MEDICAL TUESDAY . NET
Community For Better Health Care
Vol VII, No 10, Aug 26, 2008
In This Issue:
MOVIE EXPLAINING SOCIALIZED MEDICINE TO COUNTER MICHAEL MOORE's SiCKO
a pro-liberty filmmaker in Los Angeles, seeks funding for a movie exposing the
truth about socialized medicine. Clements is the former publisher of
"American Venture" magazine who made news in 2005 for a property
rights project against eminent domain called the "Lost Liberty
For more information visit www.sickandsickermovie.com or email email@example.com.
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Visual artists Fernanda Viégas and Martin Wattenberg analyzed over 10,000 songs to find out which parts of the human body were mentioned the most and broke down the resulting data by genre. The result: An interactive graphic work called "Listen" that correlates musical genres with the body parts they mention the most, as part of their ongoing Fleshmap project. Clicking on each genre brings up a more detailed representation of its chief bodily concerns.
"Listen investigates the relationship between language and the body," reads one sentence of the project's manifesto. "Verbal manifestations of human physicality in music, poetry and religion are distilled to their basic elements." By presenting those elements in such an intuitive way, Viégas and Wattenberg bring data to life graphically, so that it can be grasped in seconds.
So, what do the results tell us? Across all of the categories, the eyes are most frequently mentioned body part (Hall & Oates, "Private Eyes"), with the exceptions of hip hop, which places a firm emphasis on the posterior (Sir Mix a Lot, "Baby Got Back") and blues (Louisiana Red, "Keep Your Hands Off My Woman") and gospel music (The Gospel, "Put Your Hands Together"), which are respectively focused on the keeping off of one's hands and the clapping or raising of one's hands.
As for the genre that talks about body parts the most, hip hop takes the honors with more references than any other genre. Meanwhile, gospel refers to the body the least. There are plenty of other data points to peruse. It's nice to know that 23.64 percent of hip hop songs refer to the behind, while 11.83 percent of rock songs talk about eyes.
Viégas and Wattenberg's work has been displayed at the New York Museum of Modern Art, the London Institute of Contemporary Arts, and the Whitney Museum of American Art. The "Listen" project can be viewed free online, or you can order a print of this or any other piece from the Fleshmap series.
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In Sickness and in Health: The Kyoto Protocol versus Global Warming, By Thomas Gale Moore, The Hoover Institution.
In promoting the Kyoto Protocol, which would require a major cut in greenhouse gas emissions, the White House claims that "scientists agree that global warming and resulting climate disruptions could seriously harm human health (projections include 50 million more cases of malaria per year)" (www.studyweb.com/ ). President Clinton has asserted: "Disruptive weather events are increasing. Disease-bearing insects are moving to areas that used to be too cold for them. Average temperatures are rising. Glacial formations are receding" (address at the National Geographic Society, October 22, 1997).
In his 1997 exhortation to the environmental ministers at Kyoto, Vice President Al Gore warned that "disease and pests [are, will be?] spreading to new areas." The White House's home page continues that theme: Americans better watch out; global warming will make them sick.
The Sierra Club has also weighed in, asserting that "doctors and scientists around the world are becoming increasingly alarmed over global warming's impact on human health. Abnormal and extreme weather, which scientists have long predicted would be an early effect of global warming, have claimed hundreds of lives across the US in recent years. Our warming climate is also creating the ideal conditions for the spread of infectious disease, putting millions of people at risk" (www.sierraclub.org/global-warming/factsheets/health.html).
The Public Interest Research Group, a left-leaning environmental organization, fears "Health Threats—Climate change is projected to have wide-spread impacts on human health resulting in significant loss of life. The projected impacts range from increased incidence of illness and death due to heat stress and deteriorating air quality, to the rise in transmission rates of deadly infectious diseases such as malaria, dengue fever, and hanta virus" (www.pirg.org/environ/). Other environmentalists and health experts have also forecast that global warming would bring death and disease (Danzig 1995; IPCC 1996a; Jackson 1995; Epstein and Gelbspan 1995; Cromie 1995; Stone 1995; Monastersky 1994; Patz et al. 1996; Kalkstein 1991, 1992; Kalkstein and Davis 1989; Epstein et al. 1998).
This analysis will explore whether Americans do indeed confront a health crisis. If global warming were to occur, would the United States face an epidemic of tropical diseases, malaria being the prime suspect; would Americans face increased heatstroke and summers that brought a surge of deaths; would global warming bring more frequent and more violent hurricanes wreaking havoc on our citizens? Is it true that warmer climates are less healthy than colder ones? Would cutting greenhouse gas emissions, as the Kyoto Protocol requires, improve the health of Americans? This essay will show that the answer to all those questions is a resounding no.
Not only does my own research demonstrate that the claims of imminent doom are unwarranted, but other studies have found little cause for alarm (WHO 1990; Committee on Science, Engineering, and Public Policy 1991; Taubes 1997; White and Hertz-Picciotto 1995; Shindell and Raso 1997; Cross 1995; Singer 1997; Moore 1998a, 1998b; Murray 1996; Michaels and Balling 2000; Reiter 2000). Knowledgeable organizations, such as the World Health Organization (WHO 1997, 1998, 1999) and the American Medical Association (Council on Scientific Affairs 1996) have ignored the subject, suggesting that, in their eyes, it is unimportant.
After examining the potential impact of global warming on poor countries, the American Council on Science and Health (ACSH) took a realistic view and reported that
Nearly all of the potential adverse health effects of projected climate change are significant, real-life problems that have long persisted under stable climatic conditions. Bolstering efforts to eliminate or alleviate such problems would both decrease the current incidence of premature death and facilitate dealing with the health risks of any climate change that might occur.
Policies that weaken economies tend to weaken public health programs. Thus, it is likely that implementation of such policies would (a) increase the risk of premature death and (b) exacerbate any adverse health effects of future climate change. (Shindell and Raso 1997)
As the ACHS concludes:
From the standpoint of public health, stringently limiting such emissions [greenhouse gases] at present would not be prudent. Fossil-fuel combustion, the main source of human induced greenhouse-gas emissions, is vital to high-yield agriculture and other practices that are fundamental to the well-being of the human population. A significant short-term decline in such actions could have adverse health repercussions.
The optimal approach to dealing with [the] prospect of climate change would (a) include improvement of health infrastructures (especially in developing countries) and (b) exclude any measures that would impair economies and limit public health resources.
