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MEDICAL TUESDAY . NET |
NEWSLETTER |
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Community For Better Health Care |
Vol X, No 6,
June 28, 2011 |
In This Issue:
1.
Featured Article:
It’s Worse Than You
Think
2.
In
the News: What happened to
Doctor—Patient Confidentiality?
3.
International Medicine: Long Waits Cost
Canadians Millions
4.
Medicare: The Obama deficits portend a gloomy future.
5.
Medical Gluttony:
Non Emergency Care
in Emergency Rooms
6.
Medical Myths: Medicare Price Controls will save the government
money
7.
Overheard in the Medical Staff Lounge: Medical Practice
is Changing
8.
Voices
of Medicine: Drug Expiration
Date: Part II: A Costly Illusion
9.
The Bookshelf: A Common Sense Platform
for the 21st Century
10.
Hippocrates
& His Kin: A World Food
Crisis?
11.
Related Organizations: Restoring Accountability in Medical Practice and Society
Words of Wisdom,
Recent Postings, In Memoriam . . .
* * * * *
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.
Thus we must also remember that ObamaCare has nothing to do with
appropriate healthcare; it was similarly projected to gain loyalty by making
American citizens dependent on the government and eliminating their choice and
chance in improving their welfare or quality of healthcare. Socialists know
that once people are enslaved, freedom seems too risky to pursue.
* * * * *
1.
Featured
Article: It’s Worse Than You
Think
The Heartlander, Joseph L Bast, President
The bimonthly membership newsletter for The
Heartland Institute.
Bast: Obamanomics - It’s
Worse Than You Think
The official unemployment
rate is back up to more than 9 percent, and the percent of workers who are
unemployed or have given up trying to find jobs is higher than it was during
the Great Depression.
George W. Bush may have
owned the Great Recession of 2008–2009, but Barack Obama owns the Second Great
Depression of 2011. His policies – call them Obamanomics – are to blame.
It Started with Higher
Taxes
President Obama signed
his first major tax increase into law just 16 days into his presidency, a
62-cents-per-pack tax increase on cigarettes. It broke his campaign promise not
to increase taxes “a single cent” on households making less than $250,000 a
year.
If it weren’t for furious
public backlash during the 2010 elections, Obama would have reversed the 2001
and 2003 tax cuts, causing the top income tax rate to rise from 35 to 39.6
percent and the lowest rate to rise from 10 to 15 percent. The capital gains
tax rate would have risen from 15 to 20 percent, and the dividends tax rate
from 15 percent to 39.5 percent in 2011 and then another 3.8 points in 2013.
The marriage penalty would have returned, and the child tax credit would have
been cut in half. . .
Obama buried more than
$500 billion in tax hikes over ten years in Obamacare, including a 10 percent
tax on tanning salons, a $60 billion tax on insurance premiums, a $26.3 billion
tax on medical device manufacturers, a $27 billion tax on prescription drugs.
Starting in 2013, the 3.8 percent Medicare payroll tax will apply to investment
income, a move that is expected to raise $123 billion over seven years.
Obamacare increases the
Medicare hospital insurance payroll tax by 31 percent on income over $200,000
for singles and $250,000 for couples, expected to raise $86.8 billion over
seven years. The itemized deduction from federal income taxes for medical
expenses is reduced by raising the threshold from 7.5 percent of adjusted gross
income to 10 percent, expected to raise $15.2 billion a year.
The tax deduction for
employer-provided retirement prescription drug coverage is reduced, expected to
raise $4.5 billion. And starting in 2018, a new special tax of 40 percent will
apply to insurance policies costing more than $10,200 for individuals and
$27,500 for families.
All this comes on top of
a corporate income tax that is the highest of the 34 nations in the
Organization for Economic Cooperation and Development. (Our combined state and
federal rate is 39.2 percent, versus number two Japan at 35 percent.) Little
wonder, then, that the recession was never as deep in other countries and their
recovery has outpaced that of the U.S.
Then Came the Spending
Increases
In his first year in
office, Obama championed and signed into law a $787 billion “stimulus” act.
Average spending for federal agencies rose by more than 50 percent between 2008
and 2010.
Federal government
spending is now between 24 percent and 25 percent of GDP, up from 18 percent to
19 percent during the George W. Bush years.
The federal government
now borrows 40 cents for every dollar it spends. In February, Obama unveiled a
$3.73 trillion spending plan for 2012 with a projected deficit of $1.5
trillion. That comes on top of deficits of $1.3 trillion in 2010 and $1.4
trillion in 2009. The annual deficit, which was going down under Bush, jumped
from 1.1 percent of GDP in 2007 to 11 percent this year.
Interest on the debt
costs us $225 billion a year; the total debt stands at $14.2 trillion, 80
percent of GDP. That’s the highest since World War II.
Proposed cuts of $1
trillion or even $2 trillion over ten years sound enormous, but they shave
barely ten percent off the proposed deficits, never mind actual
spending. Just to get spending and deficits back to pre-Obama levels, spending
has to be cut by $1 trillion a year, ten times what even most
Republicans are talking about.
And Then Came Obamacare
Obama signed the Patient
Protection and Affordable Care Act ... all 3,256 pages of it ... into law on
March 23, 2010.
Most of the provisions
don’t go into effect until 2014, but some of the taxes to fund it started
immediately. By counting ten years of revenues and only six years of expenses,
the administration was able to claim it will reduce the federal debt over the
next ten years.
The Congressional Budget
Office says the act will increase federal spending by $1 trillion over the
first ten years ... but if you start the clock four years later, the cost rises
to $2.4 trillion. This is the most expensive legislation ever approved by
Congress and signed by a president. And these estimates almost certainly
under-estimate real costs.
Obamacare creates more
than 150 new bureaucracies, agencies, boards, commissions, and programs,
including an Independent Payment Advisory Board with a mandate to cut Medicare
spending by $3 trillion over the next 20 years.
Government officials are
empowered to tell physicians what quality health care is and what it is not,
and to tell insurers what health insurance they can sell, and to tell employers
and individuals what insurance they must buy. It redistributes premium income
among insurers under a new “risk adjustment” mechanism to ensure successful
companies subsidize less successful companies.
This is all right out of
“Atlas Shrugged.”
And no, you will not be
able to keep your current doctor, or your current insurance company. Chances
are, your current employer will dump you into the insurance exchange, where you
may or may not get any subsidy toward your insurance premiums, depending on
your income. If you make more than the poverty level and currently get
insurance through your employer, chances are your insurance costs will go up.
What will happen to the
quality of health care in America? We can look at Britain and Canada to see
what happens when government discourages investment, fixes prices, and rations
care. Long waiting lines for tests and surgery; millions of people suffering
chronic pain unnecessarily; thousands of people dying every year while waiting.
Some consequences of
Obamacare will be less visible but no less damaging: Less investment in care
for the most vulnerable, such as premature babies and the elderly; no more
progress in the war on cancer; no more investment in new drugs and therapies.
Where To From Here?
