MEDICAL TUESDAY. NET

NEWSLETTER

Community For Better Health Care

Vol X, No 14, Oct 28, 2011

 

In This Issue:

1.                  Featured Article: Is free transportation, regular toenail trimmings revolutionary?

2.                  In the News: Rick Perry's jobs-creation plan is a liberal nightmare.

3.                  International Medicine: UK: National Health Service

4.                  Medicare: Romney still favors an Obama approach to Healthcare

5.                  Medical Gluttony: : Transparency in Medical Charges Would Prevent Gluttony

6.                  Medical Myths: Promises of ObamaCare

7.                  Overheard in the Medical Staff Lounge: Who will be our next President? Does it matter?

8.                  Voices of Medicine: Don’t Let Chaos Get You Down

9.                  The Bookshelf: New American film: Dirty Hoover

10.              Hippocrates & His Kin: RomneyCare in America would be a BIG MISTAKE

11.              Related Organizations: Restoring Accountability in Medical Practice and Society

Words of Wisdom, Recent Postings, In Memoriam, Today in History . . .

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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.

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.

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1.      Featured Article: Is free transportation, regular toenail trimmings revolutionary?               

The Quiet Health-Care Revolution

By Tom Main and Adrian Slywotzky

While legislators talk about “bending the cost curve,” one company serving Medicare patients has discovered how to provide better care at lower cost—with wireless scales, free transportation, regular toenail trimmings, and doctors who put the patient first.

Ellen, an 82-year-old widow, lives in Anaheim, California. One Wednesday morning last year, she got on her scale, as she does every morning. One hundred and forty-six pounds—wasn’t that a little high? Ellen felt vaguely troubled as she poured herself a bowl of oat bran.

Half an hour later, the phone rang. It was Sandra at the clinic. She too was concerned about Ellen’s weight, which had jumped three pounds since the previous day. Sandra knew this because Ellen’s scale had transmitted its reading to the clinic over a wireless connection.

Given that Ellen had a history of congestive heart failure, a three-pound weight gain in 24 hours was a potentially dangerous development, a sign of possible fluid buildup in the lungs and increasing pressure on an already stressed heart. Sandra wanted her to come in for an immediate visit: the clinic would provide a car to pick her up and bring her back home. Ellen’s treatment began that very morning and continued for two weeks until she was out of danger. Had the warning signs not been noticed and addressed so quickly, she might easily have suffered a long, painful, and expensive hospitalization. . .

Read the entire article and see if you believe providing patients with taxi service is cheap? . . .

Editor’s Note: Ellen has a history of congestive heart failure which requires a decrease fluid intake or a diuretic to increase the fluid leaving the body. Since, this is a foreseeable problem, the patient and her family should have received the cautionary instruction that if the weight increases three pounds in one day, to take an extra diuretic and lose a pound or two of fluid by foregoing two glasses or one pound of water that day. If the weight hasn’t corrected in 24 hours, the patient can repeat the same procedure the following day.

The cost comparison to any even uneducated American should surely figure out that the cost of a taxi ride to and from an office and a medical examination will be at least a hundred to a thousand fold more expensive that the cost of one or two diuretic pills, self-administered. 

What poses as revolutionary health care is indeed a pathetic picture of today’s health care understanding.

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2.      In the News: Rick Perry's jobs-creation plan is a liberal nightmare.

Rick Perry's Jobs Plan Is a Nightmare for Liberals

The Atlantic Wire | by John Hudson | Oct 14, 2011

Rick Perry's jobs-creation plan is a liberal nightmare. On Friday, the Texas governor unveiled his manifesto at a steel plant in Pittsburgh, which promises to generate 1.2 million jobs by expanding oil and gas production and slashing environmental regulations. In other words: drill baby, drill. Since dropping sharply in the polls with the rise of Herman Cain, Perry sort of fell off the liberal radar screen. His “Energizing American Jobs and Security” fixed that! In today's lefty blogosphere, he's the talk of the town. Here's how they're picking apart his plan:

It will kneecap green energy startups, writes Ezra Klein at The Washington Post. Perry's plan calls for an end to green subsidies. (To be fair, he also calls for an end to gas and oil subsidies too.) But Klein says that still doesn't create an even playing field. "Analysts have argued that fossil-fuel producers would primarily benefit from such a move, since they enjoy all sorts of legacy advantages." . . .

