someone else's money, we pay less attention to costs and thus spend more.
• Most Americans are
overinsured because of government policies. Through generous tax subsidies to
employers, government "pays" up to one-half of the cost of
employer-provided health insurance. . .
• The main cause of rising
health-care spending is government. Direct government spending has increased
from 24 percent of all health-care spending in 1960 to 42 percent in 1990. . .
• Because of the third-party
character of our health-care finance system, most people have no idea how much
they are personally contributing to cover the costs. In 1992 national health spending
was equal to $8,821 for every U.S. household, with most of this burden hidden
from view.
• Because of third-party
insurance and government subsidies, the most costly services are often the
cheapest to patients. On average, patients pay only 4.5 cents out of pocket for
every dollar spent on hospitals, but 68 cents out of pocket for every dollar
spent on pharmaceuticals. Thus, to patients, hospital therapy appears cheaper
than drug therapy while for society as a whole the opposite may be true. . .
One must conclude that, however unintentionally, our
current system of third party-driven health-care finance has yielded an
unusually perverse outcome: while it contributes to higher levels of health
cost for the nation as a whole, it sends a signal to individuals which leads
them to believe that health-care costs are cheap. Consequently, the direct
effect of rising health-care costs are largely hidden from the majority of
individual health-care consumers.
In short, if the word "crisis" has any
place at all in the debate, it should not be applied to the
health-care-services production system, it should be applied to how we finance
the demand for health-care services because this system, which is based on
having someone other than the health-care consumer pay the bill, robs
individuals of a direct stake in health-care cost control.[18]
What should government be trying to do? It certainly
should not be trying to impose a massive Medicare or Medicaid system on the
whole country. Neither should it be moving to bring all Americans under the
umbrella of employer-provided health insurance. These two systems, to the
extent that they have contributed to disguising health-care costs to
individuals, have been the single most critical factor in forcing health-care
costs upward. Government should move the system away from its heavy reliance on
third-party payments toward a system based on individual accountability for
health-care spending. Is that the direction government will finally take? We
shall see.
Article
printed from The Freeman | Ideas On Liberty: www.thefreemanonline.org
URL to the entire article along with key references:
www.thefreemanonline.org/featured/rising-health-care-costs-whos-the-villain/
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2. In the News:
Medical Identity theft is a fast-growing crime, NY Times, June 13, 2009
Medical Problems Could Include Identity Theft, By WALECIA KONRAD, NY
Times
Brandon Sharp, a 37-year-old manager at an oil and gas
company in Houston, has never had any real health problems and, luckily, he has
never stepped foot in an emergency room. So imagine his surprise a few years
ago when he learned he owed thousands of dollars worth of emergency-service
medical bills.
Mr. Sharp, as it turned out, was a victim of a
fast-growing crime known as medical identity
theft.
At the time, Mr. Sharp was about to get married and
buy his first home. Before applying for a mortgage
he requested a copy of his credit report. That is when he found he had several
collection notices under his name for emergency room visits throughout the
country.
"There was even a $19,000 bill for a Life Flight
air ambulance service in some remote location I'd never heard of," said
Mr. Sharp, who made this unhappy discovery in 2003. "I had emergency room
bills from places like Bowling Green, Kan., where I've never even visited. I'm
still cleaning up the mess."
The last time federal data on the crime was collected,
for a 2007 report, more than 250,000 Americans a year were victims of medical
identity theft. That number has almost certainly increased since then, because
of the increased use of electronic medical records systems built without
extensive safeguards, said Pam Dixon, executive director of the nonprofit World
Privacy Forum and author of a report on
medical identity theft. . .
Medical identity theft takes many guises. In Mr.
Sharp's case, someone got hold of his name and Social
Security number and used them to receive emergency medical services,
which many hospitals are obliged to provide whether or
not a person has insurance.
Mr. Sharp still does not know whether he fell victim to one calamitous perp who
ended up in several emergency rooms or a ring of accident-prone conspirators.
In another variant of the crime, someone can use
stolen insurance information, like the basic member ID and group policy number
found on insurance cards, to impersonate you — and receive everything from a
routine physical to major surgery under your coverage. This is surprisingly
easy to do, because many doctors and hospitals do not ask for identification
beyond insurance information.
Even more common, however, are cases where medical
information is stolen by insiders at a medical office. Thieves download vital
personal insurance data and related information from the operation's
computerized medical records, then sell it on the black market or use it
themselves to make fraudulent billing claims.
In a widely reported case in 2006, a clerk at a
Cleveland Clinic branch office in Weston, Fla., downloaded the records of more
than 1,100 Medicare patients and gave the information to her
cousin, who in turn, made $2.8 million in bogus claims. . .
And there are none of the consumer protections for
medical identity theft victims that exist for traditional identity theft. Under
the Fair Credit Reporting Act you can get a free copy of your credit report
each year, put a fraud alert on your account and get erroneous charges deleted
from your record. If your credit card is stolen and the thief goes on a
spending spree, you're not liable for more than $50 worth of the charges.
