Community For Better Health Care

Vol X, No 21, Feb 14, 2012


In This Issue:

1.                  Featured Article: Why the World Needs America

2.                  In the News: Professor Muhammad Yunus, winner of the 2006 Nobel peace prize

3.                  International Medicine: How I woke up to the untruths of Barack Obama

4.                  Medicare: A rare injection of politics into the prayer breakfast - health care overhaul

5.                  Medical Gluttony: Only one diagnosis can be treated during one doctor’s visit

6.                  Medical Myths: Insurance companies have to provide advice nurses to control doctor costs.

7.                  Overheard in the Medical Staff Lounge: Can Santorum Restore America?

8.                  Voices of Medicine: Medical Research

9.                  Movie Review: The Iron Lady

10.              Hippocrates & His Kin: Some patients enjoy the freedom of ordering their own tests.

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

Words of Wisdom, Recent Postings, In Memoriam, Today in History . . .

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The Annual World Health Care Congress, a market of ideas, co-sponsored by The Wall Street Journal, is the most prestigious meeting of chief and senior executives from all sectors of health care. Renowned authorities and practitioners assemble to present recent results and to develop innovative strategies that foster the creation of a cost-effective and accountable U.S. health-care system. The extraordinary conference agenda includes compelling keynote panel discussions, authoritative industry speakers, international best practices, and recently released case-study data. The 9th Annual World Health Care Congress will be held April 16-18, 2012 at the Gaylord Convention Center, Washington DC. For more information, visit The future is occurring NOW.

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1.      Featured Article: Why the World Needs America

Foreign-policy pundits increasingly argue that democracy and free markets could thrive without U.S. predominance. If this sounds too good to be true, writes Robert Kagan, that's because it is.


History shows that world orders, including our own, are transient. They rise and fall, and the institutions they erect, the beliefs and "norms" that guide them, the economic systems they support—they rise and fall, too. The downfall of the Roman Empire brought an end not just to Roman rule but to Roman government and law and to an entire economic system stretching from Northern Europe to North Africa. Culture, the arts, even progress in science and technology, were set back for centuries.

Modern history has followed a similar pattern. After the Napoleonic Wars of the early 19th century, British control of the seas and the balance of great powers on the European continent provided relative security and stability. Prosperity grew, personal freedoms expanded, and the world was knit more closely together by revolutions in commerce and communication. Read more . . .

With the outbreak of World War I, the age of settled peace and advancing liberalism—of European civilization approaching its pinnacle—collapsed into an age of hyper-nationalism, despotism and economic calamity. The once-promising spread of democracy and liberalism halted and then reversed course, leaving a handful of outnumbered and besieged democracies living nervously in the shadow of fascist and totalitarian neighbors. The collapse of the British and European orders in the 20th century did not produce a new dark age—though if Nazi Germany and imperial Japan had prevailed, it might have—but the horrific conflict that it produced was, in its own way, just as devastating.

Would the end of the present American-dominated order have less dire consequences? A surprising number of American intellectuals, politicians and policy makers greet the prospect with equanimity. There is a general sense that the end of the era of American pre-eminence, if and when it comes, need not mean the end of the present international order, with its widespread freedom, unprecedented global prosperity (even amid the current economic crisis) and absence of war among the great powers.

American power may diminish, the political scientist G. John Ikenberry argues, but "the underlying foundations of the liberal international order will survive and thrive." The commentator Fareed Zakaria believes that even as the balance shifts against the U.S., rising powers like China "will continue to live within the framework of the current international system." And there are elements across the political spectrum—Republicans who call for retrenchment, Democrats who put their faith in international law and institutions—who don't imagine that a "post-American world" would look very different from the American world.

If all of this sounds too good to be true, it is. The present world order was largely shaped by American power and reflects American interests and preferences. If the balance of power shifts in the direction of other nations, the world order will change to suit their interests and preferences. Nor can we assume that all the great powers in a post-American world would agree on the benefits of preserving the present order, or have the capacity to preserve it, even if they wanted to.

Take the issue of democracy. For several decades, the balance of power in the world has favored democratic governments. In a genuinely post-American world, the balance would shift toward the great-power autocracies. Both Beijing and Moscow already protect dictators like Syria's Bashar al-Assad. If they gain greater relative influence in the future, we will see fewer democratic transitions and more autocrats hanging on to power. The balance in a new, multipolar world might be more favorable to democracy if some of the rising democracies—Brazil, India, Turkey, South Africa—picked up the slack from a declining U.S. Yet not all of them have the desire or the capacity to do it.

What about the economic order of free markets and free trade? People assume that China and other rising powers that have benefited so much from the present system would have a stake in preserving it. They wouldn't kill the goose that lays the golden eggs.

Unfortunately, they might not be able to help themselves. The creation and survival of a liberal economic order has depended, historically, on great powers that are both willing and able to support open trade and free markets, often with naval power. If a declining America is unable to maintain its long-standing hegemony on the high seas, would other nations take on the burdens and the expense of sustaining navies to fill in the gaps?

Even if they did, would this produce an open global commons—or rising tension? China and India are building bigger navies, but the result so far has been greater competition, not greater security. As Mohan Malik has noted in this newspaper, their "maritime rivalry could spill into the open in a decade or two," when India deploys an aircraft carrier in the Pacific Ocean and China deploys one in the Indian Ocean. The move from American-dominated oceans to collective policing by several great powers could be a recipe for competition and conflict rather than for a liberal economic order.

And do the Chinese really value an open economic system? The Chinese economy soon may become the largest in the world, but it will be far from the richest. Its size is a product of the country's enormous population, but in per capita terms, China remains relatively poor. The U.S., Germany and Japan have a per capita GDP of over $40,000. China's is a little over $4,000, putting it at the same level as Angola, Algeria and Belize. Even if optimistic forecasts are correct, China's per capita GDP by 2030 would still only be half that of the U.S., putting it roughly where Slovenia and Greece are today.

As Arvind Subramanian and other economists have pointed out, this will make for a historically unique situation. In the past, the largest and most dominant economies in the world have also been the richest. Nations whose peoples are such obvious winners in a relatively unfettered economic system have less temptation to pursue protectionist measures and have more of an incentive to keep the system open. . .

Another problem is that China's form of capitalism is heavily dominated by the state, with the ultimate goal of preserving the rule of the Communist Party. Unlike the eras of British and American pre-eminence, when the leading economic powers were dominated largely by private individuals or companies, China's system is more like the mercantilist arrangements of previous centuries. The government amasses wealth in order to secure its continued rule and to pay for armies and navies to compete with other great powers. . .

Finally, what about the long peace that has held among the great powers for the better part of six decades? Would it survive in a post-American world?

Most commentators who welcome this scenario imagine that American predominance would be replaced by some kind of multipolar harmony. But multipolar systems have historically been neither particularly stable nor particularly peaceful. Rough parity among powerful nations is a source of uncertainty that leads to miscalculation. Conflicts erupt as a result of fluctuations in the delicate power equation.

War among the great powers was a common, if not constant, occurrence in the long periods of multipolarity from the 16th to the 18th centuries, culminating in the series of enormously destructive Europe-wide wars that followed the French Revolution and ended with Napoleon's defeat in 1815. . . .

There is little reason to believe that a return to multipolarity in the 21st century would bring greater peace and stability than it has in the past. The era of American predominance has shown that there is no better recipe for great-power peace than certainty about who holds the upper hand. . .

But international order is not an evolution; it is an imposition. It is the domination of one vision over others—in America's case, the domination of free-market and democratic principles, together with an international system that supports them. The present order will last only as long as those who favor it and benefit from it retain the will and capacity to defend it.  . .

If and when American power declines, the institutions and norms that American power has supported will decline, too. Or more likely, if history is a guide, they may collapse altogether as we make a transition to another kind of world order, or to disorder. We may discover then that the U.S. was essential to keeping the present world order together and that the alternative to American power was not peace and harmony but chaos and catastrophe—which is what the world looked like right before the American order came into being.

—Mr. Kagan is a senior fellow in foreign policy at the Brookings Institution. Adapted from "The World America Made," published by Alfred A. Knopf. Copyright © 2012 by Robert Kagan.

Read the entire article at the WSJ – Subscription required . . .
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2.      In the News: Professor Muhammad Yunus, winner of the 2006 Nobel peace prize

Grameen’s business empire

Grabbing Grameen: Property rights in peril in Bangladesh

From The Economist | print edition | Jan 28th 2012

HE IS probably Bangladesh’s most celebrated citizen. Muhammad Yunus, winner of the 2006 Nobel peace prize, founded Grameen Bank in 1983 to provide tiny loans to poor rural women. Grameen became a global model for microfinance. It also spawned 48 other firms in sectors that stretch from textiles to mobile phones. Yet the Bangladeshi government seems determined to take Mr Yunus down a peg.

In May 2011 the government pushed him out of his job as boss of Grameen Bank, saying that he was past the retirement age for someone running a government bank. (Grameen Bank mostly belongs to its borrowers but the state owns a slice.) Mr Yunus says this is just a pretext for a power grab. The government now wants to assert more control over other firms in the Grameen network, which includes assets worth an estimated $1.6 billion. Read more . . .

This is controversial, to put it mildly, not least because some Grameen firms have big foreign partners. Grameenphone, Bangladesh’s largest telecoms provider, was created with Norway’s Telenor and generates sales of nearly $1 billion a year. Grameen Danone Foods, a yogurt-maker, and Grameen-Veolia, a water company, are joint ventures with French giants. BASF Grameen, which makes mosquito nets, and Grameen Intel, which creates software for poor farmers, also have foreign backers.

The government says that Grameen Bank owns or part-owns all these firms, and that its stakes partly belong to the government itself. Mr Yunus’s aides say the members of the Grameen family are all independent entities with no legal ties to each other.

The government will have none of this. Officials are furiously trying to unearth evidence that Mr Yunus in fact controls them. A lawyer for Bangladesh’s central bank, a state body, reasons that since Grameen Bank is a “state authority” and Mr Yunus was a “public officer”, all companies created with the help of the bank’s finances, its people or even its goodwill are in effect state resources.

The government is calling for the Grameen Empire to be brought together “under a single structure”. Bangladeshi business folk are horrified. If a Nobel prize is no defence against expropriation, that doesn’t bode well for the security of property rights in Bangladesh. . .

People and their property are not safe when the government is in session.

People and their property are not secure if the government owns a small slice of it.

The long arm of the state is the biggest threat to freedom: Yesterday, Yesteryear, Today and Tomorrow

Read the entire article in the Economist – subscription required . . .
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3.      International Medicine: How I woke up to the untruths of Barack Obama

By Christopher Booker Jan. 28, 2012


This article is from the U.K. Telegraph.

How I woke up to the untruths of Barack Obama

The President's State of the Union address was as weaselly as any politician's could be.

When I happened to wake up in the middle of the night last Wednesday and caught the BBC World Service’s live relay of President Obama’s State of the Union address to Congress, two passages had me rubbing my eyes in disbelief.

The first came when, to applause, the President spoke about the banking crash which coincided with his barnstorming 2008 election campaign. “The house of cards collapsed,” he recalled. “We learned that mortgages had been sold to people who couldn’t afford or understand them.” He excoriated the banks which had “made huge bets and bonuses with other people’s money”, while “regulators looked the other way and didn’t have the authority to stop the bad behaviour”. This, said Obama, “was wrong. It was irresponsible. And it plunged our economy into a crisis that put millions out of work.” Read more . . .

I recalled a piece I wrote in this column on January 29, 2009, just after Obama took office. It was headlined: “This is the sub-prime house that Barack Obama built”. As a rising young Chicago politician in 1995, no one campaigned more actively than Mr Obama for an amendment to the US Community Reinvestment Act, legally requiring banks to lend huge sums to millions of poor, mainly black Americans, guaranteed by the two giant mortgage associations, Fannie Mae and Freddie Mac.

It was this Act, above all, which let the US housing bubble blow up, far beyond the point where it was obvious that hundreds of thousands of homeowners would be likely to default. Yet, in 2005, no one more actively opposed moves to halt these reckless guarantees than Senator Obama, who received more donations from Fannie Mae than any other US politician (although Senator Hillary Clinton ran him close).

A later passage in Obama’s speech, when he hailed the way his country’s energy future has been transformed by the miracle of shale gas, met with a storm of applause. Not only would this give the US energy security for decades, creating 600,000 jobs, but it could now go all out to exploit its gas and oil reserves (more applause). Yet this was the man who in 2008 couldn’t stop talking about the threat of global warming, and was elected on a pledge to make the US only the second country in the world, after Britain, to commit to cutting its CO2 emissions from fossil fuels by 80 per cent within 40 years.

Even more telling than his audience’s response to this, however, was what happened when Obama referred briefly to the need to develop “clean energy on enough public land to power three million homes”. But no mention now of vast numbers of wind turbines – those props beside which he constantly chose to be filmed back in 2008. No harking back to his boast that “renewable energy” would create “four million jobs”. And even to this sole fleeting reminder of what, four years ago, was his flagship policy the response of Congress was a deafening silence.

A few months after Obama entered the White House, I suggested here that the slogan on which he was elected – “Yes we can” – seemed to have changed to “No we can’t”. It was already obvious that, having won election as an ideal Hollywood version of what “the first black President” should look and sound like, he was in reality no more than a vacuum. His speech last week was as weaselly as any politician’s performance could be, not least in its references to the sub-prime scandal.

But on no issue has this been more obvious than political America’s wholesale retreat from the great fantasy of global warming – which leaves Britain as the only country committed to the insanity of cutting “carbon emissions” by four-fifths in less than four decades. President Obama and the rest of the world have moved on.

Christopher Booker of The Sunday Telegraph exposes the ever-growing power of the European Union in Brussels and the excesses of mad officialdom.

Rear the entire article . . .

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Government Medicine does not give timely access to healthcare; it only gives access to a waiting list.

This in turn gives rise to the ever growing power of government.

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4.      Medicare: A rare injection of politics into the prayer breakfast - health care overhaul.

Obama: Jesus Would Back Higher Taxes

Thursday, 02 Feb 2012

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President Barack Obama linked his economic policies to his Christian faith, saying on Thursday that meeting the nation's challenges requires strong values as much as smart policies.

Obama, making his third appearance as president at the National Prayer Breakfast in Washington, used his remarks to justify many of his actions, such as his call for the wealthy to pay more in taxes and his health care overhaul. He said they were not only economically sound but also rooted in his Christian values.

"When I talk about shared responsibility, it's because I genuinely believe that in a time when many folks are struggling and at a time when we have enormous deficits, it's hard for me to ask seniors on a fixed income or young people with student loans or middle-class families who can barely pay the bills to shoulder the burden alone," Obama said.

"But for me as a Christian, it also coincides with Jesus' teaching that, for unto whom much is given, much shall be required," he said.

(Editor’s note: I don’t think He was talking about taxes – helping the poor was voluntary then and should be now. Force charity is NOT charity! Forced charity is NEVER perceived as charity. Forced charity never helps the down trodden. It distorts their perspective. It removes all thankfulness. It becomes an entitlement. Thankfulness is replaced by demands. Demands can never be satisfied. It’s always more . . . more . . . more . . . There is and will never be enough. As one down trodden patient told me, the rich can afford to pay 100% in taxes. Oh really? Maybe you think they can afford 200% in taxes? Certainly, he replied. They can well afford it.) Read more . . .  

His remarks came one day after Republican presidential hopeful Mitt Romney created a flap with clumsy comments about the struggling middle class. "I'm not concerned about the very poor. We have a safety net there. If it needs repair, I'll fix it. I'm not concerned about the very rich. They're doing just fine. I'm concerned about the very heart of America, the 90-95 percent of Americans who right now are struggling. You can focus on the very poor, that's not my focus," Romney said.

Obama didn't mention Romney or the other Republican candidates. But his defense of his policies was a rare injection of politics into the prayer breakfast. The annual event is hosted by lawmakers from both parties, and speakers usually refrain from direct political references, sticking instead to calls for civility and respect in Washington.

The president said his faith also guides some of his foreign policy decision, including supporting foreign aid or sending U.S. troops to Africa to target a notoriously violent rebel group.

"It's not just about strengthening alliances or promoting democratic values or projecting American leadership around the world, although it does all those things and it will make us safer and more secure," he said. "It's also about the biblical call to care for the least of these, for the poor, for those at the margins of our society; to answer the responsibility we're given in Proverbs to speak up for those who cannot speak for themselves, for the rights of all who are destitute."

Obama said that while personal religious beliefs alone should not dictate a politician's decisions, leaders should not abandon their faith entirely.

"We can't leave our values at the door. If we leave our values at the door, we abandon much of the moral glue that has held our nation together for centuries and allowed us to become somewhat more perfect a union," he said.

Obama speaks often about his faith but prefers to worship in private. He said Thursday that he starts each morning with a brief prayer, then spends time reading scripture. Sometimes, he said, pastors come to the Oval Officer to pray with him, for his family and for the country.

© Copyright 2011 The Associated Press.

Read more on Obama: Jesus Would Back Higher Taxes

·     It’s certainly difficult to understand where Obama obtain his Christian upbringing. Sen. Barack Obama's pastor says blacks should not sing "God Bless America" but "God damn America." The Rev. Jeremiah Wright, was Obama's pastor for the last 20 years prior to becoming president.

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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: Only one diagnosis can be treated in one doctor’s visit (Dr. Goodman)

Medicare has strict rules about how tasks can be combined. For example, “special needs” patients typically have five or more comorbidities — a fancy way of saying that a lot of things are going wrong at once. These patients are costing Medicare about $60,000 a year and they consume a large share of Medicare’s entire budget. Ideally, when one of these patients sees a doctor, the doctor will deal with all five problems sequentially. That would economize on the patient’s time and ensure that the treatment regimen for each malady is integrated and consistent with all the others. Read more . . .

Under Medicare’s payment system, however, a specialist can only bill Medicare the full fee for treating one of the five conditions during a single visit. If she treats the other four, she can only bill half price for those services. It’s even worse for primary care physicians. They cannot bill anything for treating the additional four conditions.

Since doctors don’t like to work for free or see their income cut in half, most have a one-visit-one-morbidity-treatment policy. Patients with five morbidities are asked to schedule additional visits for the remaining four problems with the same doctor or with other doctors. The type of medicine that would be best for the patient and that would probably save the taxpayers money in the long run is the type of medicine that is penalized under Medicare’s payment system.

Read Goodman’s Healthcare Blog at the NCPA.
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Medical Gluttony thrives in Government and Health Insurance Programs.

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

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6.      Medical Myths: Insurance companies have to provide advice nurses to control doctor costs.

A patient of mine called her insurance company, Health Net, for advice on her epigastric pain [severe pain in the pit of her stomach]. She was told to see her doctor as soon as possible and have him obtain a globulin level, a blood test for Strep, an ECHO of the heart and an ultrasound over her sternum. Read more . . .

When she came to the office she had severe epigastric tenderness consistent with Gastro Esophageal Reflux Disease (GERD). [She was immediately given Aciphex, a stomach acid reducer, and Gaviscon, an acid neutralizer.] She also had exquisite tenderness of her rib cartilages next to her sternum or breastbone, consistent with a costochondritis or inflammation of her rib cartilages. [She was given two ES Tylenol tablets immediately.] During the next 10 minutes or so, her hostility dissipated as she realized her pains were resolving. The demands for the tests that the Health Net RN recommended also disappeared. Another example of thousands of dollars worth of testing found to be irrelevant for the price of one office call.

The standard HMO impression of doctors as being incompetent and the cause of rising health care costs since about the 1980s has again backfired on the HMO. They are incompetent to play doctor or to treat patients by phone in order to save costs. In this case, if the HMO's recommendations had been followed, the cost would easily have been ten-fold higher and the patient would have remained undiagnosed or inappropriately treated.

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Medical Myths as to costs originate when someone else treats the patient.

Myths disappear when the Doctor reassumes charge on Every Service.

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7.      Overheard in the Medical Staff Lounge: Can Santorum Restore America?

Dr. Milton:      Well it looks like the Candidates are sitting in different chairs this week.

Dr. Ruth:        Senator Santorum was a surprise.

Dr. Dave:        He may be a bit far to the right, but we may be ready by November to have a conservative level head in the White House.

Dr. Yancy:      I wasn’t for Santorum. But I can take his stand for the greater good of human kind to bring us back closer to the center. Read more…

Dr. Michelle:   Do you think he’ll undo Obama Care?

Dr. Yancy:      I’m not sure anybody will be totally successful in repealing it.

Dr. Milton:      Well, one thing we know for sure, Mitt Romney and Newt Gingrich won’t come close to repealing it.

Dr. Joseph:     As a retired surgeon, I would have to agree with my surgical colleague Yancy. Obama has been so terrible for surgeons, but no one out there fully comprehends how awful he has been.

Dr. Yancy:      Allowing Obama to complete his destructive course will destroy the surgical profession. In short order we would have surgical Nurse Practitioners or Physician Assistants do much of the surgical work.  

Dr. Joseph:     You would have one catastrophe after another before the public realizes the magnitude of his subversion of the surgical profession. Some of us older surgeons would even say it borders on criminal intent.

Dr. Milton:      But by that time, several of the more aggressive PAs would be firmly entrenched with the administrators.

Dr. Rosen:      One can almost foresee the aggressive Physician Assistant scheduling his patient for a colon cancer resection.

Dr. Milton:      The current surgical reviews of the path reports, operative reports and the charts takes several months to make sure everything jives. And with a good result from several PAs, it might take a year or two to straighten out that mess.

Dr. Edwards:  By that time, many of the PAs would be firmly entrenched. With hospital administration on their side, they could no longer be removed.

Dr. Rosen:      But that could be a source of optimism. Santorum will have an uphill battle with his position on moral issues. Looking at how far we’ve strayed in the last three years, he just may be an effective force for Change—a different kind of Change. A major force for the restoration of our Republic.

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The Staff Lounge Is Where Unfiltered Opinions Are Heard.

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8.      Voices of Medicine: A Review of Articles Written by Physicians: Medical Research

Inside Medicine by Dr. Michael Wilkes, Sac Bee Feb2

For too long, medical journals have controlled and manipulated the release of scientific information to enhance profits and prestige.

Journals such as JAMA, Lancet, and the New England Journal of Medicine, are multimillion-dollar businesses, thanks to the US Government, scientists around the globe and plentiful drug advertisement.

The federal government funds the great proportion of medical research in hopes of improving our health. Once a study has been completed, researchers publish results in medical Journals for two reasons. First, they believe their research is important and they wish to have others read and know about it.  Second, publication in medical journals is necessary for the researcher to get promoted. Read more . . . .

Medical journals do not pay authors for papers the way other magazines do. They get manuscripts for free. The journal then decides if the paper appears to meet criteria for publication and, if so, they send the paper to other scientists for what is called Peer Review.

If the paper is evaluated by fellow researchers as well done and meets journal standards, it is accepted and the journal publishes the report in a paper magazine, online, or both.

To summarize, the journals get the papers for free, asks other scientists to review the papers for free, and publish a magazine filled with federally funded research that nets the journal millions of dollars through subscriptions and sales of advertisements.

It gets worse.

Let’s say I want my medical students to read a research paper in my class that I wrote and published in a medical journal. I can’t use the paper unless I pay the journal to use the article I wrote which was funded through your tax dollars.

California schools pay hundreds of thousands of dollars each year to subscribe to scientific journals that are jam-packed with research that has been funded by the state and federal governments and was conducted by our own researches at California’s colleges and universities.

Shouldn’t the people who funded the research—taxpayers—have free access to the knowledge produced?

Medical journals also use draconian news embargoes that forbid health reporters from reporting on research in their journal until some arbitrary time and day that the journals select.

I’m not sure how they got all this power and control, but it needs to change. . .

To read more, go the Sacramento Bee, February 2, 2011, page D 3.

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

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9.      Review: The Iron Lady

The Real Margaret Thatcher Story By DANIEL YERGIN

In the late 1970s, inflation neared 20% and the ruling party still wanted to own the means of production. Enter the grocer's daughter.

A movie producer once shared with me a maxim for making historical films: Faced with choosing between "drama" and "historical accuracy," compromise on the history and go with drama.

That is certainly what the producers of "The Iron Lady" have done. The result is a masterly performance by Meryl Streep as former British Prime Minister Margaret Thatcher. But the depiction of Mrs. Thatcher in the movie misses much of the larger story. That story—the struggle to define the frontier between the state and the market, and the calamities that happen when governments live beyond their means—is directly relevant to the debt dramas now rocking Europe and the United States. Read more  . . .

After World War II, Britain created the cradle-to-grave welfare state. A clause in the constitution of the Labour Party which came to power in 1945 called for government to own the "means of production." That ended up ranging from coal mines and the steel industry to appliance stores, hotels and even a travel agency. . .

By the late 1970s, enormous losses were piled up at state-owned companies, debts which had to be covered by the British Treasury. A desperate Britain needed to borrow money from the International Monetary Fund. Inflation was heading toward 20% as the deficit mounted and strike after strike disrupted economic life. Even grave diggers walked off the job. The continuing deterioration of the country seemed inevitable. Some predicted that Britain would soon be worse off than communist East Germany.

Enter Margaret Thatcher, the daughter of a grocery-shop owner who had begun her own professional life as a food chemist but decided she preferred politics to working on ice cream and cake fillings. In 1975, she was elected leader of the Conservative Party. Four years later, she became prime minister, determined to reverse Britain's decline. That required great personal conviction, which Meryl Streep brilliantly captures.

Mrs. Thatcher came with her own script, a framework provided by free-market economists who, even a few years earlier, had been regarded as fringe figures. One telling moment that "The Iron Lady" misses is when a Conservative staffer called for a middle way between left and right and the prime minister shut him down mid-comment. Slapping a copy of Friedrich Hayek's "The Constitution of Liberty" on the table, she declared: "This is what we believe." . . .

As prime minister, she encountered enormous resistance, even from her own party, to putting beliefs into practice. But she prevailed through difficult years of painful budget cuts and yanked the government out of loss-making businesses. Shares in state-owned companies were sold off, and ownership shifted from the British Treasury to pension funds, mutual funds and other investors around the world. This set off what became a global mass movement toward privatization. ("I don't like the word" privatization, she said when we met. What was really going on, she said, was "free enterprise.")

But it was labor relations that were the great drama of the Thatcher years. The country could no longer function without labor reform. This was particularly true of the government-owned coal industry, which was being subsidized with some $1.3 billion a year. The Marxist-led coal miners had great leverage over the entire economy because coal was the main source for generating Britain's electricity. Everyone remembered the paralyzing 1974 National Union of Miners strike which blacked out the country and brought down a Conservative government.

By the 1980s, it was clear that another confrontation was coming as Mrs. Thatcher's government prepared to close some of its unprofitable mines. The strike started in 1984 and was marked by violent confrontations. But the Iron Lady would not bend, and after a year the strike faltered and then petered out. Thereafter, the road was open to reformed labor relations and renewed economic growth. . . .

Margaret Thatcher and Ronald Reagan were intellectual soul mates, but the movie does not touch on arguably their greatest collaboration, which was ending the Cold War. Mrs. Thatcher's visit to Poland in 1988, for instance, gave critical impetus to the Solidarity movement in its struggle with the Communist government.

But the difference between how Reagan and Mrs. Thatcher are seen today is striking. The bitterness of the Reagan years has largely been forgotten. Not so with Margaret Thatcher. She remains a divisive figure. Her edges were sharp, as could be her tone. Moreover, she was a woman competing in what had almost completely been a man's world.

Yet her true impact has to be measured by what came after, and there the effect is clear. When Tony Blair and Gordon Brown took the leadership of the Labour Party, they set out to modernize it. They forced the repeal of the party's constitutional clause IV with its commitment to state ownership of the commanding heights of the economy.

They did not try to reverse the fundamentals of Thatcherite economics. Mr. Blair recognized that without wealth creation, the risk was redistribution of the shrinking slices of a shrinking pie. The "new" Labour Party, he once said, should not be a party that "bungs up your taxes, runs a high-inflation economy and is hopelessly inefficient" and "lets the trade unions run the show."

The lesson that governments cannot permanently live beyond their means had been learned. When economies are growing in good times, that lesson tends to be forgotten. Yet the longer it is forgotten, the more painful, contentious and dangerous the relearning will be. That is the real story of the Iron Lady. And that is the story in Europe—and the U.S.—today.

Mr. Yergin is author of "The Quest: Energy, Security, and the Remaking of the Modern World" (Penguin 2011) and chairman of IHS CERA.

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10.  Hippocrates & His Kin: Some patients enjoy the freedom of ordering their own tests.

Medicaid benefits allows for more flexibility in health care.

A Medicaid patient had numerous tests done in several cities. It turns out she had relatives in each and also property, including a farm. She stayed with members of her family as she travelled and took care of her business endeavors. It allowed her the ability to obtain almost any test she desired at the different clinics in the several cities she visited. She said most doctors were very accommodating in ordering what she felt she needed.

It must be gratifying to obtain almost any test she wished without physician interference.

It is also very expensive. But she didn’t have to worry about that.

Gingrich extends his stay in California

Newt Gingrich had a photo-op session at the San Diego Zoo feeding the Pandas. The Pandas seem to like Newt.

You suppose the Pandas will vote for Newt?


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

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

                      The National Center for Policy Analysis, John C Goodman, PhD, President, who along with Gerald L. Musgrave, and Devon M. Herrick wrote Lives at Risk, issues a weekly Health Policy Digest, a health summary of the full NCPA daily report. You may log on at and register to receive one or more of these reports.

                      Pacific Research Institute, ( Sally C Pipes, President and CEO, John R Graham, Director of Health Care Studies, publish a monthly Health Policy Prescription newsletter, which is very timely to our current health care situation. You may signup to receive their newsletters via email by clicking on the email tab or directly access their health care blog.

                      The Mercatus Center at George Mason University ( is a strong advocate for accountability in government. Maurice McTigue, QSO, a Distinguished Visiting Scholar, a former member of Parliament and cabinet minister in New Zealand, is now director of the Mercatus Center's Government Accountability Project. Join the Mercatus Center for Excellence in Government.

                      To read the rest of this column, please go to

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

                      The Galen Institute, Grace-Marie Turner President and Founder, has a weekly Health Policy Newsletter sent every Friday to which you may subscribe by logging on at A study of purchasers of Health Savings Accounts shows that the new health care financing arrangements are appealing to those who previously were shut out of the insurance market, to families, to older Americans, and to workers of all income levels.

                      Greg Scandlen, an expert in Health Savings Accounts (HSAs), has embarked on a new mission: Consumers for Health Care Choices (CHCC). Read the initial series of his newsletter, Consumers Power Reports. Become a member of CHCC, The voice of the health care consumer. Be sure to read Prescription for change: Employers, insurers, providers, and the government have all taken their turn at trying to fix American Health Care. Now it's the Consumers turn. Greg has joined the Heartland Institute, where current newsletters can be found.

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

                      The Foundation for Economic Education,, has been publishing The Freeman - Ideas On Liberty, Freedom's Magazine, for over 50 years, with Lawrence W Reed, President,  and Sheldon Richman as editor. Having bound copies of this running treatise on free-market economics for over 40 years, I still take pleasure in the relevant articles by Leonard Read and others who have devoted their lives to the cause of liberty. I have a patient who has read this journal since it was a mimeographed newsletter fifty years ago.

                      The Council for Affordable Health Insurance,, founded by Greg Scandlen in 1991, where he served as CEO for five years, is an association of insurance companies, actuarial firms, legislative consultants, physicians and insurance agents. Their mission is to develop and promote free-market solutions to America's health-care challenges by enabling a robust and competitive health insurance market that will achieve and maintain access to affordable, high-quality health care for all Americans. "The belief that more medical care means better medical care is deeply entrenched . . . Our study suggests that perhaps a third of medical spending is now devoted to services that don't appear to improve health or the quality of care–and may even make things worse."

                      The Independence Institute,, is a free-market think-tank in Golden, Colorado, that has a Health Care Policy Center, with Linda Gorman as Director. Be sure to sign up for the monthly Health Care Policy Center Newsletter.

                      Martin Masse, Director of Publications at the Montreal Economic Institute, is the publisher of the webzine: Le Quebecois Libre. Please log on at to review his free-market based articles, some of which will allow you to brush up on your French. You may also register to receive copies of their webzine on a regular basis.

                      The Fraser Institute, an independent public policy organization, focuses on the role competitive markets play in providing for the economic and social well being of all Canadians. Canadians celebrated Tax Freedom Day on June 28, the date they stopped paying taxes and started working for themselves. Log on at for an overview of the extensive research articles that are available. You may want to go directly to their health research section.

                      The Heritage Foundation,, founded in 1973, is a research and educational institute whose mission was to formulate and promote public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values and a strong national defense. -- However, since they supported the socialistic health plan instituted by Mitt Romney in Massachusetts, which is replaying the Medicare excessive increases in its first two years, and was used by some as a justification for the Obama plan, they have lost sight of their mission and we will no longer feature them as a freedom loving institution and have canceled our contributions. We would also caution that should Mitt Romney ever run for National office again, he would be dangerous in the cause of freedom in health care. The WSJ paints him as being to the left of Barrack Hussein Obama. We would also advise Steve Forbes to disassociate himself from this institution.

                      The Ludwig von Mises Institute, Lew Rockwell, President, is a rich source of free-market materials, probably the best daily course in economics we've seen. If you read these essays on a daily basis, it would probably be equivalent to taking Economics 11 and 51 in college. Please log on at to obtain the foundation's daily reports. You may also log on to Lew's premier free-market site to read some of his lectures to medical groups. Learn how state medicine subsidizes illness or to find out why anyone would want to be an MD today.

                      CATO. The Cato Institute ( was founded in 1977, by Edward H. Crane, with Charles Koch of Koch Industries. It is a nonprofit public policy research foundation headquartered in Washington, D.C. The Institute is named for Cato's Letters, a series of pamphlets that helped lay the philosophical foundation for the American Revolution. The Mission: The Cato Institute seeks to broaden the parameters of public policy debate to allow consideration of the traditional American principles of limited government, individual liberty, free markets and peace. Ed Crane reminds us that the framers of the Constitution designed to protect our liberty through a system of federalism and divided powers so that most of the governance would be at the state level where abuse of power would be limited by the citizens' ability to choose among 13 (and now 50) different systems of state government. Thus, we could all seek our favorite moral turpitude and live in our comfort zone recognizing our differences and still be proud of our unity as Americans. Michael F. Cannon is the Cato Institute's Director of Health Policy Studies. Read his bio, articles and books at

                      The Ethan Allen Institute,, is one of some 41 similar but independent state organizations associated with the State Policy Network (SPN). The mission is to put into practice the fundamentals of a free society: individual liberty, private property, competitive free enterprise, limited and frugal government, strong local communities, personal responsibility, and expanded opportunity for human endeavor.

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

                      McLauren Institute  MacLaurinCSF is a community of students, scholars, and thinkers working together to explore and understand the implications of the Christian faith for every field of study and every aspect of life.*  Our Mission: MacLaurinCSF bridges church and university in the Twin Cities metropolitan area, bringing theological resources to the university and academic resources to the church. Our goal is to strengthen Christian intellectual life in this region by creating public space for leaders in the academy and church to address enduring human questions together. MacLaurinCSF is grounded in the Christian tradition as articulated in Scripture and summarized by the Apostles’ and Nicene creeds, and our conversations are open to all.

                      The St. Croix Review, a bimonthly journal of ideas, recognizes that the world is very dangerous. Conservatives are staunch defenders of the homeland. But as Russell Kirk believed, wartime allows the federal government to grow at a frightful pace. We expect government to win the wars we engage, and we expect that our borders be guarded. But St. Croix feels the impulses of the Administration and Congress are often misguided. The politicians of both parties in Washington overreach so that we see with disgust the explosion of earmarks and perpetually increasing spending on programs that have nothing to do with winning the war. There is too much power given to Washington. Even in wartime, we have to push for limited government - while giving the government the necessary tools to win the war. To read a variety of articles in this arena, please go to

                      Chapman University: Chapman University, founded in 1861, is one of the oldest, most prestigious private universities in California. Chapman's picturesque campus is located in the heart of Orange County – one of the nation's most exciting centers of arts, business, science and technology – and draws outstanding students from across the United States and around the world. Known for its blend of liberal arts and professional programs, Chapman University encompasses seven schools and colleges: The university's mission is to provide personalized education of distinction that leads to inquiring, ethical and productive lives as global citizens.

                      Hillsdale College, the premier small liberal arts college in southern Michigan with about 1,200 students, was founded in 1844 with the mission of "educating for liberty." It is proud of its principled refusal to accept any federal funds, even in the form of student grants and loans, and of its historic policy of non-discrimination and equal opportunity. The price of freedom is never cheap. While schools throughout the nation are bowing to an unconstitutional federal mandate that schools must adopt a Constitution Day curriculum each September 17th or lose federal funds, Hillsdale students take a semester-long course on the Constitution restoring civics education and developing a civics textbook, a Constitution Reader. You may log on at to register for the annual weeklong von Mises Seminars, held every February, or their famous Shavano Institute. Congratulations to Hillsdale for its national rankings in the USNews College rankings. Changes in the Carnegie classifications, along with Hillsdale's continuing rise to national prominence, prompted the Foundation to move the College from the regional to the national liberal arts college classification. Please log on and register to receive Imprimis, their national speech digest that reaches more than one million readers each month. This month, read ? Choose recent issues.  The last ten years of Imprimis are archived.

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Words of Wisdom, Recent Postings, In Memoriam, Today in History . . .

Words of Wisdom

"If you always do what you always did, you'll always get what you always got."

— High-tech proverb  

"We do not want to gain at someone else's loss; we want to gain while helping the other person to also gain." — Jose Silva:  an American parapsychologist and author

Some Recent Postings

In The Jan Issue:

1.      Featured Article: Understanding Lung Function

2.      In the News: Have you thought about Outsourcing your New Year’s Resolutions?

3.      International Medicine: Schumpeter: Saving Britain's health service

4.      Medicare: Clowns to the left of me, jokers to the right

5.      Medical Gluttony: A Letter from the HMO concerning an 85-year-old patient with a stroke

6.      Medical Myths: The High Cost of Technology

7.      Overheard in the Medical Staff Lounge: There will be no effective opposition to Obama

8.      Voices of Medicine: From the North Coast Physician

9.      The Bookshelf: The Unbreakable Bond Between a Marine and His Military Working Dog

10.  Hippocrates & His Kin: The Low Cost of Technology

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

In Memoriam
Norman Edmund 1916-2012

He Supplied the Gadgets to Scientists of All Ages By STEPHEN MILLER- WSJ

Norman Edmund founded a mail-order operation that for decades was the go-to source for telescopes, microscopes and science toys and gadgets of every description.

Mr. Edmund, who died Jan. 16 at age 95, founded the company during World War II that later became Edmund Scientific, a reseller of military lenses rendered obsolete by the invention of radar. The company grew into a supplier for schools and industry, and especially for hobbyists.

The Edmund catalog featured boomerangs, lenses, sextants, chemistry kits, robot parts, gyroscopes and the famous drinking bird, which appeared to be a perpetual-motion machine.

The company's Barrington, N.J., showroom burgeoned with government-surplus supplies, an array of telescopes and a functioning 38-foot periscope from a Japanese submarine.

"The Edmund Scientific catalog was a geek's paradise," said Neil deGrasse Tyson, director of the Hayden Planetarium in New York. "At a time when no one had access to lasers, they had them for sale."

Growing up in Camden, N.J., Mr. Edmund was voted "most studious" by his high school class. Shortly after graduating from the Wharton School with an accounting degree, he was stricken with tuberculosis and pursued photography during an extended recuperation. He fell into the mail-order business by accident after he purchased several lenses wholesale and sold the spares he didn't need.

In 1942, he founded Edmund Salvage to purchase government-surplus optics—lenses, prisms and bombsights—and by the end of the war his inventory was taking up rented space in more than 30 garages.

His wife Pauline—who was his nurse in the tuberculosis ward—initially handled most of the bookkeeping from a card table in their living room. Mr. Edmund perused hundreds of scientific journals for ideas about new products.

The company grew fast after World War II, and actually sold optics back to the military during the Korean War. "Gee, you have more optics than the Army!" the company said an official told him at the time. . .

"Edmund is the best source we know of for low-cost scientific gadgetry," Stewart Brand wrote in "The Last Whole Earth Catalog."

Mr. Edmund retired to Florida in 1975, where he fished for tuna on his boat, called the Pickled Herring, and wrote about science education. His son Robert Edmund took charge of the family-owned business. Under his leadership Edmund Scientific sold the catalog business, which still exists, and renamed the company Edmund Optics, which makes optics for retinal scans and other military and industrial applications.

Read the entire Remembrance in the WSJ – subscription required . . .

On This Date in History – February 14

On this date, Saint Valentine's Day, commonly shortened to Valentine's Day,[1][2][3] is a holiday observed on February 14 honoring one or more early Christian martyrs named Saint Valentine. It is traditionally a day on which lovers express their love for each other by presenting flowers, offering confectionery, and sending greeting cards (known as "valentines").[1][3] The day first became associated with romantic love in the circle of Geoffrey Chaucer in the High Middle Ages, when the tradition of courtly love flourished. It was first established by Pope Gelasius I in 496 AD, and was later deleted from the General Roman Calendarof saints in 1969 by Pope Paul VI.

Modern Valentine's Day symbols include the heart-shaped outline, doves, and the figure of the winged Cupid. Since the 19th century, handwritten valentines have given way to mass-produced greeting cards.[4]  Read more . . .

On this date in 1766, Thomas Malthus was born in England. He propounded one of the gloomier theses about life by arguing that population increases in a geometrical ratio while subsistence only increases in an arithmetical ratio. He argued for “moral restraint,” postponing the age of marriage, as the best way to prevent the supply of people from out running the supply of food. So what shall it be? On February 14, you have a choice of Valentine’s Day romance or the “wait a while” counsel of that man born on this day, Thomas Malthus.

After Leonard and Thelma Spinrad

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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, any single payer initiative, Social Security was born for the benefit of the state and of a contemptuous disregard for people’s welfare.

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.