Community For Better Health Care

Vol V, No 3, May 9, 2006


In This Issue:

1.                  Featured Article: Unlocking the Secrets of Longevity Genes

2.                  In the News: And Sso to Bbed

3.                  International Medicine: From the UK - NHS Consultants Opt for Private Healthcare

4.                  Medicare: The 2006 Trustee's Annual Report: Medicare Overview

5.                  Medical Gluttony: I Don't Care If It's of No Help, I Want to Know What I'm Allergic to

6.                  Medical Myths: Modern Medicine Is An Imposing Edifice

7.                  Overheard in the Medical Staff Lounge: Driving Is No Longer a Rite Of Passage at Age 16

8.                  Voices of Medicine: Physician Assisted Suicide - Keep Physicians Out of It

9.                  Book Review: Healthy Competition - What's Holding Back Health Care and How to Free It

10.              Hippocrates & His Kin: Ethical Ban on Organ Payments

11.              Related Organizations: Restoring Accountability in HealthCare, Government and Society

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The Annual World Health Care Congress, co-sponsored by The Wall Street Journal, is the most prestigious meeting of chief and senior executives from all sectors of health care. Renowned authorities and practitioners assemble to present recent results and to develop innovative strategies that foster the creation of a cost-effective and accountable U.S. health-care system. The extraordinary conference agenda includes compelling keynote panel discussions, authoritative industry speakers, international best practices, and recently released case-study data. The 3rd annual conference was held April 17-19, 2006, in Washington, D.C. Watch these pages for reports on more than 100 presentations given. Some of the regular attendees told me that the first Congress was approximately 90 percent pro-government medicine. This year it was 50 percent, indicating open forums such as these are critically important. The 4th Annual World Health Congress has been scheduled for April 22-24, 2007, also in Washington, D.C. The World Health Care Congress - Asia will be held in Singapore on September 14-16, 2006. The World Health Care Congress - Middle East will be held in Dubai, United Arab Emirates, in November 2006. World Health Care Congress - Europe 2007 will meet in Paris. For more information, visit

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1.      Featured Article: Unlocking the Secrets of Longevity Genes

Unlocking the Secrets of Longevity Genes, By David A. Sinclair and Lenny Guarente, Scientific American

A handful of genes that control the body's defenses during hard times can also dramatically improve health and prolong life in diverse organisms. Understanding how they work may reveal the keys to extending human life span while banishing diseases of old age

You can assume quite a bit about the state of a used car just from its mileage and model year. The wear and tear of heavy driving and the passage of time will have taken an inevitable toll. The same appears to be true of aging in people, but the analogy is flawed because of a crucial difference between inanimate machines and living creatures: deterioration is not inexorable in biological systems, which can respond to their environments and use their own energy to defend and repair themselves.

At one time, scientists believed aging to be not just deterioration but an active continuation of an organism's genetically programmed development. Once an individual achieved maturity, "aging genes" began to direct its progress toward the grave. This idea has been discredited, and conventional wisdom now holds that aging really is just wearing out over time because the body's normal maintenance and repair mechanisms simply wane. . . .

Yet we and other researchers have found that a family of genes involved in an organism's ability to withstand a stressful environment, such as excessive heat or scarcity of food or water, have the power to keep its natural defense and repair activities going strong regardless of age. By optimizing the body's functioning for survival, these genes maximize the individual's chances of getting through the crisis. And if they remain activated long enough, they can also dramatically enhance the organism's health and extend its life span. In essence, they represent the opposite of aging genes--longevity genes. To read more, please go to

We began investigating this idea nearly 15 years ago by imagining that evolution would have favored a universal regulatory system to coordinate this well-known response to environmental stress. If we could identify the gene or genes that serve as its master controllers and thereby act as master regulators of an organism's life span, these natural defense mechanisms might be turned into weapons against the diseases and decline that are now apparently synonymous with human aging.

Many recently discovered genes, known by such cryptic names as daf-2, pit-1, amp-1, clk-1 and p66Shc, have been found to affect stress resistance and life span in laboratory organisms, suggesting that they could be part of a fundamental mechanism for surviving adversity. But our own two laboratories have focused on a gene called SIR2, variants of which are present in all organisms studied so far, from yeast to humans. Extra copies of the gene increase longevity in creatures as diverse as yeast, roundworms and fruit flies, and we are working to determine whether it does the same for larger animals, such as mice.

As one of the first longevity genes to have been identified, SIR2 is the best characterized, so we will focus here on its workings. They illustrate how a genetically regulated survival mechanism can extend life and improve health, and growing evidence suggests that SIR2 may be the key regulator of that mechanism.

Silence Is Golden
We first discovered that SIR2 is a longevity gene by asking what causes individual baker's yeast cells to grow old and whether a single gene might control aging in this simple organism. The notion that an understanding of yeast life span would tell us anything about human aging was deemed preposterous by many. Aging in yeast is measured by counting how many times mother cells divide to produce daughters before dying. A typical yeast cell's life span is about 20 divisions.

One of us (Guarente) began by screening yeast colonies for unusually long-lived cells in the hope of finding genes responsible for their longevity. This screen yielded a single mutation in a gene called SIR4, which encodes part of a complex of proteins containing the Sir2 enzyme. The mutation in SIR4 caused the Sir2 protein to gather at the most highly repetitive region of the yeast genome, a stretch containing the genes that encode the protein factories of the cell, known as ribosomal DNA (rDNA). More than 100 of these rDNA repeats exist in the average yeast cell's genome, and they are difficult to maintain in a stable state. Repetitive sequences are prone to "recombining" with one another, a process that in humans can lead to numerous illnesses, such as cancer and Huntington's disease. Our yeast findings suggested that aging in mother cells was caused by some form of rDNA instability that was mitigated by the Sir proteins.

To read pages 2-5, (subscription required) go to                                                                                                                                                            

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2.      In the News: And so to bed, by Lucy Atkins, UK Telegraph

There are many health benefits for those who enjoy regular sex. Lucy Atkins looks at the latest scientific research.

It does not take a degree in medicine to work out that sex is good for you. Anything that is free, feels fabulous and leaves you glowing is plainly a good idea. But scientists are now beginning to understand that the perceived feel-good effects of sexual intercourse are merely the tip of the iceberg. Sex, they are discovering, can help protect you from depression, colds, heart disease and even cancer. To read more, please go to

The latest addition to the body of evidence came last month when Professor Stuart Brody of the University of Paisley published a study showing that sex can lower blood pressure. According to Professor Brody: "We're not just talking about the immediate effects of having had nice sex. The beneficial effects could last at least a week." One theory is that intercourse stimulates a variety of nerves, most notably the "vagas" nerve, which is directly involved in soothing and calming.

To see these benefits, you have to go the whole heterosexual hog. According to Professor Brody, studies show that "penile-vaginal intercourse is the only sexual behaviour consistently associated with better psychological and physiological health".

Such sex has been linked, in women, to a heightened emotional awareness, possibly because of the "love-hormone" oxytocin that is released. One study even found that semen is a mood-enhancing ingredient.

Doctors speculate that this is because semen contains several other mood-altering hormones - including testosterone, oestrogen, prolactin and several different prostaglandins - which can pass into the woman's bloodstream. This explanation, says Dr David Hicks, sexology specialist and consultant in GU medicine at the Royal Hallamshire Hospital in Sheffield, "is certainly feasible". Condom-free sex has its drawbacks, of course: contracting HIV or any other sexually transmitted disease, or becoming pregnant unintentionally. . . .

The health benefits for middle-aged men are also particularly persuasive. Recent studies suggest that men who have orgasms twice a week are half as likely to die early as men who orgasm less than once a month. The more frequently men ejaculate, the less likely they are to develop prostate cancer, and if middle-aged men have sex twice a week or more they also have a lower risk of heart attack.

Much has been made of the slimming and toning effects of a sexual work-out. In fact, sex probably burns off about the same number of calories per minute as a brisk walk. "You get all the benefits of exercise," confirms Dr Hicks. "This includes the release of endorphins, raised heart rate, moving the muscles and joints. One study even showed that arthritis can be delayed by regular sex."

You might also look younger. "Regular sex makes you feel younger as you are more relaxed, satisfied and less stressed," says Dr Kevan Wylie, consultant andrologist at the Royal Hallamshire Hospital.

"Sex has huge mental benefits," adds Dr Hicks: "It's the outward proof that you are wanted, desired and valued." And if you feel sexy, you tend to look it, too.

Sex is not, sadly, a cure all. "There is a danger in thinking that we can fix anything by leaping into bed," says Dr Petra Boynton, a psychologist at University College in London specialising in sex and relationships. "The fact is you are likely to have a much better sex life if you are healthy and happy, rather than the other way round." Still, it can't hurt to try.

Sex could make you...

· Calm: up to a week after intercourse your blood pressure remains lower, helping you to cope with stressful situations.

· Happy: semen could have antidepressant qualities and hormones released during sex include oxytocin, which promotes loving feelings, as well as endorphins, the "feel-good" hormones.

· Healthy: regular sex raises your levels of a cold-fighting antibody. It might protect men against prostate cancer and heart disease.

· Youthful: sex increases longevity, might improve skin tone, and gives you a glow.

· Serene: touch, which one sexuality specialist calls "vitamin T", has been shown to reduce stress. Deep breathing, as any yoga fanatic will confirm, also reduces stress, and profound post-coital relaxation can certainly improve your sleep quality.

· Pain free: sex has been shown to relieve some of the symptoms of PMT, arthritis and, yes, headaches because of the release of endorphins - nature's opiates.

· Grounded: intercourse, ideally with the same partner, creates an emotional and physical bond that is a vital part of the social support we all need in order to feel truly happy.

To read the entire article, please go to

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3.      International Medicine: From the UK Telegraph: NHS Consultants Opt for Private Healthcare

Hospital consultants opt for private cover By Peter Pallot

Four in 10 hospital consultants in Britain have private medical cover, according to a survey commissioned by Bupa. A total of 41 per cent of 500 senior doctors surveyed had private insurance.

All those questioned worked in the private sector and 91 per cent also held NHS posts. One reason for having the option of private treatment was privacy - they did not want to be in a bed adjacent to one of their patients.

Other motives included speedy treatment, fears about prevalence of the MRSA superbug in state hospitals and better food and comforts in private units.

The 10 occupations most likely to take out insurance, according to the survey, by Silver Fern Research, were, in alphabetical order: accountant, armed forces, civil service, doctors, IT analysts, police, secretaries, the self-employed (consultants, plumbers, electricians etc), solicitors and teachers.

Some of these will be taking advantage of new cut-rate cover identified as likely to boost the total number of individual policyholders by 10 per cent over four years. To read more about the UK's NHS, please go to

Market analysts Datamonitor forecast 1.2 m privately insured people by 2010 because of "sophisticated offerings that cost the consumer less but in return for a lower premium, offer a lower level of cover".


Why dentists are rapidly disappearing from the NHS By Peter Pallot

Expatriates who revisit Britain and, in passing, expect to hop into their local NHS dentist could be in for a disappointment.

Like the tree pipit and the spotted flycatcher, state dentists in Britain are becoming an endangered species. Only 44 per cent of the population could find an NHS dentist willing to take them on even before changes came in this month.

A total of 2,100 practitioners said the new state contract had forced them to offer private care only. More resignations from NHS practice are widely predicted. Not only are NHS dentists virtually impossible to find in the South East, but the private option comes at around three times the cost of the new NHS tariff.

High prices are pushing western Europeans to look east. Dentists in Poland, Hungary, Turkey, Greece and Cyprus can massively undercut UK private rates and claim to have equal clinical standards. You can easily pay £3,000 per implant in Britain, an operation performed for £600 by east European dentists.

Going abroad for dentistry is not always going to be trouble-free. Follow-up care, when your dentist is 1,000 miles away and speaks a different language, is fraught with problems. Top-range international medical insurance plans can certainly help, but insurers are not mugs and benefits are as capped as the average octogenarian's molars. Most providers cover "emergency" dental care on their top plans. The volume of claims here, though, is going to be much less significant than the "routine" £500 crown or £100 root canal treatment that hits many of the middle aged.

Among leading providers, Bupa International is unusual in not covering any routine dentistry on any of its individual plans. However, Bupa's Gold plan gives emergency and accidental dental treatment cover to individuals up to £400 per person per policyholder year.

PPP International adopts a 50 per cent co-pay approach on routine dentistry, in common with several providers - insurer and insured split the cost. PPP's top Prestige plan pays half of fees up to £600 for those with worldwide cover; up to £500 for worldwide cover except USA and Canada; and up to £400 in Europe. PPP Comprehensive and Standard plans cap at £400 - again on the 50 per cent co-pay method - worldwide; £320 worldwide except USA and Canada; and £240 for Europe . . .

To read the entire article, please go to


Feeling the bite of 2004 crackdown By Peter Pallot

Even if British expatriates can find an NHS dentist willing to treat them on return home, they could still fall foul of legislation. A Government crackdown of April 2004 was aimed at making the NHS "a service for British people who live in Britain".

The Department of Health confirmed that the new strictures apply to dentists as well as to hospital and GP services. It would be illogical if they did not, since NHS dentistry is seen as less well-funded than its medical counterpart.

Under the changes, EU-based Britons who spend less than six months a year in Britain are denied access to the NHS, except in emergencies. It's tougher still for those who reside outside the EU. Expats in countries such as Canada, Australia and South Africa are ineligible if outside the UK for three months a year. Even so, some doctors have expressed doubt whether such individuals would be checked either by dentists or hospital managers.

Action against health tourism was not primarily aimed at Britons who might have paid National Insurance contributions and other taxes all their lives. They were caught by policies aimed at dealing with reported abuses by immigrants who had no connection with Britain but sought to exploit its free medical care.


On June 9, 2005, the Supreme Court of Canada ruled that Canadian Medicare does not give timely access to healthcare but only gives access to a waiting list. Lawyers for the federal government had argued the court should not interfere with the health-care system, considered "one of Canada's finest achievements and a powerful symbol of the national identity."

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4.      Medicare: The 2006 Trustee's Annual Report: Medicare Overview

Dr John Goodman of the National Center for Policy Analysis has posted the 2006 Annual Report of both Medicare and Social Security.

If you still suffer from the illusion that the government is a responsible fiscal organization, be sure to read the report and the unfunded liability of Medicare Part A, Part B, Part D. Also review how, with Social Security, we are obligating our children and grandchildren with a tax liability that will take nearly all of their tax money to pay for our entitlements. Are we really entitled to enslave our own children and grandchildren? How can we live with this unethical behavior? Read the report at

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

- Ronald Reagan

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5.      Medical Gluttony: I Don't Care If It's of No Help, I Want to Know What I'm Allergic to

When I was an intern, a medical resident was explaining to the Chief of Medicine why she had ordered an expensive test. Would it help the patient? Would it change the management of the patient's disease? When she answered no to all the questions, the Professor asked, "Then why did you order it?" To which the resident replied, "I just wanted to know."

Last week, I had a patient who developed a rash from the lotions and sunscreens she used on her hands and arms when she went bike riding on the weekends. Typically they would go away by Tuesday. However, she had one lotion and one sunscreen that she could use comfortably. She kept a year's supply of these in her medicine cabinet. She worried about what she would do if that manufacturer went out of business. To read more, please go to

She wanted an allergy consultation to test the dozens of lotions and sunscreens for their allergic potential to her skin in order to find out what specific ingredient caused her allergy.

My reasoning failed to convince her that this would not be clinically possible, and even research testing would not prove helpful since she already had checked all the ingredients and found such a variety that the process of elimination would not be productive.

Since she was so adamant, I knew that she would hail the anger on me of her HMO, her managed care organization, her health insurance carrier, and the state department of health and tie my staff up for dozens of hours if not weeks. So I called an allergist and explained the situation. He was kind enough to speak with her immediately and slowly she became convinced. After he hung up, she stated that he obviously agreed with me and she was satisfied and would not pursue this further.

Medical Truth: The Most Expensive Phrase in the Medical Lexicon: I Just Want to Know

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6.      Medical Myths: Modern Medicine Is An Imposing Edifice

To read the truth, please go to

Medical Truth: The whole imposing edifice of modern medicine is like the celebrated tower of Pisa  -  slightly off balance.

-Charles, Prince of Whales

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7.      Overheard in the Medical Staff Lounge: Driving Is No Longer a Rite Of Passage at Age 16

Many physicians are restricting their high school juniors and seniors from driving, except to school and related activities. Many are restricting their 16 and 17 year olds from driving at night or later than 9 PM, except for official school functions. Many teenagers feel driving is their entitlement. Part of this enforcement by parents  is driven by car insurance rates, some double at age 16 as an add on driver and may nearly triple if the teenager owns the car or is the primary driver. The Wall Street Journal, one of the three papers found in the Doctor's Staff Lounge, features Sue Shellenbarger last month discussing "Safety Fears, Insurance Costs, New Laws Push Back Age When Teens Start to Drive," that can be readc at Actually, it's parental responsibility in trying to avoid teenage deaths and the market forces of insurance that are more effective than new laws. However, it wouldn't be a bad idea that one should be 18 to drive on the Federal Highway System after dark. To listen in on more newspaper talk with doctors, please go to


Politics In Education Is Also Corrupting

Dan Walters, the Bee's Capital Reporter, observes, "The most fundamental rule of politics is that perception is more important than reality - which explains why politicians seemingly devote more time to polishing their images than doing their jobs."  "Perhaps the most interesting current example of how perceptions drive politics, however, is the pickle in which the venerable University of California finds itself because its executives lavished lucrative, under-the-table compensation packages on each other over the past decade."

He reports on an audit of our own University of California that has just been released by PricewaterhouseCoopers disclosing that the practice of granting elaborate packages of salaries and perquisites had been under way for a decade, with juicy details kept secret even from the regents. The auditors found that UC President Robert Dynes had received $23,000 in expense payments related to his wife, a UC professor, continuing to live in the UC San Diego chancellor's home after Dynes took over the system in Oakland - money that was not reported even to the Internal Revenue Service as required. To read the entire editorial, please go to


Since politics is incapable of objectivity or reality thinking and works primarily with public perceptions as Walters observes, it is important that health care, which is being bandied about on everyone's personal perceptions unrelated to reality, is never under the control of politicians. Americans are slowly learning the same lessons in education and many are biting the bullet to send the next generation of Americans to be schooled in private or parochial schools rather than in the politically controlled failing public education system. The future of our country depends on it.

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8.      Voices of Medicine: A Review of Local and Regional Medical Journals

Physician Assisted Suicide: Keep Physicians Out of It by Stan K. Sujka, MD, FACS, Orlando Urology Associates.  From the Florida Medical Association Quarterly Journal.

When in a 6-3 decision the Supreme Court upheld assisted suicide, David Savage of the Los Angeles Times stated that it was "a victory for states and their independent-minded voters, and a defeat for social conservatives." In my opinion it was also a great defeat for doctors because it puts physicians in the middle of this no-win situation.

In his book "Man's Search for Meaning," Victor Frankl, stresses man's freedom to transcend suffering and find a meaning to his life no matter of his circumstances. Frankl who during World War II survived Auschwitz, Dachau, and other concentration camps, contended that suicide is never a rational response to pain, whether in the sanitarium or in Auschwitz. Until his death in 1997, Frankl spoke out consistently that "A man's life retains its meaning up to the last - until he draws his last breath. The doctor must always act as an agent of the sick man's will to live and as a supporter of his right to live." Frankl understood that we have a duty and take an oath to preserve life. Frankl said: "This duty remains binding, even when he confronts a patient who has tried to destroy himself and whose life now hangs by a thread." To read more, please go to

Historically, ethical traditions of medicine strongly opposes to the taking of a life. The Hippocratic oath states, "I will not administer poison to anyone where asked," and "Be of benefit, or at least do no harm." Even when physician assisted suicide was not legal, survey of physicians in practice showed that about one in five received a request for physician assisted suicide in their career. Somewhere between 5-20 percent of these requests are believed to be honored.

For those of you who are still applauding the Supreme Court's ruling, think about the potential of abuse that exists here. Burdened family members and health care providers may encourage assisted suicide. Picture it, the ultimate cost-containment strategy! And if you still have doubts that it can happen in this country, just consider the eugenics program. Started in America, the eugenic crusade with the blessing of the U.S. Department of Agriculture, the State Department and numerous state governmental bodies, through legislated segregation and sterilization programs tried to wipe out poor people, brown-haired white people, African Americans, immigrants, Indians, Eastern European Jews, the infirm and anyone that was considered genetically inferior. Hitler learned from the United States about the program and took it to the next level.

I don't debate a right to commit suicide. I simply object as a doctor being involved in the process even in name only. We should take the "doctor" out of the assisted suicide equation. Why do you need a doctor to kill yourself? Why demand your doctor put him or herself in an ethical dilemma? Just shut the garage door tight, keep the car running and enjoy the ride; but keep doctors in the office and hospitals helping people who want to live.

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9.      Book Review: Healthy Competition - What's Holding Back Health Care and How to Free It by Michael Cannon & Michael D Tanner, Cato Institute, Part III: Chapter 8  -  Medical Malpractice Reform.

Tort law is an important protection against those who do or would injure us, yet many complain—with some reason—that the medical liability ''system'' in the United States is out of control. Frivolous lawsuits are frequent, damages are exorbitant, and the aggrieved patients receive only a fraction of the monetary awards. Many specialists (neurosurgeons and obstetricians, to name two) report they cannot afford the rising cost of medical liability insurance, and have left states with high malpractice awards. Critics note that the fear of liability forces providers to practice ''defensive medicine,'' including unnecessary but costly tests ordered merely to protect against potential liability. These and other costs of the medical tort system impose a significant burden on patients and taxpayers. Conover estimates the U.S. medical tort system provides benefits of $33.0 billion, but imposes costs of $113.7 billion, for a net cost of $80.7 billion per year. . . . To read more, please go to

 President George W. Bush has proposed federal legislation to limit medical malpractice awards. However, the U.S. Constitution does not grant Congress the authority to impose substantive rules of tort law on the states. While the federal government may enact technical procedural changes, state legislatures are the proper venue for correcting excesses in state civil justice systems. The fact that medical professionals can avoid states with inhospitable civil justice systems gives them significant leverage when advocating state-level medical liability reforms, and gives states incentives to enact such reforms.  That some states have done so further demonstrates that federal legislation is unnecessary. Michael Greve of the American Enterprise Institute notes, ''At least so long as state law is trending in an antiliability direction, experimentation is quite probably preferable to a federal 'reform' that might get it wrong, rob the reform states of their just rewards, and discourage laggard states from experimenting with their own, possibly more effective reforms.''

 What reforms might states consider? Arbitrary caps on damages may reduce the costs of frivolous lawsuits, but they foreclose adequate relief in extreme cases, and prevent patients from bargaining for greater protection. A ''loser pays'' rule often would reallocate the costs of frivolous lawsuits to the correct party. However, it also would deter less affluent patients from seeking legal redress for legitimate grievances. One study found that ''abolishing joint and several liability, restricting attorney's fees, and establishing victims' compensation funds all lead to fewer physicians per capita'' within a state. Moreover, it is possible that arbitrary limits on liability will diminish incentives for marginal providers to exercise due care. The study also found that reducing awards to victims who also collect from insurance is associated with an increase in infant mortality.

More patient-friendly and liberty-enhancing reforms would allow patients and providers to avoid the costly medical tort system via contract. Patients could choose the level of protection against malpractice they desire, rather than have that level imposed on them by the courts. Patients would select providers who offer acceptable levels of compensation for injuries caused by negligence. In cases of intentional wrongdoing or reckless behavior, tort rules would still apply. Providers could offer patients a menu of compensation options and their prices. Many providers likely would agree to high maximum awards to protect against the risk of an astronomical jury award. Supporters of legislative caps on damages could choose those limits for themselves. Patients who do not wish to limit their protections would be free to do that as well. Enforcing such contracts would mean that patients—not legislatures or the courts—would make tradeoffs between protecting themselves against immediate risks (the illness for which they seek treatment) and more remote risks (potential injuries from negligence). . . .

Some will object that patients need all the protections that U.S. courts can provide. Commenting on Staab's decision, a spokeswoman for the Centers for Disease Control cautioned, ''If you travel outside this nation, the same protections that are built into the healthcare delivery system here may not apply.'' But that is precisely the point: some patients cannot afford those protections. To save his life, Howard Staab had to negotiate around the malpractice protections and other aspects of the U.S. health care system that put heart surgery out of reach.

Restricting patients' freedom to make such decisions for themselves makes them less safe. Patients would be better served by a competitive process that acknowledges that one size does not fit all, allows patients to choose among diverse approaches to malpractice protection, and rejects those that do not work. If the courts will not respect Americans' right to make such contracts here at home, legislators should ensure that such contracts will be enforced.

To read the rest of Part III, Chapter 8  -  Medical Malpractice Reform - please go to the Cato Bookstore: The price is only $10. At that rate, consider purchasing two or three and surprise those friends, who don't understand that government involvement in health care is destroying affordable health care, with a gift that keeps on giving. There are other excellent recent titles you may want to consider. For Next month, read the conclusions.

To read some of the other book reviews that are available, please go to


 Other Reviews of Interest: "United 93" and "The Da Vinci Code":

"United 93": Facts of War: by Kathryn Jean Lopez:

Spellbinding 'United 93' Recounts Doomed Flight With Soul-Searing Intensity, by Joe Morgenstern, In First Major Film on 9/11, Director Skillfully Sets the Right Tone; Star Turn for an FAA Official, April 28, 2006;

Seeking Truth at the Movies By JOHN J. MILLER, April 28, 2006;

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10.  Hippocrates & His Kin: Ethical Objections to the Ban on Organ Payments

Cannon & Tanner, above, report that there is no shortage of transplantable organs. Economists David Kaserman and A. H. Barnett estimate that each year enough Americans die under conditions that make their organs suitable for transplant to meet the entire demand. Yet most of these organs are buried with the deceased rather than harvested to help the living. Instead of an actual shortage of organs, there exists an artificial shortage created by the prohibition of payments for transplantable organs.

That prohibition is effectively a price control that sets the price of transplantable organs at zero dollars in spite of the immense value they hold. Because government prevents the price from rising above $0, it effectively hides the potential providers information about the great need for transplantable organs. In 2000, 539 economists signed an open letter on health care reform that explained the dynamics of such price controls: "For thousands of years, governments have tried to control prices. The universal experience has been that price controls produces shortages . . ." To read more, please go to

Lloyd Cohen of George Mason University has chosen a novel way to highlight the ethical objections to the ban on organ payments. Cohen has executed legal documents that give permission for his organs to be harvested under only two conditions. The first is that the organ go to a family member or a member in good standing of the LifeSharers organization. Otherwise, Cohen denies permission for his organs to be harvested unless his estate is paid $864.27 per organ. If his estate is not paid, his organs will perish.  Cohen's goal is not to be a curmudgeon, but to illuminate the choice that opponents of organ payments have made for themselves and for others. When Cohen dies, those who oppose payments will face two options: (1) violate their principles and pay up, or (2) allow yet another patient to die unnecessarily. Those who choose the latter, Cohen writes, ''must hold that it is morally preferable, because it celebrates 'the intrinsic ineliminable, ineluctable value of human life and health,' that a 12-year-old girl die from liver failure rather than that the organ that would save her life be provided by a market.'' Cohen encourages others to give similar directions for the disposition of their organs. As more people do so, he argues, it will force society to recognize the unethical choice that is being forced on us.  Respecting the freedom of organ providers and recipients would eliminate the artificial organ shortage and save thousands of lives each year. As more transplants are performed, new discoveries will cause technological innovation to accelerate. As in the past, such advances would enable medicine to save those who previously could not be helped. The prohibition on organ payments delays those discoveries and retards innovation. As a result, it imposes costs not only on current generations, but on future generations as well.

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11.  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 on at and register to receive one or more of these reports. Be sure to read last week's news: With its recent announcement that it will open medical clinics in its super-centers, Wal-Mart is truly set to become the one-stop place to shop, says Rik Kirkland, Fortune senior-editor-at-large.

•                      Pacific Research Institute, ( Sally C Pipes, President and CEO, John R Graham, Director of Health Care Studies, publish a monthly Health Policy Prescription newsletter, which is very timely to our current health care situation. You may subscribe at or access their health page at Be sure to read Diana Ernst: We are responsible in fat fight — not lawyers, not courts, at

•                      The Mercatus Center at George Mason University ( 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 Center's Government Accountability Project. Join the Mercatus Center for Excellence in Government. To read about which federal agencies keep us best inform, be sure to read the score card at

•                      The National Association of Health Underwriters, The NAHU's Vision Statement: Every American will have access to private sector solutions for health, financial and retirement security and the services of insurance professionals. There are numerous important issues listed on the opening page.  Be sure to scan their professional journal, Health Insurance Underwriters (HIU), for articles of importance in the Health Insurance MarketPlace. The HIU magazine, with Jim Hostetler as the executive editor, covers technology, legislation and product news - everything that affects how health insurance professionals do business. Be sure to review the current articles listed on their table of contents at To see my recent column, go to

•                      To read the rest of this column, please go to

•                      The Galen Institute, Grace-Marie Turner President and Founder, has a weekly Health Policy Newsletter sent every Friday to which you may subscribe by logging on at Be sure to read her latest report on The Association Health Plans  -  The Hopes of Spring with the eyes on the Senate at

•                      Greg Scandlen, an expert in Health Savings Accounts (HSAs) has embarked on a new mission: Consumers for Health Care Choices (CHCC). To read the initial series of his newsletter, Consumers Power Reports, go to To join, go to  Be sure to read Prescription for change:  Employers, insurers, providers, and the government have all taken their turn at trying to fix American Health Care. Now it's the Consumers turn at

•                      The Heartland Institute,, publishes the Health Care News. Read the late Conrad F Meier on What is Free-Market Health Care? at   You may sign up for their health care email newsletter at

•                      The Foundation for Economic Education,, has been publishing The Freeman - Ideas On Liberty, Freedom's Magazine, for over 50 years, with Richard M Ebeling, PhD, President, and Sheldon Richman as editor. Having bound copies of this running treatise on free-market economics for over 40 years, I still take pleasure in the relevant articles by Leonard Read and others who have devoted their lives to the cause of liberty. I have a patient who has read this journal since it was a mimeographed newsletter fifty years ago. Be sure to keep up with the Freeman Classics and this month understand how "Planning Threatens Freedom" at

•                      The Council for Affordable Health Insurance,, 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." This month read Dr. Merrill Matthews, director of the Council for Affordable Health Insurance on Massachusetts Legislature Makes a Bad Bill Worse! at

•                      The Health Policy Fact Checkers is a great resource to check the facts for accuracy in reporting and can be accessed from the preceding CAHI site or directly at This week, read the Daily Medical Follies: "Woeful Tales from the World of Nationalized Health Care" at

•                      The Independence Institute,, 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  Read her latest newsletter at, which includes a section on PC Medicine and Euthanasia.  But what’s really fun is to access the home page and watch that meter which shows how fast Colorado politicians can spend money. You might also tell your friends about it.

•                      Martin Masse, Director of Publications at the Montreal Economic Institute, is the publisher of the webzine: Le Quebecois Libre. Please log on at to review his free-market based articles, some of which will allow you to brush up on your French. You may also register to receive copies of their webzine on a regular basis. This month, read enjoy a feast of Menger at, or Milton Friedman at, or Chris Leithner at, or Gennady Stolyarov II at What a smorgasbord.

Martin Masse's editorial at

•                      1.                   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. Canadians will celebrated Tax Freedom Day on June 28, the date they stopped paying taxes and started working for themselves. (Aren’t we lucky in the United States to work one less month for the government) Log on at for an overview of the extensive research articles that are available. You may want to go directly to their health research section at To see how doctors act, using taxes rather than medically accepted principles, when they are politically inclined, be sure the read the Canadian Medical Association’s president’s proposal at  

•                      The Heritage Foundation,, 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. To read the current A Serious Senate Agenda for “Health Week,” go to

•                      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. Please log on at to obtain the foundation's daily reports. Be sure to read the latest myths on the Minimum Wage at You may also log on to Lew's premier free-market site at to read some of his lectures to medical groups. To learn how state medicine subsidizes illness, see; or to find out why anyone would want to be an MD today, see

•                      CATO. The Cato Institute ( 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 If you think that gas prices are too high, you might wish to travel to Europe and pay $6 a gallon or read the commentary at  

•                      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.

•                      The Free State Project, with a goal of Liberty in Our Lifetime,, is an agreement among 20,000 pro-liberty activists to move to New Hampshire, where they will exert the fullest practical effort toward the creation of a society in which the maximum role of government is the protection of life, liberty, and property. The success of the Project would likely entail reductions in taxation and regulation, reforms at all levels of government to expand individual rights and free markets, and a restoration of constitutional federalism, demonstrating the benefits of liberty to the rest of the nation and the world. [It is indeed a tragedy that the burden of government in the U.S., a freedom society for its first 150 years, is so great that people want to escape to a state solely for the purpose of reducing that oppression. We hope this gives each of us an impetus to restore freedom from government intrusion in our own state.] Read the current report on how New Hampshire can stop the Federal Police State at

•                      Hillsdale College, 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 non-discrimination and equal opportunity. The price of freedom is never cheap. While schools throughout the nation are bowing to an unconstitutional federal mandate that schools must adopt a Constitution Day curriculum each September 17th or lose federal funds, Hillsdale students take a semester-long course on the Constitution restoring civics education and developing a civics textbook, a Constitution Reader. You may log on at to register for the annual weeklong von Mises Seminars, held every February, or their famous Shavano Institute. You may join them to explore the Roots of American Republicanism on a British Isles cruise on July 10-21, 2006. Congratulations to Hillsdale for its national rankings in the USNews College rankings. 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 Also read his comments on Ronald Reagan, RIP, at Please log on and register to receive Imprimis, their national speech digest that reaches more than one million readers each month. This month, read Steve Philip F. Anschutz: Whatever Happened to the Family Film? at Forbes, Editor-in-Chief of Forbes, The Great (and Continuing) Economic Debate of the 20th Century at The last ten years of Imprimis are archived at

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Please note: Articles that appear in MedicalTuesday may not reflect the opinion of the editorial staff.

ALSO NOTE: MedicalTuesday receives no government, foundation, or private funds. The entire cost of the website URLs, website posting, distribution, managing editor, email editor, and the twenty hours per week of writing is solely paid for and donated by the Founding Editor, while continuing his Pulmonary Practice, as a service to his patients, his profession, and in the public interest for his country.

Del Meyer

Del Meyer, MD, Editor & Founder

6620 Coyle Ave, Ste 122, Carmichael, CA 95608

Words of Wisdom

Benjamin Franklin (1706 - 1790): American statesman, scientist, philosopher, and author known for his aphorisms, inventions, and government service. His aphorisms were published in Poor Richard's Almanac (1732-1757). In Rivers and bad Government; the lightest Things swim at top - 1754.

Ibid: In general I would only observe that commerce, consisting in a mutual exchange of the necessities and conveniences of life, the more free and unrestrained it is, the more it flourishes; and the happier are all the nations concerned in it. Most of the restraints put upon it in different countries seem to have been the projects of particulars for the private interest, under pretense of public good, 1783. - The Writings of Benjamin Franklin (1905-1907)

Ibid: I have seen so much embarrassment and so little advantage in all the restraining and compulsive systems, that I feel myself strongly inclined to believe that a state which leaves all her ports open to all the world upon equal terms will, byu that means, have foreign commodities cheaper, sell its own productions dearer, and be on the whole the most prosperous.

-Leonard and Thelma Spinard

Some Recent Postings

Americans are Hilarious by David Gibson, MD.

Ashley and the Mooncorn People by Jared James Grantham, MD.

In Memoriam

Sir Hans Singer, development economist, died on February 26th, aged 95.  THE poor are always with us, said Jesus. But they are not always fashionable. Few people have been such indefatigable thinkers about the economics of poverty as Sir Hans Singer, a British development theorist who was born a Jew and brought up in a Catholic area of mainly Protestant Germany. He came from "a minority in a minority in a minority", he liked to say, with a smile that belied how much he cared about the world's marginalised.

Sir Hans - then plain Mr Singer - was planning to become a doctor when, in the early 1930s, he was won over to economics by a series of lectures by Joseph Schumpeter and Arthur Spiethoff, respectively Austrian and German economists. A year after Adolf Hitler's rise to power in 1933, Schumpeter persuaded John Maynard Keynes to accept the newly married asylum-seeker from Nazi Germany as one of his earliest PhD students at Cambridge. . . .

To read the entire Obit, please go to

On This Date in History - May 9

On this date in 1926, Lt Commander Richard E.  Byrd and Floyd Bennett made that first Polar flight over the North Pole, 17 years after modern man reached the North Pole.

On this date in 1944, the first Eye Bank opened ushering in a new kind of world with a new kind of bank. It was opened at New York Hospital, a place where human eye elements could be kept to replace others. On this anniversary date, we salute the world's greatest mechanics, the surgeons who do so well at patching up human beings.

On this date in 1800, John Brown was born in Torrington, Connecticut. He fought against slavery and felt so strongly that he killed to fight it. He helped make a new land known as bloody Kansas and he met his Waterloo at Harper's Ferry, where a military unit captured him for the trial that led to his execution. The commander of that U.S. unit was a man named Robert E. Lee, who went on to command the Confederate Army. The Union Army marched singing, "John Brown's body lies a-moldering in the grave but his soul goes marching on."