Its job-creation numbers are "unrealistic," writes Michael Levi, senior fellow for energy at the Council on Foreign Relations. Levi says 500,000 jobs created is the absolute maximum an energy policy could create by 2030. Of those numbers, about 130,000 would be oil and gas jobs. The problem with Perry's policy is that it assumes he will be "reversing deeply anti-industry Obama policies that don't actually exist (which is not to say that the Obama policies have no flaws), ignore real constraints at the state level, and don't fully account for market dynamics."

It endangers protected lands, writes Judd Legum at Think Progress. He cites two policies baked into the plan: “We also strongly recommend opening other federal lands with known resources for development, particularly in Alaska, the Atlantic OCS, and our western states. Alaska’s Arctic National Wildlife Refuge (ANWR) Coastal Plain (1002) alone contains as much as 12 billion barrels of oil and 10 trillion cubic feet of natural gas.” In another part of the plan, it discusses fast-tracking permits for drilling along the Gulf Coast. "“The first step towards energy security and job growth is returning immediately to 2007 levels of permitting in the Gulf of Mexico, responsibly making more of the Gulf available for energy production.”

Read the rest of the story on The Atlantic Wire . . .
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3.      International Medicine: UK: National Health Service

NHS reforms: American consultancy McKinsey in conflict-of-interest row

By Daniel Boffey guardian.co.uk

Firm receives £250,000 a year from government while also providing paid-for advice to GPs affected by changes

 A global consultancy firm seeking to profit out of the fallout from the shake-up to the NHS is being paid £250,000 a year by the government for advice on the transition towards health secretary Andrew Lansley's vision of the service.

The American firm, McKinsey Inc, with estimated revenues of £4.1bn a year, has been advising the Department of Health on how best to manage the radical changes since March. McKinsey is also one of a group of private consultants that have united to provide paid-for advice to GPs as they prepare for life after the reforms.

Family doctors need help from private companies because of the government's decision to abolish primary care trusts as part of their controversial changes to the health service, a move criticised as a step towards privatisation.

McKinsey's advisory services emerged in a freedom of information release published on the department's website. The job description says: "Consultancy services in support of the NHS transition programme". . .

It is unclear how McKinsey is assisting. However, in September this newspaper revealed the company had been acting as a middleman between Lansley's department and international firms, including the German company Helios, which was at one time interested in taking over selected NHS hospitals.

Christina McAnea, head of health at the Unison union, said the revelation was evidence of the increasing hold private companies had over health policy. She said: "It is clear that the Tory government's direction of travel for the NHS is towards privatisation and they are increasingly open about that.

"But what is also becoming obvious is the close relationships being built between this Conservative government and the private companies who are making, or want to make, a profit from the reforms in the health and social care bill. It is worrying for everyone, but particularly patients, because this is money that should be spent on their care." . . .

The government rate card shows that consultants can earn up to £1,870 a day each working for the civil service. A junior consultant can earn £400 a day. A three-month contract for a top consultant could net their company almost £120,000 for just 60 days' work. . .

Earlier this summer this newspaper revealed the existence of confidential emails between McKinsey and the government showing that the firm had helped the department to hold discussions last year about "international players" running up to 20 NHS hospitals.

The emails suggested there had been "good discussions" on "how international hospital provider groups may help to tackle the performance improvement of English hospitals".

It said there was "interest in [a] new solution for 10 to 20 hospitals", but said this would be "starting from a mindset of one at a time" due to "various political constraints".

The consultants suggested that a figure of £500m revenue "on the table" and a "free hand on staff management" would be needed for "international players" to run hospitals.

Private involvement has been suggested as a solution for NHS trusts with financial difficulties that may not be able to attain foundation trust status. One hospital trust, Hinchingbrooke Health Care, is already set to be run in a franchise arrangement by the private firm Circle, although the deal has been delayed awaiting ministerial sign-off. . .

A spokesman for McKinsey declined to comment.

Read the entire report at the Guardian . . .
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The NHS does not give timely access to HealthCare; it only gives access to a waiting list.
Cost of privatization will be miniscule compared to the NHS costs.

