MEDICAL TUESDAY . NET                         NEWSLETTER


Community For Better Health Care               Vol IV, No 11, Sept 13, 2005

In This Issue:

1.         Featured Article: [Health Care in America, Take Lessons from France] - Innovate

2.         In the News: “Shaken Baby Syndrome” Questioned by British Court

3.         International Medicine: Travelers Beware of Deadly Prescription Mix-Ups

4.         Medicare: A Disaster (and Health Care) Lesson from Ben Franklin

5.         Medical Gluttony for Patients with Fake Injuries: Aren't Bogus Medical Claims Legal Fraud and Lawyer Gluttony?

6.         Medical Myths: Patients Should Be Protected from the Risks of Self Diagnosis and Treatment

7.         Overheard in the Medical Staff Lounge - Email from Katrina - We Can Still See Our Rooftop

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

9.         Book Review: From the Physician Patient Bookshelf: LIFE WITHOUT DISEASE

10.       Hippocrates & His Kin: Is the Congressional Record for Real?

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

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The 3rd Annual World Health Care Congress, co-sponsored by The Wall Street Journal, is the most prestigious meeting of chief and senior executives from all sectors of health care. Renowned authorities and practitioners assemble to present recent results and to develop innovative strategies that foster the creation of a cost-effective and accountable U.S. health care system. The extraordinary conference agenda includes compelling keynote panel discussions, authoritative industry speakers, international best practices, and recently released case study data. The 2006 conference will be held from April 17-19, 2006, in Washington, DC. For more information, visit

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1.         Featured Article: [Health Care in America, Take Lessons from France] - Innovate

Brian M. Carney reported in The Wall Street Journal - Europe: Workers of Europe Innovate
July 25, 2005; Page A15. [There is a lesson for Health Care in this message. Instead of the owner/employer-manager-worker-customer relationship, transform the message into the Medicare-managed care-doctor-patient relationship and we can free American Medicine from the same oppression and regressive care.]

HALLENCOURT, France -- In this hamlet in the north of France, Jean-Francois Zobrist leads the sort of company that isn't supposed to exist any more in high-tax, high-cost socialist Europe. It's a company -- in France, remember -- where workers volunteer to work Saturdays when an extra-large order needs to be filled by Monday, where front-line employees redesign products to improve efficiency, and where prices have fallen almost every year for decades.

The business is as old-economy as they come. FAVI is an 800-employee copper foundry that began in the 1940s making plumbing fixtures. In the 1970s, with the market for copper plumbing in decline, it moved into water meters, and in the 1980s FAVI started making copper forks for automotive gear boxes; it is now the European leader in this niche, with over 50% of the market.

Moreover, FAVI makes money in markets in which its competitors lose money -- or have long since outsourced production to Asia. How does FAVI do it? Mr. Zobrist is a man of many maxims, but one of them is that the company he runs (he owns no stake in the family-owned company himself) makes its employees happy.  

The key to happiness, in Mr. Zobrist's view, is to free workers from the arbitrary restrictions of the chain of command, or rather, the chaine de comment -- the chain of "how."

"In the system of 'how,' you talk to the foreman, who doesn't know. The shop chief, he doesn't know. Neither does his boss, so he goes to the director, who doesn't know, so he asks the factory manager and the CEO. This is the chain of 'how,'" Mr. Zobrist explains, mockingly. Everyone must ask his boss how to get anything done, so nothing gets done. . . .

If this sounds overstated, few people who work in a large or medium-size company will find Mr. Zobrist's description wholly unfamiliar. The inability or reluctance to take decisive action to improve the efficiency of one's day-to-day tasks is pervasive in most firms of any size. Many of us are trapped in the chaine de comment.

When Mr. Zobrist was put in charge of FAVI, he set about to break the chain. Most businesses, in his view, are "Soviet" in character -- they rely on centralized control by bosses, whose priority is the reduction of risks to themselves. . . . At FAVI, what matters is "why" and "for whom," not "how." That is, workers aren't told how to do their jobs, but whom they are doing them for -- the customer, not their boss. "The only power lies with the customer," Mr. Zobrist avers. "I have no power in here. I enter a meeting, no one stands up. I don't have a parking space, and if I start pretending to expertise in a meeting, my people will often cut me off."

What's more, FAVI has no personnel department; Mr. Zobrist eliminated it 20 years ago, "because this department's main job was to put constraints on people's activity and grow its own ranks to enforce these constraints." There is virtually no middle management at FAVI; the company is organized into teams, which each serve one customer -- one automaker, for example. Those teams choose their own leader, who reports to Mr. Zobrist. Thus, the organizational chart is only three layers deep.

Instead of obedience, Mr. Zobrist seeks responsibility and initiative from his employees. And to get it, he gives them freedom -- to innovate and experiment, but also the freedom to solve customers' problems in their own way. He tells them they work for the customer, and gets out of the way. His only demand, just about, is that they always look for ways to do it "better and cheaper" -- and never deliver late.

Thus, the workers on the factory floor have redesigned their own work spaces to improve their own efficiency. . . . in every case, the employees exercised the freedom simply to get it done -- no review committees, no manager approval. Just try it; if it works, tell others, so they can try it too.

To some, the result seems chaotic. Mr. Zobrist tells a story of a customer, a tradition-bound car company, that sent a team to audit FAVI's work practices. "This won't do at all," they said after their inspection. "You have no metrics for tracking late orders . . . no structure, no planning, no delay management [procedures]."

Mr. Zobrist responded: "How many years have we been supplying your needs?" "11 years," said the customer. "And in 11 years, have we ever been early or late?" "No." "Have we ever delivered too many parts, or too few?" "No." "So, why do you want to put in place measures of things that don't exist?" Mr. Zobrist asked. He got no response.

Remarkably, FAVI has thrived in, of all places, France -- a country Mr. Zobrist describes as the "last Soviet Republic." . . .

Friedrich Hayek, the Nobel Prize-winning economist, argued 60 years ago that decentralized systems would always beat centralized, command-and-control systems because, in his famous phrase, all important information is distributed and the "man-on-the-spot" knows best. Thus, no one person or ministry knows enough to direct resources for an entire economy. The collapse of the Soviet system underscored his point.

But if central planning has gone out of style as a means of organizing the economy, it remains far too prevalent as a means of organizing firms. If Jean-Francois Zobrist can break that mold in France, there must be hope for workers everywhere who are trapped in the chain of command.

Mr. Carney is editorial page editor of The Wall Street Journal Europe. In August, he will join the Journal's editorial board.,,SB112225856507394646,00.html

[There is also a message of how we need to free doctors, nurses and hospitals trapped in bureaucratic mandates that prevent them from treating patients appropriately.]

It's like the beaver told the rabbit as they stared at the Hoover Dam.

"No, I didn't build it myself. But it's based on an idea of mine!"

Charles Townes, Nobel Laureate, Inventor of the Laser

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2.         In the News:  “Shaken Baby Syndrome” Questioned by British Court; Conviction Overturned - AAPS News of the Day ... In Perspective

After 4-month-old Patrick Harris died in 1999, his grief-stricken mother was sentenced to prison for manslaughter. Expert medical witnesses testified that the existence of subdural hematomas, cerebral edema, and retinal hemorrhages proved that the infant had been shaken to death.

British Court of Appeal has not only overturned the conviction but, in a 61-page opinion, questioned the very existence of “shaken baby syndrome.”

The ruling could lead to the reopening of 88 similar cases in the UK and up to 15,000 suspected child abuse cases in the U.S., stated Dr. John Plunkett of the Regina Medical Center in Hastings, Minnesota, an expert in child forensic pathology.  

One study not considered by the court, a biomechanical study published last month by Dr. Faris Bandak of the University of the Health Sciences in Bethesda, Maryland, showed that a baby’s neck would fracture before shaking would produce brain swelling. “The signature of shaken baby syndrome is cervical spine injury,” he said.

In the U.K., this case adds to a crisis regarding the role of expert medical testimony in the courtroom (New Scientist 7/30/05).

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3.         International Medicine: Travelers Beware of Deadly Prescription Mix-Ups

NCPA Daily Policy Digest: HEALTH ISSUES, Wednesday, August 24, 2005     

Prescription mix-ups create a new risk for travelers since many drugs in foreign countries have the same brand name as U.S. medications, but contain completely different ingredients, says the Wall Street Journal.

The Institute of Safe Medication Practices has identified several drugs in the United States that have the same name as very different drugs sold by different manufacturers in European countries.

    * Norpramin, an antidepressant in the United States, is the name of an ulcer drug in Spain.

    * Flomax, used for prostate disease in the United States, has the same name as a pain medication in Italy.

    * Vivelle, which is a hormone treatment for menopause and osteoporosis in the United States, is a birth-control pill in Austria. . .

These mix-ups could result in patients not getting a life-saving drug, getting the wrong drug or suffering unexpected interactions; patients who want to import less expensive drugs could encounter similar problems, says the Journal.

Moreover, there are about 16,000 drugs -- branded, generic and over-the-counter -- prescribed in the United States, and as the number continues to grow, there is no regulatory body that keeps track of names globally. Companies could do global searches but they are expensive and even alternative sources, like reference books and electronic databases, may not be exhaustive or up to date.

Until U.S. and foreign retailers collaborate, or companies ensure their labels are unique, travelers should protect themselves by packing enough medication for their whole trip and noting both brand and generic names -- with dosages -- of all drugs, says the Journal.

Source: Marilyn Chase, "Buying the Wrong Medicine Overseas," Wall Street Journal, August 16, 2005.

For text (subscription required):,,SB112415070765613880,00.html.

For more on Health Issues: Risks in Using Drugs:

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4.         Medicare: A Disaster (and Health Care) Lesson from Ben Franklin

Ben Franklin Had the Right Idea for New Orleans By John Tierney

Why is New Orleans in so much worse shape today than New York City was after the attacks on Sept. 11?

The short answer is that New York was attacked by fire, not water. But then why are urbanites so much better prepared to cope with fire than with flooding? Mostly because they learned to fight fire without any help from the Army Corps of Engineers or the Federal Emergency Management Agency.