With medical identity theft, though, the fraudulent
charges can remain unpaid and unresolved for years, permanently damaging your
credit rating. Under the federal law known as HIPAA — the Health Insurance
Portability and Accountability Act — you are entitled to a copy of your medical
records, but you may have to pay a hefty fee for them.
Worse, HIPAA privacy rules can actually work against
you. Once your medical information is intermingled with someone else's, you may
have trouble accessing your files. Privacy laws dictate that the thief's
medical information now contained in your records must be kept confidential,
too. . .
And some medical centers and doctors' offices now
require patients to show photo ID and attach photos to patient charts.
But privacy advocates worry that these steps do not go
nearly far enough, especially in light of President
Obama's plans to spend $20 billion to increase the use of electronic
medical records nationwide as part of the stimulus package. "Without
aggressive safeguards, we could be building an infrastructure for massive
medical fraud," said Ms. Dixon.
www.nytimes.com/2009/06/13/health/13patient.html?scp=3&sq=Walecia%20Konrad&st=cse
It
would be best if government bureaucracy allowed medical records to evolve
naturally and safely.
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3.
International
Medicine: The catastrophes
of Socialized Government Medicine continue to surface worldwide.
NHS trusts in England
did not come up to hygiene standards in Healthcare
The Healthcare Commission today publishes its annual ratings
of NHS services. This year it has revealed that 114 of the 391 NHS trusts
did not satisfactorily comply with hygiene standards in 2007-08.
They are: To
view the list of the unclean hospitals . . .
Why would anyone in Washington DC want us to adopt
third world healthcare?
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4. Medicare: Why It's Easy To Steal From Medicare - WSJ
The White House made a big show last week about
"turning the heat up" on Medicare fraud. The dragnet resulted in
53 indictments in Detroit for a $50 million scheme to submit bills for HIV
drugs and physical therapy that were never provided, as well as busting up a
Miami ring that used fake storefronts to steal some $100 million. As
welcome as this is, the larger issue, according to the Wall Street Journal, is
what such plots say about President Obama's plans for a new government-run
insurance program?
For example:
One of the purported benefits of nationalized health
care is that it will be more efficient than private insurers since it would
lack the profit motive and have lower administrative expenses, like Medicare. .
.
By contrast:
Private insurers try to manage care, and that takes
money. Not only does administrative spending go toward screening for waste and
fraud -- logical, given the return-on-investment incentives -- they also go
toward building networks of (honest) doctors and other providers.
Medicare doesn't pay for this legwork, so it simply
counts fraud losses as more spending.
Generally private insurers also attempt to pay for
other things that consumers find valuable, such as high quality, while Medicare
and Medicaid are forbidden by law from excluding substandard providers, unless
they're criminals.
Dead doctors, fake patients, high-school dropouts,
fly-by-night businesses and the rest will continue to swindle our sclerotic
entitlement system, no matter how far the government turns up the
after-the-fact heat. The arrests in Detroit and Miami are another argument
against importing to the rest of the health economy the model that enabled
these scams, says the Journal.
Source: Editorial, "Why It's Easy to Steal From
Medicare," Wall Street Journal, July 2, 2009
For text: http://online.wsj.com/article/SB124649425934283347.html
For more on Health Issues: www.ncpa.org/sub/dpd/index.php?Article_Category=16
www.ncpa.org/sub/dpd/index.php?Article_ID=18158
Government is not the
solution to our problems, government is the problem.
- Ronald Reagan
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5.
Medical Gluttony:
Like any other Entitlement – More is never Enough
Mr. Allred asked for an excuse from Jury Duty because
he was angry at the government of his homeland. This anger made it impossible
for him to think logically and he said he would be unable to follow any
courtroom deliberations with his mental preoccupation.
The last time he went to visit
his family, he counted 99 dead bodies among his friends, acquaintances and
townspeople. He stated that these people had cast aspersions on the government
and they simply were shot. He learned very quickly not to say anything that
could possibly be construed as adverse to the state. This still haunted him and
he requested an excuse for medical reason.
Knowing some judges personally,
they get upset with what they call Medical or Physician arrogance—the request
for an excuse without clarifying the medical reason. They resent a directive
"Please excuse" as if coming from Mt Sinai.
Thus to write an excuse, in our
estimation, requires a brief review of his last annual exam, the sequence of
diagnosis copied into the letter, and an explanation to the Jury Commissioner
why that constellation of diagnostic symptoms and findings would interfere with
normal court room proceedings, suggesting that they may want to avoid the
problem by excusing this patient from jury duty in their court room.
In an elderly medical practice,
the requests for being excused from jury duty come rather frequently. The time
involved approaches about one-half of an office call. So we started charging
for this service, clearly stating that this is not covered by insurance,
Medicare or Medicaid.
This may be a rather blunt
approach in having patients begin to understand the cost of a physician's time.
It has also stopped the creeping increase in time for an unstructured office
evaluation. It is always exasperating to give a patient an extra 10 minutes of
time and then be expected to give an additional "tens of minutes" for
a sundry of other items.
