Community For Better Health Care

Vol X, No 2, April 26, 2011


In This Issue:

1.                  Featured Article: Ayn Rand on tax day

2.                  In the News: ObamaCare Opt Outs

3.                  International Medicine: Intellectual Dishonesty On Health-Care Issues

4.                  Medicare: ObamaCare

5.                  Medical Gluttony: Tossing Drugs into the Toilet.

6.                  Medical Myths: Information technology will improve efficiency and safety

7.                  Overheard in the Medical Staff Lounge: Is Newt Gingrich Presidential?

8.                  Voices of Medicine: The Social Security trust fund is an Empty Lockbox

9.                  The Bookshelf: No one can fully appreciate the great fortune we have to be Americans . . . 

10.              Hippocrates & His Kin: The modern Squatters

11.              Related Organizations: Restoring Accountability in Medical Practice and Society

Words of Wisdom, Recent Postings, In Memoriam . . .

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Always remember that Chancellor Otto von Bismarck, the father of socialized medicine in Germany, recognized in 1861 that a government gained loyalty by making its citizens dependent on the state by social insurance. Thus socialized medicine, or any single payer initiative, was born for the benefit of the state and of a contemptuous disregard for people’s welfare.

Thus we must also remember that ObamaCare has nothing to do with appropriate healthcare; it was similarly projected to gain loyalty by making American citizens dependent on the government and eliminating their choice and chance to improve their welfare or quality of healthcare. Socialists know that once people are enslaved, freedom seems too risky to pursue.

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1.      Featured Article: Ayn Rand on tax day

American politics | Democracy in America

Taxes and government | The Economist | Apr 15th 2011

. . . April 15th, tax day! (But not this year; this year, it's Emancipation Day, which is worth observing if anything is.) And probably not coincidentally, the movie adaptation of Ayn Rand's widely-loved and loathed novel "Atlas Shrugged" opens today at theatres nationwide. So what could be more appropriate and entertainingly polarising than a discussion of Ayn Rand's views on taxation?

Ayn Rand's position on government finance is unusual, to say the least. Rand was not an anarchist and believed in the possibility of a legitimate state, but did not believe in taxation. This left her in the odd and almost certainly untenable position of advocating a minimal state financed voluntarily. In her essay "Government Financing in a Free Society", Rand wrote:

In a fully free society, taxation—or, to be exact, payment for governmental services—would be voluntary. Since the proper services of a government—the police, the armed forces, the law courts—are demonstrably needed by individual citizens and affect their interests directly, the citizens would (and should) be willing to pay for such services, as they pay for insurance.

This is faintly ridiculous. From one side, the libertarian anarchist will agree that people are willing to pay for these services, but that a government monopoly in their provision will lead only to inefficiency and abuse. From the other side, the liberal statist will defend the government provision of the public goods Rand mentions, but will quite rightly argue that Rand seems not to grasp perhaps the main reason government coercion is needed, especially if one believes, as Rand does, that individuals ought to act in their rational self-interest.

It's true that we each benefit from the availability of genuinely public goods, but we benefit most if we are able to enjoy them without paying for them. A rationally self-interested individual will not voluntarily pay for public goods if she believes others will pay and she can get a free ride. But if we're all rationally self-interested, and we know we're all rationally self-interested, we know everyone else will also try to get a free ride, in which case it is doubly irrational to voluntarily pitch in. Even if you're not inclined to ride for free, why throw good money at an enterprise bound to fail? By threatening coercion against those who refuse to pay, the state establishes the conditions under which it would not be pointless to pitch in—a condition in which you can be confident others will pitch in too. Tax collection solves the "assurance problem", as the game theorists call it.

Generally, Rand's moral and political philosophies run aground by failing to follow the correct but counterintuitve logic of the social contract tradition. The interests of individuals in society are best met when limits on self-interest are observed and enforced. At a sub-political level, the internalisation of moral constraints on self-interest is, seemingly paradoxically, a requirement of self-interest. At the political level, the artful application of state coercion overcomes the conflict and mis-coordination that prevail under conditions of "natural liberty" and establishes the peaceful and prosperous conditions of "civil liberty". It's worth adding that, in my opinion, the libertarian anarchist is right that if the public-goods argument justifies the services of the night-watchman state, it also justifies much more. In my opinion, the public-goods argument goes as far as justifying a scheme of social insurance that indemnifies individuals against a certain degree of bad fortune.  

The implausibility of voluntary-financed government notwithstanding, elements of Rand's view remain profoundly appealing. For example:

The principle of voluntary government financing rests on the following premises: that the government is not the owner of the citizens’ income and, therefore, cannot hold a blank check on that income—that the nature of the proper governmental services must be constitutionally defined and delimited, leaving the government no power to enlarge the scope of its services at its own arbitrary discretion. Consequently, the principle of voluntary government financing regards the government as the servant, not the ruler, of the citizens—as an agent who must be paid for his services, not as a benefactor whose services are gratuitous, who dispenses something for nothing.

The general view expressed here captures much of the reasonable moral core of the movement to restore and reinforce effective constitutional limits on government. Many Americans believe, not unreasonably, that far from acting always as an instrument that serves their interests, government often acts as if citizens' lives and labour are instruments to the special interests that control government. Indeed, the principle embedded in Mr Obama's budget speech, that tax increases are spending cuts, suggests the objectionable idea that all income is government-owned, which it then "spends" by choosing not to hoover it up in taxes. To object to this way of picturing the relationship between citizens, their property, and their government is not to deny that the infrastructure of security, property and law maintained by government is necessary for a well-functioning economy that generates good jobs and decent incomes. It is necessary. But that infrastructure is for us. We are not for financing it. And we certainly aren't for financing whatever extraneous functions our continually mission-creeping government happens to have taken on. Necessary taxation is not theft. But there are margins at which taxation becomes difficult to distinguish from theft.  

As Abraham Lincoln said so well, "The legitimate object of government, is to do for a community of people, whatever they need to have done, but can not do, at all, or can not, so well do, for themselves—in their separate, and individual capacities." Citizens reasonably resent a government that milks them to feed programmes that fail Lincoln's test. The inevitable problem in a democracy is that we disagree about which programmes those are. Some economists are fond of saying that "economics is not a morality play", but like it or not, our attitudes toward taxation are inevitably laden with moral assumptions. It doesn't help to ignore or casually dismiss them. It seems to me the quality and utility of our public discourse might improve were we to do a better job of making these assumptions explicit, and of seriously and respectfully considering whether our ideological opposites, be they socialists or "Atlas Shrugged" fans, might have one or two worthwhile points.

Read the whole Ayn Rand view of voluntary taxation. . .

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2.      In the News: ObamaCare Opt Outs

States turn down money for the law's new insurance exchanges.

It's not often that states turn their back on money from Washington, but at least two states may say no thanks to federal grants to implement the new federal health-care law.

In February the federal Department of Health and Human Services selected seven states to get $240 million in demonstration grants this year to kick start the health-care plan. But Oklahoma Governor Mary Fallin announced last week that the Sooner State will decline $54.6 million from the feds to establish new insurance exchanges. Read more…

And as early as this week the New Hampshire state house is expected to pass a bill rejecting $666,000 the feds bequeathed to that state to start up exchanges. Two other grant recipients—Kansas and Wisconsin—may also turn down the funds as well as request Medicaid waivers to design their own health-care law for low-income residents.

Oklahoma faces a $500 million budget shortfall and at first accepted the federal health dollars. But Oklahoma citizens approved a ballot initiative last year to block implementation of the new law and its nearly 2,000 pages of rules and mandates. Oklahoma is also among the nearly 30 states that have filed a lawsuit challenging the law's constitutionality. State officials fear that taking even one dollar of the money would run the risk of the federal government running health care in Oklahoma.

So now the Sooners are devising their own insurance plan to comply with the ObamaCare mandate that every state create an insurance exchange by 2013. The Oklahoma plan is to create an insurance "network" that would increase portability of private employer health plans, increase the range of choices of insurance coverage (including high deductible health-savings account plans), allow workers and small employers to use pre-tax dollars for health coverage, and subsidize the uninsured to purchase an insurance plan. "We think that by relying on markets, we can do this at a much lower cost to the state than the ObamaCare plan," Governor Fallin says.

Republicans who control both houses in the New Hampshire legislature have reached the same conclusion. House Speaker William O'Brien wants to return the federal money to lower the federal deficit. That's popular in the first Presidential primary state, where polls are finding that voters disapprove of the law by nearly a two to one margin.

Democratic Governor John Lynch may veto the bill, but the political trend shows that the President's health reform is not getting any more popular with age, despite Democratic and media predictions. The states are concluding that the more they get to know about ObamaCare, the less they think they can afford it.

Read the entire editorial at the WSJ – Subscription required . . .

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3.      International Medicine: Intellectual Dishonesty On Health-Care Issues

Public and private health care: facts and logic needed

By Peter Blaikie, Special to The Gazette April 27, 2011

One morning last week, after I had read the Gazette headline “Hip surgery wait times fail seniors,” I heard Mike Finnerty on CBC Daybreak interviewing three candidates. For the sake of their family and friends, I will not name them!

Mr. Finnerty asked each of them to answer a simple, direct and highly relevant question, namely, “If elected, would you act to shut down all private medical services in Quebec?” Each of the three, following the mantra clearly ordered by their respective leaders, said exactly the same thing: “Yes, if such services violated the Canada Health Act.”

All parties are displaying the most blatant intellectual dishonesty on health-care issues. To borrow from Aneurin Bevan, speaking of Anthony Eden during the Suez crisis, “If he is sincere in what he is saying then he is too stupid to be a Prime Minister.” It is perhaps more a matter of integrity than stupidity. There are a few simple facts that any moderately intelligent and intellectually honest person knows about the health-care system.

First, however much those responsible seek to deny it, we already have a two-tier system and, probably, several other tiers as well.

Second, if an attempt were made by a Canadian government to shut down all private health-care services, the entire health-care system would very quickly collapse. Of course, the threat is merely the most blatant hypocrisy, since the existence of private services is well-known to all.

Third, in its present form, the Canadian health-care system is not sustainable in the long term, either financially or in terms of resources


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Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.

