MEDICAL TUESDAY . NET
Community For Better Health Care
Vol V, No 7,
In This Issue:
The 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
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1. Featured Article: Stem Cells: The Real Culprits in Cancer? by Michael F Clarke and Michael W Becker, Scientific American, July, 2006
A dark side of stem cells - their potential to turn malignant - is at the root of a handful of cancers and may be the cause of many more. Eliminating the disease could depend on tracking down and destroying these elusive killer cells.
After more than 30 years of declared war on cancer, a few important victories can be claimed, such as 85 percent survival rates for some childhood cancers whose diagnoses once represented a death sentence. In other malignancies, new drugs are able to at least hold the disease at bay, making it a condition with which a patient can live. In 2001, for example, Gleevec was approved for the treatment of chronic myelogenous leukemia (CML). The drug has been a huge clinical success, and many patients are now in remission following treatment with Gleevec. But evidence strongly suggests that these patients are not truly cured, because a reservoir of malignant cells responsible for maintaining the disease has not been eradicated. Conventional wisdom has long held that any tumor cell remaining in the body could potentially reignite the disease. Current treatments therefore focus on killing the greatest number of cancer cells. Successes with this approach are still very much hit-or-miss, however, and for patients with advanced cases of the most common solid tumor malignancies, the prognosis remains poor.
Moreover, in CML and a few other cancers it is now clear that only a tiny percentage of tumor cells have the power to produce new cancerous tissue and that targeting these specific cells for destruction may be a far more effective way to eliminate the disease. Because they are the engines driving the growth of new cancer cells and are very probably the origin of the malignancy itself, these cells are called cancer stem cells. But they are also quite literally believed to have once been normal stem cells or their immature offspring that have undergone a malignant transformation.
This idea - that a small population of malignant stem cells can cause cancer - is far from new. Stem cell research is considered to have begun in earnest with studies during the 1950s and 1960s of solid tumors and blood malignancies. Many basic principles of healthy tissue genesis and development were revealed by these observations of what happens when the normal processes derail.
Today the study of stem cells is shedding light on cancer research. Scientists have filled in considerable detail over the past 50 years about mechanisms regulating the behavior of normal stem cells and the
cellular progeny to which they give rise. These fresh insights, in turn, have led to the discovery of similar hierarchies among cancer cells within a tumor, providing strong support for the theory that rogue stemlike cells are at the root of many cancers. Successfully targeting these cancer stem cells for eradication therefore requires a better understanding of how a good stem cell could go bad in the first place.
To read the entire seven page article (subscription required), please go to
MICHAEL F. CLARKE and MICHAEL W. BECKER worked
together in Clarke's laboratory at the
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News: Personal Information Isn't That Confidential by David Lazarus
Experts weigh in on AT&T's assertion that it owns your data, SF Chronicle, Friday, June 23, 2006
"Saying they own your information is vague and imprecise," said Eugene Volokh, a law professor at UCLA who focuses on privacy and intellectual property cases.
"They don't own it like they have a copyright," he said. "What they're actually saying is that they have a right to disclose it."
The company's new policy for Internet and video customers says that "while your account information may be personal to you, these records constitute business records that are owned by AT&T."
It says: "We may also use your information in order to investigate, prevent, or take action regarding illegal activities, suspected fraud (or) situations involving potential threats to the physical safety of any person."
Legal experts say the policy represents a contract with customers, and that AT&T apparently does have the right to share customers' data as it sees fit.
Shames said he wouldn't be surprised if all other telecom outfits, including cable companies, follow AT&T's example and claim outright ownership of customers' data.
"If AT&T is doing it," he said, "it's just a matter of time before every telecommunications provider is doing it."
To read the entire article on how privacy is no longer confidential, please go to www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2006/06/23/BUG2BJIKPN1.DTL&type=printable.
David Lazarus' column appears Wednesdays, Fridays and Sundays. Send tips or feedback to firstname.lastname@example.org.
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News: The Absurdities Of a Ban on
Smoking, by Martin Wolf, Financial Times,
Smokers are the new lepers. One already sees them huddled in doorways. Soon the health bill now before parliament will ban smoking in all workplaces in England, including pubs, restaurants and private clubs. But the government revealed on Monday night that the ban might eventually apply to doorways and entrances of offices and public buildings, as well as to bus shelters and sports stadiums. Smokers are to be driven out into the wilderness, as befits their pariah status.