So ... things are pretty
bad! But as my old friend Bob Genetski used to tell me, “big problems mean big
payoffs when they are solved.” Just simplifying the tax code, for example,
could have a huge effect on economic efficiency.
The biggest battles right
now ... the ones you need to get involved in, in order for us to win, are:
·
Don’t raise the debt ceiling. Either freeze it, or make an
increase contingent on major entitlement reform. This is being debated as this
issue of The Heartlander goes to press, and it appears Republicans ...
even Paul Ryan ... are prepared to compromise too soon and too easily with this
president. . .
·
The 2012 budget must reduce actual
spending, not merely freeze discretionary spending at current levels as Obama
proposed. Ryan’s plan is a good starting point, but it could be improved to
achieve a balanced budget sooner.
·
Block implementation of Obamacare. The House voted to
defund it, but the Senate won’t follow suit. States can and should refuse to
implement insurance exchanges.
·
Take on the public-sector unions ... on collective
bargaining rights, benefits, and pensions specifically. . .
·
Vastly and rapidly expand school choice. High levels of
spending on public K-12 schools is unsustainable, and school choice is a proven
way to cut spending while improving quality. . .
·
Vastly and rapidly expand development of the nation’s
energy resources. We are the Saudi Arabia of coal and natural gas, and our oil
reserves are growing fast, too. The only thing standing between us and energy
independence is anti-energy policies. Remove them, and drill, baby, drill!
Obamanomics is very much
worse than you thought ... but it can be stopped and undone. In the process, we
can take back the country we love.
http://www.heartland.org/publications/heartlander/article/30302
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* * * * *
2.
In the News: What happened to
Doctor—Patient Confidentiality?
Your Medical Secrets Are No
Longer Safe
Friday, 17 Jun 2011 11:57 AM
Congressman Anthony Weiner announced that
he is seeking treatment for sexual “addiction.” A private person would want to
keep that mortifying information to himself. But soon it may be difficult to
keep any sensitive medical information strictly between you and the doctor you
consult. The stimulus legislation of 2009 and the Obama health law enacted the
following year established a national electronic health database that will hold
and display your lifelong medical history.
Government will oversee the network
linking doctors and hospitals. Doctors will have to enter your treatments in
the database, and your doctors’ decisions will be monitored for compliance with
guidelines imposed by the Secretary of Health and Human Services.
The stimulus legislation allocated
billions for incentive payments to doctors and hospitals to become part of the
network. In 2015, incentives get replaced with penalties on the doctors and
hospitals that have not complied.
And Sec.1311 of the Obama health law says
private health plans can pay only doctors who implement whatever the federal
government dictates to improve “quality.” That could cover everything in
medicine.
Before the Obama health law, patients who
voluntarily bought insurance shared information with their insurer. Now
government regulators will have access.
The advantage of an electronic medical
record is obvious. When you need emergency care, a doctor can access your past
illnesses, tests, and treatments with the click of a mouse. It will reduce
testing, save money, and sometimes save a life. But there are dangers.
Mark Rothstein, a bioethicist at the University of Louisville School of
Medicine, worries that the system discloses information that is no longer
relevant but could be embarrassing. Your oral surgeon extracting a tooth
doesn’t need to know about your erectile dysfunction or your bout with
depression twenty years earlier. Nevertheless, it will be visible.
Federal proposals to protect privacy have been half-hearted. On May 31, the
Department of Health and Human Services proposed allowing patients to request a
report on who has electronically viewed their information. After the fact is
too late. Patients should have to give consent before their doctor links their
record to a nationwide database.
The National Committee on Vital and Health Statistics, a federal advisory
committee, proposed permitting patients to keep categories of information, such
as mental or reproductive health, out of the national data base.
The Goldwater Institute, a free market think tank suing to overturn the Obama
health law, argues that the law violates privacy rights by compelling Americans
to share “with millions of strangers who are not physicians, confidential
private and personal medical history information they do not wish to share.”
The other issue is control of the
patient’s care. In March, 2009 President Obama appointed David Blumenthal, a
Harvard Medical School professor, to oversee the national electronic medical
system. Blumenthal explained that his job was not about “just putting machinery
into offices.” (New England Journal of Medicine, April 9. 2009) He said that if
electronic technology is designed to save money, doctors will have to bow to a
higher authority and use “clinical decision support,” medical lingo for computers
telling doctors what to do.
Blumenthal, who has since resigned to
return to academic medicine, predicted that many doctors would resist,
resigning themselves to federal penalties or trying to get the law overturned.
Federal attempts to dictate how doctors
treat patients will be challenged. In 2006, the United States Supreme Court
struck down an attempt by the Bush administration to interfere in how doctors
in Oregon treat terminally ill patients. The justices would not permit “a
radical shift of authority from the States to the Federal Government to define
general standards of medical practice in every locality.” That’s what the Obama
health law does.
Meanwhile, the federal government is
pushing ahead, and patients need to know that what occurs in their doctor’s
office no longer stays there.
Read more on Newsmax.com: Your Medical Secrets Are No Longer Safe
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* * * * *
3.
International
Medicine: Long
Waits Cost Canadians Millions
By Nadeem Esmail, The Frasier Institute
The national median waiting time in Canada from
specialist appointment to treatment increased from 8 weeks in 2009 to 9.3 weeks
in 2010. But the measurement of waiting times, or the examination of the
absolute delay Canadians must endure in order to receive medically necessary
care, is only one way of looking at the burden of waiting for health care.
We can also calculate the privately borne cost of waiting: the value of
the time that is lost while waiting for treatment, says Nadeem Esmail, the
Fraser Institute's former Director of Health System Performance Studies and
Manager of the Alberta Policy Research Center.
Esmail's estimation of the cost of waiting in 2010 uses a
Statistics Canada finding that 11 percent of people were adversely affected by
their wait for non-emergency surgery in 2005.
This results
in an estimate that nearly 1.13 million weeks were "lost" while
patients waited for treatment.
However, because this estimate is based on the assumption that all individuals
face the same wait time for treatment in each specialty/province combination,
it is mathematically equivalent to assuming that 11 percent of the productivity
of all Canadians waiting for care was lost to a combination of mental anguish
and the pain and suffering that accompany any wait for treatment.
Multiplying this lost time by an estimate of the
average weekly wage of Canadians in 2010 gives an estimate of the cost of the
productive time that was lost while individuals waited for medically necessary
treatment in 2010.
The estimated
cost of waiting for care in Canada was roughly $10,043 for each individual
among the 11 percent of patients in the queue. That works out to roughly $912
million in lost productivity and leisure time.
This estimate assumes that only those hours during the
average work week should be counted as lost. Valuing all hours of the week,
including evenings and weekends but excluding eight hours of sleep per night,
at the average hourly wage would increase the estimated cost of waiting to more
than $2.79 billion, or about $3,384 per person.
Source: Nadeem Esmail, "The Private Cost of
Public Queues," Fraser Institute, March/April 2011.
For more on Health Issues: http://www.ncpa.org/sub/dpd/index.php?Article_Category=16
www.ncpa.org/sub/dpd/index.php?Article_ID=20807
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Canadian
Medicare does not give timely access to healthcare, it only gives access to a
waiting list.