For most of history, fire was far more feared than flooding. Cities repeatedly burned to the ground. Those catastrophes occurred sporadically enough that politicians must have been tempted to skimp on fire protection - like levee maintenance, it was a long-term investment against a calamity that probably wouldn't occur before they left office.

But urbanites learned to protect themselves through two innovations Benjamin Franklin introduced to America. He started a fire department in Philadelphia, as well as its first fire insurance company. Other cities followed, often with the firefighters organized by insurance companies with a vested interest in encouraging public safety.

Their customers had a vested interest, too, because they had to pay higher premiums if they lived in homes or neighborhoods that were prone to fire. As fire insurance became a standard requirement for homeowners, they and their insurance companies kept pressure on politicians to finance firefighting and tighten building codes. . . .

But as we've learned this week, few people seem to care passionately about maintaining levees or preparing for a predictable flood. They've left that to Washington, which promised to hold back the waters and absolved coastal dwellers from worrying about hurricanes.

Starting in the 1960's, the federal government took over the business of insuring against floods. It offered subsidized insurance to people in flood-prone areas, encouraging seaside homes that never would have been built otherwise. Even at bargain rates, most people went without flood insurance - only about a third of the homes in New Orleans carried it.

People don't bother to protect themselves because they figure - correctly - that if disaster strikes they'll be reimbursed anyway by FEMA. It gives out money so freely that it has grown into one of the great vote-buying tools of the modern presidency. . . .

. . . Since Washington didn't keep its promise to protect the city, the federal government should repair the damage and pay for a new flood-control system. But New Orleans and other coastal cities will never be safe if they go on relying on Washington for protection. Members of Congress will always have higher priorities than paying for levees in someone else's state.

The federal government has a role in coordinating flood control among states and in organizing outside disaster relief, but the locals should fight floods much the same way they fight fires. Fifteenth-century Dutch burghers didn't have the financial or technological resources of today's Louisianians, but they managed to hold back the sea without the Army Corps of Engineers.

Here's the bargain I'd offer New Orleans: the feds will spend the billions for your new levees, but then you're on your own. You and others along the coast have to buy flood insurance the same way we all buy fire insurance - from private companies that have more at stake than do Washington bureaucrats.

Private flood insurance has come to seem quaint in America, but in Britain it's the norm. If Americans paid premiums for living in risky areas, they'd think twice about building oceanfront villas. Voters and insurance companies would put pressure on local politicians to take care of the levees, prepare for the worst - and stop waiting for that bumbling white knight from Washington.

To read the original article, go to


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

- Ronald Reagan

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5.         Medical Gluttony for Patients with Fake Injuries: Aren't Bogus Medical Claims Legal Fraud and Lawyer Gluttony?

REVIEW & OUTLOOK: Case of the Vanishing X-rays, Wall Street Journal, August 31, 2005; Page A8

The judicial undressing of the silicosis scam continues, and the lawyers are really starting to sweat under the kleig lights.

Back in June, federal Judge Janis Graham Jack disparaged nearly all of 10,000 claims for the rare lung disease as having been "manufactured for money." She also told the lawyers involved that federal prosecutors wanted access to the documents and X-rays surrounding this "fraud." So imagine Judge Jack's surprise to discover at a hearing last Monday that Houston attorney Scott Hooper -- one of several tort lawyers who brought the claims -- had removed more than 1,300 X-rays from a court depository. The judge had specifically denied Mr. Hooper's request to take the X-rays.

Ms. Jack told Mr. Hooper that if he did not have the documents back in her court by 5 p.m., he'd be found in contempt and would be "held in this courtroom until they are replaced." When Mr. Hooper said that was impossible, she informed him that "If you have to hire a jet to get them here, you will get them here." She then ordered marshals to accompany him to make his calls.

The hapless Mr. Hooper offered all sorts of legal reasons he felt he had a right to the X-rays -- including an assertion that the judge no longer had jurisdiction. But the main point is that Judge Jack had specifically informed everyone that the documents and X-rays were under federal scrutiny. That Mr. Hooper still took them away suggested he might be hiding something. By last Wednesday, Judge Jack had put out an order noting that Mr. Hooper had removed 1,342 X-rays from the depository but had only returned 1,219 by the end of Monday. She added: "In the future, the Court would like Mr. Hooper to form a closer relationship with the law."

The other excitement was an extraordinary exchange between Judge Jack and trial lawyer Richard Laminack. (See a reprint at,,SB112544438517227231,00.html?mod=todays_us_opinion.)The judge had remanded most of the bogus silicosis suits to state court, but she kept one -- originally filed by Mr. Laminack's firm in her Texas jurisdiction. The "Alexander suit" includes about 100 plaintiffs who all claim to have silicosis. Yet Judge Jack's pretrial hearings helped discover that nearly 70% of these claimants had previously filed an asbestos claim. Experts testifying in Judge Jack's court had made clear that it is extremely rare for a person to have both asbestosis and silicosis.