As a life-long non-smoker, I wonder what is driving these assaults. Is it an attempt to improve public health, as campaigners suggest? Or do smokers serve a need every society seems to have - for a group of pariahs that all right-thinking people can condemn? I strongly suspect the latter.
John Stuart Mill himself said that: "As soon as any part of a person's conduct affects prejudicially the interests of others, society has jurisdiction over it." The discovery of passive smoking has, for this reason, given the anti-tobacco lobby its success. It has overwhelmed the protests of libertarians. Riding a tide of moral indignation, the government has enacted a draconian law banning smoking even in private clubs. Now it plans to extend that ban outdoors.
So how many lives might this extension "save" (or, more precisely, prolong)? Indeed, how many lives might the ban itself save?
According to a survey published in 2003 by the Parliamentary Office of Science and Technology, a mere seven out of 37 studies showed a statistically significant impact of passive smoking on lung cancer. . .
Moreover, the government's ban does not even go near to eliminating passive smoking. As for the proposed extension to open spaces, it can add nothing. The notion that people would be exposed to dangerous quantities of passive smoke in open bus shelters or the doorways of buildings seems ludicrous. It also seems next to impossible to police fairly: where do doorways stop and who decides?
These difficulties do not, as it happens, apply to the places where the most damaging forms of passive smoking occur, in homes. That is where vulnerable children are likely to be most exposed and most damagingly affected.
If the government were engaged in a serious health endeavour, as opposed to gesture politics, it would outlaw smoking in the home. This would be perfectly feasible, or at least as feasible as the much discussed possibility of banning smacking. Children could be encouraged to "shop" their parents. Random visits could be arranged. Surely a government that has given us the antisocial behaviour order would find it neither difficult nor, still less, inappropriate to police the behaviour of adults in their homes.
There is a precedent, although not a happy one: Montgomery County, in Maryland, US, did ban smoking in the home a few years ago, but then retracted the ban under global ridicule. Yet why the ridicule should have won out is far from obvious. All those people who think that the risks from passive smoking justify comprehensive legislation on public places must see the still stronger case for protecting children at home. Indeed, I wonder why the UK government does not ban the noxious weed altogether, as Bhutan has done. That would be in accord with policy on a range of prohibited drugs.
Note: I am opposed to any such policy. I am merely pointing out the absurdities of current plans. Harm to others is a necessary justification, for government interference. But it is not sufficient. Intervention should also be both effective and carry costs proportionate to the likely gains. The bans already planned may well not meet these standards. Their proposed extension outdoors would fall vastly short. An extension into the home would be logical, but also intolerable. This is gesture politics at its worst.
To read the entire article (subscription may be required), please go to
To read the original proposals, please go to Smoking in Public Places, www.parliament.uk/post/pn206.pdf.
[If the government can invade the home in an attempt to eliminate risky, unhealthy human behavior, what will stop them from invading the bedroom to eliminate anal intercourse, the riskiests, unhealthiest of all human behavior?]
Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.
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4. Medicare: How a Hospital Stumbled Across an Rx for Medicaid
Goes After Salt by JOHN CARREYROU, WSJ,
After being diagnosed with
congestive heart failure three years ago, Norma Soto became a regular at the
emergency room of
"I'd end up spending
hours there," recalls the unemployed 54-year-old, who lives alone in
public housing in
These days, when Ms. Soto
doesn't feel well, she calls a nurse who checks her weight, gives her advice
and adjusts her medicine.
The unusual program is the
result of a deal between
As health care grows ever more costly, Medicaid is becoming a growing financial burden for the states. The program, which provides health insurance to 52 million low-income Americans, saw costs rise 44% between 2000 and 2004 to $296 billion. States share the expense with the federal government, and Medicaid now consumes almost 17% of their budgets.
The lion's share of these costs is generated by a minority of recipients, typically patients with chronic diseases such as heart failure. According to the nonprofit Center for Health Care Strategies, adults with chronic illnesses represent 40% of Medicaid recipients but 80% of its expenditures. Hospital fees for these patients make up a major chunk of the costs.
