MEDICAL TUESDAY. NET

NEWSLETTER

Community For Better Health Care

Vol X, No 12, Sept 27, 2011

 

In This Issue:

1.                  Featured Article: Home Remedy

2.                  In the News: What factors lead to the rise or fall of liberalism, democracy and wealth?

3.                  International Medicine: Growing wave of consumerism sweeping Europe

4.                  Medicare: Obama’s promise he would cut health premiums by up to $2,500 a year has been revised by the CBO: premiums will rise by $2,100.

5.                  Medical Gluttony: Legal Gluttony: Last minute laws cannot be scrutinized in detail.

6.                  Medical Myths: Medical Laws like ObamaCare will become palatable after next election.

7.                  Overheard in the Medical Staff Lounge: How is ObamaCare of putting Medicaid patients into HMOs working out in the real world?

8.                  Voices of Medicine: Social Security - Of Course it’s a Ponzi Scheme –But it Should be Fixed

9.                  The Bookshelf: Flourishing and Happiness in a Free Society

10.              Hippocrates & His Kin: Doctors are forced to learn 140,000 new Medical Codes

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

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

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Always remember that Chancellor Otto von Bismarck, the father of socialized medicine in Germany, recognized in 1861 that a government gained loyalty by making its citizens dependent on the state by social insurance. Thus socialized medicine, or any single payer initiative, was born for the benefit of the state and of a contemptuous disregard for people’s welfare.

Thus we must also remember that ObamaCare has nothing to do with appropriate healthcare; it was similarly projected to gain loyalty by making American citizens dependent on the government and eliminating their choice and chance in improving their welfare or quality of healthcare. Socialists know that once people are enslaved, freedom seems too risky to pursue.

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1.      Featured Article: Home Remedy

A small town solves its physician shortage.

By David Freed

Residents of Albany, population 1,730, in northwestern Missouri, aren’t shy about talking up their town. They point to its scant crime, good schools, and tidy, Victorian-era downtown, where handsome red-brick buildings whisper of an affluent past. Beyond its family-friendly movie house and nine-hole golf course lie farm fields—wheat, corn, and soybeans mostly—and woodlands with abundant hunting and fishing.

Yet for all of Albany’s charm, trying to entice doctors and nurses to resettle there, an hour northeast of the nearest city, St. Joseph, has proved extremely difficult. Read more . . . Nearly 25 percent of Americans live in rural places like Albany, but only about 10percent of physicians practice in those areas. And as more and more country doctors retire, the rural health-care shortage grows, because so few newly minted physicians have been willing to fill their shoes. Albany’s only hospital, the nonprofit, 25-bed Northwest Medical Center, used to employ a full-time recruiter who advertised and sent out mailers to lure health-care providers from midwestern cities like Omaha, Kansas City, and St. Louis. Response was tepid.

“You pretty much took what you could get,” says John W. Richmond, who retired last year as Northwest Medical Center’s president and CEO. . .

All told, about a dozen physicians agreed to give Albany a try. Some, Richmond confides, turned out to have spotty résumés or shaky work habits. Few lasted long. “They’d give you a lot of reasons why they didn’t want to stay,” he says, “but when it came down to it, they didn’t like the rural lifestyle.”

By 2000, Albany’s hospital had become so short-staffed that registered nurses like Donna Walter were putting in 24-hour shifts. “We were exhausted,” says Walter, who today serves as the medical center’s vice president of patient services.

Richmond was at his wits’ end. “You’re doing everything you can to get somebody, and you have nobody to choose from,” he says. “Pretty soon, a light goes on: Hell, I’m not getting anywhere. If I’m going to have stability on the medical staff, I’m going to have to do it with people who are from here, who want to be here. Either we grow our own, or we starve to death.”

Richmond began speaking in local schools about the rewards of caring for family and neighbors. He orchestrated “pipeline” events, allowing kids to shadow medical staff on their rounds. He gave them paying jobs at Northwest Medical Center, even when there was no real work for them. And to those who showed potential, he awarded financial assistance to attend vocational or medical school, so long as they promised to return one day to work. They signed letters of intent to practice locally after finishing their studies, for a minimum number of years, contingent upon how much money they had received. Albany natives interested in a second career could also apply for financial aid from the hospital and return to school—again, on condition that they would agree to come back to work in Albany.