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4.      Medicare: Romney still favors an Obama approach to HealthCare

by Grace-Marie Turner | The Janesville Gazette

Opposition to the Affordable Care Act motivated millions of Americans to throw more than 60 Democrats out of Congress last November—largely because they had supported the health overhaul law.

Democratic pollster Patrick Caddell said voters saw the law’s passage as a “crime against democracy” and they want it repealed.

A majority of Americans now oppose the federal health law, and only 18 percent think it will actually help them, according to an October Kaiser public opinion survey. Voters are seething as they learn more about its harmful impact on health costs, jobs and the ballooning deficit.

RomneyCare is too similar to ObamaCare for former Massachusetts Gov. Mitt Romney to escape this voter anger. by Jonathan Gruber, who advised Romney in passing his universal coverage law, confirms the federal health law “is essentially based on what we accomplished in Massachusetts. It’s the same basic structure applied nationally.” President Obama also says Massachusetts was his model.

While Romney insists the Affordable Care Act “is bad news” and must be repealed, even he gets confused about what he means. In the most recent Republican presidential debate, he said: “We all agree about repeal and replace. And I’m proud of the fact that I’ve put together a plan that says what I’m going to replace it with.”

Does he really mean he sees Massachusetts as a model for his “replacement” plan even as he insists it’s not?

When challenged by his fellow candidates, the usually unflappable Romney stumbled. Former Pennsylvania Sen. Rick Santorum hit Romney over costs.

“What you did is exactly what Barack Obama did: focused on the wrong problem. … You expanded the pool of insurance without controlling costs. You’ve blown a hole in the budget up there. And you authored in ObamaCare, which is going to blow a hole in the budget of this country.”

Romney acknowledged “I didn’t get the job done in Massachusetts in getting the health care costs down,” but added it’s “something I think we have got to do at the national level. I intend to do that.”

But you “didn’t do it” in Massachusetts, Santorum shot back.

Health costs in Massachusetts are higher than in any other state: Health spending is rising 15 percent faster than the national average. Economists from Stanford and Columbia universities have estimated that the state health-care law was responsible for hiking premiums by as much as 6 percent. . .

The state decides how much health insurance residents can afford “not, unfortunately, from your perspective but from the state agency’s view,” a government official told them.

RomneyCare remains Romney’s Achilles’ heel. Without a clearer position, he will have trouble convincing Republican voters he is serious about repeal and will have an even harder time mapping a clear plan on health reform should he be elected president.

Read the entire article by Grace-Marie Turner . . .
 to Healthcareifver gain White Ho
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 Government is not the solution to our problems, government is the problem.

- Ronald Reagan

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5.      Medical Gluttony: Transparency in Medical Charges Would Prevent Gluttony

It’s been well known there are huge discounts available in health care as long as you have an insurance company or group practice shielding you from the cost. But what are these costs and how much is shielded?

Medical charges are somewhat hidden unless it is you that are getting the bill. Then you will see the usual charge and how much your insurance saved you from paying. However, I don’t see much consistency in the bills coming to my home. I see laboratory charges being reimbursed by my insurance at about one-third to one fifth the full charge with a statement that my doctor, or lab, or hospital can’t come after me for the difference with a little note that “we” saved you this amount of money.

When I see a $374 lab charge getting paid by my insurance company at $79, my concern rests with the laboratory. “How can they remain in business?”

When I see my $150 charge for patient care being reimbursed at $45, I’m beginning to wonder how long I can stay in business.

Today we saw the statement from an oxygen company listing a concentrator for a charge of $760.48. The Medicare Fee schedule will reimburse the oxygen supplier for $173.31. The portable oxygen system rental charge was $153.44 and the Medicare Payment in Full was $28.74. What would an individual pay who didn’t have insurance? Would the oxygen company go after the emphysema patient in respiratory failure for the entire amount or would they be satisfied with the Medicare discounted amount?  How could anyone ever consider this subterfuge to be a legitimate business proposition?

A new twist that a colleague shared with me this past week, was the variations in the payments required by Medicare, Blue Cross and Medicaid. If you didn’t have insurance, what would your charges be? And if you went to the hospital or lab before you gave them an MRI requisition, how large a discount do you think you would receive or could command?

If an MRI lists for $1500, it is likely that Medicare will reimburse the hospital approximately $800. It is likely that Blue Cross may reimburse $600. If Medicaid, maybe $400. What really shocked me was that Workers’ Comp would get the MRI for about $250.

The question is, if all of this were transparent to the public, what would the actual cash price be? Could it be so low that the cost of insurance would exceed the cost of paying cash?

As consumer health care becomes more popular, we may soon find out.

Then the cost of health care will plummet. Cash could then become King in Healthcare also.

That should make Congress nervous. What would they have left to debate?

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Medical Gluttony thrives in Government and Health Insurance Programs.

Gluttony Disappears with Appropriate Deductibles and Co-payments on Every Service.

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6.      Medical Myths: Promises of ObamaCare

When he was selling his health care reform law to the American people, President Obama made numerous promises. We were assured small businesses would receive tax credits to offset the law’s premium costs; Medicare would be protected; the law would cost under $1 trillion over 10 years; people would be able to keep their current insurance plans; insurance premiums would be reduced; and health care costs would stop rising.

President Obama recently reiterated that he still believes in the promises of the law. Yet the policies in “ObamaCare” have failed to deliver on many of their major promises — and the law is not even fully in effect.

Small Businesses, Seniors Hit

Obama promised small businesses they would receive tax credits to help alleviate the large premium costs in the bill. The Small Business Tax Credit is supposed to be the primary tool for doing this. But not only is the tax credit uselessly small—the Congressional Budget Office (CBO) estimates it will only affect 12 percent of people in the small-group market—but it ends in 2017.

Obama promised seniors their Medicare plans would be protected. But Medicare’s chief actuary, Richard Foster, has revealed Medicare is anything but safe. Between 2014 and 2023—the first 10 years of Obamacare’s full implementation—Medicare Part A and B will be cut by a combined $1.05 trillion under the law. . .

Higher Deficits, Less Coverage

In order to ease voters’ debt concerns, Obama assured Americans that ObamaCare would reduce the deficit and cost under $1 trillion over 10 years. The CBO produced a report suggesting the president was right. But that report is flawed: It uses a 10-year window that includes four years of preparation for the law and only six years of its actual implementation.

Shift the 10-year window back one year—three years of preparation, seven years of benefits—and ObamaCare’s cost jumps to $1.4 trillion. In fact, the CBO says a full repeal of ObamaCare would reduce the budget deficit by $540 billion over the next 10 years.

Obama emphatically promised, “If you like your coverage, you can keep it, no matter what.” That’s not true either. The restrictions on cost-sharing adjustments leave companies and individuals with little flexibility to change plan details without losing their grandfathered status. The administration estimates between 49 percent and 80 percent of small-employer plans, between 34 percent and 67 percent of large-employer plans, and between 40 percent and 67 percent of individual plans will not be grandfathered by 2014. . .

Rising Premiums

Obama also promised premiums wouldn’t rise under ObamaCare. The law, we were told, was going to lower premiums for families by as much as $2,500 a year. The Agency for Healthcare Research and Quality analyzed the ten largest states’ average premiums in 2010. On average, the premiums for a family plan rose 6.5 percent. In my home state of Texas, the average premium for a family plan jumped by more than $1,000. . .

Since its passage, ObamaCare has produced little besides broken promises. It is time to repeal ObamaCare and give the nation health care reform that delivers real results.

Spencer Harris (sharris@texaspolicy.com) is a policy analyst for the Center for Health Care Policy with the Texas Public Policy Foundation.

Medical Reality: Broken Promises of ObamaCare

Read more of the broken promises at the Heartland Oct 25, 2011 . . .

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Medical Myths Originate When Someone Else Pays The Medical Bills.

Myths Disappear When Patients Pay Appropriate Deductibles and Co-Payments on Every Service.

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7.      Overheard in the Medical Staff Lounge: Who will be our next President? Does it matter?

Dr. Dave:        It really does matter. Probably not in the way the media paints it. There are a number of hidden agendas that will not make things much better. And the usual qualities may not be that important.

Dr. Ruth:        I’m very concerned about Newt Gingrich. The way he got rid of one wife while she was sick and in the hospital and subsequently married the woman with whom he was having an affair. He may be a sharp professor, but I don’t think he has the qualities that I would like in a President.

Dr. Dave:        I’m very concerned about Mitt Romney. He’s for government control of medicine. He engineered the Massachusetts socialized system. The Wall Street Journal in an editorial painted him as being to the Left of Obama.

Dr. Edwards:  So if he were to run, you would essentially have two candidates with similar ideologies running against each other. What a choice. Or rather no choice. Either one would continue the destruction of private medicine and our Democratic Freedoms. We’re the first nation in history to have developed Free Enterprise to this degree and to have made more advances in medicine and pharmaceuticals, having conquered more diseases and raised the standard of living over the previous thousands of years—than any other system.

Dr. Rosen:      Did you know that the Greeks knew how to build a steam engine more than two thousand years ago but they didn’t have the economic system that America has to actually build what they knew could be built? The Occupy Wall Street (OWS) crowd has no clue as to what they are doing. They are protesting the very system that has given them the cell phones with texting, the things that are sustaining these sit-ins to allow their communication with each other. They should be “occupying" their own universities which don’t understand basic economics.

Dr. Edwards:  Or returning to the classroom enrolling in Freshman Economics 11. But do they teach Free Enterprise and Entrepreneurship in Economics anymore?

Dr. Milton:      I’ve often wondered just continues to be taught in college anymore. Is it eighteenth century Socialism? Maybe I should get myself appointed to a board of education to find out.

Dr. Rosen:      I wouldn’t count on it. When I was on a board of education, we had a devil of a time getting a copy of all the curriculum books. That’s why we need more private schools or homeschools. I’ve been amazed how popular homeschools are in Berkeley the bastion of liberalism. They don’t even trust their own system.

Dr. Edwards:  I think one of the problems with private schools is all the non-private ideas surrounding the discussion to level the playing field. Charter schools. Tax supported private schools.  That eliminates all the differences. The parents that send their children to private schools should realize they should not ask for favors. They should continue to pay the exorbitant school taxes plus the tuition for the private school. The tuition for private schools is far less than the taxes for public schools when averaged per pupil. One has to make a clean break. The voters will eventually wonder why they should pay $10,000 per pupil in public schools and private schools can do a far better job at half that tuition. That would be the biggest impetus to cut their water off at the pass. If the public school budgets were cut in half to equal private schools, there would be outrage and reform. Perhaps sometime before the next election.

Free enterprise is the biggest impetus to cut costs, fat and other trimmings.

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The Staff Lounge Is Where Unfiltered Medical Opinions Are Heard.

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8.      Voices of Medicine: A Review of Regional Medical Journals and Articles by Physicians

Andrew Weil, MD: Spontaneous Happiness: Our Nature-Deficit Disorder

Don’t Let Chaos Get You Down

Newsweek, Oct 30, 2011

You aren’t depressed; our brains just aren’t equipped for 21st-century life.

In my experience, the more people have, the less likely they are to be contented. Indeed, there is abundant evidence that depression is a “disease of affluence,” a disorder of modern life in the industrialized world. People who live in poorer countries have a lower risk of depression than those in industrialized nations. In general, countries with lifestyles that are furthest removed from modern standards have the lowest rates of depression.

Within the U.S., the rate of depression of members of the Old Order Amish—a religious sect that shuns modernity in favor of lifestyles roughly emulating those of rural Americans a century ago—is as low as one 10th that of other Americans.

Psychologist Martin Seligman, originator of the field of positive psychology and director of the Positive Psychology Center at the University of Pennsylvania, has studied the Old Order Amish, along with other premodern cultures. He concludes: “Putting this together, there seems to be something about modern life that creates fertile soil for depression.”

Another prominent researcher whose work I respect, Stephen Ilardi, professor of psychology at the University of Kansas and author of The Depression Cure, observes, “The more ‘modern’ a society’s way of life, the higher its rate of depression. It may seem baffling, but the explanation is simple: the human body was never designed for the modern postindustrial environment.”

More and more of us are sedentary, spending most of our time indoors. We eat industrial food much altered from its natural sources, and there is reason for concern about how our changed eating habits are affecting our brain activity and our moods. We are deluged by an unprecedented overload of information and stimulation in this age of the Internet, email, mobile phones, and multimedia, all of which favor social isolation and certainly affect our emotional (and physical) health.

Behaviors strongly associated with depression—reduced physical activity and human contact, overconsumption of processed food, seeking endless distraction—are the very behaviors that more and more people now can do, are even forced to do by the nature of their sedentary, indoor jobs.