The World Health Organization's World Health Report 1998: Life in the 21st Century, gave the globe an A for progress. The WHO showed that remarkable advances have been made in increasing life spans, decreasing disease and suffering, and improving health for virtually all age groups and that the future looks even rosier (see chart 1). To quote the Executive Summary: "As the new millennium approaches, the global population has never had a healthier outlook." How can this be? After all, the White House tells us the next century promises to be one of rising temperatures, spreading disease, and increasing mortality. Somehow, the WHO didn't get the word. The World Health Report 1999: Making a Difference again fails to address this problem that the White House believes is so worrisome.
According to the WHO, the only significant and growing threat to human health is HIV/AIDS, a disease that has nothing to do with climate. Indeed, we have made substantial progress in controlling many major infectious diseases. By 1980, for example, smallpox had been eradicated; yaws had virtually disappeared (except to medical students, even the name of this tropical skin disease is unfamiliar). As a result of antibiotics and insecticides, the threat of plague has declined; improvements in sanitation and hygiene have made outbreaks of relapsing fever rare. Unbelievably, for those who remember summers of fear and polio insurance, poliomyelitis is scheduled for eradication this year.
A LOOK TO THE FUTURE
Looking to the future, the WHO report identifies three global trends affecting health—none is global warming. One is economic: the WHO reports (1998) on the "unparalleled prosperity" between 1950 and 1973, which resulted in marked improvements in health and life expectancies. The organization identifies the years since 1993 as another era of economic "recovery," which has once again contributed to reduced mortality. The other trends singled out as having significant health effects are population growth and social developments, particularly urbanization.
Over the last forty years, the growth in the world's economy has brought about a doubling of the world's food supply, while the number of human mouths has grown much more slowly. This has led to a decline in the proportion of people who are undernourished. Since 1970, literacy rates have increased by more than 50 percent. Physical well-being has also grown apace. More people have access to clean water, sanitation facilities, and minimum health care than ever before. Like the 1999 review, prior World Health Reports largely ignored global warming as a significant threat to the health and well-being of the globe's population. And rightly so.
Of the 50 million plus deaths in 1997, about one-third stemmed from infectious and parasitic diseases, most of which have nothing to do with climate. The remaining deaths were from such killers as cancer, circulatory diseases, and prenatal conditions, none of which would be aggravated by a warmer world. Most infectious and parasitic diseases are unrelated to climate.
The WHO has identified AIDS, one of the most devastating afflictions, as a growing menace in Africa, but it bears no relationship to temperature or rainfall. Only insect-spread diseases, such as malaria and dengue fever, and diseases like cholera and typhoid that are spread through contaminated water, could be worsened by climate change (and then only if swampy polluted areas were allowed to expand without thought to sanitation, window screens, and other precautions that have all but eradicated those diseases in the northern latitudes).
But bear these statistics in mind: In the developed world, as recently as 1985, infectious and parasitic diseases accounted for 5 percent of all deaths; in 1997, they caused only 1 percent of all deaths. In short, even for such insect-borne diseases as malaria, climate is much less important than affluence. Singapore, located two degrees from the equator, is free of that dreadful malady, while the mosquito-carried scourge is endemic in rural areas of Malaysia, only a few hundred miles away. Singapore's healthy state stems from good sanitary practices that reduce exposure. The wealth of the island-state allows it to maintain an effective public health program.
Nor should we be overly concerned with the diseases spread by mosquitoes in tropical areas. If climate change were to occur, according to the global warming models, the poles would warm more than the equator while temperatures would increase more in the winter and at night than during the day. In consequence, the tropics, including Africa, would warm less than the United States or Europe. Any increased burden on health in Africa or southern Asia would, therefore, be small.
With or without climate change, public sanitation should be emphasized as the most effective means of attacking water- and insect-borne diseases everywhere. A warmer world will not add significantly to morbidity in Third World countries. A poorer world most certainly will.
Both the scientific community and the medical establishment assert that the frightful forecasts of an upsurge in disease and early mortality stemming from climate change are unfounded, exaggerated, or misleading and do not require reducing greenhouse gas emissions. Science magazine reported that "predictions that global warming will spark epidemics have little basis, say infectious-disease specialists, who argue that public health measures will inevitably outweigh effects of climate" (Taubes 1997). The article added: "Many of the researchers behind the dire predictions concede that the scenarios are speculative."
Global warming as currently forecast by the International Panel on Climate Change (IPCC) would not bring tropical diseases to Americans or shorten their lives or inflict more violent storms bringing death and destruction to the United States. Moreover, the warmer climate predicted for the next century is unlikely to induce a rise in heat-related deaths. As the article in Science magazine points out, "people adapt. . . . One doesn't see large numbers of cases of heat stroke in New Orleans or Phoenix, even though they are much warmer than Chicago."
TROPICAL DISEASES . . .
DEATHS IN WINTER VERSUS SUMMER
Deaths from Cold versus Heat
Recent summers have sizzled. Newspapers have reported the tragic deaths of the poor and the aged on days when the mercury reached torrid levels. Prophets of doom forecast that rising temperatures in the next century portend a future of calamitous mortality. Scenes of men, women, and children collapsing on hot streets haunt our imaginations.
Heat stress does increase mortality, but it affects typically only the old and the infirm, whose lives may be shortened by a few days or perhaps a week. There is no evidence, however, that mortality rates rise significantly. The numbers of heat stress–related deaths are very small; in the United States; the number of deaths due to weather-related cold exceeds them. During a recent ten-year period, which includes the very hot summer of 1988, the average number of weather-connected heat deaths was 132, compared with 385 who died from cold (see chart 5). Even during 1988, more than double the number of Americans died from the cold rather than from the heat of summer. A somewhat warmer climate would clearly reduce more deaths in the winter than it would add in the summer. . . .
To read the rest of this treatise, go to www.hoover.org/publications/epp/2834641.html?show=essay.
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At least 30,000 patients were left starving on NHS wards last year, despite ministers' pledges to make proper nutrition in hospitals a priority.
Last year, Health Minister Ivan Lewis admitted that some patients were given a single scoop of mash as a meal.
Others were ‘tortured' with trays of food placed just beyond their reach while nurses said they were too busy to help them eat.
And now, official figures show that between 2005 and 2007, there was an 88 per cent rise in reported cases of poor nutrition leading to a serious deterioration in a patient's health.
Last year, NHS whistleblowers reported 29,138 such errors to the National Patient Safety Agency – up from 15,473 in 2005. . .
As the figures only represent reported cases, actual numbers are likely to be even greater.
Conservative health spokesman Stephen O'Brien said: ‘People go to hospital expecting to get better, yet in 2007, 29,000 people suffered unnecessarily and completely avoidable harm from poor nutritional care.
‘Ministers have presided over this growing scandal, which I have been highlighting for over two years, and yet this Labour Government have failed to use this 60th anniversary of the NHS to address it.
‘Nutrition is central to health and dignity – how many more patients must suffer at the hands
of this inept Government?' The Mail has highlighted the lack of help given to frail patients to eat hospital food as part of its Dignity For The Elderly campaign.
And last year, a survey by the Healthcare Commission found that one in five frail and elderly patients complained they did not have enough help when eating.
Half of nurses said there were not enough staff to help those who needed it to eat and drink.
Age Concern says 60 per cent of older patients, who occupy two-thirds of general hospital beds, are at risk of worsening health or becoming malnourished. The over-80s are particularly at risk.
Patrick Smith, from the charity, said: ‘A missed meal in hospital is just as much of a risk to patient safety as missing medication for a patient's recovery. . .
‘Not only do a significant number of older people arrive in hospital already malnourished, but six out of ten are at risk of becoming malnourished, or their situation getting worse, while they are there. . .
The Government last year launched a bid to improve hospital food, after Mr Lewis admitted many elderly patients were effectively being starved in hospitals.
Dr Kevin Cleary, medical director of the NPSA, an NHS agency, said a ‘growth in incident reporting' helps prevent similar occurrences.
‘We recognise that good nutrition and hydration is
essential for the recovery of patients. And we support clinicians with guidance
to ensure that learning from reported incidents is provided.' To read the
entire report, and get a glance on what we may see in the USA should government
medicine come to pass, go to
The NHS does not give timely access to health care; it only gives access to a starvation ward.
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Social Security Is Morally Bankrupt By Alex Epstein
August 14 marks Social Security's 73rd birthday—placing it eight years past standard retirement age. But, despite the program's $10-trillion-plus dollar shortfall, no politician dares to suggest that this disastrous program be phased out and retired; all agree on one absolute: Social Security must be saved. While the program may have financial problems, virtually everyone believes that some form of mandatory government-run retirement program is morally necessary.
But is it?
Social Security is commonly portrayed as benefiting most, if not all, Americans by providing them "risk-free" financial security in old age.
This is a fraud.
Under Social Security, lower- and middle-class individuals are forced to pay a significant portion of their gross income—approximately 12 percent—for the alleged purpose of securing their retirement. That money is not saved or invested, but transferred directly to the program's current beneficiaries—with the "promise" that when current taxpayers get old, the income of future taxpayers will be transferred to them. Since this scheme creates no wealth, any benefits one person receives in excess of his payments necessarily come at the expense of others.
Under Social Security, every aspect of the government's "promise" to provide financial security is at the mercy of political whim. The government can change how much of an individual's money it takes—it has increased the payroll tax 17 times since 1935. The government can spend his money on anything it wants—observe the long-time practice of spending any annual Social Security surplus on other entitlement programs. The government can change when (and therefore if) it chooses to pay him benefits and how much they consist of—witness the current proposals to raise the age cutoff or lower future benefits. Under Social Security, whether an individual gets twice as much from others as was taken from him, or half as much, or nothing at all, is entirely at the discretion of politicians. He cannot count on Social Security for anything—except a massive drain on his income.
If Social Security did not exist—if the individual were free to use that 12 percent of his income as he chose—his ability to better his future would be incomparably greater. He could save for his retirement with a diversified, long-term, productive investment in stocks or bonds. Or he could reasonably choose not to devote all 12 percent to retirement. He might plan to work far past the age of 65. He might plan to live more comfortably when he is young and more modestly in old age. He might choose to invest in his own productivity through additional education or starting a business.
How much, when, and in what form one should provide for retirement is highly individual—and is properly left to the individual's free judgment and action. Social Security deprives the young of this freedom, and thus makes them less able to plan for the future, less able to provide for their retirement, less able to buy homes, less able to enjoy their most vital years, less able to invest in themselves. And yet Social Security's advocates continue to push it as moral. Why?
The answer lies in the program's ideal of "universal coverage"—the idea that, as a New York Times editorial preached, "all old people must have the dignity of financial security"—regardless of how irresponsibly they have acted. On this premise, since some would not save adequately on their own, everyone must be forced into some sort of "guaranteed" collective plan—no matter how irrational. Observe that Social Security's wholesale harm to those who would use their income responsibly is justified in the name of those who would not. The rational and responsible are shackled and throttled for the sake of the irrational and irresponsible. . .
Social Security in any form is morally irredeemable. We should be debating, not how to save Social Security, but how to end it—how to phase it out so as to best protect both the rights of those who have paid into it, and those who are forced to pay for it today. This will be a painful task. But it will make possible a world in which Americans enjoy far greater freedom to secure their own futures.
To read the entire analyses, and a more secure retirement than Social Security can give, go to www.aynrand.org/site/News2?page=NewsArticle&id=21009&news_iv_ctrl=1021.
Alex Epstein is an analyst at the Ayn Rand Institute, focusing on business issues. The Institute promotes Objectivism, the philosophy of Ayn Rand—author of "Atlas Shrugged" and "The Fountainhead." Contact the writer at firstname.lastname@example.org.
Government is not the solution to our problems, government is the problem.
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A friend told my wife last week that her mother was having urinary burning, had spent 6 hours in the Emergency Room and was given medications for a urinary tract infection. She was so sick and nauseated in church that she had to go home. Her daughter called my wife on Sunday afternoon reporting that her mother was still sick. I interjected that she didn't seem to need an emergency room visit because they were not envisioning that she might need to be hospitalized or require surgery. She just needed an after-hours and weekend doctor. There are "Doc-in-a-box" Urgent Care Centers scattered all over Sacramento that provide after-hours physician services. The average wait time is one hour or less.
She, however, decided to return to the Emergency Room rather than an Urgent Care Center because "they" had already seen her. "They?" Physicians and the staff change every 12 hours. It would be extremely unlikely that anyone on duty the previous day would be working that day to give any continuity of care. My wife received a phone call while they were still at the ER. They had been waiting for quite a while and did not appear to be any closer to seeing a doctor than when they arrived. She said her mother was too sick to stay any longer and they were going to take her home. The only advice they received from the nurse as they left the ER was to take the medication that was prescribed even though it made her sick.
Forgetting about duty and obligations, because any one of us would spend whatever time was necessary for a loved one's benefit, what are the hidden costs? Because she is elderly and frail, there are two family members with her each day. Use any hourly rate you're comfortable with for the 24 hours involved to estimate the hidden costs. And still no medical attention.
