1. Featured
Article: Alzheimer's: Forestalling the Darkness with New Approaches
Interventions
before symptoms appear could be key to slowing or stopping the leading cause of
dementia.
By
Gary Stix, From
the June
2010, Scientific American Magazine
Key Concepts
·
The incidence of Alzheimer's disease continues to rise
as the population ages, but effective treatments are lacking.
·
Some new drugs may have failed because they were tried
too late.
·
New techniques to track the disease before symptoms
arise may allow testing of drugs at a stage when they may be more effective.
In
his magical-realist masterpiece One Hundred Years of Solitude, Colombian author
Gabriel García Márquez takes the reader to the mythical jungle village of
Macondo, where, in one oft-recounted scene, residents suffer from a disease
that causes them to lose all memory. The malady erases "the name and
notion of things and finally the identity of people." The symptoms persist
until a traveling gypsy turns up with a drink "of a gentle color"
that returns them to health.
In
a 21st-century parallel to the townspeople of Macondo, a few hundred
residents from Medellín, Colombia, and nearby coffee-growing areas may get a
chance to assist in the search for something akin to a real-life version of the
gypsy's concoction. Medellín and its environs are home to the world's largest
contingent of individuals with a hereditary form of Alzheimer's disease.
Members of 25 extended families, with 5,000 members, develop early-onset
Alzheimer's, usually before the age of 50, if they harbor an aberrant version
of a particular gene. . .
Read
the entire article, subscription required, in Scientific American . . .
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2.
In the News: The Rise of the Part-Time Smoker
The New Smoker, Who Lights Up Only Intermittently, Needs New Strategies to
Learn to Quit
By
MELINDA BECK, WSJ,
January 12, 2010,
It's tough to be a
hard-core chain-smoker these days.
Half of the U.S.
population lives in areas where smoking is banned in workplaces, bars and
restaurants.
More than 70% of
Americans don't allow smoking in their homes, including about half of current
smokers.
Taxes have pushed the
cost of smoking ever higher ($10 per pack in New York City) and the social
costs - in disgusted looks and lectures from friends and family members - have
escalated too.
Such inconveniences
are forcing a sea change in smoking habits and upending traditional approaches
to smoking cessation. For one thing, there's a growing group of intermittent
and secret smokers who seem to smoke as much for psychological and emotional
reasons as nicotine addiction. In addition to breaking the physical addiction,
smokers who want to quit today need to understand why, when and where they
smoke, and challenge some of the thinking that goes along with it, cessation
experts say.
" 'Sneaking one
in' has become a smoker's pastime and avocation," says Timothy Stephens, a
40-year-old Manhattan lawyer who started smoking cigarettes in high school when
he played a Jet in "West Side Story." Nowadays, with a wife and baby,
he doesn't smoke at home. He takes five-minute smoking breaks outside his
office building ("four minutes if it's cold") and he drives to work
from the suburbs instead of using public transit so he can get more smoking in.
Even though the
percentage of American adults who smoke has stalled at about 20% in recent
years, smokers are smoking fewer cigarettes than they used to (an average of 13
per day, down from 21 in 1980). And a growing proportion of smokers - roughly
25% - don't smoke every day. One government study found that half of American
smokers either don't smoke daily or smoke fewer than six cigarettes a day.
Researchers used to
think light and intermittent smoking was a transitional phase for smokers on
their way to quitting or ramping up to a more serious habit. But a few recent
studies suggest that it's a new, stable pattern, particularly among young,
college-educated smokers. An analysis of smoking patterns during the 1990s,
published in the journal Nicotine & Tobacco Research last year, found that
18-to-29-year-olds were twice as likely as those aged 50 to 64 to be nondaily
smokers. Many experts expect that pattern to continue. "Young people who
have grown up with a smoke-free home, school and workplace environment may
stabilize at a much lower dependence level than those without such
restrictions," the researchers wrote. . .
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3.
International
Medicine: Access Delayed, Access Denied:
Waiting for New Medicines in Canada 2010
Authors: Brett J. Skinner, Mark Rovere Frasier Institute, March 17, 2010
Executive summary
This is the Fraser Institute's fourth annual report on
the amount of time patients must wait for access to new medicines in Canada.
The 2010 edition of this study uses the most recent data available, covering
the years 2004, 2005, 2006, 2007, and 2008. This edition replicates and adapts
the method previously used by Skinner et al. (2007) and Skinner and Rovere
(2008a; 2009) to estimate the total amount of time patients must wait for
access to new patented prescription medicines in Canada. Like the 2009 report,
this edition focuses narrowly on the wait for access to new drugs classified by
Health Canada as new drug submissions (NDS) and excludes supplemental new drug
submissions (SNDS).
The purpose of this report is (1) to draw attention to
the impact that Canadian public policies and institutions have on lengthening
the time it takes before patients have access to newly invented, patented
prescription drugs; and (2) to offer alternative policy options that could
improve access to new drugs in Canada.
Access delayed
After a new drug is developed and
ready for use by patients, various government policies extend the time that
patients must wait for access to it. An estimate of the total additional time
that Canadians must wait for access to new medicines because of government
policies and institutional performance can be calculated by adding: the
national delay the time spent waiting for Health Canada to certify the
safety and effectiveness of new drugs and approve them for use in Canada; and, the
provincial delay the time spent waiting for provincial drug insurance
programs to approve the public reimbursement of new drugs. Figure 1 shows the consolidated average wait
time for access to new medicines in Canada, broken down by each of the two segments
described above. This wait time is
measured in days and is presented as a weighted average for pharmaceutical and
biological drugs, including all new drugs classified by Health Canada as new
drug submissions (NDS) and excluding supplemental new drug submissions (SNDS).
Access denied
Despite improvements in the speed
at which decisions are made about national and provincial drug approvals, most
of the drugs that are approved by Health Canada as safe and effective are not
declared eligible for reimbursement under provincial drug plans. Averaged
across all provincial public drug programs, as of December 31, 2009, only 23.0%
of all drugs that Health Canada approved as safe and effective in 2004 had
actually been approved for reimbursement (fully or partially) by the provinces;
compared to 16.2% of new drugs certified in 2005, 28.0% of new drugs certified
in 2006, 19.1% of new drugs certified in 2007, and 20.3% of new drugs certified
in 2008.