This kind of life simply was not an option throughout most of human history, as there was no infrastructure to support it, much less require it.

Human beings evolved to thrive in natural environments and in bonded social groups. Few of us today can enjoy such a life and the emotional equilibrium it engenders, but our genetic predisposition for it has not changed. The term “nature-deficit disorder” has recently entered the popular vocabulary, though it has not yet made it into the Diagnostic and Statistical Manual of Mental Disorders or been accepted by the medical community. It was coined by the author Richard Louv to explain a wide range of behavior problems in children who spend less time outdoors but now is invoked as the root cause of an even wider range of both physical and emotional ailments in people of all ages who are disconnected from nature.

I believe we are gathering scientific evidence for the benefits of living close to nature, not simply for enjoying its beauty or getting spiritual sustenance but for keeping our brains and nervous systems in good working order. A few examples:

• We get vitamin D, now known to be necessary for optimum brain health, by spending time in the sun.

• Our cycles of sleep and waking and other circadian rhythms are maintained by exposure to bright light during the day and darkness at night. Lack of bright natural light during waking hours and exposure to artificial light at night disrupt these rhythms, interfering with our sleep, energy, and moods.

• Hunter-gatherers and other “primitive” people do not develop the deficits of vision and the need for corrective lenses as early in life as people in our society do, probably because they grow up looking at distant landscapes more often than reading books, writing, or staring at television and computer screens. Because the eye is a direct extension of the brain, eye health is an indicator of brain health. . . .

The problems stemming from nature-deficit disorder are examples of a mismatch between our genes and the modern environment. Our brains simply are not suited for the modern world. Possibly, the deterioration of emotional well-being characteristic of contemporary urban life represents a cumulative effect of lifestyle changes that have been occurring over many years, an effect that is now suddenly obvious. . .

Read the entire article in Newsweek . . .
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VOM Is an Insider's View of What Doctors are Thinking, Saying and Writing about.

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9.      Book & Cinema Review: J Edgar

New American film: Dirty Hoover

Clint Eastwood’s portrait of J. Edgar Hoover is quite a surprise

AUDIENCES expecting a hard-hitting exposé will have the rug pulled out from under them by “J. Edgar”, Clint Eastwood’s biopic about the long-serving founder of the FBI, masterfully played by Leonardo DiCaprio. Film critics have been especially curious about how Mr Eastwood would portray the private life of the original Dirty Harry. Is Hoover shown wearing a dress? (Yes, but…) Does the film portray his rumoured love affair with his aide, Clyde Tolson? (Absolutely, but…)  

At heart, “J. Edgar” is a love story between two men: the ferocious bulldog sitting atop his empire of wiretaps and blackmail and the handsome young clothes-horse he made his longtime companion without ever daring to become his lover. Already gay enough to use the word “camp” circa 1940, Clyde (Armie Hammer) loves more than he is loved in return, thanks to the repressions instilled in Edgar by his ambitious mother (Judi Dench). But his love never wavers, and neither does Edgar’s. Forget “Brokeback Mountain”, with its distracting scenery. Mr. Eastwood’s camera bores straight into his characters’ souls, discovering the sweetness hidden inside his monstrous protagonist. His “J. Edgar” turns out to be one of the most beautiful and affecting gay love stories to come out of Hollywood.


A gay love story without any sex explains why the SF Chronicle panned this movie.


If a man lies with a man as one lies with a woman, both of them have done what is detestable.
They must be put to death; their blood will be on their own heads. –Leviticus 20:13—NIV
National Geographic, | Volume 220. No 6 | December 2011 | pp. 36-57.

Read the entire cinema review in the Economist . . .
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The Review Section Is an Insider’s View of What Doctors are Seeing and Reading about.

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10.  Hippocrates & His Kin: RomneyCare From the White House

Health costs in Massachusetts are higher than in any other state: Health spending is rising 15 percent faster than the national average. Economists from Stanford and Columbia universities have estimated that the state health-care law was responsible for hiking premiums by as much as 6 percent.

It would be a catastrophe for our Country if Romney ever gained White House power.


Speaker of the house and his divorce.

