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MEDICAL TUESDAY . |
NEWSLETTER |
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Community For Better Health Care |
Vol X, No 16, |
In This Issue:
1.
Featured Article:
The Greek Tragedy
– A Lesson in Government Health and Entitlements
2.
In
the News: Doctor’s Revolt Shakes the
Social Security Disability Program
3.
International Medicine: Spreading
prosperity and growth
4.
Medicare: Can Medicare make
three-quad-trillion decisions a year? 3,000,000,000,000,000?
5.
Medical Gluttony:
Pharmacy Gluttony
6.
Medical Myths: Electronic Medical
Records are efficient savers of time.
7.
Overheard in the Medical Staff Lounge: Electronic
Medical Records—Current Status
8.
Voices
of Medicine: Polypharmacy Among Our Patients
9.
The Bookshelf: Taking Back Healthcare
for Future Generations
10.
Hippocrates
& His Kin: Sex and STD in
Sacramento;
11.
Related Organizations: Restoring
Accountability in Medical Practice and Society
Words of Wisdom, Recent Postings, In Memoriam, Today in History
. . .
* * * * *
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 in improving their welfare or quality of healthcare. Socialists know
that once people are enslaved, freedom seems too risky to pursue.
* * * * *
1. Featured Article: The Greek Tragedy –
A Lesson in Government Health Care and Entitlements
Greece
is broke, and so is Democracy
By Michael
Walker
The Globe and Mail
It is often the role of the economist to point at the
impending doom with which reality confronts our fondest wishes. For that reason
Thomas Carlisle referred to economics as the dismal science. It is made the
more dismal for the economist when the fondest wishes are held and extolled by
ones friends and those whom one admires.
I find myself in this predicament with the
pronunciations of two such people on the issue of the Greeks and their
political reactions to the gifts borne to them by
The problem with these assessments of the Greek
tragedy is that they ignore the fact that in
Democracy rests on a delicate balance of economic
interests. Citizens both pay taxes to, and receive benefits from, government
which is controlled by the democratic process. Rhetoric notwithstanding, the
normal pattern in Western democracies is that lower income families are net
beneficiaries and higher income families are net payers. The crucial balance
point for democracy is where the crossover in the weight of the electorate
occurs.
The normal circumstance is that fewer families are net
overall beneficiaries than are net payers. The ongoing process of democracy is
persuading those who pay more than they receive to support the social
infrastructure because it does provide some benefit to them and to the society
in general. Fiscal democracy works in this context as long as the attempt to
spend more is met by resistance from those who must pay – resistance of a kind
that it might take the creation of a Reform party to effect
The problem with deficit financing, which
unfortunately is being forgotten, is that it makes possible the delivery of
current benefits to the population for which nobody pays – or at least nobody
who is voting at the moment. Deficits shift the burden of spending forward onto
the shoulders of children not yet old enough to vote and those not yet born.
And in the case of the Greeks, owing to the system of transfer payments
imbedded in the European Union, at least part of the cost of their spending
could be shifted to the voters not yet born in other countries of the union.
The demonstrations in the streets of
The fondest wish of the creators of the European Union
was that the fiscal discipline which has historically eluded some European
countries would somehow emerge from the great EU democratic coming together.
Regrettably, that wish took no account of the delicate balance of interests
which is the crucial underpinning of all successful democracies and which in
the case of
Read
the entire report at the Fraser. . .
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* * * * *
2.
In the
News: Doctor’s Revolt Shakes the
Social Security Disability Program
BY DAMIAN PALETTA
Earlier this year, senior managers at the Social Security Administration in
Baltimore, frustrated by a growing backlog of applications for federal
disability benefits, called meetings with 140 of the agency's doctors.
The message was blunt: The number of people seeking benefits had soared.
Doctors had to work faster to move cases. Instead of earning $90 an hour, as
they had previously, they would receive about $80 per case—a pay cut for many
cases which can take 60 to 90 minutes to review—unless the doctors worked
faster. Most notably, it no longer mattered if doctors strayed far from their
areas of expertise when taking a case. Read more . . .
“The implication there was that you really didn’t have to be that careful
and study the whole thing,” said Rodrigo Toro, a neurologist who analyzed cases
for the SSA for more than 10 years. Some doctors, including Dr. Toro quit
following the changes. Others were fired. In all, 45 of the 140 left within
months, the agency said.
The upheaval, described by current and former doctors and agency officials,
is the latest strain on a cash-strapped program struggling to deal with a giant
influx of applications.
In targeting the doctors, the SSA says it is seeking to over hall a part of
the disability-review program that can be both expensive and slow. . .
“People who shouldn’t be getting [disability] are getting it, and people
who should be getting it aren’t getting it,’ said Neil Novin, former chief of
surgery at Baltimore’s Harbor Hospital, who worked for Social Security part
time for about 10 years. In August, Dr.
Novin said, he was pressured by a supervisor to change his medical opinion and
award benefits to someone he didn’t believe had disabilities that would prevent
the person form working.
Read
the entire story in the WSJ – subscription required . . .
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* * * * *
3.
International
Medicine: Spreading
prosperity and growth
Economic freedom is one of the main drivers of
prosperity, resulting in improved wealth, health, and education
as individuals and families take charge of their own future.
Economic freedom is the extent to which you can pursue
economic activity without interference from government, as
long as your actions don't violate the identical rights of others.
The Fraser Institute has several programs that examine
the effects of economic freedom in countries around the world:
Read more…
o The Economic Freedom of the World Index
Find out how your country rates in
economic freedom. This index is the most objective and accurate measure of
economic freedom published by any organization. It was developed by a research
team led by Nobel Laureate Milton Friedman and former Fraser Institute
Executive Director Michael Walker.
Read more...
o
North
American Economic Freedom Index
Find out how your state, province, or territory compares to other jurisdictions
across
Read more...
o
Economic
Freedom of the Arab World Report
Find out how Arab countries rate in economic freedom. This report rates 22 Arab
League Nations.
Read more...
o
Economic
Freedom Network
The Economic Freedom Network is a joint
venture involving research institutes from more than 80 countries. The Economic
Freedom Network focuses on encouraging public discussion and awareness about
the benefits of economic freedom and is committed to increasing economic
freedom and growth around the world.
Visit the official website for more info.
Economic freedom in health care would solve the
world’s HealthCare Dilemmas
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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
http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html
However,
such restriction of freedom in healthcare, only restricts health care, and
lowers quality.
* * * * *
4.
Medicare: Can Medicare make
three-quad-trillion decisions a year? 3,000,000,000,000,000?
Commentary
by John C Goodman | Co-author Thomas Saving
Source: Health Affairs Blog |
As the “Super Committee” faces mounting pressure to
rein in Medicare spending, two sides seem to be squaring off. The
don’t-touch-a-thing-other-than-squeezing-provider-fees position seems to appeal
to mainly Democrats, while eat-your-spinach reforms, including more cost
sharing and higher premiums, seem to appeal mainly to Republicans. Neither
position is very appealing to voters, however, nor should they be.
Is there a third way? Is there a way to get the job
done and appeal to voters — young and old — at the same time? We think there
is. Tom Saving and I suggested a different approach in a recent post at the Health Affairs blog.
Read more . . .
To see how it might work, we first have to understand
that what Medicare is currently trying to do is virtually impossible. Consider
that Medicare has a list of about 7,500 separate tasks that it pays physicians
to perform. For each task there is a price that varies by location and other
factors. Of the 800,000 practicing physicians in this country, not all are in
Medicare and no doctor will be a candidate to perform every task on Medicare’s
list.
Still, Medicare is potentially setting about 6 billion prices at any one time all over the
United States of America, as well as in Guam, Puerto Rico, the Mariana Islands,
American Samoa and the Virgin Islands.
Each price Medicare pays is tied to a patient with a
condition. And of the 7,500 things doctors could possibly do to treat a
condition, Medicare has to be just as diligent in not paying for inappropriate
care as it is paying for procedures that should be done. Medicare isn’t just
setting prices. It is regulating whole transactions.
Let’s say that the 50 million or so Medicare enrollees
average about 10 doctor visits per year and let’s conservatively assume that
each visit gives rise to only one procedure. Then considering all of the ways a
procedure can be correctly and incorrectly coded, Medicare is regulating 3
quadrillion potential transactions over the course of a year! (A quadrillion is
a 1 followed by 15 zeroes.)
Is there any chance that Medicare can make the right
decisions for all these transactions? Not likely.
What does it mean when Medicare makes the wrong
decisions? It often means that doctors face perverse incentives to provide care
that is too costly, too risky and less appropriate than the care they should be
providing. It also means that the skill set of our entire supply of doctors
will become misallocated, as medical students and even practicing doctors
respond to the fact that Medicare is over-paying for some skills and
under-paying for others.
A more sensible approach is to quit asking for the
impossible. Instead, let’s begin the process of allowing medical fees to be
determined the way prices are determined everywhere else in our economy — in
the marketplace.
We believe there are at least nine important policy
changes that can circumvent these two problems and free the marketplace in the
process. . .
To
read the suggested policies changes, please proceed to NCPA . . .
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Government is not the solution to our
problems, government is the problem.
- Ronald Reagan
* * * * *
5.
Medical
Gluttony: Pharmacy
Gluttony
Phone calls are
one item that pharmacies have not understood in terms of lean health care. Time
spent that does not improve health care and only adds to the cost and is an
inefficient waste of time. Time that does not produce what patients want or
need is wasted time and only adds to health care costs and decreases the
quality of health care. Anything that adds to time or costs without improving
efficiency or reducing costs is called MUDDA by the Japanese. Read more . . .
At the end of
each office visit or consultation, the plans are made for F/U care. Lab or
x-rays to be done are requisitioned. An agreement as when the next appointment
should be made is discussed and made. The patient is then given his
prescriptions with refills to last until the next office visit, plus one month
to give adequate time for the appointment to occur. We felt there would never
be a need for a phone call from the pharmacist to request a refill.
The only
reasonable time to plan the treatment schedule including the pharmaceutical
treatment was when the patient was there with his chart in front of you. With
an average of nearly a thousand patients per physician, to plan a prescription
refill without the patient in front of you and chart present for review would
be a source of error. It could also be a source for malpractice action should
error be made in one’s memory recall. The patient always had an extra month’s
supply if he/she couldn’t get in on schedule. This, we felt, should eliminate
all refill requests and improve the quality of care. It didn’t.
Some physicians
didn’t understand this concept and even went overboard in adding a prescription
phone line just for refills and staffing it with an RN. We estimated this
personnel cost to be between $40,000 and $50,000 per year. This added to the
pharmacy’s concept that phone-in prescription requests were appropriate. This
is pure MUDDA. This gross inefficiency and cost in any economy should be rather
obvious. It’s also a haven for medical errors, which is the forerunner of
medical malpractice. But apparently it wasn’t understood in many practices.
Many pharmacists bragged about their
automated prescription program. When the last refill is given, we are deluged
with refill requests by fax. We must receive between 10 and 20 such faxes a
day. This is not only a waste of paper, but a gross waist of valuable staff
time. At an insurance meeting with pharmacy program distributors present, I
presented the above. After many tries, I was unable to convince the
administrators of the cost in health care or the jeopardy in health care by
filling prescriptions without the patient’s chart. They were totally convinced
they were saving doctors' time with their efficiencies and automated programs,
which I tried to point out caused me to waste time. I had to respond to each
fax stating that it was time for that patient to come in and review his medical
program and decide which prescriptions needed to be filled and which should be
changed.
I now have an electronic prescription
service and all prescriptions are neatly typed up, the sig is always readable,
the refills usually are for a full year.
And guess what? The refill requests are
now also electronic. But I don’t have to waste my time. I can just ignore them.
When I wrote the prescription for my last patient, I noticed there were 184
electronic requests for refills. I reviewed a number of them and saw they were
just like the faxes of yesterday—refill requests before the next appointment.
And so I just closed the window and returned to the practice of medicine.
I
wish pharmacists would stop their faxes and return to the practice of pharmacy.
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Medical Gluttony thrives in Government and Health Insurance Programs.
Gluttony Disappears with Appropriate Deductibles and Co-payments on
Every Service.
* * * * *
6.
Medical
Myths: Electronic
Medical Records are efficient savers of time.
Medicare is forcing the issue of acquiring
electronic medical records under the guise of improving health care. While
waiting for the hard data of that to become available, let’s look at some
observations by the medical community. Anecdotal data is very important during
the transition. It may become more important as time continues. In fact, it may
even replace current accepted data. Read more . . .
My own physician has spent considerable
time and expense converting to
We hear the same stories from our other
colleagues, most of whom are members of an Independent Practice Association
(IPA) that either provide an EMR or will require its use.
So we called a consultant to see if we
should be concerned about the future Medicare requirement and fines. His final
opinion was that Medicare’s fines of one percent would be inconsequential to
the cost of going electronic and wouldn’t save us money for at least the next
five or ten years. By that time there may be a new administration, new rules,
different rules, or even no rules concerning EMRs. It could be catastrophic for
us to purchase an expensive EMR program at this time. Furthermore, EMR are still
in an evolving status. With few exceptions,
tomorrow’s EMRs may not be able to interface even with today’s EMRs.
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Medical Myths Originate When Someone Else Pays The Medical Bills.
Myths Disappear When Patients Pay Appropriate Deductibles and
Co-Payments on Every Service.
* * * * *
7.
Overheard
in the Medical Staff Lounge: Electronic
Medical Records—Current Status
Dr. Rosen: We’ve been
pushed to obtain EMRs by several years of the Bush Administration and now three
years by the Obama Administration. Why this big push by non-medical politicians
to force us to use EMRs? Is there a similar push to force other professions to
do things electronically? Shouldn’t there be a bigger push to have Lawyers use
Electronic Legal Records? Seeing the number of attorneys rush from one case to
the next in a court room and “hem & haw” trying to figure out the issue of
the hour should be a far greater need for attorneys to have all their records
electronic. Read
more . . .
Dr. Dave: I agree
totally. My records are concise, complete, and typed up on the office computer,
which basically gives me an
Dr. Ruth: Now with
separate pharmacy programs, we can order prescription on-line, whether to the local
pharmacies or to the mail-order pharmacies.
Dr. Milton: Actually
these free standing pharmacy programs are more flexible than the Kaiser
Permanente programs that can only send to their own pharmacies. For both local
and mail order pharmacies, we had to print out the prescription for the patient
to take to their local pharmacies or mail to their mail order pharmacies.
Dr.
Michelle: Don’t we have a Medicare Mandate to have
Dr. Milton: I think we
do. The penalty is one percent as I recall. That’s peanuts compared to the 30
to 40 percent write downs we already take on Medicare that doctors never
understood as a penalty for dealing with Medicare patients.
Dr. Edwards: Why doesn’t
Medicare or the Government understand?
Dr. Dave: The
government and/or Medicare still feel that they carry the bigger stick and that
we will “cow-tow” to them. They think they can beat us into shape. But if none
of us will bow down and kneel, how long could Medicare last without any doctors
to care for their patients?
Dr. Edwards: I see you have
that right. We now refer to “our” patients as their patients. They think they
have taken over control.
Dr. Dave: I think
they have. I don’t see many doctors giving them resistance. Organized medicine
has acquiesced.
Dr. Rosen: That is
true for the standard medical associations. The Association of American
Physicians and Surgeons is the only medical organization that unequivocally
supports private medicine. They use to be very large in the pre-Medicare days.
But as physicians lost their battle with government, and Medicare controlled
their patients, many rejoined the standard Medical Societies and have become
more socialistic with time.
Dr.
Michelle: So you think the state of medicine is hopeless?
Dr. Edwards: Not at all. All
socialistic endeavors go belly up with time. Human greed has no limits. It’s
unsustainable.
Dr. Paul: I beg
to disagree. There are no limits. Health care for all is so just and fair.
Dr. Edwards: I would think
that those of us in the trenches would begin to understand human nature. More
is never enough. It just makes you hunger and thirst for even more.
Dr. Rosen: Just
look at Greece and Europe. They can’t even agree as they go belly up.
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The Staff Lounge Is Where Unfiltered Medical Opinions Are Heard.
* * * * *
8.
Voices of
Medicine: A Review of Local and Regional Medical Journals and Articles
Polypharmacy Among Our Patients
By Stephen Sheerin, MD
Maria (not
her real name) is in her late 40s and was placed on amiodarone by her
cardiologist to control her new onset atrial fibrillation. Unbeknownst to that
physician, Maria had a remote past history of Hashitoxicosis (transient
hyperthyroidism). Within two months of starting the amiodarone, she began
having symptoms suggestive of hyperthyroid, subsequently confirmed by labs. She
was then placed on an antithyroid medication (methimazole) and eventually
became hypothyroid, despite stopping her methimazole. Her roller-coaster ride
finally ended when all her doctors were convinced to stop the amiodarone. She
was stranded in the middle of good intentions, poor outcomes, and lack of
communication and data-sharing.
Read more . . .
We physicians see patients like Maria almost daily in this era of
polypharmacy, where medicine offers a pill for practically every condition.
Patients like medications and often ask for them. Doctors oblige by writing
prescriptions, a sign that we are providing a welcome service. The time has
come, however, for us to step back and reassess our role in this pharmaco-epidemic.
Most of the
polypharmacy dilemma resides with our elderly population. According to a recent
survey, 44% of the men and 57% of the women over 65 years old are taking five
or more medications per week. Taking all these drugs leads to adverse drugs
reactions, which account for about 10% of ER visits and 10-17% of hospital
admissions.
Adverse drug reactions have two main causes. The first is the side
effect of the individual drug, and the second is the potential for drug-drug
interactions (DDI). There is a linear relation between the number of
medications and the risk of DDI: taking two meds entails a 13% chance of DDI,
whereas taking more than six meds entails an 82% chance.
For the geriatric population, the risk of falling is greatly
increased when they are taking five or more medications daily. This group is
especially sensitive to benzodiazepines, anticholinergics and sedating
psychotropics (one-third of nursing-home patients are prescribed three or more
psychotropics).
DDIs should be well known to physicians, both because of what we
can remember and because we get constant reminders through our electronic
medical records (when we email a prescription), pharmacies, and insurance and
home-care agencies. Some reminders are clinically irrelevant and bothersome,
but some may be life-saving.
I know certain patients need Plavix and aspirin, or they may be on
Coumadin and aspirin, but the red alert flashes each time they are renewed.
However, we need to be vigilant with other often-used medications. We
frequently prescribe cholinesterase inhibitors to patients with early dementia
(to increase cerebral acetylcholine) and yet they may be taking OTC
anticholinergic meds to sleep, so each med blocks the effect of the other. We
give proton pump inhibitors to nearly everyone with dyspepsia, but PPIs can
increase hip fractures, and by raising the gastric pH can decrease the
absorption of various medications. Effective absorption of levothyroxine is
decreased when the drug is taken with calcium or iron, and its efficacy is
affected by methadone, phenytoin and others. Cardioprotective doses of aspirin
for patients with coronary artery disease can be blocked by NSAIDs if both meds
are taken at the same time. Vitamin D deficiency is almost guaranteed with
patients on anticonvulsants.
Antibiotic use is especially bothersome. Though patients are on
these for brief periods, some affect everything from INRs for patients on
Coumadin, to QTc interval prolongation with fluoroquinolones, to peripheral
neuropathy, pancytopenia and pulmonary fibrosis in patients taking Macrobid
with a cr clearance under 60ml/min. I tell patients who want to clear their
fungal nail infections with an azole (such as Sporanox or Lamisil) that they
should probably stop taking all other medications.
Here’s a
classic polypharmacy scenario. An elderly patient with nocturia gets up in the
dark to urinate. He has an unsteady gait and is taking an anticholinergic, an
alpha blocker for prostatic hypertrophy, a PPI and a glitazone that increase
the risk of fractures, along with other blood-pressure meds that cause
orthostasis. In this case, we can just anticipate a fall and fracture. Data
from 2003 show that fall prevention is most dramatically decreased (by 39%)
with discontinuing psychotropic meds—more than balance/strength training
(14-27% reduction) or reducing home hazards (19%).
We must be aware of OTC and herbal remedies.
Patient compliance is always a challenge. If patients cannot
afford the prescription they won’t fill it. Several pharmacies (including
Costco, Target and Walmart) have a $4 prescription program for some generic
drugs. We also know that the more times a pill is supposed to be taken daily,
the less likely it will be taken. Moreover, many medications taken for
long-term use (except for analgesics) are probably taken for far less time than
prescribed.
So what can we do in this environment of multiple meds, multiple
docs, and an aging population? Patients often have a primary care physician and
several specialists. All these doctors must be in communication regarding new
medications prescribed. This dialogue is perhaps improved by electronic medical
records, but I have found that it is much easier to add meds than to subtract
them.
Medication reconciliation is critical and should be done with the
prescription and OTC bottles lined up for the doctor during each visit. Such
reconciliation is ultimately the responsibility of the primary care physician.
Remember to consider the drug-drug interactions and try to hone down the number
of medications. If possible, that number should be under five daily, which
decreases the risk of falling.
Dr.
Sheerin, an internist at Santa Rosa Community Health Centers, is medical
director of the House Calls program and of Friends House adult day services.
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VOM
Is an Insider's View of What Doctors are Thinking, Saying and Writing about.
* * * * *
9.
Book
Review: Taking Back Healthcare
for Future Generations
A CALL TO ACTION –Taking Back
Healthcare for Future Generations, by Hank McKinnell, McGraw-Hill, New York, Chicago,
San Francisco © 2005, ISBN: 0-07-144808-X, 218 pp, $27.95.
Hank
McKinnel, Chairman & CEO, Pfizer, opens the preface with the question, “Is
our healthcare system really in crisis?” He finds the question difficulty to
answer because it makes a presumption he doesn’t accept. The phrase with which
he has trouble is “healthcare system.” He agrees there’s a crisis, but it isn’t
in “healthcare”- it’s in “sick-care.” Read more . . .
He
quotes Mohandas Gandhi who had similar difficulty in 1932. He had led a
campaign of non-violent disobedience to help colonial
“What
do you think of Western civilization?” yelled the reporter.
“I
think it would be a good idea,” replied Gandhi.
That’s
what McKinnell thinks about our healthcare system: It would be a good idea.
He
maintains we’ve never had a healthcare system in
Today,
in healthcare, we have it entirely backwards. We’re like a community that
builds the best fire-fighting capability in the world but stops inspecting
buildings or teaching kids abut fire prevention. Fighting fires is sometimes
necessary, and we must be prepared to do that with the most modern technology
available. But firefighters around the world will tell you that they’d rather
prevent fires than fight them.
To
put it simply, McKinnell feels that our fixation on the costs of
healthcare—instead of the costs of disease—has been a catastrophe for both the
health and wealth of nations. By defining the problem strictly as the cost of
healthcare, we limit the palette of solutions to those old stand-bys—rationing
and cost controls. What if we reframe the debate and consider healthcare not as
a cost, but rather an investment at the very heart of a process focused on
health? Then other solutions suddenly appear out of the fog.
That’s
why this book was titled A Call to Action. It represents McKinnell’s
conviction that the debate on the world’s healthcare systems is on the wrong
track. Unless we correct our course, we will not be able to make the same
promises to our children and grandchildren that our parents and grandparents
delivered to us: that you will receive from us a better world than we received
from our forebears. He feels that the basic bio-medical research conducted by
his company is doing just that. But he’s concerned that his and other
research-based pharmaceutical companies might lose the capacity to advance the
science that can change the lives of our children and grandchildren for the
better, just as polio vaccines and cardiovascular medicines and other therapies
changed out lives.
McKinnell
doesn’t believe in surprise endings. Although he loves a good mystery, this
book was not meant to be one. The first phase of his book sets up its basic theme—that
when our most cherished support systems are at risk, we are called to rethink
our most well-accepted assumptions. Everywhere in the developed world, people
are dissatisfied with the healthcare their families are receiving. The near
universal experience is that healthcare is increasingly unaffordable,
fragmented, and impersonal. Thus, the first third of the book details the
proposition that the current system is profoundly misfocused in three ways. It
is preoccupied with the cost of healthcare, it defines the provider as the
center of the system, and it regards acute interventions as its primary reason
for existence. . . .
A
Call to Action distills more than three decades of experience—both joyous and
painful—that has brought McKinnell to this special vantage point. He offered
these thoughts, plans, and calls to action to give our descendants all the
benefits of healthcare that we have enjoyed. But we cannot do so under the
liabilities and constraints that today weighs down the world’s healthcare systems.
These systems promise healthcare but actually swindle people out of both their
health and wealth. He concludes that you and I, our children—indeed, our entire
human family—most certainly deserve better.
The
three decades of thought and experience shows throughout the entire treatise.
There is little to disagree with. Every physician, nurse, administrator and
healthcare executive should read this volume and keep it as a handy and useful
reference—someplace within reach, preferably on your desk. This refocus is
crucial to our understanding and to healthcare reform.
Read
the entire review . . .
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Book Review Section Is an Insider’s View of What Doctors are Reading about.
* * * * *
10. Hippocrates & His
Kin: Sex and STD in
Sacramento; Long Term Care
Insurance
STDs rise for
young women
Clinicians diagnosed Sacramento County teen
girls and young women with more sexually transmitted diseases, or STDs, last
year than ever. At the same time, the county's teen birthrate dropped to a
historic low. Read
more . . .
More than four of
every 100 women in Sacramento
County between ages 15 and 24 were diagnosed with chlamydia or gonorrhea in
2010, according to new data from the California Department of Public Health.
That's a 12
percent jump from the year before – a spike that one local women's health care specialist called
"a silent epidemic."
Though easily
treatable with antibiotics, chlamydia and gonorrhea sometimes exhibit few
symptoms and, if left undetected and untreated, can cause serious problems,
including infertility.
Read more: www.sacbee.com/2011/11/27/4081996/stds-rise-for-young-women.html
Long Term Care
Insurance
In California, the average cost of a one-year stay in a nursing home is $91,250
and increasing about $5,000 annually. Most of us have homeowners insurance but
only 1 out of 1000 home owners will ever have a serious fire. Consider that 700
out of 1000 of us over the age of 65 will need some type of long-term care.
(CDHCS). . . The cost of spending the last week of our lives in a hospital in
preparation for dying is also about $91,000. Many of us now save this $91,000
by choosing to die at home. Have you read the obituaries lately to see how many
now die at home with their loved ones around them instead of tripping over
ventilator tubes, IV infusion lines, heart monitor cables and sustaining a
fractured hip trying to give their loved ones a final kiss? Americans are very
smart and will soon figure out that spending the last year of your life in a
nursing home is very inhumane and cruel as your buns (buttocks) turn into huge
infected pus draining bedsores.
Now is the time to furnish the guest
room for mom or dad for their final year and save $91,000.
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Hippocrates
and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Yesterday, Today & Tomorrow
* * * * *
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 www.zhcenter.org and check
out their history, mission statement, newsletter, and a host of other
information. For their article, "Are you really insured?," go to www.healthplanusa.net/AE-AreYouReallyInsured.htm.
•
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. Read more . . .
•
•
PRIVATE NEUROLOGY is
a Third-Party-Free Practice in
•
•
To read the rest
of this section, please go to www.medicaltuesday.net/org.asp.
•
Michael J.
Harris, MD - www.northernurology.com
- 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 www.simplecare.com.
•
Dr David
MacDonald started Liberty Health
Group. To compare the traditional health
insurance model with the
•
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 www.ssvms.org. To read his "Lessons from the Past," go to www.ssvms.org/articles/0403gibson.asp. For additional articles, such as the cost of Single
Payer, go to www.healthplanusa.net/DGSinglePayer.htm; for Health Care Inflation, go to www.healthplanusa.net/DGHealthCareInflation.htm.
•
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 www.peerreview.org.
•
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
•
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 www.sepp.net.
•
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 www.thenewstribune.com/opinion/othervoices/story/835508.html.
•
The
Association of American Physicians & Surgeons (www.AAPSonline.org), The Voice for Private
Physicians Since 1943, representing physicians in their struggles against
bureaucratic medicine, loss of medical privacy, and intrusion by the government
into the personal and confidential relationship between patients and their
physicians. Be sure to 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
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
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, Recent
Postings, In Memoriam, Today in History . . .
Words of Wisdom
"Each person
has this magical thing called Soul Purpose within them. The difference between
surviving
and thriving has
to do with whether we see it or not." — Garrett Gunderson: an entrepreneur and author
Some Recent Postings
In The November 8th Issue: