MEDICAL TUESDAY . NET

NEWSLETTER

Community For Better Health Care

Vol VI, No 3, May 8, 2007

 

In This Issue:


1.      Featured Article: World Health Care Congress - 2007

2.      In the News: UnitedHealth and the Ghost of Dr. McGuire

3.      International Medicine: Singapore -– Asia's Leading Medical Hub

4.      Medicare: Medicare Trustees Report To Force Reform Debate

5.      Medical Gluttony: Patient Excessive Demands Must Be Handled with Sensitivity

6.      Medical Myths: Most European Countries Have Single-Payer Health Care

7.      Overheard in the Medical Staff Lounge: Is Dr Bill Going to Get His Comeuppance?

8.      Voices of Medicine: From Sonoma Medicine: Medical Arts: Capturing Beauty

9.      The Physician Patient Bookshelf: Creating Value-Based Competition on Results

10.  Hippocrates & His Kin: Gang Members Need Plenty of Lead Time

11.  Related Organizations: Restoring Accountability in HealthCare, Government and Society

* * * * *

The Annual World Health Care Congress, co-sponsored by The Wall Street Journal, is the most prestigious meeting of chief and senior executives from all sectors of health care. Renowned authorities and practitioners assemble to present recent results and to develop innovative strategies that foster the creation of a cost-effective and accountable U.S. health-care system. The extraordinary conference agenda includes compelling keynote panel discussions, authoritative industry speakers, international best practices, and recently released case-study data. The 3rd annual conference was held April 17-19, 2006, in Washington, D.C. One of the regular attendees told me that the first Congress was approximately 90 percent pro-government medicine. Last year it was 50 percent, indicating open forums such as these are critically important. The 4th Annual World Health Congress was held April 22-24, 2007 in Washington, D.C. This year, many of the world leaders in health care concluded that top down reforming of health care, whether by government or insurance carrier, does not and will not work. We have to get the physicians out of the trenches because reform will require physician and patient involvement. The World Health Care Congress - Asia will be held in Singapore on May 21-23, 2008. The World Health Care Congress - Middle East will be held in Dubai, United Arab Emirates, on November 12-14, 2007. The 4th Annual World Health Care Congress - Europe 2008 will meet in Barcelona on March 3-5, 2008. The 5th Annual World Health Care Congress will be held April 21-23, 2008 in Washington, D.C. For more information, visit www.worldcongress.com. For an overview of this year's Congress, proceed below.

* * * * *


1.      Featured Article: World Health Care Congress -– 2007

Keynote: The World's Top 10 Diseases: Tadataka Yamada, MD, MACP, President of the Bill and Melinda Gates Foundation, addressed the issues facing global health. 

In Dr. Yamada's view, the biggest global health problem is inequality, evidenced by 10 million children per year dying in developing countries.

Many diseases in the developing world can be prevented or easily treated through low-tech approaches. 

Needed are more money ($25-$70 billion per year), people (1 million health workers), and political will. Also, governments in developing countries need to spend more on health care, and individuals need to be more involved in their own health care in developing countries (and the U.S.). 

There is a big opportunity for the private sector in developing marketing, in providing and financing health care, and in making products for these markets. 

The Gates Foundation is pursing public/private partnerships that de-risk private sector undertakings. They try to catalyze investments from others, especially governments.

Specific activities focus on infectious diseases, maternal and reproductive issues, and nutrition.


Consumer-Driven Health Care (CDHC): How Is It Working? by John C. Goodman

Presentation to World Health Care Congress: Do CDHC Patients Skimp on Care?

In Destiny Health:  Immunizations are 12% Higher and Well-Baby Visits 40% higher.

In UnitedHealth Group: Preventive care is up five percent (in each of the three years) compared to non-CDHC members.

In Aetna: First-year HSA members had cervical cancer screenings at a 13.8 percent higher rate than PPO members. Use of asthma inhalers was six percent higher than in PPO members.

Does CDHC Modify Behavior?

UnitedHealth Group: Healthy CDHC members have 22 percent fewer hospital admissions and 14 percent fewer emergency room visits; Chronically ill CDHC members have eight percent fewer hospital admissions and 12 percent fewer emergency room visits than non-CDHC members. CDHC members had the same level of physician visits as PPO enrollees.


Keynote: Competition: Professor Michael Porter presented his thinking on a new model for transforming health care. Aetna CEO Ronald Williams and Kaiser CEO George Halverson then shared their reactions.

The current nature of competition in health care is bad, zero-sum competition. The right type of competition will increase the value of health care delivered. Fundamental change is needed in the delivery of care. Needed is integrated, coordinated care for "conditions" (such as diabetes) over the entire cycle of care. Measuring outcome results will be the most important driver of systemic transformation. "The type of competition that must take place is competition based on value."

Mr. Williams and Mr. Halverson both agree with Professor Porter's long-term, big-picture vision. Mr. Williams sees the challenge as one of bringing about the change. 

Mr. Halverson sees two models: 1) For acute care (25% of costs) with a data-rich infrastructure so consumers can make more informed decisions; and 2) For chronic care (75% of costs) requiring a coordinated team approach. 

IT will play a critical role in the transformation, linking providers and aggregating data for decision-making. 

There was agreement on the need to deal with the uninsured population.


Health Care Reform Needs to Focus on Health Care Reform, By George C. Halvorson, Chairman and CEO, Kaiser Foundation Health Plans and Hospitals

The current debate on health care reform tends to ignore actual health care reform.

The overwhelming focus of the current debate is on health care financing - not health care reform.

Health Care costs are simply off the American health policy radar screen - even though:

                        1) That's where the expenses are!

                        2) That's where the opportunities are!

 

Look at the numbers:  Who is spending health care dollars?

75% of American health care costs involve people with chronic disease

Five chronic diseases drive over 2/3 of those expenses. That's where we spend the money.

We do a really lousy job of taking care of people with these five conditions:

Diabetes

Asthma

Congestive Heart Failure

Coronary Artery Disease

Depression

How well do we do in these diseases? We deliver right care barely half the time (Rand Study)

Diabetes

32% of all money spent by Medicare

Number one cause of kidney failure, amputations, blindness and fatal co-morbidity with heart disease

Fastest growing disease in America

How often do we deliver total right care for diabetics? 8% of the time (Minnesota Research)

8% is not good enough - 8% creates an incredible opportunity

We need to move the 8% to 80%.

Potential Opportunity:

50% drop in kidney failures

50% drop in complication rates

Much lower costs

Add in appropriate behavior changes:

50% drop in number of people becoming diabetic

We know what needs to be done - we need to do it.

We need more consistent and dependable care for people with diabetes.

To read more, please go to www.medicaltuesday.net/index.asp.

Similar opportunities exist for:

Asthma, Congestive Heart Failure, Coronary Artery Disease and Depression

Inconsistent Care

Unlinked care

Unmeasured care

Sometimes dangerous care

Date free care

We need a health care reform agenda with FOCUS on the high opportunity diseases

Acute conditions are not driving the big expense levels:

Cancer Care 5%

Maternity Care 4%

Chronic Care 75%

Health Care Reform Agenda:

            I) Focus

            II) Tools

So Let's Focus; Let's put the tools in place that are needed to transform care.

What tools do we need?

We need data

We need to know which patients have asthma and whether they are receiving appropriate care

We need linkages between our caregivers

Care Linkage Deficiencies Abound Today (They should be unacceptable.)

So how can we get the needed tools in place?

Paper Medical Records Can Not Do The Job

Paper Records are:

1)   Incomplete

2)   Unavailable

3)   Illegible

4)   Not interactive

5)   Completely inadequate for the task at hand

 

Gold Standard for Electronic Information: Electronic Medical Record (EMR)

Full Information to the caregiver at the point of care -– complete, interactive, real-time information and follow-up support for patients and doctors.

Second Best Data Source

Personal Health Record

Claims payment based

Diagnosis, procedures, caregivers, prescriptions, lab test history, sequence of events

Electronically available ASAP

 

Health care reform should focus on reforming health care

Three primary components of real Health Care Reform:

Focus

Tools

Health

We need a national culture of health:

No trans-fats

Few saturated fats

Walk 5 days a week

(simple, high-leverage action steps)

We also need universal coverage –- both to save lives, and create social equity

Most people equate universal coverage with the Canadian single-payer system

But, most European countries with universal coverage use a mixture of private plans and government programs.

So, what is the potential impact of a single-payer system like Canada?

People usually cite the difference in administrative expense between the U.S. & Canada as the most important number to understand.

Is administrative cost, the primary reason why Canadian health care costs are less than U.S. health care costs?

Canadian care costs make the difference between the U.S. and Canada.

The health care reform efforts that have worked in the U.S. have focused on the costs of care.

We need to refocus our overall efforts on reforming actual care.

Health Care Reform Should Reform Health Care

www.kphealthysolutions.com/chronicConditions.do


Avivia Health from Kaiser Permanente

Healthy Solutions is your best health management solution. Our evidence-based, scientifically rigorous program reduces health care costs, and helps keep employees more productive, happier and healthier.

Studies show that about 20% of employees are responsible for more than 70% of health care spending. Containing the high cost of care is a national priority and a top priority of businesses everywhere. Healthy Solutions helps control costs by educating members to get maximum value from their physician visits, make informed decisions about medical care, and avoid the need for intensive medical interventions by better managing chronic health conditions.

www.kphealthysolutions.com/index.do


Healthy Heart

Robert Pearl, MD, Executive Director and CEO, The Permanente Medical Group and Mary Ann Thode, President, Northern California Region, Kaiser Foundation Health Plan and Hospitals are pleased to announce that for the first time ever we are making our nationally recognized methods and tools for prevent and managing heart disease available to all Californians.

The new program called Healthy Heart provides tools and guidelines to help assess the risk of cardiovascular disease, mange those risks, and ultimately reduce a patient's risks that can lead to death. Kaiser Permanente's "open source" approach to the general public and community caregivers will include:

1. Clinical guidelines and education that we are making accessible to physicians and other clinicians across the state.

2. Grants and consulting to community clinics and public hospitals

3.  A new Healthy Heart website for the general public on how to prevent and manage the risks of heart disease.

Nationally, cardiovascular disease is the number one killer in America. However, at Kaiser Permanente, our members have a 30 percent lower risk of dying from heart disease than non-members in California. We are very proud of this achievement, and by extending our expertise, tools and approaches, we hope to save tens of thousands of lives over the next decade.

Our Healthy Heart initiative is consistent with our mission to improve not only the health of our members, but to improve the health of the communities around us. 

Access only inside KP at this time: http://kpnet.kp.org/ncal/portal/.                                                          

* * * * *

2.      In the News: UnitedHealth and the Ghost of Dr. McGuire

Bill McGuire was a superstar who built a great company. Then came the options scandal. Now the new CEO has to clean up the mess he left behind. By Peter Elkind, Fortune editor-at-large, April 17 2007 http://money.cnn.com/magazines/fortune

[When physicians become primarily businessmen, they act like any other businessman - —maybe worse. Even if you're a non-Minnesota Lutheran, you wouldn't recognize Dr. Bill as a member of your Family of Faith. With a $2 Billion scandal from sick people's money, he still wants his $90 million retirement package? That seems to tell it all!]

(Fortune Magazine) -- No. 21) Inside the ten-story headquarters of UnitedHealth Group, on an immaculate 25-acre campus in a tranquil Minneapolis suburb, a new CEO, and his company, are trying to sluice away the stink of scandal.

For 15 years UnitedHealth (Charts), now the nation's largest health insurer, was the domain of Dr. William Wayne McGuire, a 6-foot-6, 260-pound titan of the health-care industry. During his reign the company grew from a $600 million HMO operator to a $70 billion colossus, generating an eye-popping average annual return of nearly 30% for investors - better than General Electric under Jack Welch. To read more, please go to www.medicaltuesday.net/news.asp. 

But now McGuire is gone, bounced by a board that made him a billionaire, after revelations that transformed the celebrated executive into the public face of the stock options scandal. McGuire has been replaced by his unassuming, handpicked deputy, Stephen Hemsley, a 54-year-old former CPA and operations wizard who is busily trying to restore the company's battered image and set a new tone of corporate responsibility and frugality. . .

. . . by the end of 2005, McGuire's total take for his career as CEO had a staggering paper value of $2 billion. Hemsley's new contract gives him zero options - and the board's grants, which made virtually every director millions, have been cut in half.

More ugliness lies ahead: criminal and SEC investigations, shareholder lawsuits, and the prospect of a nasty fight with the departed CEO, in which the company may seek to recover hundreds of millions while McGuire fights to secure a $90 million retirement package. Although UnitedHealth remains extremely profitable, Hemsley also faces the challenge of maintaining its stature as a highflying growth company, now that its visionary leader has plummeted to earth. (McGuire and Hemsley declined to be interviewed for this story.)

It's all part of the painful process of changing an intensely personal corporate culture - one that fueled the company's ascent but ended in flames. "A great CEO becomes dangerous over time," says Goldman Sachs health-care analyst Matthew Borsch. "If you are incredibly successful as CEO, you have tremendous power within the company, over the board, and everybody's telling you that you're invincible. And then you become the risk to the extent that your own arrogance becomes the problem."

‘'Rocket ship'

Among those who have followed the rise of UnitedHealth, McGuire's stewardship is widely regarded as a work of genius. "In my 30 years of being a health-care analyst, I've never seen one executive add more value to one company than Bill McGuire," says Ken Abramowitz, managing general partner of NGN Capital, a health-care venture capital fund. "I covered 50 companies in the industry, and this was the biggest rocket ship of them all."

McGuire took over as CEO of UnitedHealth in 1991, at the age of 42, only six years after leaving private medical practice to jump into the embryonic managed-care game. Trained as a pulmonologist, McGuire is a cerebral, ambitious man, a collector of butterflies, wine, art, and antiques. He rapidly proved himself that rarest of commodities: a physician with a gift for business.

McGuire built UnitedHealth largely through a string of acquisitions, first adding share in local markets, then doing bigger deals to establish a national footprint. He adroitly moved the company in and out of businesses, displaying a knack for jumping ahead of industry trends. As one former McGuire deputy puts it, "He saw around the corner before you got to the corner."

He had an eye for talent too, recruiting gifted executives from outside the health-care business, including a former CEO of Northwest Airlines. In 1997, when the company was starting to choke on its own growth, McGuire hired Hemsley, a 23-year veteran of Arthur Andersen (he'd once served as the firm's CFO), to make it all run smoothly. By 1999, Hemsley was president and COO - Mr. Inside to McGuire's Mr. Outside. . .

Conscious of his industry's reputation for avarice, McGuire wrapped UnitedHealth in the mission of transforming the American health-care system. "He basically wanted us to change the way medicine was practiced for the better, and do it with our power and influence," says Dr. Lee Newcomer, the company's former chief medical officer. UnitedHealth won praise for giving patients open access to medical specialists and focusing on managing medical problems instead of denying coverage. "When we improve health, we make money," McGuire declared. "When we improve health more, we make more money."

http://money.cnn.com/magazines/fortune/fortune_archive/2007/04/30/8405485/index.htm?postversion=2007041714

* * * * *

3.      International Medicine: Singapore - World-Class HealthCare - Asia's Leading Medical Hub

[Singapore Medicine (www.singaporemedicine.com) had one of the larger booths at the 4th Annual World Health Care Congress last month. Their health care system is attracting traveling patients from all over the world, especially from the United States, Canada and Europe. The first issue of the International Medical Travel Journal had just been released. There are a number of world-class medical centers developing in Bangkok (www.bangkokhospital.com/english/default.asp), Dubai (www.dhcc.ae), and in Antigua (www.zhcenter.org/custom.asp?id=188800&page=3 (www.zhcenter.org/custom.asp?id=188800&page=3)). You may visit these premier international medical centers by attending the World Health Care Congress as it meets in Singapore and Dubai during the course of the next year.]

Singapore made world headlines when a team of doctors and medical professionals successfully separated Nepalese twins, Ganga and Jamuna, who were joined at the head, in an unprecedented operation that lasted more than 90 hours in April 2001. This is one of many breakthroughs in healthcare that have placed Singapore on the world medical map.

As a leading healthcare services hub in the region, more than 400,000 (doubling yearly) international patients come to Singapore each year for a whole range of medical care. Some come for health screening, others for eye, heart and brain surgeries. Yet others come for cancer treatment. Whether their needs are basic or complex, patients find assurance in a world-class healthcare system that emphasizes safety and pushes the boundaries of excellence. To read more, please go to
www.medicaltuesday.net/intlnews.asp.

SINGAPORE is in a good position to lure American medical travellers, the author of a new guide aimed at this market said yesterday.

Mr Josef Woodman, author and publisher of Patients Beyond Borders, said Singapore's strengths lie in its quality of health care and an "immediate cultural familiarity" with the widespread use of English here.

Singapore has 11 hospitals that have been audited and certified by the Joint Commission International (JCI), the overseas arm of the United States' largest hospital accreditation agency.

That means it has the biggest number of JCI-accredited institutions worldwide outside of the US. In contrast, India has five, while Thailand has two.

Mr Woodman said: "That is huge. Americans trust American credentials." Yet Singapore is less known than India and Thailand in the US as a destination for medical travel.

Dr Jason Yap, director of the Singapore Tourism Board's health-care services, said: "A lot of the coverage in the American media has focused on India and Thailand, so this book may help present Singapore as a third option that compares very well to them."

To read more, go to www.singaporemedicine.com/.

* * * * *

4.      Medicare:  Medicare Trustees Report To Force Reform Debate

Cash Flow Crunch to Compel Rethinking the Program, Says NCPA

(WASHINGTON, D.C.) April 23, 2007 -– Deteriorating Medicare finances will force the federal government to consider reforming the nation's health care program for seniors, based on the just released annual report of the Social Security and Medicare Trustees.  

According to the report, Medicare is promising more in benefits than the program has the ability to fund without an influx of outside revenues.  The estimated unfunded liability of Medicare is $34.2 trillion over the next 75 years, and $74.6 trillion looking indefinitely into the future (see attached charts). The Medicare prescription drug program (Medicare Part D) alone has an estimated unfunded liability of $8.4 trillion over the next 75 years -– nearly double that of Social Security. To read more, please go to www.medicaltuesday.net/medicare.asp.

Today's report triggers a provision of the 2003 Medicare Modernization Act that requires the President to submit legislation that Congress must consider in an expedited manner. 

"Medicare and Social Security need to be reformed," said Public Trustee Thomas R. Saving, director of the Texas A&M University Private Enterprise Research Center and senior fellow of the NCPA.  

According to the report, the deficits in Social Security and Medicare, will cause a steadily increasing drain on other federal revenues.  Until recently, the two programs took in more revenue than they paid out in benefits.  However:

·         By 2010, Social Security and Medicare will require almost 1 in 12 federal income tax dollars.

·         By 2020, spending on these two programs will require more than 1 in 4.

·         By 2030, about the midpoint of the baby boomer retirement years, Social Security and Medicare spending will require almost 1 in every 2 income tax dollars.

·         By 2050, they will require nearly 3 in every 4.

· 

"Medicare and Social Security need to be reformed," said Public Trustee Thomas R. Saving, director of the Texas A&M University Private Enterprise Research Center and senior fellow of the NCPA.  

According to the report, the deficits in Social Security and Medicare, will cause a steadily increasing drain on other federal revenues.  Until recently, the two programs took in more revenue than they paid out in benefits.  However:

By 2010, Social Security and Medicare will require almost 1 in 12 federal income tax dollars. 

•By 2020, spending on these two programs will require more than 1 in 4

•By 2030, about the midpoint of the baby boomer retirement years, Social Security and Medicare spending will require almost 1 in every 2 income tax dollars. 

•By 2050, they will require nearly 3 in every 4

•Eventually, the deficits in these two programs will absorb the entire federal budget.

Eventually, the deficits in these two programs will absorb the entire federal budget.

 "This means that if we are to keep our promises to seniors, now and into the future, the federal government will have to stop doing just about everything else," said Saving.  "Alternatively, we will have to either raise taxes or significantly cut benefits. Either option will be very painful."

The NCPA is an internationally known nonprofit, nonpartisan research institute with offices in Dallas and Washington, D. C. that advocates private solutions to public policy problems.  We depend on the contributions of individuals, corporations and foundations that share our mission. The NCPA accepts no government grants.

To read the entire report, please go to www.ncpa.org/prs/rel/2007/20070423.html.


TRIGGERING A MEDICARE DEBATE By Matt Moore, THE WASHINGTON TIMES

Last week, the U.S. Treasury department published the annual reports for Social Security and Medicare. The new volumes -- all 460 pages, five pounds worth -- met a so-what, ho-hum reception by both the national media and congressional leaders.

 

    Not much changed since last year; what's the big deal, right?

 

    Social Security and Medicare are hurtling toward a cliff like lemmings... ho hum... $70 trillion in unfunded promises... yadda yadda, whatever... disaster, death, destruction. We've heard it all before.

 

    But this time, just maybe, it will turn out different. This time the president and Congress have to do something about it. To read this entire report, please go to http://www.washingtontimes.com/functions/print.php?StoryID=20070501-093736-3020r.

    Matt Moore is a senior policy analyst with the National Center for Policy Analysis.

 

Government is not the solution to our problems, government is the problem.

- Ronald Reagan

 * * * * *

5.      Medical Gluttony: Patient Excessive Demands Must Be Handled with Sensitivity

Rosie was a smoker for more than 20 years and had a pneumonia scar that was being followed with yearly chest x-rays. When it appeared to be enlarging, a thoracic surgeon removed the lesion, which was malignant. This carcinoma of her lung occurred at the relatively young age of 37. We obtained follow-up chest x-rays every three months for two years and then suggested they be obtained every six months for another three years, until we were assured of a five-year cure.

Rosie came unglued at waiting six months and presented herself in three months; we obliged her with a CXR. We again re-iterated that every six months would be more than adequate precaution but she returned every three months fearing that the cancer may have recurred. To read more, please go to www.medicaltuesday.net/gluttony.asp.

Her therapist could not allay her anxieties and so we thought the most cost-effective process would be to continue to oblige her. After the five-year cure, we suggested CXRs once every year. She said she would go to pieces waiting that long but didn't show up until six months had passed. She continued this pattern for several years.

When she was in last month, 15 years after the initial cancer, it was noted that she actually missed her appointment last year. Now, after 15 years, she's certain the cancer won't recur. Allaying her anxieties with about twice as many chest x-rays as necessary was indeed cost-effective.  Had we not done this, she would have sought out her primary physician or other practitioners who would have ordered the x-rays. The cost of psychiatric care would also have exceeded the cost she incurred. She was not educated or self-reflective. She was not really a candidate for psychotherapy. The radiation was infinitesimal since a chest x-ray only gives 0.6 Rroentgen when our cancer patients may receive 6,000 rRoentgens.

Sometimes excessive costs can be cost-effective.

* * * * *

6.      Medical Myths: Most European Countries Have Single-Payer Health Care

George C. Halvorson, Chairman and CEO, Kaiser Foundation Health Plans and Hospitals

pointed out at the World Health Care Congress that most people equate universal coverage with the Canadian single-payer system. But, most European countries with universal coverage use a mixture of private plans and government programs. To read more, please go to www.medicaltuesday.net/myths.asp.

Medical Fact: Most countries that have tried single-payer health care have or are evolving into a mix that includes private health plans. It would be important for the United States not to give up what Europeans and others are striving towards.

* * * * *

7.      Overheard in the Medical Staff Lounge: Is Dr Bill Going to Get His Comeuppance?

Dr. Yancy: I'm sure glad that Dr. Bill McGuire from UnitedHealth is finally being prosecuted. He made off with two billion dollars of our money.

Dr. Dave: Wouldn't it be more accurate to say that he made off with $2 billion of our patient's money and diverted it to his shareholders?

Dr. Yancy: Don't forget that a large part of our professional fees were also diverted to himself and his shareholders. To read more, please go to www.medicaltuesday.net/lounge.asp.

Dr. Michelle: I've always enjoyed the complementary copy of Clinical Evidence that Bill McGuire sent out twice a year. That must have been a rather significant expense to send a 550 page concise summary of clinical medicine to 500,000 physicians in the USA, which was being expanded to the physicians on a more global basis.

Dr. Yancy: That was just part of his own self-aggrandizement effort at patients' and doctors' expense from the 40 percent reduction in our fees.

Dr. Michelle: Maybe you're right. His name is on this book in which he wrote nothing, touting it as the international source of the best available evidence for effective health care.

Dr. Sam: I hope they take him to the cleaners and make him pay every cent of that $2 billion back.

Dr. Yancy: I hope he loses all of his assets and goes so far in the hole he will never be able to make his mortgage payments, lose his house and have to move into a rental.

Dr. Dave: Wouldn't it really be justice if they made him so poor that he would have to apply for Medicaid for his health insurance?

Dr.  Yancy: Bill McGuire on welfare? Don't hold your breath.

Dr. Sam: But I can still smile just thinking about the whole idea.

Dr. Dave: The government has too much at stake to let the biggest proponent of managed care go down the drain. They've been pushing for this for decades. No court could take this kind of risk.

* * * * *

8.      Voices of Medicine: A Review of Local and Regional Medical Journals

From Sonoma Medicine: Medical Arts: Capturing Beauty, By Sandra Rubin, MD

I recently met a lawyer at a figure-drawing "marathon" who talked about balancing her analytical left-brain activity with her drawing. The need for that kind of balance is an important aspect of my art, too. I believe there are deep spiritual aspects to both medicine and art that complement, enhance, and enrich each other.

As a doctor, I have witnessed and participated in profound moments in people's lives. These experiences deepen my sense of humanity and somehow pass through me into my art. And my art - the silent moments of appreciating beauty in color and form and the challenge of transforming paint, charcoal, or pastel to capture that beauty - somehow enriches my relationships with patients. What could otherwise be routine or mundane is never boring. To read more, please go to www.medicaltuesday.net/voicesofmedicine.asp.

I have been drawing and painting for as long as I can remember. During my first year of medical school, I simultaneously studied anatomy with a cadaver and drew the nude figure. I had truly begun to appreciate the human form.

As a child, I was told that art could be my hobby and that I should find some other way to make my living. I do appreciate being able to support myself as a doctor, and to afford the time and supplies needed to create art. Although I have sold some paintings, I am glad I don't depend on that financially. The practice of medicine has allowed me to pursue art as a passion, not as a business.

I have studied art at community colleges and community art centers. Here in Sonoma County I have had really wonderful teachers at Santa Rosa Junior College, including Lisa Beernsten, Alan Azhderian, and Maury Lapp. . .

For people who want to get started with painting or drawing, I recommend taking a class as a way to commit to making the necessary time.  .  .

I have begun to "put my work out there," another step in validating myself as an artist and looking for other people's responses. I have shown at the Kaiser Diversity Art Show and at the Sebastopol Center for the Arts. I have also donated paintings for fundraisers at Face to Face, the Roseland Children's Health Center, and the Sonoma County Jewish Community Agency. I have participated in Art at the Source for the past several years, and I have a show planned at Plaza Arts in Healdsburg in March.

To view her paintings and drawings, go to www.scma.org/magazine/scp/wn07/rubin.html.

* * * * *

9.      Book Review: Redefining Health Care -– Creating Value-Based Competition on Results  by Michael E. Porter & Elizabeth Olmsted Teisberg, Harvard Business School Press, Boston,© 2006.

Dr. Porter presented one of the most thoughtful and insightful Keynote Addresses at the World Health Care Congress last month. Shortly after his presentation, the numerous available copies sold out.

Since 2001, Professor Porter has devoted considerable attention to a fourth body of work on competition in the health care system, in both the United States and other countries. His Harvard Business Review article with Elizabeth Teisberg, ‘'Redefining Competition in Health Care' (2004), stimulated a dialog in many countries. His joint book with Professor Teisberg, Redefining Health Care: Creating Value-Based Competition on Results (Harvard Business School Press), was published on May 25, 2006. Professor Porter is currently playing an active role in catalyzing health care reform in the United States and other countries, including Holland, German, and the United Kingdom.

Porter alleges that health care in the United States and other nations is on a collision course with patient needs and economic reality. In today's dysfunctional competition, players strive not to create value for patients but to capture more revenue, shift costs, and restrict services. Competition takes place at the wrong levels and on the wrong things-between broad line institutions, in the provision of discrete services, and in local markets. Instead of rewarding good provider results with more patients, administrators make costly and ineffective attempts to micromanage care processes and second-guess provider decisions. To read more, please go to www.medicaltuesday.net/bookreviews.asp.

To reform health care, we must reform the nature of competition itself. Redefining Health Care describes how all participants-providers, health plans, employers, suppliers, consumers, and governments can redefine their strategies, operating practices, and organizational structures to unleash stunning improvements in the health value delivered.

Porter and Teisberg shed new insights on:

Why decades of reform have only worsened the problem. How physicians and provider organizations have misunderstood their true business. Why current "solutions"- consumer-driven health care, integrated health systems, pay-for-performance, electronic medical records, single-payer systems - will not suffice. Why mandatory measurement and reporting of patient results are the single most important steps in reforming the system. Why higher-quality care should cost less. How mandatory health insurance for all, with subsidies for low-income citizens, will actually make the system more efficient.

Porter goes on to explain why rising costs, mounting quality problems, and increasing numbers of citizens without health insurance are unacceptable - —and unsustainable.

We will plan to spend more time on this rather large volume in the ensuing weeks and complete a more extensive review of this signal work. To access Professor Porter's Institute for Strategy and Competitiveness site, please go to www.isc.hbs.edu/. To access another of his lectures, click on Singapore Competitiveness: A Nation in Transition.

* * * * *

10.  Hippocrates & His Kin: In God We Trust. All Others Have to Bring Their Research Data.

To combat violent gangs, West Sacramento police fought back with a legal injunction against gang members. It called for curfews and barred unnamed gang members from gathering within a three-mile swath. The ACLU challenged and the California's 3rd District Court of Appeal struck down the injunction last week saying it violated the due process rights of gang members. A three-judge panel said that the police did not give members of the gang enough advance notice. Marco Breton in Sacramento BEE replied: Yeah, sure. Gang members need plenty of lead time. Just imagine their packed schedules: Monday - —carjacking. Tuesday - —homicide. Wednesday - —illegal drug sales. They're busy people. www.sacbee.com/101/story/163061.html

Couldn't we send the gangs to some camp where they would learn how to do suicide on Thursday?

To read more vignettes, please go to www.medicaltuesday.net/hhk.asp.


Between the Office Visits: The office visit has been the best deal in medicine--but that was when it lasted 15 minutes. Reduction to 10 minutes was a bit tight. Now, Chicago University Professor Richard Epstein states he heard a rumor that managed care office visits in California were down to 5 minutes--about 300 seconds. He suggested perhaps that was not enough time to generate empathy and trust, but should be long enough to look into a pair of ears or to check for a sore throat. Physicians are paid for the time they spend with a patient; their technical training is the expensive input. Epstein holds that their psychological insight can be duplicated by others whose hourly rate is far less. To read more HHK, please go to www.healthcarecom.net/hhk1998.htm.

* * * * *

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. To view the current "counting on a crises" be sure to go to www.ncpa.org/sub/dpd/index.php?Article_ID=14503.

•                      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 subscribe at www.pacificresearch.org/pub/hpp/index.html or access their health page at www.pacificresearch.org/centers/hcs/index.html. Just released: Questionable Cure for a Questionable Crises – The Massachusetts Health Care.

•                      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. Be sure to read the 8th Annual Performance Report Scorecard.

•                      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. www.nahu.org/publications/hiu/index.htm. 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. Be sure to review the current articles listed on their table of contents at hiu.nahu.org/paper.asp?paper=1. To see my column, go to http://hiu.nahu.org/article.asp?article=1328&paper=0&cat=137.

•                      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 new 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. Also, be sure to read that the Medicare debt is 5 times our national debt?

•                       

 

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. To view the current "counting on a crises" be sure to go to www.ncpa.org/sub/dpd/index.php?Article_ID=14503.

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 subscribe at www.pacificresearch.org/pub/hpp/index.html or access their health page at www.pacificresearch.org/centers/hcs/index.html. Just released: Questionable Cure for a Questionable Crises – The Massachusetts Health Care.

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. Be sure to read the 8th Annual Performance Report Scorecard.

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. www.nahu.org/publications/hiu/index.htm. 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. Be sure to review the current articles listed on their table of contents at hiu.nahu.org/paper.asp?paper=1. To see my column, go to http://hiu.nahu.org/article.asp?article=1328&paper=0&cat=137.

•                      To read the rest of this column, please go to www.medicaltuesday.net/org.asp.

•                      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 new 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. Also, be sure to read that the Medicare debt is 5 times our national debt?

•                      Greg Scandlen, an expert in Health Savings Accounts (HSAs) has embarked on a new mission: Consumers for Health Care Choices (CHCC). To read the initial series of his newsletter, Consumers Power Reports, go to www.chcchoices.org/publications.html. To join, go to www.chcchoices.org/join.html. 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 at www.chcchoices.org/publications/cpr9.pdf.

•                      The Heartland Institute, www.heartland.org, publishes the Health Care News. Read the late Conrad F Meier on What is Free-Market Health Care?. You may sign up for their health care email newsletter at www.heartland.org/Article.cfm?artId=10478.

•                      The Foundation for Economic Education, www.fee.org, has been publishing The Freeman - Ideas On Liberty, Freedom's Magazine, for over 50 years, with Richard M Ebeling, PhD, President, and Sheldon Richman as editor. Having bound copies of this running treatise on free-market economics for over 40 years, I still take pleasure in the relevant articles by Leonard Read and others who have devoted their lives to the cause of liberty. I have a patient who has read this journal since it was a mimeographed newsletter fifty years ago. This month, be sure to read The Myth of Health Insurance.

•                      The Council for Affordable Health Insurance, www.cahi.org/index.asp, founded by Greg Scandlen in 1991, where he served as CEO for five years, is an association of insurance companies, actuarial firms, legislative consultants, physicians and insurance agents. Their mission is to develop and promote free-market solutions to America's health-care challenges by enabling a robust and competitive health insurance market that will achieve and maintain access to affordable, high-quality health care for all Americans. "The belief that more medical care means better medical care is deeply entrenched . . . Our study suggests that perhaps a third of medical spending is now devoted to services that don't appear to improve health or the quality of care–and may even make things worse." The Council for Affordable Health Insurance has released a new Issues & Answers explaining that universal health care proposals can make it more difficult to access care.  

•                      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 at www.i2i.org/healthcarecenter.aspx. Read her latest newsletter at www.i2i.org/main/page.php?page_id=9. 

•                      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 Jasmin Guιnette's editorial on SMOKING IS HEALTHIER THAN FACISM.

•                      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 at www.fraserinstitute.ca/health/index.asp?snav=he. This month, be sure to read The Misguided War Against Medicines.

•                      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. This month, read an important essay on World Wide Freedom.

•                      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. This month be sure to read Can the State Reduce Poverty at  www.mises.org/story/2526. You may also log on to 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 www.lewrockwell.com/rockwell/sickness.html; or to find out why anyone would want to be an MD today, see www.lewrockwell.com/klassen/klassen46.html.

•                      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 at www.cato.org/people/cannon.html. This month, be sure to read about "Why we're living longer, healthier, more comfortable lives on a cleaner planet."

•                      The Ethan Allen Institute, www.ethanallen.org/index2.html, is one of some 41 similar but independent state organizations associated with the State Policy Network (SPN). The mission is to put into practice the fundamentals of a free society: individual liberty, private property, competitive free enterprise, limited and frugal government, strong local communities, personal responsibility, and expanded opportunity for human endeavor.

•                      The Free State Project, with a goal of Liberty in Our Lifetime, http://freestateproject.org/, is an agreement among 20,000 pro-liberty activists to move to New Hampshire, where they will exert the fullest practical effort toward the creation of a society in which the maximum role of government is the protection of life, liberty, and property. The success of the Project would likely entail reductions in taxation and regulation, reforms at all levels of government to expand individual rights and free markets, and a restoration of constitutional federalism, demonstrating the benefits of liberty to the rest of the nation and the world. [It is indeed a tragedy that the burden of government in the U.S., a freedom society for its first 150 years, is so great that people want to escape to a state solely for the purpose of reducing that oppression. We hope this gives each of us an impetus to restore freedom from government intrusion in our own state.]

•                      The St. Croix Review, a bimonthly journal of ideas, recognizes that the world is very dangerous. Conservatives are staunch defenders of the homeland. But as Russell Kirk believed, war time allows the federal government 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 war time we have to push for limited government—while giving the government the necessary tools to win the war. To read a variety of articles in this arena, please go to www.stcroixreview.com.

•                      Hillsdale College, the premier small liberal arts college in southern Michigan with about 1,200 students, was founded in 1844 with the mission of "educating for liberty." It is proud of its principled refusal to accept any federal funds, even in the form of student grants and loans, and of its historic policy of non-discrimination and equal opportunity. The price of freedom is never cheap. While schools throughout the nation are bowing to an unconstitutional federal mandate that schools must adopt a Constitution Day curriculum each September 17th or lose federal funds, Hillsdale students take a semester-long course on the Constitution restoring civics education and developing a civics textbook, a Constitution Reader. You may log on at www.hillsdale.edu to register for the annual weeklong von Mises Seminars, held every February, or their famous Shavano Institute. You may join them to explore the Roots of American Republicanism on a British Isles cruise on July 10-21, 2006. Congratulations to Hillsdale for its national rankings in the USNews College rankings. Changes in the Carnegie classifications, along with Hillsdale's continuing rise to national prominence, prompted the Foundation to move the College from the regional to the national liberal arts college classification. Read President Arnn's comments at www.hillsdale.edu/arnn/usnews.asp. Also, read his comments on Ronald Reagan, RIP, at www.hillsdale.edu/newimprimis/default.htm. Please log on and register to receive Imprimis, their national speech digest that reaches more than one million readers each month. This month, read Rev. Robert A. Sirico Socialism, Free Enterprise, and the Common Good at www.hillsdale.edu/imprimis/2007/05/. The last ten years of Imprimis are archived at www.hillsdale.edu/imprimis/archives.htm.

* * * * *

Thank you for joining the MedicalTuesday.Network and Have Your Friends Do the Same. If you receive this as an invitation, please go to www.medicaltuesday.net/Newsletter.asp, enter your email address and join the 20,000 members who receive this newsletter. If you are one of the 50,000 guests that surf our web sites, we thank you and invite you to join the email network on a regular basis by subscribing at the website above. 


Please note that sections 1-4, 8-9 are entirely attributable quotes and editorial comments are in brackets. Permission to reprint portions has been requested and may be pending with the understanding that the reader is referred back to the author's original site. Please also note: Articles that appear in MedicalTuesday may not reflect the opinion of the editorial staff.


ALSO NOTE: MedicalTuesday receives no government, foundation, or private funds. The entire cost of the website URLs, website posting, distribution, managing editor, email editor, and the research and writing is solely paid for and donated by the Founding Editor, while continuing his Pulmonary Practice, as a service to his patients, his profession, and in the public interest for his country.


Spammator Note: MedicalTuesday uses many standard medical terms considered forbidden by many spammators. We are not always able to avoid appropriate medical terminology in the abbreviated edition sent by e-newsletter. (The Web Edition is always complete.) As readers use new spammators with an increasing rejection rate, we are not always able to navigate around these palace guards. If you miss some editions of MedicalTuesday, you may want to check your spammator settings and make appropriate adjustments. To assure uninterrupted delivery, subscribe directly from the website rather than personal communication:  www.medicaltuesday.net/newsletter.asp

 

Del Meyer

 

Del Meyer, MD, Editor & Founder

DelMeyer@MedicalTuesday.net

www.MedicalTuesday.net

6620 Coyle Ave, Ste 122, Carmichael, CA 95608

Words of Wisdom

Mark Twain: Suppose your were an idiot. And suppose you were a member of Congress. But, I repeat myself.

Frederic Bastiat: Government is the great fiction, through which everybody endeavors to live at the expense of everybody else.

Peter Drucker: Price of success in the Knowledge Society. The upward mobility of the knowledge society comes at a high price: the psychological pressures and emotional traumas of the rat race. There can be winners only if there are losers. This was not true of earlier societies. Japanese youngsters suffer sleep deprivation because they spend their evenings at a crammer to help them pass their exams. Otherwise they will not get into the prestige university of their choice, and thus into a good job. Other countries, such as America, Britain, and France, are also allowing their schools to become viciously competitive. That this happened over such a short time - —no more than thirty or forty years - —indicates how much the fear of failure has already permeated the knowledge society. Given this competitive struggle, a growing number of high successful knowledge workers - —business managers, university teachers, museum directors, doctors - —"plateau" in their forties. If their work is all they have, they are in trouble.

Knowledge workers therefore need to develop some serious satisfying outside interests.


Some Recent Postings

AMERICA ALONE, The End of the World as we Know It, by Mark Steyn www.delmeyer.net/bkrev_AmericaAlone.htm

WHO REALLY CARES - America's Charity Divide Who Gives, Who Doesn't, and Why It Matters by Arthur C. Brooks  www.delmeyer.net/bkrev_WhoReallyCares.htm

AriadneCapital: The new rules of engagement are being written now by strong feminine women who are doing amazing things. Some of us will write that code. Others will merely read it. Still others will be trying to upgrade their mental software frantically to interpret the writing on the screen. This is not going to be easy. Women are demanding to make their unique contribution - each of them - in the world. And they want men who are gentlemen in their lives - who are strong enough to be happy that they have amazing women to treat well. If you'll forgive a little nepotism, read what the CEO of Ariadne says at www.ariadnecapital.com/journal/v6e2/house_of_ariadne/article_smart_money_is_on_women.htm.

HPUSA April 2007 Newsletter: www.healthplanusa.net/April07.htm

HPUSA January 2007 Newsletter: www.healthplanusa.net/January07.htm

In Memoriam

Joseph Schumpeter:  In praise of entrepreneurs, Apr 26th 2007, From The Economist

The biography of a man who believed that uproar was the music of capitalism.

MUCH honoured as an economic prophet, Joseph Schumpeter has had to wait half a century after his death for this splendid full-dress biography covering his ideas, life and times. In 1983 Forbes pronounced him a better guide to the tumultuous world economy than John Maynard Keynes. In 1986 J.K. Galbraith described him as "the most sophisticated conservative of this century". In 2000 Business Week ran an article about him to which it gave the title "America's hottest economist died fifty years ago". There are Schumpeter lectures, Schumpeter societies and Schumpeter prizes.

Now he has received yet another accolade: a fat, learned biography by Thomas McCraw, one of America's most respected business historians, the author of a Pulitzer prize-winning history of the rise of regulation. He has found the perfect subject in Schumpeter. He succeeds in getting inside the economist's head, explaining not just what he thought but why he thought it. Beyond this, he also succeeds in painting a portrait of his times. Fin de siθcle Vienna, Weimar Germany, Harvard University (where he is seen in our photograph) before and after the first world war: all come to life on these pages. . .  To read more, please scroll down at www.medicaltuesday.net/org.asp. 

By his mid-50s he had lived in nine cities and five countries. He was Austria's finance minister for a time, and witnessed the collapse of the Habsburg Empire from close quarters. He taught in Germany when it was succumbing to the Nazi temptation. He was one of the first of the great European ιmigrιs to the United States. Daniel Bell, a liberal sociologist, described him as that rarest of creatures: an economist with a tragic sense of life.

Schumpeter is best remembered today for "Capitalism, Socialism and Democracy", published in 1942. This was a firecracker of a book that challenged wartime conventional wisdom on every front: praising giant companies as the engines of progress; giving warning of the rise of a "new class" of anti-capitalist government employees; worrying that risk-aversion might lead to the triumph of socialism. To read the entire review, go to www.economist.com/books/displaystory.cfm?story_id=9070610.

On This Date in History -– May 8

Today is World Red Cross Day, observed on the anniversary of the birth of Jan Henri Dunant, founder of the Red Cross, in 1828 in Geneva, Switzerland. Dunant, the co-winner of the first Nobel Peace Prize, helped make sure that mercy became an international language.

Today is VE Day. On this date in 1945, the World War in Europe stopped. World War II began on that continent, almost six years earlier; it still continued for a while in Asia; but the greatest bulk of the conflict was over. Today, however, peace has become relative.

On this date in 1884, Harry S. Truman, President of the United States, was born in Lamar, Missouri. He became President on April 12, 1945, when Franklin D. Roosevelt had died, and the War in Europe ended on this, his 61st birthday. People have disagreed about Truman's role in history, although generally he received quite high marks. But there is no disagreement about the fact that Harry Truman was the author and the exemplar of the tersest description ever given of the Presidency of the United States: "The buck stops here."

After Leonard and Thelma Spinrad


MOVIE EXPLAINING SOCIALIZED MEDICINE TO COUNTER MICHAEL MOORE

Logan Clements, a pro-liberty filmmaker in Los Angeles, seeks funding for a movie exposing the truth about socialized medicine. Clements' strategy is to release the documentary this summer on the same day that Michael Moore's pro-socialized medicine movie "Sicko" is released. This movie can only be made in time if Clements finds 200 doctors willing to make a tax-deductible donation of $5K each by the end of March. Clements is also seeking American doctors willing to perform operations for Canadians on wait lists. Clements is the former publisher of "American Venture" magazine who made news in 2005 for a property rights project against eminent domain called the "Lost Liberty Hotel."
For more information visit www.sickandsickermovie.com or email
logan@freestarmovie.com.