Physicians, Business, Professional and Information Technology Communities
Networking to Restore Accountability in HealthCare & Medical Practice
Tuesday, November 25, 2003
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In This Issue:
1. The Galen Institute HealthBenefitsReform Conference
2. You Own Your Body Parts, but Who Owns Your Body?
3. Review of Successful Government Programs
4. Our Monthly Review of Socialized Medicine: A Free Market for HealthCare
5. Medical Gluttony or Excessive HealthCare Costs in Germany
6. The MedicalTuesday.Network for Restoring Patient-Focused Private Practice
The Galen Institute’s HealthBenefitsReform
The Galen Institute (www.galen.org) held its first HealthBenefitsReform conference at the Palmer House in Chicago this past weekend. Grace-Marie Turner, President, who writes the weekly Health Policy Matters, presented a number of issues on health policy in the United States, including the background, the struggles with Medicare Reform and the most current legislation. By introducing consumer choice into health policy, she explained how this is a significant step forward after 36 years of Medicare.
Greg Scandlen, who directs the Center on Consumer Choice in Health Care and writes the weekly Consumer Choice Matters, chaired the round table discussion involving innovative leaders from across the country. We heard from leaders who privatized health care in their realm of influence with amazing economy in costs. Several described hospitals that are so inundated with federal rules and regulations, they are willing to accept 50 percent of their usual charges for patients who paid with cash or VISA on discharge. One hospital accepted 40 percent–a 60 percent discount. Participating laboratory and x-ray facilities extended similar discounts for cash or VISA payments. This points out the huge drag on the health care industry imposed by government and third-party payers. By eliminating government and third-party bureaucracy, we could reduce the health care costs in this country from $1.4 trillion to about $800 billion. Also, when consumers are able to choose their doctors, the laboratory testing facility and the hospital, there will be even further economies. This would make health care cost less than what Americans pay for cigarettes, alcohol and entertainment.
We owe a large amount of gratitude to the Galen Institute for their efforts in Health Policy and Consumer Choice that is making health care affordable for all Americans.
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You May Own Your Body Parts, but Who Owns Your Body?
Do you have constitutionally-protected property rights and interests in your anatomy equal to your rights to control your car and your house? Who decides what for whom? Who decides whether and how to repair your car’s bad brakes? Who decides whether and how to repair your home’s leaky roof? Who decides whether and how to repair your sick or injured body? If you own it, it is yours to decide if, how, and when to repair and to which expert to entrust your valuable property. A renowned medical law expert and nation-wide consultant on medical law and ethics, Dr. Madeleine Pelner Cosman, Esq, sharpened the four-word question, “Who Owns Your Body?” to cut through complexities in medical law in order to reveal the plain truths about our current medical entitlements.
Suppose government decreed that brake repairs and brake replacements for an automobile of your car’s age and quality are “vehicularly unnecessary” because they are too costly, and instead recommended slow driving plus deceleration plus wheel blocking. You would react with incredulous anger. It’s your car, your money and your life at risk. Or, suppose government forbade you to call a roofer for your leaking roof requiring instead that you first consult with your general constructions “gatekeeper” who, in deeming your roof requires a roofer, will refer you for specialty care. You would react to such restriction with shocked fury. It’s your house’s roof, your money and your property at stake.
Dr. Cosman arms Americans with the inspiration and the weapons to take back their medical and financial futures. Modern American medical law implies that insurance companies, employers, the state and Washington, D.C. supersede your right to decide, control, treat or withhold treatment of your body whether you are healthy, diseased, injured or fatally ill. Forty years ago, before Medicare, patients and their physicians together made decisions that now are made by the third-party payers such as Medicare, Medicaid, HMOs and insurance companies. They decide by federal mandate what shall be done or not done to your body. If you are healthy, you may not need to worry about body ownership rights. If you are mortal, you are vulnerable to the criminal law now commanding American medicine. Criminalizing medical law is a clear and present danger both to physicians and to patients. You also are susceptible to the collectivizing of patients under capitation formulas and bureaucratic decisions or medical necessity. Over the next few months, we’ll bring you further details on Dr Cosman’s book, Who Owns Your Body, due to be published shortly.
