MEDICAL TUESDAY . NET NEWSLETTER
Community For Better Health Care Vol IV, No 13,
In This Issue:
1. Featured Article: Healthy Competition - Foreword by
George P Schultz
2. In the News: The Longest War the United States Ever
Fought - The War on Poverty
3. International Medicine: Medical Savings Accounts: The Singapore Experience
4. Medicare: Watch Out for the Audit
5. Medical Gluttony: The Differences in Medical
Appetites - The Need to Know
7. Overheard in the Medical Staff Lounge: We Are
Approaching Medical Gridlock
9. From the Physician Patient Bookshelf:
THE CANCER WARD by Solzhenitsyn
10. Hippocrates & His Kin: Just a Notch Above Lawyers
11. Related
Organizations: Restoring Accountability in HealthCare, Government and Society
* * * * *
The 3rd Annual World Health
Care Congress,
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
* * * * *
1. Featured Article:
Foreword by George P Schultz to Healthy
Competition: What's Holding Back Health Care and How to Free It by Michael
F Cannon & Michael D Tanner – September
2005, ISBN: 1-930865-81-3.
We
begin with a riddle. What country’s health care system offers the best health
services in the world, is constantly criticized for not being accessible enough,
and yet is so accessible that overutilization is leading to runaway costs? The
first part reveals the answer could only be
What
are some of the characteristics of this modern world? For one thing, increased
longevity, aging baby boomers, and new medical technologies presage greater use
of medical care. Take demography. Our population’s age structure is changing.
The baby boomers are about to start moving into the over-65 category, while
longevity keeps increasing. We are getting older as well as healthier, or
maybe, because we are healthier, we are getting older. Nevertheless, the older
we are, the closer we are to death, and a disproportionate share of health care
spending comes toward the end of a person’s life. Moreover, innovation enables modern
medicine to satisfy needs that yesterday went unmet, which draws more resources
into the health sector.
These
trends are colliding with a health care system that already encourages
overutilization. To a greater degree than even our neighbors to the north,
Americans rely on someone else to pay for their health care—a tradition that
had its inception in the World War II era. Employers needed workers, and the
only enticement they could offer that was not subject to wartime wage and price
controls was health benefits. Providing health insurance was a no-brainer for
employers, but no one should be surprised that when the marginal cost of health
care approaches zero, utilization skyrockets.
Entitlement
programs add fuel to the fire. For example, Medicare is essentially ‘‘free’’
fee-for-service health care for the elderly. Seniors, even the well-to-do, pay
few if any copayments. Dr. John E. Wennberg of
Consumer-directed
health care has its detractors. Do consumers care enough to become informed? Do
they have the capacity to understand health alternatives and to make
intelligent choices? Overwhelmingly, the evidence answers in the affirmative.
Ordinary Americans are increasingly on the ball when it comes to their health.
In fact, markets are already recognizing and meeting consumers’ demand for accessible
health care and more health information. For example, in some retail stores,
nurse stations with basic equipment can provide you with quick diagnoses of
ordinary problems for a small fee. WebMD, an online resource of medical
information, receives an average of 889,000 visitors daily. Forrester Research
reports that baby boomers are better educated and more affluent than previous
generations, and are considerably more comfortable with technology. These
rising seniors are using the Internet en masse for health and leisure activities. European consumers too are
increasingly likely to seek health information online.
Accustomed
to serving themselves on retail and media sites, consumers hunger for useful
online content and comparative evaluation tools from their health care
providers. A growing wave of health care consumerism among young,
health-conscious individuals is setting the stage for consumer-directed health
plans (CDHP). Plans that are slow in developing a CDHP risk losing healthier,
engaged consumers to rival plans. The more of a stake consumers have in their
spending decisions, the better informed and the more demanding they will be.
Yet
To
purchase the book and read the rest of the story, please go to the Cato
Bookstore: www.catostore.org/index.asp?fa=ProductDetails&method=cats&scid=33&pid=1441272.
