This being an election year, we should be aware of the ethical lapses of our elected rulers. Judicial Watch, the public interest group that investigates and prosecutes government corruption, released its 2007 list of Washington's "Ten Most Wanted Corrupt Politicians."  The list, in alphabetical order, includes: . . .  To read who these scoundrels are and what their scandals were, go to www.judicialwatch.org/judicial-watch-announces-list-washington-s-ten-most-wanted-corrupt-politicians-2007.

Any Surprises?

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Barack Obama

"My friends, we live in the greatest nation in the history of the world. I hope you'll join with me as we try to change it."

Did that come out right?

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Eating Candy
I observed a ward clerk at the nursing station reading "Weight Watchers" as she devoured a "Babe Ruth." I guess that keeps the scales balanced and the economy moving. It also contributes to the epidemic in America - 60% of the population is overweight and 30% is obese. We consumed 15% more calories in 1994 than we did in 1970 and today we dine out twice as often. High school students are becoming obese and it's invading the junior high school and grade schools.

If obesity was an infectious disease, we would call it a national epidemic and a crisis.

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MediCal Backlog Rises

A headline in this week's newspaper indicates that there is an increasing backlog in MediCal, the government-sponsored Medicaid program for poor people who can't afford health insurance. The United States has had a superior safety net for health care than any socialized health care country. We have no significant waiting beyond a few days. Our pharmacy formulary exceeds what's available to the well-to-do in the European Government-controlled health care systems, such as the NHS where the waiting lists are routinely many weeks, months and sometimes years. But that may be changing. California Medicaid now can take a few weeks to get approval. This will be compounded when the MediCal reimbursement is reduced another 10 percent on July 1, 2008, from the now average reimbursement of about 25 percent of the usual and customary charges. In addition, payments will be delayed an extra thirty days.

Looks like Americans are already experiencing the reduced quality of Socialized Medicine.

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Why are more doctors getting out of the MediCal program?

As the MediCal reimbursement is decreasing to about half of the average doctor's overhead costs, more are eliminating MediCal from their practices. A few have an exclusive MediCal practice. How do they do it? Doctors traditionally have given patients all the time they needed to complete the evaluation of the medical complaint precipitating the office call. As the government-sponsored HMOs have taken over, doctors are asked to see three patients an hour if they previously saw two or four patients an hour if they previously saw three. One HMO requests five patients an hour. As one wag put it, I now have two doors in my examination room. I greet the patient at one door; my writing desk has become an elevated counter to write prescriptions. I try to keep the momentum going as I lead them out of the other door before my nurse brings the next patient through the first door and I rush to the next examination room.

MediCal practices see patients on a five- to seven-minute basis to increase the volume to maintain a cash flow. There is one physician who schedules private patients every fifteen minutes and MediCal patients ever 7 1/2 minutes.

If half of the doctors quit seeing MediCal patients, that should increase the waiting lists to what the British and Europeans have been experiencing for the past 60 years. Do politicians really see this as Nirvana rather than lowering quality?
But then Politicians wouldn't recognize Quality if the "Cue" struck them in the face.

To read more Medical Vignettes, please go to www.delmeyer.net/HMC.htm.

To read the Hippocrates Archives, please go www.healthcarecom.net/hhkintro.htm.

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