--Canadian
Supreme Court Decision 2005 SCC 35, [2005] 1 S.C.R.
791
http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html
In case you
missed it above: The average cost of being on the waiting list is $3,384 per
person.
* * * * *
4.
Medicare: The Obama deficits portend a gloomy future.
Commentary by Pete du Pont, The Wall Street Journal, February 16, 2010
Is it, as President Reagan's re-election commercial
said, "morning in America"? Back then it was, but not anymore; it is
economic evening in America as our nation's spending, government programs and
deficits balloon. The federal deficit this fiscal year will be $1.6 trillion,
or about 10.6% of gross domestic product. That is the largest deficit since
World War II, and even President Obama's optimistic estimates show our deficits
will not return to sustainable levels for at least the next decade.
The administration's projection of total federal
spending over those 10 years (2011-20) is $45.8 trillion, while expected taxes
and other receipts will be $37.3 trillion. The $8.5 trillion deficit is about
20% of spending. And all of these numbers are based on a full and lasting
economic recovery, which, based on current experience, is a pretty optimistic
projection.
Earlier this month, The
Wall Street Journal's editorial page did an analysis of the federal
government's debt that will be held by the public over the coming decade. When
the Democrats took control of Congress in 2007, the debt held by the public was
36.2% of GDP. It rose to 40.2% the next year. This year it will be about 63.6%,
next year 68.6%, then 77% of GDP in 2020. And the Obama administration's budget
estimates 218% in 2050.
The reason for these rising deficits is the huge
increases in federal spending--the intended growth of the federal
government--that Congress and the president are pushing. The deficit in 2007
was $160 billion. In the next year the Pelosi-Reid Congress took it up to $458
billion, and when President Obama came into office in 2009 it hit $1.4
trillion. The current 2010 projected deficit is $1.6 trillion, which will lead
to a tripling of our national debt from 2008 to 2020.
To the White House and congressional Democrats, these
large figures are not a surprise, a mistake or a worry. They part of a strategy
to Europeanize America, to make the government larger, broader and in charge of
almost everything. And that would of course require broad and massive tax
increases. The Washington Post's Robert Samuelson calculated that to fund all the future
deficit expenditures would require taxes to increase "by roughly 50
percent from the average 1970-2009 tax burden." A 50% tax increase would
become a permanent part of a declining America, just as such tax increases have
become a permanent part of declining European countries.
Or as Sen. Judd Gregg, top Republican on the Budget
Committee, put it the other day, this huge deficit spending "is a death
certificate to the American dream for our children. Their lives will be
mortgaged by the debt we put on their backs." Michael
Boskin, chairman of the Council of Economic
Advisers under the first President Bush, noted in The Wall Street Journal last
week that President Obama will have added more debt in his first two years in
office than George W. Bush did in eight years. In his first 15 months, Mr.
Obama will have raised the debt burden as a percentage of GDP by more than
President Reagan did in all of his eight years.
This administration wants larger, not smaller
government; broader, not lesser regulation; and greater government, not greater
individual liberties. That would make our country weaker on the international
stage, make it much more difficult for us to handle future recessions, and even
more difficult to implement new programs or strategies that may be needed to
improve our economy. Lawrence Summers, now director of the president's National
Economic Council, once asked, "How long can the world's biggest borrower
remain the world's biggest power?" Obviously not very long, and we are
rapidly moving in the wrong economic direction.
Mr. Boskin also pointed out
that all this "is by a large margin the most risky fiscal strategy in
American history." As noted above, the national debt will rise to more
than double GDP, and once it gets close to 100%, Mr. Boskin
adds, there will be "a dramatic slowing of economic growth by at least one
percentage point a year," since people will expect higher taxes, higher
interest rates and no visible resolution of the enormous and unsustainable
deficits that have come to pass.
All of this means we are indeed beginning to see a new
America, dusk rather than dawn, Europeanization rather than the life, liberty
and the pursuit of happiness that has brought us the world's best economy and a
standard of living for which the rest of the world strives. Unfortunately, that
economy was yesterday's, but will not be tomorrow's.
http://www.ncpa.org/commentaries/nightfall-in-america
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Government is not the solution to our
problems, government is the problem.
- Ronald Reagan
It is evening in America
* * * * *
5.
Medical
Gluttony: Non
Emergency Care in Emergency Rooms
A patient was referred to me for a chronic cough of
several months duration. His physician thought this might be allergic and
prescribed an albuterol inhaler. The patient didn’t think he had asthma so saw
no reason to use it.
His family persuaded him to go to the emergency room
the day before his appointment with me. He was not worse that day. His family
was just getting tired of hearing him cough. He was given a cough syrup and
told to be sure he kept his appointment with me since cough is one of the most
frequent symptoms of lung disease.
When seen, the Emergency Room treatment did not help.
However, he had a chest x-ray, electrocardiogram, lab work, scans, and CT of
the chest, which he stated were all normal.
He didn’t have his albuterol inhaler with him, so we
elected to measure his Pulmonary Function first and confirmed that it was an
allergic cough with his PFT showing rather significant asthma. We then
proceeded to administer the Albuterol inhaler for the post bronchodilator
study. His coughing stopped immediately. If we had given him the bronchodilator
initially, then the PFT may have returned to normal and the diagnosis not have
been convincing. Doing the PFT out of sequence (before the usual medical
history followed by physical examination followed by the PFT) allowed a
diagnostic pulmonary testing that confirmed the diagnosis.
We then proceeded into completing the medical history,
the remainder of the physical examination, and then it was time for the post
bronchodilator PFT, which is usually done 20 minutes after the albuterol. The
second PFT was nearly normal. Thus we were able to confirm a diagnostic asthma
study.
Our entire consultation, physical examination and PFT
were about $400. The ER charge at our hospital is $600 for the room before any
testing is done. The average charge of the ER visit is usually ten times that.
He had experienced the cough for several months. If he
had fended off his family and avoided a useless ER visit since he had a
pulmonary consult scheduled the following day, he would have saved the
considerable hospital ER charge. Hospital charges are not transparent, but
let’s assume the ER visit was $4,000 (most would be more like $6,000 to
$9,000), he obtained definitive care in my office for 10% of his ER visit.
When this was brought to the family’s attention, they
replied they couldn’t wait another day. After three months of coughing, “Can’t
wait one more day?” They would rather have a non-Pulmonologist evaluate a
pulmonary complaint and spend thousands of dollars of premium money (theirs and
others with the same company), which is entirely Medical Gluttony.
What’s the answer? In our experience and research,
this type of Medical Gluttony will not be affected by any government mandate
until the co-payment changes from the usual $25 or $50 to a percentage
co-payment. To prevent abuse and not interfere with necessary health care, the
ER co-pay should be 20%. On a $600 basic charge, that would be $120 cash or
credit card at the registration desk. Our research suggests that about 90% of
non-emergency care would turn away from the registration desk and keep the next
day appointment, previously made in this case. The few that feel they have an
emergency may change their mind during the course of the next six hours of
waiting in the ER after realizing that wait was half way towards tomorrow’s
appointment with a specialist.
Thus Medical Gluttony stops immediately on the same day, the same
visit, and is prevented in the future.
What an easy and quick way to control health care costs.
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Medical Gluttony thrives in Government and Health Insurance Programs
with Full Coverage.
Gluttony Disappears with Appropriate Deductibles and Percentage
Co-payments on Every Service.
* * * * *
6.
Medical
Myths: Medicare Price Controls will save the government
money
Sally Pipes: PIPING UP: Senior Citizens
Will Pay Dearly For Health Care Price Controls
Squabbles
over spending cuts have ruled the negotiations over increasing the debt
ceiling. But even after the ink is dry on the budget deal just passed,
lawmakers will still be charged with reducing federal spending further.
One
proposal that refuses to die would impose price controls on prescription drugs
in the Medicare Part D program. Sen. Jay Rockefeller (D-W.Va.) and Rep. Henry
Waxman (D-Calif.) are the latest lawmakers to advocate such an approach.
Price
controls may seem like a tempting way to save the government money on
prescription drugs, but in reality, they’ll force seniors to pay more for the
drugs they need — or worse, deprive them of access to critical medicines. . .
Nevermind that Part D’s costs have been about 40
percent lower than the Congressional Budget Office’s (CBO) initial estimates.
Or that Part D plans have negotiated rebates on brand-name prescription drugs
of between 20 and 30 percent — which they’ve passed onto beneficiaries in the
form of lower premiums.
Critics
of the program believe that prices could still be lower.
They
draw their inspiration from Medicaid. The federal government legally requires drugmakers to pay several rebates for drugs consumed by
Medicaid patients. Experts estimate that the average rebate for a brand-name
drug in 2011 reaches 40%.
Of
course, a mandated 40-percent discount is larger than the 20% to 30% rebates
that are the norm currently in Part D. CBO therefore projects that instituting
Medicaid-style price controls in Part D for the low-income Americans eligible
for both Medicare and Medicaid could save up to $112 billion over 10 years.
That
begs an important question. If Medicaid is able to secure bigger rebates than
Part D, wouldn’t both patients and the government benefit from extending
Medicaid’s price controls to Medicare’s low-income beneficiaries, at the very
least?
In
a word, no. According to a new analysis from former CBO Director Douglas Holtz-Eakin and economist Michael Ramlet,
instituting Medicaid-style rebates in Part D would drive beneficiaries’ monthly
premiums up between 19.6% and 39.4%.
All
told, Holtz-Eakin and Ramlet
project that new rebates in Part D would increase seniors’ annual out-of-pocket
drug costs by $1.5 to $3.7 billion. That translates to as much as $208.80 in
additional costs for every senior — every year.
Why
the huge increases? A phenomenon known as “cost-shifting.”
Drug
manufacturers won’t just absorb the financial hit associated with paying higher
rebates to the government. They’ll pass those costs along. So insurance plans
participating in Part D will not be able to secure the rebates of 20-30 percent
they’d received pre-price controls, as drug companies will have less room to
negotiate.
Consequently,
seniors will pay more for coverage.
Privately
insured folks will similarly face higher prescription-drug prices, as
manufacturers try to shore up their balance sheets.
Indeed,
as Dr. Scott Gottlieb, an economist and practicing physician, stated in
testimony before the Senate’s Special Committee on Aging, “Mandatory rebates
create a strong incentive for companies to launch drugs at higher prices in
anticipation of the payments that they will have to provide to the states and
the federal government.”
In
other words, the cost-savings associated with extending Medicaid-style price
controls are entirely illusory — particularly if drug makers just raise prices
before the new rebates go into effect.
Meanwhile,
the evidence suggests the Part D as currently structured is actually lowering
drug costs across the market. According to one recent study, average retail
prices for non-Medicare patients are down 5.4% — yielding savings of about $2.6
billion per year.
As
Gottlieb put it in his testimony, the “economic benefits of Part D’s
competitive structure . . . spill over into the rest of the commercial market.”
Make
no mistake — lawmakers must find ways to trim federal spending. But expanding
Medicaid-style price controls into Part D will not deliver the savings
promised. Instead, premiums will rise, benefits will fall, and seniors
will bear costs far greater than any of Uncle Sam’s potential savings.
Sally C. Pipes is President, CEO, and Taube Fellow in
Health Care Studies at the Pacific Research Institute. Her latest book is The Truth About Obamacare (Regnery 2010).
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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.
* * * * *
7.
Overheard
in the Medical Staff Lounge: Medical Practice
is Changing
Dr. Edwards: Is anyone noting a change in their practice
composition? I have a private and managed care combination. I take my share of
Medicaid patients. But now I’m feeling like I’m getting the Medicaid through
the HMO door surreptitiously.
Dr. Dave: I have gotten my fill of Medicaid patients. They
miss too many appointments. They don’t follow through on recommendations and
are generally noncompliant. They call the office for minutiae with no
appreciating for tying up a receptionist for 10 or 15 minutes at $20 to $25 an
hour. Costs go up and income goes down.
Dr. Ruth: I have my share of Medicaid or Welfare patients. But
I never joined an HMO and thus my practice is not a’ changing. I just never
wanted anyone to take advantage of me. I regulate my time to the nearest 10
minutes since I'm jockeying patient and family time.
Dr. Kaleb: I’ve been able to take any patient that calls for an
appointment. Over the two years I’ve been in practice, my schedule is
essentially full. So I can be more selective. At the present time I would
estimate that I have 50 percent Medicaid, 40 percent Medicare and the rest a
variety of patients. But my accountant says I will have to start being more
selective. The 50 percent Medicaid patients bring in less than 10 percent of my
income. But they occupy close to two-thirds of my time. We have a new baby at
home and I scarcely see him. I really think that I could increase my practice
to 75 percent Medicaid and increase my hours to 70 per week instead of 60 and
have less income for more work and less time with my wife and baby.
Dr. Milton: I have tried to balance my practice as much as I can.
I see about 20 percent Medicaid, 40 percent managed care and 40 percent
Medicare and private patients. I’m beginning to see the same thing that Edwards
is seeing, more Medicaid are slipping into my practice through the HMO door.
And I don’t appreciate that.
Dr. Yancy: Hey you guys better get use to that. That’s the name
of the Obama game. Better get that desk out of your office, replace it with a
fold down writing area and add a second door to your office or you’ll never
make it through the day.
Dr. Rosen: That’s also my understanding of what’s happening.
With 35 million folks in Medicaid, and with Obama planning to place another 35
million, it will totally overwhelm the system and us. But we can’t be sure as
to how much duplication there is. When Pew did his statistics that came up with
35 million uninsured, many of the Medicaid patients checked off “Uninsured.”
They felt that since they couldn’t find a doctor, they basically didn’t have
any significant insurance coverage. So we may find that a lot of the uninsured
already have Medicaid. So the Obama plan won’t help them.
Dr. Sam: There is only one solution to all these problems.
That is to get the government out of health care.
Dr. Dave: That’s easier said than done.
Dr. Sam: If all doctors quit accepting insurance, the problem
would be over.
Dr. Dave: If you quit accepting insurance and go on a cash
basis, you won’t have any patients.
Dr. Sam:
You miss understood me. If ALL DOCTORS quit accepting insurance, there would
only be a week or two of no patients. They then start drifting in and before
long you would have a huge snow bank full of patients.
Dr. Rosen: What most doctors don’t realize is that without
insurance, even if you dropped your fees 50 percent, that would still top what
you get from Medicaid. Then competition would keep the price low and the volume
up. That would essentially solve the health care crisis. No government
interference. No health insurance to police what we do. No copying of our
patient charts for outside review of our quality, which already is the best in
the world. We would have just a confidential Doctor-Patient interface. Everyone
would be happy. Everyone would be happy except the health insurance companies
and the government. But we’re not in the business of making the government and health
insurance companies happy. We’re in the business of providing excellent care to
our patients and making them well and happy. That will never happen in
government control or mandated medicine.
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8.
Voices of
Medicine: A Review of Regional Medical Journals: Drug Expiration
Dates: Part II
Bulletin
of the Humboldt-Del Norte County
Medical Society,March 2011
IN MY OPINION BY SCOTT SATTLER, MD
The Drug Expiration Date: Part II: A Costly Illusion
Last month’s Bulletin
editorial began a discussion of pharmaceutical
expiration dates. This is the second in the series
. . .
The FDA Regulations
Since 1979 the FDA has
required that drug products bear an expiration date
determined by appropriate stability testing (21 CFR
211.137 and 211.166). The FDA defines the
expiration date as “the date placed on the
container/labels of a drug product designating the time
during which a batch of the product is expected to remain
within the approved shelf life specifications if
stored under defined conditions, and after
which it may not be used.” Federally mandated
shelf life specifications require drugs to
safely maintain 90% of their originally
labeled content. There
are exceptions for those drugs with a narrow therapeutic index.
The Morphing of the Expiration Date
There is a substantial body
of evidence that pharmaceutical manufacturers are not
determining the length of time that their drugs remain
safe and effective1,3,4,5. Current FDA enforcement
policy allows them instead to choose an arbitrary date and to
perform tests demonstrating safety and potency as
of that selected date only, and label that
arbitrary date as the drug’s expiration date.
According to the Pharmaceutical Research and Manufacturers
of America (PhRMA), marketed prescription
drug products in the U.S. have
expiration dates ranging from 12 to 60 months from
the time of manufacture. In practice the industry has chosen to
set the maximum arbitrary date on the more
conservative side. “Two to three years is a very comfortable
point of commercial convenience,” said Mark van Arandonk,
senior director for pharmaceutical
development at Pharmacia & Upjohn Inc, when
quoted in a Wall Street Journal article on this
subject4. In
short, the much touted and legally enforced ‘expiration
date’ is more accurately described as an ‘arbitrary quality
assurance date’. The continued use of the term
‘expiration date’ (to expire means to come to an end,
to die) is a falsehood that perpetuates a costly
illusion.
Enter the USP’s ‘Beyond Use’ Date
The United States
Pharmacopeia (USP) is a non-governmental, official
public standards-setting authority for prescription and OTC
medicines and other healthcare products manufactured
or sold in the United States. In 1985 the USP declared that
once the manufacturer’s original shipping
container is opened and the drug product is transferred
to another container for dispensing or
repackaging, the expiration date no longer
applies. They urged that all medications dispensed
in this fashion be relabeled with a one-year maximum “Beyond Use” date
stating, “Do not use after ___.” In 1997 the USP
made this a requirement for participating pharmacists
and by 2000, 17 states had passed laws mandating that their
pharmacists comply. According to the AMA, there
is little scientific basis for this action, yet for
some reason current AMA policy (Policy H-115.983) supports it6. Thus
the
misleading ‘expiration date’ has been upgraded into an
even more illusory ‘beyond use’ date requiring pharmacists to
order patients to discard potentially safe and
effective medications (see SLEP study below) yearly.
Do patients really do this? A Wall Street
Journal survey of 1000 patients found that 70%
said they would not take outdated prescription medicines and 72% said
they would not take expired OTC meds.
The DoD/FDA Shelf Life Extension Program (SLEP) 1,2
As I mentioned in last
month’s article, in 1985 the military questioned the
validity of expiration dating and asked the
FDA to see if these dates had a basis in
fact. They didn’t. They were not even close. In
88%
of 3005 lots of 122 drug products eventually tested,
they found that the drugs remained stable for
an average of 66 months longer than their labeled expiration date.3
In SLEP’s first year, these significant shelf
life extensions saved the Department of Defense (DoD) 59 times the cost of testing by obviating the
need for discarding perfectly good medications.
Between the years of 1993 and 1998, for $3.9M in testing, SLEP
saved over $263M in drug wastage. The
pharmaceutical companies have never found fault with SLEP’s
procedures or scientific determinations. The following are some specific
SLEP findings that might be of interest.
As you read them, understand that according
to the 1992 FDA SLEP director Francis
Flaherty, the outdate extensions SLEP
authorizes are “intentionally conservative,” in that
if SLEP extended an outdate by 36 months it
had
concluded that the drug would be safe and effective
(maintaining at least 90% of its labeled active
ingredient without degrading into toxic substances) for at least
72 months.4
Tetracycline:
In 1963 G.W. Frimpter et al reported in JAMA, (184:111) that outdated
tetracycline degraded into a toxic substance, causing kidney damage and
reversible Fanconi’s syndrome. This has been the only
known study to purport that a prescription medication became toxic with age.
Despite the fact that other studies failed to confirm this report, the spread
of this misperception continues to ensnare physicians and pharmacists.
In fact the current (2010)
Merck Manual listing for tetracycline still proclaims this illusion of
toxicity. The SLEP study determined that this perception is not supported by
fact. To the contrary, SLEP found tetracycline to be quite stable. If stored
correctly it can be used safely for years beyond its stated expiration date.
Aspirin:
Bayer gives a 2-3 year
outdate label on their aspirin and states that it should be destroyed after
that date. SLEP found that this product was good for at least 4 years from
manufacture, and Dr. Jens Carstensen, professor emeritus
of pharmacy at the University of Wisconsin found that it was still stable after
5 years. Interestingly, the 2010 Merck Manual states that aspirin, too, becomes
toxic beyond its stated expiration date. Like tetracycline, this toxicity is
not supported by fact. Acetylsalicylic acid (ASA) may break down into salicylic
acid and acetic acid (the active ingredient in vinegar) after prolonged
exposure to heat and humidity, but neither substance is toxic at these levels.
Salicylic acid was actually a precursor of aspirin (ASA) and is still being
used as an anti-inflammatory.
Cipro:
The DoD
maintains a large stockpile of Cipro (Bayer) to deal
with the threat of disseminated anthrax. It carries a 3 year outdate. SLEP was
asked to evaluate Cipro stability and found the
tablets to safely maintain potency for at least 13 years after manufacture.
Atropine injectable:
Not a common household
medication, “Costly, Continued From Page 3 this drug is used in
hospitals and clinics world wide to control secretions and cardiac arrhythmias.
It’s also important in the treatment of nerve gas poisoning. The standard
military outdate was for 2 years after manufacture. SLEP found it to be stable
for 15 years after manufacture.
Pralidoxime HCL autoinjector:
This nerve gas antidote carried
an initial shelf life of 5 years. SLEP found it to be safe and effective for 18
years.
Diazepam autoinjector:
This anti-seizure
medication (Valium) carried an initial shelf life of 4 years. SLEP extended it
to 9 years.
Doxycycline tablets:
Its initial shelf life was
2 years. SLEP found it still safe and effective at 7 years.
The list goes on and on:
Penicillin, Thorazine, Tagamet, Lasix, Dilantin,
potassium iodide, captopril, cefoxitin,
each had their outdates extended by SLEP investigators.
Summary to Date:
It is clear from the above
data that, as the FDA’s SLEP director stated years ago4, expiration
dates (and by extension, ‘beyond use dates’) have essentially no bearing on
whether or not a drug is usable for a longer period. The stated expiration date
does not mean or even imply that a given drug will stop being effective or
become harmful after that date. That is the simple truth. It appears that the
FDA has abdicated its responsibility to enforce compliance with the expiration
date regulations, for instead of requiring drug makers to determine a drug’s
actual expiration date, — that is, when it can be reasonably expected to become
unsafe and/or lose more than 10% of its declared potency—the FDA has allowed
the industry to create “arbitrary quality assurance dates” and falsely label
them “expiration dates” or, even worse, as “beyond use” dates. But then, as a
former FDA expiration date compliance chief, Joel Davis, once said: “It’s not
the job of the FDA to be concerned about a consumer’s economic interest....it
would be up to Congress to impose changes.”4
1 Extending the Shelf Life
of Critical Chemical, Biological, Nuclear and Radiological (CRBN) Medical
Materiel Using the FDA/DoD Shelf Life Extension
Program Oct 1, 2009 https://slep.dmsbfda.army.mil/slep/slep_info_paper.doc
2 SLEP Website homepage: https://slep.dmsbfda.army.mil/portal/page/portal/SLEP_PAGE_GRP/SLEP_HOME_NEW
3 Lyon RC, Taylor JS,
Porter DA, et al. Stability profiles of drug products extended beyond labeled
expiration dates. J Pharm Sci
2006;95(7):1549-1560.
4 Cohen LP. Many medicines
prove potent for years past their expiration dates. Wall Street Journal. March
28, 2000. http://www.terrierman.com/antibiotics-WSJ.htm
5 Maximizing State and
Local Medical Countermeasure Stockpile Investments Through the Shelf-Life
Extension Program. Brooke Courtney, Joshua Easton, Thomas V. Inglesby, and Christine SooHoo Biosecurity and Bioterrorism: Volume 7, Number 1, 2009 ©
Mary Ann Liebert, Inc. DOI: 10.1089/bsp.2009.0011
URL: http://www.upmc-biosecurity.org/
website/resources/publications/2009/2009-03-27-max_st_local_med_cntr.html
6 American Medical
Association. (2008, February). Report 1 of the Council on Scientific Affairs
(A001): Pharmaceutical expiration dates. §
This editorial will be continued next
month as we look a bit more at SLEP and also at some of the costs – social,
environmental and political – of the drug expiration date illusion.
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Is an Insider's View of What Doctors are Thinking, Saying and Writing about.
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9.
Book
Review: A Common Sense Platform
for the 21st Century
A
Common Sense Platform for the 21st Century by Beverly Eakman, Midnight Whistler Publisher, www.midnightwhistler.com © 2010, ISBN 1452887721 (soft cover);
ISBN-13: 978-1452887722, (soft cover)
Book Review: A Common Sense Platform
for the 21st Century, January 2, 2011
A
Common Sense Platform for the 21st Century (Platform) has been formulated by award
winning author and columnist Beverly K. Eakman. Among a long list of
credentials and works, Ms. Eakman has most recently contributed feature length
articles to The Washington Times, National Review, and The
Washington Post. She was also Editor in Chief of NASA’s official
newspaper, and chief speechwriter for Chief Justice Warren E. Burger. Ms. Eakman’s award winning books include Educating for the
New World Order, and Cloning of the American Mind: Eradicating
Morality through Education. A more comprehensive list of Ms. Ekman’s background and works can be found here. Platform (Midnight
Whistler Publishers) is available in paperback and in Kindle format. Among
other locations, it can be found at Amazon (ISBN: 1452887721).
Ms. Eakman’s new book contains
a platform for candidates and political groups who might be best described as
Constitutionalists, or more casually referred to as freedom loving Americans.
Aside from the platform itself, the author guides us through the reasons for
the need of a new platform. This is done through a review of both positive and
negative events in American history, as well as the mind-set that has led to
the events that have put us in our current, unenviable position. Tea Party
people are definitely the prime audience for this book, but the real world
problems, and common sense solutions provided, would likely spark active
thought in anyone willing to give the book a chance. This is critical if the
new American Revival is to reach past the choir and out to those who are not
yet paying full attention. The movement to reinstate Constitutional principles
must reach past the Tea Party if it is to succeed. Platform takes a
long stride in this direction.
Within Platform’s 120 pages, Ms. Eakman does a
nice job of condensing the common sense notions that drift through so many minds,
but given busy lifestyles, don’t often thicken into complete and organized
thoughts. For example, she points to the obsession that the Boomer generation
seems to have with rules and limitations. It is both gratifying and eye-opening
when she leads us to consider both the irony and the danger of this fixation.
One way she does this is by highlighting the gap between modern American
attitudes and the more traditional mode of American thinking.
“[M]odern Americans, on the
whole, do not equate accelerating incursions into their daily lives or the
overabundance of rules, regulations and handouts with control, dependency and
collectivism. Indeed, talk of self-sufficiency today is akin to being called a
“loner,” and we are reminded daily that loners are dangerous, on a level with
sociopaths.”
This statement and others like it trumpet how the
American spirit has been altered, and ultimately, the book offers ideas on how
to correct for this sway.
It’s funny to have to mention, but many of the thoughts
expressed in Platform are so commonly sensible that they may actually
seem drastic to some modern political observers. In “Section 6—The Platform,”
the following concept is presented.
“No single agency of government can hold power greater
than the people’s elected representatives, and no elected representative can
attest to powers greater than the legal citizenry that keeps him or her in
office.”
This is simple enough, but a timely example of the need
for the restoration of this concept can be found in the recent FCC “Net
Neutrality” decree. Factually, creating federal regulations is specifically
restricted to Congress (see the U.S. Constitution: Article I, Section 1,
sentence 1). However, three of five unelected and unaccountable administrators
at the FCC voted, and simply granted themselves the power to regulate aspects
of the Internet for 300 million people. This is power that our representatives
in Congress (the people) have refused to award to them, and that the courts
(the guardians of justice) have actually ruled
illegal. This is regulation without representation, and is just the sort of
thing Ms. Eakman is referring to in the above quote.
The reader will find that most of the concepts presented
in Platform have been presented before—one way or the other. However,
the importance of this book lies in its success in pulling these common sense
ideas together into a one-stop political guidebook. The platform itself is well
organized, the problems and solutions presented are timely and understandable,
and there are a couple of sections that are openly reminiscent of this
country’s founding era. These elements are well mixed to make Platform
educational, motivational, and even exciting.
There is just one aspect of Platform that falls
into the “disappointment” category. It’s painful to disclose, but there are
several noticeable typing errors (Paperback, First Edition, October 2010). Platform
as a whole is great, and is full of little gems (get your highlighter out).
However, the scattered editing mistakes may obscure the book’s greater points
when perused by a reluctant or skeptical reader. Certainly, the book should
have been more thoroughly proofread.
The Constitution is the rule book for Washington, but the
players have ignored the rules for decades. This is because the people have not
been paying attention. The luxury that results from a society founded in
liberty has distracted us, and now we are faced with the loss of our liberty,
as well as the subsequent loss of the abundance that goes with it. We must
begin to pay attention and be involved, and then remain vigilant thereafter. Platform
is an excellent guidebook for this pursuit, a guidebook that can lead us back
to Constitutional principles. In this respect, rather than calling it a
guidebook, Platform might be better described as a treasure map.
This entry was
posted in Limited Government,
The Cause,
Uncategorized.
Bookmark the permalink.
*****************************************
This
book review is found at http://durhamteaparty.org/liberty/?p=289
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10. Hippocrates
& His Kin: A World Food Crisis?
The NASA
space shuttle program goes into cyberspace or limbo?
The John F Kennedy race to the moon is finished after
40 years with the 135th departure in the 30-year-old shuttle program
with Atlantis’ last flight. The herds of satellites occupying orbital space
have made modern communications possible. They are integral not only to
communications but also social media, business transactions, military
operations and surveillance, surveys for charting world resources and climate,
and the GPS devices that help us keep tract of ourselves and others. The
Challenger and Columbia disasters set back the program, which never approached
an early objective to fly every few weeks at a cost of $7 million a flight
mushrooming to $1.5 billion a mission.
That’s a 200-fold increase in cost over projections.
About like other government programs such as Social Security and Medicare.
A World Food
Crisis?
Countless experiments have established that increased
carbon dioxide levels not only speed up plant growth, but enable plants to do
better under stressed conditions of drought, pollution and attacks by insects
and fungi. –Independent
Institute
The
Beneficial Side of Global Warming?
Please
complete these forms so we can deliver oxygen to your patient.
A request from Medicaid asks “Does your patient still
need oxygen?”
No. The patient died on March 23, 2011. There is no
further need for oxygen.
Could you give us the last oxygen saturation level to
verify that he no longer needs oxygen?
Assuming the casket is permeable to oxygen, his
Saturation of Oxygen is 20%.
We then got a 12-month authorization that our patient
still needs oxygen.
I wish it
were this easy to get oxygen for living hypoxic patients.
To read more HHK
. . .
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read more HMC . . .
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Hippocrates
and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Yesterday, Today & Tomorrow
* * * * *
11. Professionals Restoring
Accountability in Medical Practice, Government and Society:
John and
Alieta Eck, MDs, for their first-century solution to twenty-first century needs. With
46 million people in this country uninsured, we need an innovative solution apart
from the place of employment and apart from the government. To read the rest of
the story, go to www.zhcenter.org and check
out their history, mission statement, newsletter, and a host of other
information. For their article, "Are you really insured?," go to www.healthplanusa.net/AE-AreYouReallyInsured.htm.
Medi-Share Medi-Share is based on the biblical principles of caring
for and sharing in one another's burdens (as outlined in Galatians 6:2). And as
such, adhering to biblical principles of health and lifestyle are important
requirements for membership in Medi-Share.
This is not insurance.
PATMOS EmergiClinic - where Robert Berry, MD, an emergency
physician and internist, practices. To read his story and the background for
naming his clinic PATMOS EmergiClinic - the island where John was exiled and an
acronym for "payment at time of service," go to www.patmosemergiclinic.com/ To
read more on Dr Berry, please click on the various topics at his website. To
review How
to Start a Third-Party Free Medical Practice . . .
PRIVATE NEUROLOGY is a Third-Party-Free Practice in Derby, NY with Larry Huntoon, MD, PhD,
FANN. (http://home.earthlink.net/~doctorlrhuntoon/)
Dr Huntoon does not allow any HMO or government interference in your medical
care. "Since I am not forced to use CPT codes and ICD-9 codes (coding
numbers required on claim forms) in our practice, I have been able to keep our
fee structure very simple." I have no interest in "playing
games" so as to "run up the bill." My goal is to provide
competent, compassionate, ethical care at a price that patients can afford. I
also believe in an honest day's pay for an honest day's work. Please Note that PAYMENT IS EXPECTED AT
THE TIME OF SERVICE. Private Neurology also guarantees that medical records in our office are kept
totally private and confidential - in accordance with the Oath of Hippocrates.
Since I am a non-covered entity under HIPAA, your medical records are safe from
the increased risk of disclosure under HIPAA law.
FIRM: Freedom and Individual Rights in
Medicine, Lin Zinser, JD, Founder, www.westandfirm.org, researches
and studies the work of scholars and policy experts in the areas of health
care, law, philosophy, and economics to inform and to foster public debate on
the causes and potential solutions of rising costs of health care and health
insurance. Read Lin
Zinser’s view on today’s health care problem: In today’s proposals for sweeping changes
in the field of medicine, the term “socialized medicine” is never used. Instead
we hear demands for “universal,” “mandatory,” “singlepayer,” and/or
“comprehensive” systems. These demands aim to force one healthcare plan
(sometimes with options) onto all Americans; it is a plan under which all
medical services are paid for, and thus controlled, by government agencies.
Sometimes, proponents call this “nationalized financing” or “nationalized
health insurance.” In a more honest day, it was called socialized medicine.
To read the rest of this section, please
go to www.medicaltuesday.net/org.asp.
Michael J. Harris, MD - www.northernurology.com - an active member in the
American Urological Association, Association of American Physicians and
Surgeons, Societe' Internationale D'Urologie, has an active cash'n carry
practice in urology in Traverse City, Michigan. He has no contracts, no
Medicare, Medicaid, no HIPAA, just patient care. Dr Harris is nationally
recognized for his medical care system reform initiatives. To understand that
Medical Bureaucrats and Administrators are basically Medical Illiterates
telling the experts how to practice medicine, be sure to savor his article on
"Administrativectomy:
The Cure For Toxic Bureaucratosis."