--Canadian Supreme Court Decision 2005 SCC 35, [2005] 1 S.C.R. 791

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4.      Medicare: ObamoCare

Although the federal district courts have split on whether people can be forced to purchase government-designed health insurance, they have assumed that Congress may constitutionally regulate health insurance in general. But that assumption is wrong: In fact, the congressional power to regulate "Commerce ... among the several States" does not include authority to regulate health insurance. Under the Constitution, health insurance is a matter of state, not federal, jurisdiction.

In assuming the contrary, the lower courts have relied on a single erroneous U.S. Supreme Court decision, U.S. v. South-Eastern Underwriters Association. Since the case is standing precedent, lower courts must follow it. However, when the cases challenging the recent health care legislation reach the Supreme Court, the justices should begin by overruling that case.

As used in the Constitution, "commerce" refers only to a particular subset of economic activity — primarily the buying and selling of goods by merchants. We know this from several studies of how the founding generation used the term. In two studies, for example, Georgetown University Law Center professor Randy Barnett surveyed thousands of contemporaneous uses and found this to be the dominant meaning. . .

The founding-era understanding that "commerce" excluded most forms of insurance was honored by the Supreme Court for more than 150 years after the Constitution was adopted. In a string of cases, the Court affirmed that "commerce" did not include insurance. In the most famous of these, Paul v. Virginia (1869), a unanimous Court wrote that insurance contracts "are not articles of commerce in any proper meaning of the word." . . .

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

- Ronald Reagan

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5.      Medical Gluttony: Tossing Drugs into the Toilet.

Mary had peptic disease manifested by heartburns that awakened her at night. Her family physician prescribed an acid reducer in the form of Pepcid, which she felt was very effective in relieving the daytime symptoms and eliminating the nocturnal discomfort. Another physician prescribed Ranitidine. She had three bottles of these two acid reducers essentially nearly full.

For reasons unknown, her physician sent her to a gastroenterologist who told her to discard the acid reducers she had and take Prilosec.

The Pepcid and Ranitidine, when they were proprietary, cost $4 or $120 a month. They are now ten cents or $3 per month. The Prilosec, before it became generic, was $5 or $150 a month. It is now 50˘ or $15 a month.

So the cost of throwing a few hundred tablets in the toilet wasn’t all that much. But it creates a culture of tossing medications.

Several years ago, that same attitude would have tossed $120 or $150 into the toilet.

Medical Letter cites research that most drugs are good for about 10 years after the expiration date. Hence, there is seldom a reason to toss medications for symptoms that are ongoing. Drugs manufactured in the United States are unusually stable. The exception is liquid medications. 

Physicians and nurses need to be oriented to all cost-saving measures. Tossing good pharmaceuticals is not one of them.

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Medical Gluttony thrives in Government and Health Insurance Programs.

Gluttony Disappears with Appropriate Deductibles and Co-payments on Every Service.

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6.      Medical Myths: Information technology will improve efficiency and safety.

A large part of the savings projected from “healthcare reform” is supposed to come from wider use of information technology. The federal government is expected to “invest” some $45 billion in encouraging (or compelling) doctors and hospitals to use electronic records systems.

“Information is the lifeblood of modern medicine. Health information technology (HIT) is destined to be its circulatory system,” writes David Blumenthal, M.D., M.P.P., of the Office of that National Coordinator for Health Information Technology (New England Journal of Medicine 12/30/09). “Physicians and institutions trying to practice highest-quality medicine without HIT are like Olympians trying to perform with a failing heart,” he states. (Note that Blumenthal’s numerous financial disclosures are in a separate document.)

In the real world, there are many problems in implementation. The University of California San Francisco Medical Center is one institution that is quietly writing off about a third of the $50 million it has poured into electronic medical records over the past 5 years. The system is still not fully up and running. UCSF terminated its contractor and is prepared to start part of the project from scratch (Huffington Post 11/23/09).

According to one study, between 50% and 80% of electronic health records systems fail. The larger the EHR project, the higher the risk of failure (IEEE Spectrum 1/1/10). . .

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Medical Myths Originate When the Government Designs Healthcare.

Myths Disappear When Patients Pay Appropriate Deductibles and Co-Payments on Every Service.

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7.      Overheard in the Medical Staff Lounge: Is Newt Gingrich Presidential?

Dr. Rosen: Last week we discuss how best to contribute effectively politically. The landscape is changing. We now have Newt Gingrich with a web machine that’s bringing in $millions. Is he a winning candidate? Does he represent physicians' interests? Does he represent true constitutional interests? Would he be good for America?

Dr. Yancy: I wouldn’t vote for Newt if he was the final candidate. He tried to turn off our government and then reneged after 10 days.

Dr. Ruth: And the people that had a week off without pay returned and got all their back pay when he got cold feet.

Dr. Michelle: That was a week and a half of additional paid vacation for all federal workers. But did he have an option?

Dr. Yancy: Certainly. If he had kept the government shut down for a month or two we would have saved considerable moneys.

Dr. Dave: We might also have found out that we could run the government with significantly fewer employees.

Dr. Milton: Maybe half?

Dr. Dave: Well, maybe not that many. But I would guess we could cut 20-30 percent without any loss in services.

Dr. Paul: How could you have possibly come up with that figure?

Dr. Milton: Have you ever gone into a government office and found more than half really working?

Dr. Dave: It’s the culture of a government job. It’s just a gravy train to retirement. Using sick time before or after a holiday is just considered a benefit—like vacation time. There is no virus or bacteria that only strikes 24 hours before a holiday.

Dr. Milton: My government patients come in with the flimsiest excuses and want me to write a note that they can’t work for a few days.

Dr. Yancy: Have you ever tried not writing that note and succeeded without a threat of RIGHTS?

Dr. Milton: I’ve hesitated a few times, then quickly realized they would have their Union Organization get involved. It’s almost as if they have a constitutional right to be out for fake sickness.

Dr. Rosen: So you’re left with an ethical dilemma. They are not sick enough to require time off from work so you’re party to subterfuge and unethical medical practice by writing the note.

Dr. Michelle: I’ve been able to sweet talk a patient into believing work would be good for him.

Dr. Milton: But you’re sweet, smart and gorgeous and could talk almost anybody into anything you set your mind to.

Dr. Michelle: I’ve had my share of grumpy patients.

Dr. Rosen: Back to Newt. I wouldn’t vote for him because of his lack of character. Any man who carries on an affair with his staff, then criticizes the president for messing around with an intern, is not a role model fit for a president.

Dr. Ruth: What really set me against him was not only him having an affair while his wife was in the hospital with breast cancer, but when he actually went to the hospital and told his wife in the midst of her critical cancer time that he was divorcing her. He couldn’t even wait until she was home to do it privately.

Dr. Michelle: That really was unbelievable, crude, inhumane, insensitive and so undignified that he should never be the leader of our country. He’s a scum bag.

Dr. Milton: He’s got so much baggage that he would be the easiest for Obama to annihilate. It would cause irreparable harm to the constitutional party.

Dr. Rosen: Then we would really become Napoleon’s France or Germany’s Bismarck—pouring 250 years of progress in Freedom down the drain.

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The Staff Lounge Is Where Unfiltered Medical Opinions Are Heard.

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8.      Voices of Medicine: A Review of Articles by Physicians

Social Security: It’s still an empty lockbox

By Charles Krauthammer, MD, Opinion Writer, Washington Post ,

Last week, President Obama’s budget chief, Jack Lew, took to his White House blog to repeat his claim that the Social Security trust fund is solvent through 2037. And to chide me for suggesting otherwise. I had argued in my last column that the trust fund is empty, indeed fictional.

If Lew’s claim were just wrong, that would be one thing. But it provides the intellectual justification for precisely the kind of debt denial and entitlement complacency that his boss is now engaged in. Therefore, once more unto the breach.

Lew acknowledges that the Social Security surpluses of the last decades were siphoned off to the Treasury Department and spent. He also agrees that Treasury then deposited corresponding IOUs — called “special issue” bonds — in the Social Security trust fund. These have real value, claims Lew. After all, “these Treasury bonds are backed by the full faith and credit of the U.S. government in the same way that all other U.S. Treasury bonds are.”

Really? If these trust fund bonds represent anything real, why is it that in calculating national indebtedness they are not even included? We measure national solvency by debt/GDP ratio. As calculated by everyone from the OMB to the CIA, from the Simpson-Bowles to the Domenici-Rivlin commissions, the debt/GDP ratio counts only publicly held debt. This means bonds held by China, Saudi Arabia, you and me. The debt ratio completely ignores the kind of intragovernmental bonds that Lew insists are the equivalent of publicly held bonds.

Why? Because the intragovernmental bond is nothing more than a bookkeeping device that records how much one part of the U.S. government (Treasury) owes another part of the same government (the Social Security Administration). In judging the creditworthiness of the United States, the world doesn’t care what the left hand owes the right. It’s all one entity. It cares only what that one entity owes the world.

That’s why publicly held bonds are so radically different from intragovernmental bonds. If we default on Chinese-held debt, decades of AAA creditworthiness are destroyed, the world stops lending to us, the dollar collapses, the economy goes into a spiral and we become Argentina. That’s why such a default is inconceivable.

On the other hand, what would happen to financial markets if the Treasury stopped honoring the “special issue” bonds in the Social Security trust fund? A lot of angry grumbling at home for sure. But externally? Nothing.

This “default” would simply be the Treasury telling the Social Security Administration that henceforth it would have to fend for itself in covering its annual shortfall. How? By means-testing (cutting the benefits to the rich), changing the inflation formula, raising the retirement age and, if necessary, hiking the cap on income subject to the payroll tax . . .

Invoking the “full faith and credit” mantra for those IOUs in the trust fund is empty bluster. It does not change the fact that, as the OMB itself acknowledged, those IOUs “do not consist of real economic assets that can be drawn down in the future to fund benefits.” Yet Lew continues to insist that these “special issue” trinkets will pay off seniors for the next 26 years.

Nonsense. That money is gone with the wind. Those trust fund trinkets are nothing more than a record of past borrowings. They say nothing about the future.

Consider: If Treasury had borrowed twice as much from Social Security in the past — producing twice as many IOUs sitting in the lockbox — would this mean the trust fund is today twice as strong? Solvent for 50-some years instead of just 26? Of course not. The trust fund “balances” are mere historical record-keeping. As the OMB itself admitted, future payouts will have to be met by future taxes and future borrowings — or by Social Security reform that, by reducing benefits, makes such taxing and borrowing unnecessary.

There is no third alternative. There is no free lunch. And there is nothing in the lockbox.

Read Dr. Krauthammer’s entire OpEd on the Washington Post . . .

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VOM Is an Insider's View of What Doctors are Thinking, Saying and Writing about.

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9.      Book Review: No one can fully appreciate the great fortune we have to be Americans . . . 

A Time For Freedom, by Lynne Cheney, Simon & Schuster, New York, © 2005, ISBN: 13-978-1-4169-0925-5, 282 pp, $15.95 US, $21.95 CAN.

“No one can fully appreciate the great fortune we have to be Americans without knowing the events that brought us to where we are today.” –Lynne Cheney

Lynne Cheney, a teacher, states in her introduction that our freedom and strength are products of the past, and although the choices made by the brave men and women who preceded us do not offer sure guidance to the future, they offer the best guidance that we have. Read more. . .

Unfortunately, fewer and fewer of us are leaving school knowing the basic facts of our history. One study found that two thirds of seventeen-year-olds could not identify the half-century in which the Civil War occurred. A survey of seniors at elite colleges and universities showed that only one out of five was familiar with the words of the Gettysburg Address. A significant number of seniors thought that Ulysses S. Grant was a general in the Revolutionary War.

Facts alone are not enough for understanding history of course, but without the facts understanding is impossible. A full appreciation of the achievement represented by the Nineteenth Amendment, ratified in 1920, requires knowing that women first organized to work for the right to vote in 1848, more than seventy years before. Comprehending why the Civil War occurred in the 1860s requires knowing that our nation expanded dramatically in the 1840s. It was a question of whether new states would be free or slave that finally made it impossible to paper over the great moral contradiction that slavery represented in a nation dedicated to freedom.

Cheney feels that some dates should be locked in our memory—1492, 1607, 1620, 1776, and 1787 for starters. But it is equally important to be familiar enough with the order of events so that one has a sense of the progress of our national story. We should all understand that when the delegates to the Continental Congress declared that “all men are created equal,” they provided more than a rationale for independence; they gave inspiration to generations of men and women whose struggles would make that ideal a reality for more and ever more Americans.

This book is a time line of the events in our nation’s history. She chose to highlight our political history rather than many other areas of importance. She feels the history of the entire world ought to be a subject of interest for students. But in A Time for Freedom, she chose to start with America. This is our home—how lucky we are that it is.

We shall highlight a few dozen of the hundreds of dates she has listed hoping that will inspire you to obtain a copy of her book and search further. . .

Read the entire book review . . .
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The Book Review Section Is an Insider’s View of What Doctors are Reading about.

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10.  Hippocrates & His Kin: The modern Squatters

In Miami, nearly 60% of home sales last year were buyers from overseas; for newly built condos in down town Miami, the figure jumps to 90%.

What a way to take over a State? –or a Country?

The American Way of Death (We’re researching the validity of this claim)       

On two tablets of stone, DIETS & DYING found on Mt Ararat, a short distance from Mt Sinai, the final word on nutrition and health were found:

The Japanese eat very little fat or red wine and suffer fewer heart attacks than the
British or Americans.
The French eat a lot of fat, drink a lot of red wine, and also suffer fewer heart attacks than the British or Americans.
Italians drink excessive red wine and a lot of cheese and suffer fewer heart attacks than the British or Americans.

Conclusion: Eat and drink what you like. Speaking English is apparently what kills you.

The health care industry violates natural law.

The health care industry is the only sector of the economy that is failing and there’s nothing employers can do about it. Health care is the only product or service (outside of public education) that has consistently grown worse over the past 30 years.  Every other product and service in our economy has improved in quality and grown less expensive over time.

What I will do today is show you why providing health care by ignoring or violating the laws of economics is like trying to run an airline while ignoring or violating the laws of gravity.  Because doctors and patients are no more above the laws of economics than pilots and skydivers are above the laws of gravity.

Excerpted from an address by Gerry Smedinghoff

Researchers say:

If Students Misbehave Just 2 Percent of The Time, Teacher Effectiveness Drops By 60 Percent.

—Economic Intuition/Quarterly Journal of Economics


Two people in discussion at the Pearly Gates as they’re waiting for Moses to sign them in:

Well, with me it was killer bees. It happened when I stopped to smell the roses.

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Hippocrates and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Yesterday, Today & Tomorrow

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11.  Professionals Restoring Accountability in Medical Practice, Government and Society:

                      John and Alieta Eck, MDs, for their first-century solution to twenty-first century needs. With 46 million people in this country uninsured, we need an innovative solution apart from the place of employment and apart from the government. To read the rest of the story, go to and check out their history, mission statement, newsletter, and a host of other information. For their article, "Are you really insured?," go to

                      Medi-Share Medi-Share is based on the biblical principles of caring for and sharing in one another's burdens (as outlined in Galatians 6:2). And as such, adhering to biblical principles of health and lifestyle are important requirements for membership in Medi-Share. This is not insurance.

                      PATMOS EmergiClinic - where Robert Berry, MD, an emergency physician and internist, practices. To read his story and the background for naming his clinic PATMOS EmergiClinic - the island where John was exiled and an acronym for "payment at time of service," go to To read more on Dr Berry, please click on the various topics at his website. Review How to Start a Third-Party Free Medical Practice . . .

                      PRIVATE NEUROLOGY is a Third-Party-Free Practice in Derby, NY with Larry Huntoon, MD, PhD, FANN. ( Dr Huntoon does not allow any HMO or government interference in your medical care. "Since I am not forced to use CPT codes and ICD-9 codes (coding numbers required on claim forms) in our practice, I have been able to keep our fee structure very simple." I have no interest in "playing games" so as to "run up the bill." My goal is to provide competent, compassionate, ethical care at a price that patients can afford. I also believe in an honest day's pay for an honest day's work. Please Note that PAYMENT IS EXPECTED AT THE TIME OF SERVICE. Private Neurology also guarantees that medical records in our office are kept totally private and confidential - in accordance with the Oath of Hippocrates. Since I am a non-covered entity under HIPAA, your medical records are safe from the increased risk of disclosure under HIPAA law. 

                      FIRM: Freedom and Individual Rights in Medicine, Lin Zinser, JD, Founder,, researches and studies the work of scholars and policy experts in the areas of health care, law, philosophy, and economics to inform and to foster public debate on the causes and potential solutions of rising costs of health care and health insurance. Read Lin Zinser’s view on today’s health care problem:  In today’s proposals for sweeping changes in the field of medicine, the term “socialized medicine” is never used. Instead we hear demands for “universal,” “mandatory,” “singlepayer,” and/or “comprehensive” systems. These demands aim to force one healthcare plan (sometimes with options) onto all Americans; it is a plan under which all medical services are paid for, and thus controlled, by government agencies. Sometimes, proponents call this “nationalized financing” or “nationalized health insurance.” In a more honest day, it was called “socialized medicine.”

                      To read the rest of this section, please go to

                      Michael J. Harris, MD - - an active member in the American Urological Association, Association of American Physicians and Surgeons, Societe' Internationale D'Urologie, has an active cash'n carry practice in urology in Traverse City, Michigan. He has no contracts, no Medicare, Medicaid, no HIPAA, just patient care. Dr Harris is nationally recognized for his medical care system reform initiatives. To understand that Medical Bureaucrats and Administrators are basically Medical Illiterates telling the experts how to practice medicine, be sure to savor his article on "Administrativectomy: The Cure For Toxic Bureaucratosis."

                      Dr Vern Cherewatenko concerning success in restoring private-based medical practice which has grown internationally through the SimpleCare model network. Dr Vern calls his practice PIFATOS – Pay In Full At Time Of Service, the "Cash-Based Revolution." The patient pays in full before leaving. Because doctor charges are anywhere from 25–50 percent inflated due to administrative costs caused by the health insurance industry, you'll be paying drastically reduced rates for your medical expenses. In conjunction with a regular catastrophic health insurance policy to cover extremely costly procedures, PIFATOS can save the average healthy adult and/or family up to $5000/year! To read the rest of the story, go to 

                      Dr David MacDonald started Liberty Health Group. To compare the traditional health insurance model with the Liberty high-deductible model, go to There is extensive data available for your study. Dr Dave is available to speak to your group on a consultative basis.

                      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 To read his "Lessons from the Past," go to For additional articles, such as the cost of Single Payer, go to; for Health Care Inflation, go to

                      ReflectiveMedical Information Systems (RMIS), delivering information that empowers patients, is a new venture by Dr. Gibson, one of our contributors, and his research group which will go far in making health care costs transparent. This site provides access to information related to medical costs as an informational and educational service to users of the website. This site contains general information regarding the historical, estimates, actual and Medicare range of amounts paid to providers and billed by providers to treat the procedures listed. These amounts were calculated based on actual claims paid. These amounts are not estimates of costs that may be incurred in the future. Although national or regional representations and estimates may be displayed, data from certain areas may not be included. You may want to follow this development at During your visit you may wish to enroll your own data to attract patients to your practice. This is truly innovative and has been needed for a long time. Congratulations to Dr. Gibson and staff for being at the cutting edge of healthcare reform with transparency. 

                      Dr Richard B Willner, President, Center Peer Review Justice Inc, states: We are a group of healthcare doctors -- physicians, podiatrists, dentists, osteopaths -- who have experienced and/or witnessed the tragedy of the perversion of medical peer review by malice and bad faith. We have seen the statutory immunity, which is provided to our "peers" for the purposes of quality assurance and credentialing, used as cover to allow those "peers" to ruin careers and reputations to further their own, usually monetary agenda of destroying the competition. We are dedicated to the exposure, conviction, and sanction of any and all doctors, and affiliated hospitals, HMOs, medical boards, and other such institutions, who would use peer review as a weapon to unfairly destroy other professionals. Read the rest of the story, as well as a wealth of information, at

                      Semmelweis Society International, Verner S. Waite MD, FACS, Founder; Henry Butler MD, FACS, President; Ralph Bard MD, JD, Vice President; W. Hinnant MD, JD, Secretary-Treasurer; is named after Ignaz Philipp Semmelweis, MD (1818-1865), an obstetrician who has been hailed as the savior of mothers. He noted maternal mortality of 25-30 percent in the obstetrical clinic in Vienna. He also noted that the first division of the clinic run by medical students had a death rate 2-3 times as high as the second division run by midwives. He also noticed that medical students came from the dissecting room to the maternity ward. He ordered the students to wash their hands in a solution of chlorinated lime before each examination. The maternal mortality dropped, and by 1848, no women died in childbirth in his division. He lost his appointment the following year and was unable to obtain a teaching appointment. Although ahead of his peers, he was not accepted by them. When Dr Verner Waite received similar treatment from a hospital, he organized the Semmelweis Society with his own funds using Dr Semmelweis as a model: To read the article he wrote at my request for Sacramento Medicine when I was editor in 1994, see To see Attorney Sharon Kime's response, as well as the California Medical Board response, see Scroll down to read some very interesting letters to the editor from the Medical Board of California, from a member of the MBC, and from Deane Hillsman, MD.

To view some horror stories of atrocities against physicians and how organized medicine still treats this problem, please go to

                      Dennis Gabos, MD, President of the Society for the Education of Physicians and Patients (SEPP), is making efforts in Protecting, Preserving, and Promoting the Rights, Freedoms and Responsibilities of Patients and Health Care Professionals. For more information, go to

                      Robert J Cihak, MD, former president of the AAPS, and Michael Arnold Glueck, M.D, who wrote an informative Medicine Men column at NewsMax, have now retired. Please log on to review the archives. He now has a new column with Richard Dolinar, MD, worth reading at

                      The Association of American Physicians & Surgeons (, The Voice for Private Physicians Since 1943 representing physicians in their struggles against bureaucratic medicine, loss of medical privacy, and intrusion by the government into the personal and confidential relationship between patients and their physicians. Be sure to read News of the Day in Perspective. Don't miss the "AAPS News," written by Jane Orient, MD, and archived on this site which provides valuable information on a monthly basis. Browse the archives of their official organ, the Journal of American Physicians and Surgeons, with Larry Huntoon, MD, PhD, a neurologist in New York, as the Editor-in-Chief. There are a number of important articles that can be accessed from the Table of Contents.

The AAPS California Chapter is an unincorporated association made up of members. The Goal of the AAPS California Chapter is to carry on the activities of the Association of American Physicians and Surgeons (AAPS) on a statewide basis. This is accomplished by having meetings and providing communications that support the medical professional needs and interests of independent physicians in private practice. To join the AAPS California Chapter, all you need to do is join national AAPS and be a physician licensed to practice in the State of California. There is no additional cost or fee to be a member of the AAPS California State Chapter.
Go to California Chapter Web Page . . .

Bottom line: "We are the best deal Physicians can get from a statewide physician based organization!"

 PA-AAPS is the Pennsylvania Chapter of the Association of American Physicians and Surgeons (AAPS), a non-partisan professional association of physicians in all types of practices and specialties across the country. Since 1943, AAPS has been dedicated to the highest ethical standards of the Oath of Hippocrates and to preserving the sanctity of the patient-physician relationship and the practice of private medicine. We welcome all physicians (M.D. and D.O.) as members. Podiatrists, dentists, chiropractors and other medical professionals are welcome to join as professional associate members. Staff members and the public are welcome as associate members. Medical students are welcome to join free of charge.

Our motto, "omnia pro aegroto" means "all for the patient."

Words of Wisdom

“Imagination is more important than knowledge.” –Albert Einstein

“Don’t argue with a fool. The spectators can’t tell the difference.” –Charles Nalin

“Anyone who has never made a mistake has never tried anything new.” –Albert Einstein

Some Recent Postings

In The April 12 Issue:

1.      Featured Article: Breasts will be the First Practical Natural Stem Cell Therapy  

2.      In the News: Medicaid: Coverage and Costs: 69.5 Beneficiaries; 43 % of Health care costs

3.      International Medicine: Universal health care is still just a dream even in Canada

4.      Medicare: Entitlements are enslaving Americans

5.      Medical Gluttony: Is only exceeded by Government Gluttony

6.      Medical Myths: Health Care: A Commonly Misunderstood Concept

7.      Overheard in the Medical Staff Lounge: Where are political donations most effective?

8.      Voices of Medicine: Snore and you sleep alone.

9.      Movie Review: The Gospel According to Hollywood: One Blockbuster per Generation

10.  Hippocrates & His Kin: ObamaCare Health without adequate coverage

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

Words of Wisdom, Recent Postings, In Memoriam . . .

In Memoriam

Dame Elizabeth Taylor, actress, died on March 23rd, aged 79

BESOTTED with her radiant beauty, men lined up to lay huge jewels at Elizabeth Taylor’s feet. Their size didn’t matter so much to her, she said. Though the Krupp diamond was 33.19 carat, flaming with life when the light shone through it, and the Taylor-Burton 69.42 carat, so big that it made Princess Margaret’s eyes start out of her head, what mattered more was the emotion that lay behind them.

So the $10,000 diamond and platinum ring that Nicky Hilton, the first of her seven husbands, presented to her in 1950 was the biggest thing that had so far happened to her, as marriage was. In the end it meant nothing, because he beat her. The ring of diamonds and sapphires from Michael Wilding, her second husband, which she rather than he steered to the correct finger, symbolised his caution; it soon became as dull as he was. Michael Todd, her third husband, gave her a Cartier set of rubies and diamonds and a $25,000 tiara, trinkets for the life of Hollywood extravagance to which he had introduced her. She wore the Cartier even barefoot under the lawn sprinkler. At this stage of her life, with Oscar nominations mounting up for her acting in raw, demanding parts, she began to feel that gorgeous ornaments—like lavish contracts—were only what she deserved.

It was Richard Burton’s jewels she treasured most, the wild spontaneity with which he gave them mirroring their explosive, unmanageable, on-again-off-again love. The Krupp came for beating her at ping-pong, the Taylor-Burton because, one night, he had insulted her hands. (He insulted her whole self, too, calling her a “fat little tart”, saying her legs were too short; she’d slap him, wrestle him on the ground, then make up, and so on and so on.) As the new rocks arrived during their two-decade Sturm und Drang she would parade them eagerly to friends, and sit at table silently adoring them while, with her free hand, she wolfed down steak-and-kidney pie.

Jewels were something to hide behind as, chronically shy, she always wished to hide. The glitter at wrist and neck and the cleavage-plunging pearls made “Elizabeth Taylor” less boring to her. The dutiful girl who had given up her childhood to her mother’s pushing in Hollywood, whose baby cheek had been daubed with eye-pencil to accentuate her beauty spot, who had eagerly promised to grow breasts at 12 to please the producer of “National Velvet”, could disappear behind the dazzle. She hid behind other things, too: scorching flights of four-letter words, the brash character of the “broad” or the “dame”, a demanding, regal arrogance, clouds of her own perfume (“Passion” or “White Diamonds”), pills, booze, food. Ordinary Elizabeth would then try to take that character in hand, forcing her to diet and behave.

She insisted on marriage, too, to seal the tempestuous affairs her wilder self kept falling into. Weddings allowed her to become a willing, wifely shadow behind her husbands. Cheerfully she took up Todd’s Judaism, John Warner’s senatorial Virginia tweediness, Burton’s rugby-loving, hard-drinking Welshness, and, temporarily, the weaknesses of all of them. She could “spin on a dime” for love—and spin again when another enchanted man strayed close.

Each film role gave her more cover. On screen, boring Elizabeth could win the Grand National, or tussle with horrific memories of murder in “Suddenly Last Summer”, or seduce both Caesar and Mark Anthony in real-gold robes in “Cleopatra” (1962), then the costliest film ever made. Decorous, timid Elizabeth could be a needy, whining, abandoned wife in “Cat on a Hot Tin Roof” (1958), or a disturbing prostitute in “Butterfield 8” (1960), the film for which she won her first Oscar, though she hated it. She never found acting hard, had no lessons, simply tried to become the other person, grateful to inhabit an alternative to herself. On screen she radiated a thoughtfulness in those blue-violet eyes which she defined as “concentration”. She brought it even to the dishevelled, bawling Martha baiting Burton’s George in “Who’s Afraid of Virginia Woolf?” (1966), a film that epitomised her louder life and won her her second Oscar. . .

Read the entire obit at The Economist . . .

On This Date in History – April 26

On this date in History: For years, this date has been remembered in some Southern states as Confederate Memorial Day, reserved to honor the ultimate heroes of a lost cause. It is one thing to honor all the fallen heroes; it is another to honor those who are and were our very own. May we never forget not only how this war fixed our national unity, but also how it finally made us all equal with verification on December 6, 1865 with the Thirteenth Amendment.

On this date in 1785, John James Audubon was born. John James Audubon made America aware of the magnificence of its birds. He drew them and described them with a master’s touch. We have come to see that knowledge of and concern for the living things that share our world can help to keep that world healthy. We have come to recognize that Nature’s children can learn from each other.

After Leonard and Thelma Spinrad

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Announcing The 1st Annual World Health Care Congress Latin America, October, 2011 in
Săo Paulo, Brazil

The World Health Care Congress (WHCC) convenes the most prestigious forum of global health industry executives and public policy makers. Building on the 8th annual event in the United States, the 7th annual event in Europe and the inaugural Middle East event, we are pleased to announce the 1st Annual World Health Care Congress - Latin America to be held in October, 2011 in Săo Paulo, Brazil.

This prominent international forum is the only conference in which over 500 leaders from all regions of Latin America will convene to address access, quality and cost issues, including Latin American health ministers, government officials, hospital/health system executives, insurance executives, health technology innovators, pharmaceutical, medical device, and supplier executives.

World Health Care Congress Latin America will address escalating challenges such as improving access to quality care, financing and insurance models for health care, driving innovation in health IT, promoting evidence-based medicine and clinical best practices. World Health Care Congress Latin America will feature a series of plenary keynotes, invitational executive Summits, in-depth working group sessions on emerging issues, as well as substantial business development and networking opportunities.