It's always a pleasure to see a
business person who knows the appointment time is 20 minutes and, in about 18
minutes, start drawing the discussion to a close because he values the cost of
time. It's time for all patients to begin to comprehend this before government
controlled office visits occur and everyone becomes unhappy and probably rather
angry.
In the U.S. Air Force, when we
got behind in seeing patients, the hospital commander just decreased office
visits to ten minutes with a warning that if we didn't keep up and get the
troops seen, he would reduce the office visit to 7 ½ minutes.
When government bureaucrats run
our practice, they will have no problem in cutting the physician's and
patient's schedule to whatever they deem important. I've already heard one
attorney say, it shouldn't take more than five minutes to look into a pair of
ears and listen to the chest. Why does a doctor want to take 20 minutes?
Meanwhile, patients want 30
minutes, 50 minutes, 70 minutes or 90 minutes. We must inform our patients that
should the government take over their healthcare, the appointment time will go
in the opposite direction. And at that point, it will be too late to reverse
the direction.
Medical Gluttony may cause perverse incentives for
patients.
*
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6. Medical Myths: An electronic medical record could save
your life in an emergency
Information technology does not stop bleeding, start
IVs, defibrillate the heart, or put in a breathing tube. In an emergency, those
are the things that save your life. If you need them, the doctor does not have
time to look at your EMR.
In an emergency, the doctor needs to know your blood
sugar NOW, not what it was 6 months ago. Ditto for your chest x-ray. If the
test needs to be done STAT, the old results are probably irrelevant, and if it
doesn't need to be done STAT, there's time to make a phone call and ask for a
faxed report.
The most important information in an emergency is
what just happened to you, and that will NOT
be in your EMR.
If you have a serious allergy or other problem that
your doctor needs to know in an emergency, wear a MedicAlert bracelet or
something else attached to your body. In a bad emergency, your ID may be lost,
the computer may be down, or the power may be off.
The EMR is being promoted for the convenience of
bureaucrats and lawyers, and for the profits of vendors. Sometimes it helps
doctors; sometimes it's a hindrance. Only the doctor can decide.
The EMR costs a huge amount of money, and the costs
never stop. It might save a few dollars in preventing unnecessary tests for
people who have bad memories or can't keep track of paper records. *
The whole record could be destroyed by a power surge
(especially if it's an electromagnetic pulse or EMP). Or it could become
unreadable; tapes, disks, and other media become obsolete and are not
necessarily durable. On the other hand, it can be nearly impossible to
extirpate errors.
The EMR may prevent some errors, but introduce
others, especially ones caused by identity theft, sloppy data entry, poor
typing skills, confusing software, dry-labbed information entry by macro, and
failure to check data once entered. It could even kill you.
EMR systems are a non-consented experiment, the
results of which may be kept secret by the vendors.
If you're desperately ill or critically injured, you
need a doctor, not a computer. Your doctor needs to be able to keep his records
in a way that works for him, and to choose his own tools, computers included.
[* We've found that good memories that can keep
track of tests do not prevent unnecessary tests when they are free of
significant co-payments.]
Additional information:
"EMR: A Nonconsented Experiment," AAPS News, July 2008.
Please send suggestions for other mythbusters to jane@aapsonline.org.
Read this and other Myths at www.aapsonline.org/newsoftheday/00287.
Medical Myths originate when politicians practice medicine.
Medical Myths disappear when Doctors are in charge of the practice
medicine.
Medical Myths also disappear when Patients have significant co-payments
on every test.
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7. Overheard in the Medical Staff Lounge: Are Co-payments
Cost Effective?
Dr. Rosen: We have shown how to reduce health insurance costs by
30 or more percent.
Dr. Ruth: How so?
Dr. Rosen: We've been
conducting a clinical study in my office which isn't double blind but I still
think is valid.
Dr. Milton: I think clinical
studies and just plain clinical judgment are valid more often than not.
Dr. Ruth: Exactly, what kind
of clinical studies are we talking about?
Dr. Rosen: Clinical cost
controls projections and measurements.
Dr. Milton: I think I've been
doing clinical studies similar to yours, thinking about the last time we
discussed this. If this test would have a 30 percent co-payment, would you
still want it since it's relatively unrelated to your health or disease?
Dr. Rosen: We've found that
the 30 percent co-pay for outpatient work is the point at which unnecessary
tests are cut off but important tests are still done, which means that the
patient thinks that a cost of 30 percent is beneficial enough to warrant the
cost. In other words, all necessary tests are still done and personal
healthcare does not suffer.
Dr. Patricia: Why don't you
do a real double-blind study so it will be valid?
Dr. Rosen: No one has quite
figured out how to do a double-blind, cost-control study. It is impossible to
blind the cost of a test or an x-ray or a medication.
Dr. Patricia: Do medications
have a co-payment? I thought labs and x-rays don't.