Some states have tried
limiting the expenses they cover. Others have dropped thousands of people from
the rolls by changing eligibility criteria. Neither approach tackles the core
problem. Reducing hospitalization rates for chronically ill people is "the
Holy Grail of Medicaid cost savings," says James Tallon, president of the
United Hospital Fund, a philanthropic organization that tries to improve
To read the entire article (subscription is required), please go to http://online.wsj.com/article_print/SB115093743962087028.html.
Government is not the solution to our problems, government is the problem.
- Ronald Reagan
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A 59-year-old lady came into the office last week having made a change in her insurance affiliation. She brought in the laboratory requisition she had received from her prior personal physician for my OK to proceed and add any tests I thought she needed. I noted that a basic chemistry panel and a comprehensive chemistry panel were checked. The latter includes the former plus additional tests. There was a number of individual liver tests checked that are also included in each of the preceding panels. A lipid panel was also checked, including cholesterol and triglycerides that are also a part of the lipid panel. A thyroid profile was checked, as well as individual thyroid tests.
I've noted in the past that patients sometimes have duplicate tests on the same day from different physicians. For instance, a personal physician may give the patient a laboratory requisitions for a series of tests. A surgeon may give the patient a requisition for preoperative tests. Patients prefer to have their blood drawn once, if possible, and may take all requisitions into the laboratory on the same day to be stuck only once. This would be the perfect opportunity for the laboratory to eliminate duplicate testing at the source. The laboratory, however, told me that they are not allowed to eliminate duplicate tests and have to do them just as they are ordered. In this case, the patient would have three sets of liver tests - one in each panel, the set individually ordered and a duplicate.
This is another case where mandates and regulations triple health care costs. If ordinary human reason had been allowed to function, only the necessary lab testing would have been requested and duplicates would have automatically been eliminated.
The Trillion Dollar HealthCare Question:
How do we neutralize and keep the bureaucrats from pushing health care costs out of reach?
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Our annual guests from the
A journalist for TIME
Magazine, who had the lead editorial on the back page of the
Why do some
journalist fail to comprehend the very basic economic law of supply and
demand? Gas prices follow the law of supply and demand rather well. When the
price of gasoline increases beyond what people are willing to pay (in
It's just like everything else we purchase. The price of electricity in my home has increased four-fold in the last decade. But the last time I checked, this was still cheaper than the price of a solar energy roof. Electric power has to double again before alternate forms of energy for my home become economically feasible.
Our country has wasted billions to develop electric cars before people will purchase them for economic reasons without subsidies paid by the government. If we just let the economic laws work without interference from the politicians, prices will seek their own level and we will be free of fossil fuels much sooner.
An example of this is the recent news that we are coming close to synthesizing jet fuel. It has become economically feasible, as airlines are going into bankruptcy and losing passengers due to higher fares, that alternative fuels for airlines are in the research pipeline. The same will happen to automobile fuel, if we let universal laws of nature and economics work.
Why do so many people think
that health care doesn't respond to market forces? Just last week a patient
told me he took all his prescriptions to
To read the entire TIME Essay "A Million Little Barrels" by Walter Kirn, please go to www.time.com/time/archive/preview/0,10987,1194013,00.html.
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Dr Sam continued to hold forth on
his Medicare predicament. He had gotten a Medicare check for a significant
amount above the $3 and the $6 he'd gotten the previous two weeks. Then he came
across the press release:
The notice: "Providers
need to be aware of these payment delays, which are mandated by section 5203 of
the Deficit Reduction Act (DRA) of 2006. Accelerated payments using normal
procedures will be considered. No interest will be accrued or paid, and no late
penalty will be paid to an entity or individual for any delay in a payment by
reason of this one-time hold on payments. All claims held as a result of this
one-time policy that would have otherwise been paid on one of these nine days
will be paid on
Dr Ruth was commenting on the news release about doctors being derelict in the treatment of diabetes and hypertension.
"Millions of diabetics are being inadequately treated because of "clinical inertia" on the part of physicians who fail to push doses of diabetes drugs, insulin and blood pressure medications to levels that can best protect patients from the disease and its complications . . .
"There is a lack of physician action in the face of abnormal findings," said Nathaniel G. Clark, a physician and vice president of the association. "We are simply not achieving what we need to in clinical diabetes care."
The studies are the latest addition to the growing body of evidence that millions of Americans get less than optimal health care even when they are insured, well educated and middle class. The findings are especially troubling because they involve a disease -- Type 2 diabetes (once called "adult-onset") -- that affects 21 million Americans and whose prevalence is increasing at the rate of 8 percent a year.
Unanswered by the studies is what practitioners are thinking when they fail to intensify treatment. At a news conference Friday, the first day of the meeting, the researchers speculated that many factors are at work.
Among them are: the difficulty of hitting treatment goals when doctors do try; the time and effort required to start a patient on a new drug; the reluctance of many patients to take more pills or shots; the reality that elevated blood sugar and blood pressure rarely cause symptoms; the distraction of minor but immediate problems, such as sore throats, that patients tend to focus on during doctor visits; and a human tendency to be satisfied with results that are "close enough."
While not dismissing any of those, the researchers said they do not add up to an excuse . . ."
To read the entire article, including how the NHS bribes physicians into compliance, please go to www.washingtonpost.com/wp-dyn/content/article/2006/06/10/AR2006061000815.html.
[Dr Ruth pointed out that the basis for treating a patient more aggressively is for the patients to monitor their blood sugars four times a day so the dose of insulin or oral agents can be adjusted appropriately, or measure their blood pressure twice a day so that the dose of anti-hypertensives can be adjusted as needed. "I've had both diabetic and hypertensive patients who were state bureaucrats, who couldn't be bothered with checking their blood sugars appropriately or their blood pressures regularly. So in most cases, it appears that the cause for less than optimal care lies with the patients, including the bureaucrats themselves, rather than the physicians." It was also of interest to her that the patients who go to specialists and a personal physician have less close monitoring and dose adjustments than if they just went to their personal private physician.]
Dr Rosen pointed out that the Feds assigned doctors a Unique Personal Identification Number (UPIN) that has been used for many years. Now the federal bureaucracy thinks they can abandon their misstep and simply reassign a new number that 800,000 physicians should just simply start using. In case you missed it, here's a note from the Florida Medical Assn on obtaining your NPI (National Provider Identifiers).
PROVIDER IDENTIFIER NUMBERS
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Courage at the Threshold, by Tom Crane, MD
patients can bring up our own worst fears and make us feel utterly inadequate
to the task of doctoring. It's a clichι that medical education trains us how to
prolong life, not to usher it out; but it's also true. My first clinical
rotation began with a patient dying of pemphigus,
even though death was never mentioned in the hospital chart. The dermatologist
simply stopped returning calls from the family and the frantic medical student.
I also have an indelible image from residency of a terrified old man, kept
conscious by CPR, but with no hope of survival. The last words he heard were
those of the cardiologist announcing "Abandon!" and then walking out
of the ICU.
The history of medicine is also the history of empathy in the care of dying patients. In the days when hope of cure was often small, doctors saw their duty as attending to patients, sitting vigil at the bedside, and comforting the sick and dying.
The practice of empathic listening and emotional connection to patients is still central to good doctoring. We all want our physician to be smart, diligent and, most of all, caring. However, medicine is now a tightly run, time-constrained enterprise. Doctors must see outpatients rapidly just to survive financially. Meanwhile, hospitals have become finely tuned organizations whose job is to treat illness expeditiously, then quickly make the bed available for the next patient. Resources are scarce; discharge planners meet patients soon after they are admitted to the floor. In this context, the drama of the dying patient often gets short shrift.
Enter palliative care. Palliative care seeks to treat difficult symptoms and to help patients and their families grapple with life-threatening illnesses. The Latin root palliare means to cloak or mitigate, as in lessening the violence of disease. In modern terms, palliative care is a discipline with many roots. The bioethics movement has helped lead doctors away from the paternalism of past medical practice to the awareness that patient preferences and choices are keys to good medical care. Narrative therapy stresses the importance of honoring the patient's own story and shows what we can learn from the patient's experience of his or her illness . . .
The goal of palliative care programs is to move "upstream" and identify patients appropriate for palliative care before they arrive in the Emergency Department in extremis. Counseling outpatients about alternatives can avoid painful and sometimes futile hospitalizations, give patients a stronger sense of control, and allow them to make decisions that better reflect their deepest desires as they near the end of life.
Santa Rosa began its Palliative Care Service in March 2005. Our team consists
of a social worker, a nurse, and a physician. We've begun seeing patients in
their homes, and we're developing an outpatient department to serve our
Dr. Crane is a palliative care specialist at Kaiser Santa Rosa.
To read the entire feature, please go to www.scma.org/magazine/scp/sp06/crane.html.
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9. Book Review: Healthy Competition - What's Holding Back Health Care and How to Free It: Conclusion by Michael Cannon & Michael D Tanner, Cato Institute
Despite its marvels,
Although there are dark clouds on the horizon, we are heartened by the creation and steady growth of health savings accounts. HSAs have already begun to change private-sector health care from within, and will enable a reexamination of the role of government in health care. It is one thing to impose costly regulations on consumers - such as requiring them to purchase coverage for acupuncture and hairpieces - when it seems that employers are paying the bill. It will be more difficult to do so when the cost is apparent to millions of individual consumers.
HSAs also represent a down payment on reform of government health programs.1 First, they will help to contain medical inflation by making millions of consumers more price-sensitive. That will benefit all payers, including taxpayers. Second, experience with HSAs will accustom Americans to exercising more control over their own health care. That may make Americans more comfortable with experimenting with HSAs in government health programs. In particular, as more HSA holders reach age 65, they could form a powerful constituency for Medicare reforms based on choice and competition. It is one thing for the federal government to make health care decisions for retirees when those retirees are already accustomed to surrendering control over such decisions to their employers. It will become more difficult for government to do so if workers are accustomed to making their own health care and insurance decisions. Finally, HSAs enable today's workers to save for their retirement health expenses and can help build support for prefunding Medicare through personal savings accounts.
We are heartened by the
creation of health savings accounts for more than these reasons, though. HSAs
represent a moral victory for freedom and competition in health care. We are
eager to see how health care will change as health savings accounts restore to
patients and providers much of the autonomy that has been eroded by decades of
increasing government control. However,
HSAs alone will not fully restore choice and competition to
The competitive market process will do a better job than government of making medical care of ever-increasing quality available to an ever-increasing number of consumers. We have seen competition deliver higher quality and lower prices in other areas of the economy.
As Michael Porter and Elizabeth Teisberg write:
It is often argued that health care is different because it is
complex; because consumers have limited information; and
because services are highly customized. Health care
undoubtedly has these characteristics, but so do other industries
where competition works well. For example, the business
of providing customized software and technical services
to corporations is highly complex, yet, when adjusted for quality,
the cost of enterprise computing has fallen dramatically over the last decade.
Although we share Porter and Teisberg's view, we also share one view held by many proponents of government activism in the health care sector: health care is a special area of the economy. Unlike software, wireless communications, or banking, health care involves very emotional decisions, which often entail matters of human dignity, life, and death. However, we do not see the gravity of these matters as a reason to divert power away from individuals and toward government. Rather, we see the special nature of health care as all the more reason to increase each consumer's sphere of autonomy. The special nature of health care makes it all the more important that we use the competitive process to make health care available to more consumers - and makes it all the more important to get started now.
To read the rest of - Healthy Competition - please go to the Cato Bookstore: www.catostore.org/index.asp?fa=ProductDetails&method=cats&scid=33&pid=1441272. The price is only $10. At that rate, consider purchasing two or three and surprise those friends, who don't understand that government involvement in health care is destroying affordable health care, with a gift that keeps on giving. There are other excellent recent titles you may want to consider.
To read some of the other book reviews that are available, please go to www.delmeyer.net/PhysicianPatientBookshelf.htm.
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10. Hippocrates & His Kin: Drugs Are Cheap At Any Price by Peter Huber
the extraordinary advances that bioengineering now makes possible, we are at
the threshold of an entirely new era in pharmacology. There can be no serious
doubt that in due course we will find drugs to halt colon, breast and lung
cancers in their tracks, drugs that curb obesity and thus heart disease, and
that will not merely suppress the HIV virus but cure AIDS completely. A new
pharmacology of the brain will cure depression and halt the onset of
Alzheimer's. With the advances in molecular science that have occurred over the
past few decades, all of these once inscrutable scourges are
now--essentially--problems in diligent engineering.
Yes, very difficult and expensive problems, as engineering problems go. But when well-engineered molecular machines displace manual labor, costs don't rise, they fall. We will indeed spend more on drugs in the coming years than anyone has allowed for in existing budgets. They will be cheap at the price.
Peter Huber, a Manhattan Institute senior fellow, is the author of Hard Green: Saving the Environment From the Environmentalists and the Digital Power Report. Find past columns at www.forbes.com/huber.
Government Subsidies For Buses Exceeds Giving Every Student A Private Taxi Ride To School
The bus ride to Folsom Lake College from the Iron Point light-rail station is a great deal for students but not so much for state taxpayers.
For each ride on a Folsom Stage Line bus between campus and the light-rail station, state taxpayers chipped in $17.65 in 2004-2005, according to figures from the city.
The private Folsom Lake Cab service would charge $14.75 for the 4.8-mile trip, co-owner Alex Vartolomey said. www.sacbee.com/content/business/taxes/v-print/story/14274343p-15084185c.html
How about giving poor people a private taxi ride to see their doctor?
Hasn't anyone at TIME heard of Supply and Demand?
Time magazine has recently published an editorial that none of the old economic ideas seem applicable when it comes to the price of gasoline. Fortunately, the price of gasoline follows the old economic ideas rather well. We just don't want to face reality.
How did the essay get pass the editorial staff?
To read more HHK vignettes from the Archives, please go to www.healthcarecom.net/hhk2000.htm.
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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. Be sure to read the current one on HEALTH CARE SPENDING: WHAT THE FUTURE WILL LOOK LIKE. www.ncpa.org/sub/dpd/?page=article&Article_ID=8856
Pacific Research Institute, (www.pacificresearch.org) Sally C Pipes, President and CEO, John R Graham, Director of Health Care Studies, publish a monthly Health Policy Prescription newsletter, which is very timely to our current health care situation. You may subscribe at www.pacificresearch.org/pub/hpp/index.html or access their health page at www.pacificresearch.org/centers/hcs/index.html. Be sure to read John R Graham's current article: Deadly Solution: SB-840 and the Government Takeover of California Health Care at www.pacificresearch.org/pub/sab/health/2006/deadly-solution.html.
The National Association of Health Underwriters, www.NAHU.org. The NAHU's Vision Statement: Every American will have access to private sector solutions for health, financial and retirement security and the services of insurance professionals. There are numerous important issues listed on the opening page. Be sure to scan their professional journal, Health Insurance Underwriters (HIU), for articles of importance in the Health Insurance MarketPlace. www.nahu.org/publications/hiu/index.htm. The HIU magazine, with Jim Hostetler as the executive editor, covers technology, legislation and product news - everything that affects how health insurance professionals do business. Be sure to review the current articles listed in their table of contents at hiu.nahu.org/paper.asp?paper=1. To see my recent column, go to http://hiu.nahu.org/article.asp?article=1328&paper=0&cat=137.
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. To read her latest report on Market Innovations, go to www.galen.org/ownins.asp?docID=903.
Greg Scandlen, an expert in Health Savings Accounts (HSAs) has embarked on a new mission: Consumers for Health Care Choices (CHCC). To read the initial series of his newsletter, Consumers Power Reports, go to www.chcchoices.org/publications.html. To join, go to www.chcchoices.org/join.html. Be sure to read Prescription for change: Employers, insurers, providers, and the government have all taken their turn at trying to fix American Health Care. Now it's the Consumers turn: www.chcchoices.org/publications/cpr9.pdf. Be sure to read Greg's current article on 100 Years of Market Distortions: www.chcchoices.org/publications/Market%20Distortions.PDF
The Heartland Institute, www.heartland.org, publishes the Health Care News. Read the late Conrad F Meier on What is Free-Market Health Care? at www.heartland.org/Article.cfm?artId=10333. You may sign up for their health care email newsletter at www.heartland.org/Article.cfm?artId=10478. Read about the Free Market Health Care Alternatives at www.heartland.org/Article.cfm?artId=19012.
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. Be sure to brush up on your economics with another Freeman Classic on Prices found at www.fee.org/publications/the-freeman/article.asp?aid=567.
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 http://www.factcheckers.org/showArticleSection.php?section=follies.
Independence Institute, www.i2i.org, is a free-market think-tank in Golden,
Martin Masse, Director of Publications at the Montreal Economic Institute, is the publisher of the webzine: Le Quebecois Libre. Please log on at www.quebecoislibre.org/apmasse.htm to review his free-market based articles, some of which will allow you to brush up on your French. You may also register to receive copies of their webzine on a regular basis. To brush up on Global Warming, please go to www.quebecoislibre.org/06/060702-5.htm. To understand why Public Utility Monopolies Fail, go to www.quebecoislibre.org/06/060702-3.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. Canadians celebrated Tax Freedom Day on June 28, the date they stopped paying taxes and started working for themselves. Log on at www.fraserinstitute.ca for an overview of the extensive research articles that are available. You may want to go directly to their health research section at www.fraserinstitute.ca/health/index.asp?snav=he. Canadians reached their tax freedom day five days earlier than last year. Read the details at www.fraserinstitute.ca/shared/readmore.asp?sNav=nr&id=731.
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. This month, be sure to read the article on Ownership of Health Care Data at www.heritage.org/research/healthcare/wm1131.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. The current essay on Price Controls on Labor can be found at www.mises.org/story/2229 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; The Individualistic Code, or to understand how illiterate we are of the History of Any Religion go to www.lewrockwell.com/orig7/individualist-code.html 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. Click on FreedomFest06 or on EAI Commentary or on LINKS at the left of the home page for a wealth of freedom information.
The Free State Project, with a goal of Liberty in Our Lifetime, http://freestateproject.org/, is an agreement among 20,000 pro-liberty activists to move to New Hampshire, where they will exert the fullest practical effort toward the creation of a society in which the maximum role of government is the protection of life, liberty, and property. The success of the Project would likely entail reductions in taxation and regulation, reforms at all levels of government to expand individual rights and free markets, and a restoration of constitutional federalism, demonstrating the benefits of liberty to the rest of the nation and the world. [It is indeed a tragedy that the burden of government in the U.S., a freedom society for its first 150 years, is so great that people want to escape to a state solely for the purpose of reducing that oppression. We hope this gives each of us an impetus to restore freedom from government intrusion in our own state.] NH wins the prize of paying the least income to taxes of any state in the U.S. See U.S. Census data at www.unionleader.com/article.aspx?articleId=d18a2afd-0363-4008-b401-10054d5603a4.
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Del Meyer, MD, Editor & Founder
Words of Wisdom
Eden Chen Forsythe, who was raised under the
twin pillars of communism --
Mark Twain, (1866): There is no distinctly native American criminal class save Congress.
Some Recent Postings
The Encyclopedia of Stress and Stress-Related Diseases by Ada P. Kahn, PhD, has now been published. To read the foreword I wrote please go to www.delmeyer.net/MedInfo2005.htm. Published by Facts On File: www.factsonfile.com/. Enter Kahn in the search box
Publisher Patriot WSJ,
REVIEW & OUTLOOK
The world of journalism and
politics lost a friend of liberty this week with the presumed drowning of
Philip Merrill in a boating accident. The 72-year-old publisher went for a solo
weekend sail on the
In the view of some modern
media ethicists, journalists aren't supposed to spend time in government. But
Mr. Merrill moved between the two with ease, and the country is better for it.
He was a successful publisher of the Capital-Gazette Newspapers and
Washingtonian magazine. He also worked for six Presidential administrations
over the years, usually in foreign policy or Defense posts, and most notably as
assistant secretary general of NATO during the historic period from 1990 to 1992
when the Soviet empire was imploding and
We knew Mr. Merrill as a
stalwart hawk against Soviet oppression and a believer in free markets. He was
also a philanthropist, giving away big chunks of his wealth to a variety of
causes, notably in education with a $10 million gift to the
Above all, he was an energetic businessman-journalist who understood that a free press is more vital and independent if it also makes money. The last time we talked to him -- at a dinner honoring his friend and our former colleague, George Melloan -- Mr. Merrill offered all sorts of ideas for how newspapers could make money on the Internet. He stayed up late with the younger writers, telling stories. As usual, they were very good stories.
On This Date in History - July 11
On this date in history, in 1274, Robert
"The Bruce" was born In
On this date in history, in 1804, Aaron
Burr fatally wounded Alexander Hamilton in a duel in 1804. History remembers
today as the day when, on the bluffs of Weehaawken,
across the river from
Speaker's Lifetime Library, © 1979, Leonard and Thelma Spinard