Physicians, Business, Professional and Information Technology Communities

 Networking to Restore Accountability in HealthCare & Medical Practice

 Tuesday, July 27, 2004

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, physicians were sidelined. Proponents of third-party or single-payer health care felt these meetings were counter productive 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.

We welcome you to the reestablishment of these MedicalTuesday interchanges now occurring on the world wide web. If this newsletter has been forwarded to you or you have not been on our email list, please go to www.MedicalTuesday.net and subscribe to continue to receive these free messages on alternate MedicalTuesdays. At this site you can also subscribe to the companion quarterly newsletter, HealthPlanUSA, designed to make HealthCare more affordable for all Americans. Please forward this message to your friends. This newsletter distribution is now so large, we’ve had to utilize Topica for distribution.  If you were referred in error or do not wish to receive these messages, we have made it easier for you to unsubscribe simply by clicking the MedicalTuesday Remove Link below - Do Not Use the Topica Unsubscribe. It will not reach us.

In This Issue:
1. Can Government Force People To Buy Insurance?
2. No Reverse Gear in Health Care Spending
3. Medical Safety - Avoidance of System Errors
4. This Week’s Review of Corporate Socialized Medicine - Why Everyone Hates HMOs
5. Medical Gluttony: May Not Be Un-Learnable
6. Medical Myths: But Doctor, The Test Made Me Feel Better.
7. Overheard in the Medical Staff Lounge - Medicare Bonuses?
8. The MedicalTuesday Recommendations for Restoring Accountability in Medical Practice, HealthCare and Government

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1. Can Government Force People To Buy Insurance?
The Council for Affordable Health Insurance points out in a recent publication (No 123) that some lawmakers have proposed a seemingly simple way to ensure that all Americans have health insurance: require them to buy it. These lawmakers often refer to state laws that require people to purchase auto insurance as a model for a new individual health insurance requirement. State laws requiring motorists to purchase coverage and sanctioning penalties for drivers who fail to comply have been ineffective at reducing the number of uninsured motorists. The Insurance Research Council (IRC) conducts the most reliable nationwide research on the number of uninsured motorists. In its latest study, using 1997 insurance data, the IRC estimates that 13 percent of drivers are uninsured — not much lower than the 15 percent of Americans who don’t have health insurance.

Proponents of mandating health insurance coverage further contend that the uninsured problem will be eliminated if the mandate is coupled with consequences, such as imposing tax penalties on those who do not purchase coverage. Yet states have long attached penalties and enforcement provisions to compulsory auto insurance laws, and millions of motorists continue to ignore the laws. Consequences for not having auto insurance include fines, jail time, license or registration revocation, confiscation of license plates and vehicle impounding. Nearly 86 percent of the states can impose fines, which can be as high as $5,000, for failure to purchase insurance. Jail time also is an ineffective deterrent. None of these penalties have significantly reduced the rate of uninsured drivers. The majority of states have maintained compulsory laws on their books for at least 20 years with negligible effects on the number of uninsured motorists.

Why Don’t Mandates Work? With laws and penalties on the books, why do so many people forgo auto insurance? Many don’t buy liability auto insurance for the same reason they don’t buy health insurance: they can’t afford it. To read the CAHI entire report, go to http://www.cahi.org/cahi_contents/resources/pdf/n123GovernmentMandate.pdf

When so many laws (mandates) are passed that no one can observe all of them, then you have a nation of lawbreakers. You can then get conviction after conviction for total servitude. - Ayn Rand

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2. No Reverse Gear in Health Care Spending
The Economist reports that soon after Britain's NHS came into being in 1948, Aneurin Bevan, its political founder, predicted that an initial surge of demand would subside as the service caught up with the backlog. A year later he knew better: “I shudder to think of the ceaseless cascade of medicine which is pouring down British throats at the present time.” In 1951, he resigned when the Treasury imposed minor health-service charges. Already, costs were three times higher than originally expected.

