MEDICAL TUESDAY .
Community For Better Health Care
Vol IX, No 23,
In This Issue:
11. Related Organizations: Restoring Accountability in HealthCare, Government and Society
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The Annual World Health Care Congress, a market of ideas, 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
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1. Featured Article: Animal Domestication
By Evan Ratliff, National Geographic
Photograph by Vincent J. Musi
"Hello! How are you doing?" Lyudmila Trut says, reaching down to unlatch the door of a wire cage
labeled "Mavrik." We're standing between
two long rows of similar crates on a farm just outside the city of
Mavrik, the object of Trut's attention, is about the size of a Shetland sheepdog, with chestnut orange fur and a white bib down his front. He plays his designated role in turn: wagging his tail, rolling on his back, panting eagerly in anticipation of attention. In adjacent cages lining either side of the narrow, open-sided shed, dozens of canids do the same, yelping and clamoring in an explosion of fur and unbridled excitement. "As you can see," Trut says above the din, "all of them want human contact." Today, however, Mavrik is the lucky recipient. Trut reaches in and scoops him up, then hands him over to me. Cradled in my arms, gently jawing my hand in his mouth, he's as docile as any lapdog.
Except that Mavrik, as it
happens, is not a dog at all. He's a fox. Hidden away on this overgrown
property, flanked by birch forests and barred by a rusty metal gate, he and
several hundred of his relatives are the only population of domesticated silver
foxes in the world. (Most of them are, indeed, silver or dark gray; Mavrik is rare in his chestnut fur.) And by
"domesticated" I don't mean captured and tamed, or raised by humans
and conditioned by food to tolerate the occasional petting. I mean bred for
domestication, as tame as your tabby cat or your
It started more than a half century ago, when Trut was still a graduate student. Led by a biologist named
Dmitry Belyaev, researchers at the nearby
With each generation of fox kits, Belyaev and his colleagues tested their reactions to human
contact, selecting those most approachable to breed for the next generation. By
the mid-1960s the experiment was working beyond what he could've imagined. They
were producing foxes like Mavrik, not just unafraid
of humans but actively seeking to bond with them. His team even repeated the
experiment in two other species, mink and rats. "One huge thing that Belyaev showed was the timescale," says Gordon Lark, a
Miraculously, Belyaev had
compressed thousands of years of domestication into a few years. But he wasn't
just looking to prove he could create friendly foxes. He had a hunch that he
could use them to unlock domestication's molecular mysteries. Domesticated
animals are known to share a common set of characteristics, a fact documented
Belyaev suspected that as the foxes became domesticated, they too might begin to show aspects of a domestication phenotype. He was right again: Selecting which foxes to breed based solely on how well they got along with humans seemed to alter their physical appearance along with their dispositions. After only nine generations, the researchers recorded fox kits born with floppier ears. Piebald patterns appeared on their coats. By this time the foxes were already whining and wagging their tails in response to a human presence, behaviors never seen in wild foxes.
Driving those changes, Belyaev
postulated, was a collection of genes that conferred a propensity to tameness—a
genotype that the foxes perhaps shared with any species that could be
domesticated. Here on the fox farm, Kukekova and Trut are searching for precisely those genes today.
Elsewhere, researchers are delving into the
The exercise of dominion over plants and animals is arguably the most consequential event in human history. Along with cultivated agriculture, the ability to raise and manage domesticated fauna—of which wolves were likely the first, but chickens, cattle, and other food species the most important—altered the human diet, paving the way for settlements and eventually nation-states to flourish. By putting humans in close contact with animals, domestication also created vectors for the diseases that shaped society.
Yet the process by which it all happened has remained stubbornly impenetrable. Animal bones and stone carvings can sometimes shed light on the when and where each species came to live side by side with humans. More difficult to untangle is the how. Did a few curious boar creep closer to human populations, feeding off their garbage and with each successive generation becoming a little more a part of our diet? Did humans capture red jungle fowl, the ancestor of the modern chicken, straight from the wild—or did the fowl make the first approach? Out of 148 large mammal species on Earth, why have no more than 15 ever been domesticated? Why have we been able to tame and breed horses for thousands of years, but never their close relative the zebra, despite numerous attempts?
In fact, scientists have even struggled to define domestication precisely. We all know that individual animals can be trained to exist in close contact with humans. A tiger cub fed by hand, imprinting on its captors, may grow up to treat them like family. But that tiger's offspring, at birth, will be just as wild as its ancestors. Domestication, by contrast, is not a quality trained into an individual, but one bred into an entire population through generations of living in proximity to humans. Many if not most of the species' wild instincts have long since been lost. Domestication, in other words, is mostly in the genes.
Yet the borders between domesticated and wild are
often fluid. A growing body of evidence shows that historically, domesticated
animals likely played a large part in their own taming, habituating themselves
to humans before we took an active role in the process. "My working
hypothesis," says Greger Larson, an expert on
genetics and domestication at
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On Feb 16, the
“In healthcare, we talk about turning data into knowledge. That’s really what Watson does.”
Joe Jasinski, Program
Medical records, texts, journals and research documents are all written in natural language – a language that computers traditionally struggle to understand. A system that instantly delivers a single, precise answer from these documents could transform the healthcare industry.
Thought leaders including Dr. Herbert Chase, Professor of Clinical Medicine at Columbia University School of Physicians and Surgeons, share their thoughts on how the DeepQA technology that powers Watson could impact the way doctors diagnose and treat patients.
Watson represents the latest in a long line of groundbreaking innovations from a company dedicated to building a Smarter Planet. Watson combines major advances in deep analytics and system design into a solution with the possibility to transform entire industries.
Watch as Sam Palmisano, Chairman and CEO of
“Watson is the latest example of
Over the past three days,the TV show
"Jeopardy!" featured a showdown between a clever
"Jeopardy!" involves understanding complexities of humor, puns, metaphors, analogies, ironies and other subtleties. Elsewhere, computers are advancing on many other fronts, from ...
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3. International Medicine: Here’s the ugly truth about government-controlled health care
The UK's Telegraph (2/26, Donnelly) reported that an investigation by The Sunday Telegraph uncovered "more than 80 cases in which desperately sick NHS patients have been refused the cancer drugs their doctor sought, in the four months since a £200 million fund was introduced to stop health authorities rationing treatments." The fund was developed by the "Coalition so that those suffering from cancer would never again be refused drugs on grounds of cost." But in its first "four months, the fund has paid for approximately 1,300 patients' drugs -- even though research last March suggested up to 20,000 cancer patients' lives were being shortened each year by drugs rationing."
“A few extra months towards the end of a patient’s life can mean the difference between seeing a child get married or graduate.”
Barbara Moss, 56, from Worcester, became one of the most high-profile cases to be refused drugs by the NHS after she was diagnosed with bowel cancer.
After doctors said that without Avastin she would only live for a matter of months, her 86-year-old mother gave her funds to pay for the drugs.
More than four years later, the former schoolteacher is “climbing mountains and enjoying every moment” of life.
Her case, featured in The Sunday Telegraph, was among several to trigger a public outcry about the way NHS rationing decisions are made, resulting in a Conservative party election manifesto pledge last year to set up the £200 million drugs fund. . .
Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.
--Canadian Supreme Court Decision 2005
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All Medicare providers are eligible to earn a 1 percent incentive on their total Medicare Part B allowed charges by electronically prescribing a total of 25 times from Jan. 1 to Dec. 31, 2011 and having at least 10 percent of their total Medicare Part B charges made up of denominator codes.
providers who want to avoid a 1 percent penalty in 2012 must report an
e-prescribing measure through their claims at least 10 times between Jan. 1 and
plan to participate in the EHR incentive program in 2011, you will not be
eligible to collect the 1 percent e-prescribing bonus.
Will these one percent bonuses pay for the extra time to read the rules to win and become indentured slaves to Medicare?
Government is not the solution to our problems, government is the problem.
- Ronald Reagan
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5. Medical Gluttony: ER visits are becoming a separate circular practice which is unaccountable.
become sophisticated in gaming the Medicaid and Medicare system. Since more and
more tests and procedures involved a delay, pre-authorization, problems in
obtaining a physician consult who accepts Medicare and Medicaid; patients are
going more frequently to the emergency rooms since they can short circuit the
entire controls to referrals with diagnostic testing order directly in the
Emergency Departments without any insurance oversight or controls. While it
might take a week or two to get authorization for an
recently went to the emergency room for what she considered sinus congestion
with a stuffy nose. Rather than treat this symptomatically and empirically, a
CT scan of the sinuses was obtained for possible sinusitis. Although this was
read as negative, the
On reviewing her
chart while the ECG was obtained, the above studies were discussed with the
patient. On reviewing the CT of the sinuses, she was appalled that they were
read as negative for a deviated septum or for any sinus infection which she was
led to believe was present. She was given a copy of her ECG and one was sent to
She inquired why
she should take a copy to the
Rather than get
involved in a political confrontation, she was advised to keep the appointment
and take a copy of the CT report and discuss it frankly with the
The patient being involved in the decision matter, not only prevented unnecessary surgery, but stopped the exorbitant costs in the tracts, although she already had more than $10,000 worth of unnecessary tests and consults from the Emergency Department. These tests and consults were more than 100 times as expensive as one office visit to obtain the necessary medications for treatment.
Before we cast
blame on the Emergency Department, we must understand that they have a
different mission which must allow for moving seriously ill and critical
patient with all dispatch. Hence, when a patient comes in with an ordinary
outpatient medical problem, an element of patient responsibility is necessary.
This only comes with a significant co-payment which in our research analysis
comes to 20 percent for emergency room visits. That would have stop this
exorbitant cost when the
There is no quicker way to fiscal responsibility and restraint in health care than a healthy patient co-payment.
The government regulations are imposed under the rational of controlling costs or practice patterns. However, there are always patients who will be smarter than the government bureaucrats and will be able to work around the regulations and mandates. A hospital administrator once told me, when a new Medicare directive was received, that they frequently hire another administrative specialist to work around the government regulation. The cost of another salary was cheaper than the cost of more government regulations.
There is no other way to reduce health care costs than to remove the government regs and mandates.
Medical Gluttony thrives in Government and Health Insurance Programs.
Gluttony Disappears with Appropriate Deductibles and Co-payments on Every Service.
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Medical practice starts with a physician doing a medical history and physical examination. This makes the clinical diagnosis in two-thirds of patient encounters. A few laboratory tests, ECGs, x-rays, PFTs generally confirm the clinical diagnosis in most of the others. Only in very few cases is the diagnosis absolutely certain or sometimes still totally in doubt. Generally we deal in clinical terms treating the best diagnostic impressions.
Lawyers, on the other hand, work in a laws, rules and regulation environment and expect physicians to do the same. You either follow the law, rule or regulation or you’re guilty even if you’ve provided better care than the law, rules or regulations would have allowed.
The thousands of pages of Obama Laws, Rules, and Regulations in the Health Care Reform Act were primarily written by attorneys. What’s best for patients was not the primary drive. It was usually economics, practice guidelines (usually rules or mandates) that non-medical people can measure and control. This then leads to fines or in the case of physicians, also possible incarceration.
Patient benefit is never the primary drive in any lawsuit. It’s always whether the hospital or physician is guilty or not guilty.
When I was in medical school in the 1960s, professors of medicine would readily admit their fallibility by wondering out loud how many of their patients were in the grave because of their medical misjudgments. They would then point out new information and research that made diagnosis and treatment more accurate thereby decreasing fatalities. Attorneys look at this as medical error for which someone should be held accountable, judged guilty, fined or other retribution, e.g. loss of property (medical licensure, the basis of our ability to make an income). The point of the professors was to instill in the budding physician of tomorrow a humanity and humility in which we always strive to do our best. Our best is not always good enough in a lawyer’s or judge’s view. When that is not enough, what more is there to give?
As we comply with the Obama laws, rules, regulations and other mandates that circumnavigate the legislative laws, we no longer are able to think of the patient first. Primum non nocere – first do no harm has been the principal precept of medical ethics that all medical students are taught in medical school and is a fundamental principle for emergency medical services around the world. Since at least 1860, the phrase has been for physicians a hallowed expression of hope, intention, humility and recognition that human acts with good intentions may have unwanted consequences.
These concepts are not understood by the legal profession as they outline laws, rules, regulations and mandates. Physicians must now first make sure that they don’t violate the new health care laws, rules, regulations and mandates. The patient’s welfare must now become secondary.
This was exemplified by a senior physician who advised me not to fully evaluate patients admitted to the hospital. He suggested I pick out a primary complaint, evaluate it, treat it and dscharge the patient as soon as possible. Total care was no longer affordable in the current health care environment.
The corollary is seen in Medicare micromanaged healthcare. Physicians and hospitals are pushed to discharge as rapidly as possible. However, if the patient is readmitted, Medicare holds the physician and hospital responsible and may not pay for the readmission since it implies inferior care, which is the likely result of Medicare’s micromanagement.
Thus economics and inferior care, rather than the patient, is the primary concern of medical practice today.
Medical Myths originate when lawyers or others make medical decisions.
Medical Myths will disappear when Physicians regain charge of their medical practice.
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Dr. Rosen: Do most of us have membership in the local medical society?
Dr. Dave: I dropped my membership several years ago. I couldn’t see where it helped in any fashion.
Dr. Yancy: I put in an
application when I arrived in
Dr. Rosen: That should not have been hard to do. Wouldn’t they accept that you took three months off? People in training do that, you know.
Dr. Yancy: But I wasn’t in training.
Dr. Rosen: Well, if you were in practice, you certainly could take three months off.
Dr. Yancy: I’m no longer sure just what all the fuss was about. But I just got fed up with the process. They wanted me to withdraw my application.
Dr. Patricia: Well, did you?
Dr. Yancy: I just left it in Limbo and never pursued it further. I felt the society was probably inconsequential to my career and practice.
Dr. Joseph: I was a member for 40 years of practice and when I retired, I was a non-paying senior and kept getting the society magazine and kept up with all the news.
Dr. Sam: Did you think it was worth it?
Dr. Joseph: In those days it was just assumed that you would join the club. The society and the medical board were working fairly closely together.
Dr. Sam: I joined when I
started practice, but dropped out of the AMA a short time later. When I no
longer felt the
Dr. Paul: I never joined. The pediatricians I knew and shared call with said I shouldn’t waste my money.
Dr. Patricia: Were you ever sorry?
Dr. Paul: In pediatrics, we’re basically on the front line and referrals are from other patients and mothers. So we really don’t need to interface with society members. I did join the Pediatric Group on the second Tuesday of the month. That was always a welcome respite with colleagues at our Aldo’s Restaurant.
Dr. Edwards: That reminds me that I belonged to the Internal Medicine Society and we met on the fourth Tuesday of the month also at Aldo’s. But I also enjoyed the Medical Society on the third Tuesday of every month.
Dr. Milton: I, too, enjoyed both of those meetings. There were collegial and educational. I remember the medical society filled the largest ballroom in town at the Sacramento Inn. I believe we had more than 20 tables filled. Now we can scarcely fill three or four tables.
Dr. Edwards: And it’s no longer monthly. It’s three or four times a year. How sad.
Dr. Rosen: As the societies have become irrelevant, what has taken its place?
Dr. Ruth: We formerly had hospital staff meetings every month. These have now also essentially been reduced to once or twice a year.
Dr. Rosen: Since we no longer have the society, specialty and staff meetings, it looks like managed care meetings have replaced these where we are more-or-less told how to perform. We have lost our independence.
Dr. Milton: Any thoughts on how to regain our position in the health care establishment?
Dr. Paul: I just plan to keep on practicing pediatrics and let all the busy bodies try to ruin our practice.
Dr. Milton: All these outsiders and do gooders certainly will not improve our practice.
Dr. Rosen: Maybe that’s why the government, Medicare and lawyers have taken over. There’s no resistance when you’re filling a void.
The Staff Lounge Is Where Unfiltered Opinions Are Heard.
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The Republicans who now control the House of Representatives hope to repeal or defund ObamaCare, but the law has already yielded profound, destructive changes that will not be undone by repeal or defunding alone. Active steps and new laws will be needed to repair the damage.
The most significant change is a wave of frantic consolidation in the health industry. Because the law mandates that insurers accept all patients regardless of pre-existing conditions, insurers will not make money with their current premium and provider-payment structures. As a result, they have already started to raise premiums and cut payments to doctors and hospitals. Smaller and weaker insurers are being forced to sell themselves to larger entities.
Doctors and hospitals, meanwhile, have decided that they cannot survive unless they achieve massive size—and fast. Six years ago, doctors owned more than two-thirds of U.S. medical practices, according to the Medical Group Management Association. By next year, nearly two-thirds will be salaried employees of larger institutions.
Consolidation is not necessarily bad, as larger medical practices and hospital systems can create some efficiencies. But in the context of ObamaCare's spiderweb of rules and regulations, consolidation is more akin to collectivization. It means that government bureaucrats will be able to impose controls with much greater ease.
With far fewer and much larger entities to browbeat, all changes in Medicare and Medicaid policies will go through the entire system like a shock wave. There will be far fewer individual insurers, doctors, hospitals, device makers, drug manufacturers, nursing homes and other health-care players to resist.
There is little mystery how the government will exercise its power. Choices will be limited. Pathways to expensive specialist care such as advanced radiology and surgery will decline. Cutting-edge devices and medicines will come into the system much more slowly and be used much less frequently.
This is why simply defunding enforcement of the individual mandate and other upcoming directives will not be enough: Given all this consolidation, limits on treatment choices are already becoming hardwired into the system. Lawmakers must take concrete steps to stop and reverse this.
On the provider end, this means enacting tax and other economic shields for insurers and providers that choose not to succumb to the financial pressure encouraging consolidation. It means unwinding all of the rules—about data compilation, reporting and compliance requirements, and information technology—designed to increase overhead to the point that only massive and easily regulated provider organizations can survive.
Legislators will have to scrub the 2,700-page ObamaCare law line by line to remove all of the disincentives for medical practices, hospitals and others to remain smaller and independent.. /. . .
ObamaCare is already doing great damage, even years before its individual mandate and other controls kick in. Its systematic undoing is an urgent necessity.
Dr. Krieger, is a plastic surgeon
VOM Is an Insider's View of What Doctors are Thinking, Saying and Writing about
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By Prof Charles Andrews
“Three kings in
Speaking of a “behind the scenes” look at this
historical moment seems particularly apt given that the film functions at one
level as a film about theater—political theater staged with the highest stakes
as the world collapses into global warfare. Like Mike Leigh’s Topsy-Turvy (1999)
which used the stormy partnership of Gilbert and Sullivan as an entry point
into social dynamics of the nineteenth century British stage, Hooper’s film
focuses on the personal triumph of King George’s speech therapy and the
rich-yet-trying friendship with his therapist Lionel Logue (Geoffrey Rush).
Around the edges of this central relationship is the rise of Hitler, the
maneuvering of Churchill, and the transition from Stanley Baldwin to Neville
Chamberlain as Prime Minister. The tension in the film is largely produced by
the King’s rehearsals for major public performances—his coronation and his first
radio broadcast about the war. Colin Firth fills these rehearsals with
self-hating grimaces and delivers each line as though ripping through
taciturnity. His portrayal of the King is modeled on the restraint of his
breakout role as Mr. Darcy in the
Playing his role as the King, the second son of George V, Firth’s character fears his subjects’ scorn while accepting his fate as their figurehead and national emblem. Looking and sounding the part of monarch is essential to reassuring the public and to retaining the dwindling power of the monarchy. Pretending to have power is the fate of modern British royalty, and in the modern technological era the voice is paramount in this pretense.
Today, new communication technologies such as television and the Internet allow unprecedented access to the up-to-the-second thoughts of public (and private) figures, but The King’s Speech looks back with a kind of wistfulness to the age of the wireless and the newsreel camera as an analogue to our contemporary scene. The Archbishop (Derek Jacobi) notes that mass media is a Pandora’s box that cannot be closed, and we, along with George VI, must agree. Twitter feeds, Facebook walls, and YouTube’s viral videos all seem an extension of Pandora’s furies, and thus we sympathize with the new King who is asked to do what his grandfather never would have. But we also see an era when the politician has much more control over his self-presentation. In a few public appearances, he must act braver than and more eloquent than he really is, but those times are limited and brief. . .
But the film’s emotional core and its most
engaging political content is the friendship between Lionel Logue and the King
(called, after a tussle with nicknames, “Bertie”). So few films manage to
depict friendships among adult men.
. . . the way it conveys stage fright, the sweep of history, and the compassion of two men elevates it above any small film morass. The strident eloquence of Hitler, which acts as a counterpoint to King George’s petrified stammer, provides a sinister undercurrent. In the end, stern British stick-to-itiveness prevails, and viewers may leave a bit more concerned for their leaders despite their privilege. In our modern technocracy, it is refreshing to be reminded that two people sharing faith and fate might transcend the anomie of their day.
The Review Section Is an Insider’s View of What Films and
Books Doctors are Seeing &
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10. Hippocrates & His Kin: Troopers Hunt for Wisconsin Senators
Playing Cops and Robbers
Wisconsin Republican lawmakers dispatched state troopers to the homes of absent Democratic senators in search of a quorum Thursday but came up empty as the state's legislative standoff continued.
Isn’t it amazing that State Senators are now the fugitives?
Lawyers break through the steel roof.
Big Law’s $1250 an hour club for high stakes law that only high profile cases such as “bankruptcy” and “M & A” (Mergers & Acquisitions) can afford.
I’d rather be a physician making $125 an hour treating the poor and needy.
Billing system errors
Thirty percent of medical bills
contain errors. –Stephen Parente, Professor of Health Finance at the
How many are caused by confusions from what’s covered and what’s denied by insurance carriers.
We’ve seen hospital bills in which 80 percent of charges were denied by Medicare or Insurance carriers.
I wonder if that is considered an error or business as usual.
The Fugitives from
Reporters found the
What fugitives except lawmakers could have a more secure safe house?
and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Today & Tomorrow
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• The National Center for Policy Analysis, John C Goodman, PhD, President, who along with Gerald L. Musgrave, and Devon M. Herrick wrote Lives at Risk, issues a weekly Health Policy Digest, a health summary of the full NCPA daily report. You may log on at www.ncpa.org and register to receive one or more of these reports. This month, read their Free-Market Health Care Policy. . .
• Pacific Research Institute, (www.pacificresearch.org) Sally C Pipes, President and CEO, John R Graham, Director of Health Care Studies, publish a monthly Health Policy Prescription newsletter, which is very timely to our current health care situation. You may signup to receive their newsletters via email by clicking on the email tab or directly access their health care blog. This month read about the California Sick Tax . . .
• To read the rest of this column, please go to www.medicaltuesday.net/org.asp.
• The National Association of Health Underwriters, www.NAHU.org. The NAHU's Vision Statement: Every American will have access to private sector solutions for health, financial and retirement security and the services of insurance professionals. There are numerous important issues listed on the opening page. Be sure to scan their professional journal, Health Insurance Underwriters (HIU), for articles of importance in the Health Insurance MarketPlace. The HIU magazine, with Jim Hostetler as the executive editor, covers technology, legislation and product news - everything that affects how health insurance professionals do business.
• The Galen Institute, Grace-Marie Turner President and Founder, has a weekly Health Policy Newsletter sent every Friday to which you may subscribe by logging on at www.galen.org. A study of purchasers of Health Savings Accounts shows that the new health care financing arrangements are appealing to those who previously were shut out of the insurance market, to families, to older Americans, and to workers of all income levels. This month, you might focus on the March Surprise of Obama Care’s one year anniversary.
• Greg Scandlen, an expert in Health Savings Accounts (HSAs), has embarked on a new mission: Consumers for Health Care Choices (CHCC). Read the initial series of his newsletter, Consumers Power Reports. Become a member of CHCC, The voice of the health care consumer. Be sure to read Prescription for change: Employers, insurers, providers, and the government have all taken their turn at trying to fix American Health Care. Now it's the Consumers turn. Greg has joined the Heartland Institute, where current newsletters can be found.
• The Heartland Institute, www.heartland.org, Joseph Bast, President, publishes the Health Care News and the Heartlander. You may sign up for their health care email newsletter. Read the late Conrad F Meier on What is Free-Market Health Care?. This month, be sure to read what 33 governors wrote to President Obama.
for Economic Education, www.fee.org, has
been publishing The Freeman - Ideas On Liberty, Freedom's Magazine, for
over 50 years, with
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
Independence Institute, www.i2i.org, is a
free-market think-tank in Golden,
• 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 how Liberty in the Middle East means Liberty at Home.
• The Fraser Institute, an independent public policy organization, focuses on the role competitive markets play in providing for the economic and social well being of all Canadians. Canadians celebrated Tax Freedom Day on June 28, the date they stopped paying taxes and started working for themselves. Log on at www.fraserinstitute.ca for an overview of the extensive research articles that are available. You may want to go directly to their health research section.
• The Heritage Foundation, www.heritage.org/, founded in 1973, is a research and educational institute whose mission was to formulate and promote public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values and a strong national defense. -- However, since they supported the socialistic health plan instituted by Mitt Romney in Massachusetts, which is replaying the Medicare excessive increases in its first two years, and was used by some as a justification for the Obama plan, they have lost sight of their mission and we will no longer feature them as a freedom loving institution and have canceled our contributions. We would also caution that should Mitt Romney ever run for National office again, he would be dangerous in the cause of freedom in health care. The WSJ paints him as being to the left of Barrack Hussein Obama. We would also advise Steve Forbes to disassociate himself from this institution.
• The Ludwig von Mises Institute, Lew Rockwell, President, is a rich source of free-market materials, probably the best daily course in economics we've seen. If you read these essays on a daily basis, it would probably be equivalent to taking Economics 11 and 51 in college. Please log on at www.mises.org to obtain the foundation's daily reports. You may also log on to Lew's premier free-market site to read some of his lectures to medical groups. Learn how state medicine subsidizes illness or to find out why anyone would want to be an MD today.
CATO. The Cato Institute (www.cato.org) was
founded in 1977, by Edward H. Crane, with Charles Koch of Koch Industries. It
is a nonprofit public policy research foundation headquartered in
Ethan Allen Institute, www.ethanallen.org/index2.html, is one of some 41 similar but independent state
organizations associated with the State Policy Network (
• 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.]
St. Croix Review, a
bimonthly journal of ideas, recognizes that the world is very dangerous.
Conservatives are staunch defenders of the homeland. But as Russell Kirk
believed, wartime allows the federal government to grow at a frightful pace. We
expect government to win the wars we engage, and we expect that our borders be
* * * * *
In the present state of medical knowledge, a pronouncement of the sentence of “incurable” on a patient places a serious responsibility on the physician and implies a greater knowledge than he possesses. –Ernst P. Boas
If a little knowledge is dangerous, where is the man who has so much as to be out of danger? –Thomas H. Huxley.
Many of the supposed increasers of knowledge have only given a new name, and often a worse, to what was well known before. –August W. Hare
Our present knowledge of the universe is such as to leave us with a very inadequate conception of the majesty of existence. –Sir Oliver J. Lodge
Some Recent Postings
TUESDAY - NEWSLETTER - Vol IX, No 22,
11. Related Organizations: Restoring Accountability in Medical Practice and Society
Utilizing the $2 Trillion Information Technology Industry
To Transform the $3 Trillion HealthCare Industry into Affordable HealthCare
Through Innovation by moving from a Vertical to a Horizontal Industry
Thus eliminating $1 Trillion wasted
Insuring every American without spending the Extra $1Trillion Projected
To purchase a copy of the business plan, go to the bookstore at www.healthplanusa.net/index.asp.
In This Issue:
1. Featured Article: Bad Medicine
2. In the News: : Federal Largess allows Crime to Flourish
4. Government Healthcare: Around the World
5. Lean HealthCare: Going Horizontal
6. Misdirection in Healthcare: Why Doctors Don’t Want Free-Market Medicine
7. Overheard on Capital Hill: Jefferson's tender lament didn't make it into the Declaration
8. Innovations in Healthcare: Health Care's 'Radical Improver'
10. Restoring Accountability in Medical Practice by Moving from a Vertical to a Horizontal Industry:
from The Economist | print edition | Mar 3rd 2011
AS THE smiling customer brought the potted plant to the cash register at DeBaggio Herbs in Chantilly, Virginia, Tom DeBaggio began to panic. The plant was small, with spiny, silvery leaves, woody stems and blue flowers. When rubbed between the fingers it gave off a warm, strong, piney smell, a bit like floor polish. But he did not know what it was. He fumbled for the tag, and when he couldn’t find that, asked his wife Joyce what it could be. She told him, rosemary.
Yet he knew rosemary. He probably loved it more than any other plant in his nursery—though the basils and lavenders were right up there, too. He had once been called the best rosemaryologist in America for the work he had done, combing the world for new varieties or cultivating his own. “Gorizia”, found in Italy, with lobelia-blue flowers; “Madalene Hill”, which could take the worst soil and the coldest weather; “Lottie DeBaggio”, straight and pale-flowered, named after his grandmother; “Joyce DeBaggio”, with gold-edged leaves, named after his wife. The last was possibly his favourite, grown from one small, unusual, yellow branch. But now, in 1999, after 25 years in the nursery, he barely knew any of those familiar friends. Come to that, he was having trouble with the cash register, too.
On a beautiful spring day—weather that urged him into the garden, as if he wasn’t there already potting and watering, planting and selling, for 16 hours a day—the doctor told him he had early-onset Alzheimer’s Disease. He was 57. His first reaction was to rage and cry. His second was to go into his greenhouse, where the rosemary plants were in misty, lovely flower, and pull from somewhere the cruel adage that rosemary meant remembrance. But his third reaction was more positive, or desperate. He would try to chronicle for people what having Alzheimer’s was like.
Before he had turned, in 1974, to herb-growing, he had been a journalist on the Wilmington Independent and the Northern Virginia Sun. He hadn’t lasted long at either; his ideas were too left-wing. But there was still a novel in him, somewhere. He knew how to use words, and he realised that as long as he could articulate them, write them, recognise them and arrange them—all tasks that became increasingly difficult—he could give doctors an insight into a world few rationally entered, and almost no one spoke of. At the same time, he could try to pin down the thin, fast-fading shadow that was himself and his past. Otherwise, there would be nothing left.
In the four years after his diagnosis he gave four interviews to National Public Radio; appeared on Oprah Winfrey’s TV talk show; was filmed for an HBO documentary; and produced two books, “Losing My Mind” and “When It Gets Dark”. His interview answers often started confidently, with a rush of distant memories—his report on the first integrated high-school dinner in Virginia, the name of his editor, the exact time he handed in his copy—but foundered in tears when the words failed. He would cry, but then go on. The words were there somewhere, behind blurred window glass, in dark corners, as long as he could remember what he was searching for. That was the trouble: he would suddenly find himself driving his car on Route 50, or in the garden with watering can in hand, and have no idea why he was there. . .
On This Date in History – March 8
On this date in
1841, Oliver Wendell Holmes, Jr., who served 30 years on the
On this date in 1952,
After Leonard and Thelma Spinrad
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We must always
remember that Chancellor Otto von Bismarck, the father of socialized
We must also remember that ObamaCare has nothing to do with appropriate healthcare; it was projected to gain loyalty by making citizens depended on the government and eliminating their choice and chance in improving their welfare or healthcare.