Add the overhead of a large institution such as a hospital, that runs into hundreds of dollars per minute, and the basic cost is extremely high. That's why the equivalent of an office visit to the ER is closer to $600 plus the tests.
The Urgent Care Centers are usually private institutions or practices. Hence, their business and practice is dependent on prompt and efficient service to the people that walk in. That's why the cost to an Urgent Care Center may be as low as $60 plus the cost of any laboratory work.
The hospital emergency rooms are socialistic centers mandated by government to provide services to all comers. Some statistics suggest that 75 to 85 percent of all comers are not emergencies. Hence, they must be placed at the bottom of the wait list. As emergencies keep coming into the emergency room, they go immediately to the top of the list and the non-emergent urinary infections go further down the list. Is there an alternative?
Most third-party payers, such as insurance companies, cover emergency services. Because this makes their costs so insignificant, people who don't consider their time valuable will spend six hours in an emergency room even if they don't have a life threatening emergency.
Take away the government mandates and third-party insurance maneuvering and watch the hospitals provide efficient care.
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Can Technology Better Manage Healthcare? Joe Marion
Last week, while on vacation, I had the opportunity to experience an example of healthcare up close and personal, as they say. Let me qualify what I am about to address by saying that this may have been an isolated incident. My fear is that it is not, and that is why I chose to write about it.
I should like to describe what happened, and then highlight where I think the system broke down.
While in Florida visiting a 90-year old family member, she managed to slip and fall the first night of our visit. She has difficulty walking and was using a walker at the time. The walker caught on something, and down she went! She complained of soreness but was able to get back up with assistance.
The next morning, she was no better, and she opted to be taken to the emergency department of a nearby hospital – by ambulance, as we were unable to move her. Upon arrival, she was placed in an emergency room bay and attached to vital sign monitors. At some point a nurse came in to take her history, draw blood, and insert additional lines. She was given a pain pill, after initially being told she could not have anything to eat or drink, as she might require surgery. . .
After another two hours, she was finally taken to MR for an exam, and then taken up to a patient ward, where she was kept overnight. All told, over seven hours in the ER!
We were met the next day by a case worker who was to assist us with her disposition. We quickly learned that in Florida (and as I have come to find out, is also true in many other states), as long as the patient is in control of their facilities, they make the final call on their course of action. We had felt the best thing for her would have been a continuous care facility, but when confronted, she indicated she wanted to go home – no surprise there! The case worker indicated that she would take care of making all the arrangements with the proper agencies, and she would be released later in the day. At some point we learned that she could not be released without these arrangements for in-home care. . .
Now, for the issues with the process:
1. The hospital was extremely up-to-date, having an automated ER tracking and documentation system, CR and PACS in Radiology, and mobile documentation carts on the nursing floors (can you tell I was meddling!).
2. A key element of patient history was missed by the nurse when taking a history – she has IBS . . .
3. There was no known reason for spending seven hours in the ER, other than delays in the CT and MRI scheduling, and supposedly, availability of a bed . . .
4. At no time in the ER was she ever examined by a physician. . . .
5. When it came time for discharge, no one from the hospital followed up to insure that a home care person was available to accompany her. . .
My key issue? Despite all the technology available to this facility, it played little in the overall quality and timeliness of care that this patient received! I could write it off to staff indifference. After all, there did not appear to be any incentive for the ER to see that she was informed or expedited to a room. Similarly, the caseworker seemed more intent on getting her discharged than on any care that she might receive. It was not the hospital's fault that she refused the CT exam, although, had the staff spent any time explaining it to her, perhaps she might not have refused it when they were about to do the exam!
Instead, I have concluded that the root of the problem is a breakdown in communication, and "departmentalization," and that no amount of technology could fix the problem. Perhaps it was the way technology was deployed at this facility on a departmental level, or the lack of either an information system application or personnel to oversee the process. This has me wondering if other facilities mange patients from an institutional level? . . .
So, I ask myself:
· How could technology have been better employed to track and alert staff throughout the entire length of stay?
· Is this a reasonable thing to ask for?
· Has technology been "pigeonholed" (in this facility and in general) to departmentalization, or are there mechanisms that could have better managed the patient from an institutional level?
· Was this just a poorly managed random case?
I'd be interested in your perspective - isolated example, or a real issue? Please feel free to comment. I'm particularly interested in whether technology is too departmental, or whether it can be institutionalized to better manage the patient. I look forward to your response.
Response left by Del Meyer, MD:
Satish, Joe and Anthony have each describe a blind man's impression of the elephant, and each is correct. But a seven-hour Emergency Room visit appears to be normal for Sacramento. But what technology are we talking about? Isn't the real issue economic?
Each of the four hospital systems in Sacramento has a $100+ million expansion program. Despite the emphasis on outpatient medicine, the hospitals are betting they can alter the landscape. The ER appears to fund the expansion.
I see patients with chest pain who have been to the ER and obtained every cardiac evaluation possible. After six to ten hours they are then told, "We are happy to inform you that you have no serious heart disease." They are asked to see their personal physician the next day to transfer liability away from the hospital. When I see this patient, my hand goes immediately to the chest where the patient states the pain is and as I press on the costochondral junction (rib-breast bone junction). They say, "Now that's the pain I went to the ER to have evaluated."
Costochondritis, inflammation where the ribs articulate with the sternum, is a very common musculo-skeletal problem. I see at least several every week and several every month that have gone to the ER with a full cardiac workup and no diagnosis, one that I make in the first 30 seconds. An ER doctor told me that they couldn't make any money if they diagnosed something in the first few minutes. They and the hospital work by hours and shifts.
A clerk who works in the ER of one of these hospitals is a patient in my office. She told me that they are told not to play doctor but to treat every chest pain equally. She states that the average hospital charge for chest pain complaint is $9,000. How else would they pay for the $100 million hospital addition? But the insurance company is able to negotiate their portion down to perhaps one-third; the patient still pays the full 20 percent on the total charge.
The whole issue could be solved in the free enterprise market. In our research, studying 5, 10, 20, 30, 40, and 50 percent co-pays, we've found that a 20% co-payment for ER evaluations reduces all ER visits to the minimum without limiting access or reducing the quality of care.
This was recently demonstrated by a patient who went to the hospital ER for breathlessness without chest pain. She had Medicare and was responsible for the first 20%. She was in mild cardiac failure, which resolved on the first dose of IV Lasix. She already had a cardiac ECHO and had good heart function. As they were about to wheel her out for more tests, she asked about the cost. When she found out that it was a few thousand dollars more testing, she told them to hold on. She felt better and desired to go home since they had assured her that she did not have a coronary. She said she would be back if she got worse. She was doing very well the next day. She stated that the ER staff seemed very upset over her early departure. She was wondering if perhaps she cut off the cash flow. She was still doing very well when seen a month later.
She said she got out of the ER with a charge of 20% of $3500 or $700. She found out that the tests would have gone over $8,000 and she was so thankful that she cut if off at the $700 copay, rather than $1600 copay if she had stayed longer.
A percentage copay will bring health care costs under control and make it efficient. Patients who pay 20% will not visit a hospital again that averages thousands of unnecessary dollars a visit and instead will seek out the best ER with the most efficient care at the most reasonable costs. Any one can make one costly mistake. But no one will make a second costly mistake. Health care cost control occurs with the second if not the first visit. Government cost control occurs after months and years of congressional hearings, debates, political maneuvering, and legislation, which more often than not increases the cost.
And patients will no longer brag to their friends, relatives and neighbors that they went to the ER and had $10,000 worth of tests and all was normal and it only cost a $50 co-payment. That beats Mayo Clinic and all the rest for efficiency. Nobody even thinks of the $10,000 additional premium that has to be collected downstream for each visit. Such a raw deal.
Instead, they will go to their friends, relatives and neighbors stating that they had chest pain, which they thought surely was a coronary. After an ECG, ECHO, and several blood tests they were assured that they had no heart disease and the total charge was only $1200, of which they only had to pay $240. Such a good deal for this kind of re-assurance.
The former will only lead to rationing and the ones that need life-saving care will be rationed out of care and may die.
The latter is the landscape, the responsible one that will save American Medicine, the world's finest and most sophisticated.
Sorry, Joe, technology is important but not the answer without the economic answer. Third-party health care will never make this more efficient. Just read MedicalTuesday for a few weeks to see that 25 to 40 percent of health care costs would vanish overnight with a percentage co-payment for every item in the CPT.
Del Meyer, MD
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Dr. Dave: I'm just amazed at the lack of economic understanding among patients.
Dr. Ruth: How so?
Dr. Dave: I had a patient with Rhino-sinus symptoms who needed some antihistamines and decongestants. I told him these drugs are essentially generic and OTC at a reasonable costs.
Dr. Ruth: He didn't appreciate your trying to save him money?
Dr. Dave: Actually he became upset at the very idea of paying cash. He would run it through his insurance company. He paid them enough that they should be happy he's getting a generic..
Dr. Ruth: Did you actually explain the pricing structure so he could understand?
Dr. Dave: My staff thinks I waste too much of my expensive time because it isn't appreciated.
Dr. Yancy: It's been shown that patients change insurance plans and doctors for as little as a $6 change in premium.
Dr. Dave: I explained that some of these antihistamines were $4 a pill or $120 for a month's supply when they were proprietary and now they are not only generic, but over the counter with as much as a 10-month supply for only $12.
Dr. Ruth: Didn't he think that was a bargain?
Dr. Dave: No. He said that he didn't have $12. That's why he had insurance to pay for this.
Dr. Ruth: But what was his co-pay?
Dr. Dave: He said $5. I pointed out that $5 for a month supply was far more than $12 for a 10 month's supply.
Dr. Ruth: He could certainly understand that, couldn't he?
Dr. Dave: Well, his response was simply, "You doctors all work for the insurance company trying to save them money."
Dr. Edwards: I've recently had a number of Kaiser Permanente patients enter my practice because they thought the KP premiums were too high.
Dr. Michelle: I understand there was a significant increase last year.
Dr. Edwards: But they were dismayed when the co-payments started to add up because they wanted to see the same number of consultants that they saw at KP.
Dr. Michelle: And the inconvenience of driving to several different offices to see these consultants when they previously had everything so conveniently located.
Dr. Dave: Then to drive to pharmacies, laboratories and x-ray facilities instead of just going downstairs to these ancillary services, which is also a wrinkle they didn't expect.
Dr. Rosen: Their lack of understanding of all the other variances in health plans frequently add up to more costs.
Dr. Edwards: I saw one patient who went from KP to another HMO plan that had shorter office visits than he was used to at KP. I believe it was 15 minutes instead of 20 minutes.
Dr. Michelle: Well, did you keep him happy?
Dr. Edwards: My appointments are very flexible. I may get one patient seen in 15 minutes and another one may take 25 minutes. But over the course of the day, I'm able to see my 5 PM appointment by 6 PM. I schedule every 20 minutes, with new patients every 40 minutes. But many new patients may take an hour. I feel in this business one can't be more punctual. My patients who are seen an hour late thank me for waiting for them. Most administrators think of this in the reverse - the patient is waiting too long. The backward thinking of socialized medicine.
Dr. Rosen: It's this economic naiveté that's going to bring about socialized medicine. People will think it means getting even with doctors. Even when they have to wait six to twelve months to get a consult that they could have previously gotten the following week. After the cancer may have spread while waiting, they still won't understand. They don't believe the rationing all other countries with socialized medicine are experiencing. But they'll be happier blaming government doctors who will be totally impotent.
Dr. Michelle: By that time, I'll be out of this rat race.
Dr. Yancy: And if I'm not, I'll find something else to do.
Dr. Rosen: I wonder how long it will take Americans to realize that a six to twelve month wait to see the specialist they need to cure a suffering life-threatening disease is really more expensive than the $6 monthly premium saved?
Dr. Yancy: They won't realize it until it's too late.
Dr. Rosen: Then the politicians will have a political football that will end the real football game. Only politicians can change the rules, move the goal posts, lengthen the playing field, or even stop the clock by a vote of Congress or a filibuster. It no longer is a real game - just a playing field. Or a crapshoot - heads they win, tails you lose. And we, the patients and their doctors and nurses, are too desperate to quit playing the subterfuge. The noble professions have become the despised profession. The ultimate losers are our patients. But we didn't change the course of the game while there was still time. Doesn't that make us the real losers in the eyes of History?
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Orange County Medical Association: What's the Fuss About? By Lytton W. Smith, MD
The Joint Commission recently produced its annual standards for hospital accreditation for 2008.
The standards related to medical staff governance created havoc for some hospital organizations.
The Joint Commission, formerly the Joint Commission for the Accreditation of Hospital Organizations, produced its annual standards for hospital accreditation for 2008. The Hospital Accreditation Procedure manual gives a full description of the expected standards for hospital compliance. The standards related to medical staff governance created havoc for some hospital organizations. After learning of the issues, we at the California Medical Association's Organized Medical Staff Section chose to reread Shakespeare's Much Ado About Nothing in preparation for our discussion!
In order to participate in the Medicare program, hospitals must receive oversight from the Centers for Medicare and Medicaid Services. The CMS developed a series of standards for participation in the Medicare program. The Joint Commission, which was established prior to CMS, had a system of hospital inspections. The CMS contracts with the Joint Commission to certify that hospitals comply with the standards of participation. This contract elevates the importance of being certified by the Joint Commission. The Joint Commission also establishes its own standards to push for improvement in the delivery of patient care in hospitals.
On a regular basis, the Joint Commission's Standards Committee reviews and changes the standards based upon input from many sources. Major changes to the HAP occur every five to 10 years, so you should expect some major changes in 2009. The change that excited the American Hospital Association, however, occurred subtly in 2008: the infamous MS. 1.2!
Hidden in the Medical Staff Section, MS. 1.2 sought to destroy the relationship between hospitals and medical staffs. Yes, a plot by the American Medical Association--caught just in time by the AHA--surfaced, threatening the viability of the Joint Commission's survey program. Stop the presses!
From the Comprehensive Accreditation Manual for
Hospitals: the Official Handbook:
Medical staff bylaws address self governance and accountability to the governing board.
Element of Performance
A description of the medical executive's function, size and composition, and of the methods for selecting and removing its members and the organized medical staff officers.
Aye, there's the plot: to remove members of the Medical Executive Committee. Imagine after all the effort to stack the MEC with administration-friendly physicians, the medical staff might actually remove them. You mean, once all the paid medical directors take their assigned places on the MEC, the medical staff could actually vote to remove them? What was the Joint Commission thinking? You mean the medical staff bylaws need adjustment to allow this element of performance? Most AMA-recognized attorneys estimated less than $2,000.
Thank California for this mess. Those darn doctors in Ventura did this! The administration in that small community's hospital decided to stack the MEC with their chosen few. The doctors of the medical staff objected and voted to remove the MEC members, replacing them with their own elected medical staff members. Then the Board of Trustees unilaterally changed the bylaws, forcing a legal battle heard around the country. In California, this battle set the stage for the passage of California Senate Bill 1325, which defined in statute the rights of medical staff members to self governance.
So now the battle over the right of the medical staff to remove the MEC surfaces on a national level. The CMA OMSS and AMA OMSS conference calls abound with this issue. Will the Joint Commission capitulate and remove this innocuous standard? Will the AHA win a concession? Will removal of "and removing" satisfy the AHA? If removed, will the medical staff be truly self-governing?
Please stay tuned and, if you have time, reread Shakespeare's Much Ado About Nothing!
To read more VOM, please go to www.healthcarecom.net/voicemed.htm.
To read HMC, please go to www.delmeyer.net/HMC.htm.
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Code Blue: Health Care in Crisis by Edward R. Annis, MD, Regnery Gateway Press, Washington, D.C. 1993, 278 pages.
Review by Del Meyer, MD
Doctor Annis opens his introduction describing the two worlds that physicians live in: The wonderland of modern medicine, a gratifying and challenging world of achievement in research, education, and clinical practice; and the faltering American health care world, which is on the verge of collapse. Not unlike Charles Dickens in the opening to this Tale of Two Cities: "It was the best of times. It was the worst of times."
Annis gives us many anecdotal insights into the history of American medicine: Fleming's discovery of penicillin in England in 1928, that sat on the shelf until American drug companies developed methods of production in 1943, making it available to patients; sick England in the postwar era to healthy America; the high death rate of Europe to increased life expectancy to 68 years in America in 1949. The high cost of living is only exceeded by the higher cost of dying. His chapter on health insurance ("Call the Plumber, We're Insured!") is a parody on why health insurance is not insurance and, therefore, cannot work in its current format.
Edward Annis, who never chaired a meeting or held an organized medicine office, was elected president of the AMA at a young age in an attempt to counter a cunning band of political sophists in Washington, D.C. He champions the fight to head off government intrusion between doctor and patient and dispels the myth that a "managed" health care system would solve America's problems. He feels the problems in health care have a "Made in Washington" label. Health care already is the most regulated industry in America, strangling doctors and hospitals by senseless paper work, counterproductive bureaucracy, an abusive civil court system, and price controls that are actually driving prices up. He feels it should be labeled a crisis in government that can only be solved by less government interference.
In his final chapter, "What's the Solution?" Annis gives us his analysis of why third-party systems aren't working. Clinton's health plan; and two well-thought-out plans which he feels put the patient back in the driver's seat – in charge of his or her own money. He favors "An Agenda for Solving America's Health Care Crisis," by the National Center for Policy Analysis, which can be reached at 214-386-6272. The other plan "A National Health System for America," is by the Heritage Foundation and can be obtained by calling 202-546-4400.
Dr. Annis quotes Tom Paine's 1976 Revolutionary Era treatise, Common Sense, decrying excessive government, Time makes more converts than reason.
This review is found at www.delmeyer.net/bkrev_CodeBlue.htm.
To read more book reviews, go to www.delmeyer.net/PhysicianPatientBookshelf.htm.
To read book reviews topically, go to www.healthcarecom.net/bookrevs.htm.
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Medical Bureaucrat (administrator): We are going to be adopting the best practices in our hospital and enforcing it rigidly.
Doctor: If we all do it, won't best practices be the same as mediocre?
Medical Bureaucrat: (administrator) Stop making mediocrity sound bad. [After Scott Adams]
Best Practice is a Doctor's Middle Name. What don't the bureaucrats understand?
Elsewhere in this week's newsletter, we report on visits to the ER for chest pain that takes hours to evaluate at high costs. Sometimes it's just a tender rib cartilage called costochondritis that requires an OTC pain pill, not even an ECG. The writer couldn't understand why modern technology wasn't more efficient.
Sometimes it is more cost effective and time efficient to resort to the old standbys of a medical history and physical examination than to use thousands of dollars worth of technology, which in this case missed the diagnosis.
Diagnoses are hard to make without a doctor's examination.
To read more HHK, go to www.healthcarecom.net/hhk2001.htm.
To read more HMC, go to www.delmeyer.net/hmc2005.htm.
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• John and Alieta Eck, MDs, for their first-century solution to twenty-first century needs. With 46 million people in this country uninsured, we need an innovative solution apart from the place of employment and apart from the government. To read the rest of the story, go to www.zhcenter.org and check out their history, mission statement, newsletter, and a host of other information. This month, be sure to read Alieta's Letter to the Editor concerning a hospital closure after 130 years. For "Are you really insured?" go to www.healthplanusa.net/AE-AreYouReallyInsured.htm.
• PATMOS EmergiClinic - where Robert Berry, MD, an emergency physician and internist practices. To read his story and the background for naming his clinic PATMOS EmergiClinic - the island where John was exiled and an acronym for "payment at time of service," go to www.emergiclinic.com. To read more on Dr Berry, please click on the various topics at his website. This month, be sure to read his Congressional Testimony.
• PRIVATE NEUROLOGY is a Third-Party-Free Practice in Derby, NY with Larry Huntoon, MD, PhD, FANN. http://home.earthlink.net/~doctorlrhuntoon/. Dr Huntoon does not allow any HMO or government interference in your medical care. "Since I am not forced to use CPT codes and ICD-9 codes (coding numbers required on claim forms) in our practice, I have been able to keep our fee structure very simple." I have no interest in "playing games" so as to "run up the bill." My goal is to provide competent, compassionate, ethical care at a price that patients can afford. I also believe in an honest day's pay for an honest day's work. Please Note that PAYMENT IS EXPECTED AT THE TIME OF SERVICE. Private Neurology also guarantees that medical records in our office are kept totally private and confidential - in accordance with the Oath of Hippocrates. Since I am a non-covered entity under HIPAA, your medical records are safe from the increased risk of disclosure under HIPAA law. Read and understand "Third Party Free Practice."
• Michael J. Harris, MD - www.northernurology.com - an active member in the American Urological Association, Association of American Physicians and Surgeons, Societe' Internationale D'Urologie, has an active cash'n carry practice in urology in Traverse City, Michigan. He has no contracts, no Medicare, Medicaid, no HIPAA, just patient care. Dr Harris is nationally recognized for his medical care system reform initiatives. To understand that Medical Bureaucrats and Administrators are basically Medical Illiterates telling the experts how to practice medicine, be sure to savor his article on "Administrativectomy: The Cure For Toxic Bureaucratosis." To really understand the finances of Opting out of Medicare, read his excellent analysis. Yes indeed, a very bold move. Would the rest of us be so bold?
• Dr Vern Cherewatenko concerning success in restoring private-based medical practice which has grown internationally through the SimpleCare model network. Dr Vern calls his practice PIFATOS – Pay In Full At Time Of Service, the "Cash-Based Revolution." The patient pays in full before leaving. Because doctor charges are anywhere from 25-50 percent inflated due to administrative costs caused by the health insurance industry, you'll be paying drastically reduced rates for your medical expenses. In conjunction with a regular catastrophic health insurance policy to cover extremely costly procedures, PIFATOS can save the average healthy adult and/or family up to $5000/year! To read the rest of the story, go to www.simplecare.com.
· Dr David MacDonald started Liberty Health Group. To compare the traditional health insurance model with the Liberty high-deductible model, go to www.libertyhealthgroup.com/Liberty_Solutions.htm. There is extensive data available for your study. Dr Dave is available to speak to your group on a consultative basis. Read the basis for Affordable Health Care.
• Madeleine Pelner Cosman, JD, PhD, Esq, who has made important efforts in restoring accountability in health care, has died (1937-2006). Her obituary is at www.signonsandiego.com/news/obituaries/20060311-9999-1m11cosman.html. She will be remembered for her important work, Who Owns Your Body, which is reviewed at www.delmeyer.net/bkrev_WhoOwnsYourBody.htm. Please go to www.healthplanusa.net/MPCosman.htm, to view some of her articles that highlight the government's efforts in criminalizing medicine. For other OpEd articles that are important to the practice of medicine and health care in general, click on her name at www.healthcarecom.net/OpEd.htm.
• David J Gibson, MD, Consulting Partner of Illumination Medical, Inc. has made important contributions to the free Medical MarketPlace in speeches and writings. His series of articles in Sacramento Medicine can be found at www.ssvms.org. To read his "Lessons from the Past," go to www.ssvms.org/articles/0403gibson.asp. For additional articles, such as the cost of Single Payer, go to www.healthplanusa.net/DGSinglePayer.htm; for Health Care Inflation, go to www.healthplanusa.net/DGHealthCareInflation.htm. For A Disingenuous Debate on Health Care Policy, go to www.ssvms.org/articles/0805gibson.asp for a very important election analysis.
• Dr Richard B Willner, President, Center Peer Review Justice Inc, states: We are a group of healthcare doctors -- physicians, podiatrists, dentists, osteopaths -- who have experienced and/or witnessed the tragedy of the perversion of medical peer review by malice and bad faith. We have seen the statutory immunity, which is provided to our "peers" for the purposes of quality assurance and credentialing, used as cover to allow those "peers" to ruin careers and reputations to further their own, usually monetary agenda of destroying the competition. We are dedicated to the exposure, conviction, and sanction of any and all doctors, and affiliated hospitals, HMOs, medical boards, and other such institutions, who would use peer review as a weapon to unfairly destroy other professionals. Read the rest of the story, as well as a wealth of information, at www.peerreview.org.
• Semmelweis Society International, Verner S. Waite MD, FACS, Founder; Henry Butler MD, FACS, President; Ralph Bard MD, JD, Vice President; W. Hinnant MD, JD, Secretary-Treasurer; is named after Ignaz Philipp Semmelweis, MD (1818-1865), an obstetrician who has been hailed as the savior of mothers. He noted maternal mortality of 25-30 percent in the obstetrical clinic in Vienna. He also noted that the first division of the clinic run by medical students had a death rate 2-3 times as high as the second division run by midwives. He also noticed that medical students came from the dissecting room to the maternity ward. He ordered the students to wash their hands in a solution of chlorinated lime before each examination. The maternal mortality dropped, and by 1848, no women died in childbirth in his division. He lost his appointment the following year and was unable to obtain a teaching appointment. Although ahead of his peers, he was not accepted by them. When Dr Verner Waite received similar treatment from a hospital, he organized the Semmelweis Society with his own funds using Dr Semmelweis as a model: To read the article he wrote at my request for Sacramento Medicine when I was editor in 1994, see www.delmeyer.net/HMCPeerRev.htm. To see Attorney Sharon Kime's response, as well as the California Medical Board response, see www.delmeyer.net/HMCPeerRev.htm. Scroll down to read some very interesting letters to the editor from the Medical Board of California, from a member of the MBC, and from Deane Hillsman, MD.
To view some horror stories of atrocities against physicians and how organized medicine still treats this problem, please go to www.semmelweissociety.net.
• Dennis Gabos, MD, President of the Society for the Education of Physicians and Patients (SEPP), is making efforts in Protecting, Preserving, and Promoting the Rights, Freedoms and Responsibilities of Patients and Health Care Professionals. For more information, go to www.sepp.net.
• Robert J Cihak, MD, former president of the AAPS, and Michael Arnold Glueck, M.D, write an informative Medicine Men column at NewsMax. Please log on to review the last five weeks' topics or go to archives to see the last two years' topics. Be sure to read: Dying for Universal Health Care.
• The Association of American Physicians & Surgeons (www.AAPSonline.org), The Voice for Private Physicians Since 1943, representing physicians in their struggles against bureaucratic medicine, loss of medical privacy, and intrusion by the government into the personal and confidential relationship between patients and their physicians. Be sure to read News of the Day in Perspective: Senator Coburn under fire for delivering babies for free at www.aapsonline.org/newsoftheday/0051. Don't miss the "AAPS News," written by Jane Orient, MD, and archived on this site, that provides valuable information. Browse the archives of their official organ, the Journal of American Physicians and Surgeons, with Larry Huntoon, MD, PhD, a neurologist in New York, as the Editor-in-Chief. There are a number of important articles that can be accessed from the Table of Contents of the current issue. Don't miss the excellent articles on the Sexual Revolution Consequences or the extensive book review section that covers four great books this month.
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Del Meyer, MD, Editor & Founder
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Words of Wisdom
Liberals extol the virtues of communism and flock to its promise of the redistribution of wealth. But if it really worked, then how come all of the gold in Russia still resides in the Kremlin? Why wasn't it redistributed? http://benjamin-politix.blogspot.com/
The study of history is a powerful antidote to contemporary arrogance. It is humbling to discover how many of our glib assumptions, which seem to us novel and plausible, have been tested before, not once but many times and in innumerable guises; and discovered to be, at great human cost, wholly false. -Paul Johnson, www.tsowell.com/quotes.html
I'd rather vote for the first ten people in the phone book than for anyone in Washington. -William Buckley. [Looks like this year we can vote for someone who isn't from Washington and can field dress a moose. How refreshing.]
Take a music bath once or twice a week for a few seasons and you will find that it is to the soul what the water bath is to the body. -Oliver Wendell Holmes, U.S. Author and Physician (1809 – 1894)
Some Recent Postings
HEALTH CARE CO-OPS IN UGANDA - Effectively Launching Micro Health Groups in African Villages, by George C. Halvorson www.delmeyer.net/bkrev_HealthCareCo-OPInUganda.htm
A CALL TO ACTION - Taking Back Healthcare for Future Generations by Hank McKinnell www.delmeyer.net/bkrev_ACallToAction.htm
PUTTING OUR HOUSE IN ORDER - A Guide to Social Security & Health Care Reform by George P. Shultz and John B Shoven www.delmeyer.net/bkrev_PuttingOurHouseInOrder.htm
SUPPORTERS put the best face they could on him. A real Southern gentleman, from owlish glasses to black wingtip shoes, who would hold the door for any woman and thank you, with a nod and a smile, for smoking North Carolinian tobacco in his office. A kind-hearted soul, who had adopted a boy with cerebral palsy, who bought ice-cream for his congressional pages and was delightful at dinner, both to Democrats and Republicans. A true patriot, who saw America as God's country and the world's hope, who defended its values against the liberal media and the "muck" of decadent artists, and who had no truck with arms-control treaties, test-ban treaties, missile reduction, or any crimp on sovereignty. An anti-communist to make all others fade, convinced that the Soviets were irredeemable cheats and liars, determined never to deal with Fidel Castro's Cuba but to make sure the tyrant left it "in a vertical position or a horizontal position", preferably the latter. A doughty lover of liberty, who believed government should be small, laws unobtrusive, and men left alone to take responsibility for their own lives and their own decisions. "Compromise, hell!" he wrote in 1959. "If freedom is right and tyranny wrong, why should those who believe in freedom treat it as if it were a roll of bologna to be bartered a slice at a time?" He would have said the same, with his unwavering gimlet glare, 50 years later. . . To read more, please scroll down at www.medicaltuesday.net/org.asp.
The truth was that American conservatism owed much to Mr Helms. He demonstrated, in 12 years of peak-time broadcasts for the Tobacco Radio Network and WRAL-TV, the power of talk radio to move minds, well before Rush Limbaugh caught on to it. He developed, in his North Carolina Congressional Club and later through Richard Viguerie (a direct-mail maestro), an independent donor base that raised millions for his campaigns and became a template for the Christian right. The efforts of the NCCC in 1976 delivered North Carolina to Ronald Reagan at a point where his primary campaign was collapsing, and stiffened his spine for subsequent runs for office. Mr Helms, therefore, helped to give America its greatest conservative president. He also prefigured the Republican renaissance in the South and across the country, changing parties in 1970 and luring working-class Democrats in overalls and pickup trucks to vote for him, the first Republican senator from North Carolina for more than a hundred years. . .
To read about the other side of Jesse and the entire obit, please go to www.economist.com/obituary/displaystory.cfm?story_id=11701805.
On This Date in History - August 26
On this date in 1920, the Nineteenth Amendment to the Constitution, Women's Suffrage, was ratified. It didn't end discrimination against women, but it put into their hands a weapon they had not had before in the United States. And today as John McCain chose Sarah Palin as the Vice Presidential Candidate, we may see a woman in the second highest office in the land in a matter of months. And, who knows, Governor Palin could be the first woman president crashing through the glass ceiling before the hundredth anniversary of this amendment. Can we hope by 2016?
On this date in 1873, Lee De Forest, a great American Inventor, was born. He was one of a relatively small group of brilliant men who took Marconi's invention of the radio and developed it into the great broadcasting instrument of today, transmitting sight and sound, talking pictures, through the air to your home. He lived almost 88 years in Council Bluffs, Iowa.
On this date 55 BC, Roman forces under Julius Caesar invaded Britain, the original British Invasion. When Julius Caesar became the ruler of Britain in 55 BC, his engineers shaped the landscape. Amazingly, much of the Romans' work still remains to this day. The roads, canals, and aqueducts that crisscross the country, connecting cities like London, Bath, and Cambridge, were all founded by the Romans.
After Leonard and Thelma Spinrad