Joan Walsh outlines Gingrich's flaws and foibles in a Tuesday column. She concludes: "The seemingly affable professor and author is a hothead with many political liabilities and almost as many enemies. He's committed so many political and ethical transgressions that his baggage has baggage."

"If Newt Gingrich can't be faithful to his wife, how can we trust him to be faithful to conservative voters?"


State and Local Budget Cuts (Kevin Yamamura in the Sacramento Bee)

With revenue shortfalls, there will be fewer public schools days, cuts to libraries, reduction in services to the developmentally disabled, etc., et. al.

Yesterday, we had a patient who could not fill out a basic office registration form stating he couldn’t read or write. During the Medical Interview which always includes a patient’s educational achievements he stated he had only gone to the 10th grade.

He said he never learned how to read or write in grade school or high school. He was able to sign his name. He looked at our receptionist and smiled, “My mom taught me how to sign my name.”

I guess that in our public schools it wouldn’t hurt education to shorten the school year a few months or even eliminate a few grades.


California’s Chronic Budget Problems

The California State Senate gave an average of a 7% pay raise to at least 169 staff employees during the past three months. (Torey Van Oot in the Sac Bee.)

Lack of money doesn’t seem to stop lawmakers from spending it.


The Federal Debt has reached Never-seen-before heights

Does anyone really know what the national debt is today to the nearest “Ten Trillion Dollars?”

Lack of money doesn’t seem to stop Congress from spending it


Rumor Mill

The Obama Administration is Planning to Eliminate the Tax Deduction of 401(k)'s and IRA's. . . 
There is also a plan being floated on taxing retirement benefits.

There is never an end to the “Tax & Spend Party’s” search for new things to tax.
Have no fear. When everything is taxed, they will just add more taxes on to present taxes.
Witness your telephone bill! Mine has nine taxes on it already.

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Hippocrates and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Yesterday, Today & Tomorrow

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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.

                      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: Will Wikileaks lead to HIPAA leaks? Don't miss the "AAPS News," written by Jane Orient, MD, and archived on this site which provides valuable information on a monthly basis. This month, be sure to read Docs in a Skinner Box. 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."


Words of Wisdom, Recent Postings, In Memoriam, Today in History . . .

Words of Wisdom

"The budget should be balanced, the Treasury should be refilled, public debt should be reduced, the arrogance of officialdom should be tempered and controlled, and the assistance to foreign lands should be curtailed lest Rome become bankrupt. People must again learn to work instead of living on public assistance." –Cicero, 55 BC

So have we not learned anything in the past 20 centuries?


"Formal education will make you a living; self-education will make you a fortune." — Jim Rohn:
A
n American author and motivational speaker. Nightingale-Conant


 Have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary." — Steve Jobs: An American inventor and businessman.


Some Recent Postings

In The October 14 Issue:


1.         Featured Article: Nobel Prize in Physiology & Medicine for Innate and Adaptive Immunity

2.         In the News: Should people be told about any nasty surprises discovered in their DNA?

3.         International Medicine: Private Partnership takes over a failed NHS Hospital.

4.         Medicare: Developing a Sustainable Health System

5.         Medical Gluttony: Driving the Rich to Off Shore Medicine or into the Sea

6.         Medical Myths: People should drink at least eight glasses of water a day.

7.         Overheard in the Medical Staff Lounge: Practicing medicine under government control was like    “practicing on a conveyer belt.” 

8.         Voices of Medicine: Surviving In These Tough Times

9.         The Bookshelf: Enjoy Every Sandwich

10.    Hippocrates & His Kin: Scars of War

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

            * * * * *

In Memoriam

Dan Warren and Fred Shuttlesworth, fighters for desegregation in America’s South, died on September 18th and October 5th respectively, aged 85 and 89

THE golden beaches at St Augustine in Florida, America’s oldest city, stretch for 40 miles along the Atlantic, sloping gently into the blue, lazy surf. They seem the last possible place for a battle. But in the summer of 1964 the waves were full of Klansmen with wooden stakes and the beach beside the pier heaving with helmeted police, as a line of blacks in bathing gear tried to desegregate with a “wade-in” the warm, whites-only water.

Head of the Negro column, tall, lean, proud, unable to swim but not caring, flinging himself into the ocean as he flung himself at everything else, was Fred Shuttlesworth. He was a Baptist pastor from Birmingham, Alabama, loud with a country preacher’s whooping and singing as the Spirit took hold of him, and fresh from turning that hard-coal, hard-heart city, the very cradle of segregation, into a model of change. He’d led hundreds of blacks to ride at the front of the buses, sit-in at segregated lunch counters, march through the streets, until city officials at last opened up the amenities to people of every race. When his NAACP chapter in Birmingham had been outlawed in 1956, he had come up instantly with the Alabama Christian Movement for Human Rights, which did just the same thing. He never stopped organising the prophetic struggle, stoking the fire that no hoses or axes could put out, just as he was doing now, pushing the white racists of St Augustine farther into the sea.

Watching him from the beach, deeply worried, was Dan Warren, the state attorney for the seventh judicial circuit in Florida. His job, to which he had just been appointed by the governor, was to keep the two sides apart and calm down the city, just now the most violent in America. On this day he had ordered the police to see that the blacks were allowed to swim.

His career as a trial lawyer had taught him never to rise to provocation. Calm reason was his stock in trade. Since arriving in the city from Daytona, he had meticulously kept a diary of everything he had done. This included prosecuting both Mr Shuttlesworth and Martin Luther King for trespassing in the whites-only restaurant of the Monson Motor Lodge, where half a dozen other blacks had jumped into the pool and had acid poured on them by the owner. In court, though, Mr Warren had made a point of shaking King’s hand, loudly saying how much he admired him; and even boasting that he had been in the civil-rights movement longer than King had, trying to integrate services in his home town of Greensboro, North Carolina. . .

Darkness visible

He never protected himself, not with a gun, not even with a toothpick. He believed in confrontation, was arrested 35 times, and was rougher in his ways and words than ever King was, always nagging the leader to do more; he even alienated his own congregations, but he never dealt in violence. Prayer was his armament. For Mr. Warren the enemy was largely invisible, Klansmen carrying out attacks by night, though he managed, for the first time, to prosecute a few. For Mr. Shuttlesworth his nemesis was Bull Connor, Birmingham’s commissioner of public safety, a low, rough, rasping man who used the Klan as well as dogs and billy-clubs, and made the Darkness visible for all to see.

Where both men came closest was in their attitude to the law. When the Supreme Court in 1954 announced the desegregation of America’s schools Mr. Shuttlesworth felt that he, the son of a sharecropper, stood equal in rights with any man. He expected the law henceforth to represent him; when he wanted an integrated police force, or access for blacks to the public parks, he sued the city of Birmingham, and each time he again. failed he sued Mr. Warren, as a Southern lawyer, was convinced that America was a land of hypocrisy unless it protected black and white equally and alike. Both men realised that flowery speeches and lofty court rulings meant nothing without action.

On July 1st 1964 the wade-ins and marches in St Augustine were called off. They had had their effect. The next day, President Lyndon Johnson signed the Civil Rights Act. Among the catalysts were two men who were hardly known outside their own cities; but who, one summer day, had gone down together to the ocean.

Read the entire obituary in the Economist – Subscription required . . .

On This Date in History – October 28

On this date in the first century, St. Jude, one of the Twelve Apostles of Jesus is remembered. He is generally identified with Thaddeusthe, Patron Saint of the impossible. The Armenian Apostolic Church, Eastern Orthodox, and Coptic honor Thaddeus along with Saint Bartholomew as its patron saints. In the Roman Catholic Church he is the patron saint of desperate cases and lost causes. In St Jude Medical, the Epic, Biocor and Trifecta valves were innovative. There are a large number of medical institutions that bear the St. Jude name.

On this date in 1886, the Statute of Liberty was dedicated in the New York Harbor. The dedicatory speech by President Grover Cleveland said, “We will not forget that Liberty has here made her home; nor shall her chosen altar be neglected.” The Statue shows liberty holding aloft a torch and clutching a book.

—After Leonard and Thelma Spinrad

* * * * *

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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.


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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 U.S. health-care system. The extraordinary conference agenda includes compelling keynote panel discussions, authoritative industry speakers, international best practices, and recently released case-study data. The 9th Annual World Health Care Congress will be held April 16-18, 2012 at the Gaylord Convention Center, Washington DC. For more information, visit www.worldcongress.com. The future is NOW.