WELCOME TO THE MEDICAL TUESDAY NETWORK
Physicians, Business, Professional and Information Technology Communities
Networking to Restore Accountability in HealthCare & Medical Practice
Tuesday, February 11, 2003
For the Advancement of Science
The Association of American Physicians and Surgeons (AAPS)
met in San Antonio on February 1, 2003, to discuss regulatory intrusion of
medicine practices which destroys patient privacy and lowers the level of
patient care. After finding a seat at the 8 AM meeting, I booted up my laptop,
connected my Nextel and downloaded my email. The first message was a news alert
timed 7:01 AM from WSJ concerning the Columbia disaster. Two of our physician
colleagues along with other pioneers gave their lives to the cause of scientific
achievement and advancement. Our sincere sympathy to the families of our heroes.
Remember the Alamo
We visited the Alamo where 183 heroes (according to
historian Walter Lord, author of A Time To Stand–The Epic of The Alamo)
who defended Fort Alamo gave their lives on March 6, 1836, the thirteenth day of
battle. The women and children huddled in the chapel were spared. Forty-six days
later, April 21, 1836, Texas came roaring back. Chanting “Remember the
Alamo,” they won their independence in an 18 minute battle. The Republic
of Texas was established and a decade later became the twenty-eighth state in
the USA.
Altering the Course of History
Meanwhile, at the AAPS meeting, speaker after speaker
testified to the intrusion, under the ruse of protecting confidentiality, of
medical practice by government regulators, insurance carriers (which have
become health maintenance organizations) and hospital sham peer reviewers. As a
result, our patient records have been made available to many organizations, some
of which are only peripherally involved in the health care process and do not
need confidential patient information. The federal government, in their efforts
to micro-manage Medicare, has criminalized medical coding. Hence, our legal
counsel outlined the status of physicians who have been or are being sent to
prison for minor variations in their practice. For example, if one item of the
examination wasn’t fully recorded, the evaluation and management code changes;
this makes medical-legal criminals out of our profession. These unsung heroes
have given their professional lives. Let’s hope that Congress and Medicare and
the Courts will soon understand the problem and restore our freedom to help our
patients.
MedicalTuesday Will Continue to Bring You Messages
That Affect Your Practice
If you have received this message as a forward, please
click on DelMeyer@MedicalTuesday.net
and request your personal free subscription. Be sure to include your name,
business or profession, and city/country with your email address. Please forward
this message to any person you feel is or should be interested in providing
patients with confidential, high quality personalized health care without the
intrusion of the government. Government involvement will always compromise
medical care, confidentiality and privacy.
British National Health Service (NHS) On the Brink
of Implosion (From our UK Connection)
The Financial Times reported last week that,
in a pamphlet to be published by the Centre for Policy Studies (www.cps.org.uk),
that Dr Maurice Slevin, a leading cancer consultant at Barts and the London NHS
Trust for the past 20 years, says “I still work in the NHS as a cancer
physician. I have seen at first hand the steady decay of a great public
institution.... The NHS is imploding.” His scathing report is backed by 15
fellow specialists. “Waste and mismanagement are rife,” and there is
“little evidence” that the new investment of £40 billion of public spending
over five years will make much difference. The pamphlet, Resuscitating the
NHS: A Consultant’s View, concludes that the extra funds will produce
results only if the way the money is spent is changed. He urges a dramatic
reduction in the number of managers and administrators in the NHS and proposes a
voucher system to enable patients to shop around for treatment in the public or
private sector. He points out that the NHS has nearly as many health service
managers, administrators and support staff as they have qualified nurses. A
private hospital in London employs 240 nurses and has 43 management,
administrative, and support staff–a ratio of one to six instead of one to one.
The chief executive of the NHS retorted that over the last year the waiting list
has decreased by 5 percent.
Why Would Americans Want a System of Health Care
Where Years of Waiting Can Be Reduced by Only 5 Percent Instead of Eliminated?
Why are there proponents of a single payer system in our
country who maintain that we want this British or Canadian system? I have
personally never encountered significant waiting time for diagnostic testing,
surgery, consultation, or hospitalization, for either a wealthy patient or one
on welfare. Why would anyone want to exchange a system that delivers HealthCare
for one that puts you on hold? Single payer proponents are interested in neither
patients nor their HealthCare. They are only interested in gaining power and
control, even if it means destroying freedom and hurting sick people.
Government Lack of Protecting Freedom Is a Twentieth
Century Phenomenon and Applies to All Government Functions or Programs
When California passed Proposition 13 to reduce taxes and
make schools and government leaner and more efficient, they mimicked the
British. They actually fired teachers and hired more administrators–just the
reverse of what the voting taxpayers wanted. The government was neither
interested in our children nor their education–only in money and power, and in
teaching the voters a lesson even if it meant hurting children and making them
more illiterate.
National HealthCare Systems in the English-speaking
World (No 11)
In his recent update of the “Twenty Myths about National
Health Insurance,” John C Goodman, PhD, president of the National Center for
Policy Analysis (www.ncpa.org), states
that ordinary citizens lack an understanding of the defects of national health
insurance and all too often have an idealized view of socialized medicine. For
that reason, Goodman and his associates have chosen to present their information
regarding commonly held myths in the form of rebuttal. See previous issues or
the archives at www.MedicalTuesday.net
for the summary of the first ten myths or go to www.ncpa.org
for the original 21 chapters of the book.
Myth Eleven: Under Single-payer Health Systems, Health Care Dollars Would Be Allocated So That They Have the Greatest Impact on Health.
Of all the characteristics of foreign health care systems, the one that describes how limited resources are allocated among competing needs strike American observers as the most bizarre. Foreign governments do not merely deny lifesaving medical technology to patients under national insurance schemes. They also take millions of dollars that could be used to save lives and cure diseases and use it to provide services to people who are not seriously ill. Often, these services have little if anything to do with health care.
Spending Priorities in Britain
Goodman, et al, point out that throughout the British
National Health Service (NHS), there is a tendency to divert funds from
expensive care for the small number who are seriously ill toward the large
number who seek relatively inexpensive services for minor ills. Take the British
ambulance service, for example:
• English “patients” take between 18 and 19 million
ambulance rides each year–about one ride for every three people in England.
• Almost 80 percent of these rides are for non-emergency
purposes (such as taking an outpatient to a hospital or an elderly person to a
local pharmacy) and amounts to what might be described as little more than free
taxi service.
While as many as 25,000 people die each year from lack of
the most advanced treatments for cancer, the NHS provides an array of comforts
for the many chronically ill people who have less serious health problems. For
example:
• The NHS provides nonmedical services to about 1.5
million people a year
• These include daycare services to more than 260,000,
homecare or home help services to 578,000, home alterations for 375,000, and
occupational therapy for 300,000.
While more than one million people wait to be admitted to
NHS hospitals, the NHS wastes millions on time lost by general practitioners and
outpatient departments because patients don’t show up for their appointments
and don’t cancel:
• An estimated 10 million GP appointments totaling more
than 2.5 million hours are missed each year.
• The Doctor Patient Partnership, a British health
education group, has calculated that this represents the work done by an
additional 1,692 doctors.
• Options to charge patients for missed appointments
creating money to treat thousands of additional cancer patients each year are
not seriously considered.
Spending Priorities in Canada, Australia, and New
Zealand
Although not as pronounced, similar trends can be observed
in Canada, Australia and New Zealand. Here the government has expanded the
services of general practitioners while tightly controlling access to modern
medical technology. All these countries also encourage the provision of routine
services for the many mostly healthy people at the expense of specialized care
for the few seriously ill. For example:
• In the US, only 11 percent of all physicians are
engaged in general or family practice
• In Canada, just over half of all physicians are
general practitioners
• In Australia, approximately two in three physicians
are general practitioners
• In New Zealand, nearly half of all physicians are
general practitioners
In general, Canadians have little trouble seeing a GP, but
often wait as long as 28 weeks to see a specialist. While the US has seen a
major expansion of outpatient surgery, Canada has actively discouraged this
trend–presumably to control spending. CT scanners are generally restricted to
hospitals.
Medical Gluttony (or Unnecessary Medical Care)
Last week I saw a 40-year-old patient, a graduate
engineer, who has a mild degree of obstructive sleep apnea. He is obese but has
no underlying lung disease. He does not qualify, according to guidelines, for a
nocturnal Continuous Positive Airway Pressure (CPAP) breathing device. I noted
that he is not working and is on Medicaid, the US health and welfare program for
the indigent. Since he is able to work, I asked why he wasn’t. He stated he
chose not to work so that he could develop an engineering program on his
computer and go into business sometime in the future. If he took a job, he
wouldn’t have the time to do this. Since he has no income, the state must give
him both his welfare check and his Medicaid health benefits.
The MedicalTuesday Recommends the Following in
Restoring Accountability in Government and Society:
• The National Center for Policy Analysis, John C
Goodman, PhD, President, issues a weekly Health Policy Digest which is a
health summary of the full NCPA daily report. You may log on to NCPA (www.ncpa.org)
and register to received one or more of these reports.
• The Mercatus Center at George Mason University
is a strong advocate for accountability in government. Nobel Laureate Vernon
L Smith, PhD, has recently joined its Economics faculty. This week we heard
from Dr Paul Edwards, President, introducing J C Watts, as a Distinguished
Visiting Scholar after eight years in Congress. He is a former star
quarterback for the University of Oklahoma, a football dynasty. He joins Lawrence
Kudlow, of Kudlow & Cramer on CNBC, a Distinguished Scholar, and
Maurice McTigue, QSO, also a Distinguished Visiting Scholar, who was
instrumental in revolutionizing the way government did business in New Zealand
from 1984 to 1994. By looking at how effective every single government program
was in achieving the required results, New Zealand went from having the most
socialized and highly-regulated economy of any western-style democracy, to
having the freest, reducing the cost of government from nearly half the GDP to
slightly over a quarter of the GDP. He is optimistic about making the same
progress in the US. The Mercatus Center recently published a pamphlet, “A
Day in the Life of a Regulated American Family,” that documents the costs
of $8,000 the average American family pays per year to meet government
regulations. (So you thought July 4, Independence Day was the day you start
working for yourself having paid your tax obligations? Well try Labor Day, The
First Monday in September, as the day we begin laboring for ourselves having
completed our financial servitude to the government.) Please log on at www.mercatus.org
to read the government accountability reports and information on Dr Smith’s
economic experiments which help us understand health care issues. You can also
register to receive updates.
• Martin Masse, director of the Montreal
Economic Institute, is the publisher of the webzine: Le Québécois Libre.
Please log on at www.quebecoislibre.org/apmasse.htm
to review his free market-based articles, some will allow you to brush up on
your French You may register to receive copies of his webzine on a regular
basis.
• 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
with considerably less bias. Please log on at www.mises.org
to obtain the foundation’s daily reports. You may also log onto Lew’s
premier free market site at www.lewrockwell.com
to read some of his lectures to medical groups such as how state medicine
subsidizes illness.
• Hillsdale College, the premier institution for
producing graduates that understand Free Market accountability, which receives
no federal subsidies placing them at a monetary disadvantage to all other
colleges and universities, recognizing that the price of freedom is never cheap.
You may log on to (www.hillsdale.edu)
to register and receive Imprimis, the national speech digest, that
reaches over one million readers each month. Last month Imprimis
featured Charles Krauthammer, MD, a psychiatrist at Mass General prior to
becoming a journalist in Washington, DC, who also serves on President Bush’s
Council on Bioethics.
MedicalTuesday Supports These Efforts in Restoring
the Doctor & Patient Relationship:
• PATMOS EmergiClinic - www.emergiclinic.com
where Robert Berry, MD, an emergency physician and internist, provides
prompt care for many of the injuries and illnesses treated in Emergency Rooms at
a fraction of their cost as well as an internal medicine practice;
• Dennis Gabos, MD, President of the Society for the
Education of Physicians and Patients (SEPP) www.sepp.net
for making efforts in Protecting, Preserving, and Promoting, the Rights,
Freedoms, and Responsibilities of Patients and Health Care Professionals, with a
special page for our colleagues in nursing;
• Drs David MacDonald and Vern Cherewatenko for
their success in restoring private based medical practice which has grown
internationally through their SimpleCare model network, www.simplecare.com;
Dr MacDonald presented their plan in San Antonio on Saturday, February 1, 2003.
Dr Dave has also partnered with Ron Kirkpatrick to start the Liberty Health
Group (www.LibertyHealthGroup.com)
to assist physicians by helping them to control their medical benefit costs for
their staff and patients. He says, “More importantly, we educate and empower
their employees and patients regarding the benefits of payment at the time of
service.” He is available to speak to your group on a consultative basis. You
may contact him at DrDavid@LibertyHealthGroup.com.
• The Association of American Physicians &
Surgeons, (www.AAPSonline.org) The
Voice for Private Physicians Since 1943, representing physicians in their
struggles against bureaucratic medicine and loss of medical privacy. The AAPS
midyear one day conference, Thrive–Not Just Survive II, last Saturday,
February 1, 2003, in San Antonio was a repeat sold out success. The voluminous
resource book exceeded that of most three-five day conferences. Topics included
Opting out of Medicare; How to set up a cash practice with SimpleCare; Billing,
Coding, Compliance & Pitfalls; Save on HIPAA Compliance; Prepare for and
avoid fraud prosecutions and audits and how make your practice judgment proof;
Surviving sham peer review and licensing hoops. Thanks to Kathryn Serkes,
our liaison in Washington, DC, for compiling these resources.
Stay Tuned to the MedicalTuesday.network and Have
Your Friends Do the Same
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Del Meyer
Del Meyer, MD, CEO & Founder
DelMeyer@MedicalTuesday.net
www.MedicalTuesday.net