* * * * *
2. In the News: The Longest
War the
Katrina crisis renews focus
on
Westphal reports: The
searing images of thousands of
Despite more than 35 years
of solid economic growth and income gains, the nation's poverty rate is
virtually no better than it was in 1968, four years after President Johnson
launched a war on poverty.
With poverty in
hurricane-stricken areas approaching 30 percent - higher among African
Americans - political leaders of many stripes have issued urgent calls for the
nation to do something about the 37 million Americans who fall into the
category of have-nots.
"We do, I think at some
point, need to see that people couldn't evacuate who were poor," Secretary
of State Condoleezza Rice said, "and understand better how to make sure
that that doesn't happen again."
Former Democratic Sen. John
Edwards of
Americans officially are
considered in poverty if their household income is under about $19,000 for a
family of four. The figure for a couple under 65 with no children is $12,649.
Making progress against
American poverty constitutes a massive challenge. The nation's poverty rate is
the worst, by many calculations, in the developed world. It's been growing for
four straight years. Blacks and other minorities suffer at much higher rates.
Yet the
Here are more questions and
answers about poverty in the
But Douglas Besharov, a
scholar at the American Enterprise Institute, says American poverty is not so
much a matter of neglect as it is a purposeful decision to concentrate more on
faster economic growth and lower rates of unemployment - at the expense of
higher poverty. "I think what you're seeing now in
To read the full article,
please go to www.sacbee.com/24hour/special_reports/katrina/bee/v-print/story/13584628p-14425405c.html.
The Bee's David Westphal can
be reached at (202) 383-0002 or dwestphal@mcclatchydc.com.
* * * * *
3. International Medicine:
Medical Savings Accounts: The
In 1984
To achieve this record, the
government has implemented three programs that help people pay for medical
expenses: Medisave, Medishield and Medifund.
The Medisave Program.
Created in 1984, Medisave is
a compulsory national health care savings program designed to help citizens
meet their individual responsibilities and to supplement funds drawn from their
own savings. Medisave contributions range between 6 and 8 percent according to
the worker's age, and can be used to pay for a variety of specified inpatient
and outpatient medical services, both before and after retirement.
The Medishield Program.
Since Medisave accounts
alone may be insufficient to cover a serious or prolonged illness, Medishield
was established in 1990 as a catastrophic insurance program to pay
extraordinary hospital expenses for those under 70 years of age.
The Medifund Program.
Since the combination of
out-of-pocket, Medisave and Medishield payments may not cover all low-income
workers' medical expenses, Medifund was established in April 1993 to provide
assistance.
Public institutions dominate
In principle, individuals
are free to choose among the five levels. Medical social workers provide
financial counseling to everyone at the time of admission into the public
hospitals. They advise patients that it is their responsibility to choose a
ward class they can afford and to cover their expenses through a combination of
subsidy, Medisave, Medishield and personal funds. If necessary, patients can
draw on their spouse's, children's or parents' Medisave accounts.
Quality of service is an
important issue for
To read the entire article,
go to www.ncpa.org/studies/s203/s203.html.
About the Authors:
Dr. Thomas A. Massaro is the
Harrison Foundation Professor of Medicine and Law. He is Professor of
Pediatrics and Business Administration and a Senior Fellow of the
Yu-Ning Wong was an undergraduate
at the
Closing comment at the time
of this article:
"If MSAs Were Available
in the
Prudent Buying Would Begin
to Chip Away at the High Cost of Care."
* * * * *
4. Medicare: Watch Out for the Audit
Some time ago, a family
physician mentioned that he always had an internist or surgeon take care of his
hospital patients. He was not able to provide daily hospital care. In fact, he
normally saw his hospitalized patients only twice a week. Therefore, his office
automatically entered a hospital charge on Tuesdays and Thursdays for his
hospital patients since on those days his scheduled started an hour late to
allow him time for hospital rounds. Once, because of family obligations, he saw
the patients Monday, Wednesday and Friday. Unfortunately, he failed to tell his
office who then failed to change the date of service.
On Medicare audit, he was charged
with Medicare Fraud, and was about to be cited and fined because of Tuesday and
Thursday charges for evaluations that did not occur. He pleaded that he had
actually seen the patient three times rather than twice and that Medicare
really owed him more money or in fact, as billed, saved money. Uncle Sam’s
position was that not charging for Monday, Wednesday and Friday that week was
his choice; but charging for Tuesday and Thursday and not seeing the patient
was Medicare Fraud. It cost him about ten hours of legal fees for his attorney
to straighten it out.
Government
is not the solution to our problems, government is the problem.
- Ronald Reagan
* * * * *
5. Medical Gluttony: The
Differences in Medical Appetites - The Need to Know
A state senator commenting
on the costs of health care stated, as I recall, that we needed to get the
doctors and hospitals in line and under control to conserve expenditures. When
told that patients have different and sometimes-huge appetites for health care,
she replied, “I’m not aware of any patient using more care than absolutely
necessary.”
This brings to mind two
senior patients who were about the same age and had similar elevated blood
pressures and dizziness when getting up or moving around quickly. There was
about a 10 mm Hg drop in blood pressure in each on getting up from the sitting
to the standing position. It would reverse in a matter of seconds. The
neurological examination revealed that the cranial nerves, motor and sensory
examination, reflexes and coordination were all intact. The doctor explained
that it was most likely a postural effect, but could be due to small lacunar
strokes in the central portion of his brain. Many times, these don’t even show
on a CT scan of the brain.
The first patient accepted
this explanation and revised his living habits by getting up more slowly and
steadying himself on something solid when he made a change in position. He did
quite well. Total cost: $100 (one office visit)
The second patient said, “I
need to know exactly what caused it.” She didn’t care what it would cost to
find out since she had Medicare. She insisted on a carotid Doppler to check her
circulation. It was normal. She had a normal brain CT scan. She had a brain MRI
scan that showed some small lacunar infarcts. She then insisted on seeing a
brain specialist. A neurologist examined her very carefully and after a repeat
detailed neurological examination, came to the same diagnosis as the personal
physician: small lacunar strokes aggravated by postural blood pressure changes.
Her baseline blood pressure was normal and he told her there was no treatment
required for this problem and advised to keep her blood pressure normal. “You
haven’t even done a brain wave on me,” was her response. So the neurologist
ordered an EEG, which was normal. After talking with her friends and
researching medical web sites, she returned to the neurologist and demanded a
PET scan, the latest and most sophisticated brain test. So the neurologist
ordered a $2300 PET scan, which was normal.
When she returned to her
personal internist, he asked her if she was happy now that all the
possibilities had been evaluated and we knew exactly what her problem was
having done the most sophisticated tests - tests that would not be readily
available in approximately 167 of the 192 countries of the world. She replied,
“No. I’m more anxious than ever to think I may have had a stroke.” Do you want
to discuss your anxieties with a psychiatrist? “Heavens no. I want someone to
tell me I didn’t have a stroke.” Total estimated cost: $5600 (two office
visits, carotid Doppler, CT brain, MRI brain, neurologic consultation, EEG,
neurologic follow up to discuss all the findings, PET scan, final neurologic
summation visit)
Did the second patient
receive a higher quality of care than the first? No. The 55 fold (5,500%
increase in cost) difference occurred in a government-controlled healthcare
environment, such as the United States, where 90 percent of health care is
government regulated - more socialized than in countries with socialized
medicine. The only way to have reduced this cost would be in a market-based
environment. If the patient had to pay a percentage of the cost, the expensive
investigation would have stopped in its tracks after about the second
unnecessary test.
Quality of care is not an
issue in this case. In fact, if the QOC cops had evaluated this scenario, they
would have faulted the first internist for not providing the best quality. QOC
is only an issue in government-regulated healthcare. In a free market, quality
continually improves automatically. In government medicine, quality of care
always decreases to the level of the lowest incompetent physician or hospital.
Having recently visited the
offices of lawmakers who do not understand human variations such as this, we
must make every effort to neutralize their efforts in Healthcare.
* * * * *
The debate over
While disaster experts say
the modification would greatly help fight multiple blazes after a major
earthquake, Fire Chief Joanne Hayes-White says the cost would tax her
department's budget. "Besides," she says, "the city's hydrants
don't need changing."
Those who have made a study
of the chaotic responses to such tragedies as the recent Hurricane Katrina, the
For less than the price of a
"Standardization of
equipment is vitally important," said Dale Chessey, a spokesman for the
state Office of Emergency Services. "Sure, $800,000 is a lot of money to
do all at once. But maybe they do it a little at a time."
[This should dispel any
belief that even a local government can administer medical care effectively.
Budgetary limits could allow an epidemic to spread unchecked while City Hall
debates whether they can afford to spend the cost of a home to save lives.]
* * * * *
7. Overheard in the Medical Staff Lounge: We Are Approaching
Medical Gridlock
Dr Edwards: Senator LeRoy
Greene upon his retirement from the
Dr Rosen: We must also
remember that the members of the medical review committee are frequently
further removed from the latest in standard of care and thus project an
inferior standard on the doctors they review who are practicing on a higher standard. Thus the review committee can further
decrease the quality of care (QOC).
* * * * *
8. Voices of Medicine: A
Review of Local and Regional Medical Journals and the Press
Medical Arts: A Different Kind of Healing reported by Stacey Kerr,
MD, in
My Left Breast - A One-woman Autobiographical Monologue by Susan
Miller, 15 years after she was diagnosed with breast cancer, as played by
Stacey Kerr, MD.
“It was opening night, we had a sold-out house, and
I was supposed to be doing my ‘warm-ups.’ I had to sharpen my senses, loosen up
my body so it was available for the character, and fully explore my own
emotional state. What was going on that might get in the way of the
performance? I had to let it all go and then work to become as vulnerable as
possible; turn my skin inside out and push past the edges of safety.
“Familiar with the warm-ups that were most
effective, I worked to find within myself the truth of my mortality, the utter
loneliness of being a single mother, the fear of dying alone and unfulfilled. I
had a half hour to locate that dark place of bleak hopelessness and then to
bring myself back up into sanity with bravery, lust, humor, and triumph. I
worked for a foundation of life-threatening fear so I could rise above it. My stomach
churned with dread, and I used every bit of that dread for the character I
would become: Susan Miller, a one-breasted, menopausal, Jewish, bisexual,
lesbian Mom.
“But this night I could only go so far into that
vulnerability before my logical and scientific brain started asking the
obvious: Why bother? What is it about human beings getting up on a stage and
prancing around reciting words someone else has written? Isn’t this silly? I
can’t take it seriously. Why not just get up there, remember the lines and the
blocking, go through the motions, and get out of there alive? . . . . To read more about Dr Kerr’s reaction to the
play, see the link below. She concludes her story with the following comments:
“My
Left Breast”
was a successful play. In January, we sold out six performances in
“I continue to treat strep throat and to recommend
surgery when needed. I also continue to strive for truth and vulnerability when
I work on stage, knowing that the work I do in theater can be as valid and
powerful as the work I do in the examining room. It’s just a different kind of
healing.
“Dr. Kerr, a
www.scma.org/magazine/scp/sm05/kerr.html
____________________________________
Myths and Truths of Medical Spas
Janis Rizzuto gives us the
first installation of a special report about the quick-moving medical spa
marketing the Southern California
Physician. “Physicians and others comment on the trend and clarify some
incorrect assumptions.
“In the past five years, the number of medical spas
has increased 205 percent, according to the International Spa Association.
“Nonsurgical cosmetic procedures in 2004 increased
51 percent from 2003, according to the American Society for Aesthetic Plastic
Surgery. The biggest increases were in dermal fillers (up 659 percent), laser
skin resurfacing (up 363 percent) and cellulite treatments (up 193 percent).
“‘It’s a good thing that more physicians are getting
involved,’ says Howard Murad, MD. ‘It’s a trend we can’t deny. Patients want
more. They want to look healthier and feel better. They often feel they don’t
have enough time for themselves, but in a spa environment, they have our full
attention. They feel cared for much more than in a doctor’s office.’
“Dr. Murad should know. He is the renowned
dermatologist who is widely considered the father of the medical spa industry,
having launched the first medically supervised day spa in El Segundo back in
1988.
“But as medical spas caught on, so did permutations
of the concept. ‘If you ask four doctors, you get five different opinions.
Everyone has their own opinion of what a medical spa should be,’ Dr. Murad
says. ‘Everybody uses the name and does something different.’
“Still, Dr. Murad, who is a member of the Los
Angeles County Medical Association, takes a strict view that all medical
procedures should be done by physicians, not just registered nurses or
aestheticians under supervision. ‘We must concern ourselves that procedures are
done correctly and done by who should be doing them,’ he says”.
To read this month’s entire
article, go to www.southerncaliforniaphysician.com/site/jul05/feature3.pdfwww.socalphys.com/jul05/feature3.pdf.
To read the continuation of
this series, see the August issue at http://www.southerncaliforniaphysician.com/site/aug05/,
September issue at http://www.southerncaliforniaphysician.com/site/sep05/
and October issue at http://www.southerncaliforniaphysician.com/site/oct05/.
* * * * *
9. Book Review: THE CANCER WARD by Alexander
Solzhenitsyn
Translated by Nicholas
Bethel and David Burg, Noonday Press,
This work of fiction is
based on the author’s own experiences as a patient in a cancer ward in the
1950's, but it speaks to us more clearly with each passing year as our country
grapples with the problem of providing basic health care for all.
As the story opens, Nobel
laureate Solzhenitsyn’s Soviet world of 40 years ago seems like a strange and
foreign place indeed, with its detached, impersonal, "universal free
health care" system which serviced frightened powerless patients with
competent but distant doctors whose passionless demeanor would have served them
as well if they had been engineers or plumbers.
The chapter titled "The
Old Doctor," is particularly prophetic. A 75 year old physician, Dr.
Oreshchenkov, mourns the extinction of the family doctor in modern Soviet
medicine. He characterizes this practitioner of a bygone era as the "most
comforting figure in our lives...a figure without whom the family cannot exist
in a developing society. He knows the needs of each member of the family, just
as the mother knows their tastes...the kind of person to whom they can pour out
the fears they have deeply concealed or even found shameful... But he has been
cut down and foreshortened. [It is very difficult] to find a doctor nowadays who
is prepared to give you as much time as you need and understands you
completely, all of you." A fellow physician and patient responds,
"All right, but...they just can’t be fitted into our system of universal,
free, public health services." Dr Oreshchenkov retorts, "Universal
and public--yes. Free, no." The colleague replies, "But the fact that
it is free is our greatest achievement."
Dr Oreshchenkov then gives
us the real message for our time: "What do you mean by 'free’? The doctors
don’t work without pay. It’s just that the patient doesn’t pay them; they’re
paid out of the public budget. The public budget comes from these same
patients. Treatment isn’t free, it’s just depersonalized. If the cost of it
were left with the patient, he’d turn the ten rubles over and over in his
hands.
The Author then describes
how he feels the health care system should be. He felt that primary treatment
should be at the expense of the patient, but hospitalizations or costly
procedures should be free. Then patients would be in control of when and how
often and from whom they should seek medical treatment. "With the right
kind of primary system,...there would be fewer cases altogether, and no
neglected ones..." Each patient could be treated as a whole person instead
of a collection of diseases, to be tossed from specialist to specialist like a
basketball.
Solzhenitsyn’s story is a
classic - as relevant today in
www.healthcarecom.net/bkrev_CancerWard.htm
To read some of the other book reviews that are
available, please go to http://www.delmeyer.net/PhysicianPatientBookshelf.htm.
* * * * *
10. Hippocrates & His Kin: Just a Notch above Lawyers
The Dutch government has
expanded its euthanasia policy from the aged to newborns. With the coming flu
pandemic expected to be as severe as the one in 1918 when 50 million people
died, will we begin to euthanize people of any age with hopeless flu? M Stanton
Evans, at the AAPS Meeting last month, stated during a euthanasia presentation:
Old terms seems to have taken on new meaning. “You’re better off dead.”
____________________________________
Leon Louw, the South African
economist, says that in the past 30 years, the world has poured $450 billion of
aid into
____________________________________
Hostess pointing out guests
to new arrivals at a cocktail party: "The Von Soostens under the
chandelier represent old money; the Hendersons by the champagne punch represent
new money; the Gibbons admiring the bookcase represent lottery money; the
Krogers sitting on the velvet divan ladened with gold and diamonds around their
wrists, waist, and necks represent managed care money; and Dr Livingstone, my
HMO doctor, bending over the diving board with his wife tugging on his coat
represents no money."
____________________________________
A patient
brought in a hospital bill stating, "here’s one for your column." He
had gone through a pulmonary rehabilitation program at one of the hospitals.
The bill to Medicare was $4576 for 18 three-hour sessions. He said with a class
of 12, it was $54,912 for the hospital or $3000 per session, which involved one
respiratory therapist, or one employee making $1000 per hour for the hospital.
He said he was unable to find any medical benefit. He called some of the twelve
and they couldn’t either... Who needs beds anyway? Sounds like converting the
patient rooms to a few exercise rooms should do it.
____________________________________
A prospective juror in an
insurance case was asked if he had ever done business with the insurance
company in question, and what he thought of insurance agents. He replied that
he placed them "just a notch above lawyers." We may think of this as
just another ploy to avoid serving on a lengthy jury trial, but the association
is sobering--even if you don’t drink. Remember when "public
confidence" polls placed doctors near the top along with priests,
ministers, rabbis, and Supreme Court justices? At the other end of the spectrum
were congressmen, legislators, lawyers, and used car salesmen. As we leave the
high moral ground and become increasingly preoccupied with the bottom dwellers,
who have the temerity to question our quality of care, might we not also fall
to "just a notch above lawyers?"
* * * * *
11. Restoring Accountability in
HealthCare, Government and Society:
$ The National
Center for Policy Analysis, John C
Goodman, PhD, President, who along with Devon Herrick wrote Twenty Myths about Single-Payer Health
Insurance, which we reviewed in this newsletter the first twenty months,
issues a weekly Health Policy Digest,
a health summary of the full NCPA
daily report. You may log on at www.ncpa.org
and register to receive one or more of these reports.
$ The Mercatus
Center at
$ The Galen Institute,
Grace-Marie Turner President and Founder, has a weekly Health Policy Newsletter sent every Friday to which you may
subscribe by logging on at www.galen.org. A
new study of purchasers of Health Savings Accounts shows that the new health
care financing arrangements are appealing to those who previously were shut out
of the insurance market, to families, to older Americans, and to workers of all
income levels.
$ Greg Scandlen, Director of the “Center for Consumer-Driven Health Care” at the Galen Institute, has a Weekly Health
News Letter: Consumer Choice Matters.
You may subscribe to this newsletter that is distributed every Tuesday by
logging on at www.galen.org
and clicking on Consumer Choice Matters.
Archives are now located at www.galen.org/ccm_archives.asp. This is the flagship publication of Galen's
new Center for Consumer-Driven Health Care and is written by its director, Greg
Scandlen, an expert in Health Savings Accounts (HSAs).
$ The Heartland
Institute, www.heartland.org, publishes the Health Care News, Conrad
Meier, Managing Editor Emeritus. Be sure to read A Moment of Silence for
John Walton … and Wal-Mart, at www.heartland.org/Article.cfm?artId=17694.
$ The Foundation for
Economic Education, www.fee.org, has been
publishing The Freeman - Ideas On
Liberty, Freedom’s Magazine, for over 50 years, with Richard M Ebeling, PhD, President, and Sheldon Richman as editor. Having bound copies of this running
treatise on free-market economics for over 40 years, I still take pleasure in
the relevant articles by Leonard Read and others who have devoted their lives
to the cause of liberty. I have a patient who has read this journal since it
was a mimeographed newsletter fifty years ago. This is an opportunity to keep
up with classics in economics. Be sure to read this month’s classic by
political science expert Allan C. Brownfeld: Knowledge and Decisions at www.fee.org/vnews.php?nid=868.