Dr Vern
Cherewatenko
concerning success in restoring private-based medical practice which has grown
internationally through the SimpleCare model network. Dr Vern calls his
practice PIFATOS – Pay In Full At Time Of Service, the "Cash-Based
Revolution." The patient pays in full before leaving. Because doctor
charges are anywhere from 25–50 percent inflated due to administrative costs
caused by the health insurance industry, you'll be paying drastically reduced
rates for your medical expenses. In conjunction with a regular catastrophic
health insurance policy to cover extremely costly procedures, PIFATOS can save
the average healthy adult and/or family up to $5000/year! To read the rest of
the story, go to www.simplecare.com.
Dr David MacDonald started Liberty Health Group. To compare the traditional health
insurance model with the Liberty high-deductible model, go to www.libertyhealthgroup.com/Liberty_Solutions.htm.
There is extensive data available for your study. Dr Dave is available to speak
to your group on a consultative basis.
David J Gibson, MD,
Consulting Partner of Illumination Medical, Inc. has made important contributions to the
free Medical MarketPlace in speeches and writings. His series of articles in Sacramento
Medicine can be found at www.ssvms.org. To read his "Lessons from the Past," go to www.ssvms.org/articles/0403gibson.asp. For additional articles, such as the cost of Single
Payer, go to www.healthplanusa.net/DGSinglePayer.htm; for Health Care Inflation, go to www.healthplanusa.net/DGHealthCareInflation.htm.
ReflectiveMedical Information Systems (RMIS), delivering information that empowers
patients, is a new venture by Dr. Gibson which will go far in making health
care costs transparent. This site
provides access to information related to medical costs as an informational and
educational service to users of the website. This site contains general
information regarding the historical, estimates, actual and Medicare range of
amounts paid to providers and billed by providers to treat the procedures
listed. These amounts were calculated based on actual claims paid. These amounts
are not estimates of costs that may be incurred in the future. Although
national or regional representations and estimates may be displayed, data from
certain areas may not be included. You may want to
follow this development at www.ReflectiveMedical.com.
Dr Richard B Willner, President, Center Peer Review Justice
Inc, states: We are a group of healthcare doctors -- physicians,
podiatrists, dentists, osteopaths -- who have experienced and/or witnessed the
tragedy of the perversion of medical peer review by malice and bad faith. We
have seen the statutory immunity, which is provided to our "peers"
for the purposes of quality assurance and credentialing, used as cover to allow
those "peers" to ruin careers and reputations to further their own,
usually monetary agenda of destroying the competition. We are dedicated to the
exposure, conviction, and sanction of any and all doctors, and affiliated
hospitals, HMOs, medical boards, and other such institutions, who would use
peer review as a weapon to unfairly destroy other professionals. Read the rest
of the story, as well as a wealth of information, at www.peerreview.org.
Semmelweis Society
International, Verner S. Waite MD, FACS, Founder; Henry Butler MD, FACS,
President; Ralph Bard MD, JD, Vice President; W. Hinnant MD, JD,
Secretary-Treasurer; is
named after Ignaz Philipp Semmelweis, MD (1818-1865), an obstetrician
who has been hailed as the savior of mothers. He noted maternal mortality of
25-30 percent in the obstetrical clinic in Vienna. He also noted that the first
division of the clinic run by medical students had a death rate 2-3 times as
high as the second division run by midwives. He also noticed that medical
students came from the dissecting room to the maternity ward. He ordered the
students to wash their hands in a solution of chlorinated lime before each
examination. The maternal mortality dropped, and by 1848, no women died in
childbirth in his division. He lost his appointment the following year and was
unable to obtain a teaching appointment. Although ahead of his peers, he was
not accepted by them. When Dr Verner Waite received similar treatment from a
hospital, he organized the Semmelweis Society with his own funds using Dr
Semmelweis as a model: To read the article he wrote at my request for
Sacramento Medicine when I was editor in 1994, see www.delmeyer.net/HMCPeerRev.htm. To see Attorney Sharon Kime's response, as well as the
California Medical Board response, see www.delmeyer.net/HMCPeerRev.htm. Scroll down to read some
very interesting letters to the editor from the Medical Board of California,
from a member of the MBC, and from Deane Hillsman, MD.
To view some horror stories of atrocities
against physicians and how organized medicine still treats this problem, please
go to www.semmelweissociety.net.
Dennis Gabos, MD, President of the Society for the
Education of Physicians and Patients (SEPP), is making efforts in
Protecting, Preserving, and Promoting the Rights, Freedoms and Responsibilities
of Patients and Health Care Professionals. For more information, go to www.sepp.net.
Robert J Cihak, MD, former president of the AAPS, and Michael
Arnold Glueck, M.D, who wrote an informative Medicine Men column at
NewsMax, have now retired. Please log on to review the archives. He now has a new
column with Richard Dolinar, MD, worth reading at www.thenewstribune.com/opinion/othervoices/story/835508.html.
The Association of American Physicians
& Surgeons (www.AAPSonline.org),
The Voice for Private Physicians Since 1943, representing physicians in their
struggles against bureaucratic medicine, loss of medical privacy, and intrusion
by the government into the personal and confidential relationship between
patients and their physicians. Be sure to read News of the Day in
Perspective: HuffPo & Public Radio praise free market health care
solutions. Don't miss the "AAPS News," written by Jane
Orient, MD, and archived on this site which provides valuable information on a
monthly basis. Browse the archives of their official organ, the Journal of American Physicians and Surgeons,
with Larry Huntoon, MD, PhD, a neurologist in New York, as the Editor-in-Chief.
There are a number of important articles that can be accessed from the Table of Contents.
The AAPS California
Chapter is an unincorporated
association made up of members. The Goal of the AAPS California Chapter is to
carry on the activities of the Association of American Physicians and Surgeons
(AAPS) on a statewide basis. This is accomplished by having meetings and
providing communications that support the medical professional needs and interests
of independent physicians in private practice. To join the AAPS California
Chapter, all you need to do is join national AAPS and be a physician licensed
to practice in the State of California. There is no additional cost or fee to
be a member of the AAPS California State Chapter.
Go to California
Chapter Web Page . . .
Bottom
line: "We are the best deal Physicians can get from a statewide physician
based organization!"
PA-AAPS is the Pennsylvania Chapter of the Association of
American Physicians and Surgeons (AAPS), a non-partisan professional
association of physicians in all types of practices and specialties across the
country. Since 1943, AAPS has been dedicated to the highest ethical standards
of the Oath of Hippocrates and to preserving the sanctity of the
patient-physician relationship and the practice of private medicine. We welcome
all physicians (M.D. and D.O.) as members. Podiatrists, dentists, chiropractors
and other medical professionals are welcome to join as professional associate
members. Staff members and the public are welcome as associate members. Medical
students are welcome to join free of charge.
Our motto, "omnia pro aegroto"
means "all for the patient."
“Only government can take perfectly good paper, cover
it with perfectly good ink, and make the combination worthless.” –Reagan on
Paper Money
“The Constitution is not an instrument for the government
to restrain the people; it is an instrument for the people to restrain the
government - lest it come to dominate our lives and interests.” - Patrick Henry
Some Recent
Postings
In The June 14 Issue: