MEDICAL TUESDAY .
Community For Better Health Care
Vol X, No 3,
In This Issue:
11. Related Organizations: Restoring Accountability in HealthCare, Government and Society
* * * * *
Announcing The 1st Annual World Health Care Congress
The World Health Care Congress (WHCC)
convenes the most prestigious forum of global health industry executives and
public policy makers. Building on the 8th annual event in the
This prominent international forum is the
only conference in which over 500 leaders from all regions of
World Health Care Congress Latin America will address escalating challenges such as improving access to quality care, financing and insurance models for health care, driving innovation in health IT, promoting evidence-based medicine and clinical best practices. World Health Care Congress Latin America will feature a series of plenary keynotes, invitational executive Summits, in-depth working group sessions on emerging issues, as well as substantial business development and networking opportunities.
* * * * *
1. Featured Article: Why Are Asthma Rates Soaring?
Researchers once blamed a cleaner world. Now they are not so sure.
Asthma rates have been surging around the globe over the past three decades, and for a long time researchers thought they had a good idea of what might be fueling the increase: the world we live in is just a little too clean. According to this notion—known as the hygiene hypothesis—exposure in early childhood to infectious agents programs the immune system to mount differing highly effective defenses against disease-causing viruses, bacteria and parasites. Better sanitary conditions deprive the immune system of this training, so that for reasons that are still unclear, the body pounces on harmless particles—such as dust and ragweed—as if they were deadly threats. The resulting allergic reaction leads to the classic signs of asthma: chronic inflammation or swelling of the airways and acute spasms of those passageways.
Or so the thinking went. Although a lot of data support the hygiene hypothesis for allergies, the same cannot be said for asthma. Contrary to expectations, asthma rates have skyrocketed in urban areas in the U.S. that are not particularly clean. Moreover, the big increase in asthma rates in developed countries did not kick off until the 1980s—well after general sanitary conditions in the richer parts of the world had improved. And some studies are beginning to show that far from protecting children from asthma, respiratory infections in early childhood may actually be a risk factor for it.
The collapse of the hygiene hypothesis as a general explanation for the startling jump in asthma rates has led physicians and scientists to a new realization: asthma is a much more complex condition than anyone had truly appreciated. Indeed, it may not be even be a single disease. Studies now suggest that only half of asthma cases have an allergic component.
The prevention and treatment implications are significant. If, for instance, it is true that allergy is not a fundamental cause of asthma in many people, then an alternative mix of treatments may be more effective for those individuals. To root out asthma’s cause (or causes) and properly treat the burgeoning number of people who are affected—300 million globally at last count—scientists will have to come to grips with the biology of its various forms.
The hygiene hypothesis was first described in 1989 by David P. Strachan, a British epidemiologist who was studying hay fever. The more children in a family, he noticed, the lower the rates of hay fever and eczema, an allergic skin condition. Children in large families tend to swap colds and other infections more often than children with fewer siblings. Could it be that increased exposure to pathogens from their many siblings was protecting children from large families against allergies?
That same year Erika von Mutius, an epidemiologist at Munich University, was looking into the effect of air pollution on asthma in what was then East and West Germany. Children from dirtier East Germany, she was shocked to find, had dramatically less asthma than their West German counterparts living in cleaner, more modern circumstances. The East German children, unlike their Western counterparts, had spent more time in day care and thus had likely been exposed to many more viruses and bacteria. “That was astonishing,” she recalls, and led to “a major shift” in thinking.
These findings sparked intense debate among scientists. What is it about unhygienic living that might protect against asthma? One of the more popular explanations in the following decades entailed a balance between the immune cells that are involved in the body’s reaction to most viruses and bacteria and those that are involved in the reaction to most parasites and allergens. These two groups of cells produce chemicals that inhibit each other. Early-childhood exposure to bacteria and viruses would cause the infection-related cells to become active, keeping the allergy- and parasite-related cells in check. Without that interplay, the allergy-related cells would later become overreactive, starting an allergic chain reaction that became chronic and ended in constricted airways, asthmatic spasms and labored breathing. . .
* * * * *
2. In the News: Would a 25 percent education budget cut affect classroom education?
Public education now costs federal, state and local governments upward of $500 billion annually. This total is up from $354 billion 15 years ago and currently represents the largest state and local government expenditure. While spending increased nearly 50 percent, enrollment increased by just over 10 percent, reading and science scores held steady and on-time graduation hovered at 70 percent.
districts claim that funding cuts would require them to close schools and
drastically increase class sizes, but states have little choice: K-12 schools
take an average of 36 percent of general funds annually.
Money in the
districts very often define spending categories in unexpected ways, making it
difficult to distinguish classroom spending from operational costs. While
schools annually spend an average of about $10,000 per student, the
if instructional expenses were clearly defined, lengthy regulations make it
nearly impossible to determine how much money actually ends up in the
classroom. For example,
Defining Total Spending. While the NCES reports that instruction is 60 percent of expenditures in the 100 largest districts, a closer analysis reveals that the instructional category only takes an average of 51 percent. The discrepancy arises because the percent of instructional spending is calculated after excluding capital expenditures — including land purchases, construction projects and long-term debt payments — and other spending, such as for leased equipment and adult education. Excluding these expenditures allows districts to report spending a higher percentage on instruction.
Including all dollars spent reduces instruction’s share and gives a clearer picture of the total bill. The figure compares instruction’s reported percentage to its percentage of total spending in a few large school districts. For instance, during the 2008-2009 school year:
School Accountability Requires Transparency. Confusion surrounding K-12 spending is caused by not limiting the expenses classified as instructional to the classroom and not considering all spending when calculating instruction’s share. Determining how many dollars end up in classrooms would allow parents, teachers and legislators to hold administrators accountable, but this cannot be done until classroom spending is distinguished from all other spending. Districts could then measure what percent of expenditures are devoted to the classroom in proportion to every dollar spent, regardless of its budget category.
Instead of cutting dollars spent in the classroom, state legislators should require clear accounting for how education tax dollars are spent, cap noninstructional expenditures as a percentage of spending and limit the growth of spending outside the classroom.
Michael Barba is a graduate student fellow with the
* * * * *
3. International Medicine: The international rankings of healthcare-Commentary Magazine-Blog
| Commentary Magazine | 04.26.2011
has just made available to all online readers Scott W. Atlas’s “The
Worst Study Ever?” from their April issue. Atlas is a professor of
radiology and chief of neuroradiology at the
In fact, World Health Report 2000 was an intellectual fraud of historic consequence—a profoundly deceptive document that is only marginally a measure of health-care performance at all. The report’s true achievement was to rank countries according to their alignment with a specific political and economic ideal—socialized medicine—and then claim it was an objective measure of “quality.”
really go to
* * * * *
Your editorial's criticism of Mitt Romney's 2006 Massachusetts health law is correct in that taxes, costs and political interference in medical decisions have all gone up while access to medical care has deteriorated ("Obama's Running Mate," May 12*). The Massachusetts law also jeopardizes the very solvency of private health plans in the Bay State.
Because it was politically intolerable to allow premiums to rise in line with the costs of RomneyCare, the state's insurance commissioner denied 235 of 276 rate increases in April 2010. For a short time, no new policies were offered and plans suffered significant losses. Read more… The next month, Blue Cross Blue Shield of Massachusetts, the state's largest carrier, announced a $55 million provision for anticipated losses in the second quarter alone. Of the 12 largest carriers, five were already operating at a loss. At this point, even if the state allows Blue Cross Blue Shield of Massachusetts to increase rates in line with medical costs, my analysis concludes that the carrier will become insolvent somewhere around 2017.
John R. Graham
Pacific Research Institute Read more on the Blame Game . . .
*The Romney camp blames all this on a failure of execution, not of design. But by this cause-and-effect standard, Mr. Romney could push someone out of an airplane and blame the ground for killing him. Once government takes on the direct or implicit liability of paying for health care for everyone, the only way to afford it is through raw political control of all medical decisions.
Mr. Romney's refusal to appreciate this, then and now, reveals a troubling failure of political understanding and principle. The raucous national debate over health care isn't about this or that technocratic detail, but about basic differences over the role of government. In the current debate over Medicare, Paul Ryan wants to reduce costs by encouraging private competition while Mr. Obama wants the cost-cutting done by a body of unelected experts like the one emerging in Massachusetts.
Mr. Romney's fundamental error was assuming that such differences could be parsed by his own group of experts, as if government can be run by management consultants. He still seems to believe he somehow squared the views of Jonathan Gruber, the MIT evangelist for ObamaCare, with those of the Heritage Foundation.
In reality, his ostensible liberal allies like the late Ted Kennedy saw an opening to advance their own priorities, and in Mr. Romney they took advantage of a politician who still doesn't seem to understand how government works. It's no accident that RomneyCare's most vociferous defenders now are in the White House and left-wing media and think tanks. They know what happened, even if he doesn't
Government is not the solution to our problems, government is the problem.
- Ronald Reagan
* * * * *
5. Medical Gluttony: The Hospital Bill
Mr George brought in the hospital bill for his two-days admission for alleged pneumonia.
Amount Billed: $47,366 (In for 48 hours-$1,000 per hour)
Amount Pd by Medicare: $12,148 ($250 per hour allowed)
Amount Not Allowed: $34,085 (Listed as savings for the patient)
Co-Payment: $ 0
Amount Paid by Insurance $ 1,132
receiving the hospital records, the x-ray report said
The diagnosis more likely than not would be “An acute febrile illness, probably self limited. Treatment with bed rest, analgesics and antipyretics (OTC or in most people's medicine cabinet) would very likely have produced the same result at virtually no significant medical costs.
Medical Gluttony thrives in Government and Health Insurance Programs.
It Disappears with Appropriate Deductibles and Co-payments on Every Service.
* * * * *
6. Medical Myths: You should drink at least eight glasses of water a day.
The origin of this myth is most likely the fact that a 1945 government agency said that the human body needed around 8 glasses of fluid a day. This included the fluid from all of the foods we eat and drinks like tea and coffee. Somehow over time “fluid” turned to “water” and the modern water myth arose. This also lead to silly slogans like “if you are thirsty it is too late” – a concept that would seem to have been invented by water bottlers who have something to gain from excess water consumption by the general population. So, in reality, if you are thirsty, drink some water. If you are not, don’t.
It is not uncommon in medical practice to find over hydration. This is usually at the behest of some well meaning nurse, wife, mother, daughter telling the patient that they need to drink eight to 10 glasses of water a day. They are also frequently told not to wait until they’re thirsty.
If one drinks more fluids than the heart and circulatory system can manage, the body stores the excess fluid in the legs as edema. As the legs fill up with fluid, the knees then and thighs, hips and even the back develop edema. Of course as the water level in our bodies rise further, it begins to fill up our lungs. At this stage if you don’t get to a physician in time to reverse this and drive two to four glasses away from your body rapidly by diuresis through your kidneys, you will proceed to die in congestive heart failure.
Some times the battlefield will become a winner versus loser struggle. The doctor managing the case will explain to the well-meaning nurse, wife, mother, daughter that the patient is dying in his own excess fluid. On occasion, they may listen. On other occasions, the well meaning nurse, wife, mother, daughter feel they have an incompetent physician who doesn’t appreciate this simple “medical rule” and will continue to give the patient excessive fluids during the evening, night and morning when no one can monitor their misunderstanding and the physician loses the battle to save his patient’s life.
Ignorance will sometimes reign supreme.
Old Wives’ tales are sometimes difficult to manage.
* * * * *
7. Overheard in the Medical Staff Lounge: Is Mitt Romney Presidential?
Dr. Rosen: Last week we were discussing why Newt Gingrich wasn’t fit to be president. I believe that Ruth took issue, not because the marriage was over, but that he chose to tell his wife while she was in the hospital in the midst of her critical cancer time that he was divorcing her. He couldn’t even wait until she was home to do it privately. Meanwhile, Michelle felt that his arrogant behavior was really unbelievably, crude, inhumane, insensitive and so undignified that he should never be the leader of our country. I think she even referred to him as a scumbag. Maybe the events of his staff deserting him were well deserved. I don’t think we can even imagine that Governor Mitt Romney would ever be subject to such behavior. But is he Presidential?
Dr, Ruth: I agree, he will never have an adverse moral issue.
Dr. Sam: He’s a far greater threat to freedom than Gingrich ever thought of being.
Dr. Paul: How do you figure?
Dr. Dave: He did in
Dr. Paul: I know some doctors
who feel health care has improved under Mitt Romney in
Dr. Dave: I think if you read the accolades closely, the ones that like Mitt Romney’s brand of government medicine are more committed to government control than to patient’s medical welfare.
Dr. Paul: Don’t you think that reading your interpretation into what Mitt Romney says is your own bias?
Dr. Dave: It’s not only what
Mitt Romney says, but also that he was able to pull it off in
Dr. Sam: Prejudice is sometimes difficult to overcome.
Dr. Paul: I don’t think it’s
prejudice. I think these are well-meaning physicians who truly believe that
Romney care has improved healthcare in
Dr. Sam: I think if you look at all the stats, what people are covered, how well they’re covered, the costs overruns that have reduced benefits in their second year; there is nothing but a downside. Like Medicare, the cost overruns measure into catastrophic numbers. And still people call it a success—it will work if we do some fine-tuning. We’ve been fine-tuning Medicare for fifty years, and it is still out of tune. Even with the government contracting most of the program out to insurance companies in the various states.
Dr. Dave: We can look at
every government healthcare program throughout the world.
Dr. Edwards: We formerly had a socialist at the county medical society journal and we would go through the same arguments. He would simply brush them all off and tell us “Socialized Medicine has never been done right. It has always allowed too much freedom for people to choose. We have to have enough power to force the people to toe the line, monitor every medical decision to see what is most cost effective, and not allow any variation from the best of care.”
Dr. Milton: He didn’t have enough understanding of finances to even begin to understand the cost of monitoring healthcare with RNs behind every nurse’s station monitoring the orders as written, RNs reviewing every doctor’s private charts, RNs reviewing every lab order, RN’s reviewing every x-ray order, etc, et. al. Every two or three RNs would equal one physician’s entire income.
Dr. Rosen: One insurance man from a large medical insurance firm once admitted to me, after a meeting when everyone was gathering in the lounge, that they could problem dispense with their army of nurse reviewers, pay the usual and customary fees from doctors and other providers, and probably save money. But, don’t think we’ll ever give up our control over doctors and hospitals.
Dr. Dave: The WSJ stated that Romney was to the left of Obama. It would seem that Obama should choose Romney as his running mate in 2012.
Dr. Rosen: That’s an excellent idea. At least they are two birds of same feather. If Romney ran against Obama, I would be unable to vote.
Dr. Ruth: I agree. I wouldn’t be able to vote in 2012 either if Obama ran against Romney. After the elections were over, no one would know the will of the people.
Dr. Dave: That would be the height of confusion and misdirection and misinterpretation. The politicians could lead us by the nose and say it was the will of the people.
Dr, Rosen: How did we ever get into this political mess? There would be no front door of leadership to a known future. Politics would reign supreme. Politicians enjoy keeping people confused and misdirected. That’s how the re-enslavement revolution will come about—without firing a shot. Humankind will have wasted 300 years in their search for freedom. Everything could be lost in one administration. What a human tragedy—of Shakespearian dimension.
The Staff Lounge Is Where Unfiltered Opinions Are Heard.
* * * * *
8. Voices of Medicine: A Review of Local and Regional Medical Journals: Sonoma Medicine
By Herb Brosbe, MD
The title of this article tells you that you are dealing with an elder physician. You’ll have to Google Marcus Welby. There are no references in this article. It is one of those close-to-home pieces. I feel an overwhelming need to express myself. If I offend anyone, I apologize.
I feel like the last of the Mohicans. My culture is dying. Everywhere I look medicine is changing. I cannot stop it, but I need not applaud.
The current model of primary care (the gatekeepers have left, right?) appears to be a clinic. A place where the doctors triage and treat. You have a short time to diagnose the problem. Patients are often interrupted as you try to get to the point. You can’t get too far behind.
When I grew up in medicine, the commonest model was private practice. A small office of one to three physicians. This model is now considered inefficient. I simply do not believe this to be true. Read more . .
I was classically trained that taking the history was the most important part of the interaction. The exam, laying on of hands, provided more clues to reinforce the information you gleaned from the patient’s story.
Recently I had a man follow up from a visit to the ER for severe chest pain (case details have been changed throughout this article). As my office staff once again scrambled to gather whatever information was available, I could not help but wonder why in the 21st century communication between the ER and the community physician is so abysmal. Apparently the young doctor (the patient’s description) ordered the usual cardiac evaluation: CT chest and angiogram. The patient was sent home with hydrocodone and omeprazole. I asked him about his day before the chest pain. He had spent the day pruning trees. Hard repetitive work for hours. When I examined him, I pressed upon his chest wall muscles and reproduced the severe pain. This does not make me a better doctor, it just means I make time to take the history.
Dr. Abraham Verghese, author of Cutting for Stone, is professor for the theory and practice of medicine at Stanford. He spends hours teaching his students the art of taking a history and doing a physical before ordering tests. When I was a medical student at UCSF in the 1970s, this was not a novel idea.
Only a dozen or so primary care doctors in our community still admit their own patients. I am in awe of the young hospitalists. So talented, so competent. I have worked in countries in which the best and the brightest work in hospitals and the rest are in community clinics. Often a veil of disdain grows between these physicians over the years.
Our hospitalists appear to be overworked. They do not have time to communicate with the patient’s primary care doctor, and often tests are repeated that were taken recently elsewhere. I have seen a hospitalist admit one of my cardiac patients, change her medications and discharge her, never telling her cardiologist that she had been admitted. . .
gets compromised when my specialist’s office staff is too busy to ask the
patient, “Who referred you? Who is your primary care doctor?” Case in point. My
patient gets sent to the orthopedist. Orthopedist without communicating with me
sends her on to neurologist. Neurologist without communicating with orthopedist
sends her on to medical center. Later I get an email asking, “What am I
supposed to do now?” I have to respond, “What are you trying to say?” Stunned,
I read the reply: “I was diagnosed with
Colleagues, why can’t we treat each other with a little respect and communicate with each other?
In my small office, I have the privilege of being able to spend more time with patients if I choose. Case in point. “Carlos” is 19. He is dressed in typical rapper fashion. He wants to discuss how to get rid of multiple warts on his fingers and hands. I explain what a wart is and the various ways they can be treated. I know Carlos. I delivered Carlos.
I ask him, “How’s work with your uncle going?”
“Didn’t work out,” he states simply.
“Too bad,” I respond. “What’s next?”
“That’s the problem,” he says, “I don’t know.”
We talk for a while about the possibilities. I encourage him to seek an appointment with a guidance counselor at the JC. He agrees. He stands up to leave. I extend my hand. He gives me a hug. “Thanks, doc,” he says.
And that, ladies and gentleman, is what it’s all about. Caring. . .
It is true that I do not see 30 patients a day. I see 15 usually. I do not believe that makes my style of medicine obsolete or inefficient. Caring for patients is different from treating them. Competency and caring are the skills that lead to better outcomes with less expense. This I know.
Dr. Brosbe is a
VOM Is an Insider's View of What Doctors are Thinking, Saying and Writing about
* * * * *
9. Book Review: CLONING OF THE AMERICAN MIND
CLONING OF THE AMERICAN
"The educational system should be a sieve, through which all the children of the country are passed. . . It is very desirable that no child escape inspection. . ."
Paul Popenoe, behavioral eugenicist
American Eugenics Society; Editor, 1926
With this quotation, B K Eakman, educator, speech and
technical writer, and researcher, sets the tone and the caution of a
well-researched "call to alarms." She previously wrote the first
publication to warn of individually identifiable psychological assessments
being given under cover of academic (achievement) testing. That 1991 book, Educating
for the "
Eakman does a masterful job chronicling three parallel efforts dating over a century--information gathering methodologies, behavioral science, and legislation--and places these in context to provide insight, not only into the times and circumstances surrounding each event, but the ramifications for our present era.
Cloning of the American Mind centers on
This book explores today's behemoth psychographic consulting/information brokerage industry, focusing in particular on state-of-the-art computer technologies and advertising strategies to illustrate how behavioral scientists are combining these with psychiatry to reform education. In the process, Eakman shows us two factions of behavioral science as they evolve, clash, and then come together to accomplish what no extremist group or power elite has been able to do in the history of the world: hold an entire population hostage to a set of quasi-political, psychological criteria by predicating children's job prospects on whether they hold "acceptable" worldviews and opinions. These social engineers, by obtaining personal information about youngsters and their families, also get into the belief system of the students and correct any viewpoints they find distasteful.
As a society we are getting desensitized to divulging personal information. We're no longer sure what "personal" means. Certainly our children don't know. When they're asked questions about the family's medicine cabinet, mental problems, drinking habits, sexual practices, they are only too eager to impress, divulge and exaggerate information to please the teacher, and sound impressive misinterpreting what they see and hear. False information is thereby interspersed with accuracy being of little or no concern to those collecting information. The media, of course, has no stake whatsoever in other people's privacy.
The critical point is that there is a computer model available to predict behavior, simply by deriving a pattern of one's past activities. These activities can include anything from long-distance telephone usage to spending, recreation, and health. These are increasingly available, not only as part of any security background check, but also can now be added to a routine background check. If this is not enough, there is the ever-lurking "information underground' to which even government officials turn when they cannot get their data on us through legitimate channels.
Eakman points out that Jeffrey Rothfeder in his 1992 volume, Privacy For Sale, decided to show just how much information he could obtain about a prominent public figure. He selected former Vice-President Dan Quayle, someone he held in mild contempt. By using his personal computer and telephone, Rothfeder found he could easily gain access to information he wasn't supposed to be able to get. He found more than he bargained for and started sounding alarms. However, Rothfeder was blissfully unaware that techniques identical to those he was describing were being used in the nation's elementary and secondary schools. A database exists that not only has the capability to track and cross-reference generic information about people, their beliefs, family ties, friends' and associates' names, addresses, phone numbers and aliases; political/civic clubs and associations joined; magazine subscriptions; frequent shopping places; political campaigns and causes contributed to; how important a person is by region, state, or city; what potentially embarrassing information one may harbor; but can also predict a person's future action.
Education policy--indeed, all of social policy today--is aimed at dysfunctional people, not toward the backbone of society. When ordinary folk use the term "parents," we mean the majority of upstanding, decent people who care about their children. Statistics show that about one-half of one percent of American youngsters have no responsible adult to care for them. Yet, over the past 30 years, social and domestic policy has focused almost exclusively upon this irresponsible, negligent and abusive element. So when education policy makers hear the term "parents," they're thinking of negligent, abusive, and irresponsible people, or at the very least, of "rank amateurs." . . .
By the late 1970s, day care was a booming business. Awash in unworkable philosophies of child management for over a decade, parents could scarcely get rid of their youngsters fast enough or for long enough periods. Psychiatrists touted the day care concept as beneficial not only to parents, but a boon to a child's socialization and school-readiness. Reality, however, was less positive. Daycare overstimulated toddlers, transmitted diseases like hepatitis, and weakened the bonds between parent and child. Institutions of learning had now taken on a new function: that of substitute parent.
Eakman's behind-the-scenes objective look at our bureaucratic education system makes Cloning of the American Mind an indispensable book for parents, educators, physicians, or anyone involved with our children. One can open up this volume to almost any of its 600 pages and find alarming news. In these two pages I have just touch the tip of the iceberg of what Eakman is telling us is happening to our children and the future of our society. We should all purchase our own volume for careful reading and tell all our friends about this book. We should even consider an extra volume for a concerned friend, and one for a member of our local school board. Our country's future is at stake--and our children won't be able to save it unless we take drastic action now.
The epitaph of the 20th century should be: "Here lie the victims of open-mindedness." --Joseph Sobran, syndicated columnist.
The Book Review Section Is an Insider’s View of What Doctors are Reading about.
* * * * *
10. Hippocrates & His Kin: In Vino Veritas
P. J. O’Rourke with a modest proposal for a more honest politics.
Mitt Romney (with apologies
for making him violate his religious principles by taking a drink): “I’m a
technocrat. I fix problems. I fix a problem whether the problem exists or not.
Like health care in
Newt Gingrich: "The thing is I'm brilliant—dazzlingly brilliant. I'm dazzled by my own brilliance. I'm so dazzled sometimes I can't see where I'm going. I bumped right into Paul Ryan's budget proposal. I'm a deer in my own headlights."
Mr. O’Rourke’s many books include “Don’t Vote—It Just Encourages the Bastards.” WSJ
Dear President Obama:
I am writing
today with a somewhat unusual request. I am asking that you return
Prime Minister Benjamin Netanyahu
and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Yesterday, Today & Tomorrow
* * * * *
• 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. NCPA HealthCare Policy: We have a health care crisis because doctors, patients, employers and employees are trapped in a wasteful, broken system that is too bureaucratic and far too unresponsive to patient needs and market forces. To solve our problems, your doctor needs the opportunity to produce higher-quality, less-costly care. As a patient, you need access to services you are not now getting. At the workplace, you need access to health insurance that costs less and gives you more. At the NCPA, we believe sensible reforms, based on the innovative and competitive nature of the free-market, would help us build a more sustainable health care system.
• 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. Vol.9 No.4, April 2011, Key Points
•The Medicare part of the Ryan budget is superior to Obamacare but needs more definition.
•The current proposal would limit future Medicare beneficiaries’ choices to those selected from a federal exchange.
•Medicare beneficiaries would benefit more from Republicans’ clear commitment to restore Medicare Advantage, a popular alternative to the traditional Medicare monopoly that half of current beneficiaries will lose due to Obamacare.
•Republicans should advance Medicare reforms in a way that makes their benefits more clear to the public, by building on the popularity of Medicare Advantage and Medigap, rather than appropriating the language of “exchanges” from Obamacare.
Throughout the time period
examined, the portion of Medicare that is funded by our tax dollars is slated
to remain roughly constant at 40%. As a percentage of
• 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 what’s happening to Medicare: Without a serious course adjustment, Medicare will become a third-rate, price-controlled program that rations a lower quality of care through waiting lines and other restrictions. If the antiquated, open-ended, fee-for-service model isn’t reformed, then we will continue to pour deficit-funded dollars into the program or raise taxes to levels that would topple the economy as millions of baby boomers hit retirement. The only way to save Medicare is to change it.
• 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?. On November 2, millions of Americans voted to take back their country. Now the real work begins: to hold those elected officials accountable to their promises of lower taxes and smaller government. To support their efforts, The Heartland Institute is making available free copies of a new 260-page book, The Patriot's Toolbox, and nearly a dozen booklets that present in plain English what needs to be done to reform health care, state budgets, schools, environmental policy, and more. You can read these publications online, download, them, or ask for free copies. (read more)
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. "No one would accept the argument that a mugger or a burglar is entitled to someone’s property if he’s walking down a given street or living in a given neighbourhood. So what entitles the state to make that identical claim?"
• 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
* * * * *
Words of Wisdom by Eric Hoffer (1902-1983)
We clamor for equality chiefly in matters in which we ourselves
cannot hope to obtain excellence. –The
Passionate State of
No matter how noble the objectives of a government, if it blurs
decency and kindness, cheapens human life, and breeds ill will and suspicion—it
is an evil government. –The Passionate
We cannot win the weak by sharing our wealth with them. They feel our generosity as oppression. –The Ordeal of Change
There can be no freedom without the freedom to fail. –The Ordeal of Change
I doubt if the oppressed ever fight for freedom. They fight for pride and power—the power to oppress others. The oppressed want above all to imitate their oppressors; they want to retaliate. –The True Believer
It is to escape the responsibility for failure that the weak so eagerly throw themselves into grandiose undertakings. –The True Believer
Some Recent Postings
In The April 26 Issue:
The Economist | Apr 28th 2011 | from the print edition
ALTHOUGH it was medicine for which he won his Nobel prize, Barry Blumberg was really an explorer. Growing up in Brooklyn, he dreamed of being Shackleton at the South Pole or Darwin on board the Beagle. His heroes were Lewis and Clark, the intrepid explorers of the new American continent, and the field-trip grants he founded in later life were named after them. Invited to China in 1977 to talk about his great discovery, a virus that caused hepatitis, and his greater invention, a vaccine to prevent it, he would slip out in the early mornings to run for hours through fields, farmyards or the just-stirring streets of Beijing. As master of Balliol College, Oxford from 1989-94—the first American to hold the post, and the first scientist—he would pedal out eagerly into the countryside, his burly frame well waterproofed against the English weather, to see what he might see.
On these trips he would have a vague plan A, a goal in view, for he had learned to appreciate planning during a wartime spell in the navy; but plans B and C might be good, too. Like Tristram Shandy, he preferred the apparently random and open-minded route. His scientific method was to gather huge amounts of data, with exuberant curiosity, in order to let some discovery surprise him. “Goal-oriented” institutions, such as the National Institutes of Health, found it hard to work with him, and he with them, but he would cheerfully decamp to freer places, such as the Institute for Cancer Research, which let him roam until relevance emerged from his roamings. “Expect the unexpected” was his motto—after Heraclitus, who said you could never step into the same river twice.
His career in medicine (itself unexpected, since he had wandered towards maths, in the steps of his Uncle Henry, and then physics, all within the reach of his omnivorous intelligence, before ending up, at his father’s stray suggestion, at Columbia University’s medical school) was animated not by a goal, but by a question. Why did some people fall sick, when others did not? As a young doctor on the hellish, Hogarthian wards of the Bellevue Hospital in lower Manhattan, he noticed that some among his poor, desperate patients contracted TB, while others stayed healthy. A field trip in 1950 to Suriname, to a remote township reachable only by river, reinforced the puzzle: native Creole workers in the sugar plantations often developed elephantiasis, but Javanese did not. Dr Blumberg became fascinated by polymorphism, the study of inherited variations in human beings. Round the world he went, to Nigeria, Australia, the Arctic, India, taking thousands of blood samples, hoping something would show up.
What showed up one day in 1964, quite unexpectedly, as he was studying yellow jaundice, was a mysterious protein in the blood of an Australian aborigine. It turned out to be the surface antigen, or immune-response trigger, for hepatitis B—a principal killer among the world’s diseases, and a chief precursor of liver cancer. Once the virus and its antigen were found, Dr Blumberg and his team devised tests for it, so that donors could be screened before giving the blood that often transmitted the infection. They also made a vaccine for it, the first “cancer vaccine” ever invented.
The scientific establishment was reluctant to accept his work, and pharmaceutical companies were slower to develop it; Dr Blumberg felt like a usurper battering at the palace gates. Defiantly, and with typical generosity, he shared his findings with the world, sending out reagent kits and copies of his patent to anyone who wanted to carry forward his research. At last, in 1982, Merck put the vaccine on the market. Its effects were dramatic. In China the chronic hepatitis B infection rate among children fell from 15% to around 1% in a decade; in the United States and many other countries, post-transfusion hepatitis B was almost eradicated within a few years. Public immunisation programmes, urged on by Dr Blumberg in private chats with the high-and-mighty, saved and are still saving millions of lives. . .
On This Date in History – May 10
On this date in
1869, the first transcontinental railroad link was completed at Promontory,
On this date in
1940, Winston Churchill became Prime Minister of
After Leonard and Thelma Spinrad
Thank you for joining the MedicalTuesday.Network and Have Your Friends Do the Same. If you receive this as an invitation, please go to www.medicaltuesday.net/Newsletter.asp, enter you email address and join the 10,000 members who receive this newsletter. If you are one of the 80,000 guests that surf our web sites, we thank you and invite you to join the email network on a regular basis by subscribing at the website above. To subscribe to our companion publication concerning health plans and our pending national challenges, please go to www.healthplanusa.net/newsletter.asp and enter your email address. Then go to the archives to scan the last several important HPUSA newsletters and current issues in healthcare.
Please note that sections 1-4, 6, 8-9 are entirely attributable quotes and editorial comments are in brackets. Permission to reprint portions has been requested and may be pending with the understanding that the reader is referred back to the author's original site. We respect copyright as exemplified by George Helprin who is the author, most recently, of “Digital Barbarism,” just published by HarperCollins. We hope our highlighting articles leads to greater exposure of their work and brings more viewers to their page. Please also note: Articles that appear in MedicalTuesday may not reflect the opinion of the editorial staff.
ALSO NOTE: MedicalTuesday receives no government, foundation, or private funds. The entire cost of the website URLs, website posting, distribution, managing editor, email editor, and the research and writing is solely paid for and donated by the Founding Editor, while continuing his Pulmonary Practice, as a service to his patients, his profession, and in the public interest for his country.
Spammator Note: MedicalTuesday uses many standard medical terms considered forbidden by many spammators. We are not always able to avoid appropriate medical terminology in the abbreviated edition sent by e-newsletter. (The Web Edition is always complete.) As readers use new spammators with an increasing rejection rate, we are not always able to navigate around these palace guards. If you miss some editions of MedicalTuesday, you may want to check your spammator settings and make appropriate adjustments. To assure uninterrupted delivery, subscribe directly from the website rather than personal communication: www.medicaltuesday.net/newsletter.asp. Also subscribe to our companion newsletter concerning current and future health care plans: www.healthplanusa.net/newsletter.asp
Del Meyer, MD, Editor & Founder
Always remember that Chancellor
Otto von Bismarck, the father of socialized medicine in
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.