1. Featured Article: The music
died on February 3, 1959; the PPO died on January 1, 2010
The Day the
PPO Died By David J. Gibson, MD &
Jennifer Shaw Gibson
While
the music died[1] on February
3, 1959, the PPO died on January 1, 2010.
On that Friday, America's perambulation through
the tangent of managed care ended. That
was the day when the realization that the health care market had evolved from a
buyer's to a seller's market became apparent.
Physicians no longer need to sell their services under a discounted
contract.
On that day, 3,000 Medicare patients who had been getting care at
the Glendale Mayo Clinic facility in Arizona had to begin paying out of their
own pocket or find another doctor. Patients choosing to continue receiving care
at the Clinic were then required to pay $1,500 per year out-of-pocket.
So, why is the Mayo event of national importance? The answer, it gives permission for doctors
across the country who are contemplating a similar move to proceed. In June of this year President Obama cited
the Mayo Clinic and the Cleveland Clinic for
offering "the highest quality care at costs well below the national
norm." Furthermore, throughout the
health care reform debate this year, the Mayo Clinic has been supportive of
health care reform as defined by ObamaCare.
Now it is learned that self-interest and economic survival trumps
utopian idealism. The Mayo Clinic
reported that last year its 3,700 staff physicians and scientists treated
526,000 patients. The clinic lost $840 million during that year on Medicare.
In
an informal poll, we visited with colleagues in large and small group and
individual practices across the country.
All of our contacts in every region of the country indicated that they
were either seriously contemplating or about to implement the Mayo business
move.
So,
what have we learned from this 30-year experience in managed care and network
discount contracting; and what does this portend for the future?
1.
Reducing
medical services to a commodity structure based upon Current Procedural
Terminology (CPT) defined fixed reimbursement rates was an anomaly based upon a
temporary buyer's market within health care.
It had no chance of long-term survival.
Furthermore, this payment methodology is foreign to the entire service
based economy within the U.S. No other
group of professionals has ever agreed to this structure for reimbursement.
2.
The idea that third
parties can manage care and thereby improve quality, rationalize utilization,
coordinate care for chronic conditions or stabilize cost has been definitively
discredited. We have further learned
that these third parties are incompetent when they insert themselves into
clinical decision making. The only role
they can credibly play is to rationalize the rationing of services.
3.
The only segment of the
market where PPOs will likely continue to function will be in government
financed health care.
4.
The government will
continue to have a safetynet role in financing care for the unfortunate and
for those covered by entitlement programs and government retirement plans. However, the care delivered will be well
outside the mainstream.
a.
Mainstreaming has failed
in health care just as it has failed in the public school system.
b.
The private market will
no longer tolerate the cross-subsidization required to support the government's
inadequate reimbursement for medical services.
This cross-subsidization has financed the mainstreaming of government
financed health plans. A report by Milliman published in December 2008
demonstrated that the cost shifting to the private sector totals 15-percent.[2]
c.
The care financed by
government will have much more restricted access. As we have seen in the health care debate this past year,
"best practice" guidelines will limit high cost services,
particularly for the elderly and those with limited survival rates. It will lack the breadth of coverage, access
to cutting edge technology and service accoutrements delivered to the private
sector.
d.
In all likelihood
government funded PPO delivery structures will devolve back to the old county
hospital systems of yesteryear with take-a-number packed waiting rooms and
appended clinics that are staffed by idealistic or elderly employed physicians.
5.
The role that organized
medicine will play in the future representing the interests of practicing
physicians has been called into question.
Why, because the revenue from licensing fees for the CPT codes has
alienated the relationship between the American Medical Association (AMA) and
its members. The AMA now derives a
significant portion of its income from revenue generated by the licensing fee
for the CPT codes and other proprietary products. This revenue dependence left the organization vulnerable to
extortion from the administration as it relates to support for ObamaCare. The administration's explicit threat to
develop an alternative procedure defining system and move away from the AMA's
CPT definitions resulted in the AMA's support for ObamaCare despite significant
resistance from the organization's membership.
6.
Unless ObamaCare is
enacted, which seems unlikely at this point, all of the health care, Washington
centric membership organizations (the AMA, the American Association of Retired
Persons (AARP) and as illustrated by the just announced resignation of Billy Tauzin, president of the Pharmaceutical Research and
Manufacturers of America) will be marginalized. Cutting deals with partisans has consequences when you play and
lose. When the Republicans increase
their numbers in Congress next year, the likelihood of preventing the
21.2-percent pay cut for physicians called for in 2010 under the 1998 enacted
"Sustainable Growth Rate" for physicians participating in Medicare
will be problematic. The AMA is now
viewed as any other Democratic special interest group by the Republicans.
Welcome
to the new world of American health care.
We predict that managed care will be remembered as a temporary market
experiment that had its origin in academic utopianism.
We
will be delivering a follow-on article examining the process of dissolution of
managed care in the private sector of the market in the next issue of
MedicalTuesday.
David Gibson is the
president of Reflective Medical, a health care software development company. Jennifer
Gibson is an economist specializing in evolving health care markets as well as
a futures commodity trader specializing energy.
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2. In the News: Whose body needs protecting? Mandates do
not protect us.
Whose Body Is It?
By John
Stossel | February 25, 2010
The government should "protect" us less and
respect our liberty more
People suffer and die because the government
"protects" us. It should protect us less and respect our liberty
more.
The most basic questions are: Who owns you, and who
should control what you put into your body? In what sense are you free if you
can't decide what medicines you will take?
This will be the subject of my Fox Business program
tonight.
We'll hear from people like Bruce Tower. Tower has
prostate cancer. He wanted to take a drug that showed promise against his
cancer, but the Food and Drug Administration would not allow it. One bureaucrat
told him the government was protecting him from dangerous side effects. Tower's
outraged response was: "Side effects - who cares? Every treatment I've had
I've suffered from side effects. If I'm terminal, it should be my option to
endure any side effects."
Of course it should be his option. Why, in our
"free" country, do Americans meekly stand aside and let the state
limit our choices, even when we are dying?