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Review of Successful Government Programs
Featured headlines in the Sacramento Bee’s front page yesterday reported the success of Thunder Valley Indian Casino in nearby Auburn, between Sacramento and the Tahoe/Reno area. The Casino opened in June with lines of cars extending from each direction; parking lots were overflowing. The average daily crowd continues at a staggering 8,000 customers a day making Thunder Valley one of the nation’s most lucrative casinos. Although Indian revenues need not be disclosed to the public, the management company has shareholders and divulged that its 24 percent commission on the net income will be $65MM to $75MM per year. This suggests that the Auburn Indian Community of 240 tribal members will realize a $200MM yearly profit.
But, it hasn’t meant instant personal wealth for the descendants of the 25 Nisenan Maidu and Sierra Miwok who survived the nineteenth century depredation of California Indians. According to author Steve Wiegand, they became the Auburn tribe in 1917. For 86 years the tribe members lived from broken government promise to government handout, in dilapidated mobile homes and trailers on a sun-baked hillside without such amenities as running water or telephone service. After Congress decided to terminate the tribe in 1958 and sold all but two acres, it took 26 years for the tribe to legally re-establish itself. Before housing can be built, tribe leaders estimate that it will take about two years and most of the casino money to pay off debts, teach their members how to use check books and credit cards, establish a health plan and build schools.
It’s not only our native Americans that have lived under broken promises for centuries. This past week, I’ve had patients in my office who have complained about broken promises our government made over much of their lifetimes. These are patients and their dependents from the military and many on Medicare, Medicaid and county welfare whose major complaint is that they were promised more health care and other benefits than they are currently able to receive.
Is there any government program that is successful? Three of the four essential government programs, Defense, State and Justice, are having difficulty finding a consensus both in Congress and in the public arena. Why would anyone want to place health care for the rest of us in a government bureaucracy with no significant measure of success, not only in this country but anywhere on the globe? Government medicine (single-payer or universal health care) would be cruel and inhumane. We must all work against being put “out on the reservation” to be forgotten. We must join the movement to private, consumer-choice, patient-based health care which is gaining momentum.
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Our Monthly Review of Universal Coverage Known as
Socialized or Single-Payer Medicine
Jacob G Hornberger, a former trial attorney and adjunct professor of law and economics at the University of Dallas, and Richard M Ebeling, the Ludwig von Mises Professor of Economics at Hillsdale College, who was recently named president of the Foundation for Economic Education discusses the Free-Market approach to HealthCare in The Dangers of Socialized Medicine. Sheldon L Richman, former senior editor at the Cato Institute and now Editor of Ideas on Liberty, has a chapter in which he discusses A Free Market for HealthCare.
Concerned about rising costs and the number of Americans without medical insurance, nearly everyone is worried these days about health care. Not a day goes by without a presidential candidate or a magazine calling for something drastic to be done. Each advocate maintains that his plan will bring skyrocketing costs under control, make health care accessible to low-income people, and bring health insurance within the reach of the 34 million Americans who currently do without it. The American people are being handed a Hobson’s choice between a government takeover of the medical insurance industry and mandatory provision of insurance by the nation’s employers, with the government as insurer of last resort.
There is a real alternative solution that relies on competition in the open marketplace. That solution recognizes that the undesirable aspects of the current system are not the result of the free market, but rather are the outcome of decades of governmental intervention in the health-care industry. Elimination of that intervention would shift power and responsibility from impersonal bureaucracies to consumers. The resulting free market, characterized by prudent consumers spending their own money, would control costs and let the American people have the kind of medical care they want.
Those who call for greater governmental involvement are fond of comparing how much Americans spend on health care with how much is spent in other countries. But these comparisons are misleading for many reasons. The demographics of countries are different. Nevertheless, we can say that Americans spend too much on health care in the sense that identifiable government interventions raise costs higher than they would be otherwise. They do that by artificially stimulating demand and artificially constricting supply.
On the demand side, the problem is simply this: The government pays for about half the health care purchased in this country, through the national health insurance for the poor and elderly known as Medicaid and Medicare. The costs of these programs have exploded over the years. Since Medicaid and Medicare patients pay little or nothing for health care, they demand more of it than they would otherwise. They have no need to shop for the best value or to be prudent about elective procedures.
On the supply side, various governmental regulations enacted at the behest of the medical profession have constricted the supply of doctors and other health-care professionals. Medical licensing and the power to accredit medical schools were explicitly motivated by the medical profession’s wish to reduce competition and to increase the remaining practitioners’ incomes. (This was done under the illusion of improving quality.) Between 1910 and 1920, when accreditation power was granted, the number of medical schools in the United States dropped from 131 to 85. The cut particularly harmed women and minorities; by 1944 the number of medical schools which predominantly admitted blacks fell from seven to two. Thanks to government, the medical industry is far less competitive than it would be if left free of interference.
