Physicians, Business, Professional and Information Technology Communities

 Networking to Restore Accountability in HealthCare & Medical Practice

 Tuesday, February 8, 2005

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MedicalTuesday refers to the meetings that were traditionally held on Tuesday evenings where physicians met with their colleagues and the interested business and professional communities to discuss the medical and health care issues of the day. As major changes occurred in health care delivery during the past several decades, the need for physicians to meet with the business and professional communities became even more important. However, proponents of third-party or single-payer health care felt these meetings were counterproductive and they essentially disappeared. Rationing, a common component of government medicine throughout the world, was introduced into the United States with Health Maintenance Organizations (HMOs), under the illusion that this was free enterprise. Instead, the consumers (patients) lost all control of their personal and private health-care decision making, the reverse of what was needed to control health care costs and improve quality of care.

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In This Issue:

1.                  How Can Loaning Money to Beggars Improve a Nation's Health?

2.                  Shopping Hospitals' Price Lists

3.                  Advances in Clinical Medicine - A Higher Level of Confusion?

4.                  Government Medicine Is Not Confused At All - This Year's Priority is Anchovies

5.                  Medical Gluttony - Is Kaiser the Antidote to Excessive Health Care Costs?

6.                  Medical Myths: No 8: Insurance Is Discounted Prepaid Mandated Medical Care

7.                  Anecdotes from the Consultation Room - A Love Story

8.                  The MedicalTuesday Recommendations for Restoring Accountability in HealthCare, Government and Society

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1.                  How Can Loaning Money to Beggars Improve a Nation's Health?

The World Health Care Congress opened in Washington, DC, on Sunday January 30, 2005, with a Keynote address by Dr Muhammad Yunus, a former Economics professor from Bangladesh. He changed the plight of poor people in his country, including their health care, by lending money to beggars. He saw the excitement in their eyes and tried to get the banks to lend the money. He offered to serve as guarantor, but the banks were still not interested. So he started his own bank in 1983. He gave each beggar a blanket. Dr Yunus feels that poverty is not just the lack of food or money; success comes from giving the poor a vision for their lives. He found that the Grameen Bank logo was a desired status symbol. So he devised a system of credits whereby the bank logo, of which they are proud, could be earned. You join Grameen Bank by digging a hole for a latrine. He got a lot of resistance from this, since people of Bangladesh just "go" any where. But he persuaded them it didn't cost anything and it would help control disease. He would then lend money to poor people who were members of Grameen without any legal instruments. It was called micro-credit since the amount loaned was measured in pennies. Ninety-five percent paid back the loan.

Literacy is very rare in Bangladesh. He told all the Grameen members that they should send their children to school. Literacy improved, probably secondary to the efforts of the women who cared for the children. Children now go to school, and some go on to college and even medical school despite the low literacy rate of most of the country.

Dr Yunus found that only 50 percent of the Grameen members had moved out of poverty. His research found that one sick person in a household kept many in poverty. Night blindness was a bad problem. UNICEF was willing to give them Vitamin A pills to combat the disease. Dr Yunus discussed this with the villages, and they decided that although this year UNICEF has money; next year they might not. Then they would have a problem because people would become dependent on the tablets. Then they might look for other "tablets." They decided not to accept the UNICEF offer for free Vitamin A pills, and they would cure and prevent night blindness by having the mothers grow vegetables. It became a profitable industry and they formed a company to import seeds. The disease was eradicated by mothers insisting that every member of her family eat fresh vegetables; now the peasants don't even know what night blindness is.

He found that cataracts caused many adults to become blind. He located a doctor that could remove cataracts in a clinic office. He was able to provide this service, including the implanted lens, for $28. The people were amazed that they could see. He decided that it would be a good idea to have health insurance for such large items as cataracts and other more expensive care and began selling health insurance to members of the Grameen Bank for $3.00 a year. They rebelled, but he finally convinced them of the benefit should they have expensive health problems. He then extended health insurance to nonmembers for $6.00 a year.

After this marvelous address illustrating how people pulled themselves out of poverty and disease while refusing government and UNICEF handouts (the epitome of patient-directed health care sweeping this country), the first comment at this conference opening was: "But we can't get Americans . . . ." It doesn't matter whether the rest of that statement and the ensuing diatribe was about our people or our doctors or our health care. This person did not understand any part of Dr Yunus' speech or the important message Dr Yunus brought to America.

Dr Yunus said that we seem to have an uninsured problem over here. He suggested that they charter some planes and they will take care of all of our uninsured. Since we seem to think we have 45 million, that would be too many to fly to Bangladesh. So they'll establish a Grameen Bank Clinic offshore, on one of the islands in the Caribbean, and they'll do our health care. But they may have to charge us double, or $56 per cataract surgery.

To read a transcript of the speech, please go to http://healthplanusa.net/GrameenBank.htm. For more information and a video of this presentation, visit: http://www.worldcongress.com.

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2.                  Shopping Hospitals' Price Lists

Victoria Colliver, a staff writer for the San Francisco Chronicle, reports on the wide discrepancies in charges at the area hospitals. She found that abdominal CT scans cost nearly $4,800 at Berkeley's Alta Bates Medical Center, but less than $1,000 at St Luke's Hospital in San Francisco. A complete blood count is priced at $36 at Alameda County Medical Center in Oakland and $140 at Kaiser Permanente in San Francisco. An electrocardiogram costs $145 at Kaiser Permanente and $502 at San Ramon Regional Medical Center. (What is omitted is that an electrocardiogram may cost only $80 in a physician's office.) Some hospitals charges $12 for a tablet of ibuprofen, others do not charge anything for something that can be self administered, while others charge $7 for an aspirin. (I had one patient who was incensed when he saw the hospital charges for simple medications like digoxin and phenobarbital that exceeded the monthly costs of a prescription each day he was in the hospital. So he brought in his own supply the next admission. When he checked the bill his insurance paid that time, he still found a $5 charge per pill which he was told was the cost of the nurse supervising the administration.)

When Colliver interviewed the hospitals, a spokeswoman said, "We could charge a million dollars, but our negotiated rate . . . could be $500. No matter what our charge is, that's not . . . what they're (patients) going to pay, unless they have no insurance."

And isn't that the reason the uninsured have a problem? Being charged a "million" when those with a contract pay $500? The uninsured are the very ones that should be able to search for the most competitive facility in the open Medical MarketPlace, instead of being held hostage by those who have excluded competition. The competitive MarketPlace would facilitate finding providers even below the contract rate. Just like the new cash practices are sometimes only half the going rate because they've eliminated the business office, insurance billing and prescription hassles trying to figure out with the pharmacists what brand is covered. So far we have not found that any of these doctors have had a malpractice suit. As that aspect becomes actuarially documented, it may also solve the malpractice crises. All without any government intervention or mandates which is at least 20 percent of health care costs.

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3.                  Advances in Clinical Medicine - A Higher Level of Confusion?

The Various Medical Research Organizations met in Carmel-by-the-Sea, California, on February 2-5, 2005. The California Thoracic Society (CTS), of which I'm a member, holds their annual conference at the same time. The focus this year was on "Controversies in Pulmonary and Critical Care Medicine." After hearing the latest controversies in asthma, the importance of the work of breathing, as well as the latest modes in mechanical ventilation, the last speaker had a final slide:

In some ways we are as confused as ever, but we believe we are confused at a higher level,

and about more important things. Alan Feinstein, 1977

Doctors are working very hard to keep up with the latest advances in medicine. Present at this conference were pulmonologists 80 years of age and retired. At Medical Grand Rounds, I see attendants bring wheelchair-bound physicians who have had a stroke to attend the conference so they can keep up with the latest advances in medicine, even though they no longer are in practice. What other profession has this tremendous thirst for learning for the pure joy of keeping current with the latest? What other profession is being abused by government and HMO bureaucrats to reduce this huge fund of knowledge to a few medical guidelines that are not patient friendly? What other profession is being taken over by the "medical illiterates," as my Russian colleagues refer to government bureaucrats? We must unleash this huge reservoir of medical knowledge into the practice of medicine for the benefit of patients, instead of giving this profession a black eye under the ruse of improving quality when the problem is of the bureaucrat's making. Quality was our middle name until government and our own medical bureaucrats tried to control the profession by making every doctor feel inferior to the bureaucrat. Medical guidelines and socialized medicine reimburses the worst and the best doctors at the same rate, causing medicine to sink to that given by the worst. Let's unfetter this vast medical knowledge to the betterment of our patients' health.

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4.                  Government Medicine Is Not Confused At All - This Year's Priority is Anchovies

Some years ago, as a visiting Consultant to San Juan Hospital in Lima, Peru, I had my first introduction to government medicine "in the raw." San Juan Hospital was the largest hospital in the country and had university affiliation. I received a tour of the hospital by the chief of thoracic surgery. There was no pulmonologist, the medical counterpoint to surgery of the chest. The surgeon presented to me a patient who was a smoker, had bronchitis, and coughed up blood. The chest x-ray revealed a lesion in the patients lung that looked suspicious for lung cancer. (The surgeon was elated to have gotten a chest x-ray since only two of the seven x-ray machines were working that day. He felt fortunate if there was one of the seven rooms operational.) The surgeon was unable to do a bronchoscopy to obtain a biopsy because there were no bronchoscopes. He hastened to add that he had requested one for each of the previous seven years, but it was denied. Denied by whom? By the government bureaucrats who had other priorities for tax payers money. How was he going to make the diagnosis? He said that he would have to surgically open the chest to obtain a biopsy. At that time, all eight hospitals in Sacramento had bronchoscopes.

He took me on a tour of the Intensive Care Unit and I noted that none of the cardiac monitors were working. He said that they had requested monitors made by Hewlett-Packard, but the ones they acquired came from Eastern Europe. Why? The minister of trade sold anchovies to Eastern Europe and the best thing they could buy from Eastern Europe was cardiac monitoring equipment. But they didn't work and thus no hearts were monitored in the ICU. The Thoracic Surgeon told me that was irrelevant to medical bureaucrats. The hospital had requested medical equipment and the bureaucrats were elated to get this item behind them.

Government is not the solution to our problems, government is the problem.

- Ronald Reagan

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5.                  Medical Gluttony - Is Kaiser the Antidote to Excessive Health Care Costs?

Recently, a lot of former Kaiser patients have come into our practice. Kaiser is a staff model HMO. According to Robert Pearl, MD, Executive Director and CEO of Kaiser-Permanente, Northern California, in an address to the La Quinta Leadership Conference, Kaiser does a good job of both health care and controlling costs. They seem to have the ultimate procedures in place to remind patients when their prostate exams, their mammograms, their paps smears and other preventive measures are due.

However, the best laid plans of mice and men often go astray. Were seeing patients with hypercholesterolemia with no diet plan, medication with no monitoring of the levels. Were seeing patients who have not had a mammogram or paps smear or prostate exam in a number of years.

Not doing all these tests is obviously a health care cost reduction, but their failure to be utilized by patients points out that bureaucrats who attempt to peg patients into a slot, have no clue as to how people respond to the best thought out programs. Government and HMO bureaucrats should quit interfering and intervening with patients' welfare and health care. Kaiser and other private programs should be allowed to advance as reality dictates. Progress will come faster.

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6.                  Medical Myths: No 8: Insurance Is Discounted Prepaid Mandated Medical Care

Madeleine Pelner Cosman, PhD, JD, Esq, in her upcoming book, Who Owns Your Body, gives Nine Myths of American Medicine. Today we review Myth 8. For the previous seven, see http://www.healthplanusa.net/MC_WhoOwnsYourBodyIntro.htm.

This chapter details the misconceptions about insurance and the false crutches that "health insurance" creates in the American medical system.

Insurance, like automobile, fire, and theft insurance, even life insurance, is a risk contract that protects our assets from events we hope will not happen. But they might happen. Prudence requires our providing for our potential losses of assets if disasters occur. Insurance companies make their profit by their actuaries predicting that disasters will not occur for large numbers of premium payers. Insurance pays for disasters that small numbers of insured people suffer.

The ABCs of true insurance protect people against astronomical costs of unusual or bizarre events that people consider catastrophic. Insured occurrences are expensive, unusual, and undesired. Our car insurance insures against thefts and crashes, but not against routine maintenance of changing oil and filling the tank with gasoline. Our household insurance insures against fires, floods, and burglary, but not against changing light bulbs and filling the refrigerator with food.

Payment for routine medical maintenance, for mandated medical services, and for known required services is not insurance. Payment is payment. The only true medical insurance is Catastrophic Medical insurance coverage for major expensive, unusual, undesired diseases or injuries. Catastrophic policies have very high "deductibles," such as $2000, because the policies are only for catastrophes, not routine body maintenance. About 80% of Americans spend less than $2000 annually for healthcare. They pay far more for pseudo insurance premiums than the value of the medical care they get.

Insurance related myths that must be dispelled are:

* Medicare is health insurance

* Community rated insurance is fair and generous

* Insurance capitation payments per patient head honor patients individuality

Current "medical insurance" truly is prepaid discounted medical fees. The physician is paid a discounted amount of customary fees negotiated in advance with the "insurance company" or the doctor is paid monthly a small amount of money per head of citizen by capitation, no matter how much or how little medical care the body attached to the head requires. Whether the patient arrives daily for care and expensive medication or never comes for care at all, the doctor is paid no more and no less. Medical payment remains inflexible whether the patients treatment is comprehensive for pulmonary edema or cursory with one Ace bandage for ankle sprain. The physician risks profit for time and talent. This exploits intelligent, productive physicians, and dissociates patients from real costs of their care. Worse, pseudo insurance falsely promises patients asset protection that it cannot and will not fulfill.

Catastrophic medical insurance, however, is the foundation for ethical, excellent, consumer driven medicine that protects people against terrible, expensive, and devastating diseases and injuries while nevertheless giving them control, choice, and responsibility for everything else. Medical Savings Accounts are among a dozen such programs.

(TRUTH 8: Insurance is Asset Protection for Events We Hope Wont Happen)

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7.                  Anecdotes from the Consultation Room - A Love Story

Last week, an 81-year-old man came in for his routine annual examination, chest x-ray, and pulmonary function tests. I watched him struggle the past year as his wife was becoming very disabled and he found it difficult to care for her every bodily need. After he placed her in a skilled nursing facility, he became very depressed about whether he had done the right thing. Some antidepressants did lift him, perhaps to Cloud Three, but never to Cloud Nine. He continues to visit her every day for five or six hours and brings her home every other weekend to be close to her and sleep with her. During the course of our interview and exam, he mentioned that when he visits, they hold and caress each other for the major part of the time. That week, as they were caressing, his wife said, When you hold me like that, I have this wonderful feeling in my pelvis. Do you suppose we could make love again? He stated that she was 82 years old and that he had become impotent more than twelve years ago. They didn't have potency pills at that time. He had seen the commercials for Levitra. He asked if it would OK for him to try them. After checking his chart, I found no contraindications for Levitra and prescribed him five with a dozen refills for the year.

As is frequently the case, there are no medical guidelines in these circumstances. Physicians are perfectly capable of acting on their own fund of knowledge without any government, bureaucratic or insurance protocols or restrictions. Since MedicalTuesday has very few government bureaucratic readers, I feel it should be safe to mention this beautiful story. Otherwise, I'm sure they would come up with a few volumes or a thousand pages of guidelines for old seniors that don't follow conventional bureaucratic wisdom and even ruin the final stages of a love story.

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8.                  MedicalTuesday Recommends the Following Organizations for Their Efforts in Restoring Accountability in HealthCare, Government and Society:


                     The National Center for Policy Analysis, John C Goodman, PhD, President, who, along with Devon Herrick, wrote Twenty Myths about Single-Payer Health Insurance, which we reviewed in this newsletter the first twenty months, issues a weekly Health Policy Digest, a health summary of the full NCPA daily report. You may log onto http://www.ncpa.org and register to receive one or more of these reports. Please read a review of their new book, Lives at Risk, http://www.healthcarecom.net/JGLivesAtRisk.htm, the definitive work on Single-Payer National Health Insurance Around the World. It shows that the United States has the best health care system in the world. The book can be ordered at http://www.ncpa.org/pub/lives_risk.htm. Dr Goodman had a new posting last month on Ten Easy Health Reforms, found at http://www.ncpa.org/pub/ba/ba497/. Last week, Bruce Bartlett at NCPA proposed Meaningful Benefit Cuts in Social Security. Although this is considered by some to be political suicide, he feels that the public is now sufficiently aware of the catastrophe awaiting us that meaningful cuts in growth can be openly discussed. To read the entire article, go to http://www.ncpa.org/edo/bb/2005/20050126bb.htmhttp://www.ncpa.org/edo/bb/2005/20050126bb.htm.

                     The Mercatus Center at George Mason University (http://www.mercatus.org) is a strong advocate for accountability in government. Maurice McTigue, QSO, a Distinguished Visiting Scholar, a former member of Parliament and cabinet minister in New Zealand, is now director of the Mercatus Centers Government Accountability Project. Mercatus has launched the Global Prosperity Initiative presenting a new Mercatus Policy Series. Overall, the Series aims to bridge the gap between advances in scholarship and the practical requirements of policy. The Series includes three types of studies: Policy Primers present an accessible explanation of fundamental economic ideas necessary to the practice of sound policy. To review the overall objectives, please go to http://www.mercatus.org/globalprosperity/subcategory.php/213.html.

                     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 onto their website at http://www.galen.org. Turner reports that the brouhaha over Medicare and prescription drugs escalated this week with an irresponsible story in The Washington Post on Wednesday claiming that the new Medicare prescription drug benefit will cost more than $1.2 trillion in the coming decade, triple the original cost estimates. To review this messy debate, go to http://www.galen.org/pdrugs.asp?docID=768.

                     Greg Scandlen, Director of the Center for Consumer-Driven Health Care at the Galen Institute, has a Weekly Health News Letter: Consumer Choice Matters. You may subscribe to this informative and well-outlined newsletter that is distributed every Tuesday by logging onto http://www.galen.org and clicking on Consumer Choice Matters. Archives are now located at http://www.galen.org/ccm_archives.asp. This is the flagship publication of Galen's new Center for Consumer-Driven Health Care and is written by its director, Greg Scandlen, an expert in Health Savings Accounts (HSAs). To review his last newsletter on Commonwealth Prescribes Disasters, go to http://www.galen.org/ownins.asp?docID=767.

                     The Heartland Institute, http://www.heartland.org, publishes the Health Care News, Conrad Meier, Managing Editor Emeritus. Sean Parnell writes a letter response to Hospitals & The Free Market in the Washington Times at http://www.heartland.org/Article.cfm?artId=16425. Thomas Sowell previously wrote in Health Care News about "The Problem With Price Controls." Prices are what pay for costs--and if they do not pay enough to cover the costs, then the supply is going to decline in quantity or quality, or both. In the case of medical care, the supply is a matter of life and death. For political purposes, what "bringing down the cost of medical care" means is some quick fix that will win votes at the next election, regardless of what the repercussions are thereafter. There are already 125,000 pages of Medicare regulations. "Universal health care" can only mean more. To see graphically how price controls and bureaucratic medicine cause patients to die, see Sowell's entire editorial at http://www.heartland.org/Article.cfm?artId=15031.

                     The Foundation for Economic Education, http://www.fee.org, has been publishing The Freeman - Ideas On Liberty, Freedoms Magazine, for over 50 years, has 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, John Chamberlain 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 another timeless FEE classic, The Progressive Income Tax by John Chamberlain, on how the politico, with the peoples total earnings at his potential legal disposal, will inevitably move toward taking it all. In return for votes, the politico will, of course, hand most of it back as welfare--or as legalized patronage. But even in handing it back there will be strings attached to it: following Galbraith, the politico will tell the people how the money is to be spent. To read the entire classic, go to http://www.fee.org/vnews.php?nid=951.

                     The Council for Affordable Health Insurance, http://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 America's health-care challenges by enabling a robust and competitive health insurance market that will achieve and maintain access to affordable, high-quality health care for all Americans. The belief that more medical care means better medical care is deeply entrenched . . . Our study suggests that perhaps a third of medical spending is now devoted to services that don't appear to improve health or the quality of care--and may even make things worse. To see their latest Updated State Mandate Publication, and what it does to health insurance cost, go to http://www.cahi.org/cahi_contents/newsroom/article.asp?id=515.

                     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 at http://www.factcheckers.org/. This week, read the Daily Medical Follies: Woeful Tales from the World of Nationalized Health Care such as a year and a half after the Liberal government promised to reduce hospital waiting lists, 114,484 Quebecers are still awaiting surgery; surgery backlog tops 5,500 at kids' hospitals; and other frightful stories at http://www.factcheckers.org/showArticleSection.php?section=follies.

                     The Independence Institute, http://www.i2i.org, is a free-market think-tank in Golden, Colorado, that has a Health Care Policy Center, with Linda Gorman as Director. Be sure to sign up for the monthly Health Care Policy Center Newsletter at http://www.i2i.org/healthcarecenter.aspx. Read her latest newsletter Is Health Insurance Cheaper than You Think? at http://www.i2i.org/article.aspx?ID=1100.

                     The National Association of Health Underwriters, http://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. What is a High Risk Medical Pool? To read The Consumer Guide To High Risk Pools go to http://www.nahu.org/consumer/HRPGuide.htm.

                     Martin Masse, Director of Publications at the Montreal Economic Institute, is the publisher of the webzine: Le Qubcois 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. There are several articles in the contents on this page. You might scan down to Gennady Stolyarov II who gives us the reality of government intervention in his latest opinion on The Immorality of Government Tsunami Relief. Stolyarov asks, How is it, that government relief to flood victims would damage them, whereas private relief would assist them? Then again, how is it that government aid to the unemployed robs them of the stimulus to return to work and resume earning an income for themselves? How is it that government efforts to rehabilitate criminals, drug addicts, and alcoholics have corresponded with a statistical increase of all three groups over the past several decades? How is it that government efforts to "protect consumers," through regulatory agencies such as the FDA, have resulted in millions of consumer deaths from disease because of the time delays involved in forcing new drugs to undergo unnecessarily stringent tests before being released to the open market? How is it that government labor laws and minimum wage statutes damage the least skilled among workers by forbidding employers to hire them at rates that their skills warrant and are simultaneously profitable to companies? We find that, whenever government intervenes on behalf of a group it deems a victim of society, personal deficiency, private action, or nature, its intervention only serves to further incapacitate the victims. To delve into these insightful questions, you may want to read the entire OpEd article at http://www.quebecoislibre.org/05/050115_5.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 http://www.fraserinstitute.ca for an overview of the extensive research articles that are available. News release: Manitoba Tops the Fraser Institutes Generosity Index for the Fifth Straight Year, but Americans are twice as generous as Canadians (http://www.fraserinstitute.ca/shared/readmore.asp?sNav=nr&id=638). You may want to go directly to their health research section at http://www.fraserinstitute.ca/health/index.asp?snav=he. Among the numerous excellent articles on Canadian HealthCare, you may want to pay particular attention to last weeks editorial by their senior health policy analyst Nadeem Esmail on The Black Hole that is Canada's Medicare. If you're pressed for time, the first paragraph puts it all into perspective at http://www.fraserinstitute.ca/shared/readmore1.asp?sNav=ed&id=332.

                     The Heritage Foundation, http://www.heritage.org/, founded in 1973, is a research and educational institute whose mission is to formulate and promote public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values and a strong national defense. The Center for Health Policy Studies supports and does extensive research on health care policy that is readily available at their site. Be sure to read Stuart Butlers rather humorous article on the AARP (American Assn of Retired Persons) having a Senior Moment at http://www.heritage.org/press/dailybriefing/policyweblog.cfm?blogid=02D23E50_A0C9_D18A_0F7779F0BFAA9D8A. If you're still not convinced about the AARP, you might like to read my review of Dale Van Atta's book, TRUST BETRAYED - Inside the AARP, at http://healthcarecom.net/bkrev_TrustBetrayed.htm.

                     The Ludwig von Mises Institute, Lew Rockwell, President, is a rich source of free-market materials, probably the best daily course in economics we've seen. If you read these essays on a daily basis, it would probably be equivalent to taking Economics 11 and 51 in college and you'll become knowledgeable in a few years. Please log on at http://www.mises.org to obtain the foundations daily reports. Be sure to read Ninos Malek's essay, A Free Market in Workplace Regulations at http://www.mises.org/fullstory.aspx?Id=1735. You may also log onto Lew's premier free-market site at http://www.lewrockwell.com to read some of his lectures to medical groups. To learn how state medicine subsidizes illness, see http://www.lewrockwell.com/rockwell/sickness.html; or to find out why anyone would want to be an MD today, see http://www.lewrockwell.com/klassen/klassen46.html.

                        CATO. The Cato Institute (http://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 Washington, D.C. The Institute is named for Cato's Letters, a series of pamphlets that helped lay the philosophical foundation for the American Revolution. The Mission: The Cato Institute seeks to broaden the parameters of public policy debate to allow consideration of the traditional American principles of limited government, individual liberty, free markets and peace. Ed Crane reminds us that the framers of the Constitution designed to protect our liberty through a system of federalism and divided powers so that most of the governance would be at the state level where abuse of power would be limited by the citizens ability to choose among 13 (and now 50) different systems of state government. Thus, we could all seek our favorite moral turpitude and live in our comfort zone recognizing our differences and still be proud of our unity as Americans. Michael F. Cannon is the Cato Institute's Director of Health Policy Studies. Read his bio at http://www.cato.org/people/cannon.html. To read this weeks message by William Shipman on the 130 countries struggling with social security reform, No Half-way Measures, go to http://www.cato.org/pub_display.php?pub_id=3668.

                     The Ethan Allen Institute is one of some 41 similar but independent state organizations associated with the State Policy Network (SPN). The mission is to put into practice the fundamentals of a free society: individual liberty, private property, competitive free enterprise, limited and frugal government, strong local communities, personal responsibility, and expanded opportunity for human endeavor. Please see http://www.ethanallen.org/index2.html and click on links to see the other 41 free-market organizations throughout the U.S. and Canada, which will then direct you to even more free-market sites. This week, you may like to review why third-world policy makers state that they'd rather have their children starve than to eat genetically enhanced foods. Read about the biotech rejection tragedy among developing countries at http://www.truthabouttrade.org/article.asp?id=3346.

                     Hillsdale College, http://www.hillsdale.edu, the premier small liberal arts college in southern Michigan with about 1,200 students, was founded in 1844 with the mission of educating for liberty. It is proud of its principled refusal to accept any federal funds, even in the form of student grants and loans, and of its historic policy of nondiscrimination and equal opportunity. The price of freedom is never cheap. Congratulations to Hillsdale for its national rankings in the USNews College rankings. Last year, changes in the Carnegie classifications, along with Hillsdale's continuing rise to national prominence, prompted the Foundation to move the College from the regional to the national liberal arts college classification. Read President Arnn's comments at http://www.hillsdale.edu/arnn/usnews.asp. Also read his comments on Ronald Reagan, RIP, at http://www.hillsdale.edu/newimprimis/default.htm. Please log on and register to receive Imprimis, their national speech digest that reaches more than one million readers each month. This month, read The Honorable Zell Millers, United States Senator, comment on Vietnam, Iraq, and the 2004 Election at http://www.hillsdale.edu/newimprimis/2005/January/default.htm. The last ten years of Imprimis are archived at http://www.hillsdale.edu/imprimis/archives.htm.

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Del Meyer

Del Meyer, MD, CEO & Founder



6620 Coyle Ave, Suite 122, Carmichael, CA 95608

Words of Wisdom

P. J. O'Rourke: When buying and selling are controlled by legislation, the first thing to be bought and sold are legislatures.

Mark Twain, (1866): There is no distinctly native American criminal class save Congress.

Will Rogers: I don't make jokes. I just watch the government and report the facts.

Some Recent Postings

Dr Muhammad Yunus, Global Health Care at http://healthplanusa.net/GrameenBank.htm

David Gibson, MD, Fundamental Health Care Reform at http://healthplanusa.net/DGFundamentalHealthCareReform.htm

On This Date in History - February 8

Birth of a Nation had its world premiere in Los Angeles on this date in 1915. Today is an anniversary for motion pictures with this motion picture like no picture ever made before. Its director, D W Griffith, used camera and editing techniques that revolutionized the whole business of picture making. It dealt with a subject, the rise of the Ku Klux Klan in the South, that was controversial in an industry which had been spending its time trying to please everybody. It was priced higher and a lot longer than most motion pictures. And it surmounted all these obstacles--because it was made and marketed by people willing to take a chance on the power of their own imagination. They did what a lot of people told them could not be done.

On this date in 1828, Jules Verne, the king of science fiction in his time, was born. He practically invented the form. He wrote about ships that traveled in the depths of the sea, voyages to the moon and to the center of the earth and other fantasies. Today, it may be more accurate to say that fact has a way of catching up with fiction as his fiction turned out not to be quite so fantastic after all since at times it is very difficult to know what is fantasy and what is fact.



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