Markets, Not
Mandates, by
Ronald
Bailey | July 28, 2009
How medical markets would improve health care and reduce
costs
The New York Times calls it "possibly
the most complex legislation in modern history." The health care
"reform" currently being hammered out by the Democratic leadership of
the House of Representatives already clocks in at $1 trillion and 1,000 pages -
and it's nowhere near done. But one thing is clear: the legislation attempts to
substitute top-down mandates from a centralized bureaucracy for the distributed
decisions made by millions of consumers, physicians, and insurers acting in a
marketplace. This will fail.
While congressional
reform efforts screech and shudder along, let's take a moment to dream: What
would real reform look like? It would be consumer driven, transparent, and
competitive.
Right now consumers are locked
into the health insurance and health care plans that their employers choose,
thanks to previous government meddling with the health care system and the tax
code. Consequently, most consumers simply don't have a clue what their health
insurance costs. They have no way to reduce those costs, and no incentive to do
so, even if they could.
Harvard University
business professor Regina Herzlinger is stuck in exactly the same place as most
Americans - her employer, in this case, the president of Harvard, buys
her health insurance for her. "I wouldn't permit him to buy my
house or my clothing or my food for me. Yet as my employer, he could take up to
$15,000 of my salary each year and buy my health insurance for me, without
knowing anything about my preferences or needs. It's ridiculous." Indeed
it is.
Third party payments are
the main source of dysfunction in the American health system. "The devil
systematically built our health insurance system," once suggested Princeton University health
economist Uwe Reinhardt. As evidence, Reinhardt pointed out that it "has
the feature that when you're down on your luck, you're unemployed, you lose
your insurance. Only the devil could ever have invented such a system."
So the first step toward
real reform is to give consumers responsibility for buying their own health
insurance. The employer-based health insurance system must be dismantled, and
the money spent by employers for insurance should be converted to additional
income. This would immediately inject cost consciousness into health insurance
decisions.
Since governments have
been intervening in and distorting medical markets for more than a century,
there are no examples of truly free-market medicine in any of the developed
countries. (Switzerland is probably the nearest that any developed country
comes to having a free market in health care and health insurance.) So it is
impossible to know what might have happened had health care markets been
allowed to evolve. While there are hints of what a market system might look
like embedded within our current mess, much of what could happen under medical
markets is tough to predict. Nevertheless, here's one partial vision of how a
system of competitive health care and health insurance might develop if real
reform were adopted.
The typical American
might purchase high-deductible health insurance policies that would cover
expensive treatments for chronic diseases such as heart disease, cancer, AIDS,
diabetes, multiple sclerosis, or the catastrophic consequences of accidents.
Coverage would also include expensive treatments such as heart surgery, organ
transplants, dialysis, radiation therapy, etc. In addition, Americans
would be able to buy health-status insurance that would
guarantee that they could purchase health insurance at reasonable prices in the
future.
The good news is that
such policies are available even now. A quick check on online health insurance
clearinghouse eHealthInsurance pulls a quote of $131 per month from Anthem Blue
Cross Blue Shield for a single 55-year-old male with a $3,000 annual
deductible, no co-pay after the deductible, reasonable pharmaceutical benefits,
and lifetime maximum benefits of $7 million. . . That was the cheapest plan,
but over 80 other insurance policies were available. Of course, as deductibles
went down, the prices for other plans went up. The UnitedHealth Group has begun
offering a policy that guarantees purchasers the right to buy an
individual medical insurance policy in the future even if they become sick. . .
Once consumers are
unleashed, the medical marketplace would be transformed. Most likely, a lot of
routine care would be done through retail health centers located in shopping
malls, drug store chains, and mega-stores. Such centers would not be staffed
with physicians but with nurse practitioners or other qualified personnel.
Consumers would generally pay for routine, everyday care directly out of their
health savings accounts
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3. International Medicine: The NHS has a mortality rate a third
higher than the national average
The worst
NHS wards ... where safety is a lottery byAnushka Asthana and
Denis Campbell
The Observer, Sunday 29 November
2009
An
explosive report reveals a terrifying picture of many English hospitals, with
people dying after being admitted with 'low-risk' conditions.
For Adrian Underwood, it began with a terrifying loss of
movement down the left side of his body. A hospital scan in Nottingham
identified a benign tumour that if untreated would eventually crush his brain.
Yet no one told him about it.
More than 50 miles away in Solihull, Jenny Morgan sat in
A&E for 90 minutes after suffering a stroke, before deciding to leave so
she could "die at home". Half-blinded and in excruciating pain, she
later returned, only to be told the stroke unit was full. And on a ward in
Essex, Gillian Flack found her severely disabled son drenched in urine and no
nurses in sight. That night Kyle Flack, 20, suffocated after getting his head
wedged in the metal bars of the hospital bed. "You think hospitals are
safe," said his 54-year-old mother, her voice trembling. "But if I
had never taken Kyle to hospital he would have been alive."
Her son died at Basildon University Hospital, where a
report last week revealed evidence of dozens of patients dying needlessly in
filthy conditions.
The NHS trust was revealed to have a
mortality rate a third higher than the national average: about 350 more people
died in a year than would be expected.
Today, the Observer can reveal that Basildon is
far from alone. A major report has found evidence of systemic failures in
patient safety across the NHS in England over the past year. According to Dr
Foster, a health information organisation based at Imperial College London,
cases such as that of Underwood, Morgan and Flack are just the tip of the
iceberg.
The report highlights dozens of cases of surgery carried out
on the wrong part of the body and incidents in which "foreign
objects" such as gauzes were left inside people. It finds that thousands
admitted with "low-risk" conditions went on to die in hospital;
hundreds of them were under 65. It exposes the fact that one in five trusts
failed to check patients in A&E for the superbug MRSA; that four out of 10
did not investigate unexpected deaths or cases of serious harm on their wards;
and that more than a third failed to adopt a "track and trigger"
system that monitors acute patients to prevent their condition deteriorating.
And it names the trusts which perform as poorly as Basildon.
The Dr Foster Hospital Guide 2009 opens with a question: how safe is your hospital? It closes with a league
table of NHS Trusts across England, rating each one's performance on patient
safety.
The Essex trust sits at the foot of the table, but 11
others were also given the lowest rating of 1 on a patient safety scale
designed by the research team. All were deemed to be "significantly underperforming
on basic safety measures". Many had very high mortality rates with more
than 1,000 patients dying who could have been saved in those hospitals alone.
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The NHS does
not give timely access to quality healthcare; it only gives access to unsafe
healthcare.
*
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4. Medicare: The Costs of Mitt Romney Care in
Massachusetts is as elusive as Obama Care
The
Massachusetts Health Plan: Much Pain, Little Gain, by Aaron Yelowitz and Michael F. Cannon
In 2006, Massachusetts enacted a sweeping health
insurance law that mirrors the legislation currently before Congress. After
signing the measure, Gov. Mitt Romney (R) wrote, "Every uninsured citizen
in Massachusetts will soon have affordable health insurance and the costs of
health care will be reduced." But did the legislation achieve these goals?
And what other effects has it had? This paper is the first to use Current
Population Survey data for 2008 to evaluate the Massachusetts law, and the
first to examine its effects on the accuracy of the CPS's uninsured estimates,
self-reported health, the extent of "crowd-out" of private insurance
for both children and adults, and in-migration of new Massachusetts residents.
We find evidence that Massachusetts' individual
mandate induces uninsured residents to conceal their true insurance status.
Even setting that source of bias aside, we find the official estimate reported
by the Commonwealth almost certainly overstates the law's impact on insurance
coverage, likely by 45 percent. In contrast to previous studies, we find
evidence of substantial crowd out of private coverage among low-income adults
and children. The law appears to have compressed self-reported health outcomes,
without necessarily improving overall health. Our results suggest that more
than 60 percent fewer young adults are relocating to Massachusetts as a result
of the law. Finally, we conclude that leading estimates understate the law's
cost by at least one third, and likely more.
Our results hold important lessons for the legislation
moving through Congress. As in Massachusetts, there has been no effort to
estimate the cost of the private health insurance mandates that legislation
would impose on individuals and employers. The costs may therefore be far
greater than legislators and voters believe, while the benefits may be smaller
than the conventional wisdom about Massachusetts suggests.
Aaron Yelowitz
is an associate professor of economics at the University of Kentucky and an
adjunct scholar at the Cato Institute. Michael F. Cannon is
director of health policy studies at the Cato Institute and coauthor of Healthy
Competition: What's Holding Back Health Care and How to Free It.
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Government is not the solution to our
problems, government is the problem.
-
Ronald Reagan
* * * * *
5. Medical Gluttony: The most Gluttonous Patients don't
see their own Gluttony.
Recently, a patient and his wife, who are for
Obama's mega-gluttonous health care diatribe, said that everybody could have
free health care with the things that Obama would save. By trimming $400
billion off of Medicare as I recall (the numbers are so huge now that even my
patients are getting millions, billions and trillions all mixed up), that
should make health care so much more efficient. Although his demands were so
exorbitant that day, I couldn't broach the subject because he was relatively
new to the practice. So I spent a few thousand more than I thought was
necessary.
When this went on for the
next few visits and the spouse reacted the same way, I asked if they still felt
the way they did on their first visit - that there was considerable money to be
saved by cutting unnecessary care in Medicare. They responded,
"Absolutely. We shouldn't let doctors and hospitals get away with gouging
the system." I responded, "Do you think that you have received
unnecessary care?" Again both responded, "Absolutely not. We're still
not cured and we need a lot more tests done."
I pointed out that I sat on
some Medical Review Committees and was aware of what reviewing doctors
considered unnecessary care. I then pointed out that about one-third of their
expenses to Medicare were not needed and my overtures during the previous visit
on going easy were not well received by them. Hence, we spent considerable more
than necessary and I felt most physicians in my shoes would do the same early
in the physician-patient relationship. But it was now time to pull in the reins
since both were recovering with about the speed projected and we had to let
nature do a little between episodes of treatment.
They weren't too happy when
they left and I felt I would never see them again. But they kept returning as
directed and never brought up cost containment again.
Maybe at some time in the
future, I will feel comfortable enough to see if they are still for Obama's Trillions.
The fact that they didn't bring up saving Medicare money again makes me feel
rather sure that they are still Obama fans but don't see themselves as
socialists.
Oh, that God the
gift would give us. To see ourselves as others see us -
Robert Burns
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Medical Gluttony thrives in Government and
Health Insurance Programs.
It Disappears with Appropriate Deductibles
and Co-payments on Every Service.
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6. Medical Myths: No one has a right to care in universal health
care, just a right to a waiting list
Myth 17: Health care reform
will establish a right to health care.
AAPS
- Tuesday, August 25, 2009
Everybody in a country with "universal
health care" has a "right" to health care, but Americans do not
- or so it is argued. "Health care reform" is supposed to correct a
moral deficiency in the United States, and, at long last, grant a fundamental
human right to Americans.
At present, Americans who have purchased
insurance have a contractual right, enforceable in court, to whatever benefits
are agreed to in the contract. Federal law entitles them to a screening
examination and stabilization if they present to an emergency facility, even if
they have no ability to pay - and the hospital and on-call physicians are
obligated by law to provide the service.
In an American hospital, women in labor will
be delivered; patients with a surgical emergency will have an operation; and
patients with a life-threatening medical emergency will be admitted. But later,
the hospital will try to collect payment. Americans have no right to receive
medical services at taxpayer expense. Those enrolled in Medicare, Medicaid, or
other government program have an entitlement to certain benefits, determined by
politicians and bureaucrats. About half of U.S. medical expenditures are made
by government through such programs.
How is the situation different under
"universal health care"?
In Canada, patients are entitled to treatment
only after they present their insurance card. If they lack a card, say because
they are homeless and haven't signed up for the program, treatment will be
denied.
One man in Quebec forgot his card at home,
and was denied care, even though his name was in their computer. No card, no
service. When he went home to get the card, his appendix ruptured, and by the
time the ambulance arrived, he was dead. At age 21. As Mark Steyn writes, "He didn't make it to 22 because
he accepted the right of a government bureaucrat to deny him medical treatment
for which he and his family have been confiscatorially taxed all their
lives."
Under "universal health care," one
has no right to care that is timely, convenient, or state-of-the-art.
Under a "single payer" (government-payer-only) system, one has no
right to pay extra to allow the operating room, imaging center, or clinic to
stay open longer - even though this would decrease the waiting time for
everyone, including those who could not afford to pay more. One has the right
to receive only the services that "society" (politicians and
bureaucrats) has decided to make available.
Most nations of the world have a private
sector that relieves some of the strain on the public system, though people who
receive private services have paid twice for medical care - once for the public
services that they do not use, and again for the care they do receive. Canada
and North Korea have a single payer; Canadians have the right to pay twice if
they go abroad for treatment.
Rights that Americans would lose under
proposed reforms include: the right to buy true insurance, for which premiums
are based on risk; the right to decline to buy a plan they don't want; the
right to self insure; the right to reap the benefits of healthful living, hard
work, and prudent spending; and the right to keep their medical records
confidential. If the reforms evolve into a single payer, as many advocates
intend, Americans would lose the liberty to use their own property to prolong
or enhance their own lives.
Obligations that reform would impose on
Americans include: continually proving that they had paid for coverage that the
federal government deems acceptable; paying what the government deems to be
their "fair share" for insuring persons below a certain income
threshold; paying for procedures they deem to be harmful or immoral if coverage
is mandated by government; and paying for expanded, costly bureaucracy.
America's extraordinary prosperity and
technological progress occurred in an atmosphere of freedom. The losses
resulting from a central chokehold on innovation are incalculable. Advocates of
reform often attribute the high cost of American medicine to new drugs,
devices, and procedures, and want still-heavier regulation to restrain these
advances. Both Americans and the result of the world's peoples will lose if
America is no longer the engine of progress.
Americans are being asked to exchange their
birthright of freedom for - politicians' promises. And to trade their natural,
God-given rights to life, liberty, and property for government-granted
privileges or entitlements.
If you have to show a card that proves you
are eligible to receive a certain service in a certain facility, you do not
have a right, only a privilege. A privilege that can be revoked by bureaucrats
calculating the gains and losses to "society" from your treatment.
People have come to trust their government
entitlement programs, just as they once trusted Bernie Madoff. However,
Americans have no constitutional or contractual right to their Social
Security benefits, for which they have been taxed all their lives. This was
established decades ago by the U.S. Supreme Court, in the case of a man who was
deported for being a Communist after paying Social Security taxes for 19 years.
In upholding the 1954 law that revoked the Social Security privilege for such
persons, the Court cited the necessity of Section 1104 of the 1935 Act,
entitled "Reservation of Power," reads: "The right to
alter, amend, or repeal any provision of this Act is hereby reserved to
Congress."
The Court ruled: "To engraft upon the
Social Security system a concept of accrued property rights would deprive it of
the flexibility and boldness in adjustment to ever- changing conditions which
it demands...." (AAPS News, August
2008). Remember that Medicare is part of the Social Security Act.
Fundamental rights guaranteed by the U.S.
Constitution must be abridged to grant a "right" to taxpayer-funded
medical treatment. The tradeoff is of true rights for what is actually a
privilege or entitlement.
What the government gives, the government can
take away. And of course, whatever it gives was first taken from someone.
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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: Where are the
cracks in the healthcare net?
Dr. Sam: Aren't you getting tired of
all this Obama ranting and raving about the people without health insurance?
Dr. Dave: He sure is hitting a
populist theme. Who wouldn't want free care?
Dr. Paul: You conservatives have no
conscience. There are a lot of people that fall through the cracks.
Dr. Nicole: I certainly have a lot of
patients who don't have health insurance and can't afford to obtain their
health care.
Dr. Sam: That's a non-sequitur.
Dr. Paul: No it isn't. I also
see a lot of folks without insurance who can't afford to come in to see me.
Dr. Edwards: The line from the
liberals hasn't really changed since the 1960s. There will never be enough
money to make them happy.
Dr. Rosen: But the population
that's being discussed today is a totally different population than the one
from the 1960s.
Dr. Paul: How's that?
Dr. Rosen: Since the 1960s,
we have Medicare to cover all the old folks from 65 and older. So there are no
cracks for anyone over 65 to fall through.
Dr. Paul: Ok! So I'll give
you that argument. But there are many pediatric and other folks uncovered.
Dr. Rosen: Since the 1960s,
we've covered all the poor people with Medicaid. So the bottom 12-15% of
society is covered and there are no cracks for the poor people in our country
to fall through.
Dr. Nicole: I don't believe
that for a minute.
Dr. Rosen: Since the 1960s we
also have Medicare Disability to cover all the people of any age who are
disabled for two years.
Dr. Paul: Why doesn't
Medicare Disability cover all who are disabled?
Dr. Rosen: Many are temporarily
disabled for a variety of reasons including work injuries. The two-year cutoff
is an appropriate time to determine if the disability will be permanent.
Dr. Sam: Don't forget the
military. All the retired and all the disabled are also covered.
Dr. Edwards: Getting back to
the poor people, in some states, Medicaid covers people making $60,000 to
$75,000 a year. I find it hard to justify the Obama trillions to cover people
that are making $5,000 to $6,000 a month.
Dr. Dave: He's going to have
to rob those that have health coverage to give to those that should be able to
cover a basic health care policy.
Dr. Paul: How can you say
that $6,000 a month is rich?
Dr. Edwards: We're not saying
that $6,000 a month is rich. But they don't need taxpayers' money from those
that are making $3,000 to $4,000 a month who are managing their lives frugally.
Dr. Nicole: But have you
looked at the premiums for health insurance. I have patients paying $15,000 a
year.
Dr. Sam: That's $1250 a
month. That's not much for what surgeons and hospitals cost.
Dr. Nicole: But what surgeons
and hospitals cost is a fact of life.
Dr. Dave: No it is not. In
fact, I just saw a policy advertised to cover hospital and surgeons for about
$250 a month.
Dr. Paul: But that doesn't
cover the cost of going to the doctor.
Dr. Sam: It shouldn't. That's
the problem. It shouldn't cover ordinary costs any more than car or house
insurance covers ordinary costs. It should just cover catastrophic costs and
that's what health insurance should cover.
Dr. Paul: Well, I think
health insurance should cover all health care costs.
Dr. Dave: Paul you're not
paying any attention. If health insurance is $1250 a month and a hospital
surgery plan costs $250. Then the $1000 you save every month will purchase a
lot of office calls, blood counts, cholesterols and x-rays. In fact you will
have money left over.
Dr. Rosen: Also another thing
you're forgetting is when you pay cash, you can ask and frequently bargain. We
do this every day in the rest of our lives. When I found out that there was a
shirt laundry that did shirts 75 cents cheaper, I started going there. My
former cleaners called my office and wanted to know why she hadn't seen me. I
pointed out that 75 cents for seven shirts a week if $5 a week or $250 a year. You
know, she wanted my business so badly that a few days later she called back and
said that she would meet the same price as the competition.
Dr. Dave: Isn't that what the
market is all about? Our schools are failing to teach market economics and so
many people can't even see how competition lowers cost.
Dr. Rosen: It also works in
health care. The lab I was sent to quoted me $375 for my lab requisitioned by
my doctor. So I went across the hall and they gave me 20% discount. Who knows,
maybe surgeons would start giving discounts. Isn't that better than the
insurance companies just arbitrarily cutting your fees in half?
Dr. Paul: But the
corporations just gouge the public and keep raising their prices.
Dr. Dave: Paul, you act as if
Coke, for instance, could just raise their prices by another 10 cents without a
problem.
Dr. Nicole: Well, they could.
Dr. Dave: No they could not.
Pepsi wouldn't let them. Pepsi would maintain their prices or even drop them
and next month's financial statement could show that Pepsi had overtaken Coke
as America's number one soda. You think Coke would take that risk by raising
their price?
Dr. Nicole: I think you're
making this more complicated than it is.
Dr. Sam: Come on now, Nicole,
don't you believe in competition?
Dr. Nicole: Maybe in the soda
world. But it wouldn't work in medicine.
Dr. Dave: It especially would
work in medicine. If all Internists were paid by the patients instead of
insurance companies, we would all find ways of providing better services at
reasonable affordable prices.
Dr. Nicole: But you can't cut
your office visit charges.
Dr. Dave: I bet I could
streamline my office and provide better services and increase my income. With
health insurance, the worst internists get paid the same as the best
internists. Why not let quality be one determinant factor?
Dr. Nicole: I don't see where
you could cut enough to make any difference.
Dr. Sam: If patients paid me
directly, I could offer a broad spectrum of services that I can't do at the
present.
Dr. Nicole: I'm being spread
too thing already.
Dr. Sam: That's because
you're still thinking and looking backwards. We're in the Information
Technology world now. I could service half of my practice with phone call
evaluations at $10 each and email consultations at $25 each which is probably
adequate for established patients who have simple questions or simple problems
since I have their information on my computer. And most patients would prefer
that option for medical questions or brief email discussions that don't require
an exam at the moment.
Dr. Nicole: Most insurance
companies don't pay for phone and email consultations.
Dr. Dave: That's precisely
the point. We're being controlled by companies that are living in the past and
are not innovative.
Dr. Nicole: But they would
pay if they saw it as more efficient.
Dr. Rosen: Only the
individual entrepreneur is able to see efficiency. And if he or she were
running the show, he/she would see new efficiencies every day that a large organization
would think too risky to venture in. The physicians of tomorrow will have to
cut the chains to health insurance so that they can provide more efficient,
cost-effective care and solve the health care conundrum. Our present
administration in Washington will bury us in the old and stodgy ways of
yesteryear's medicine and bankrupt our nation by keeping medicine inefficient
for many more years and enslave our children and grandchildren.
Dr. Sam: And if our foreign
creditors ever call the bank notes, our children could live in the United
Chinese States of America with Peking as our capital.
Dr. Rosen: And we'd all have
to learn how to speak Chinese and be foreigners on our own soil.
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8. Voices of Medicine: A Review of Local and Regional
Medical Journals and Articles
VITAL SIGNS Journal of The
Fresno-Madera And Kern Counties Medical Societies
Medicine and the Coroner's Office, by David Hadden, MD, Fresno County Coroner
The Coroner's morning briefing was well under way when
a tall young man abruptly appeared in the room interrupting a lively discussion
concerning the need to post a case from the previous day. He was wearing an old
pair of dark washable pants and an I'm-going-to-the-mountains kind of shirt
with boots to match.
"Who
are you?" I said, putting the question to the look on my face.
"I'm
a deputy sheriff."
"Sure
you are."
"No, no. I've got some
bones with me," said the deputy. "We are going to Dinky Creek to look
for the rest of this guy. We think he's a hunter that's been missing for a few
weeks."
He
thrust a plastic bag at the group. Inside were two clearly visible long bones.
"Are
these human?" he asked.
"Looks
like. Where did you get them?" Dr. Gopal inquired.
"Between Dinky Creek
and the Big Trees," replied the deputy.
"A guy brought them in last evening. If you think they are human,
we will go up there today and look for more." "They are clearly human
- a tibia and a fibula," opined Dr. Gopal. . .
"How long have they
been there and are they male?" were the earnest questions from the deputy.
"You can't tell how
old they are after six months," replied Dr. Gopal. "We will have a
forensic anthropologist examine them and get back to you in a few days. Let's
make sure they are male." The deputy looked distressed. "They are
quicker than that on TV."
"Yea," I shot
back. "Detectives are better dressed on TV, too." The deputy looked
offended. To change the subject he turned the bag over exposing a metal plate
on the tibia.
"What's that
plate?" he asked. "It's got two lines of numbers." Whoa. That
plate was an attention getter that changed everything. This was not just
another bag of bones. "That is orthopedic hardware," I said with
enthusiasm.
The deputy told us he'd been
looking for a missing hunter up in the Dinky Creek area for a couple of months.
"We think it's him," he said.
"Call his family and
see if he had a leg operation," I directed. The detective unhooked his radio and called his "boss".
In a few minutes it was confirmed that the missing hunter was never under the
knife.
In the meantime I called
orthopedist Don Huene, MD, with whom I had previously done some forensic work.
"Don, we've got old bones with an attached orthopedic plate about
five-inches long. There are six closely
placed screw holes," I explained to Don. . .
I was transferred to a
somewhat defensive voice identified as Joanna. After I assured her that this
was a CSI thing and no trial lawyers were involved, she produced what she said
were two pages of addresses from that lot number showing that that particular
part was shipped all over California. . .
"Well, there was one shipped to St. Agnes Hospital in Fresno on
April 3, 1999." I thanked her profusely and called St. Agnes. After going through several departments, we
were connected to David in the orthopedic department. With the date of
operation in hand, he soon identified the patient.
Meanwhile, the Coroner's
Office and the sheriff's deputies were searching their memories for Dinky Creek
area missing persons. Deputy Coroner Loretta Andrews remembered a 2006 case
where a body was recovered and she thought perhaps it had a missing leg. She
pulled the record and brought the name to my office just as David called back
from St. Agnes with a name the same name Integrating medicine and the
Coroner's Office gave us a match and positive identification in less time than
it takes to drive to Dinky Creek.
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9. Book Review: Eradicating
Morality Through Education
CLONING OF THE AMERICAN MIND - Eradicating Morality Through Education, by B. K. Eakman; Huntington House Publishers, Lafayette,
LA, 1998, 606 pp, ISBN: 1-56384-147-9
"The
educational system should be a sieve, through which all the children of the
country are passed. . . It is very desirable that no child escape inspection. .
."
Paul Popenoe, behavioral eugenicist, American Eugenics Society; Editor, 1926
With this quotation, B K Eakman, educator, speech and
technical writer, and researcher, sets the tone and the caution of a well
researched "call to alarms." She previously wrote the first
publication to warn of individually identifiable psychological assessments
being given under cover of academic (achievement) testing. That 1991 book, Educating
for the "New World Order," was a surprise hit. It revealed that
"corrective" curricula were being brought into classrooms under the
umbrella of remediation. Youngsters' beliefs and viewpoints were being
remediated, not their skills in academic disciplines.
Eakman does a masterful job chronicling three parallel
efforts dating over a century--information gathering methodologies, behavioral
science, and legislation--and places these in context to provide insight, not
only into the times and circumstances surrounding each event, but the
ramifications for our present era.
Cloning of the American Mind centers on America's "illiteracy cartel," a
term Eakman coined to describe an out-of-control psychographic consulting
industry. Psychographics is a relatively new field that combines elements of
demographic and marketing research, where personal, student, and family records
assume a commodity that with recent advances in computer technology can be
acquired by almost anyone. Psychographics means "the study of social class
based upon the demographics . . . income, race, color, religion, and
personality traits. . . which can be measured to predict behavior." Their
use in persons in captive, compulsory settings like elementary and secondary
schools is of serious ethical and civil rights concerns.
This book explores today's behemoth psychographic
consulting/information brokerage industry, focusing in particular on
state-of-the-art computer technologies and advertising strategies to illustrate
how behavioral scientists are combining these with psychiatry to reform
education. In the process, Eakman shows us two factions of behavioral science
as they evolve, clash, and then come together to accomplish what no extremist
group or power elite has been able to do in the history of the world: hold an
entire population hostage to a set of quasi-political, psychological criteria
by predicating children's job prospects on whether they hold
"acceptable" worldviews and opinions. These social engineers, by
obtaining personal information about youngsters and their families, also get
into the belief system of the students and correct any viewpoints they find
distasteful.
As a society we are getting desensitized to divulging
personal information. We're no longer sure what "personal" means.
Certainly our children don't know. When they're asked questions about the
family's medicine cabinet, mental problems, drinking habits, sexual practices,
they are only too eager to impress, divulge and exaggerate information to
please the teacher, and sound impressive misinterpreting what they see and
hear. False information is thereby interspersed with accuracy being of little
or no concern to those collecting information. The media, of course, has no
stake whatsoever in other people's privacy.
The critical point is that there is a computer model
available to predict behavior, simply by deriving a pattern of one's past
activities. These activities can include anything from long-distance telephone
usage to spending, recreation, and health. These are increasingly available,
not only as part of any security background check, but also can now be added to
a routine background check. If this is not enough, there is the ever-lurking
"information underground' to which even government officials turn when
they cannot get their data on us through legitimate channels.
Eakman points out that Jeffrey Rothfeder in his 1992
volume, Privacy For Sale, decided to show just how much information he
could obtain about a prominent public figure. He selected former Vice-President
Dan Quayle, someone he held in mild contempt. By using his personal computer
and telephone, Rothfeder found he could easily gain access to information he
wasn't supposed to be able to get. He found more than he bargained for and
started sounding alarms. However, Rothfeder was blissfully unaware that
techniques identical to those he was describing were being used in the nation's
elementary and secondary schools. A database exists that not only has the
capability to track and cross-reference generic information about people, their
beliefs, family ties, friends' and associates' names, addresses, phone numbers
and aliases; political/civic clubs and associations joined; magazine
subscriptions; frequent shopping places; political campaigns and causes
contributed to; how important a person is by region, state, or city; what
potentially embarrassing information one may harbor; but can also predict a
person's future action.
Education policy--indeed, all of social policy
today--is aimed at dysfunctional people, not toward the backbone of society.
When ordinary folk use the term "parents," we mean the majority of
upstanding, decent people who care about their children. Statistics show that
about one-half of one percent of American youngsters have no responsible adult
to care for them. Yet, over the past 30 years, social and domestic policy has
focused almost exclusively upon this irresponsible, negligent and abusive
element. So when education policy makers hear the term "parents,"
they're thinking of negligent, abusive, and irresponsible people, or at the
very least, of "rank amateurs."
Eakman found that the Educational Quality Assessment
(EQA) test was made up of 375 questions covering attitudes, worldviews, and
opinions with 30 questions on math and another 30 covering verbal analogies,
which amounts to just enough academic questions to appear credible. However,
she found the scoring mechanism revealed that points were given only for what
were called "minimum positive attitudes"--in other words,
state-desired responses, which the parents saw as neither positive nor
desirable. It was years before behavior modification, a specialized clinical
technique used primarily by licensed psychologists to achieve a therapeutic
goal with patients, was the admitted purpose and the EQA was indeed
psychological testing.
The National Institutes of Health made a grant to the
Western Psychiatric Institute and Clinic for a "Multi-site Multimodal
Treatment Study...." Among the significant aspects of this case was that
psychological data was being mixed not only with students' education records
but also with medical records. This violates the bible of the law profession, Black's
Law. There one finds that malpractice has three aspects: ethical violation
of the doctor-patient relationship; lack of good-faith; and compensable harm.
In this case neither the student nor the parent sought out the doctor or
psychologist. Instead the clinic went looking (stalking) for a
"patient" (subject) and thus no doctor-patient relationship occurred.
There was no informed consent, and, therefore, no good-faith. There was no
proof that data on a particular child could not be retrieved at a later
time causing compensable harm. In fact, insurance companies, potential
employers or even a political candidate find such information useful (e.g. as a
child having been seen or treated by a psychiatrist, forced sexual activity,
use of a weapon, cruelty to animals, to name a few).
It was the year of the nation's Bicentennial, 1976,
when education's high priests finally succeeded in their long-standing struggle
to shift schools from academics and scholarship to socialization and
guardianship. Teachers threw out stuffy old books, learned how to say
"Hey, Man!", exchange their dresses and suits for blue jeans, and
dismissed "the value of x." Likewise, student dress codes and rote
learning were scrapped, tests and curricula were dumbed down, once-neat rows of
desks were traded for "open classrooms," teachers lecturing and
grading scales were condemned, and a technique called "behavioral
conditioning" began replacing drill and repetition. The teachers became
unionized, in some places with legislative mandates, with the NEA and AFT
getting a windfall from membership dues. This implemented an us vs them
mentality. Principals and superintendents withdrew the traditional disciplinary
support teachers had enjoyed for decades. School administrators were no longer
expected to have had taught any academic subjects as long as they obtained the
requisite administration credentials. They pushed teachers to pass failing
students and to "relate to youngsters on their own terms." Teachers
now had to forget what little they ever knew of a classical education and
change their focus to "humanizing the education process" and
"being relevant."
Students loved watching teachers traipse about in
cutoffs and listening to "hip" music while doing math. But they
quickly became disenchanted when creatures who didn't look much different than
they did started getting huffy around mid-term and demanding assignments. Their
response frequently was an obscene gesture. Meanwhile educational psychologists
in expensive "think tanks" questioned whether the ability to spell
correctly was worth the price of a traumatized student. They didn't ask if the
license to spell incorrectly was worth the price of a traumatized adult.
As time went on, good, responsible parents became less trusting of the schools,
and finally apathetic. Statistics began showing that after a child's fourth
year of school, parental interest dropped dramatically. . .
Eakman's behind-the-scenes objective look at our
bureaucratic education system makes Cloning of the American Mind an
indispensable book for parents, educators, physicians, or anyone involved with
our children. One can open up this volume to almost any of its 600 pages and
find alarming news. In these two pages I have just touch the tip of the iceberg
of what Eakman is telling us is happening to our children and the future of our
society. We should all purchase our own volume for careful reading and tell all
our friends about this book. We should even consider an extra volume for a
concerned friend, and one for a member of our local school board. Our country's
future is at stake--and our children won't be able to save it unless we take
drastic action now.
The epitaph of the 20th century should be: "Here
lie the victims of open-mindedness." --Joseph Sobran, syndicated
columnist.
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review is found at . . .
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10. Hippocrates & His Kin: Does Multitasking short
change Memory?
IRS Agent
Can't Look In the Mirror after What He Does To People
Disgraced Sacramento CPA William
Murray once confided to a friend and client that he left a job at the IRS
because "I can't look in the mirror after what I do to people." He is
now accused by the Government of taking more than $13.3 million from a select clientele
of his tax preparation business over the past decade to pay their income taxes
but never forwarded the funds to the IRS. He's free on $500,000 bail but may
not be for long.
Maybe they should make a cell for him with four walls
of mirrors!
Does Multitasking Shortchange Memory?
Multitasking
messes with the brain in several ways. At the most basic level, the mental
balancing acts that it requires - the constant switching and pivoting -
energize regions of the brain that specialize in visual processing and physical
coordination and simultaneously appear to shortchange some of the higher areas
related to memory and learning. We concentrate on the act of concentration at
the expense of whatever it is that we're supposed to be concentration on.
Multitasking
is dumbing us down and driving us crazy. . .
Is Mitt Romney
a Socialist? Or is that a Rhetorical Question?
Mitt
Romney has a new book, No Apology, in
which it appears that he is still supporting his socialized medicine plan for
Massachusetts while he was governor. His editorial in the Wall Street Journal also said as much. His interview in Parade indicates he did it because he
didn't want to be party to saying NO. At the Town Hall meeting with Congressman
Dan Lungren, when asked if he should be the party that's always saying no, a
lady from the audience shouted, "You should be saying Hell NO." The
book subtitle, The Case for American
Greatness, is an obvious ploy trying to reverse his image and seduce the
American people into thinking that he is a conservative in his efforts to
capture the White House. However, those of us in the "People"
business know that people don't change all that much over a lifetime. What he
did to Massachusetts he would do the United States of America. Hence, the
surest way to implement "Constrictive Government Controlled Socialized
Medicine" in our country would be to elect a Wolf in Sheepskin to the
White House. Mitt would complete what Obama won't be able to complete and no
one could stop him before it became a fait
accompli.
AMERICANS BEWARE
OR WE MIGHT LOSE WHAT WE
HAVE ACCOMPLISHED IN 235 YEARS
UNLESS BARRACK OBAMA BEATS
MITT TO THE ARMAGEDDON
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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 informative Ten Easy Reforms
To Cover Preexisting Conditions.
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. Read Sally Pipes on
Health
reform plans represent financial malpractice.
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, treat yourself to
an article by Peter Leeson: Two Cheers for
Capitalism?
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 Washington-Knows-Best
the Wrong Approach to Health Care Reform.
