MEDICAL TUESDAY . NET
Community For Better Health Care
Vol IV, No 19,
In This Issue:
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
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A landmark law has allowed American universities to profit by patenting their innovations. But the costs are adding up. by Economist.com
agrees the reform had the noblest of intentions; yet some now regard it as an
assault on the values of academia. A quarter of a century ago this month, America
passed the Bayh-Dole act, named after its sponsors, Birch Bayh and Bob Dole,
both then members of America's Senate. It was billed as a minor legal
tweak—encouraging universities to patent and license the results of federally
funded research—but it has had huge effects, both good and ill. It is credited
by some with helping pull
The act enables universities to patent any innovation that springs from government-funded research, license it and share the spoils with the inventor. The idea was not to enrich universities, but to give them a reason to propagate the fruits of research, which had been mouldering unexploited. And it has worked. In the past 25 years, more than 4,500 firms have been spun out from non-profit research institutes, based on patents generated as a consequence of this law.
of medical advances and technical innovations have resulted, including MRI
body scanning, the vaccine for hepatitis B,
the atomic-force microscope and even the technique behind Google's search
engine. In 2004 alone, American universities and institutes raked in $1.39
billion in licensing revenue, and applied for more than 10,000 new patents.
Impressed with this apparent success, other countries, including
A law of unintended consequences
Yet the yelps from critics have grown louder over the years. Many scientists, economists and lawyers believe the act distorts the mission of universities, diverting them from the pursuit of basic knowledge, which is freely disseminated, to a focused search for results that have practical and industrial purposes. Whether that is a bad thing is a matter of debate. What is not in dispute is that it makes American academic institutions behave more like businesses than neutral arbiters of truth. For example, a study published in 2003 by Jerry and Marie Thursby, of Emory University and the Georgia Institute of Technology respectively, showed that more than a quarter of the licences [sic] issued by universities and research institutes include clauses allowing the business partner in the arrangement to delete information from research papers. Almost half allow them to insist on publication being delayed.
there is ample evidence that scientific research is being delayed, deterred or
abandoned due to the presence of patents and proprietary technologies.
Researchers (and particularly their minders in university patent-licensing
offices) are increasingly reluctant to share materials and knowledge with
others unless such sharing is accompanied by legal agreements about
“reach-through” royalties on potential findings and the right to restrict publication
of results. A study released in October by the American Association for the
Advancement of Science noted that 35% of academic biotechnology researchers
experience difficulties getting hold of patented technologies that they need
for their work, even though non-commercial research is supposed to be exempt
from the normal restrictions of patents. The question is just how
“non-commercial” such research really is. Lawsuits between universities and
researchers over patents and royalties are now common. Indeed, though he was
eventually exonerated, a student from the
industry is starting to complain about a gold-digger mentality among academic
administrators. The most notorious example is
To read the entire original article including the backlash that has already developed, go to www.economist.com/displaystory.cfm?story_id=5327661.
miss the larger picture. A flawed law in the
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In the News: Literacy of College Graduates Is on Decline by Lois
Survey's Finding of a Drop in Reading Proficiency Is Inexplicable, Experts Say
Literacy experts and educators say they are stunned by the results of a recent adult literacy assessment, which shows that the reading proficiency of college graduates has declined in the past decade, with no obvious explanation.
appalling -- it's really astounding," said Michael Gorman, president of
the American Library Association and a librarian at
more Americans are graduating from college, and more than ever are applying for
admission, far fewer are leaving higher education with the skills needed to
comprehend routine data, such as reading a table about the relationship between
blood pressure and physical activity, according to the federal study conducted
Experts could not definitively explain the drop.
"The declining impact of education on our adult population was the biggest surprise for us, and we just don't have a good explanation," said Mark S. Schneider, commissioner of education statistics. "It may be that institutions have not yet figured out how to teach a whole generation of students who learned to read on the computer and who watch more TV. It's a different kind of literacy."
"What's disturbing is that the assessment is not designed to test your understanding of Proust, but to test your ability to read labels," he added. . .
The results were based on a sample of more than 19,000 people 16 or older, who were interviewed in their homes. They were asked to read prose, do math and find facts in documents. The scores for "intermediate" reading abilities went up for college students, causing educators to question whether most college instruction is offered at the intermediate level because students face reading challenges.
Gorman said that he has been shocked by how few entering freshmen understand how to use a basic library system, or enjoy reading for pleasure. "There is a failure in the core values of education," he said. "They're told to go to college in order to get a better job -- and that's okay. But the real task is to produce educated people."
Other experts noted that the slip in scores could be attributed to most state schools not being particularly selective, accepting most high school graduates to bolster enrollment. In addition, Schneider said schools may not be taking into account a more diverse population, and the language and cultural barriers that come with shifting demographics . . .
Perin, a reading expert at
On average, adult literacy is virtually unchanged since 1992, with 30 million people struggling with basic reading tasks. While adults made some progress in quantitative literacy, such as the ability to calculate taxes, the study showed that from 1992 to 2003 adults made no improvement in their ability read newspapers or books, or comprehend basic forms.
One bright spot is that blacks are making significant gains in reading and math and are reaching higher levels of education. For instance, the report showed that the average rate of prose literacy, or reading, among blacks rose six percentage points since 1992. Prose and document reading scores for whites remained the same.
To read the entire article, please go to
[The Finding of a “Drop in Reading Proficiency Is Inexplicable” is only because these are all government funded or government controlled schools. No such drop is seen in private or parochial schools where students and their parents pay for the education. If the student doesn’t learn to read, the parents will not enroll the child the following year and the school will go out of business and the teachers become unemployed. Therefore, the teachers will make sure their students learn the course work. The answer to our education problem, which is similar to the answer to our health care problem, is to get the government out of education.
vouchers do not get the government out of education. They just open the door to
allow the government to also destroy private and parochial education. Witness
the Hillsdale experience of never accepting any funds forcibly extracted from
To Paraphrase Paul Revere: The Socialists Are Coming. The Socialists Are Coming.
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3. International Medicine: Nationalism And Science Don't Mix by Economist.com
THE twisted tale of Hwang Woo-suk, a once-feted but now-disgraced South Korean stem-cell researcher, is salutary at many levels. It shows, first, that you can't cut corners in science—at least, not in any meaningful way. The occasional dud result in a low-profile field of endeavour[sic] may escape critical scrutiny, but if you report inaccurate work in an area as controversial and important as human cloning, your slips will catch up with you pretty quickly. Second, it shows the risks to scientists of becoming celebrities. An artistic celebrity's audience may prove fickle, but ultimately it is only that artist's talent that is being judged. A scientific celebrity's success, by contrast, relies both on his talent and on nature delivering the goods to him in a timely fashion—and nature does not bend to a scientist's will, however much he or his audience may wish it might.
Hubris and vanity are all too human vices and, despite occasional propaganda to the contrary, scientists are, indeed, only human. But the third salutary lesson of this episode, though related to the other two, is deeper. It is that nationalism and science are uneasy bedfellows. Dr Hwang's downfall was set in train by his elevation by the South Korean government into an emblem of his country's emergence as a scientific power. That both flattered him and demanded the next great breakthrough from his laboratory. In the end, he came up with a fatally flawed piece of research that has now been disowned by collaborators (see article).
most famous example of deluded scientific nationalism was Trofim Lysenko, a
Soviet geneticist. Or, rather, a non-geneticist. Lysenko was flattered and
financed by Stalin because he claimed that an organism could pass on to its
offspring characteristics it acquired in its lifetime. That fitted well with
Marxist ideology about the mutability of nature, but wrecked the
reverse phenomenon, of discounting something because of its source, applies
too. Before the second world war, many of
spite of the success of the
The truth will out
with these dire examples of waste and destruction, Dr Hwang's mistake looks
relatively modest. Those opposed to human cloning may raise a cheer or two that
a great leap forward which they had feared seems not to have happened. But, as
the Nazis discovered, denying reality just because you don't like it is equally
foolish. Eventually, somebody probably will clone a human being. Just not,
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We are only into the second week of the new Pharmacy Benefit Program now called Medicare Part D. Most of my patients are having difficulty navigating the federal waters, to put it mildly. Many still don’t have any idea whether their conventional insurance, their HMO or Medicare is paying for their medications. One thing they all seem to expect is that they are not paying and someone else should. So after the first round of prescriptions with a trip to the pharmacy, and a denial, the federal waterfall turns back to the doctor’s office to get something that is covered. The pharmacists aren’t sure yet what’s covered. They just want another round of prescriptions, which they will run through their computer. If you ask, “Just tell me which one is covered?” the response is that they can’t tell until they have the new prescription with the patient’s ID in front of them as they scroll their computer. Then if it isn’t covered, they will just send another fax.