Dr. Rosen: In our study, we have
also found that a 30 percent co-payment on medications is also the most
cost-effective co-pay with no loss of quality.
Dr. Ruth: Don't you still have to still police
generic versus proprietary medications?
Dr. Rosen: In our study, we
found that the 30 percent co-payment on medications will in 90 percent of cases
cause the patient to voluntarily buy generics rather than proprietary.
Dr. Yancy: It seems to me if
proprietary medications are covered by insurance, that everybody will get the
proprietary.
Dr. Rosen: But you have to
remember with 30 percent co-pay, proprietary drugs will be more than twice the
cost of generics.
Dr. Yancy: How can that be?
Dr. Rosen: I know it's
difficult to think of having the patient in charge and making choices based on
market costs, but patients, rich and poor will both be driven to the generics
since co-payments of 30 percent of proprietary may be less than half or a third
of the 30 percent co-payment of proprietary medications.
Dr. Yancy: What sleeight of hand
are you talking about?
Dr. Rosen: Let's use Lipitor
that has a price of about $120 for a month's supply. Another statin is on the
$4 list at Costco, Wal-Mart, Sam's Club, and Target, or $10 for a three-month
supply. So the co-pay on Lipitor would be $36 per month (30% of $120) or $108
for a three-month supply. A co-payment on Zocor is $3 for a three-months supply
(30% of $10).
Dr. Ruth: That really
clinches your argument, doesn't it? I don't think I've ever heard it explained
so lucidly. I would agree that more than 90 percent of patients would buy
generic voluntarily and make that decision at the pharmacy. Amazing, and no
government or insurance forcing the issue.
Dr. Milton: And no
pharmacists calling back to say the patient wants an alternate cheaper drug.
That should save me at least an hour a day.
Dr. Rosen: The main point
that still has to continually be made, or the public won't understand, is that
this simple maneuver has saved 97 percent of that prescription cost without any
government, Medicare or insurance mandate.
Dr. Ruth: That should be a
no-brainer, even for a Congressman or Senator. Even for those that have worked
very hard for that recognition.
Dr. Yancy: We all know it's
much harder to hoodwink the public and get into the Senate than to become a
Brigadier General.
Dr. Dave: But not a Brigadier
General with Southern courtesies when addressing a Lady as "Ma'am."
Dr. Yancy: Even a Senator who's not a Lady.
Dr. Milton: Rosen, getting
back to cost comparisons that patients make, I think you've made the same
comparisons with laboratory tests and x-rays, haven't you?
Dr. Rosen: Today, the tests
doctors order do not have a co-payment. So the patient's appetite is rather
huge. They have no comprehension that the tests they want or their spouse wants
or their kids want may cost a hundred dollars, a thousand dollars or even more.
But if they had to pay the same outpatient co-pay rate of 30 percent, they have
an immediate recognition of costs and an immediate cost-control attitude
without any force from Medicare or the insurance plan. In our experience, this
would save more than 50 percent of healthcare costs.
Dr. Patricia: Then why
doesn't Congress implement this?
Dr. Rosen: Government doesn't
have any basis for making business decisions. Government can only make
political decisions. What will it take to survive the next election and get
re-elected? Nothing else really matters.
Dr. Milton: Since their vote
is always with their constituencies in mind, and our citizens are increasingly
looking out only for themselves, there can be no improvement in our country,
and bankruptcy is the ultimate end. How many generations downstream can the
politicians borrow from?
Dr. Rosen: What a juvenile
attitude.
Dr. Milton: I think William
Golding wrote a book on what happens when juveniles run the kingdom.
Dr. Rosen: Yes, Lord of
the Flies was very illuminating about human nature.
The Staff Lounge Is Where Unfiltered Opinions Are
Heard.
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8.
Voices of
Medicine: A Review of Local and Regional Medical Journals
Dr.
Michael Champeau writes about Tom Daschle's book on health care reform in the
Spring issue of the CSA Bulletin.
. . . while casting about
for a worthy subject, I was intrigued when a friend suggested that I review
former senator Tom Daschle's 2008 book on healthcare reform, Critical—What
We Can Do About the Health-Care Crisis. . .
The idea presented a serendipitous opportunity to get inside the
head, so to speak, of the incoming Secretary of Health and Human Services, the
man tapped to lead the Obama administration's attack on the nation's healthcare
woes. At the time, it seemed that Daschle's perspective on healthcare reform
might be of legitimate interest to the membership.
I therefore read Senator
Daschle's book, dutifully taking some eight pages of notes in the process, so
as to accurately report my findings. Some of what I read was to be expected,
some was [disconcerting], some insightful, and some just plain interesting.
Unfortunately, on the very day I finished reading the book, Daschle's own ship ran
aground when his failure to pay a portion of his income taxes came to light.
Apparently Senator Daschle's enthusiasm for taxing the population didn't extend
to his personal situation. Suddenly stranded with a deadline and a dead line of
reasoning for my essay, I was struck by the irony of the reformer falling
victim to the same human foible he blames for our healthcare woes: greed. .