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 the article: "I quit
when medicine was placed under State control, some years ago," said
Dr. Hendricks. "Do you know what it takes to perform a brain operation? Do
you know the kind of skill demands, and the years of passionate, merciless,
excruciating devotion that go to acquire that skill? That was what I would not
place at the disposal of men whose sole qualification to rule me was their
capacity to spout the fraudulent generalities that got them elected to the
privilege of enforcing their wishes at the point of a gun.
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 at Healing
America: The Free Market Instead of Government Health Care.
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 careand 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. Read the latest newsletter
Defend Colorado from Obama
Care!
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 Ending
An Economic Stimulus Package.
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 is to
formulate and promote public policies based on the principles of free enterprise,
limited government, individual freedom, traditional American values and a
strong national defense. The Center for Health Policy Studies supports and does
extensive research on health care policy that is readily available at
their site. -- However, since they supported the socialistic health plan
instituted by Mitt Romney in Massachusetts, which is replaying the Medicare
excessive increases in its first two years, they have lost site of their
mission and we will no longer feature them as a freedom loving institution and
have canceled our contributions.
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, was found 43 years ago on the following guiding principles
which are as true today as when it was founded: 1) The federal government of the United States is too big; 2)
Governments, like individuals, should live within their budgets. 3) A market
economy is the only way to ensure prosperity and is harmonious with human
nature. 4) We should preserve the value of Western Civilization: The
Greco-Roman and Judeo-Christian traditions. St Croix 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
supporting these principles, please go to www.stcroixreview.com. This month,
read the editorial on Double-Dealing Healthcare Reform; Obama's Plan and Key
Battleground; The Death Blow to Climate Change; Healthcare. To experience a
rare voice of reason and good sense, why don't you subscribe to a print or web
edition or make a donation while perusing the website?
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
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Del Meyer
Del Meyer, MD, Editor & Founder
6945 Fair Oaks Blvd, Ste A-2, Carmichael, CA 95608
"Life is an
adventure, dare it." - Mother Teresa: Nobel Peace Prize winner
"Only by contending
with challenges that seem to be beyond your strength to handle at the moment
you can grow more surely toward the stars." - Brian Tracy: Self-help author and lecturer
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The answers will come to you of their own accord." - Earl Nightingale, a motivational speaker and
author, a radio personality, and the co-founder of Nightingale-Conant
Some Recent Postings
Why
Government Doesn't Work, By Harry Browne
HealthPlanUSA.net/Newsletters.
. . Stay Current with the HealthPlan Debate . . .
In Memoriam
Alexander Meigs Haig, soldier and public servant,
died on February 20th, aged 85
From The Economist print
edition | Feb 25th 2010
GRANT and Eisenhower aside,
America is uneasy about handing civil power to soldiers; and from the very
start of the Reagan administration, in 1981, there was nothing Al Haig could do
to erase the impression that he wished to take over the country. At his
confirmation hearings for the post of secretary of state he rode roughshod over
his interrogators ("No one has a monopoly on virtue, not even you,
senator"). He let slip that he wanted to be the "vicar" of foreign
policy, a word with pope-size pretensions. The press pinned on him the word
"arrogant", and never removed it. His picture appeared on the cover
of Time, chin high and arms akimbo, above the words "Taking
Command".
This portrayal was not without
foundation. It was well known that in 1973-74, as Richard Nixon crumbled under
the weight of Watergate, General Haig, then chief of staff in succession to the
disgraced H.R. Haldeman, kept the administration functioning. He advised Nixon
how to deal with his enemies, and when to resign; he suggested to Gerald Ford
that he should pardon his predecessor. His power was such that when Nixon
appeared to ask him for a way out of his turmoil, "a pistol in the
drawer", he immediately ordered the president's doctors to take away his
pills.
He had no politicians'
sleazy graces, and was proud of that. The brusque attitude and tone had been
instilled at West Point, together with the gimlet stare and the preference for
dealing with America's adversaries, whether Cubans, Palestinians or leftist
Nicaraguans, with a bombing run or an invasion. His duties at the White House,
on Henry Kissinger's National Security Council and for Nixon, had been carried
out while still under military orders and earned him a dizzy ascent, from
colonel to four-star general in four years. His scar tissue came from battles
both actual and political.
As a soldier, he believed
in certain rules of behaviour. First, the need to keep secrets and not go
leaking to the newspapers, for soldiers died when secrets came into the enemy's
possession. And second, to follow the chain of command. Foreign policy in
particular required a single source, one clear voice speaking for America. The
greatest danger in those cold-war years was to show the Soviet enemy a soft,
disunited front. The Soviets would surge through then, expanding their
troublemaking and missile-rattling round the globe, just as the Chinese and
North Koreans had driven through the "foolishly divided" front at the
Yalu river in 1950, leaving 12,000 Americans dead or wounded in the ice, when
he was a young lieutenant. . .
The moment for which he was
best remembered came on March 30th 1981, when Reagan was shot. Sweating and
intense, his hands shaking, General Haig declared to the press that "As of
now, I am in control here, in the White House, pending return of the
vice-president." Hedged words; but he never lived them down.
Some thought he had become
unmanageable, and he could give that appearance. But the nub of the matter, as
he described it in a calmly lyrical passage of his book, "Caveat",
was this:
The [Reagan] White House
was as mysterious as a ghost ship; you heard the creak of the rigging and the
groan of the timbers and sometimes even glimpsed the crew on deck. But which of
the crew had the helm?
It was impossible to know
If someone evidently had
the helm, General Haig saluted. If not, rather than let drift and uncertainty
give any comfort to America's enemies, he had acquired the habit of seizing the
wheel himself.
Read
the entire obituary . . .
On This Date in History - March 9
On this date in
1401, Amerigo Vespucci, the man after whom America is named, was born in
Florence, Italy. No one understands why America was given the
Christian name of the navigator and mapmaker who placed the continent on a
navigational chart. It is hard to imagine the United States of Vespucci.
On this date in
1790, Benjamin Franklin wrote his creed to the Reverend Ezra Stiles who had
asked about Dr. Franklin's religious beliefs. "I believe
in one God," wrote Franklin, "Creator of the Universe. That he
governs it by his Providence. That he ought to be worshipped. That the most
acceptable Service we render to him is doing good to his other children."
After Leonard and
Thelma Spinrad
We must 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.