So what’s the economics of this government bureaucracy? After the office visit which includes a minute or two of amenities, a review of the patient’s chart, a brief review of the current problem or status of the prior medical problems, a brief examination, an assessment of the findings, a brief discussion with the patient of the possible treatments, the prescriptions or requisitions are then written and the medical record is completed in case the government reviews the chart to police the actions that occurred. These twenty minutes are paid by the carrier or Medicare at about half the usual rate. The writing of the prescriptions is a huge unknown. We know that there will be numerous faxes from the pharmacists for alternatives.
Before all the faxes have come and gone, before a new treatment program can be implemented, it may be necessary to have another review of the patient’s record, an assessment of the medical problem to see if the requested alternative medication will work, rewriting the prescriptions, faxing them back to the pharmacists, and revising the medical record to reflect the changes. In short, this is another office call essentially in cyberspace. Only this one is not even reimbursed at half rate. So now there have been essentially two office calls for one-half the price of one. Not only don’t the bureaucrats understand the drag on the system, one’s own employees, pharmacists, and patients do not understand this doubling of costs. It cannot go on indefinitely.
The pharmaceutical industry and pharmacists have come to the partial rescue with many large chains giving out a few days supplies to allow the federal government’s incompetence to ameliorate. One of the local pharmacists says he doesn’t have the financial resources to give out free medications. He’s been kept on hold for two hours and then has his phone go dead in an attempt to sort this out for his patients. He says the “D” in Medicare Part D stands for “Disaster” and it’s of Biblical Proportions. (See “Confusion reigns over drug plans” at www.sacbee.com/content/news/v-print/story/14046778p-14878200c.html.)
No wonder there is this huge exodus away from Medicare and also from private insurers. How sad for patients. Even worse, why are doctors tolerating this?
What’s even more tragic is that this hyperbolic
increase in government entitlement has come under the watch of a business
president with an MBA who should have known better, rather than a lawyer who
sees legal complications as an increase in his professional security.
To read about the Medicare Pharmacy Benefit Plan that should have been implemented to allow Medicare to continue for our grandchildren, please to go to http://www.delmeyer.net/hmc2005.htm.
Government is not the solution to our problems, government is the problem.
- Ronald Reagan
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A reader of MedicalTuesday writes that Medical Gluttony is not limited to patients. Physicians also practice it; to which we would add hospitals also practice it. The interests of consumers (patients), producers and the payer are well aligned in the free market. That’s because the consumer and the payer are the same person. However, in healthcare, the consumer and the payer are not the same person and this creates conflict, loss of accountability, excessive utilizations and total corruption of the Medical MarketPlace. In a free and open Medical MarketPlace, there can be no Medical Gluttony, not by patients, not by physicians and other providers, and not by hospitals. (Please see Cannon and Tanner in Section 9 below.
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remember a few years ago, DVD recorders were $2,000. Now they are just a couple
of hundred bucks," said Jim Babb, a spokesman for electronics retailer
"Falling prices is just one of the essential truths of consumer electronics," he said. That's borne out in a segment of the Consumer Price Index that charts price changes for personal computers and peripherals, and adjusts for advances in technology such as processing power, memory and storage.
According to the index, technology prices have plunged 88 percent since December 1997, while the CPI as a whole is up 22.5 percent over the same period.
Falling prices are one manifestation of Moore's Law, the 1965 prediction by Intel co-founder Gordon Moore that the number of transistors on a computer chip would double every two years. That phenomenon has contributed to more powerful but less expensive devices, ranging from cellular phones to microwave ovens and laptop computers.
[The fall in technology prices was not allowed to decrease the technology of medicine. During the same period above, as Medical Director of the Pulmonary Function Laboratory and Respiratory Therapy Services of American River Hospital, I purchased a new Arterial Blood Gas Analyzer. Although the price was about $2,000, it reduced my technician’s time from 30 minutes to three minutes to perform one ABG. The capital cost could be amortized to about one dollar per blood gas. Hence, the savings in technical labor was huge. I suggested a measly $5 decrease in the price of an ABG from $25 to $20 after demonstrating that my department would more than triple its profits despite this decrease; however, it would be a small step in reducing health care costs. I was overruled by the administrator who immediately increased the charge to $30. He notified me about three months later that Medicare, Medicaid, Blue Cross-Blue Shield and Foundation Health Plan were paying the new rate without discount, thus indicating that his decision was correct. Therefore, he increased the charge further to $35. He said he would continue to increase the charge until he found the maximum that Medicare and insurance carriers would pay. I tried to have an ethics discussion concerning the immorality of gouging the sick patients with obscene prices; he simply turned around and walked away shaking his head.
[The hospital is a major cause of the health care inflation after the advent in the 1960s of Medicare, government medicine and third-party insurance, which removed the patient from the financial interface with their doctors and hospitals. Had physicians been allowed to be an effective voice in medical care, the technological advances of medicine would have brought considerable savings to health care. Free market, competition-oriented physicians are continuing to be sidelined by the Medical-Hospital Complex. Only the open and free Medical MarketPlace can still correct the problems of health-care costs.]
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THOMAS P. STOSSEL: Mere Magazines
“The Journal of the American Medical Association has declared industry-sponsored research categorically untrustworthy, and, to publish it, demands that an academic researcher be an author and take responsibility for its integrity, and also that an independent academic statistician analyze its data. This and other journals rail obsessively against 'financial conflicts of interest' of academic researchers working with companies and conduct inquisitions to identify every possible financial motive that might corrupt researchers' objectivity. . . .
“If reporters understood that journals are magazines, not Holy Scripture, we might not be witnessing ever more onerous regulations inhibiting interactions between academic and industry science. Prestigious biomedical journals are good for our health -- provided they stick to their core business of facilitating imperfect communication between researchers. Leave drug and device monitoring to the FDA -- and theology to theologians.”
Mere Magazines: http://online.wsj.com/article_print/SB113590672017634344.html (Subscription required.)
Termites Ate the Research Data: The British Medical Journal
In 1992, the British Medical Association's flagship journal published a study led by Indian doctor Ram B. Singh with a striking finding: Heart-attack victims who ate more fiber, fruits and vegetables for a year cut their risk of death during that period by almost half.
A year later, Richard Smith, the journal's editor, received two letters questioning the findings. What followed was an extraordinary inquiry stretching over a dozen years and 5,000 miles. Along the way, Dr. Singh contended that termites had eaten crucial data and Dr. Smith spent four years begging a busy statistician to deliver a report . . .
Even Dr. Smith, who stepped down from BMJ last year to take a position at UnitedHealth Group Inc., now says that journals "are not really set up to administer justice in these kinds of cases."
http://online.wsj.com/article/SB113565052512831921.html?mod=todays_us_page_one (Subscription required.)
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8. Voices of Medicine: Competition Fuels the Market - Part II by Charles B. Clark, M.D.
So how does competition fuel the market? And how does all this apply to our present status and our future as medical doctors? It is a process called negotiation. Let’s see how it works.
One of our hospitals recently decided that they were not going to contract any longer with one of the larger managed care plans. This was all about reimbursement. We physicians were advised that we would not be able to admit those patients after a certain date. Managed Care had the alternative of admitting their patients to another hospital chain. After a period of negotiation, we were informed that we could admit those patients to our hospital once again. This type of negotiation explains why the hospitals accept such horrific reductions in the fees they submit to their contracted managed care organizations. However, it places an intolerable burden on the uninsured patient who does not have the advantage of a “negotiated contract.”
In terms of Dr. Average Physician, he has a practice whose reimbursement is largely controlled by managed care plans. From the beginning, the effect of managed care was to reduce the reimbursement to physicians. Most physicians passively watched this happen because so many patients were insured by these plans. “A Piece of the Pie”
Then we began to see various specialists forming groups. Gastroenterologists and cardiologists, for example, were banding together. The stated purpose of this joining forces was to be able to compete more effectively for managed care contracts.