Most of the proposed solutions, however, ignore the causes of the problem and would even aggravate the situation. The most popular approach, the one taken by many Democrats, as well as a coalition of Big Business and Big Labor, is known as “play or pay.” Under this plan, the federal government would require all employers to provide health insurance to their workers or to pay a new payroll tax (over 7 percent), the revenue from which would provide insurance. (California is trying to implement this very proposal.) The supporters of “play or pay” also favor regulations on insurance premiums and various methods of cost containment. Notice that this proposal would only make things worse. Government would insure even more people than now, and its control of costs-price controls-would bring about distortions and bureaucratic rationing. Moreover, as the price of insurance continued to rise, the system would create incentives for small businesses to pay into the government fund, moving us closer to national health insurance. And when “play or pay” failed to improve the health-care system, the statists would inevitably say, “Private enterprise was given a chance and has failed; now it’s time for the government to take over.”
It should be obvious that if governments at all levels were not confiscating close to half of the people’s wealth, medical care would be a manageable necessity of life. Without the onerous tax burden under which people now labor, they would be able to save for the medical expenses required during their working and retirement years. True, some people would not be able to provide for their own care-and they would have to rely on private charity. But the medical profession itself has always been generous in helping the indigent.
Governmental intervention is always dangerous. But nowhere is it more so than in the healthcare industry. The sooner we get the government out, the sooner we can all breathe easier-and perhaps even live longer. (The above article was written three elections ago. The names are different but the facts today are disturbingly similar.)
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Medical Gluttony or Excessive HealthCare Costs
A patient came in to see me for her annual examination of her occupational asthma. She is also afflicted with Lupus which has been stable for years since her last Rheumatologic consultation. She didn’t require any treatment beyond occasional routine analgesics. She was elated to report that she had obtained an additional Rheumatologic consultation at the University in the interim. She proudly handed me a 10-page sheath of laboratory data, which determined that after a thorough evaluation there were no other recommendations. When I asked her how much this cost, she announced that she was poor and, therefore, did not have to pay for it–it was free. I looked at her registration sheet, and there it was: she had the world’s finest catch net insurance called Medicaid. It allows her to obtain medical care anytime of day or night, weekday or weekend, with a physician or medical center of her choosing, and an unlimited MediCal Insurance Card (like a Credit Card with no maximum) with no obligation to manage or even be concerned about costs. I took the laboratory reports to the nearby lab and was told the cost was well over $700. If we add the consultation fees of the University Professor, this extra opinion would be about $1,000.
If we had universal or single-payer health care, everyone could shop for what they perceived as health care, even if it had no relevance to improved health, as in the case of this lady. If only one-third of our population, or 100 million Americans, would then avail themselves of this, that would be an extra $100 Billion of feel good health care that has no relevance to improving one’s health.
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MedicalTuesday Supports These Efforts in Restoring Accountability in Medical Practice by Restoring the Doctor & Patient Relationship Unencumbered by Bureaucracy:
• PATMOS EmergiClinic - www.emergiclinic.com - where Robert Berry, MD, an emergency physician and internist, provides prompt care for many of the injuries and illnesses treated in Emergency Rooms at a fraction of their cost. Congratulations to Dr Berry for a Wall Street Journal Front Page & Center article, Pay-as-You-Go MD: The Doctor Is In, But Insurance Is Out. To read, see http://online.wsj.com/article/0,,SB10680718663821200-search,00.html
• Dennis Gabos, MD, President of the Society for the Education of Physicians and Patients (SEPP), www.sepp.net, for making efforts in Protecting, Preserving, and Promoting, the Rights, Freedoms and Responsibilities of Patients and Health Care Professionals, with a special page for our colleagues in nursing. Several free newsletters are available. Call 412-364-1994 or 724-929-5711 to join and be part of protecting and preserving what is right with American Healthcare - - physicians, nurses, pharmacists, psychologists, all health professionals and all concerned are urged to join.
• Dr Vern Cherewatenko for success in restoring private-based medical practice which has grown internationally through the SimpleCare model network, www.simplecare.com. SimpleCare is a common-sense health care program designed by members of the American Association of Patients and Providers (AAPP). The non-profit AAPP was formed by practicing board-certified physicians in an effort to bring together the voices and strengths of patients, physicians and all health care providers as the "agents of change" across the nation. Any patient or person may become a member of SimpleCare. Remember, SimpleCare IS NOT an insurance company nor does it provide any insurance services.