When Judge Jack brought this troubling fact up again in last week's hearing, Mr. Laminack shocked everyone by explaining that he doubts his clients ever had asbestosis. Put another way, so eager was Mr. Laminack to support the credibility of his silicosis claims that he admitted in federal court that he believed his clients had previously filed fraudulent asbestos claims. His admission is all the more notable because Mr. Laminack was indicting some of the lions of the asbestos bar -- Dickie Scruggs, for instance -- who (according to defense attorneys) were among those filing "Alexander" asbestos claims.

To read the entire editorial (subscription required), please go to,,SB112544438428727225,00.html?mod=todays_us_opinion.

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6.         Medical Myths: Patients Should Be Protected from the Risks of Self Diagnosis and Treatment


Consumers benefit from self-administered over-the-counter (OTC) medications because of lower prices and easier access. However, rigid FDA rules lock many drugs that are readily accessible to consumers in other countries behind U.S. pharmacy counters, say Paul Kittinger, an intern, and Devon Herrick, a senior fellow, both with the National Center for Policy Analysis.

The FDA can approve a prescription drug for OTC sale once it decides that the benefits outweigh the risks, the potential for abuse is low, consumers can self-diagnose the condition, labels can be easily understood and administration by health practitioners is unnecessary.

The 89 prescription products the FDA has switched over the past 30 years include such familiar brands as Advil, Afrin, Drixoral, Aleve, Pepcid AC, Zantac-75, Nicorrette, Rogaine and Lamisil. Recently, however, FDA approval for OTC sale has slowed dramatically, say Kittinger and Herrick:

    * In the past five years, it has reclassified only seven prescription drugs (including the bestselling drugs Claritin and Prilosec).

    * Over a 20 year period, by contrast, European countries approved about four times as many prescription medications for OTC sale as the United States, according to a 2003 report from the Tufts Center for the Study of Drug Development.

Every year, Americans spend more than $200 billion on prescription medicines, but only one-tenth that amount -- about $20 billion -- on OTC medications. Moreover, the average price of an OTC medication is much lower than that of a prescription drug:

    * The average name-brand prescription costs about $96.

    * Generic prescription drugs cost about $28.

    * OTC drugs cost an average of about $7.

Stringent FDA rules limit consumer access to treatments that could safely be moved over the counter. One solution is to allow any drug approved for OTC use in Europe to be sold in the United States, says Kittinger and Herrick.

Source: Paul Kittinger and Devon Herrick, "Patient Power: Over-the-Counter Drugs," National Center for Policy Analysis, Brief Analysis No. 524, August 22, 2005.

For text:,

For more on Health Issues: Drug Research and Development:

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7.         Overheard in the Medical Staff Lounge: Email from Katrina - We Can Still See Our Rooftop

[As many doctors and nurses are signing up with the American Red Cross and "Search and Rescue" teams are leaving to provide medical services in New Orleans, we received an email from Dr Rich Willner, President of Peer Review Justice, whom we list in our "Restoring Accountability in Medical Practice and Society" section in the second issue of each month.]

We evacuated New Orleans along with our closest friend who is the Chief of Staff of the largest hospital in suburban New Orleans. We went to his condo in Perdido Key, 200 miles from New Orleans, where we were again forced to evacuate. The danger was to the access roads to this beach condo.

We evacuated to Tallahassee. While the women did their thing, we systematically studied the details of sham peer reviewed surgeons. Until this time, he was a non believer. Now he is one of us.

We are watching TV, and receiving first hand accounts. At this time, the flood waters are at the roof of our house, our store, and my wife lost her job. The estimates are it will be months before the flood waters recede.

I am heading towards Delray Beach to visit my dad. Following this, we plan to move to Dallas as it is our priority to put our teenage daughter in school.

The Center for Peer Review Justice has changed its phone number to 512-587-0064, an Austin #. Thank you for your prayers. Rich

Stay tuned to Rich at

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

We are glad to see that the Canadian Medical Association is FINALLY backing private care in Canada......after they let Dr. Jacques Chaoulli take all the risks (i.e. loser pays in the court) and do all of the heavy lifting. This is the story of "The Little Red Hen." Where was the Canadian Medical Association when Jacques was baking the cake? Larry Huntoon, MD, Editor, JAPS


Larry's comments are right on target. In fact, the Canadian Medical Association deserves even more criticism. I met one of its top officers and he said the Association had filed an amicus brief in Chaoulli's case in an attempt to preserve the socialized system! Andy Schlafly, Esq, Counsel


Richard H Guth, MD, AMA delegate from Riverside, comments on the AMA Annual Meetings. Each year the solution to the problem of organized medicine becomes more obvious to him. He feels we need an AMA that truly represents all of America's physicians even if membership dues must be dropped so low that the AMA has limited staff and limited budgets for all its activities. From the archives, VOM, Dec 1998.


The San Francisco Medical Society has had their own symphony orchestra for more than 30 years. In 1946, SF Medical Society members returning from World War II set up the SFMS Symphony which met every Monday night at either the medical society auditorium or area hospitals. The SFMS symphony gave two public concerts each year performing each program twice. Contributions of the members funded the symphony, and the proceeds from the concerts were donated to charitable causes, such as the Blood Bank and The Hearing and Speech Center. As interest declined in the 1970s, the Monday sessions took a summer recess. They were never resumed. Ten years later, the son of a physician, a graduate student in biophysics at UCSF, asked to join the symphony and finding none, organized one that he led until 1995. Today, the Medical Society symphony is no more but the UCSF orchestra is carrying on beautifully.

Atul Gawande, MD, in a Medical Dispatch column of the September 21, 1998, issue of The New Yorker, writes an article titled "The Pain Perplex." When a patient has chronic pain without physical explanation--and such patients are common--physicians tend to be dismissive. Psychologist Ronald Melzack and Physiologist Patrick Wall propose that the Cartesian model of pain be replaced with the gate-controlled theory of pain. They argue that before pain signals reach the brain, they must pass through a gating mechanism in the spinal cord that could ratchet the signals up or down or even stop pain impulses from going to the brain. However, the most startling suggestion of Melzack and Wall was that emotions and other "output" from the brain also controlled the gate. This helped explain how mood, gender and beliefs influence pain. Studies have shown that social conditions play a dominant role in many chronic-pain syndromes. This does not mean that people are faking their distress, but that a more compassionate approach toward chronic pain includes investigating its social coordinates, not just its physical ones. The solution to chronic pain may lie more in what goes on around us than in what is going on inside us.

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9.         Book Review: From the Physician Patient Bookshelf: LIFE WITHOUT DISEASE

LIFE WITHOUT DISEASE - The Pursuit of Medical Utopia by William B Schwartz, MD. University of California Press, Berkeley, 1998, xii + 178 pp, $22. ISBN 0-520-21467-6.

Academic physician Doctor William Schwartz has been studying health policy for more than two decades. In 1994, he coauthored The Painful Prescription: Rationing Hospital Care. Schwartz spent the last five years writing Life Without Disease - The Pursuit of Medical Utopia. His research, findings, and understanding of our present healthcare delivery dilemma and proposals for the future provide a link to a possible answer.

Schwartz reviews the health-care system in the US since mid century pointing out that all attempts at controlling costs have been merely one-time adjustments and have failed because they do not attack the root of the problem. He takes issue with others who feel that medical services can be brought under control in piecemeal fashion. Schwartz does not feel that managed care is an effective means for long-term cost control of an ever-expanding medical technology; it only encourages eliminating inefficiencies. When the increasing competition has squeezed out any remaining inefficiencies in the system, managed care can produce further savings only when competing providers impose serious restrictions on the availability and quality of care offered. He believes that managed-care organizations will inevitably limit not only marginal and unnecessary care but also possible beneficial care deemed too expensive. He then uses microeconomics to calculate the "expected benefits per dollar."  

Dr Schwartz feels the long-term solution to cost-control lies in molecular biology and genetic engineering. He envisions a drug that can be designed that works only on the molecule affecting the disease in the body and on no other. He predicts that as we eliminate disease through prevention and molecular intervention, our healthy life span will increase by 40 years. The next generation may live to be 130, free of the chronic illnesses that now plague us. Consequently, the need for medical services will be greatly reduced.

Schwartz traces the birth and growth of "big medicine" to the post World War II period and the success of research efforts such as the Manhattan Project. Scientists and government leaders reasoned that aggressive government support of medical research could yield equally dramatic results. Schwartz considers this a pragmatic rather than a utopian dream. There was no concept of the scale of either the costs or the success of a technological revolution. Leaders were aware that medical progress was costly but believed the American people were ready to harness the nation's economic muscle in the fight to eliminate disease. Schwartz recounts the story of Albert and Mary Lasker, who through their wealth, influence, and determination welded together a coalition of public and private leaders dedicated to putting medical research funding on the national agenda. The Laskers exploited their friendships with influential physicians and powerful politicians to further their cause. The couple heavily contributed to election campaigns, befriended presidents, charmed the press, and built a network of like-minded movers and shakers, all of which Elizabeth Drew memorably describes in an Atlantic Monthly article "The Health Syndicate: Washington's Noble Conspirators." As a result of these efforts, the National Institutes of Health (NIH) began its rise from a small agency with a budget of $26 million in 1948 to become the Goliath it is today with a budget of $12.4 billion. This rise in technology has driven the cost of health care out of reach of many of our citizens.

Schwartz gives us neither economic nor political solutions for this dilemma. It would seem a giant leap to envision a minority of working Americans supporting the retirement and health care needs of the majority through 65 plus years of leisure (age 65-130). When F D Roosevelt started Social Security, and the average life expectancy was 60. Retirement was set at 65 years of age. Thus, those that had prepared for their old age (including healthcare), who lived more than 5 years beyond the life expectancy would have Social Security to fall back on. Later, Medicare was set for the same age. If Social Security and Medicare had kept pace by keeping benefits starting 5 years beyond the average life expectancy, we would not now have problems financing these systems. But politicians are unable to bite the economic bullet. Physicians in politics seem equally impotent. To read the entire review, go to To peruse the Physician/Patient Book Shelf, please go to

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10.       Hippocrates & His Kin: Is the Congressional Record for Real? WalMart Spouses

John Stossel, on 20/20, reports on the Congressional Record, an alleged verbatim report, that the record is mostly Fake. In fact, it can be changed if the congressman doesn't like the first Fake record or find that it has MISTAKES in it to make it a more acceptable Fake. He concludes that Congress is wasting $469 per page and doesn't seem to be able to keep from wasting anything they touch. . . . If we ever let congress destroy the health care we provide our patients it would be the most critical of all MISTAKES.


A produce manager at WalMart was a man who had clogged coronaries that produces a high risk of cardiac arrhythmia, infarctions and cardiac arrests. After his death, his widow won $253.4 million from ten members of a 12-jury panel against the company that spent a billion dollars developing Vioxx and making it available to arthritis sufferers. Vioxx, a cyclooxygenase-2 (cox-2) inhibitor which causes less risk of gastric bleeding than the commonly prescribed aspirin, Advil, Aleve and approximately 40 other nonsteroidal antiinflammatory drugs (NSAID), shares the increased cardiac risk factors as the other Cox-2 inhibitors such as Celebrex and Bextra. The FDA noted in February 2005 that the Cox-2 inhibitors, Vioxx, Celebrex and Bextra, posed heart risks but recommended that they should be available to consumers. Vioxx and Bextra have been voluntarily withdrawn from the market.

"Plaintiff lawyers are sharks and they smell blood," said David A Logan, the dean of Roger Williams University School of Law. From the advertisements that accompany the newspaper postings such as the following, the Dean appears to have made a factual statement.

There have been many serious medical conditions associated with Vioxx, Celebrex and Bextra, including: Stroke, Heart Attack, Blood Clots, Nonbacterial Meningitis, Interaction with Blood Pressure Medication, Kidney Damage Leading to Kidney Failure.

If you or someone dear to you has taken Vioxx, Celebrex or Bextra and believe that it may have caused any of the symptoms or conditions listed above, please contact our experienced Vioxx attorneys.

It is estimated that the thousands of lawsuits pending, in which it can never be stated that the Cox-2 inhibitors are at fault rather than the underlying heart disease related to the patients' gluttonous dietary habits, will cost the pharmaceutical company $20 to $50 billion and deprive Americans of at least 20-50 new lifesaving pharmaceutical drugs, the largest private funding source for medical research. What is seldom mentioned is the $6 billion that the attorneys will pocket as the ads stake out the next $6 to $15 billion for their next assault on Celebrex or Bextra, as soon as they get enough patients to call in for the next pharmaceutical lottery.

Our patients on Celebrex complain that it isn't as effective as Vioxx and always ask me if I still have samples of Vioxx. Some had stashed away a large supply of Vioxx when the publicity started and take it as needed for severe arthritic pain. Asked if they are afraid of arrhythmias, they say that all drugs have risks and doubling a one percent risk of heart attacks is an acceptable risk.

To read more Medical Vignettes archives, go to

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More than half of the presidents of the United States–a country burdened with huge debt, a devastating crime rate, a failing education system, excessive acid rain and an embarrassing series of World Cup performances–have been lawyers.

Lawyers and Other Reptiles by Jess M Brallier, courtesy of my attorney.

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11.       Restoring Accountability in HealthCare, Government and Society:

These are sites you may wish to access on a regular basis in order to obtain the latest in important health care issues. We have made it easy for you to access these sites on MedicalTuesdays. If you have made Tuesdays your day to review and become knowledgeable about the world of health care (with corollaries in education that have already been nearly destroyed by government intervention), you will find that many of these sites have weekly postings that present the latest in a vital dialogue. If you are pushed for time, the following thumbnail sketches will give you an overview–a brief glance to keep you current.

$          The National Center for Policy Analysis, John C Goodman, PhD, President, who along with Devon Herrick wrote Twenty Myths about Single-Payer Health Insurance,, which we reviewed in this newsletter the first twenty months. Their survey included national health insurance in countries around the world and provides convincing evidence that government control of health care usually makes citizens worse off. When health care is made free at the point of consumption, rationing by waiting is inevitable. Government control of the health care system makes the rationing problem worse as governments attempt to limit access to modern medical technology. Under government management, both efficiency and quality of patient care steadily deteriorate. Also see their 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.

$          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. He will be speaking at the annual meeting of the Association of American Physicians and Surgeons next week on September 21-24 in Washington, DC. Make your reservations at and plan to attend in historic Georgetown. Meet an outstanding panel of professors, congressmen, lawyers, and international faculty discussing how to protect American Medicine from the Government before it’s too late.

$          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 As more Americans move into consumer-directed health plans, more and more studies are being produced that report on early experience with these plans. The Galen has released a paper that summarizes some of the newest studies of these products, including Health Savings Accounts and Health Reimbursement Arrangements, which offer new incentives for consumers to help manage their health care and health costs. The bottom line: Consumerism is working in these plans. Grace-Marie Turner was to speak at the National Foundation for Women Legislators Annual Conference last week (for information, go to and will be the luncheon speaker today at The Heartland Institute's Emerging Issues Forum. (For more information, go to 

$          Greg Scandlen, Director of the “Center for Consumer-Driven Health Care” at the Galen Institute, has a Health News Letter: Consumer Choice Matters. You may subscribe to this newsletter that is distributed on Tuesdays by logging on at and clicking on Consumer Choice Matters. Archives are now located at  This is the flagship publication of Galen's new Center for Consumer-Driven Health Care and is written by its director, Greg Scandlen, an expert in Health Savings Accounts (HSAs). There is a new center for Consumer Driven Health Care you may access at To read Greg's paper on "Rethinking the Uninsured," go to

$          The Heartland Institute,, publishes the Health Care News, Conrad Meier, Managing Editor Emeritus. The Heartland Institute and Miller College of Business at Ball State University have released Reforming the Health Care System, a 38-page paperback book featuring a debate between Kenneth E. Thorpe, Ph.D. of Emory University and John C. Goodman, Ph.D. of the National Center for Policy Analysis. For more information or to order your copy, go to

$          The Foundation for Economic Education,, has been publishing The Freeman - Ideas On Liberty, Freedom’s Magazine, for over 50 years, with Richard M Ebeling, PhD, President, and Sheldon Richman as editor. Having bound copies of this running treatise on free-market economics for over 40 years, I still take pleasure in the relevant articles by Leonard Read and others who have devoted their lives to the cause of liberty. I have a patient who has read this journal since it was a mimeographed newsletter fifty years ago. Read the current posting of the classic by Ridgway K. Foley, Jr., "Essay on Caring." Be sure to pay special attention to The Dividing Line.

"A remarkable duality pervades the concept of caring and its current implementation. Force represents the dividing line. Application or refrain from coercion separates the wrongful intrusion into the sanctity of the life of another from the permissible compassionate endeavor. The law ought not impede attempts to aid others or to solve problems where those enterprises occur without compulsion. This should be true where the majority decries the problem as ridiculous or the solution as ill-advised; after all, the crowd often proves ineluctably wrong and, in any event, no human being possesses either the ability or the moral privilege to substitute his judgment for that of another choosing sentient being.

"Conversely, no one should employ the legal monopoly of force to compel adherence to, participation in, or compliance with an artifice designed to better another, no matter how well intentioned or meritorious the plan. No individual should be permitted to thrust a decision or shunt responsibility for the consequences of his choice upon another, unwilling human being. Disregard of this salient principle necessarily denies the dignity of that other individual, since moral choice and accountability constitute an essential element in the human condition.

"All too often, those who preach caring, compassion and concern rest their case upon the root of envy: Loathe the rich and trust the poor; take from the evil producer and give to the high- principled but helpless victim of circumstance and oppression. Such caring persons really do not care at all about others: The creators must be plundered, the users must be pandered, by force and violence, by false premises and promises, in order to salve the promoter’s inordinate ego and to effect his flawed view of mankind and the world. In these, the vast majority of instances, one can always count upon the concerned to care—for themselves!"  Read the entire classic at

$          The Council for Affordable Health Insurance,, founded by Greg Scandlen in 1991, where he served as CEO for five years, is an association of insurance companies, actuarial firms, legislative consultants, physicians and insurance agents. Their mission is to develop and promote free-market solutions to America's health-care challenges by enabling a robust and competitive health insurance market that will achieve and maintain access to affordable, high-quality health care for all Americans. “The belief that more medical care means better medical care is deeply entrenched. . . . Our study suggests that perhaps a third of medical spending is now devoted to services that don’t appear to improve health or the quality of care–and may even make things worse.” The Council for Affordable Health Insurance Calls Association-Sponsored Health Plans Critical to California Insurance Mix. Patients and the Public Need Affordable Limited-Benefit Plans, says National Coalition. Read the entire article at

$          The Health Policy Fact Checkers is a great resource to check the facts for accuracy in reporting and can be accessed from the preceding CAHI site or directly at This week, read the facts concerning the Commonwealth Fund report that in 2003, more than two of every five U.S. adults -- about 77 million individuals -- had problems with paying medical bills, had accrued medical debt, or both, according to a study released on August 10, 2005. But the Fact Checkers report that The Department of Justice has produced data that validates the criticism of the medical bankruptcy study. Its U.S. Trustees Program, which oversees bankruptcy cases in 21 regional offices nationwide, said medical bills were in fact not a significant cause of bankruptcies in the 1998-2000 period they studied. "Overall, medical debt did not seem to be a major factor in the vast majority of cases. The average medical debt listed per debtor was $2,582, or about 5.6 percent of the total general unsecured debt. More than one half (53.6 percent) of the debtors reported no medical debt at all. … Only 11.1 percent of debtors reported $5,000 or more in medical debts, and in only 4.4 percent of cases did medical debt comprise one-half or more of total unsecured debt." Read the trustees report at

$          The Independence Institute,, is a free-market think-tank in Golden, Colorado, that has a Health Care Policy Center, with Linda Gorman as Director. Be sure to sign up for the monthly Health Care Policy Center Newsletter at To understand how Federal Funding of Universities are bad for education, be sure to read Jon Caldara's editorial on what's happening at Colorado University when his recommendation for president was implemented. In his previous post as president of the University of Northern Colorado, Hank Brown in just a few short years eliminated 100 administrative positions, seven assistant vice president positions, two vice president positions, sold off the campus NPR radio station KUNC, providing it a much-needed financial kick in the pants, (it is now listener financed.) and sold off the campus bookstore, making it much more lucrative in the process. He found $7 million per year in inefficiencies that he restored to education. In the first few days at CU, he was able to pump $1 million annually back into education. Read the entire editorial (and analogize how Federal Funding is also destroying health care) at

$          The National Association of Health Underwriters, The NAHU is a professional association of more than 20,000 health insurance agents, brokers and benefit specialists that is extremely concerned about the problem of the uninsured. "One of our primary goals is to help ensure that Americans have access to appropriate health coverage. To help address this problem, we have developed the Health Care Coverage Options Database (Database), an on-line tool to help make American health care consumers aware of all of the coverage options available to them. The Database contains information about private health insurance coverage, as well as the many public and private programs available to Americans to help them obtain the medical care they need. Policymakers, the media and other interested parties can also use the Database as a means of comparing health care coverage options for Americans on a state-by-state basis." The Database is broken up in to four components: Employer-Based Health Insurance Coverage; Individual Health Insurance Coverage; Assistance for Obtaining Health Coverage; and Assistance for Obtaining Health Coverage. You can also use the database to review all of the information available for a particular state at

$          Martin Masse, Director of Publications at the Montreal Economic Institute, is the publisher of the webzine: Le Québécois Libre. Please log on at to review his free-market based articles, some of which will allow you to brush up on your French. You may also register to receive copies of their webzine on a regular basis. This month, read Bradley Doucet's opinion piece, "Regulating Risk: the Role of Choice in a Free Society." "The State today is like an overprotective parent, extremely risk-averse with regard to its 'children,' with the predictably perverse result of infantilizing us little by little." To read the entire article, go to

$          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. Log on for an overview of the extensive research articles that are available. You may review their impressive list of advisory board members, that includes a number of Nobel Laureate economist, at You may want to go directly to their health research section at and review the 2005 report, "How Good Is Canadian Health Care?"

$          The Heritage Foundation,, founded in 1973, is a research and educational institute whose mission is to formulate and promote public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values and a strong national defense. The Center for Health Policy Studies supports and does extensive research on health care policy that is readily available at their site. “One of the important things about financing these programs is getting people to work longer,” Saving said. “By working longer, we would increase revenue while reducing the burden placed upon the system.”

$          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. If you can't brush up on economics, you may be interested in a home-study course by Hillsdale professor Robert P. Murphy that you can purchase at You may also log on to Lew’s premier free-market site at to read some of his lectures to medical groups. To learn how state medicine subsidizes illness, see; or to find out why anyone would want to be an MD today, see To read his latest speech, "The Definition and Defense of Freedom," go to

$          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 it to protect our liberty through a system of federalism and divided powers so that most of the governance would be at the state level where abuse of power would be limited by the citizens’ ability to choose among 13 (and now 50) different systems of state government. Thus, we could all seek our favorite moral turpitude and live in our comfort zone recognizing our differences and still be proud of our unity as Americans. Michael F. Cannon is the Cato Institute's Director of Health Policy Studies. Read his bio at He is co-author of Healthy Competition: What's Holding Back Health Care and How to Free It, to be released by Cato next month. Jonathan Cohn takes aim at one of the most innovative health policy proposals in recent memory: the Health Care Choice Act, a bill sponsored by Representative John Shadegg of Arizona. Currently, if you buy health insurance you are allowed only to buy a policy licensed within the state where you live. Michael Cannon says the Shadegg's bill would allow you to buy a policy from anywhere in the country. Read his response 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.

$          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. 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. Please log on and register to receive Imprimis, their national speech digest that reaches more than one million readers each month. This month, brush up on your understanding of the constitution, with Stephen Markman, Justice, Michigan Supreme Court, who spoke on "Constitutional Myths and Realities." The last ten years of Imprimis are archived at

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Stay Tuned to the MedicalTuesday.Network and Have Your Friends Do the Same


Del Meyer

Del Meyer, MD, CEO & Founder

6620 Coyle Ave, Ste 122, Carmichael, CA 95608

Words of Wisdom

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

Ronald Reagan (1986): Government's view of the economy could be summed up in a few short phrases:

If it moves, tax it. If it keeps moving, regulate it. If it stops moving, subsidize it.

Heritage Foundation, Medicare Malady #54: Want to Keep Medicare Solvent? Keep Working.

On This Date in History - September 13

The First US National Elections were authorized by Congress on this date in 1788 to occur on the first Wednesday in January, 1789.

The Battle of Quebec, when the British under General Wolfe defeated the French under General Montcalm on this date in 1788, was noteworthy not only for British Canada, but also the for the historical importance that it was a battle in which both commanding generals were killed.