So the negotiations began. Group A contracts with Managed Care Plan for x dollars a unit. Group B wants a bigger share of the action so they contract with Managed Care Plan for x minus one dollar a unit. Now Group B is getting the business. Group A agrees to contract with Managed Care Plan for x minus two dollars. And so it goes on. Where will it stop? Will it stop? Why should it stop? Virtually all of us have submitted quite passively to this competitive struggle for the patients. Yes, competition fuels the market but the market may be becoming stressed to the brink of extinction in its present form.
As we float quietly down the river into the misty fog of oblivion, who is to blame for our demise? We need look no farther than the mirror.
To review Dr Clark’s earlier posting, please go to www.healthcarecom.net/CBCCompetitionFuelsMarket.htm.
To read additional Voices of Medicine, go to www.healthcarecom.net/vom1999.htm.
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9. Book Review: Healthy Competition: What's Holding Back Health Care and How to Free It by Michael F Cannon & Michael D Tanner, Cato Institute, Washington, DC © 2005, ISBN 1-930865-81-3, 173 pp, $10. Part III –Underlying Diseases, Strong Medicine: Chapter 4 - Too Much of a Good Thing Can Be Very Bad.
“What can policymakers do to make health
care of ever-increasing quality available to an ever-increasing number of
consumers? The answer begins with an accurate diagnosis of the problem. As
discussed in the Introduction, producers in an open market must compete to meet
consumers’ needs at the lowest possible cost. Consumers who must weigh
different options against one another tend to focus on getting the highest
value per dollar spent, and they reward producers who provide it. Consumers and
efficient producers both gain. Inefficient ways of doing things are driven from
the market. Competition constantly pushes producers to reduce prices and
improve quality. However, this process does not describe
“Why does health care lack the vigorous competition that produces wonders in other sectors of the economy? As we survey the scene, we see that many of the necessary conditions of healthy competition have been disabled. On the consumer side, government promotes excessive levels of health coverage. On the producer side, it imposes excessive regulation, which dampens competition. In each instance, government usually has a stated goal of making health care more affordable, protecting consumers, or even increasing market competition. However, its interventions often produce the opposite effect. When it limits experimentation and learning in the marketplace, government inhibits the competitive discovery process and most often leaves consumers worse off.
“Health insurance plays a crucial role in financing health care. But Americans rely on health coverage beyond its usefulness. Like auto, fire, and homeowner’s insurance, health insurance is supposed to protect against unlikely but high-cost events. Ordinarily, it would not cover regular checkups for the same reason that auto insurance does not cover oil changes: such expenses are neither unlikely nor high-cost. It is easier to pay for smaller, predictable expenses directly rather than through insurance. Of course, there is no reason why someone should not be able to purchase coverage for regular checkups—as long as she is willing to pay the added cost.
“Health insurance works differently in the
“Deductibles and co-payments give the patients an interest in eliminating wasteful expenditures and utilizing only medical care that they expect will provide value. These cost-sharing measures realign the interests of patients, payers, and providers. Having patients choose the terms of their health insurance in advance further harmonizes the parties’ interests. This allows insurers to convey the costs of different ways of dealing with the problems of third-party payment (i.e., different deductibles, co-payments, and other features) and requires consumers to weigh those costs.
“When government hides the full cost of coverage from consumers, however, it makes the problem of conflicting interests worse . . .
“One result is unnecessary conflict between patients and payers. Since patients pay an average of only 14 cents for each dollar of care, they utilize more care than they would if they had to shoulder more of the cost. The added utilization imposes costs on the people who ultimately pay for the other 86 percent—workers and taxpayers. They perceive no benefit from a stranger’s overuse of the health care system. Through their agents (insurers, employers, and governments), they push back by refusing to pay for care that patients want. Excessive coverage also creates conflict between patients and payers by encouraging 'moral hazard.' By reducing the (apparent) costs to consumers of risky behaviors (e.g., obesity, smoking, reckless driving), it encourages consumers to do less than they otherwise would to safeguard their health.
“Encouraging excessive coverage also
creates conflict between payers and providers. Providers often see the payers’
coverage decisions as an intrusion on the doctor-patient relationship and an
affront to their professional judgment. One result is that providers (and
presumably patients) often deceive payers to obtain coverage. Researchers from
'Tactics reported by physicians have included exaggerating
the severity of the patient’s condition, changing the patient’s
diagnosis for billing, or reporting signs or symptoms that the
patient did not have. Deceptions may involve brief change
in wording, as when physicians rule out cancer as the indication
for a test rather than screening. . . (e.g., inventing findings such as breast
lumps to obtain a referral for screening mammography). . .'
“The RAND Health Insurance Experiment confirms that people with excessive coverage utilize care that does nothing to improve health. Families who had to weigh the cost of the first few thousand dollars of medical expenses saw 'little to no net adverse effect on health for the average person,' compared with families with 100 percent coverage. 'Indeed, restricted activity days fell.'
“It may be impossible to estimate the
total amount of waste in
“Discouraging patients from shopping for value and distracting physicians from pursuing higher quality care at lower prices cannot help but stifle competition. Michael Porter and Elizabeth Teisberg write,
'The most fundamental and
unrecognized problem in
“Most physicians now rely extensively on third-party payers. More than 95 percent of physicians accept Medicare patients. In 2001, about 90 percent of physicians had at least one managed-care contract, and on average physicians received roughly 40 percent of their income from managed care. Only about a quarter of physicians practiced independently, compared with 41 percent in 1983.
“This trend has had a negative impact on the way physicians practice medicine and the doctor-patient relationship. Swiss medical ethicist Ernest Truffer argues that the increasing interjection of 'gate keepers,' 'case managers,' and other forms of bureaucracy between doctors and patients 'amounts to a rejection of the medical ethic— which is to care for a patient according to his specific medical requirements—in favor of a veterinary ethic, which consists of caring for the sick animal not in accordance with its specific medical needs, but according to the requirements of its master and owner, the person responsible for paying any costs incurred.'
“When doctors are paid a set amount per office visit, as they often are, it leads to less time to meet with patients, which can have an impact on effective diagnoses and treatment. After receiving a second opinion that corrected a serious misdiagnosis (which missed three blocked coronary arteries), author Jay Neugeboren observed,
'the way the health care system is now run [has] undermined the traditional doctor-patient relationship. Not only do doctors have less and less time to meet with us, but, given the vagaries of health insurance, the doctor we see one time may not be the same doctor we see the next time, and so we often remain strangers to one another . . . [I]n the words of Dr. Bernard Lown, inventor of the defibrillator, listening to the patient and taking a careful history remains 'the most effective, quickest and least costly way to get to the bottom of most medical problems.'
"A growing movement among some physicians to reject third-party coverage attests to the impact it has had on the practice of medicine and the physician-patient relationship. . . .”
To read the rest of Part III, Chapter 4 – Too Much of a Good Thing Can Be Very Bad, 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 your 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.
For Next month, read Part III: Chapter 5 – Tax Policy and Health Care
To read some of the other book reviews that are available, please go to www.delmeyer.net/PhysicianPatientBookshelf.htm.
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The Medicare Drug Benefit Program (MDBP) has gotten off to a rocky start and appears to be very complicated. Patients aren’t sure if they want to join. One patient came up with a recipe for success: Take your age, divide by your height, multiply times your weight, divide by your lipids, multiply times your blood pressure, subtract the number of donuts you eat per day, and add in your income, and subtract the square root of your taxes. If you come up with a number, any number, you qualify.
Just as we thought: It doesn’t help the current generation but eliminates income for our children.
Hospital Chief Of Staff Which Formerly Was a Sought After Position But Now Is a “No Win” Position
Psychiatrist to the patient on his couch: You must get over this fear of doctors.
Patient: But why?
Psychiatrist: Because you’re the hospital’s chief of staff. (after Benita Epstein)
To read more HHK Vignettes, go to www.healthcarecom.net/hhk1998.htm - July/August%201998.
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• The National Center for Policy Analysis, (www.ncpa.org) John C Goodman, PhD, President, who along with Devon Herrick wrote Twenty Myths about Single-Payer Health Insurance, which was reviewed in this newsletter during our first twenty months. John C Goodman, Gerald R Musgrave and Devon Herrick, have recently published Lives at Risk. Read a chapter at www.ncpa.org/pub/lives_risk/livesrisk_24.pdf. Read a review at www.healthcarecom.net/JGLivesAtRisk.htm. You may log on at www.ncpa.org/sub/ and register to receive the weekly Health Policy Digest, a health summary of the full NCPA daily report, Executive Alerts, New NCPA publications, and a number of other fine reports. Be sure to visit their new Consumer Driven Health Care website at cdhc.ncpa.org/ for the latest on Market Competition Improving Quality while reducing costs and the value of Medical Research. Read a brief history by the father of the Health Savings Accounts, Dr John Goodman, which started two years ago this month: cdhc.ncpa.org/about/brief-history-of-health-savings-accounts
• 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. This month, be sure to read Sally Pipes on Health Savings Accounts which put the insurance back into health insurance: www.pacificresearch.org/press/opd/2006/opd_06-01-01sp.html.
The Mercatus Center at
• 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 on their table of contents at hiu.nahu.org/paper.asp?paper=1.
• 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. Be sure to read her latest report on the Drug Benefit and now AARP’s support for it at www.galen.org/medicare.asp?docID=855.
• 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.
• The Heartland Institute, www.heartland.org, publishes the Health Care News, Conrad Meier, Managing Editor Emeritus until his untimely death last year. Be sure to look over the "Health Care Suite" of columns and articles at www.heartland.org/IssueSuites.cfm?issId=9.
• 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 month, read a very timely article on State Subsidy to Private Schools: A Case History of Destruction by John Chodes: www.fee.org/publications/the-freeman/article.asp?aid=659.
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 .
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 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 Take A Bite Out Of Organized Crime - Eliminate Drug Laws by Bradley Doucet at www.quebecoislibre.org/05/051215-4.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 current report by Nadeem Esmail, “Pain and Suffering, Guaranteed,” is an analysis of what the medical profession agrees is a reasonable wait, e.g. 12 weeks for a knee or hip replacement vs. the Provinces Benchmark of one-half year at www.fraserinstitute.ca/shared/readmore1.asp?sNav=ed&id=392.
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
download the 12th Annual Index of Economic Freedom. The
higher the score on a factor, the greater the level of government interference
in the economy of the 161 countries reviewed and the less economic freedom a
country enjoys. The scores of 99 countries are better, the scores of 51 are
worse, and the scores of five are unchanged. Of the 157 countries numerically
graded in the 2006 Index, 20 are classified as "free," 52 as
"mostly free," 73 as "mostly unfree," and 12 as
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.
You may find this week's report, “The Make-Believe World of Central Banking,”
written by Thorsten Polleit to
understand inflation at www.mises.org/story/1996. 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. Review the latest article on
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). Click on the link at the left. 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. If you still think that government subsidies help, you might want to read “Amtrak's Waste Is Being Rewarded - More taxpayer money given to dismal failure” by Adam Summers at www.reason.org/commentaries/summers_20051230.shtml. Amtrak’s debt continues to climb and is now at $4 Billion.
• 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.]
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Stay Tuned to the MedicalTuesday.Network and Have Your Friends Do the Same
Please note: Articles that appear in MedicalTuesday may not reflect the opinion of the editorial staff.
Del Meyer, MD, Editor & Founder
Words of Wisdom
Mark Twain, (1866): Courage is the resistance to fear . . . not absence of fear.
Abraham Lincoln: It often requires more courage to dare to do right than to fear to do wrong.
Winston Churchill: Courage is what it takes to stand up and speak.
Some Recent Postings
Madeleine Pelner Cosman, PhD, Esq: Letter from Osama: KATRINA, OSAMA, AND PREEMPTIVE SURRENDER TO DISASTER. www.healthplanusa.net/MC_Katrina.htm
BIOTERRORISM: How You Can SURVIVE by Russell L Blaylock, MD, Physicians Preference, Inc.(www.PhysiciansPreference.com)
Gross, who was implicated in nine deaths as part of a Nazi plot to eliminate "worthless lives," had escaped trial in March after a court ruled he suffered from severe dementia. No cause of death was given in a brief statement issued by his family.
Gross was a leading
[What will happen to the doctors today that are involved in perinatal killing and the killing of the infirmed and aged who are deemed to have “worthless lives,” under the euphemistic term of euthanasia? How did we ever get to this place in our own history without a Hitler?]
On This Date in History – January 10
On This Date in 1738, Ethan Allen, the
Revolutionary War Commander, was born. When he demanded the surrender
On This Date in
1901, Oil was discovered in