.
Basically, Daschle's take
is that America's healthcare system is fundamentally flawed, and although those
in government know this, they are politically incapable of making the required
changes. . .
Final
Thoughts
. . . the book offers an
easy peek inside the head of one of our nation's chief political thinkers on
healthcare issues. There is much to like, and much that causes concern. While I
could barely restrain my glee with his statement that "the savings we seek
will come out of executives' salaries and companies' profits," I was
disheartened to learn that the author is completely oblivious to the grossly inadequate
payments paid to physicians by the governmental programs. Ironically, these
underpayments are a direct cause of the cost shifting he so abhors. His view of
the Medicare and Medicaid programs as perfectly acceptable forms of healthcare
coverage unfortunately reveals his ignorance of an important aspect of the
American healthcare landscape.
Daschle's book is an easy and interesting read and should be available
soon in paperback. Now that his career in healthcare reform is over . . . it's
never a bad idea to see how these guys in Washington think.
To read CSA President's
entire review, please go to www.csahq.org/pdf/bulletin/pres_58_2x.pdf
VOM
Is Where Doctors' Thinking is Crystallized into Writing.
*
* * * *
9. Book Review:
Terrorism before 9-11-2001
BIOTERRORISM: How You Can SURVIVE by Russell L Blaylock, MD,
Physicians Preference, Inc, (www.PhysiciansPreference.com)
1–877-351-0593, 36 pp, $10
Bioterrorism took front and center stage in October
2001 only a month after the terrorist attack on the World Trade Center and the
Pentagon. But acts of terror have been present in the United States for more
than 15 years, e.g. the intentional Salmonella contamination in Oregon in 1984,
and the Shigella contamination in a hospital in Texas in 1996.
The Soviet program, under the aegis of Biopreparate
which at its height employed more than fifty thousand scientists and
technicians in over forty research and production facilities, was allegedly
dismantled by Yeltsin in 1989. The resulting diaspora of tens of thousands of
highly trained bioweapons personnel left many wondering: where are these people
now and what are they doing?
In 1998, Robin Cook, MD, points out in the
"author's notes" of his medical novel, Vector, (Penguin
Putnam, Inc, © 1999) that much of what his characters say about bioweapons and
bioterrorism is true. He documented the sources of his information, as he
frequently does, with key references. He stated that it is not a question of whether
a major bioterrorism attack in the United States will occur, but only a
question of when. Three years later in October 2001, Anthrax spores were
indeed sent by mail just as Robin Cook predicted. With a few dozen envelops,
terrorists in this country have demonstrated that almost anyone can be reached.
As a result, three people have died and forty-one have been confirmed infected.
The hospitals in the Sacramento area had
bioterrorism as a topic for their grand rounds within weeks. Medical societies
had terrorist workshops within the first few months.
The Mayo Clinic sent an Health Information
Bioterrorism Alert within a month of the Anthrax scare outlining the threat of
Anthrax, Botulism, Small Pox, Plague, Tularemia, Viral Hemorrhagic fevers, as
well as chemical weapons such as the sarin gas in Tokyo, with mustard gas,
chlorine, phosgene and hydrogen cyanide gases. However, it minimize the risks
as stating that these weapons are difficult to control once released and the
risk to most Americans has been considered low.
Bioterrorism: How you can survive is a privately published
and timely work by Russell L Blaylock, MD, a neurosurgeon. It was published just
after the biologic terrorism of October 2001 and gives a fresh presentation of
facts as well as a hopeful perspective. The public in general does not see the
terrorist network as a unified enemy, but rather as small groups of
disgruntled, poorly educated impoverished bands of nutcases who can
periodically cause nasty things to happen and are no real danger to the
powerful West. The fact that terrorist organizations appear so dispersed and
disjointed is not a weakness but a strength and makes the counterterrorist's
job that much more difficult. Many terrorism experts have stated on television
that biological agents are too difficult for the average terrorist to dispense.
University medical specialists in infectious disease who were interviewed on
television news had no expertise in weaponized biological agents and merely
described naturally occurring disease. One even assured the audience that
anthrax would not make a good terrorist weapon.
But Blaylock quotes Dr Michael Osterholm, author of Living
Terrors, who points out that there are numerous compact aerosol devices
available in medical supply and hardware stores that efficiently dispense these
biological weapons inexpensively. Even a simple humidifier was very efficient
in dispersing test organisms over a wide area. The effectiveness of bioweapon
killing power is illuminating by this comparison: In order to kill
everyone in a square kilometer, conventional weapons would cost about $2,000,
nuclear $800, nerve gas $600, and biological weapons $1. Research has
determined that new and used crop dusting airplanes, which can spray both dry
and wet materials, can be purchased over the internet with no questions asked.
The buyer and seller never meet. As Major General Marshall Stubbs warned in
1986, an enemy with only ten aircraft with dry biological material such as
anthrax or plague, could kill or incapacitate 70 million Americans.
Other bioweapons such as smallpox, plague and ten or
more others, which we are inexperienced to defend against are chosen by terrorists
for that very reason. Vaccines are very specific and will not protect us
against the large number of microorganisms that have been weaponized. Blaylock
outlines the basic care we should follow in case of exposure bringing us back
to America's frontiers of yesteryear. He also recommends use of nutritional
supplements and dietary modifications to protect ourselves and our loved ones
against bioterrorism, as well as what we should keep in our emergency supply
chest. In case of onset of actual disease, he outlines a program of maximizing
normal body defenses.
Blaylock points out the pitfalls of much of what is
stated by experts and the media. The terrorists not only want to kill us, but
also destroy our economy. Just as the destruction of the world trade center
killed 3,000 people, it also put over a million people out of work. Blaylock
reminds us that terrorism is not an end in itself. Initially it was used to get
the media's attention, make demands, and change our foreign policy. Then the
terrorists destroyed property and blew up airplanes, ships, marine barracks,
and embassies. As the level of violence increased, the demands became fewer.
Now they are seeking a world socialist government ruled by terrorist elite,
under the guise of Islamic fundamentalism. As their writings and speeches
proclaim, the new goal is the total destruction of the West, Christianity, and
capitalism. Nothing less will be accepted.
Joseph D Douglass, Jr, PhD, coauthor of America
the Vulnerable: The Threat of Chemical and Biological Warfare and CBW:
The Poor Man's Atomic Bomb states in his introduction that Blaylock's book
is the best on the problem of biological warfare he has read in over 30 years.
He surmises that we have just seen the initial warning of terrorist attacks;
escalation can come in almost any form.
If the limited attack through the mail system with
three fatalities and forty-one infected can overwhelm the capabilities of our
CDC to its breaking point according to its chief, what will happen in a real
terrorist attack affecting thousands and millions? Blaylock's pamphlet is
literally packed with information that every physician and every family should
read and study before it's too late. It will depend on the information that's
given in this book for us to survive. .
.
To order Bioterrorism:
How You Can Survive call toll free 1-877-351-0593.
Price per copy (when this was posted) was $10, which included shipping and
handling.
To read the entire book review, including the Table of Contents . . .
To read more book
reviews . . .
To read book reviews topically
. . .
*
* * * *
10. Hippocrates & His Kin: Only in Government can
workers add $100K by Retiring.
Looking
at Sacramento County's rising personnel costs
The lowest paid full-time employee - an
entry-level food service worker - made about $29,000 a year.
The median salary for all employees was about $54,000 in base wages.
The median gross salary was about $61,000.
Most overtime for a single employee: $57,434.
Highest base salary: $260, 312.
Highest Gross Salary: $374,058 (for a retiree who cashed out accrued sick
leave, holiday and vacation pay).
Where,
except in a government out of control, can anyone make an extra $100,000 by
retiring rather than working full time?
Maybe at GM (Government Motors).
Government Largess
The U. S.
Government hands out $4 Billion in grants each year.
How about reducing taxes by $4 Billion?
America's
World Class Pharmaceutical Retail Industry
Look at Wal-Mart, Costco, Sam's Club, and
Target that have cut nearly 500 medications to one-tenth (Prilosec was $5 a capsule,
the generic Omeprazole is 50 cents) and some to one-hundredth of their previous
price (Claritin was $4 a capsule, the generic Loratadine is four cents) by
competing in the private arena. The lawmakers in Washington spend years on how
to cut drug costs by 10% by force, yet private enterprise can cut them by 90
percent or so without coercion. Doctors competing in the private arena would
also reduce their costs and their charges as their expenses decreased. Doctors
that limit their practice to cash or credit cards have already decreased their
fees by one-third to one-half to reflect the absence of billing, insurance and
business office costs.
The
answer to cost control in health care is to eliminate government interference.
Doctors
Maligned.
Doctors on the whole desire
to cure the sick, and - if they are good doctors and this choice were fairly
put to them - would rather cure the patient and lose their fee than lose the
patient and get their fee.
- John Ruskin
Doctors are
not the only ones Maligned, many businesses are destroyed by Government
Mandates.
California has a mandate for gas stations requiring
them to install new gas-dispensing nozzles to capture 98 percent of the vapor
emissions instead of the current 95 percent. California has about 10,000 gas
stations operating with one-third out of compliance with the California Air
Resources Board (CARB). The legislature assured the operators they would be
sensitive to loss of jobs and businesses. The CARB would be flexible. However,
fines in the first few months approached $1 million - 64 stations have closed;
149 are on the brink of closure. (Carmichael
Times May 12, 2009)
Doctors
beware: Bureaucrats love their power and they will get even more intoxicated by
closing medical practices that don't follow government mandates starting in
2010. Killing physicians professionally is higher up on the bureaucrat's
promotion scale that service station owners.
*
* * * *
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, read the informative article on how Canadian public
figures opt out of Canadian Medicare when they personally experience Cancer.
They know the government healthcare waiting list is a death knell. . .
•
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
signup to receive their newsletters via email by clicking on the email tab or directly access their health
care blog. Be sure to read
Sally Pipes analysis of Romney's
Massachusetts Healtcare Disaster. . .
•
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, prepare for the flu pandemic .
. .
•
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. 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.
This month, read their letter to Leaders of Congress
concerning healthcare reform . . .
•
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 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,
you might focus on How
Americans Really Feel about Healthcare Reform . . . or gain insight into
the Massachusetts'
Health Reform Plan: Miracle or Muddle?
•
Greg Scandlen, an expert in Health Savings Accounts (HSAs), has
embarked on a new mission: Consumers for Health Care Choices (CHCC).
Read the initial series of his newsletter, Consumers
Power Reports. Greg has joined the Heartland Institute, where current
newsletters can be found.
•
The Heartland
Institute, www.heartland.org,
Joseph Bast, President, publishes the Health Care News.
You may sign up for their
health care email newsletter. Read the late Conrad F Meier on What is Free-Market Health Care? This month, be sure to read the Overview of Healthcare
Policy . . .
•
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. Having recently celebrated America's Independence
from King George, be sure to read the current article on how America
has embraced a system of criminal
law that King George himself would have
decried as tyrannical and unfit for any Englishman. . .
•
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." Be sure to read what happened to Tennessee when they tried to
implement universal healthcare through TennCare . . .
•
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. Read her latest Blog on how Colorado wanted to give Medicaid to All, when most doctors
won't see Medicaid Patients because reimbursement is below costs. . .
•
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, enjoy THE EMPEROR'S DERRIÈRE . . .
•
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. This month be sure to read: U.S. medical bankruptcies a myth; personal
bankruptcy rate higher in Canada.
•
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. -- However, since they supported the socialistic
health plan instituted by Mitt Romney in Massachusetts, which is replaying the
Medicare excessive increases in its first two years, they have lost site of
their mission and we will no longer feature them as a freedom loving
institution. Also beware of what appears to be Mitt Romney running for the
presidency in 2012 which would be another healthcare disaster.
•
The
Ludwig von Mises Institute,
Lew Rockwell, President, is a rich source of free-market materials,
probably the best daily course in economics we've seen. If you read these
essays on a daily basis, it would probably be equivalent to taking Economics 11
and 51 in college. Please log on at www.mises.org to obtain the foundation's daily reports. You may also log
on to Lew's premier free-market site to read some of his lectures to medical groups. Learn how state medicine subsidizes illness or to find out why anyone would want to
be an MD today.
Treat yourself to an alternate point of view on Bernie Madoff . . .
•
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, articles and books at www.cato.org/people/cannon.html. Read
his current take on health care reform . . .
•
The Ethan
Allen Institute, www.ethanallen.org/index2.html, is one of some 41 similar but independent state
organizations associated with the State Policy Network (SPN). The mission is to
put into practice the fundamentals of a free society: individual liberty,
private property, competitive free enterprise, limited and frugal government,
strong local communities, personal responsibility, and expanded opportunity for
human endeavor.
•
The 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.]
•
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 to 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, 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 the annual weeklong von Mises Seminars,
held every February, or their famous Shavano Institute. Congratulations to
Hillsdale for its national rankings in the USNews 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 the current issue at www.hillsdale.edu/news/imprimis.asp.
The last ten years of Imprimis are archived.
* * * * *
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joining the MedicalTuesday.Network and Have Your Friends Do the Same. If you
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you and invite you to join the email network on a regular basis by subscribing
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Please note that sections 1-4, 6, 8-9 are entirely
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Del Meyer
Del Meyer, MD, Editor & Founder
6945 Fair Oaks Blvd, Ste A-2, Carmichael, CA 95608
Did you know that lobbyists
outnumber our Senators 74 to 1? Boyd's Grab Bag
Professionals least likely
to abandon their careers for other lines of work are doctors, lawyers,
dentists, pharmacists, architects, engineers and physicists. Research suggests
that bill collecting is most likely to be abandoned. One debt detective said,
"I couldn't make enough money, so quit when I was inadvertently assigned
to go after myself." L. M. Boyd
If you don't stand for anything,
you'll fall for anything.
Some Relevant Postings
Why Does
California Want a Third World Health Care System? By David Gibson, MD
Bird
Flu And Illegal Aliens by the late Madeleine Pelner Cosman, PhD, Esq
Politicians
Cannot Manage a Health Care System By David Gibson, MD
Emergency Medical
Treatment And Labor Act by the late Madeleine Pelner Cosman, PhD, Esq
In Memoriam
Daniel Carroll (Danny La Rue), female impersonator,
died on May 31st, aged 81
From The
Economist print edition, Jun 11th 2009
HE WAS tall, dark and handsome, with broad
shoulders and a crushing handshake. His turned-up nose once annoyed him so much
that for a while he slept with a peg on it. He could growl "Ol' Man
River" like Harry Belafonte, and once defended the honour of Barbara
Windsor, a well-endowed Cockney comedienne, by socking a man on the jaw. On
board ship, no storm ever bothered him; he was practical and calm, even when pianos
toppled and chinaware smashed all round him.
She was tall and handsome also, but there
the resemblance ended. Her hair was blonde, brunette, raven-black, silver minx,
as the mood took her. However coiffed, she looked stunning. Fabulous loops of
glitter-beading hung from her arms; sun-bursts of diamanté snaked round her
hips; fluorescent feather-boas kissed her neck. One day she was Marlene
Dietrich in a silver sheath, the next Joan Collins in a deep blue gown, the
next Carmen Miranda, in nine-inch platform shoes and with three tons of fruit
on her head. She was probably never more herself than when descending the grand
staircase at London's Palace Theatre, where she played for two unbroken years,
with huge pink plumes bobbing on her head and 20 feet of ostrich feathers
slithering behind her.
He was well-mannered and rather shy,
schooled in respect by his Irish mother and reinforced in fatalism by his
fervent Catholic faith. Hard work was his cardinal virtue; in 50 years of
cabaret, theatre and music hall he never missed a show. She was a lady of
leisure who, under her inimitable elegance, could be lewd, rude and blue. He
called her a tart, which she was. In fact, a whole array of tarts: Nell Gywnne,
Lady Hamilton, Cleopatra (to tiny Ronnie Corbett's Caesar). She was Lady
Cynthia Grope, political hostess ("Life's better under the Tories, and I
should know"), as well as "the girl with a little bit more".
Nudge, wink. What she could never be was ugly, clumsy, or just a man in drag.
His beginnings were clear enough: born in
Cork, brought up in Soho, undistinguished schooldays, a wartime in the navy.
Hers were more misty. She emerged in Juliet at school, with a costume of
coloured crepe paper, and then in a navy production of "White Cargo",
a pouting beauty wearing nothing but a tan and a sheet she had pinched from the
officers' quarters. Once out in public, she caused a sensation. Bob Hope called
her the most glamorous woman in the world. Ingrid Bergman said no one could
walk down a staircase like her. From 1964 to 1973 her allure alone packed out
his night club in Hanover Square with Hollywood stars and the crowned heads of
Europe. Women deluged her with requests for advice on how to move, how to stand
and what to do with their hands. Every woman longed to look like her (he said),
but didn't dare.
In certain ways, their characters
coincided. Both knew they were stars, no question. Both adored clothes. As a
child, he once laid newspaper down the street to keep his new shoes clean. In
the navy, lined up on his ship with 1,199 other seamen in pure white, he
affected navy and white because it looked nicer. He could happily have stayed
as a window-dresser at J.V. Hutton's General Outfitters (Exeter and London),
but the limelight called him, as it did her.
Looking fabulous was all her money was
for. A cool £10,000 was budgeted for her frocks at the Palace, and £30,000 when
she played Widow Twankey in "Aladdin". One mirrored train cost
£7,000; one wrap involved £8,500-worth of fox-fur. He spent his earnings on
houses, a stately home with 76 bedrooms, a Rolls Royce and fine porcelain.
Fire, and a fraud into which he innocently stumbled in 1983, destroyed almost
all he had saved for. He started again, doggedly doing the rounds of clubs,
pier-ends and provincial theatres, the outposts of a disappearing world.
Over half an hour each night in the
dressing room, he slowly became her. First, a shave (the face only, leaving a
touch of stubble for shading; his legs he left alone). Then the pan make-up,
powder on face and eyes, mascara and false lashes. Her foam-rubber bosoms were
built into each dress; more pan-stick painted a cleavage. "I can hang my
tits up when it's hot!" she once boasted to another envious girl. Last
came the wig, made especially for her. . .
He was the person, he always said. She was
the illusion. In practice, it didn't seem quite as simple as that.
Read the entire obit
at
www.economist.com/obituary/displaystory.cfm?story_id=13815003.
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On This Date in History - July 14
On this date in 1789,
the French stormed the Bastille prison in Paris during the French Revolution.
Today, Bastille Day is a French national holiday. It started as a
great victory for the rights of man but it also produced the infamous Reign of
Terror.
On this date in
1913, President Gerald Ford was born. Sometimes a person's place in history is
secured by accident as much as of what he does by design. He was a President
who came to office in a time of crisis precipitated by an absolutely
unprecedented series of events. Gerald Ford was not elected President by the
people; he wasn't even elected Vice President. He was the Republican minority
leader in the House of Representatives when the then Vice President, Spiro
Agnew, pleaded no contest to charges of falsifying tax returns, was fined and
resigned his office in October 1973. Two days later, Gerald Ford was nominated
by President Nixon to fill Agnew's term. On Dec 6, 1973, he was confirmed as
Vice President by both Houses of Congress. Nine months later, Nixon himself
resigned after the Watergate impeachment hearings and Gerald Ford found himself
President of the United States.
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 which is in
progress. 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 or to view the trailer, go to www.sickandsickermovie.com or
email logan@freestarmovie.com.