Free Download: Download
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Canadian Medicare
does not give timely access to healthcare, it only gives access to a waiting
list.
--Canadian Supreme Court Decision 2005 SCC 35, [2005] 1 S.C.R.
791
http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html
*
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4. Medicare: "Risk-based pricing" vs.
"Guaranteed issue"
ObamaCare Could Punish You For Being Healthy by David Whelan, Forbes, 06.12.09
Will smokers and marathon runners pay the same?
In the 1970s HMOs started the rather
innovative concept of pricing health
insurance on the basis of an individual's health. This
"risk-based pricing" means that if you treat your body like a temple
you pay less for health care than your counterpart who
overeats and smokes a pack a day. Even as HMOs came to be reviled, this
practice continues in 45 states . . .
In
California, a risk-rating state, you can get basic coverage for under $100 a
month if you are male and in your 20s with no red flags in your chart. A quick
search on eHealth's ( EHTH
- news -
people ) Web site
found numerous plans for non-smoking males born in 1981. One high deductible
PPO plan is offered for $49 a month from Health Net ( HNT
- news -
people ).
Now
do the same experiment in New York, which has "guaranteed issue,"
much like ObamaCare will have. The same 28-year-old male will have to pay $150
for a hospital-only indemnity Blues plan. And HMO policies with high
deductibles start in the $300 to $400 a month range. That's because plans in
New York are priced with the assumption that you must be sick or you wouldn't
need health insurance.
Risk-based
health insurance pricing is not all sunshine and rainbows. Breast cancer
survivors, juvenile diabetes patients and accident victims have trouble even
getting a quote in risk-rating states like California and Illinois. An
estimated 10% of individual applicants are turned down. The insurer of last
resort—the state-run high-risk pools that exist in about 30 states—are known
for their long wait lists and expensive premiums. (For example, the California
high-risk pool offers a Blue Shield plan for a 60-year-old that's $1,611 a
month.)
Supporters
of guaranteed issue argue that it will improve the market for people with pre-existing
conditions and, when combined with a mandate that everyone must buy insurance,
eliminate the problem of the insurance pool only attracting sick patients. This
argument makes sense, yet the structure would still create a system where
compliant, responsible patients are subsidizing those who don't take care of
themselves. The perverse incentive would still exist.
The
insurance industry, in failing to make sure that
"innocent" patients with pre-existing conditions can get affordable
individual health insurance on the open market, has in a way brought reform
upon itself. That may be why the HMO lobby, America's Health Insurance Plans,
grudgingly conceded, right after Obama won the election, that it would accept
legislation that included "guaranteed issue."
But,
says Wharton's Harrington, if you remove incentives to stay healthy, health
reform could miss the mark. As health diminishes, costs will rise, and scarce resources
will be run through more quickly. Reformers, for all their trouble, could get a
decrease in health and a decrease in health care, while trying to accomplish
the opposite.
Read
the entire somewhat dated but relevant article in Forbes . . .
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Government is not the solution to our
problems, government is the problem.
-
Ronald Reagan
* * * * *
5. Medical Gluttony: Starts with the political climate in
each state
There is no limit on Politicians spending Taxpayers dollars.
California:
Governor
of California is jogging with his dog along a nature trail. A coyote jumps
out and attacks dog.
1. Governor starts to intervene, reflects
upon the movie "Bambi" and then realizes he should stop; the coyote
is only doing what is natural.
2. He calls animal control. Animal control
captures coyote and spends $200 testing it for diseases and $500 upon
relocating it.
3. He calls veterinarian. Vet collects
dead dog and spends $200 testing it for diseases.
4. Governor goes to hospital and spends
$3,500 getting checked for diseases from the coyote and on getting bite wound
bandaged.
5. Running trail gets shut down for six
months while wildlife services conduct a $100,000 survey to make sure the area
is clear of dangerous animals.
6. Governor spends $50,000 of state funds
implementing a "coyote awareness" program for residents of the area.
7. State legislature spends $2 million
investigating how to better handle rabies and how to possibly eradicate the
disease.
8. Governor's security agent is fired for
not stopping the attack and for letting the Governor intervene.
9. Cost: $75,000 to train new security
agent.
10. PETA protests the coyote relocation
and files suit against the state.
New
York:
Governor
of New York is jogging with his dog along a nature trail. A coyote jumps out
and attacks dog.
See answers 1-10 above
Texas:
Governor
of Texas is jogging with his dog along a nature trail. A coyote jumps out and
attacks dog.
1. Governor shoots coyote and keeps
jogging. Governor has spent a dollar on a .45 ACP hollow-point cartridge.
Buzzards eat dead coyote.
Nevada
Governor
of Nevada is jogging with his dog along a nature trail. A coyote jumps out and
attacks dog.
1. Governor shoots coyote and keeps
jogging. Governor has spent a dollar on a .45 ACP hollow-point cartridge.
Buzzards eat dead coyote.
What
is the Moral of this Story?
Which state is the safest? Which
state is the most unsafe?
Which state has the leanest cost of
government? The most bloated government?
Which 7 states have no income
taxes? Alaska, Florida, Nevada,
South Dakota, Texas, Washington, and
Wyoming.
Which 9 states don't double tax
Federal Income Taxes? (No Taxes on Taxes - all taxes are deducted from income
before other taxes are applied) Alabama, Iowa, Louisiana, Missouri, Montana,
North Dakota, Oklahoma, Oregon and Utah
Which 27 states allow for full
deductions for social security benefits? Alabama, Arizona, Arkansas,
California, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Kentucky,
Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Jersey,
New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina,
Virginia and Wisconsin
Which states tax SS benefits that
are the result of other taxes previously paid and thus are double taxed? (Hey!
this is simple arithmetic.)
Which states are growing?
Which states are losing population
so taxes are raised on those that stay?
Need
any help with the answers?
Ever wonder why some states are going
broke?
Should
we shoot all the lawmakers? (After Shakespeare)
Read Income Taxes by
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Gluttony
thrives in Government.
It Disappears with Appropriate Responsibilities.
*
* * * *
6. Medical Myths: It is past time for the U.S. to join the march
to coercive, state-funded medicine.
We constantly hear that the United States is the
only nation in the "developed," or "industrialized" world
(we no longer say "civilized" world or "free" world) that
doesn't have taxpayer-funded medical care for all.
It is therefore past time for the U.S. to relinquish
the traditional idea that "the voluntary way is the American way" and
join the "progressive" march to coercive, state-funded and
state-directed medicine—as instituted by Chancellor Otto von Bismarck in
Germany in 1884. These days, the state-owned variant, adopted by Britain in
1948 based on a model developed by Lenin in 1911, is considered
"politically unfeasible" in America.
We need to give up our own perception of having the
best medical care the world has ever known (in the eyes of individual American
citizens and foreign visitors) and aspire to move from the 37th position closer
to the 1st position held by France in 2000 (in the eyes of the World Health
Organization, which prefers equal misery to unequal blessings)—or so say
advocates of "reform."
Meanwhile, countries outside the U.S. are moving
away from failing single-payer systems. "Health insurers worldwide added
over 100 million covered lives in 2008 in one of the strongest markets since
health insurance was invented in 1880s, according to official government
statistics" (HealthPlanWire 8/24/09). The number is projected
to exceed 1 billion by 2012.
Single-payer systems are declining because they are
based in countries with static or declining populations—many of which are also
adopting market-based reforms. Private insurance is growing rapidly in
countries with the fastest growing populations. Building a health financing
system for the first time, countries on five continents are choosing the
private way. Examples include China, South Africa, Mexico, India, Australia,
and most of Eastern Europe. But in at least 25 of the 125 nations with national
health systems, private insurance is growing faster than the government-run
system (ibid.).
Democrat-proposed reform plans would restrict
out-of-pocket payment for "covered" services—while U.S. patients
already have the lowest out-of-pocket costs (OOP) as a percentage of total
national health spending of any developed country except France, Luxembourg,
the Czech Republic, and Ireland. They are even lower than in Canada. OOP
spending in the U.S. represented about 60% of real per-capita spending on
medical care in the U.S. in 1960, and dropped to 10% by 2002. This surely has a
lot to do with escalating costs. But Democrat reformers would eschew financial
incentives to patients in favor of "health information tools"
enabling payment denials right in the doctor's office (Scott Gottlieb, Wall St J 8/15-16/09).
A few facts about private insurance and self payment
in nations with national health systems (Gregory Dattilo and Dave Racer, Your Health Matters, Alethos Press; 2006):
Health Canada pays about $1 billion for services
purchased in the U.S. because of a shortage of facilities in the country. It is
not known how much Canadians spend abroad beyond this amount.
In the UK, 13% of its residents own private
insurance, enabling them to bypass waiting lists.
The Japanese face a coinsurance cost of up to 30%,
and pay an average of 44% of employer-based premiums. Childbirth, check-ups,
vaccines, and prosthetics are not covered. The maximum OOP for a Japanese
worker, if copied in the U.S., would expose the average worker to a potential
health cost exceeding 50% of his disposable income. Japan relies largely on
market forces to restrain expenditures.
About 85% of French citizens buy private
supplemental insurance. Because of escalating costs, the government increased
co-payments to as much as 30% to 40%.
Germany is the only [European] country where
high-income people, self-employed, and civil servants may opt out of the compulsory
social security system and join private health insurance. (See comments by German physicians,
with English subtitles, and Myth 20.)
Per capita spending rates are increasing as fast in
most national health systems as in the U.S. Increases between 1990 and 2003
were: U.S., 28%; Germany, 30.5%; France, 17.4%; Canada, 10%; Japan, 33%; and
England, 28%.
The French system, held up as the example now that
Canada and Britain have lost appeal, is also in trouble. "Citizens must
pay more and doctors must alter their behaviour" said a
government-commissioned report (BBC News 1/23/04). In 2009, the total cost of the system,
from employee and employer combined, is more than half the worker's wages (Investors Business Daily 8/26/09).
"In France, the supply of doctors is so limited
that during an August 2003 heat wave when many doctors were on vacation and
hospitals were stretched beyond capacity—15,000 elderly citizens died,"
wrote David Gratzer (ibid.).
While upcoming nations are choosing the private,
voluntary path, American "reformers" are pushing for a regression to
19th century, consistently failed systems of centrally planned coercion.
Additional information:
•
"Financing Free-Market Medicine,
presented by Ralph Weber, C.L.U., at AAPS annual meeting 2008.
•
"Socialized Medicine," by Dan Smoot, originally published in The
Freeman, April 1960.
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Myth 23 . . .
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Medical Myths originate when someone else pays the
medical bills.
Myths disappear when Patients pay Appropriate
Deductibles and Co-payments on Every Service.
*
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7. Overheard in the Medical Staff Lounge: Whistle Blowers
Dr. Rosen: We are hearing a lot about "Whistle Blowers"
being subjected to abusive "PEER REVIEW" and losing their medical
staff privileges. Is that happening in our community?
Dr. Yancy: Certainly. All the
time. Confidentially, I had an episode where I blew the whistle on an
incompetent surgeon and immediately became the butt of abusive Peer Review in
my former hospital. I got out of there and moved to Sacramento before it went
anywhere and had my privileges secured here in two hospitals, doing good
surgery, before they ever found out about it.
Dr. Dave: Legitimate Peer
Review became abusive when doctors, not held in favor by those in charge in
hospitals, had a large number of charts put into "Chart Review"
stacks for the Department Committees to review. Minor variations in care
precipitated referral of these charts through the Peer Review Committee. These
were run by doctors in positions of power in hospitals.
Dr. Milton: That's what was
happening until recent years.
Dr. Rosen: And it was usually
precipitated by good physicians and surgeons who took issue on very poor, if
not dangerous care. But what was obviously below standard of care was gradually
extended to minor variations in care, which actually was acceptable care.
Dr. Yancy: I was formerly a
"Whistle Blower" but since I came to Sacramento, I have refrained.
Blowing the whistle is much too dangerous.
Dr. Rosen: So you're saying a
good physician, by helping clean out our own ranks, allowed physicians in
power, who actually may not have been our best doctors, get rid of good
physicians?
Dr. Yancy: Exactly. I saw a
lot of poor surgery with bad outcomes in my previous hospital and I though I
was doing the Peer Review Committee a favor by pointing this out and then they
pounced on me. I hadn't realized that those dangerous surgeons were hospital
insiders and financially important to the hospital.
Dr. Rosen: Isn't that rather
like the Cardiologist and Cardiac Surgeons at the Redding Medical Center who
did Coronary Artery Bypass Grafts on patients that didn't need them?
Dr. Ruth: I understand that Peer
Review didn't work there because everyone knew if they interfered with this
major source of hospital revenue, they wouldn't survive.
Dr. Rosen: I think that is
what the "Whistle Blowers Group" is trying to highlight. Most of Peer
Review these days has nothing to do with the quality of medical care. It has
provided a mechanism for hospitals and the Medical Executive Committee to
eliminate the competition that is perfectly legal.
Dr. Edwards: And therein,
lies the crux. It is legal and thus outside the court system and lethal.
Dr. Milton: And that's a
Paradox. Anyone that is seen as unfavorable to the hospital or the major groups
in power can be eliminated by a chart review, a summary suspension, a Kangaroo
trial and elimination from the staff.
Dr. Edwards: But it's not as
simple as losing a job. This goes to the National Data Bank, which is available
to all hospitals, and anyone found in the Data Bank will never get another job
as a physician or surgeon.
Dr. Ruth: Isn't that why the
National Data Bank is called the National Tomb for Doctors? You will never get
the opportunity to practice again. Your children, spouse and family may leave,
and your home and assets will be sold to pay the attorney fees and medical
board fines.
Dr. Joseph: I retired from
surgery just in time to avoid all this. When we saw a surgeon who we thought
made a serious mistake, we talked seriously to him and he usually saw his
error, apologized and offered some recompense by reporting some research on the
problem discussed at another meeting. Surgical care was improved and no one got
hurt, least of all patients.
Dr. Paul: I think you are all
barking up a dead tree. In Pediatrics we use Peer Review but it's always
pleasant and people apologize, shake hands and get back to work. It's more like
a family at odds where pediatricians make up. I can't think of one of us that
was ever thrown off the staff.
Dr. Yancy: How many pediatric
groups do you have competing with each other?
Dr. Paul: We all share call
and thus watch over each other's practice. That keeps all of us on our toes.
And it also keeps us talking to each other.
Dr. Milton: I wish all
Internists could get along that well. We're not all that busy and a few less
would be beneficial.
Dr. Michelle: So you are
thinking about being a "Whistle Blower" and get the numbers down?
Dr. Milton: I would never be
involved with whistle blowing in this climate. I'd get eliminated in no time.
I'll leave "Whistle Blowing" to the large societies that are doing a
good job of it.
For more on Abusive Peer Review . .
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For more on Whistle Blowing, Semmelweis Society International . . .
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The Staff Lounge Is Where Unfiltered Opinions Are
Heard.
*
* * * *
8. Voices of Medicine: A Review of Articles by Physicians
Guest
column, Dr. Alieta Eck | MurraySabrin.com
As
Illegals Take, Are Americans Free? By Alieta Eck, MD
Abolish
Legal Plunder-End the Empire-Restore Free Enterprise
We
do not have "universal health care. We have mandatory free "health
care for the universe." A middle-aged woman came to our local emergency
room, suitcase in tow, complaining of a severe headache and diminished vision.
A CT scan of the head showed a brain tumor. The neurosurgeon on call was
summoned and within days the patient had surgery to preserve her vision.
An inspiring story giving tribute to the wonderful ingenuity, generosity,
and high standards in our country? There's more.
This
woman knew about her brain tumor and had already had an unsuccessful attempt at
surgery in her home country. She booked a flight as a tourist, and her
extended family took her directly from the airport to the emergency room. None
of them had the slightest intention of paying any part of her bill. American
patients, insurance subscribers, and taxpayers will subsidize the hospital,
albeit inadequately. The neurosurgeon will not get paid, but will still
be fully liable for any adverse outcome in our medical malpractice environment.
For
foreigners, it appears that dishonesty pays. But those who are completely
honest have a harder time. The headmaster of a Christian grammar school in
Liberia had an abdominal tumor the size of a football. No one in Liberia felt
capable of handling such surgery so our church arranged for him to come to that
same hospital in New Jersey. Since US government officials knew this man needed
medical attention, he was asked to supply letters from the church guaranteeing
payment for his surgery. Only then, would the US embassy give him a visa. The
church, here, will fulfill its promise and pay a fair price as this is the
honorable thing to do. The surgeon will be paid unless he voluntarily chooses
to perform the procedure for free, and everyone is uplifted.
There
will be those who say they would do anything to get medical care for a loved
one. Does this mean they would steal for it? And does their need make stealing
right?
Charity
is a noble thing, but it cannot be mandated. Our government's requiring
physicians and hospitals to provide free services to whomever walks into the ER
does not represent true charity, but a taking of the services from those with
valuable skills. The more that is taken, the less charity can be freely given,
and all patients suffer as services become less available. Many hospitals now
lack neurosurgery coverage for any patient, insured or not. . .
An
added attraction is automatic American citizenship for the child. Births to
illegal alien mothers constitute nearly 40% of all births paid for by Medi-Cal.
Dozens of hospitals along the border in California, Arizona, New Mexico, and
Texas have been forced to close or go bankrupt because of the unfunded federal
mandate to provide free care to illegals.
The
Arizona state government has passed a law making it a state offense to cross
the border illegally. It is already a federal offense. How else
should Arizona respond when the federal government does not take seriously its
constitutional obligation to protect the US borders? Our forefathers came to this
country with only the shirts on their backs, expecting nothing but an
opportunity to work in freedom. They did not demand free services but worked
alongside hardworking Americans to build their own American dream. That was
always the promise of America and we need to be vigilant lest we lose it.
Dr.
Alieta Eck, MD
graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School
of Medicine in St. Louis, MO. She studied Internal Medicine at Robert
Wood Johnson University Hospital in New Brunswick, NJ and has been in private
practice with her husband, Dr. John Eck, MD in Piscataway, NJ since 1988. She
has been involved in health care reform since residency and is convinced that
the government is a poor provider of medical care. She testified before the
Joint Economic Committee of the US Congress in 2004 about better ways to
deliver health care in the United States. In 2003, she and her husband founded
the Zarephath Health Center, a free clinic for the poor and uninsured that
currently cares for 300-400 patients per month utilizing the donated services
of volunteer physicians and nurses. Dr. Eck is a long time member of the
Christian Medical Dental Association and in 2009 joined the board of the Association
of American Physicians and Surgeons. In addition, she serves on the advisory
board of Christian Care Medi-Share, a faith based medical cost sharing
Ministry. She is a member of Zarephath Christian Church and she and her husband
have five children, one in medical school in NJ.
Read
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VOM Is an Insider's View of What Doctors are Thinking,
Saying and Writing About.
*
* * * *
9. Book Review: The Revolutionary Book That Will Change
the Way You Do Business
THE INNOVATOR’S DILEMMA, The
Revolutionary Book That Will Change the Way You Do Business, by Clayton M. Christensen, DBA, HarperBusiness, New
York, © 2000, ISBN-10: 0-06-052199-6; ISBN-13: 978-0-06-052199-8, 286 pp,
$17.99. Hardcover edition was published in 1997 by Harvard Business School
Press.
“This book ought to chill any executive who feels bulletproof - and
inspired entrepreneurs aiming their guns.” -Forbes
Clayton M. Christensen is the architect of and the world’s foremost authority on disruptive innovation, a framework which describes the process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves ‘up market’, eventually displacing established competitors. Consistently acknowledged in rankings and surveys as one of the world’s leading thinkers on innovation, Christensen is widely sought after as a speaker, advisor and board member. His research has been applied to national economies, start-up and Fortune 50 companies, as well as to early and late stage investing.
His seminal book The Innovator’s Dilemma (1997), which first outlined his disruptive innovation frameworks, received the Global Business Book Award for the Best Business Book of the Year in 1997, was a New York Times bestseller, has been translated into over 10 languages, and is sold in over 25 countries. He is also a four-time recipient of the McKinsey Award for the Harvard Business Review’s best article. See entire bio . . .
I
first heard Dr. Christensen speak at the sixth World Health Care Congress in
Washington DC in 2008. Amongst a faculty of hundreds speaking to thousands of
the business and professional health care leaders of the world, he was the
towering speaker that singularly put hope and confidence in the future of
health care. He was totally out of sync with the other speakers who talked
about patches to the current system. He showed those participants that there
would be serious disruption in health care before any new direction would be
realized. Using free enterprise and market efficiency to reduce costs is not
well understood or taught in today’s educational environment.
This
book, as Christensen states in his introduction, is about the failure of
companies to stay atop their industries when they confront certain types of
marked and technological change. It’s not simply about the failure of any
company, but of good companies - the kinds that many managers have admired and
tried to emulate; the companies known for their abilities to innovate and
execute. Companies stumble for many reasons, of course, among them bureaucracy,
arrogance, tired executive blood, poor planning, short-term investment
horizons, inadequate skills and resources, and just plain bad luck. But this
book, he continues, it not about companies with such weaknesses. It is about
well-managed companies that have their competitive antennae up, listen astutely
to their customers, invest aggressively in new technologies, and yet still lose
market dominance.
Such
seemingly unaccountable failure happens in industries that move quickly and in
those that move slowly; in those built on electronics technology and those
built on chemical and mechanical technology; in manufacturing and in service
industries. Dr. Christensen in illustrating the Innovator’s Dilemma takes on a
tour of several industries.
Sears
Roebuck, for example, was regarded for decades as one of the most astutely
managed retailers in the world. It pioneered several innovations critical to
the success of today’s most admired retailers: for example, supply chain
management, store brands, catalogue retailing, and credit card sales. Yet no
one speaks about Sears that way today. Somehow, it completely missed the advent
of discount retailing and home centers. In the midst of today’s catalogue
retailing boom, Sears has been driven from that business. Indeed, the very
viability of its retailing operations has been questioned.
Consider
the computer industry. IBM dominated the mainframe market but missed by years
the emergence of minicomputers, which were technologically much simpler than
mainframes. In fact, no other major manufacturer of mainframe computers became
a significant player in the minicomputer business. Digital Equipment
Corporation created the minicomputer market and was joined by a set of other
aggressively managed companies. But each of these companies in turn missed the
desktop personal computer market. It was left to Apple Computer, together with
Commodore, Tandy, and IBM’s stand-alone PC division, to create the personal
computing market. But Apple and IBM lagged five years behind the leaders in
bringing portable computers to market. In 1980s, Digital Equipment was the most
prominently featured company.
In
Digital’s case, as in Sears, the very decisions that led to its decline were
made at the time it was so widely regarded as being an astutely managed firm.
It was praised as a paragon of managerial excellence at the very time it was
ignoring the arrival of the desktop computers that besieged it a few years
later.
The
list of leading companies that failed when confronted with disruptive changes
in technology and market structure is a long one. At first glance, there seems
to be no pattern in the changes that overtook them. In some cases, the new
technologies swept through quickly; in others, the transition took decades. In
some, the new technologies were complex and expensive to develop. In others,
the deadly technologies were simple extensions of what the leading companies
already did better than anyone else. One theme common to all of these failures,
however, is that the decisions that led to failure were made when the leaders
in question were widely regarded as being among the best companies in the
world.
How
to resolve this paradox? Christensen excluded poor management and hard luck
because good fortune ran out. These failed firms were as well run as one could
expect from firms managed by mortals. From the research reported in this book,
he proposed that there is something about the way decisions get made in
successful organizations that sows the seeds of eventual failure.
Good
management was the most powerful reason these firms failed to stay atop their
industries. Precisely because these
firms listened to their customers and invested aggressively in new technologies
that would provide their customers more and better products of the sort they
wanted, and because they carefully studied market trends and systematically
allocated investment capital to innovations that promised the best returns,
they lost their position of leadership.
At
a deeper level is that many of what are now widely accepted principles of good
management are, in fact, only situationally appropriate. There are times at
which it is right not to listen to
customers, right to invest in developing lower-performance products that
promise lower margins, and right to
aggressively pursue small, rather than substantial, markets.
The
Innovator’s Dilemma helps executives understand how logical and competent
decisions of management critical to the success of their companies in the near
term can undermine them in the long term if they don’t focus adequate resources
on the disruptive technologies that are surfacing below that could lead to their
down fall.
Christensen
spends the first two chapters recounting in some detail the history of the disk
drive industry, where the saga of “good-companies-hitting-hard-times” has been
played out over and over again. This industry is an ideal field for studying
failure because rich data about it exists and because, in the words of Harvard
Business School Dean Kim B. Clark, it is “fast history.” In just a few years,
market segments, companies and technologies have emerged, matured and declined.
Only twice in the six times that new architectural technologies have emerged in
this field has the industry’s dominant firm maintained its lead in the
subsequent generation.
“Those
that study genetics avoid studying humans,” as Christensen analogizes his
research to genetics. “Because new generations come along only every thirty
years or so, it takes a long time to understand the cause and effect of any
changes. Instead, they study fruit flies, because they are conceived, born,
mature, and die all within a single day.” If you want to understand why
something happens in business, study the disk drive industry. Those companies
are the closest things to fruit flies that the business world will ever
see.
Nowhere
in the history of business has there been an industry like disk drives, where
changes in technology, market structure, global scope and vertical integration
have been so pervasive, rapid, and unrelenting. While this pace and complexity
might be a nightmare for managers, it is a fertile ground for research. Few
industries offer researchers the same opportunities for developing theories
about how different types of change cause certain types of firms to succeed or
fail or for testing those theories as the industry repeats its cycles of
change.
When
the best firms succeeded, they did so because they listened responsively to
their customers and invested aggressively in the technology, products and
manufacturing capabilities that satisfied their customers’ next-generation
needs. But, paradoxically, when the best firms subsequently failed, it was for
the same reasons. Blindly following the maxim that good managers should keep
close to their customers can sometimes be a fatal mistake. This provided the
framework for Christensen to understand when “keeping close to your customers”
is good advice—and when it is not. At this point Christensen gives the basics
of the disk drive industry in two chapters, which is a tour de force.
HOW DISK DRIVES WORK
Disk drives write and read information that computers use. They comprise read-write heads mounted at the end of an arm that swings over the surface of a rotating disk in much the same way that a phonograph needle and arm reach over a record; aluminum or glass disks coated with magnetic material; at least two electric motors, a spin motor that drives the rotation of the disks and an actuator motor that moves the head to the desired position over the disk; and a variety of electric circuits that control the drive’s operation and its interface with the computer.
The read-write head is a tiny electromagnet whose polarity
changes whenever the direction of the electrical current running through it
changes. Because opposite magnetic poles attract, when he polarity of the head
becomes positive, the polarity of the area on the disk beneath the head
switches to negative, and Vice Versa. By rapidly changing the direction of
current flowing through the head’s electromagnet as the disk spins beneath the
head, a sequence of positively and negatively oriented magnetic domains are created
in concentric tracks on the disk’s surface. Disk drives can use the positive
and negative domains on the disk as a binary numeric system - 1 and 0 - to
“write” information onto disks. Drives read information from disks in
essentially the opposite process: Changes in the magnetic flux fields on the
disk surface induce changes in the micro current flowing through the head.
Researches
at IBM’s San Jose research laboratories developed the first disk drive between
1952 and 1956. It was named RAMAC (for Random Access Method for Accounting and
Control) and was the size of a large refrigerator, incorporating fifty 24-inch
disks and storing 5 megabytes (MB) of information. Most of the fundamental
architectural concepts and component technologies that defined today’s dominant
disk drive component were also developed at IBM. These include the removable
packs of rigid disks (introduced in 1961), the floppy disk drive (1971) and the
Winchester architecture (1973).
As
IBM produced drives to meet its own needs, an independent disk drive industry
emerged serving two distinct markets. A few firms developed the plug-compatible
market (PCM) in the 1960s, selling souped-up copies of IBM drives directly to
IBM customers at discount prices. Although most of IBM’s competitors in
computers (for example Burroughs and Univac) were integrated vertically into
the manufacture of their own disk drives, the emergence in the 1970s of
smaller, nonintegrated computer makers spawned an original equipment market
(OEM) for disk drives as well. By 1976 about $1 billion worth of disk drives
were produced, of which captive production accounted for 50 percent and PCM and
OEM for about 25 percent each. The value of drives produced rose to about $18
billion by 1995. By the mid-1980s the PCM market had become insignificant,
while OEM output grew to represent about three-fourths of world production. Of
the seventeen firms populating the industry in 1976, all of which were
relatively large, diversified corporations, all except IBM’s disk drive operation,
had failed or had been acquired by 1995. During this period an additional 129
firms entered the industry, and 109 of those also failed. Aside from IBM,
Fujitsu, Hitachi, and NEC, all of the producers remaining by 1996 had entered
the industry as start-ups after 1976.
The
number of megabits (MB) of information that the industry’s engineers have been
able to pack into a square inch of disk surface had increased by 35 percent per
year, on average, from 50 KB in 1967 to 1.7 MB in 1973, 12 MB in 1981, and 1100
MB by 1995. The physical size of the drives was reduced at a similar pace: The
smallest available 20 MB drive shrank from 800 cubic inches in 1978 to 1.4 by
1993, a 35 percent annual rate of reduction. The number of terabytes (one
thousand gigabytes) of disk storage capacity shipped in the industry’s history,
with each doubling of cumulative terabyte shipped, decreased the cost per
megabyte of memory to 53 percent of its former level. This is a much steeper
rate of price decline than the 70 percent slope observed in the markets for
most other microelectronics products.
The
story of the 14-inch Winchester architecture change to the small 8-inch
entrants sold their disruptive drives into new applications—minicomputers. Then
the 8-inch drive penetrated the mainframe market and within a
three-to-four-year period, the 8-inch drives began to invade the market above
them. Of the established 14-inch drive makers, the few that entered the 8-inch
market did so two years belatedly. Two-thirds never entered the 8-inch market
and were driven from the industry. This story was repeated in the 5.25-inch
disk drive, again repeated in the 3.5-inch drive, then the 2.5-inch drive and
finally in the 1.8-inch drive. All were disruptive forces from below the
current market. All entered new and distinctive markets.
Less
we think this can only happen in the “fruit fly” of modern industry,
Christensen goes on exploring the mechanical excavator industry and finds that
the same factors that precipitated the failure of the leading disk drive makers
also proved to be the undoing of the leading makers of mechanical excavators,
in an industry that moves with a very different pace and technological
intensity.
He
then concludes Part One of the volume completing the disruptive framework and
uses it to show why integrated steel companies worldwide have proven so
incapable of blunting the attacks of the minimill steel makers. Another
fascinating journey that’s worth taking.
The
names associated with all these studies are an excellent history of our times,
going from Honda to DaimlerChrysler, from the Sears Card to VISA and
MasterCard, and dozens more.
The
book begins by posing a puzzle: Why was it that firms esteemed as aggressive, innovative,
customer-sensitive organizations could ignore or attend belatedly to
technological innovations with enormous strategic importance? Purchasing,
reading and referencing this book is important for us in the healthcare
industry, an area that Christensen tackles so well in his next book, The
Innovator's Prescription.
This book review
is found at . . .
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* * * *
10. Hippocrates & His Kin: Doctor Tom Coburn for
President of the USA
Stephen Moore writing in the Wall
Street Journal's Political Diary e-newsletter: It's on
almost no one's radar screen, but Oklahoma is hosting a Senate race this year—a
race, but not a contest. In a year when many incumbents are supposedly in deep
trouble, Republican Tom Coburn faces not a single challenger from either party.
"He's easily the most popular politician in Oklahoma," says Stuart
Jolly, director of the Oklahoma chapter of Americans for Prosperity. "No
one will run against him, because no one can come anywhere close to him."
One obvious reason is
Mr. Coburn's unrelenting battle against the same status quo (e.g., earmarks)
that voters this year have decided they are sick of. It began when he first
arrived in the Senate and Democrats immediately slapped him with an ethics
complaint for continuing to practice medicine, which Dr. Coburn said he would
do partly to avoid becoming too attached to his Senate salary and perks.
This week, Dr. Coburn, from the town of Muskogee, made a
startling revelation that should silence his critics. He lost $11,000 in his
practice last year because, while he has kept seeing patients, he doesn't
charge them. "I want to keep practicing medicine even if I don't make
money at it. I'm prouder of being a doctor than a Senator," he recently
told me in all seriousness.
Mr. Coburn is already
being mentioned as a possible presidential candidate in 2012, and his stock
will certainly rise after what looks like a runaway re-election victory in
2010, especially because he's been freed up to put his time into raising money
for other candidates. "He's one of the godfathers of the tea party
movement," says Matt Kibbe, director of Freedom Works. That gives Mr.
Coburn a growing national base that few other Republicans have shown any knack
for tapping into.
Looks like a platform all Americans could tap
into.
Failure to brush your
teeth twice a day increases risk of heart disease By Katherine Harmon, SCIAM
Neglecting to brush twice a day could lead to a 70 percent increased risk of cardiovascular disease,
according to a new large population-based study. . .
This
should help our indoor environment.
Fathers No Longer Just Backup Parents,
By Emily Anthes, Scientific
American Mind
Move over, "mommy brain." Men go through their own
biological changes after a baby is born. But dads are programmed to challenge their
kids, not coddle them. . . . Fathers influence children in unique ways.
In particular, they play an outsized role in stretching their emotional and
cognitive capabilities - enriching their verbal skills, for example, and
encouraging them to take risks. Read more .
. .
Are fathers
re-entering the family?
To
read more HHK . . .
To read more HMC . . .
Feedback
. . .
Subscribe MedicalTuesday .
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Subscribe HealthPlanUSA .
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*
* * * *
11. Organizations Restoring Accountability in HealthCare,
Government and Society:
•
The National Center
for Policy Analysis, John C
Goodman, PhD, President, who along with Gerald L. Musgrave, and Devon M. Herrick
wrote Lives at Risk, issues a
weekly Health Policy Digest, a health summary of the full NCPA
daily report. You may log on at www.ncpa.org and register to receive one or more
of these reports. This month, read the The Hobbesian Jungle,
Part I.
•
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. Recently released: Let's
Face It: Nobody Will Ever Fully Understand This Bill.
•
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, congratulations: The Honorable Maurice McTigue, QSO,
Vice President at the Mercatus Center at George
Mason University, has been named to Virginia
Governor Bob McDonnell's Commission on Government Reform and Restructuring.
•
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.
•
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 Soaring ObamaCare Costs Break the Bank.
•
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. Become a
member of CHCC, The voice of the health care consumer. Be sure to
read Prescription for
change: Employers, insurers, providers, and the government have all taken
their turn at trying to fix American Health Care. Now it's the Consumers turn.
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 and the Heartlander. 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: Of the
four million people the Congressional
Budget Office expects to pay the IRS-levied fine rather than purchase health
insurance, the vast majority of penalties are expected to be paid from
households with incomes more than 400 percent above the federal poverty level.
The penalties at that point should average around $1,000 a year – well below
the expected cost of coverage. I continue to believe that, given the simple
math involved, these estimates are far lower than the actual number of people
who will pay the fine and skip the coverage until they need it. As much as 15
percent of American drivers lack auto insurance, and I expect nearly that
percentage to avoid purchasing health insurance
•
The Foundation for
Economic Education, www.fee.org, has
been publishing The Freeman - Ideas On Liberty, Freedom's Magazine, for
over 50 years, with Lawrence W Reed, 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. Be sure to read the current lesson on Economic Education: Freedom Seminars of Portland,
Ore.
•
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."
•
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. This month read: President Jon Caldara Statement: On Sunday, March 21st, the
US House of Representatives passed what we call "Obama-care." This is
one of the darkest moments in American history. The federal government has
taken a large step towards control of our healthcare, and with it control of our
very bodies. The federal government is taking away our decisions over health
insurance and, unprecedented in history, forcing citizens to purchase private
products, ultimately under penalty of incarceration.
•
Martin Masse, Director of Publications at the Montreal Economic Institute, is the
publisher of the webzine: Le Quebecois Libre. Please log on at www.quebecoislibre.org/apmasse.htm
to review his free-market based articles, some of which will allow you to brush
up on your French. You may also register to receive copies of their webzine on
a regular basis. This month, read The return of Keynesianism:
If an individual,
family or business has long lived for the day and disregarded the morrow,
spending more than it earns, buying what it doesn't need and can't afford,
making foolish and reckless "investments" (which are actually
consumption) and borrowing more than it can repay, then it must eventually face
a reckoning. When that day arrives, what must it do? Few people would prescribe
more of the same: that'd be like taking an alcoholic on a pub crawl. Most would
agree that a profligate family or business must ultimately mend its ways.
Whether it likes it or not, it must live within its means.
•
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.
•
The
Heritage Foundation, www.heritage.org/,
founded in 1973, is a research and educational institute whose mission was 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. -- 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, and was used by some as a justification for the Obama plan, they
have lost sight of their mission and we will no longer feature them as a
freedom loving institution and have canceled our contributions and 5,000
physicians have done the same. We would also caution that should Mitt
Romney ever run for National office again, he would be dangerous in the cause
of freedom in health care. We would also advise Steve Forbes to disassociate
himself from this institution.
•
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.
•
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.
•
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. Read the current issue at www.hillsdale.edu/news/imprimis.asp.
The last ten years of Imprimis are archived.
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Don't wish for what you want. Don't wait for what you want. Command What You Want . . . -Earle Nightingale
"Remember, you only
have to succeed the last time." -Brian Tracy: Author,
speaker, and consultant.
Learn to make long-lasting personal changes by doing
nothing more than kicking back and listening. You'll LOVE the results! -Vic Conant
"Priorities lead to prosperity." -Michelle Singletary: Nationally syndicated columnist for The Washington
Post
Some Recent Postings
Health Care: A Two-Decade Blunder Tevi Troy . . .
The
Prisoner's Dilemma of Health Insurance by
Gerry Smedinghoff
Sorting Fact From
Fiction on Health Care Jerome Groopman, MD and Pamela Hartzband, MD
In Memoriam
Art Linkletter-American Hobo : "A Great way to see
this great country!"
By STEPHEN MOORE
America lost a laughing
legend this week when Art Linkletter, the iconic face of American comedy TV in
the 1950s and 1960s, died at the age of 97. He was one of the last of the
remaining big names from TV's star-studded early years. I was fortunate enough
to visit Art on several occasions at his home up in the mountains above Beverly
Hills.
Linkletter was a Canadian immigrant who lived a story-book, rags-to-riches
American life. An orphan adopted by "a one-legged preacher,"
Linkletter left home at 17, bummed around America as a hobo on the
trains—"a great way to see this great country," he said—and at age 19
was a stock runner on Wall Street when the market crashed in October 1929.
"I was out of a job the next day; people were crying and jumping out of windows,"
he recalled.
Never at a loss for
a funny line, Linkletter became one of the most famous radio voices in the
1930s, then made the rare successful transition to television. He hosted a
series of daily TV shows that were all hits, the most enduring of which was the
wildly popular "Kids Say the Darndest Things."
Linkletter could go
on for hours telling hilarious stories from that show. One of his favorites was
of the 7-year-old boy whose dog died. He told the teary-eyed lad, "Don't
be sad because your dog is up in heaven with God." The boy responded,
"Mr. Linkletter, what would God want with a dead dog?"
A staunch political
conservative, he told me he'd tried to talk his friend Ronald Reagan out of
running for the White House because "an actor will never be president . .
. Thank God he ignored my advice, because Ronnie really turned this country
around. "
In the last years of his life Linkletter crusaded for Social Security
privatization and repeal of the estate tax. Social Security was "the worst
investment that any of us will ever make in our lifetimes," he said,
adding, "The trust fund is a fraud. How do these members of Congress stay
out of jail?" He thought the death tax was "the cruelest of taxes,
because why should the government help itself to half of a man's lifetime
earnings?" I had no answer. . .
Mr. Moore is senior economics writer for The Wall Street Journal.
Printed
in The Wall Street Journal, May 29,
2010, page A11
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Art
Linkletter, TV Host, Dies at 97
By WILLIAM
GRIMES
Published: May 26, 2010, NY Times
Art Linkletter, the genial host who parlayed his
talent for the ad-libbed interview into two of television's longest-running
shows, "People Are Funny" and "House Party," in the 1950s
and 1960s, died on Wednesday at his home in the Bel Air section of Los Angeles.
He was 97. . .
Gordon Arthur Kelly was born on July 17, 1912, in
Moose Jaw, Saskatchewan. Before he was a month old he was abandoned by his
parents and adopted by Fulton John and Mary Metzler Linkletter, a middle-age
couple whose two children had died. It was not until he was 12, while rummaging
through his father's desk, that he discovered he was adopted. . .
"I know enough about a lot of things to be
interesting, but I'm not interested enough in any one thing to be boring,"
Mr. Linkletter told The New York Post in 1965 . . .
After graduating from high school at 16, Mr.
Linkletter decided to see the world. With $10 in his pocket, he rode freight trains
and hitchhiked around the country, working here and there as a meatpacker, a
harvester and a busboy in a roadhouse. "Among other things, I learned to
chisel rides on freight trains, outwit the road bulls, cook stew with the
bindlestiffs and never to argue with a gun," he later recalled.
Read the entire
obituary in the NY Times. . .
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On This Date in History - June 9
On this date in
1791, John Howard Payne, who wrote "Home Sweet Home," was born in New
York. Although he was the author of dozens of plays and an actor of some
repute, it shows that one success outlives a parade of lesser efforts. Be it
ever so humble, there's no place like the top, and John Howard Payne made it
once and is remembered for it.
On this date in
1891, another songwriter, Cole Porter, was born in Peru, Indiana. Instead of
just one, he had many successes. He was one of our best-known popular songwriters
and his Broadway hits were innumerable, his lyrics sophisticated, his music
catchy and clever. His selection of themes included: "Anything Goes,"
"Just One of Those Things," "My Heart Belongs to Daddy,"
"Don't Fence Me In," "Wake Up and Dream," "You're the
Top" and "Let's Do It," to name just a few.
After Leonard and
Thelma Spinrad
Always remember that Chancellor
Otto von Bismarck, the father of socialized medicine in Germany, recognized
in 1861 that a government gained loyalty by making its citizens
dependent on the state by social insurance. Thus socialized medicine, or any
single payer initiative, was born for the benefit of the state and of a
contemptuous disregard for people's welfare.