$ The Council
for Affordable Health Insurance, www.cahi.org/index.asp,
founded by Greg Scandlen in 1991, where he served as CEO for five years, is an
association of insurance companies, actuarial firms, legislative consultants,
physicians and insurance agents. Their mission is to develop and promote
free-market solutions to
$ The Health
Policy Fact Checkers is a great resource to check the facts for accuracy in
reporting and can be accessed from the preceding CAHI site or directly at www.factcheckers.org/. This week, read
the Daily Medical Follies: “Woeful Tales from the World of Nationalized Health
Care,” at www.factcheckers.org/showArticleSection.php?section=follies.
$ The Independence Institute, www.i2i.org,
is a free-market think-tank in Golden,
$ The National Association of Health
Underwriters, www.NAHU.org. The NAHU's Vision
Statement: Every American will have access to private sector solutions for health,
financial and retirement security and the services of insurance professionals.
There are numerous important issues, guides, and reports listed on the opening
page that are very important in the world of health insurance. Be sure to
bookmark for future reference their guides to all types of health insurance.
$ Martin Masse, Director of Publications
at the Montreal Economic Institute, is the publisher of the webzine: Le Québécois Libre. Please log on at www.quebecoislibre.org/apmasse.htm to
review his free-market based articles, some of which will allow you to brush up
on your French. You may also register to receive copies of their webzine on a
regular basis. This month, read an excellent report on “Should Canada Try
Health Savings Accounts?” at www.quebecoislibre.org/05/050915-8.htm.
$ The
Fraser Institute, an independent public policy organization, focuses on the
role competitive markets play in providing for the economic and social well
being of all Canadians. Log on at www.fraserinstitute.ca
for an overview of the extensive research articles that are available. You may
want to go directly to their health research section at www.fraserinstitute.ca/health/index.asp?snav=he.
$ The Heritage Foundation, www.heritage.org/, founded in 1973, is a research
and educational institute whose mission is to formulate and promote public
policies based on the principles of free enterprise, limited government,
individual freedom, traditional American values and a strong national defense.
The Center for Health Policy Studies supports and does extensive research on health care policy that is readily
available at their site. Be sure to read the timely research on “The Growing
Disconnect: Federal Spending and Congressional Leadership” at http://www.heritage.org/Research/Budget/wm865.cfm.
$ The Ludwig von Mises Institute, Lew Rockwell, President, is a rich
source of free-market materials, probably the best daily course in economics
we’ve seen. If you read these essays on a daily basis, it would probably be
equivalent to taking Economics 11 and 51 in college. Please log on at www.mises.org to obtain the foundation’s daily
reports. Be sure to read this week's Free Markets and Social Welfare by Gabriel
Openshaw at www.mises.org/story/1915.
You may also log on to Lew’s premier free-market site at www.lewrockwell.com to read some of his
lectures to medical groups. To learn how state medicine subsidizes illness, see
www.lewrockwell.com/rockwell/sickness.html;
or to find out why anyone would want to be an MD today, see www.lewrockwell.com/klassen/klassen46.html.
$ CATO. The Cato Institute (www.cato.org) was founded in 1977 by Edward H.
Crane, with Charles Koch of Koch Industries. It is a nonprofit public policy
research foundation headquartered in
$ The Ethan Allen Institute, www.ethanallen.org/index2.html,
is one of some 41 similar but independent state organizations associated with
the State Policy Network (SPN). The mission is to put into practice the
fundamentals of a free society: individual liberty, private property,
competitive free enterprise, limited and frugal government, strong local
communities, personal responsibility, and expanded opportunity for human
endeavor.
$
* * * * *
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Del Meyer
Del Meyer, MD, CEO & Founder
Words of Wisdom
P. J. O'Rourke: When buying and selling are controlled
by legislation, the first thing to be bought and sold is legislatures.
Mark Twain, (1866):
There is no distinctly native American criminal class save Congress.
On
This Date in History - October 11
General Pulaski Memorial Day: Casimir Pulaski,
who came to the