This episode, when “the first thing that happened was that expenditure took off into the stratosphere and had to be sat upon very firmly,” was long etched into the collective memory of senior health and finance officials, says Jeremy Hurst, a health economist at the OECD. For many years, Britain imposed strict controls that helped keep its costs down rather more successfully than those in other rich countries. Yet public discontent with an increasingly rickety service has prompted a massive boost to resources under today's Labour government. Spending on the NHS is scheduled to rise by over 7% a year in real terms until 2007-08. By then, total health expenditure in Britain will have vaulted to 9.4 percent of GDP, compared with 6.9 percent in 1998, the year before the spending spree started - a 36 percent increase.

Over the longer term, as Paul Ginsburg of the Centre for Studying Health System Change in Washington, DC, points out, the increase in health-care spending per person in other industrialized countries has been remarkably similar to America's. Since 1970, the average real growth in rich countries outside America has been 4.0 percent a year, compared with 4.4 percent in America.

This suggests a common cause. A survey conducted by Victor Fuchs of Stanford University in 1995 showed that most health economists point the finger at advances in medical technology. Scientific research establishes the basis for expensive new medical procedures (e.g., transplants), products (e.g., magnetic resonance imaging scanners) and drugs. The Tufts Centre for the Study of Drug Development calculates that, taking into account failed products, it now costs $900m to develop a new prescription drug. America usually adopts new technologies first, but they soon spread to other countries.

Over time, the cost of medical technologies declines, especially when proper account is taken of quality improvements. Expensive drugs protected by patent are replaced by cheap generics. Surgical procedures and medical devices fall in price, so the cost per patient drops. But this is more than offset by the rise in the demand for such treatments, which pushes up expenditure per person.

National health systems in different countries appear diverse, but all of them are forms of insurance against unexpected medical bills. This means that the bulk of health care is paid for by third parties, whether private insurers or governments. Medical technologies are developed for and used in a market that is much less sensitive to budget constraints than individual consumers would be. “It's the interaction of health insurance with innovation that's driving the system,” says Dana Goldman, a health economist at the RAND think-tank in Los Angeles.

In this third-party-payer market, doctors play an ambivalent role: they both supply medical care and demand it on behalf of their patients. This can create “supplier-induced demand.” Victor Fuchs draws an analogy with the car market. Suppose, he says, car dealers had to certify whether you needed a new car, and you were not paying for it directly out of your own pocket: there would be a lot more luxury cars around.

“The idea that we have a classic competitive market just doesn't apply to health care,” says Alan Garber, director of the Centre for Health Policy at Stanford University. In some sectors, he points out, there are monopolies, such as drugs under patent; in others there are oligopolies, such as hospitals, which face weak competition because most medical care is demanded and provided locally.

Without reforms to change the structure of health-care markets, expenditure looks set to continue to rise. And before long costs will get another upward nudge as the number of older people in rich countries rises.  At about 2010, the big baby-boom generation born after the war will reach retirement. This will increase the proportion of Americans over 65 from 12 percent in 2000 to 20 percent by 2030. In many other developed countries, the share will be even higher.

The Economist is my most expensive weekly journal, now exceeding the New England Journal of Medicine and all three of the American weekly news magazines combined. But breadth of  reporting, and depth of analysis makes it far more valuable. Thanks to my daughter, the CEO of AriadneCapital.com, for introducing me to this fine British News Magazine some ten years ago. To read the entire excellent article, please go to  http://www.economist.com/PrinterFriendly.cfm?Story_ID=2895966. If you can't enter the site a month after the date of issue, it will be well worth your subscription to be able to download any article as needed for study and review.

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3. Medical Safety - Avoidance of System Errors
Medical errors are to die for - literally. But to correct them requires a hard look at the system - primarily the hospital system. Many hold physicians responsible for everything that goes on in the hospital. However, that may not necessarily be true. Stephen A. Meffert, MD, a Santa Rosa ophthalmologist, who serves on the Sonoma County Medical Association Editorial Board, has a review of the book titled Internal Bleeding in the current issue of Sonoma Medicine. The authors, Drs. Robert Wachter and Kaveh Shojania, both Department of Medicine faculty at UCSF, point out some egregious errors that may not be either physician or system induced but more related to disease presentations in a patient that not even the professor of medicine could diagnose. The caveat that the authors struggle with about their troubling subject is well highlighted in their introduction: 1) Most American hospitals are safe for the vast majority of patients, the vast majority of time. 2) The vast majority of our caregivers are well trained and conscientious. 3) Western medicine's ability to save and extend life, and to improve the quality of life for the chronically ill, is nothing short of miraculous. This applies not just to extraordinary procedures like heart transplants, but also to our ability to prevent, diagnose, treat, and often cure diseases that only a generation ago were routinely fatal. With this understanding of the health care system, you may want to read this book review at http://www.scma.org/magazine/scp/sm04/meffert.html.

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4. This Week’s Review of Corporate Socialized Medicine - Why Everyone Hates HMOs.
Gerry Smedinghoff, an actuarial consultant, discusses Health Care and HMOs in a recent publication. He cites that poor Richard Huber, the former CEO of Aetna, had both the fortune and misfortune of running a company in the over-regulated health care industry, where the customer feedback loop is measured in decades. In unregulated consumer products, where the feedback loop is measured in weeks or even days, things are vastly different.

In less than 90 days, U. S. consumers so overwhelmingly rejected New Coke that the Coca Cola company was forced to return to its original formula. But HMOs, born in 1973 with the HMO Act, signed into law by President Nixon, keep going and going - like the Energizer Bunny - regardless of how intensely consumers hate them.

What’s truly amazing about HMOs is that they’ve lasted this long. Although few people are aware of it, twenty years ago, two major U. S. corporations restructured their businesses on the HMO model. But since both were disastrous failures, they didn’t last very long, and consumers never got a chance to hate them as much as HMOs. They failed for the simple reason that no company can cover a category so well that it offers a complete range of products and services to all people, at all times, in all places, with the highest quality, at the best price.

The most famous attempt by a regular business to adopt the HMO model is United Airlines, or more accurately, Allegis. Allegis? Yes, back in the 1980s, that was the name for the new parent company that United thought would revolutionize commercial travel. Like HMOs, which pretend to be an association of networks covering every possible health care need, in every possible way, at the highest level of quality, at the lowest price, Allegis was going to be a similar association of travel networks - what could be described as a Travel Maintenance Organization, or TMO. Allegis was going to cover the traveler’s every need from door-to-door, including the flight, the cruise, the hotel, the rental car, etc. No one would want to seek travel outside the Allegis TMO because it had everything and because its discounts would assure that it would offer the best price.

Fortunately, because Allegis’s concept wasn’t backed by coercive government legislation — such as the Internal Revenue Code (IRC) Section 105 tax-exemption for employer sponsored health benefits and the HMO Act - travelers today can fly any airline, get a car from any rental agency, and stay at any hotel they choose. And, by the way, they don’t require any new federal legislation to sue their travel agent.

The other great corporate venture using the HMO model was the Sears Financial Network model of a Financial Maintenance Organization or FMO. This was the world-beater combination of Allstate Insurance, Dean Witter brokerage, the Discover credit card, and home mortgage lending by Coldwell Bankers - not to mention supplementing your home with Sears furniture, Kenmore appliances, and Craftsman tools.

Without the coercion of federal legislation, Sears attempted to leverage its dominance (at the time) in the retail sector by refusing to accept American Express, Master Card, and Visa. Instead, Sears offered its customers the annoying timewasting option of filling out an application for their new Discover card. To some extent, this strategy worked. Sears was able to gain limited acceptance of its FMO and get its Discover card off the ground. Unfortunately, it was even more successful at driving away its customers to the plethora of other stores that readily accepted other major credit cards.

The only industry that still uses the HMO model is a weak, half-hearted attempt by new car dealers to convince their customers to get all their parts and service though them. But since they don’t have coercive legislation to back them up, and since they can’t be the best at everything, most people get their oil changed at Jiffy Lube, buy batteries from Sears, tires from Goodyear, and mufflers from Midas. And no one needs to get a referral from Mr. Goodwrench (their primary care mechanic) to go there.

The moral of the story: if you want to push mediocre overpriced products and services onto the public, and deny them any choices and options, you’d better get Congress and the IRS to do the dirty work for you. Because the free market will tolerate that kind of behavior only as long as you’re willing to burn through your dwindling supply of cash. The free market didn’t create HMOs; Congress did. And Congress didn’t have the foresight to kill the Allegis TMO and the Sears FMO, angry and indifferent customers did.

Congress once had the sense to deregulate the travel industry and the banking industry (although there’s still more work to be done here). It should have the collective intelligence to deregulate the health care industry by repealing the HMO Act and doing away with the IRC.

Otherwise, the state of Minnesota will have to change its motto to “the land of 10,000 lakes … but only one health plan.”

Gerry Smedinghoff is a consulting actuary with UniversalCIO, an application service provider (ASP) in Wheaton,
Illinois, and is a frequent speaker on health care reform. Read this entire speech at http://library.soa.org/library/sectionnews/health/HSN0012.pdf.

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5. Medical Gluttony: May Not Be Un-Learnable
It this section, we highlight the excessive use of health care that does not improve health or well being. When Medicare projects cost savings of maybe two, three or five percent, it really has no relevance to the individual excessive use that may exceed appropriate economic choices. Items in this column exceed appropriate health care costs by a minimum of 100 percent and frequently by 1000, 10,000 or 100,000 percent. This requires a totally different mind set from the usual economic analysis. We have had actuarial projections of 25 percent to as high as 50 percent cost savings if health care were on an economic market basis.

The feed back on this section has been rather illuminating. We normally do not recruit patients or staff to this newsletter, fearing that it may interfere with patient care. However, a number of patients have subscribed on the basis of information seen on my desk or because they have made bold statements concerning the economics of health care which suggest that they understand the Medical MarketPlace - where decisions are made medically and modified on the basis of cost-benefit analysis.

Recently several patients have identified a medical situation in the column to which they could relate. Some even thought that I had quoted a situation similar to their own. Then recognition set in. They had demanded excessive diagnostic testing and were not listening to my clinical assessment of their problems. They simply assumed that I was trying to save insurance costs and in retrospect realized that they had demanded thousands of dollars worth of testing that had no medical value to their condition. The delay in the learning curve of months or years or never can be speeded up to occur in a matter of days or weeks with a financial incentive of cost sharing. To significantly change our health care cost analysis requires a new orientation in our thinking about the economics of health care. It won't happen until the patient is financially responsible for a portion of the health care cost of every medical decision.

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6. Medical Myths: But Doctor, The Test Made Me Feel Better.
The authors of Internal Bleeding (see paragraph three above) quote the case of Joan Morris, a 67-year-old woman who was scheduled for embolization of her cerebral artery aneurysm. Instead she was taken to the cardiac electrophysiology laboratory and received a cardiac catheterization rather than being taken to the neurosurgical operating suite. After the cardiologist was unable to find any abnormal areas of twitchy heart, they discovered the error of having the wrong patient on the table. Thereafter, her cerebral artery embolization was completed successfully. She comments on her therapeutic misadventure: “I'm glad my heart checked out OK.”

Many patients are so anxious about so many aspects of health care, that left to their own devices where Medicare, Medicaid, HMO provide free care, there are few diagnostic procedures they wouldn't like. Rather than pit the patient against the health care system, let’s make the patient a part of the system by providing appropriate financial incentives to help them make an objective decision. Let's dispel the myth that diagnostic testing is therapeutic. I now have more patients that ask me:  “Doctor I just want your best opinion on what it is that I've got.” Many don’t even ask for any testing seeming quite happy with my clinical judgement. This would be the attitude of every patient if there were a financial stake in the matter.

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7. Overheard in the Medical Staff Lounge - Medicare Bonuses?
Dr Edwards mentioned the recent report that officials at the Centers for Medicare and Medicaid Services (CMS) are so determined to encourage quality care that they're willing to pay (bribe) doctors and hospitals to do it. The director of the division of payment policy stated that Medicare has five initiatives that offer some type of "pay for performance" incentives to hospitals and physician groups. CMS is working to get the Physician Group Practice Demonstration off the ground by next year. This program tries to prevent hospitalizations through care management based on cost reductions in patient care. CMS chose New Jersey because hospitals in the state have long lengths of stay and high physician payments. However, a federal judge halted the demonstration because the project violates a federal statute prohibiting payments to physicians who reduce or limit services to Medicare patients. The director stated they would move ahead in New Jersey or someplace else. The cost to CMS was $7 million a year which the director said "adds up to real money."

Dr George noted that if $7 million were distributed to 700,000 physicians, that would be a bonus of ten dollars per doctor per year. With the average physician overhead at $100 per hour, he felt he had already lost more money in the time wasted to read the article than the bonus offered. And furthermore, he felt, Medicare wouldn't recognize quality if it hit them broadside.

Dr Edwards agreed that the entire emphasis was on reducing care and costs and had nothing to do with quality of health care. Medicare judges doctors by their own moral standards. They cannot comprehend that "quality" is every physician’s middle name. Doctors could not conceive of giving a patient less than the best for his medical condition until some were corrupted by Medicare, Medicaid, and HMOs.

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

Ronald Reagan

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8. MedicalTuesday Supports These Efforts of the Medical and Professional Community in Restoring Accountability in Medical Practice, HeathCare and Government

PATMOS EmergiClinic - 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 the usual emergency room fees. Be sure to read his article on how the Robert Wood Johnson Foundation, is using "Cover the Uninsured" as a ruse to promote single-payer HeathCare by government mandate. Also read the article "Health Coverage Does Not Equal Health Care" at  www.emergiclinic.com.  To read Dr Berry's testimony in Congress, click on the sidebar. To read Dr Berry’s response to Physician’s Support of Single-Payer Health Care or Socialism go to http://www.delmeyer.net/hmc2004.htm#by%20Robert%20Berry.

• Dr Vern Cherewatenko concerning success in restoring private-based medical practice which has grown internationally through the SimpleCare model network, www.simplecare.com.  Any patient or provider may become a member of SimpleCare. A number of brochures are available on line about a practice that is becoming increasingly popular. There have been a number of news network and press reports. For the AP article: of April 27, 2004, go to  http://apnews.myway.com/article/20040404/D81O7R7O0.html

• Dr David MacDonald started Liberty Health Group, www.LibertyHealthGroup.com, to assist physicians in controlling their own medical benefit costs for their staff and patients. There is extensive data available for your study. Dr Dave is available to speak to your group on a consultative basis.

• 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. Please visit them at www.zhcenter.org, and check out their history, mission statement, newsletter, and a host of other information. For their article “Are you really insured?,” go to http://www.healthplanusa.net/AE-AreYouReallyInsured.htm.

• Madeleine Pelner Cosman, JD, PhD, Esq, has made important efforts in restoring accountability in health care. Please visit http://www.healthplanusa.net/MPCosman.htm to view some of her articles that highlight the government’s efforts in criminalizing medicine, and the introduction to her new book, Who Owns Your Body. For other OpEd articles that are important to the practice of medicine and health care in general click on her name at http://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 http://www.ssvms.org. Dr Gibson recently edited the March/April historical issue. To read his "Lessons from the Past" go to http://www.ssvms.org/articles/0403gibson.asp. For additional articles such as Health Care Inflation, log on at http://www.healthplanusa.net/DGHealthCareInflation.htm.

• Dr Richard B Willner, President, Center Peer Review Justice Inc, reports his latest success story and the secret of helping doctors keep their medical license. On a daily basis, doctors are reviewed, are suspended, lose their medical licenses and go to jail on trumped-up charges. These "extra"-legal services are necessary services that your lawyer does not offer. Stay current with a wealth of information on Abuse of Peer Review and Sham Peer Review, at http://www.peerreview.org. The president of the AMA, John Clowes, can be heard on a commercial tape acknowledging more than 80% of medical peer review is done for economic reasons (to eliminate competition). Still the AMA and organized medicine at the state levels have indicated no desire to change the system or remove the immunity. It is up to the outraged victims of this system to change it by vigorous action of their own. If you've ever received a letter from your hospital or medical board concerning Peer Review, it will be worth your while to spend a day or two reading all the articles on this site.

• 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. He then went to St Rochus Hospital in the city of Pest and reduced the epidemic of puerperal fever to 0.85 percent. The rate in Vienna was still 10-15 percent. 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: All we ask is that peer review be done with “clean hands.” To read the article he wrote for Sacramento Medicine when I was editor in 1994, “Medicine is a Rough Playing Field,” see  http://www.delmeyer.net/HMCPeer.htm#by%20Verner%20Waite%20and%20Robert%20Walker. To see Attorney Sharon Kime’s response, “The Hunted Physician” as well as the California Medical Board response, see http://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. For the current website and to see some horror stories of atrocities against physicians and how organized medicine still treats this problem, please go to http://www.semmelweissociety.net.

• 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. Several free newsletters are available. Be part of protecting and preserving what is right with American HeathCare–physicians, nurses, pharmacists, psychologists, all health professionals and all concerned individuals are urged to join.

• Robert J Cihak, MD, former president of the AAPS, and Michael Arnold Glueck, M.D, write an informative Medicine Men column that is at NewsMax. Please log on to review the last five week's topics or click on archives to see the last two year's topics at http://www.newsmax.com/pundits/Medicine_Men.shtml. This week’s column is on "The Runaway Trial Lawyer" and can be found at http://www.newsmax.com/archives/articles/2004/7/7/103053.shtml.

• 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 scroll down on the left to departments and click on News of the Day for perspectives on today's headlines. The “AAPS News,” written by Jane Orient, MD, and archived on this site, provides valuable information on a monthly basis. Scroll further to the 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 page of the current issue.

• The AAPS will be holding its 61st annual meeting at the Benson Hotel in Portland, Oregon, on October 13-16, 2004. The theme for this year is “RECLAIMING AMERICAN MEDICINE.” Be sure to register at www.AAPSonline.org for the meeting and make hotel reservations at the Benson Hotel, www.bensonhotel.com, or call 800-663-1144. Since organized and unionized medicine have become primarily oriented towards the state control of our profession and the practice of medicine, the AAPS has attracted not only physicians who believe in the private practice of medicine, but also many professional, business, and lay associate members who believe in our cause. If you are a physician, please send in your $285 membership dues and if a non-physician, consider supporting this effort with a $95 associate membership and come to Portland on October 13-16, 2004. The registration fees are reduced to $125 for new members with payment of annual dues.

Special guests this year include Madeleine Pelner Cosman, JD, PhD, Esq, President of Medical Equity, Inc, and national medical law consultant since 1980 as well as popular worldwide lecturer on medical law and medical ethics, who will be the banquet speaker adresssing “Illegal Aliens and American Medicine,” http://www.healthplanusa.net/MPCosman.htm; Radio Talk Show Host, Lars Larson, www.LarsLarson.com; author Star Parker, www.UrbanCure.org; Greg Scandlen, of the Galen Institute, www.Galen.org; and Art Robinson, of the Oregon Institute of Science and Medicine, www.OISM.org.

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Stay Tuned to the MedicalTuesday.Network and Have Your Friends Do the Same
The MedicalTuesday site has now been automated. Each individual on our mailing list and those that have been forwarded to us are now able to invite, register, or de-enroll as desired. You may want to copy this message to your Template file so that they are available to be forwarded or reformatted as new when the occasion arises. Then, save the message to a folder in your Inbox labeled MedicalTuesday. If you have difficulty de-enrolling, please send an email to Admin@MedicalTuesday.net with your “Remove” and “Email address” in the subject line.

Read the latest medical news of the day at http://www.healthplanusa.net/MedicalNews.htm which will also lead you to the headlines for the past month.

If you would like to participate in this informational campaign on behalf of your patients or the HeathCare community, please send your resume to Personnel@MedicalTuesday.net.

If you would like to participate in the development of the affordable HealthPlan for All Americans, please send your resume to Personnel@HealthPlanUSA.net.

Del Meyer

Del Meyer, MD, CEO & Founder
6620 Coyle Avenue, Ste 122, Carmichael, CA 95608

 Words of Wisdom

P. J. O'Rourke: If you think that health care is expensive now, wait until you see what it costs when it's free.

Winston Churchill: We contend that for a nation to try to tax itself into prosperity is like a man standing in a bucket and trying to lift himself up by the handle.

Edward Langley, Artist 1928-1995: What this country needs are more unemployed politicians.

 Review of Some Recent Postings Below.

Voices of Medicine: To read a review of the first issue of Sacramento Medicine in 1950, go to http://www.ssvms.org/articles/0403vom.asp, remembering that the first 132 years are no longer available. To read this years series of my column, the "Voices of Medicine," go to http://healthcarecom.net/vom2004.htm.

Charles B Clark, MD: A Piece of the Pie: What are we going to tell those bright-eyed little boys and girls who are going to be the doctors of tomorrow? When there isn’t anything left for them, are we going to tell them we didn’t fight because the changes were inevitable anyway? What are we going to say when they ask us why we laid down and died when things got a little tough? Are we going to feel good about ourselves when we tell them it’s all right because we got a piece of the pie? Read Dr Clark at http://www.healthcarecom.net/CBCPieceofPie.htm.

Ada P Kahn, PhD: Foreword to "Encyclopedia of Work-Related Injuries, Illnesses and Health Issues. Dr Kahn came to Sacramento in February and I joined her on a Channel 31 interview about her book. I was privileged to write the foreword which we’ve posted at http://www.delmeyer.net/MedInfo2004.htm. To purchase the book, go to http://www.factsonfile.com/ and type in KAHN under search.

Henry Chang, MD: WEIGHT LOST FOREVER - The Five Second Guide to Permanent Weight Loss suggest daily weights to stem the weight loss before it becomes a problem and, if it does,  how to take it off and keep it off. Congratulations to Dr Chang for winning the Sacramento Publishers and Authors 2004 award for “Best Health Book of the Year.” Read our review at http://www.healthcarecom.net/bkrev_WeightLostForever.htm.

Tammy Bruce: The Death of Right and Wrong (Understanding the difference between the right and the left on our culture and values.) http://www.townhall.com/bookclub/bruce.html.
Reviewed by Courtney Rosenbladt

An Alzheimer's Story: To read a touching story by a nurse about her Alzheimer's patient, go to http://www.delmeyer.net/MedInfo2003.htm.

An Entrepreneur's Story: AriadneCapital (http://www.AriadneCapital.com) provided the initial funding for MedicalTuesday and the Global Trademarking. Julie Meyer, the CEO, has a clear vision in her mind of the world that she wants to live in, and it's considerably different from how it looks now. If you're an entrepreneurial woman, or if you lost hope or are having difficulty envisioning success (if you'll forgive a little nepotism), the following article may be of interest to you: http://observer.guardian.co.uk/business/story/0,6903,1237363,00.html.

 On This Date in History - July 27

Transatlantic Cable between England and US completed in 1866 making it possible for news to cross the ocean immediately, and that, in turn, speeded up the tempo of events to a pace never before known.

After nearly two years of endless negotiations, the Korean War armistice was signed in Panmunjom in 1953, on the border between North and South Korea. It was an uneasy truce for decades thereafter, and its anniversary reminds us that a tense peace has only one thing to recommend it, namely that it is better than a hot war.


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