To date, at least 23 nurses, two medical technicians, and a certified registered nurse anesthetist have received financial assistance. So have two family-practice doctors who will soon finish their residency training and begin serving full-time on Northwest Medical Center’s five-physician staff. . .

David Freed is a screenwriter and former investigative reporter for the Los Angeles Times, where he shared in a Pulitzer Prize for coverage of the 1992 Rodney King riots.

Read the entire article in The Atlantic . . .
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2.      In the News: What factors lead to the rise or fall of liberalism, democracy and wealth?

Does Disease Cause Autocracy?

In attempting to explain those factors which lead to the rise or fall of liberalism, democracy and wealth, several scientists believe they have identified a new culprit: disease. The eradication of proliferating diseases correlates strongly with the rise of democratic institutions and liberal social norms such as individualism, gender egalitarianism and property rights. Such a relationship may seem distant, but new research offer several explanations, says Ronald Bailey, Reason Magazine's science correspondent.

Firstly, disease keeps the poor, poor. Read more . . .

·                     Heavy disease burdens create persistent poverty traps from which poor people cannot extricate themselves.

·                     High disease rates lower their economic productivity so they can't afford to improve sanitation and medical care, which in turn leaves them vulnerable to more disease and further reduces their ability to prosper economically.

Secondly, a high prevalence of disease encourages intolerance and localism.

·                     In the same way that the human immune system adapts to fight pathogens, groups of people evolve customs that reduce the transmission of diseases.

·                     This usually includes a degree of xenophobia, whereby members of isolated groups avoid contacts with "out-group" members who may have parasites to which the group is neither accustomed nor resistant.

·                     This limits the flow of people and ideas, diminishing social tolerance and eating away at the foundation of liberal thinking.

This natural defensiveness toward out-groups, developed by survival instincts, also explains the lack of power sharing in these nations. Elites, who because of their wealth have not been so heavily exposed to disease and parasites, limit interaction with the poor for this very reason, decreasing the potential for top-down reform. Simultaneously, bottom-up reform is undercut by the inability of the poor to organize because of the aforementioned xenophobia. Thus, the lack of unity amongst the lower class opens these societies to autocratic rule.

Should these hypotheses prove true, the implications for foreign aid to poor nations are that efforts should prioritize disease eradication over the myriad of other issues. It remains to be seen, however, if the very ethnocentrism and xenophobia predicted by these studies will also hinder efforts by outsiders to break the vicious cycle.

Source: Ronald Bailey, "Does Disease Cause Autocracy?" Reason Magazine, October 2011.

For text: http://reason.com/archives/2011/09/16/does-disease-cause-autocracy

For more on Government Issues: http://www.ncpa.org/sub/dpd/index.php?Article_Category=33

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3.      International Medicine: Growing wave of consumerism sweeping Europe

Britain Moves toward Doctor-Patient Control
Grace-Marie Turner
National Review Online, July 27, 2010

Britain’s new coalition government is proposing a major transformation of its socialized health-care system to give doctors much more authority over decisions involving their patients’ care.

This most entrenched of government-run health systems is recognizing the importance of the doctor-patient relationship just as the United States is taking a sharp left turn toward more centralized government control over health care.

Is the world turning upside down? Read more . . .

The New York Times examines the plan “to shift control of England’s $160 billion annual health budget from a centralized bureaucracy to doctors at the local level,” calling it “the most radical reorganization of the National Health Service, as the system is called, since its inception in 1948.”

Currently, how and where patients are treated, and by whom, is largely determined by decisions made by 150 entities known as primary care trusts — all of which would be abolished under the plan, with some of those choices going to patients. It would also abolish many current government-set targets, like limits on how long patients have to wait for treatment.

Britain is trying to find a way to respond to the growing wave of consumerism sweeping Europe. Better-informed patients are demanding more control over health-care decisions and are increasingly fighting the authority of large, centralized bureaucracies to make decisions about their care.

Not surprisingly, the British government’s proposal is facing strong opposition from entrenched interests. “Many critics . . . doubt that general practitioners are the right people to decide how the health care budget should be spent,” the Times reports. One of these critics is David Furness of the Social Market Foundation, a London think tank. He calculates that the plan would make every general practitioner (GP) in London responsible for a $3.4 million budget. GPs would band together in regional consortia to buy services from hospitals and other providers.

“It’s like getting your waiter to manage a restaurant,” Furness said. “The government is saying that G.P.’s know what the patient wants, just the way a waiter knows what you want to eat. But a waiter isn’t necessarily any good at ordering stock, managing the premises, talking to the chef — why would they be? They’re waiters.”

He disparages doctors at his peril.

Under the proposed plan, hospitals would escape some of the bureaucratic micromanagement that binds them in red tape. They would become “foundation trusts” with much more independence, somewhat like charter schools in the U.S.

British health secretary Andrew Lansley is straightforward about the rationale for his proposal. His government’s white paper explains: “Liberating the N.H.S., and putting power in the hands of patients and clinicians, means we will be able to effect a radical simplification, and remove layers of management.”

Opponents are sounding alarms that the changes mean the terminally ill won’t get adequate care and that waiting times will be even longer for surgeries like knee and hip replacements.

There always is a risk with any government rationing system that more care will be provided to the healthy majority of patients who vote, leaving less for those who are older and sicker. But is it safer to give the relevant decision-making authority to doctors, or to bureaucrats and politicians? If there is less money for administrators, there will be more money for patients.

The labor unions and the bureaucrats are, of course, apoplectic about the loss of some of the bureaucratic jobs that have swallowed up most of the money from a tripling of the NHS budget since 1998. . .

You can’t make this up. Britain’s coalition government is getting it right. Bureaucrats don’t deliver care; doctors do. Sixty-two years after the founding of the NHS, the British government recognizes it has no choice but to give doctors and patients more authority over health-care decisions.

The complex plan — which would affect only England — will need legislative approval to be enacted, but we should expect some version of it to pass, because it reflects a growing awakening in Europe to the importance of consumer control and choice. . .

Throughout Europe, a network of private hospitals is growing. Government officials say private hospitals serve as a safety valve for public health systems; they allow people to escape waiting lines that would be even longer without their services. Many believe the private hospitals make public hospitals better by providing competition. How tragic, then, that the recently passed health-overhaul law in the U.S. effectively prohibits new physician-owned private hospitals from opening. Physician Hospitals of America has rightly filed suit, challenging these provisions.

Clearly, Europeans have come to these conclusions based upon long experience with government-controlled, bureaucratically run health systems. Such systems don’t work, especially with something as personal as health care. And yet, the U.S. has adopted “reforms” that will reduce genuine competition and put more control over health-care decisions in the hands of government bureaucrats.

We should also note that President Obama has bypassed the constitutionally required Senate confirmation process to put Dr. Don Berwick — who is in love with Britain’s socialized health-care system — in charge of implementing key parts of his health-overhaul law. When Berwick appears at some point before a congressional committee, members might want to ask him what he thinks about Britain’s move to give doctors and patients, not bureaucrats, more authority over health-care decisions.

As Rep. Paul Ryan (R., Wis.) said at a recent Galen Institute conference, Obamacare “will not stand.” The political system, the courts, or the American people — and probably all three — will get us back on the right path.

Published in National Review Online, July 27, 2010.

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European Socialized Medicine is much like Canadian Medicare . . .

Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.

--Canadian Supreme Court Decision 2005 SCC 35, [2005] 1 S.C.R. 791

http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html

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4.      Medicare: Actuaries released new estimates of growth in health costs over next decade

Counting Up ObamaCare’s Health Cost Inflation
Forbes.com By: Sally C. Pipes
8.9.2011

It’s time to add yet another study to the growing list of research showing that ObamaCare isn’t delivering on its grand promises.

In the July issue of the journal Health Affairs, Medicare’s actuaries released new estimates of the rate of growth of national health costs. Surprise, surprise — they’re projected to increase over the next decade. Read more . . .

The bad news for ObamaCare’s proponents? ObamaCare won’t help contain health costs, as the president so often claimed while lobbying for passage of his reform package. Instead, it will exacerbate them. Remember his oft-repeated statement that his plan would “cut the cost of a typical family’s premium by up to $2,500 a year.” As the CBO rightly explained, premiums will rise by $2,100.

Researchers estimate that health care spending will grow an average of 5.8% per year through 2020. The actuaries found that total health care costs in this country will hit $4.6 trillion by the end of the decade — equivalent to about one-fifth of the entire U.S. economy. That’s about $14,000 in annual spending for every man, woman, and child.

In 2014, when the law’s major coverage provisions kick in, total healthcare costs will jump 8.3 percent — a rate well above the 5.5% expected for 2013. As the study puts it, the president’s law is “anticipated to contribute to a significant acceleration in the national health spending growth rate in 2014.”

Worse still, spending on private insurance plans is expected to expand 9.4% that year. That rate is over 4 percentage points higher than the actuaries would have expected without ObamaCare.

The biggest costs from the health law come in the form of expansions in public insurance programs. ObamaCare increases Medicaid spending by over 20 percent in 2014 and will bring the program’s total enrollment to 75.6 million people. Over the next eight years, the law increases Medicaid expenditures by a whopping $700 billion.

In 2010, the government spent $1.2 trillion on health care. In 2020, it will spend an astonishing $2.3 trillion, comprising nearly half of all healthcare expenditures. Medicaid alone will account for a fifth of national health spending. . .

The White House has repeatedly said that its brand of health reform will bend the healthcare cost curve down. Medicare’s actuaries have taken a sober look at the numbers — and arrived at the opposite conclusion. The American people may not allow President Obama to ignore the preponderance of evidence for much longer.

Source: http://blogs.forbes.com/sallypipes/2011/08/08/counting-up-obamacares-health-cost-inflation/

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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: Legal Gluttony: Last minute laws cannot be scrutinized in detail.
SacBee10-17-2011

Most bills go through a months-long process of hearings, negotiations, amendments and votes. But that’s too much openness for illegal and criminal activity schemes by the legislators.

The California State Legislature wrote 48 bills in the last three weeks of the regular session, long after the deadlines for most lawmaking procedures had passed. They did so by deleting the text of existing bills and replacing it with something new and often unrelated—a process known as “gut and amend.” Some self-serving bills were written close to midnight on the last day. Read more. . .

Lawmakers sent 22 of those bills to the governor, who signed all but three of them.

Looks like legal subterfuge—which would be a crime in any other profession if lawmakers found out about it. Lawmakers can do equally criminal behavior and it is never perceived as crime because such a law has no chance of being passed by lawmakers.

What’s the answer?

Reforming lawmakers who are lawyers is untenable. You can’t watch everyone’s lips to note when they move. We need a part time citizen legislature. If we had a legislature that met for two or three months every other year, many farmers, entrepreneurs, business and professional people including pastors, priests and rabbis could and would run for office. The legislature would be crime free by the end of the first session.

The dungeon of criminals would disappear without a single arrest being needed.
Now, wouldn’t that be a neat treat?

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Medical Gluttony Appropriate thrives in Government and Health Insurance Programs.

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

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6.      Medical Myths: Medical Laws like ObamaCare will become palatable after next election.

President Barrack Hussein Obama and his cronies were very shrewd with in developing the ObamaCare with what they felt would be painless maneuvers during this term of office with the excessive costs, loss of freedom, conscription, and plunging in the quality of health care all delayed until 2014. His philosophy was to make it reality before the people woke up in a socialized straitjacket existence.

Who would ever have thought that four centuries of progress toward freedom could be reversed in four short years? Read more . . .

Who would ever have thought that such a large segment of my Medical Profession could be hoodwinked into Socialized Medicine so quickly?

Of course, this all began under the reign of FDR in 1933 with a dramatic push by LBJ in 1966. Even the costs which exceeded the best estimates by 800 percent didn’t slow the blind march of Socialized Medicine. Perhaps the hyperbolic curve of BHO has awakened more Americans as to what is really happening. Even the Democrats in the Senate are beginning to avoid appearing to be under the BHO mantra. If this cleans out the Senate in 2012, perhaps the BHO hyperbolic swing will take us back towards the principles of our independence of 1776. If we then begin teaching civics and constitution in our schools, there will be great hope for our nation and human freedom.

