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Physicians, Business, Professional and Information Technology
Networking to Restore Accountability in HealthCare & Medical Practice
Tuesday, June 10, 2003
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In This Issue:
1. HealthCare in Fifty Countries Not Reassuring
2. Private Research Funding Now Exceeds Taxpayer-Funded
Research
3. Market Driven Health Care - Who Wins, Who Loses, A
Book Review
4. Our Monthly Review of the Twenty Myths of National
Health Insurance
5. Medical Gluttony or Excessive HealthCare Costs
6. The MedicalTuesday.Network for Restoring
Accountability in HealthCare & Government
7. The MedicalTuesday.Network for Restoring
Patient-Focused Private Practice
Keeping Up with the Latest Developments in
MedicalCare
The annual international meeting of my subspecialty in
Internal Medicine, the American Thoracic Society (ATS), occurs every May. I look
forward to sharing notes with as many colleagues from around the world as
possible. This year in Seattle, Washington, approximately 15,000 converged to
share the latest. All areas of subspecialty medicine share common interests.
Hence we had pulmonary physicians, pediatricians, pathologists, thoracic
surgeons, chest radiologists, respiratory nurse clinical specialists and
respiratory therapists. With more than 40 concurrent sessions that ran from 7
a.m. until 9 p.m. for four days, it was a challenge selecting topics that would
provide the most useful information to ones primary interest as possible. Tapes
were available for nearly all sessions and many attendees purchased 30 to 40
tapes for sessions they were unable to attend. By listening to these lectures,
one could gain the information from attending two of the 40 concurrent sessions.
During the next year, the International Societies for Asthma, Emphysema,
Pulmonary Fibrosis, Cystic Fibrosis, Tuberculosis, Critical Care Medicine,
Thoracic Surgery, Bronchoscopy, and a host of related groups will be meeting to
present the latest in their sub-subspecialty. These will be further distilled
for the 100th annual meeting of the ATS next May in Orlando, Florida. It
truly represents a thirst for medical knowledge and allows the latest medical
developments to be shared by the medical, nursing and respiratory therapy
professions. Similar advances occur in the other dozen or so organ system
subspecialties. In light of these massive efforts and evolving advances, with
hundreds of thousands of research articles published each year, it is not only
arrogant but unbelievably naive for politicians in our state assemblies or
congress to suggest that they or their clerical and professional staffs can
determine and make available the health care needs of the masses. Our founders
stated, “We have given you a republic, if you can keep it.” This statement
points out the forever demanding efforts we must use to keep patient-oriented
rather than government-dominated MedicalCare alive and the wave of the future.
Remember Richard A. Epstein wrote in Mortal Peril that unregulated health care
will make more of this available to human kind than any socialized [or single-payer]
governmental program. For a review of this book, see http://www.HealthCareCom.net/bkrev_MortalPeril.htm
HealthCare Practices in Fifty Countries–Not a
Reassuring Message
I had the opportunity of meeting physicians from
approximately twenty-five of the fifty countries at the ATS meeting. The
recurring theme was the endless bureaucracy of HealthCare throughout the world.
The sad fact was that although the majority of physicians saw the failing of
their governmental health care, a large number were too young to have ever
experienced private patient-centered medical care. They simply had difficulty
envisioning unfettered health care without a bureaucrat making rules about how
to provide care.
HealthCare Practices in the United States–a Reason
for Concerted Efforts
During the four days of the meeting, my wife went on daily
tours in Seattle and in the Pacific Northwest. She interfaced with spouses from
many other states and many other countries. The foreign spouses are concerned
with the hopelessness of HealthCare throughout the world of government medicine.
The chief interest of the American spouses, many of which work in their
husband’s offices, is centered around “if” and “when” the United
States adopts a single-payer HealthCare like all the “enlightened” foreign
countries. These messages are almost like a Tom Stoppard play, where two actors
talk at cross-purposes, neither understanding the message of the other.
Hopefully, we can become enlightened to the problems of single-payer or
socialized medicine before the rest of the world privatizes, for if we become
socialized, the rest of the world will give up. Private-based MedicalCare will
cease to exist and government will control the lives of all people.
The Pharmaceutical Industry Research Exceeds That of
the National Institutes of Health
The research supported voluntarily by the pharmaceutical
industry now totals $30 billion dollars a year. This exceeds that of the
National Institutes of Health which extracts funds from citizens through
coercive taxation. The private research industry now pays for two-thirds of all
research; taxpayer supported research has dropped from two-thirds to one-third.
Thanks to the pharmaceutical industry for improving our lives with the latest
treatment for illnesses. We hope the government does not destroy this noble
endeavor in the United States, as has been done throughout much of Europe. If
Europe does not change to a market-based pharmaceutical industry that allows
noble human aspirations as well as profits, it will retreat to the eighteenth
century.
Market Driven Health Care - Who Wins, Who Loses in the Transformation of America's Largest Service Industry by Regina Herzlinger. Dr Herzlinger, Professor of Business Administration, Harvard Business School, suggests by her title "how the market--not managed care... will provide the solution to the deep problems that plague the American health care system." Consumers in the United States are ambivalent about medical care--bemoaning high costs and inefficiency while applauding research advances and individual health care providers. The abundant information that is available for other sectors--prices, cost, quality, availability--is stunningly absent in health care. Read the review at http://www.healthcarecom.net/bkrev_MarketDrivenHealthCare.htm.
National HealthCare Systems in the English-Speaking
World (No 15)
In his recent update of the “Twenty Myths about
National Health Insurance,” John C Goodman, PhD, president of the National
Center for Policy Analysis (www.ncpa.org),
states that ordinary citizens lack an understanding of the defects of national
health insurance and all too often have an idealized view of socialized
medicine. For that reason, Goodman and his associates have chosen to present
their information in the form of rebuttal to commonly held myths. See previous
issues or the archives at www.MedicalTuesday.net
for the summary of the first fourteen myths or www.ncpa.org
for the original 21 chapters of the book.
Myth Fifteen: Single-Payer Health Insurance Would Benefit America’s Elderly
If the experience of other countries is any guide, the elderly have the most to lose under a national health insurance system. In general, when life-saving care is rationed, the young get preferential treatment over the old.
Age Discrimination in Britain. For the most part, the elderly are able to schedule appointments with GPs and can usually gain access to medical facilities, albeit with difficulty. However, many find it difficult to receive the treatment and specialized care that many conditions associated with advanced age require. Access to surgery, both emergency and non-emergency, is limited, as younger, healthier patients are given priority and allowed to pass the seniors in queue. In Britain, what is termed “ageism” has been discussed extensively in medical circles and in the popular media.
• Extrapolating from a Gallup survey, the U.K.
charity Age Concern estimates that one in 10 people (nearly 2 million) notice a
difference in their treatment from the NHS after their 50th birthday.
• One in 20 people over age 65 said they had been
refused treatment; many said their doctors told them the money would be better
spent on treating younger patients.
• According to an article published in the British
Medical Journal, in many coronary care units, age rather than medical
considerations often determines whether a patient will be treated.
• Although more than one-third of all diagnosed cancers
occur in patients 75 years of age or older, most cancer-screening programs in
the NHS do not include people over age 65.
• A report by the British Thoracic Society and the
Society of Cardiothoracic Surgeons of Great Britain and Ireland said only one in
50 lung cancer patients over age 75 receives surgery.
• In one particularly disturbing case, BBC News alleged
that 60 seniors died after being deprived of food and water by hospital staff in
an effort to relieve the pressure on the hospital for beds.
Age discrimination is not just an action of individual doctors or hospital staff. In countries with single-payer health insurance systems, denial of care to the elderly also occurs as a result of institutional obstacles. For example, in Britain:
• Guidelines issued by the British Medical
Association allow NHS doctors to withdraw food and water given by tube to
elderly patients suffering from severe stroke and dementia even if they are not
facing imminent death.
• In an effort to curb costs, the NHS has cut the number
of geriatric beds in British hospitals by 50 percent over the past 20 years.
Some critics of the NHS claim that its policies toward the elderly are deliberately aimed at eliminating a burden on the system and amount to a strategy of conducting involuntary euthanasia with older patients.
Age Discrimination in New Zealand. The same sort of discrimination against the elderly exists in other countries with national health insurance. New Zealand’s guidelines for end-stage renal failure programs say that age should not be the sole factor in determining eligibility, but that “in usual circumstances people over 75 should not be accepted.” Since there is no private dialysis service in New Zealand, this amounts to a death sentence for the elderly with kidney failure.
International Comparisons. A recent Commonwealth Foundation survey asked seniors in the UK, Canada, and the US to rate the performance of their nation’s health care system. The survey found that the United States is the only country of the three in which the elderly are more satisfied with their health care system than the non-elderly.
As the proportion of the population that is elderly continues to grow in most developed countries, seniors’ access to health care in countries with single-payer health insurance systems is likely to deteriorate even further. These countries will increasingly be faced with the unpleasant choice of raising taxes or more rationing of care.
The World Sees America as Medical
Gluttony–Excessive HealthCare Costs
One recurring theme from the physicians and health care
workers from around the world at the International ATS meeting in Seattle noted
above was that they have become so used to restricted care, that they think of
HealthCare in America as Gluttonous Medicine. Whether from physicians in
meetings or their spouses on tour, from Scandinavia to Asia to South America,
they believe Americans are so used to excessive HealthCare that they would have
a hard time getting use to socialized or single-payer medicine. We heard
comments such as, “In Sweden, we understand that the government provides just
the basics of health care. If we want more, then we have to pay for it
privately.” In America, national single-payer or socialized medicine is
promoted as providing even more care than HMOs provide, which does not bear up
in these discussions.
The recurring theme from U.S. health care workers, including physician’s spouses working in medical offices, is that we should not put up with the restricted care that HMOs, Medicaid and Medicare demand, and we should have socialized or single-payer medicine so “everyone can have everything.” Americans cannot think of being denied drugs and procedures which are routinely denied in most countries of the world.
If office employed physician spouses who work through the current morass of restrictions think that socialized or single-payer HealthCare would be less restrictive, then the train may be out of the station and impossible to stop. Those parties that would like to enslave us into government medicine will have open season on rationally thinking responsible Americans, if health care workers are equally deluded.
However, we are optimistic that numerous efforts
such as this will give responsible Americans pause to consider the constriction
of Freedom such proposals will produce.
The MedicalTuesday Network Recommends the Following
for Their Efforts in Restoring Accountability in HealthCare, Government and
Society:
• The National Center for Policy Analysis, John C
Goodman, PhD, President, who along with Devon Herrick wrote Twenty Myths
about Single-Payer Health Insurance which we review in this newsletter
monthly, issues a weekly Health Policy Digest, a health summary of the full NCPA
daily report. You may log onto www.ncpa.org
and register to receive one or more of these reports.
• The Mercatus Center at George Mason University
is a strong advocate for accountability in government. Nobel Laureate Vernon L
Smith, PhD, has joined its Economics faculty. Please log on at www.mercatus.org
to read the government accountability reports–their fourth annual Performance
Report Scorecard by author Maurice McTigue, QSO, a Distinguished Visiting
Scholar, a former government minister in New Zealand, and now director of the
Mercatus Center’s Government Accountability Project. This week we see
another unintended consequence of mandates. Well-Intentioned Insurance
Legislation May Increase Alcohol Abuse: In a new working paper, Mercatus
scholars Jonathan Klick and Thomas Stratmann examine the effects of state laws
requiring insurance policies to include treatment for alcohol and substance
abuse. They statistically measure the effect on alcohol consumption today of
laws that increase the level of insurance for addiction treatment in the future.
They find that these insurance mandates lead to a statistically significant
increase in alcohol consumption––on the order of an additional beer per week
per person!
• The Galen Institute, Grace-Marie Turner President
and Founder, has a weekly Health Policy Newsletter to which you may
subscribe by logging onto their website www.galen.org.
The health sector is poised to enter a dramatic new era of consumer-driven
health care. People are demanding more control over decisions involving their
health care and medical coverage. And the Internet allows consumers easy access
to a wealth of medical information that was available only to professionals as
recently as a few years ago. But public policy is lagging behind. It is suited
to an Industrial Age, not our Information Age. Private and public sector
bureaucracies, not consumers, are still in charge because they control the
finances and therefore the decisions. We have expanded existing government
health care programs, especially Medicaid, to cover more and more people and
have even created new programs, like the State Children's Health Insurance
Program. Yet the number of uninsured remains stubbornly high. It seems clear
that we need to look for other solutions. And that means looking not at further
expanding government programs but at harnessing the creativity and energy of the
private sector. As amazing as it may seem in our capitalistic economy, this is
the one thing we haven't tried! And the public policy change that will empower
millions of consumers to lead this transformative change is giving them more
financial control over their health care and coverage. Read the Galen philosophy
at http://www.galen.org/news/transforming.html.
• Greg Scandlen, Director of the “Center for
Consumer-Driven Health Care” at the Galen Institute, has a Weekly Health
News Letter: Consumer Choice Matters. You may subscribe to this
informative and well-outlined newsletter or read the current issue by logging
onto www.galen.org and clicking
Consumer Choice Matters. The current issue 18 cites a number of "Business
Journals" which headlined "Big Businesses Call for Universal
Health Care Coverage." Scandlen’s translation: "We've caved in to
union demands for ever-richer [health care] benefits for decades, so now we want
the government to mandate the same burden on our competitors." (Or in
the vernacular, let’s make sure that everyone gets screwed equally.) SOURCE: washington.bizjournals.com/washington/stories/2003/05/26/newscolumn3.html.
• Martin Masse, Director of the Montreal Economic
Institute, is the publisher of the webzine: Le Québécois Libre. Please log
on at www.quebecoislibre.org/apmasse.htm
to review his free market-based articles, some will allow you to brush up on
your French. You may also register to receive copies of his webzine on a regular
basis. This week he discusses his interview with Father James Sadowsky who is
not a well-known figure of the libertarian movement. But he is a pioneer and one
of a small band of enlightened people who met regularly in Murray
Rothbard's apartment in Manhattan in the early sixties to discuss revolutionary
ideas which today can be shared with hundreds of thousands of people through the
Internet. Martin Masse says, “I met Jim for the first time four years
ago when he gave a lecture in Montreal . . . on why the poor need
capitalism. Since then, we've met regularly. . . We've had dozens of
wonderful conversations on economics, the Austrian school, history, religion, my
Quebec French accent, cats, and many other things. I thought QL readers should
have the chance to share one of these conversations with him.” Please give
yourself a treat at http://www.quebecoislibre.org/030607-2.htm.
• 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. The Current report: The journalist's
skill as an observer can only take him so far, if he is observing with the wrong
theory in mind. As Thomas Friedman's "Theory of Everything" shows,
without the distinction between power and market . . . a theory of everything
can easily turn into a theory of nothing.
You may also log onto Lew’s premier free market
site at www.lewrockwell.com
to read some of his lectures to medical groups. To learn how state medicine
subsidizes illness see http://www.lewrockwell.com/rockwell/sickness.html.
• 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. You may log onto www.hillsdale.edu
to register for the annual week-long von Mises Seminars which are now held every
February, or their famous Shavano Institutes. Call 800-797-9519 to join the
Mediterranean Cruise October 1-13, 2003 to explore the Roots of Western
Civilization. On-board speakers this year include Wall Street Journal Editor
Emeritus Robert Bartley, Historian Paul Johnson, President Reagan’s UN
Ambassador Jeane J Kirkpatrick, theologian Michael Novak and National Review
contributor and FOX News analyst Victor Davis Hanson, who will also conduct a
two-day pre-cruise excursion in Athens. There will be a gala in Rome with the US
Ambassador to Italy. Please log on and register to receive Imprimis,
their national speech digest that reaches more than one million readers each
month. The last ten years of Imprimis are archived at http://www.hillsdale.edu/newimprimis/archives.htm.
• Robert J Cihak, MD, & Michael Arnold Glueck,
M.D, write an informative Medicine Men column that is now at NewsMax.
Please log on to read or subscribe at http://www.newsmax.com/pundits/Medicine_Men.shtml.
Every pundit in the land has his own diagnosis for the health care crisis. Dr
Cihak feels that the frequently given diagnosis of lack of adequate health
insurance is the wrong diagnosis and what we really need is less insurance –
not more! After a recent experience with health insurance, he’s decided to pay
cash and negotiate all HealthCare expenses including hospital care. So far it
has been cost effective for him. This week read about "Rational Medical
Ignorance" at http://www.newsmax.com/archives/articles/2003/6/2/203417.shtml.
We appreciate his kind words about our efforts with MedicalTuesday.
* * * * *
MedicalTuesday Supports These Efforts in Restoring
Accountability in Medical Practice by Restoring the Doctor & Patient
Relationship Unencumbered by Bureaucracy:
• PATMOS EmergiClinic - www.emergiclinic.com
- where Robert Berry, MD, an emergency physician and internist, provides prompt
care for many of the injuries and illnesses treated in Emergency Rooms at a
fraction of their cost. Dr. Berry also has an internal medicine practice.
He has posted a letter sent to Senator Fred Thompson during the summer of 2000
after meeting with a representative from his office for about an hour. It was
later forwarded to Senator Bill Frist, MD, and Representative Bill Jenkins. It
received only perfunctory responses from the offices of each. “Seeing the
futility of trying to effect change through the political process, I have not
wasted anymore time trying to persuade the men who represent us at the level of
the federal government.” Click on “Email to my Senators” on the
website above. (Sounds like good advice for the Business/Professional community
that is genuinely interested in helping patients.)
• Dennis Gabos, MD, President of the Society for the
Education of Physicians and Patients (SEPP) www.sepp.net,
for making efforts in Protecting, Preserving, and Promoting, the Rights,
Freedoms and Responsibilities of Patients and Health Care Professionals, with a
special page for our colleagues in nursing. Several free newsletters are
available.
• Dr Vern Cherewatenko for success in restoring
private-based medical practice which has grown internationally through the
SimpleCare model network, www.simplecare.com.
An 80-slide Power Point Lecture has been posted at http://www.simplecare.com/PowerPoint%20Files/SimpleCare%20Info%20Slide%20Show%205-17-03_files/frame.htm.
• Dr David MacDonald has partnered with Ron
Kirkpatrick to start the Liberty Health Group (www.LibertyHealthGroup.com)
to assist physicians by helping them to control their medical benefit costs for
their staff and patients. He is available to speak to your group on a
consultative basis. Contact him at DrDave@LibertyHealthGroup.com.
• Oregon Town Chooses SimpleCare: The McMinnville
[Oregon] Physicians Organization (MPO) brought in David MacDonald, D.O., and
Vern Cherewatenko, M.D., of Renton, WA, cofounders of SimpleCare, to speak to
major employers in this town of 95,000. Of the 65 physicians in town, 62 joined
SimpleCare. A $50/month major medical/hospital-only insurance policy has been
made available. Dr. MacDonald told physicians that they could make more money
and provide better service by charging patients directly, even at fees 20 to 50
percent less than the fee encumbered by insurance overhead. It is expected that
physicians will back away from all of their insurance contracts.
• The Association of American Physicians &
Surgeons, (www.AAPSonline.org) The Voice
for Private Physicians Since 1943, representing physicians in their
struggles against bureaucratic medicine and loss of medical privacy. They have
renamed their official organ the Journal of American Physicians and Surgeons,
and named Larry Huntoon, MD, PhD, a neurologist in New York, as the
Editor-in-Chief. Dr Huntoon published a letter to the editor from Robert
Cihak who feels that to call Medicare a Ponzi scheme is unfair to Mr Ponzi. Mr
Ponzi’s scheme, although illegal, was voluntary. Medicare and Social Security
are not–they are the “Law of the Land.” The AAPS had a successful
quarterly meeting in Seattle on Saturday, May 31, 2003. The annual meeting
will be held at Point Clear, Alabama on September 17-20, 2003. You'll hear
practicing physicians who have cut the cord to managed care and Medicare -
keeping their patients and creating a healthy bottom line. You'll continue to
get the details on how to keep HIPAA claims problems from drying up your cash
flow, and how to respond to expected privacy complaints. Because of HIPAA
criminalizing so much of what we do, there has been renewed interest in the AAPS.
You may register on the website above.
* * * * *
Stay Tuned to the MedicalTuesday.Network and Have
Your Friends Do the Same
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Del Meyer
Del Meyer, MD, CEO & Founder
DelMeyer@MedicalTuesday.net
www.MedicalTuesday.net