• Dr David MacDonald has partnered with Ron Kirkpatrick to start the Liberty Health Group (www.LibertyHealthGroup.com) to assist physicians by helping them to control their medical benefit costs for their staff and patients. You can obtain a quote from www.eHealthInsurance.com at this site. He is available to speak to your group on a consultative basis. Contact him at DrDave@LibertyHealthGroup.com.
• Robert J Cihak, MD, former president of the AAPS, and Michael Arnold Glueck, M.D, write an informative Medicine Men column that is now at NewsMax. Please log on to read or subscribe at http://www.newsmax.com/pundits/Medicine_Men.shtml. Michael Arnold Glueck wrote this week's column: The Caduceus Conspiracy: How We Can Take Back Medicine. It's always something with medicine! The column de jour for many op-ed writers this week is the crisis of the prescription drug plan – a benefit or entitlement, depending on which side of the aisle you sit on! In American politics, nothing matters unless it's defined as a "crisis." That's one reason why we have the same crises decade after decade. In medicine, however, "crisis" has a more specific meaning. It's the moment when you either die or begin to recover. Today, American health care is in both kinds of crisis. Read the entire column at http://www.newsmax.com/archives/articles/2003/11/18/223844.shtml.
• Richard B Willner, President, Center Peer Review Justice Inc, reports his latest success story and the secret of helping doctors keep their medical license. Doctors are daily reviewed, suspended, lose their medical licenses, and go to jail on trumped up charges that most attorneys don’t understand. This week Dr Willner reports another Sham Peer Review case the doctor has been fighting since 1993. After spending $500,000 on legal fees with attorneys who didn’t understand hospital and medical boards, the Center for Peer Review Justice acting as the consultant to guide the non-legal aspect of a case was able to place this doctor on the offensive after eight years of defense, gain public support through a web site, replace eight sham peer reviewers on the medical board and turn the case around. Although the doctor lost everything he had including his retirement, he feels happy to have finally neutralized the evildoers. Dr Willner says, “We try to make sure that every act done is a positive one.” Read the pages of physicians targeted at http://www.peerreview.org/ and their stories. Thanks, Rich, for protecting us from professional homicide by our colleagues on hospital medical staffs and state medical boards. Keep up the good work.
• The Association of American Physicians & Surgeons (www.AAPSonline.org), The Voice for Private Physicians Since 1943, representing physicians in their struggles against bureaucratic medicine and loss of medical privacy. The “AAPS News” written by Jane Orient, MD, is archived on this site providing valuable information on a monthly basis. They have renamed their official organ the Journal of American Physicians and Surgeons, and named Larry Huntoon, MD, PhD, a neurologist in New York, as the Editor-in-Chief. An important resolution was passed to Oppose Single Payer Medical System, which can be sent to you directly from the website, which is a cyberspace library of books of interest, brochures, the journal, as well as congressional testimonies, fraud, economics, action alerts, and health care news.
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URL References for your perusal or study at leisure. You may want to Bookmark these or add to your Favorites.
Single Payer Initiatives: http://www.healthcarecom.net/EditorialNov94.html
David Gibson, MD, National Health Care Consultant:
Single Payer: http://www.healthplanusa.net/DGSinglePayer.htm
Why are the uninsured, uninsured: http://www.healthplanusa.net/DGUninsured.htm
What’s behind health care costs: http://www.healthplanusa.net/DGRisingHealthCareCosts.htm
Pharmacy costs: http://www.healthplanusa.net/DGPharmacyCosts.htm
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Tammy Bruce: The Death of Right and
Wrong (Understanding the difference between the right and the left on our
culture and values.) http://www.townhall.com/bookclub/bruce.html
Reviewed by Courtney Rosenbladt
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Stay Tuned to the MedicalTuesday.Network and Have
Your Friends Do the Same
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If you would like to participate in the development of the affordable HealthPlan for All Americans and their employers, please send your resume to Personnel@HealthPlanUSA.net. We thank the international response we received last week and look forward to meeting some of you on our next international travel. Apparently professionals throughout the world look up to America to solve the health care problems without government enslavement. With your help we can do this.
Del Meyer, MD, CEO & Founder