ObamaCare may become totally unpalatable by 2012 and first class health care may be restored.

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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: How is Obama Care of putting Medicaid patients into HMOs working out in the real world

Dr. Rosen:      How are we handling the onslaught of patients being dumped from Medicaid into a basket of HMOs?

Dr. Edwards: We told our HMO that we’d take our share. But that number has grown from 150 to 250 and now 400 welfare patients trying to adjust to private HMO care in just one practice. Read more . . .

Dr. Ruth:        We answered very grudgingly. We accepted a hundred which we felt was probably more than our share. But that one hundred is taking up more time and office resources than all of our other patients. They can’t be satisfied. I think they’ve always felt that private patients could demand the sky and everything would be ordered. They refuse to accept limits. They don’t understand that there are limits to how much health care they can consume.

Dr. Yancy:      The practice of surgery has gotten so bad that I will operate on anyone for anything he wishes, except an unnecessary amputation.

Dr. Paul:         Well, I don’t have any such worries. Mothers will always bring in their kids for any problem the mothers are worried about.

Dr. Rosen:      Don’t they balk at your copayments?

Dr. Paul:         My patients don’t have copayments. They all have Medicaid and Medicaid patients don’t have to pay anything?

Dr. Edwards:  Didn’t you have any Medicaid patients dumped into your HMO?

Dr. Paul:         Certainly. But that was a treat. The Medicaid/HMOs pay good for the first visit.

Dr. Edwards:  But after the first visit, isn’t it starvation wages again?

Dr. Paul:         I don’t understand your starvation wages. The second visit and beyond it’s the same as any other Medicaid patient. So I enjoy that little hump in payment. So overall, I’m better off with the dump into HMOs.

Dr.  Milton:     Well, would you mind telling us how much Medicaid pays you?

Dr. Paul:         I believe it’s $14 a visit.

Dr. Milton:      So in Pediatrics I’m sure you can see twice as many as we internists do. Instead of four patients an hour you must see six or eight?

Dr. Paul:         You’re kidding. I have to see at least 12 patients an hours to pay for my staff and my family.

Dr. Milton:      I have a hard time seeing four patients an hour. How can you see 12?

Dr. Paul:         Well, you internists sit down and chat a few minutes, then get up and move the patient to the exam table, and then sit down to write prescriptions and orders. Pediatricians don’t have time to sit.

Dr. Edwards:  Just a minute. You don’t sit down in pediatrics?

Dr. Paul:         I know of a few pediatricians that do but they have a contingent of private paying patients. Four of those bring in as much as 12 of mine. Big difference.

Dr. Edwards:  I guess a fully welfare type of practice is rather different.

Dr. Paul:         Isn’t it great that there are a few of us that see the down and outers and don’t complain?

Dr. Edwards:  I guess it is. It probably also explains why you believe in socialized government healthcare.

Dr. Paul:         It’s all going to go that way and when the government controls every dollar spent on healthcare, I’ll be there on the front lines to continue to do what I’ve been doing for the past decade.

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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

Social Security is a Ponzi scheme – and it should be fixed

By Charles Krauthammer

The Great Social Security Debate, Proposition 1: Of course it's a Ponzi scheme.

In a Ponzi scheme, the people who invest early get their money out with dividends. But these dividends don't come from any profitable or productive activity – they consist entirely of money paid in by later participants.

This cannot go on forever because at some point there just aren't enough new investors to support the earlier entrants. Word gets around that there are no profits, just money transferred from new to old. The merry-go-round stops, the scheme collapses and the remaining investors lose everything. Read more . . .

Now, Social Security is a pay-as-you-go program. A current beneficiary isn't receiving the money she paid in years ago. That money is gone. It went to her parents' Social Security check. The money in her check is coming from her son's FICA tax today – i.e., her "investment" was paid out years ago to earlier entrants in the system and her current benefits are coming from the "investment" of the new entrants into the system. Pay-as-you-go is the definition of a Ponzi scheme.

So what's the difference? Ponzi schemes are illegal, suggested one of my colleagues on "Inside Washington."

But this is perfectly irrelevant. Imagine that Charles Ponzi had lived not in Boston but in the lesser parts of Papua New Guinea where the securities and fraud laws were, shall we say, less developed. He runs his same scheme among the locals – give me ("invest") one goat today, I'll give ("return") you two after six full moons – but escapes any legal sanction. Is his legal enterprise any less a Ponzi scheme? Of course not.

So what is the difference?

Proposition 2: The crucial distinction between a Ponzi scheme and Social Security is that Social Security is mandatory.

That's why Ponzi schemes always collapse and Social Security has not. When it's mandatory, you've ensured an endless supply of new participants. Indeed, if Charles Ponzi had had the benefit of the law forcing people into his scheme, he'd still be going strong – and a perfect candidate for commissioner of the Social Security Administration.

But there's a catch. Compulsion allows sustainability; it does not guarantee it. Hence …

Proposition 3: Even a mandatory Ponzi scheme like Social Security can fail if it cannot rustle up enough new entrants.

You can force young people into Social Security, but if there just aren't enough young people in existence to support current beneficiaries, the system will collapse anyway.

When Social Security began making monthly distributions in 1940, there were 160 workers for every senior receiving benefits. In 1950, there were 16.5; today, three; in 20 years, there will be but two.

Now, the average senior receives in Social Security about a third of what the average worker makes. Applying that ratio retroactively, this means that in 1940, the average worker had to pay 0.2 percent of his salary to sustain the older folks of his time; in 1950, 2 percent; today, 11 percent; in 20 years, 17 percent. This is a staggering sum, considering that it is apart from all the other taxes he pays to sustain other functions of government, such as Medicare whose costs are exploding.

The Treasury already steps in and borrows the money required to cover the gap between what workers pay into Social Security and what seniors take out. When young people were plentiful, Social Security produced a surplus. Starting now and for decades to come, it will add to the deficit, increasingly so as the population ages.

Demography is destiny. Which leads directly to Proposition 4: This is one Ponzi scheme that can be saved by adapting to the new demographics.

Three easy steps: Change the cost-of-living measure, means test for richer recipients and, most important, raise the retirement age. The current retirement age is an absurd anachronism. Bismarck arbitrarily chose 70 when he created social insurance in 1889. Clever guy: Life expectancy at the time was under 50.

When Franklin Roosevelt created Social Security, choosing 65 as the eligibility age, life expectancy was 62. Today it is almost 80. FDR wanted to prevent the aged few from suffering destitution in their last remaining years. Social Security was not meant to provide two decades of greens fees for baby boomers.

Of course it's a Ponzi scheme. So what? It's also the most vital, humane and fixable of all social programs. The question for the candidates is: Forget Ponzi – are you going to fix Social Security?

Read more: http://www.sacbee.com/2011/09/16/3914260/social-security-is-a-ponzi-scheme.html#ixzz1ZP4VxMSs

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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 Review: THE RATIONAL ARGUMENTATOR, Edward Younkins, Editor

A Review of Edward W. Younkins's
Flourishing and Happiness in a Free Society

 

 

by Gennady Stolyarov II

 

For much of the past decade, Dr. Edward Younkins has been busy synthesizing the ideas and approaches of some of history's most promising schools of thought, in an endeavor to, in his words, “present a broad brush outline of a potential philosophical foundation and edifice for a free society based on the natural law, natural rights, liberal tradition.” The culmination of this effort is his new book – Flourishing and Happiness in a Free Society: Read more . . . Toward a Synthesis of Aristotelianism, Austrian Economics, and Ayn Rand's Objectivism – forthcoming at the time of this review. This book condenses immense knowledge, inspiration, and guidance into under150 pages and can serve as both an introduction to natural-law, natural-rights ideas for beginners and as a reflection and consideration of further steps to take for those who already study and apply these ideas extensively.

 

 

This book is itself a synthesis of three of Dr. Younkins's articles, presented here as three chapters and tied together by an introduction that presents the philosophical and biographical backgrounds of the thinkers being considered and a conclusion that offers guidance as to how to infuse their ideas into the world of today. . .

Read the entire book review at quebecoislibre . . .  
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The Book Review Section Is an Insider’s View of What Doctors are Reading.

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10.  Hippocrates & His Kin: Doctors are forced to learn 140,000 new Medical Codes

According to a letter to the Editor of Wall St. Journal written by Dr. Michael Petersen, Newport, OR that they are expanding the Medical Codes to 140,000 and the heading says (this) is Rx for futility. 

Why doesn’t the AMA understand that this increase in our workload adds nothing to Quality?


[MOBILE FACTOID] press@healthexecmobile.com
Only 9% of resident physicians said they're prepared for the business side of medicine, and 56% of residents said they did not receive any formal instruction on contracts, compensation arrangements and reimbursement models during medical training.

No wonder new doctors are such easy prey for the Socialist.

Read more . . .


California Assembly won’t reveal expense details

The Sacramento BEE analysis of the California Assembly’s member expense reports suggested underreporting the amount of money spent to run legislators’ offices and over-reporting committee spending. The gap was created by the use of committee funds to pay for legislators’ personal staff. The legislature refused to release the data to expose this subterfuge. The BEE also learned that this transfer of payroll funds could be backdated to the beginning of the legislative year.

What happened to business corporations that back dated stock options?
Why are these Legislators not in Jail?


State Workers rushing to buy service credit. By John Ortiz

More than 12,000 members of the California Public Employees’ Retirement System asked for price estimates to buy additional retirement service credit—sometimes called “airtime” [since no service was rendered] to boost lifelong benefits at the taxpayer’s expense.

People “hardly working” buying more “hardly working time” so they don’t have to work at all!


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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. Read more . . .

                      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:  ?. 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 ? . 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."


The AAPS Nevada Chapter

Nevada Chapter meeting: Saturday October 22, 2011 at 12:00 to 2:00 pm at

Dr. Andrew and Janet Zak


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

Words of Wisdom

"If you think health care is expensive now, wait until you see what it costs when it's free."  -P.J. O'Rourke

Congress is so strange; a man gets up to speak and says nothing, nobody listens, and then everybody disagrees. –Will Rogers

Then Congress makes a joke it’s a law, and when they make a law, it’s a joke. –Will Rogers

Some Recent Postings

In The Sept 13 Issue:


1.      Featured Article: I Wish I Never Would Have Won the Lottery. 

2.      In the News: In Government We Mistrust

3.      International Medicine: Related to Economic Freedom

4.      Medicare: $Billions Wasted

5.      Medical Gluttony: Socialized Universal Healthcare

6.      Medical Myths: Socialized Medicine Controls Health Care Costs

7.      Overheard in the Medical Staff Lounge: The Medicare Whip

8.      Voices of Medicine: How Religion Can Inoculate Against Radicalism

9.      The Bookshelf:  The Fall of the Faculty, The Rise of the All Administrative University

10.  Hippocrates & His Kin: The fastest growing crime wave: Educational Theft

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

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

In Memoriam

Michael Hart, father of e-books and founder of Project Gutenberg, died on September 6th, aged 64

AMONG the episodes in his life that didn’t last, that were over almost before they began, including a spell in the army and a try at marriage, Michael Hart was a street musician in San Francisco. He made no money at it, but then he never bought into the money system much—garage-sale T-shirts, canned beans for supper, were his sort of thing. He gave the music away for nothing because he believed it should be as freely available as the air you breathed, or as the wild blackberries and raspberries he used to gorge on, growing up, in the woods near Tacoma in Washington state. All good things should be abundant, and they should be free. Read more . . .

He came to apply that principle to books, too. Everyone should have access to the great works of the world, whether heavy (Shakespeare, “Moby-Dick”, pi to 1m places), or light (Peter Pan, Sherlock Holmes, the “Kama Sutra”). Everyone should have a free library of their own, the whole Library of Congress if they wanted, or some esoteric little subset; he liked Romanian poetry himself, and Herman Hesse’s “Siddhartha”. The joy of e-books, which he invented, was that anyone could read those books anywhere, free, on any device, and every text could be replicated millions of times over. He dreamed that by 2021 he would have provided a million e-books each, a petabyte of information that could probably be held in one hand, to a billion people all over the globe—a quadrillion books, just given away. As powerful as the Bomb, but beneficial.

That dream had grown from small beginnings: from him, a student at the University of Illinois in Urbana, hanging round a huge old mainframe computer on the night of the Fourth of July in 1971, with the sound of fireworks still in his ears. The engineers had given him by his reckoning $100m-worth of computer time, in those infant days of the internet. Wondering what to do, ferreting in his bag, he found a copy of the Declaration of Independence he had been given at the grocery store, and a light-bulb pinged on in his head. Slowly, on a 50-year-old Teletype machine with punched-paper tape, he began to bang out “When in the Course of human events…”

This was the first free e-text, and none better as a declaration of freedom from the old-boy network of publishing. What he typed could not even be sent as an e-mail, in case it crashed the ancient Arpanet system; he had to send a message to say that it could be downloaded. Six people did, of perhaps 100 on the network. It was followed over years by the Gettysburg Address, the Constitution and the King James Bible, all arduously hand-typed, full of errors, by Mr Hart. No one particularly noticed. He mended people’s hi-fis to get by. Then from 1981, with a growing band of volunteer helpers scanning, rather than typing, a flood of e-texts gathered. By 2011 there were 33,000, accumulating at a rate of 200 a month, with translations into 60 languages, all given away free. No wonder money-oriented rivals such as Google and Yahoo! sprang up all round as the new century dawned, claiming to have invented e-books before him.

He called his enterprise Project Gutenberg. This was partly because Gutenberg with his printing press had put wagonloads of books within the reach of people who had never read before; and also because printing had torn down the wall between haves and have-nots, literate and illiterate, rich and poor, until whole power-structures toppled. Mr Hart, for all his burly, hippy affability, was a cyber-revolutionary, with a snappy list of the effects he expected e-books to have:

Books prices plummet.
Literacy rates soar.
Education rates soar.
Old structures crumble, as did the Church.
Scientific Revolution.
Industrial Revolution.
Humanitarian Revolution.

If all these upheavals were tardier than he hoped, it was because of the Mickey Mouse copyright laws. Every time men found a speedier way to spread information to each other, government made it illegal. During the lifetime of Project Gutenberg alone, the average time a book stayed in copyright in America rose from 30 to almost 100 years. Mr. Hart tried to keep out of trouble, posting works that were safely in the public domain, but chafed at being unable to give away books that were new, and fought all copyright extensions like a tiger. “Unlimited distribution” was his mantra. Give everyone everything! Break the bars of ignorance down! . . . 

 Read the entire obituary in The Economist – Subscription Required . . .

On This Date in History - September 27

On this date in 1722, Samuel Adams who was a second cousin of John Adams was born. He was the firebrand of his time, the leader of the resistance to the Stamp Act and one of the prime instigators of the Boston Tea Party. When Sam Adams spoke, things seemed to happen. This can be very encouraging to some speakers and very frightening to others. Always bearing in mind Sam Adams’ injunction: “Let us contemplate our forefathers, and posterity, and resolve to maintain the rights bequeathed to us from the former, for the sake of the latter.”

On this date in 1840, Thomas Nast was born in Germany. Every time you see a donkey symbolizing the Democrats or an elephant symbolizing the Republicans, you are seeing the work of Thomas Nast, the great political cartoonist who flourished in the latter half of the nineteenth century. Thomas Nast showed the power of a picture.

After Leonard and Thelma Spinrad

* * * * *

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Please note that sections 1-4, 8-9 are entirely attributable quotes and editorial comments are in brackets. Permission to reprint portions has been requested and may be pending with the understanding that the reader is referred back to the author's original site. 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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Announcing The 1st Annual World Health Care Congress Latin America, October, 2011 in
São Paulo, Brazil

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 United States, the 7th annual event in Europe and the inaugural Middle East event, we are pleased to announce the 1st Annual World Health Care Congress - Latin America to be held in October, 2011 in São Paulo, Brazil.

This prominent international forum is the only conference in which over 500 leaders from all regions of Latin America will convene to address access, quality and cost issues, including Latin American health ministers, government officials, hospital/health system executives, insurance executives, health technology innovators, pharmaceutical, medical device, and supplier executives.

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.

For more information on the World Health Care Congress Latin America . . .

For information on the 9th Annual World Health Care Congress on April 16-18, 2012 . . .