MEDICINE

JANUARY 2012

MEDICAL FREEDOM ZONES
By Jack McHugh, Dec. 6, 2011, Michigan Capitol Confidential

America’s health care system is a dysfunctional mess for a fundamental reason: There is no real market in health care. It was wrecked by a combination of incentive-skewing federal tax policies, innovation-killing “fee for service” payment systems in the two federal programs that pay for practically half of all health care consumed (Medicare and Medicaid), restrictive state policies that create limited cartels of health care professionals and facilities (reducing supply and so increasing price), and more.

It all seems a hopeless quagmire, in part because instead of going to the root cause of the dysfunctions to find solutions, politicians have instead “doubled down” on market-killing policies, most recently with the monumentally destructive Obamacare law, which comes on top of innumerable other counter-productive government intrusions enacted on a bipartisan basis at both the state and federal levels.

An interesting proposal from a Mackinac Center sister-think tank in Wyoming seeks to cut this Gordian knot of perverse incentives and pernicious restrictions with something called “medical freedom zones”: a “legally recognized geographic area where health care professionals may provide services and conduct research governed by professional associations and private contracts.”

Here’s more from the paper on the idea authored by the Wyoming Liberty Group:

Both the federal and state governments hamper doctors’ ability to innovate in medicine and to offer more affordable or alternative care. While the federal government delays innovative medicine, state governments make affordable care more difficult by limiting the number of doctors and saddling those who do practice with difficult liability rules. Similarly, the ability of care providers and patients to fashion their own agreements governing medical procedures is entirely hamstrung through state regulation. The result? More than 500,000 Americans fled the United States in 2008 for medical tourism. The time for innovative reform is now.
Alas, even this creative solution cannot get to the root of the problem, because the “freedom zones” don’t fix the two “original sins” primarily responsible for wrecking health care, and which can only be fixed in Washington: Allowing unlimited employer tax deductions for the cost of employee health insurance, and Medicare and Medicaid’s “fee for service” payment model.

The first of these, the tax code, is responsible for the third-party payment system under which, unlike areas where markets truly exist, consumers don’t behave like frugal, prudent value seekers, and providers aren’t forced by competition to respond by becoming innovative, efficiency-generating value-maximizers. The second source of the dysfunctions, Medicare and Medicaid’s payment system, imposes price controls in a way that mostly takes away any reward for providers reducing costs through innovation, destroying the incentive for them to even try.

Fix those two things, and our health care delivery system can finally begin to heal itself by becoming a real market. Leave them untouched, or worse yet pile a huge new layer of regulation, subsidy and rationing on top of them (Obamacare), and no fundamental improvement can ever be expected to occur in our health care system.

It’s in our hands to make this right — but this requires forcing the politicians in Washington to undo these core sources of dysfunction. If they did, medical freedom zones could have the potential to accelerate the healing process for our health care system.

Permission to reprint in whole or in part is hereby granted, provided that the author and the Mackinac Center are properly cited. http://www.michigancapitolconfidential.com

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MAY 2011

LOW-FAT FOODS CAN BE BAD FOR YOU

A report in the April 11, 2011 edition of the Daily Mail Online (UK) says a study performed at the Cambridge Nutrition Clinic shows that low-fat diets can actually increase the risk of heart disease. 

According to Nutritionist Dr. Natasha Campbell-McBride, a lack of fats and cholesterol can damage the arteries and veins and lead to heart attacks, strokes or organ failure because low-fat diets weaken the immune system.  She said: "The whole notion of saturated fat as some kind of bete noire is simply wrong, as is the existence of so-called 'bad' cholesterol.  Fats and cholesterol help create and protect the white blood cells and millions of other cells that repair the wall linings when damaged.  The so-called 'bad' type of cholesterol, LDL, is specifically sent to the wound by the liver and this is why patients with heart disease are seen to have high levels in their body.  Unfortunately, because LDL is found at the 'crime scene,' the cholesterol is mistakenly blamed for the heart condition when in fact it is nature's way of trying to combat it.

"We've been subjected to relentless medical advice demonizing natural fats and cholesterol but they are in fact essential to life.  Extensive reviews of the available studies have shown me that the myth of heart disease being due to fat is wrong.  If the anti-fat message was correct then we should by now be seeing a reduction in the level of heart disease when in reality we're not."

People who follow low-fat diets do not have sufficient fats and cholesterol to repair arteries, leading to scarring and narrowing of the arteries and increasing the risk of dangerous blockages, which in turn increases the chances of heart conditions and can also lead to degenerative diseases such as Parkinson's and Alzheimer's.

Dr. Campbell-McBride's research is supported by American scientists who found that strict vegetarians are at a 'substantial risk  of heart disease.  She supports a balanced diet, which incorporates fat and LDL cholesterol.

She added:  "Heart disease is now the number one killer in the UK despite a concerted effort by doctors and the NHS to improve the public's cardiovascular health.  It's now time to re-examine things and at the center of that must be the foods we eat.  By doing this, we can better protect our bodies and help the horrific situation we are faced with today.  This mistaken view has only been around for 50 or so years while humans have prized fat as the most valuable and nutritious food for millennia."

Dr. Campbell-McBride has released her findings in a new book "Put Your Heart in Your Mouth."

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FEBRUARY 2011

ANOTHER STATIN STUDY DISCLOSES LIMITED BENEFIT

On December 19, 2011, The Telegraph from London, reported on the latest study of statins which suggested that for 3/4 of those taking them, they offer little or no value, while exposing millions to the hazard of undesirable side effects.

The story of their popularity began in 1975, when Henry Gadsden, the chief executive of Merck, decided that he wanted to sell to everyone, rather than just people who were ill.  Thus began the arrival of "cholesterol consciousness": the thesis that those indulging in (for example) bacon and eggs for breakfast boosted the cholesterol level in the blood, causing the arteries to become narrow, and making a heart attack more likely. While there may be some merit in the small proportion of the population with a genetic predisposition towards high cholesterol levels switching to a healthy diet, it did not lower the risk of circulatory disorders.  This led to the idea that cholesterol-lowering drugs might be the answer.

The first statin, Lovastatin, was launched in America in 1987, accompanied by an education program encouraging everyone to get their cholesterol check and take medication if it was found to be raised.  Other drug companies got in on the act and from $3 billion in sales in the mid-1990s.  Today it is a $26 billion business. 

Guidelines were established for cholesterol levels, and have forced the "normal" level ever lower, making more people eligible for treatment.

The bottom line is that statins are not nearly as effective in preventing heart disease and strokes as they are portrayed.  This applies to the vast majority of users whose cholesterol level is deemed "high" but who are otherwise healthy.  For those people statins have no effect on mortality either way.  In contrast, for men -- but not women -- under 70 with a history of heart problems, they do save lives.

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AUGUST 2010

CHOLESTEROL STUDY RAISES NEW CONCERNS

About 2 years ago, a study known as the JUPITER (Justification for the Use of Statins in Primary Prevention) trial raised the possibility of using cholesterol-busting statins to stave off heart-related death in many more than just those with high cholesterol, according to Charles Bankhead, ABC News MedPage Today staff writer on June 29, 2010.

A second look by researchers found that the results of the study are flawed and do not support the benefits initially reported, showing no evidence of "striking decrease in coronary heart disease [CHD] complications"  and that the data set appears biased. 

This new look by Dr. Michel de Lorgeril of Joseph Fourier University and the National Center of Scientific Research in Grenoble, France and coauthors was reported in the June 28 issue of Archives of Internal Medicine.

While the original supporters of the claim argue with this study, the French group points out that 9 of the 14 authors of the study have financial relationships with AstraZeneca, which sponsored the trial.

Authors of another article in the same issue of Archives reported that a review of 11 primary-prevention trials showed no effect of statin therapy on deaths in high-risk patients.

On the basis of their review, do Lorgeril and coauthors concluded that " time has come for a critical reappraisal of cholesterol-lowering and statin treatments for the prevention of CHD  complications.  The emphasis on pharmaceuticals for the prevention of CHD diverts individual and public health attention away from the proven efficacy of adopting healthy lifestyle, including regular physical activity, not smoking, and a Mediterranean-style diet."

In another analysis reported in the same issue of the journal, Dr. Kausik K. Ray of the University of Cambridge in England examined the findings of 11 randomized clinical trials involving a total of 65,229 patients to see if statins cut death rates among intermediate and high-risk people with no history of cardiovascular disease.  In this study, too, the support for statin use was lacking.

In an editorial that accompanied the two articles, Dr. Lee Green of the University of Michigan in Ann Arbor said the de Lorgeril and Ray studies add fuel to a high-stakes debate.

"In the long term, although sincere advocates on both sides will try to convince us otherwise we really must admit that we do not know," Green Wrote.  "We need good research to find out, and, as de Lorgeril and colleagues point out, that search must be free of incentives to find any particular desired answer."

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FEBRUARY 2010

THE TRUTH ABOUT OBAMACARE
By John Lilly, January 13, 2010

A senior Obama Administration official almost let the cat out of the bag about the real impact of Obama-style health care "reform." Here's the background.

The three most important things in real estate are location, location, and location. In health care, one could argue that it's reimbursements, reimbursements, and reimbursements. One in every six workers receives a paycheck that depends on physician and hospital reimbursement for services. Except for Medicaid, Medicare reimbursement rates are the lowest of all entities that reimburse physicians and hospitals. All private insurance and Medicare Advantage reimbursements are higher than traditional Medicare ones. Medicare and Medicare Advantage plans take a $425-billion cut in the current health care reform legislation.

In 2008, a Physician Foundation survey found that 36% of physicians said Medicare reimbursement is less than their cost of providing care, and 65% of physicians said that Medicaid reimbursement is less than their cost of providing care. Raise your hand if you work for free. Then why is the administration asking one-sixth of all U.S. workers to do just that?

Larry Summers, the Obama administration's Director of the National Economic Council, spoke at The Economic Club of Washington at their April 2009 meeting. C-SPAN was there, and at roughly minute 41, Summers said the following:

That's why health care reform is so important because a large fraction of the federal budget is health care and if health care spending is growing three to four percent a year faster than the rest of the economy then there is no way that the federal budget can be under control. And if you try to control federal spending without controlling overall health spending you know what's going to happen. The people in the federal programs aren't going to be able to ...

Then he paused before continuing:

The health care system isn't going to want to serve the people in the federal programs. That's why the health care agenda is crucial to the long term financial sustainability agenda.

I think it is obvious that Summers was going to say that "the people in the federal programs aren't going to be able to find a doctor if you have Medicare," but he rephrased it before his original thought came out of his mouth. When he talks about overall health spending, he is including all public and private entities that reimburse physicians and hospitals. Federal spending includes just Medicare and Medicaid.

When Medicare reimbursement does not cover the cost of doing business, guess who will have a tough time finding a doctor. If there is a choice, then doctors, like any rational consumer, will prefer plans like Medicare Advantage and private insurance, which have higher reimbursement rates. The administration's idea of holding down costs is forcing all reimbursements down to Medicare levels or lower. They know that if there are alternatives, patients who are stuck with traditional Medicare won't be able to find a doctor. Recently, one of the Mayo Clinics in Arizona stopped taking Medicare because it's a money-loser. Mayo's hospital and four clinics in Arizona, including the one that stopped taking Medicare, lost $120 million on Medicare patients last year. The program's payments covered only 50% of the cost of treating elderly primary-care patients.

If all reimbursement rates are forced down to Medicare rates or lower, then get ready for five-minute doctor visits and waiting times measured in weeks and months before appointments for major diagnostic testing like MRIs.

Unfortunately, the Republicans do not have the answers, either. Their proposals will not control costs. Only when you introduce free-market competition and eliminate the current reimbursement system will you get lower costs. That will require a fundamental change in Medicare and all reimbursement systems.

John Lilly, MBA, D.O. is a family physician and the vice president of The YOUNG Conservatives of America (tycoa.com).

Page Reprinted by permission from the American Thinker: http://www.americanthinker.com/2010/01/the_truth_about_obamacare.html

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OCTOBER 2009

STORIES FROM ENGLAND ON NHS

In articles recently published in England on the National Health Service (NHS), their socialized medical care, there is one horror story after another.  Remember, England is a country of about 60 million people with the NHS being the largest employer in the country -- over 1.5 million.  Only the Chinese Army and Walmart have more employees.  Consider the size of the program for over 300 million Americans, and whether or not the government could possibly manage a program that size any better. . . .

On Sep. 4, 2009, the Mail Online, reported that the number of medication errors have doubled in two years.  While the reported number of more than 86,000 mistakes, including drugs being given to the wrong person or the wrong dose were endangering patient safety.  However, it is believed that fewer than 10% of errors were being reported to the NHS, meaning the true number was probably close to one million.

On Sep. 8, 2009, the MailOnline reported that thousands of women are being denied better osteoporosis drugs because of unnecessarily restrictive Government guidelines established by the drug rationing body, the National Institute for Health and Clinical Excellence (NICE).  This is the group that was patterned in the Stimulus Bill and is already established in law.  (This is why Obama says they don't need to put the panel in the proposed health care/insurance/single payer plan now under consideration.  It is already established.)

On Sep. 9, 2009, the guardian.co.uk reported that the Conservative party says hospitals are at a breaking point and claims that a second wave of swine flu could result in a bed shortage.

However, this shouldn't have been a surprise.  On Aug. 26, 2009, MailOnline reported that shortages of hospital beds and midwives forced 4,000 mothers to give birth in elevators, offices, corridors and hospital toilets.

They appear to be the lucky ones.  The Telegraph.co.uk reported on Sep. 2, 2009 that a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.  Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

The Telegraph.co.uk reported on a particular case on Sep. 8, 2009.  The daughters of a stroke victim claimed that her father was wrongly placed on an NHS scheme for the terminally ill which was causing him to die too soon.  Once the removal of fluids, medication and other treatments has started, the patient weakens and there is no going back.  The daughters believe that the hospital personnel decided from the beginning that he was 95 so should be written off. 

On Sep. 15, 2009, the MailOnline reported that more than a quarter of families are not told when life support is withdrawn from terminally-ill loved ones, leading to a fear of "backdoor euthanasia" especially for patients whose average age was 81.

The decision not to treat is not limited to old people.  On Sep. 9, 2009, the MailOnline reported on a woman who was told that it was against the rules to treat or try to save her premature baby.  He was born 2 days prior to 22 weeks.  He lived for almost 2 hours without any medical support, breathing unaided, had a strong heartbeat, and was moving his arms and legs.  However, medics refused to admit him to a special care baby unit.

When the government "pays" it sets the rules.  If these aren't death panels, I don't know what they would look like. 

Remember, when our country was established, the Constitution established the federal government with limited power.  The representatives were supposed to work for the people.  Every day, we are getting closer to working for the government.  We are on the way to being subjects, not citizens.

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AUGUST 2009

CANADA'S NATIONAL HEALTH CARE AND BABIES

Investor's Business Daily, on June 30, 2009, noted that under Canada's National Health Care System, fragile babies depend on the United States in many cases.  Under the government planned system used there, neonatal care is simply not available in many cases and has to be obtained from American hospitals across the border.

Infant mortality rates are often cited as a reason socialized medicine and a single-payer system is supposed to be better than what we have here.  But, according to Dr. Linda Halderman, a policy adviser in the California State Senate, these comparisons are bogus.

As she points out, in the US, low birth-weight babies are still babies.  In Canada, Germany and Austria, a premature baby weighing less than 500 grams is not considered a living child and is not counted in such statistics.  They're considered "unsalvageable" and therefore never alive.

Norway boasts one of the lowest infant mortality rates in the world -- until you factor in weight at birth, and then its rate is no better than in the US.

In many countries babies that survive less than 24 hours are considered stillborn or a miscarriage.  In some, a baby must be 30 centimeters long to be considered a live birth.

In 2007, there were at least 40 mothers and their babies who were airlifted from British Columbia alone to the US because Canadian hospitals didn't have room.  Since 2000, 42 of the world's 52 surviving babies weighing less than 400 grams (.9 pounds) were born in the US.

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MARCH 2009

SURPRISES IN THE "STIMULUS" BILL

David Limbaugh in his Feb. 20, 2009, column on Townhall.com noted how the Democrats have been diminishing the freedoms and rights of Americans since Obama was elected.  In doing so, he brought up the gigantic "Stimulus" bill which had to be passed before anyone could read it.

Former New York Lt. Gov. Betsy McCaughey, at the personal expense of incurring the fury of such liberal mouth foamers as MSNBC's Keith Olbermann, has helped expose hidden health care provisions in President Obama's stimulus nightmare that "will affect 'every individual in the United States.'"

The bill creates a new bureaucracy, the Office of the National Coordinator for Health Information Technology, which "will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective." Note: not what your doctor deems appropriate, but what the federal government does. Doctors and hospitals will face penalties if they fail to kowtow to this fiat requiring uniformity. This new bureaucracy will receive greater funding than "the Army, Navy, Marines, and Air Force combined."

Worse, the bill will result in the rationing of care for the elderly. But that's OK because Big Brother has determined that individuals will benefit in their younger years and will have to sacrifice later. I'm not making this up. This is one of the rationales defenders of these innovations are serving up.

Much of the impetus for these health care changes came from disgraced former Sen. Tom Daschle, who would be head of Health and Human Services right now but for his little tax issue. McCaughey shares revealing gems from Daschle's 2008 book, "Critical: What We Can Do About the Health-Care Crisis." Among them are his opinions that doctors must give up autonomy and "learn to operate less like solo practitioners" and that seniors will have to learn to deal with -- rather than receive treatment for -- conditions that arise from their age.

Perhaps the most chilling aspect of this particularly noxious stealth provision of the stimulus scheme is not what's in it, but how it -- and other such free market-destroying provisions -- were rushed through under deliberate cover of darkness. McCaughey attributes this strategy to Daschle, as well.

A year ago, McCaughey tells us, Daschle warned that the next president should not make the same mistake the Clintons made with Hillary Care, which was to allow debate. Daschle wrote: "If that means attaching a health-care plan to the federal budget, so be it. The issue is too important to be stalled by Senate protocol."

So much for "liberal" democracy. So much for transparency. So much for a new era of hope and change.

If Obama's plot to micromanage health care from on high doesn't move you, how about the abolition of welfare reform provisions imbedded in the bill? Never mind that welfare reform has been such a smashing success that even Bill Clinton tries to take credit for it despite his twice-frustrated efforts to block it. What's important is not whether it has worked, but whether it satisfies Obama's vision for expanding the welfare state.

 You have to keep your eyes open with this bunch.  The only way to stop this nonsense is to get Congress to pass another bill overturning these changes.  Contact Rep. Bart Stupak at http://www.house.gov/stupak and Sens. Carl Levin at http://levin.senate.gov/contact/index.cfm and Debbie Stabenow at http://stabenow.senate.gov/email.cfm.  If you wish to phone them, call the Congressional Switchboard -- 1-202-224-3121

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FEBRUARY 2009

MORE TO THINK ABOUT WITH HEALTHCARE

The Democrat administration is working hard to try to impose government controlled healthcare on the American people. 

The Wall Street Journal noted on Jan. 21, 2009 that the US House of Representatives passed a major expansion of the State Children's Health Insurance Program.  The program will more than double in size with $73.3 billion in new spending over the next decade (less than the true cost because of an accounting gimmick).  This program, which was supposed to help children from working poor families will now cover everyone up to 300% of the federal poverty level -- $63,081 for a family of four.  According to the Census Bureau the US median income is $50,233.  States can get a waiver to go even higher.

Every time the program grows, it displaces private insurance.  National taxpayers end up paying 65 to 83% of the total cost.  When states make health-care promises they can't afford -- such a New York, which expanded the program to 400% of poverty -- the feds always step in with a bailout.  This is all supposed to be paid for with an increase in the federal tobacco tax from 39 cents to $1 a pack, financing a permanent and growing entitlement with a declining corps of smokers. 

Dr. Scott Gottlieb, a resident fellow at the American Enterprise Institute in an article in The Wall Street Journal on Jan. 20, 2009 noted that in Britain, a government agency evaluates new medical products for their "cost effectiveness" before citizens can get access to them.  The agency has concluded that $45,000 is the most worth paying for products that extend a person's life by one "quality-adjusted" year.  (By their  calculus, a year combating cancer is worth less than a year in perfect health.)

As a part of the $800-plus billion stimulus package, studies will compare different drugs and devices to "save money and lives" are included.  Incoming Secretary of Health, Tom Daschle, has long advocated a US approach based on the British model, arguing that the only way to reduce spending is by allocated medical products based on "cost effectiveness."   

Many if Britain object to the constraints which deny cancer patients many effective new drugs that are widely prescribed in the US.  Of course, the rich are able to opt out of the British controls, but the politicians control access for most people.

In the irishtimes.com on Jan. 19, 2009, noted that with the Irish national health service, three-quarters of a million people with a neurological condition  are waiting 18 months to see a consultant and 10 months to have an MRI scan in order to secure a diagnosis, is now the norm.

ABC News, in an article by Dr. Paul Hsieh, on Jan. 11, 2009, noted that in Japan, the government regularly checks the waistlines of citizens over age 40. Anyone who is deemed too fat is required to undergo diet counseling, "reeducation" if that doesn't work and stiff fines.  The government argues that it must regulate citizens' lifestyles because it is paying their health costs.

The British government has banned some television ads for eggs on the grounds that they were promoting an unhealthy lifestyle.

New Zealand banned the entry of persons whose obesity would "impose significant costs . . . on New Zealand's health or special education services."

Hsieh noted that nanny state regulations have exploded here in the US as well -- everything from smoking, banning trans fats, and prohibiting new fast food restaurant in South Los Angeles, California.  These, and other proposals to tax certain foods are certain to increase if government takes over and adopts universal health care.

On Jan. 11, 2009, the dcexaminer.com noted in an editorial that the much-touted Massachusetts plan to force all residents to buy health insurance has turned out to be an embarrassing flop.

Within a year after the law passed, state insurers were already jacking up rates to twice the national average.  43 mandatory benefits, including many that most people did not need or want, such as invitro fertilization -- raised the costs as much as 56%.

Small businesses with more than 10 employees were required to provide health insurance or pay an extra fee to subsidize uninsured low-income residents, yet the overall costs of the program increased more than $400 million, 85% higher than original projections.  To make up the difference, payments to health care providers were slashed, so many doctors and dentists in Massachusetts began refusing to take on new patients, leaving some people to wait over a year for a simple physical exam.

Naturally, the original goal, to make certain everyone has coverage has not been met, despite the disastrous cost increases.

Rushing forward to implement universal socialist medical coverage would be a major mistake.

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JANUARY 2009

WELCOME TO ACORN GENERAL HOSPITAL
By Carol Peracchio, December 15, 2008

I've been a registered nurse for 30 years, so the future of American health care is one of my greatest concerns. Now that Mr. Obama has won the election, I decided to investigate what may be facing patients and health care workers.

I started my research at Barack Obama's website and his Plan for a Healthy America. What a waste of time. It read like a treatise from a beauty pageant contestant.

What kind of medical expertise does Barack have? Remember th[e] youtube where his teleprompter malfunctioned? He stumbled through an excruciatingly inept explanation of how health care costs can be lowered if kids with asthma could just be provided "breathalyzers," or "inhalators" instead of cluttering up emergency rooms.

This brilliant (as we're told ad nauseam) Ivy League lawyer-savant wants to run our health care but apparently is ignorant of the word inhaler. (There must have been more than one nurse in that crowd shaking her head and thinking, "Great. Another dunce.")

Certainly Obama is not the first politician who clumsily attempts to feign a molecule of medical knowledge in order to sway voters who know even less. Obviously, he is not capable of writing (or possibly even reading) any health care legislation. I decided I'd need to find out the views of his advisors. Since his wife Michelle had actually worked for a hospital, I began with her.

Let's start with her resume. Michelle came to the University of Chicago Medical Center from The University of Chicago, where she ran something called the University of Chicago Community Service Center:

which offered new opportunities to student, staff, and faculty for service learning, volunteerism and civic engagement. This was a first step for the University to engage students in community service activities.

Looks like Community Organizing was an Obama family affair!

In 2002 Michelle was recruited by the Medical Center, where she first was hired as the Executive Director of Community Affairs. After three years, she was promoted to Vice President for Community and External Relations and her salary was tripled to over $300,000.00 a year. It is entirely coincidental, we are assured, that her husband was elected to the US Senate the year of her promotion.

When she was promoted, Michelle said:

My goal in this position is to continue to broaden the Hospitals' relationships with our neighborhood and with our city. We have an obligation to ensure that we use our resources on behalf of our neighborhood and our city. In this new role, my goal is to better integrate community engagement into the culture of this institution and to expand our partnerships with local organizations and institutions.

Nowhere in this mishmash of goalspeak is there any hint of taking care of sick people. It looks like Michelle's view is that the hospital has "an obligation to ensure we use our resources on behalf of our neighborhood and our city." Community organizing meets health care.

And what did Michelle accomplish as a hospital Vice President? According to her resume:

She grew a staff of two into a diverse, 23-person team that carries out a threefold mission of improving community-based health care, increasing business opportunity of South Side businesses and enhancing the Medical Center's considerable service to the surrounding community.

So her first accomplishment was increasing the size of her own department eleven-fold! Forget the use of the word "diverse". The sheer amount of expenditure involved in a 23 person department with a Director earning over 300K is breathtaking! I can just imagine the response to clinical department heads submitting budget requests in the Era of Michelle: "Sorry, there's no money for (write your request here). Vice Presidents married to US Senators don't come cheap!"

Michelle declared she had a threefold mission for her position at the hospital. First, "improving community-based health care." At least this claim involves health care. However, I doubt it took a very expensive Senator's wife to do it. I've known social workers who accomplish this every day with much less support and no fanfare.

Her second mission was "increasing business opportunity of South Side businesses."

Increasing business opportunity? Call me crazy, but for 30 years I've been under the impression that hospitals exist to take care of sick people. The patient comes first! (At least that's what they always told us during those interminable new employee orientation days.) Sometimes the hospital hires area businesses in order to improve the delivery of care. But the businesses aren't the focus. The patient is.

Next, Michelle enhanced "the Medical Center's considerable service to the surrounding community." So how did Michelle enhance the hospital's community service? Here's a partial list from her resume:

Service Learning Initiatives, Day of Service and Reflection, Adopt-A-School programs, Principal for a Day and Real Men Cook celebrations.

Sounds like a $300,000.00 agenda to me! Seriously, most of these "accomplishments" sound exactly like the Eagle Scout projects completed by my son's Boy Scout Troop! The difference being my son and his friends didn't charge the local hospital.

For all the glowing praise heaped upon Michelle for her External Relations work, I can see that she did seem to have one problem. Her day of Service and Reflection drew less than 300 volunteers. (I'm sure that's including the diverse staff of 23). Out of a workforce of 9,500 Medical Center employees, this is a dismal turnout.

But it's predictable when a country has a free market health care system. It works like this: The nurse goes to the hospital that hires her for, let's say, 1/6th the pay of an External Relations Director. The nurse agrees to practice nursing for 40 hours a week, more if the floor is short-staffed. At the end of her 8 or 12-hour day the nurse goes home.

The last thing 9,200 Medical Center employees want to do after a tough week is to spend a day "reflecting" with Michelle and her diverse staff. And because, at the moment, the nurse works for the hospital and not for Barack's federal government, she has the freedom to say "No thanks."

But this free market setup was all wrong for Michelle's goal: to mine the rich resources of money and hospital personnel for the necessary work of community organizing. The money wasn't too difficult -- just divert those resources that have been set aside for raises, or equipment, or education. Then tell the staff how broke the hospital is because "reimbursements aren't keeping up with expenditures."

The problem is that health care workers aren't college students. Forced "service learning hours" aren't part of the job description, and if one hospital tells me that taking part in Michelle's "Adopt-A-School" program is part of my contract, I'll head over to the hospital down the road. And I'll deck the first limousine liberal who tells me that health care workers need to be forced to help their communities.

Drop by any health fair, Relay for Life, blood drive, or free clinic. All staffed by volunteers, many of them health care workers. Think back to 9/11. I knew of so many nurses, paramedics, and other health professionals who jumped in their cars and just drove to New York and DC to serve.

But try to imagine health care in the world of Obama. All of us will be enlisted in the Community Service army, where patient care is merely ancillary to your job. Now we will leave work to go staff the after school program at the new community center. Next weekend it's over to the mall where we will work the voter registration table. It's all part of "enhancing the hospital service to the community." Because in Barack and Michelle's world, there's no individual patient. Only a vast, nebulous "community." Welcome to ACORN General.

Page reprinted by permission from The American Thinker: http://www.americanthinker.com/2008/12/welcome_to_acorn_general_hospi.html

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DECEMBER 2008

THOSE 46 MILLION WE HEAR ABOUT

In the Nov. 21, 2008 edition of The Wall Street Journal, William Snyder analyzed the alleged 46 million uninsured to see if a total reorganization of the nation's health care system is really warranted.

While many Americans believe the uninsured are too poor to purchase coverage and government programs are not available to them, that is not the case.  A study published in Health Affairs in November 2006 estimated that 25% were in fact eligible for government coverage and another 20% could probably afford coverage on their own.  Applying those percentages to today's uninsured population leaves about 25 million people who need some assistance.

A study published by the California HealthCare Foundation (CHCF) in April 2000 found 50% of California residents at twice the poverty level had received care for which they were charged, another 8% received care for which they were not charged. 89% of them were very or somewhat satisfied with the care they received and only 15% went to the emergency room as opposed to a doctor's office or clinic.  Another study, published by Health Affairs in August had similar findings, and estimated that uninsured Americans will receive $86 billion worth of health care in 2008.

The CHCF study found that the 1.3 million uninsured who received care for which they were charged, 80% paid for it, and almost half the remaining 20% were paying in installments.  The Health Affairs study estimated that the uninsured would pay for $30 billion of their health care costs this year out of pocket.

For the millions of the uninsured, then, who are getting and paying for satisfactory care on their own, foregoing needed care and sticking the public with huge ER bills is a myth.

These studies bring into question the necessity for significant expansions of government programs, legal requirements for everyone to carry insurance, or a combination of the two.  It would be better to encourage those who are currently eligible for government programs to enroll and deal separately with that small number of persons who truly have fallen through the cracks. 

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MAY 2008

MORE CHOLESTEROL NONSENSE

In the May, 2007 newsletter, the article “High Cholesterol Is Good for You” reported on the British study that showed that statin drugs, such as Lipitor, Crestor and other widely used brands, did not work for women and for very few men.

Now, there is a new study showing that Vytorin and Zetia failed to improved heart disease even though they worked as intended to reduce three key risk factors. These drugs have racked $5 billion in sales. The study was completed 2 years ago, but the results were just presented at a recent American College of Cardiology conference in Chicago and published on the internet by the New England Journal of Medicine, according to an Associated Press report of March 31, 2008.

While these drugs dramatically lowered LDL (bad cholesterol), fats in the blood called triglycerides and a measure of artery inflammation, CRP, they showed NO BENEFIT in reducing plaque build up in the arteries, which is thought to be a way to reduce risks of heart disease.

The interesting thing to note, is that Yale Cardiologist Dr. Harlan Krumholz, recommended that doctors and patients should return to statins. That is also an interesting recommendation in view of the report published in Lancet (the Medical Journal of England) and featured in our May 2007 report.

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MARCH 2008

MEDICAL SURPRISES

The Australian Broadcasting Corporation, on January 24, 2008, reported on a 15-year-old Australian liver transplant patient who has made medical history.

Demi-Lee Brennan had a liver transplant after she suffered liver failure.  Nine months later, doctors at Sydney's Westmead Children's Hospital were amazed to find the teenager's blood group had changed to the donor's blood type.  The stem cells from her donor had penetrated her bone marrow.  Her immune system had almost totally been replaced by that of the donor, meaning she no longer had to take anti-rejection drugs.

Now, the medical team is trying to determine how the phenomenon happened and whether it can be replicated.  It is possible that the type of liver failure she had, which required some drugs to suppress the immune system and the fact that she suffered an infection with cytomegalovirus, which can also suppress the immune system had a role to play.

If this can be replicated with other patients, transplant patients may not have to take the anti-rejection drugs which have significant side effects.

The case was published in the New England Journal of Medicine.

The Daily Mail, from England, reported on Jan. 28, 2008, about a school boy who was suddenly cured after 9 years of deafness. 

It seems that Jerome Bartens, 11, was diagnosed as deaf in his right ear when he was just 2.  After years of treatment and difficulty in school and in life because of his hearing problem, he was playing pool with friends in a church hall when he felt a sudden pop.  He put his finger in his ear and there was the tip of a cotton wool bud which had been wedged there for almost 10 years.  He could hear immediately.

His family believes that he put the cotton bud in his ear as a toddler and the cotton came off the plastic stem. 

There is no explanation for why the many doctors who have examined Jerome over the years failed to find the bud.

UPI reported on Jan. 17, 2008, that blood samples revealed infection with a parasite carried by domestic animals may increase the risk of schizophrenia, a study published in the American Journal of Psychiatry found.  Of 180 subjects diagnosed with schizophrenia, 7% had been infected with toxoplasma prior to diagnosis, compared to 5% of the healthy military recruits.

While this 24% difference in risk of developing schizophrenia may seem small, it is important because of the possibility of treating patients with anti-parasitic drugs may affect the progression of schizophrenia.

The parasite toxoplasma  gondii can come from cat feces or undercooked beef or pork.  Infections rarely cause symptoms and the parasite can lay dormant for years.

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NOVEMBER 2007

THOSE AUSSIES ARE CREATIVE

On October 10, 2007, The Sydney Morning Herald reported on the case of a 24-year old tourist who apparently tried to do himself harm swallowed ethylene glycol, an ingredient in antifreeze, which is highly toxic.

The accepted treatment of this condition is to administer pure alcohol, which the Australian doctors at Mckay Base Hospital in Queensland did until they exhausted their supply. 

Not be thwarted, they ordered a case of vodka and drip-fed him the equivalent of about 3 standard drinks an hour for 3 days in the intensive care unit.

One of his treating doctors, Todd Fraser said" "Fortunately for him, he was in a medically induced coma for a good portion of that.  By the time he woke up, I think his hangover would have well and truly gone."

The Italian man, treated in August, made a successful recovery and returned home. 

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OCTOBER 2007

MORE PROBLEMS WITH CANADIAN HEALTH SERVICES

On September 18, 2007, Canada.com published an article by Pamela Cowan, Saskatchewan News Network reporter, about a lady named Joyce Manz who has been on a wait list for back surgery since August 2006. When she called the Saskatchewan Surgical Care Network in September, she was told her surgery will not take place until February. No reason was given.

She got a prescription for morphine last week to help control the shooting pain in her right leg. She is afraid that by the time the surgery takes place, she will be addicted to morphine.

Saskatchewan Health Minister Len Taylor acknowledged that surgical waits are long in some areas, but said the situation is improving and that since 2004, the Surgical Care Network’s figures show that the number of patients waiting for surgery has declined by over 1,000. He did not say how many people are waiting.

How long do you want to wait for “free” medical care?

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SEPTEMBER 2007

MEDICAL DEVELOPMENTS

In the July 26, 2007 edition of CBC News, a report from the British medical journal, Lancet, Dr. Stanley Zammit, one of the authors of the study published on July 27, stated that smoking pot may increase the risk for the type of psychosis commonly associated with schizophrenia.  Occasional smokers were 40% more likely to suffer from psychosis, while dedicated tokers who used marijauna daily or weekly increased their risk by 50 to 200 per cent.  The risk of developing schizophrenia remains about 5 in 1000 people.

Zammit and his colleagues examined 35 studies that tracked tens of thousand of people for periods ranging from one to 27 years to examine the effect of marijauna on mental health.  "The available evidence now suggests that cannabis is not as harmless as many people think," said Dr. Zammit.

While there are questions about whether marijauna use increases the risk of psychosis, or whether there is something about the users that causes the psychosis is not clear. 

Wende Wood, drug use and drug information pharmacist with the Centre for Addiction and Mental Health in Toronto, Canada, agrees.  She says chronic pot use can push people predisposed to psychosis over the edge.

Reuters reported on August 1, 2007, about a study by Astrid Limb and her colleagues at the University College London's Institute of Ophthalmology, in which they studies the ability of zebrafish to regenerate damaged retinas.

The researchers  said that they had successfully grown in the laboratory a type of adult stem cell found in the eyes of both fish and mammals that develops into neurons in the retina.  They studied Mueller glial cells in the eyes people aged from 18 months to 91 years and found they were able to develop them into all types of neurons found in the retina and grow them easily in the lab.

They hope to be able to inject a person's own stem cells into his own eye and treat diseased retinas causing blindness, such as macular degeneration, glaucoma and diabetes-related blindness.

On August 13, 2007, The Globe and Mail (Canada) reported that a team of scientists at the British Columbia Cancer Agency discovered a unique gene that can stop cancerous cells from multiplying into tumors. 

The team, led by Dr. Poul Sorensen, says the gene, HACE 1, has the power to suppress the growth of human tumors in multiple cancers, including breast, lung and liver, particularly when it is kick-started.

The study appeared  in Nature Medicine advance online edition of the September 2007 issue.

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AUGUST 2007

BONE MARROW TREATMENT SUCCESSFUL

In the Feb. 12, 2007 edition of The Jerusalem Post, Julie Siegel-Itzkovich, reported on a first-time procedure in Israel. 

A woman suffering from secondary acute leukemia was saved by umbilical cord blood donated by two mothers after they gave birth.  One cord does not contain enough blood for the procedure.  Stem cells from cord blood do not have to be the exact tissue type of the recipient, unlike bone marrow from adults.

A spokesman for Sheba Hospital in Tel Hashomer, where the procedure was performed, said the graft "took in 2 weeks rather than the month it usually takes for bone marrow.  Since only one in four patients who need a bone marrow transfer are successful in finding a match, the cord blood donation offers great potential in increasing the pool.

The establishment of cord blood banks makes it easier to find suitable donors. 

Previously, the hospital had transplanted stem cells from umbilical cord blood only into children, one dose at a time.  The use of two doses at one time made the treatment faster and more effective.  The patient is now in good condition.

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JULY 2007

SOCIALIZED MEDICINE = RATIONING

In the June 26, 2007 edition of The Scotsman, Lyndsay Moss, Health Correspondent, reported that the British Medical Association (BMA) held a conference in which they were told that the government and National Health Service (NHS) must be more open with patients about the need to ration treatments and services in a system with a limited pot of cash.

Alex Smallwood, from the BMA's junior doctors committee said: "It is no longer possible to provide all the latest to absolutely everybody without notable detriment to others."

Reducing the choice of patients would require the drawing up a list of acceptable treatments, but, might include a restriction on treating things like hernias and varicose veins - conditions with which people could live.

And, in Scotland, young doctors, who have been trained at a cost of 250 pounds paid for by the taxpayers, are being forced to leave the country.  She and others who have trained to be General Practitioners have no place to work.  A few have been able to get jobs in England, but many have been forced to go overseas for employment.

See how well everything works when the government runs it.

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JUNE 2007

STAR TREK SCANNERS ON THE HORIZON?

In the May 22, 2007 edition of the Telegraph.co.uk, was a report that scientists have moved closer to developing a Star Trek-type scanner that can identify the molecular indications of cancer and other diseases without surgery.

The discovery that x-ray images contain patterns that can help doctors translate the genetic "language" of tumors is being compared to the "Rosetta Stone" that enabled archeologists to read hieroglyphics. 

The research, reported in an online edition of Nature Biotechnology, revealed previously missed patterns in X-ray images from CT scans that correlate with genetic profiles, giving hope of developing a "tricorder" type devise that appeared in almost every episode of Star Trek.  It was used to non-invasively scan matter to determine its molecular makeup.

The object is to come up with a way to systematically connect gene activity, obtained by "reading" DNA using devices called microarrays, to imaging patterns to disease process.  Radiologists, already expert in recognizing the differences between normal images and those reflecting changes caused by disease, could hold the key to the technology's potential.

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MAY 2007

HIGH CHOLESTEROL IS GOOD FOR YOU

Most of you will now think your editor has gone off the deep end, (which may be true) but, an article in the Daily Mail, (UK) on Jan. 23, 2007 by Dr. Malcolm Kendrick, discussed an article in the British medical journal The Lancet.  Trying to lower your cholesterol level by taking statin drugs is probably not worth it. 

Women don't benefit from taking them at all, nor do men over 69 who haven't had a heart attack.  There is a very faint benefit if you are a younger man who also hasn't had a heart attack.  Out of 50 men who take the drug for 5 years, one will benefit.

What your doctor should be saying is the following:

A high diet, saturated or otherwise, does not affect blood cholesterol levels.

High cholesterol levels don't cause heart disease.

Statins do not protect against heart disease by lowering cholesterol --when they do work, they do so in another way.

The protection provided by statins is so small as to be not worth bothering about for most people (and all women).  The reality is that the benefits have been hyped beyond belief.

Statins have many more unpleasant side effects than has been admitted, while experts in this area should be treated with healthy skepticism because they are almost universally paid large sums by statin manufacturers to sing loudly from their hymnal.

Many major studies show that cutting back on saturated fats makes no difference, and is more likely to do harm. The conclusion is that saturated fat showed no relationship with cardiovascular disease in men.  Among the women, cardiovascular mortality showed a downward trend with increasing saturated fat intake.  In other words, the more saturated fat, the less chance of dying from heart disease.  Low cholesterol levels greatly increase your risk of dying younger.

A detailed discussion of cholesterol research appears  in an article published by The Weston A. Price Foundation entitled "The Benefits of High Cholesterol" by Uffe Ravnskov, MD, PhD.

He discusses a number of studies, well footnoted, which should make those people with high cholesterol quite pleased.  It is much better to have high than low cholesterol if you want to live to be very old.

If you are taking medications to lower your cholesterol levels, it would be worth your while to do a little research on this subject and discuss it with your doctor because many of the medications have side effects which are likely more dangerous than your cholesterol level.

http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=43068d2&in_page_i
http://www.westonaprice.org/moderndiseases/benefits_cholest.html

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JULY 2006

ABUSE OF WOMEN IN SCOTLAND

In the June 20, 2006, edition of The Scotsman, Lyndsay Moss reported that a 36-year old Scots mother elected to have her breasts removed and a hysterectomy after being told she would have to wait at least two more years for the results of genetic tests to discover if she had an increased risk of cancer. The woman has already been waiting for 4 years for the test. 

She is not alone.  The backlog of women waiting for results has been blamed on lack of funding and trained staff, changes to the way National Health Service (NHS) services are delivered and delay in getting licenses to carry out the tests, which have to be obtained from genetics watchdogs.  The wait in Britain is much longer.

In Scotland, some women chose to pay for private tests, at a cost of about 1800 pounds, to get test results in weeks rather than years.

About 5% of breast cancers diagnosed each year are due to inherited faulty genes linked to a strong family history of the disease.  A further 1- to 15% occur in women with a moderate family history of breast cancer.  Women who carry the faulty genes face a lifetime risk of developing breast cancer of up to 85%, and up to 40% for ovarian cancer.

Many of those who test positive for the faulty genes decide to have a preventive mastectomy and/or hysterectomy to avoid the disease.  Apparently, the women who are stuck in the National Health Service system have to play Russian Roulette with their lives while they wait for tests.

Let's make sure that only those people who want to place their lives in the hands of a government run health system have to do so.  All of you who are interested, form a line on the Left.

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MAY 2006

NATIONAL HEALTH SERVICE STILL FAILING

A scathing report by three British Government inspectorates, entitled Living Well Into Later Life, published on March 27, 2006, and featured the same day in The Independent, concluded that the nation's elderly are being neglected, poorly treated and marginalized by the country's National Health Service (NHS) system.

Many older patients went hungry because meals were taken away before they could eat them, while others suffered embarrassment through being cared for on mixed-sex wards.  There were also frequent complaints about dirty wards, the strong smell of urine from unemptied bottles and people waiting on trolleys.

The report says: "There is still evidence of ageism across all services.  This ranges from patronizing and thoughtless treatment from staff, to the failure of some mainstream services such as transport to take the needs and aspirations of older people seriously.  Many older people find it difficult to challenge ageist attitudes and their reluctance to complain can often mean that nothing changes."

Two days earlier, the London Times Online reported that the NHS was telling patients with multiple sclerosis (MS) they could not have drugs to prevent their disease from getting worse because the NHS cannot afford them.

Ministers in the British government have insisted that staff layoffs and hospital deficits have had no effect on patient care.  But a consulting neurologist, Mike Boggild, from the Walton Centre in Liverpool, says he knows of 50-100 MS patients who have been told they cannot have the drugs, even though under an agreement reached in 2002 ministers promised thy would be provided to all those who qualified.

The Department of Health said: "We have been assured they are trying to get the drugs to new patients in Staffordshire as soon as they can."

Keep these stories in mind when politicians promise you that if only the government ran all of the health care, everything would be wonderful.

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DECEMBER 2005

GOOD NEWS ON FAT

In the November 8, 2005 edition of Tech Central Station, John Luik brings us some rare good news on fat. 

Research present at the recent annual conference of the North American Association for the Study of Obesity (NAASO), which was held in Vancouver, British Columbia shows that much of what passes for obesity science has a large element of junk science in it, such as the 400,000 Americans who die from being overweight each year (false), or the claim that consumers of French fries are likely to get cancer from acryl amide (false).

Studies question the claim that school vending machines are responsible for making kids fat and should be banned.  Four groups were compared, one didn't use it at all or bought only water, one group bought 1-3 items, another 4-6, and the last, more than 6, all in the previous 30 days. Comparing body mass index (BMI) and calories, found no difference between the groups.  The authors concluded: "Results suggest that frequency of purchase from school vending machines was not associated with BMI percentile or DQ (Diet Quality)."

Another study tested the theory that portion sizes in restaurants make people fat.  What they found was that portion size made no difference in the amount of food consumed.  Participants who had received large portions did not eat more food than participants who had received small portions, even though their portion contained five times more food.

These two studies only confirm previous research.  A recent Canadian study that looked at the eating habits of 4,298 school children found that eating in a fast food restaurant was not a statistically significant risk factor for obesity, even for children who eat in these restaurants more than three times a week.  It also found that there was not a statistically significant difference between the quantity of soft drinks consumed by children attending schools that did not sell soft drinks and those that did.  It also concluded that there was no association between the availability of soft drinks and schools with vending machines and the risk of children becoming obese.

He concludes: "In short, these three studies provide good reasons to reject not only the soft drinks + vending machines = obesity theses, but also the claims of the fat police that portion sizes promote obesity."  And coming in the same week that the US House of Representatives passed the Personal Responsibility in Food Consumption Act by a margin of 306-120, which would prevent the country's trial lawyers from suing restaurants and the food industry for allegedly making people fat, it was all in all a good week for sound science in the service of responsible public policy."

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JULY 2005

CANADA'S FOUR-TIER HEALTH SYSTEM

Mindelle Jacobs, in The Edmonton Sun, on June 11, 2005 commented on the recent Canadian Supreme Court's ruling that allowed Canadians to purchase private health insurance.

There are many in Canada who object to the ruling on the grounds that it could threaten Canadians' equal access to treatment.

However, there is not equal treatment under the present system.  Military personnel, the RCMP, prisoners and workers' compensation claimants do not fall under the Canada Health Act and get speedy access to treatment.

Since most Canadians wait and wait for a diagnostic test or surgery, a New Brunswick man figured a way around the cue.  He told police he was planning a shooting rampage and was jailed for three years.  He actually wasn't going to hurt anyone.  The 44-year old man, with no prior criminal history needed heart surgery.  He got it quickly while in custody.

Injured workers don't wait.  While the average person waits months or years for an MRI, an injured worker received one in two days because the worker receives wage benefits when he is off work.  The same is not true of a mother with children.

The first tier of recipients are those who are wealthy enough to go abroad for treatment.

The second tier is composed of the special classes of people which were previously discussed.

The third tier is composed of people who have pull or influence -- they know a doctor or have a friend on the hospital board.

The fourth and last tier are average Canadians who need care but have no way of expediting the process.

The senior health policy analyst with the Fraser Institute, Nadeem Esmail argues that instead of suspending the priveleges that have been bestowed on certain groups, all Canadians should have the option of buying health insurance.

What a novel idea.

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MARCH 2005

IF YOU DON'T WANT TO GO TO ASSISTED LIVING. . .

John McCaslin, in his February 3, 2005 "Inside the Beltway" column in The Washington Times, recalled that in a previous column he noted that it costs just about the same for an 80-year-old American to live out his or her days on a luxury cruise ship ($230,497) as in an assisted-living facility ($228,075).  It generated considerable response --

"On our October cruise on Royal Caribbean lines, there was an elderly lady who actually resided on the ship 'Voyager of the Sea," wrote Becky Jackson-Turner of Acworth, Georgia.

"Medicare took care of her medical needs, which were few, and whenever the ship would pull in to its main port, she would disembark for a few hours. . . .

"She told us that it was just more financially feasible to do this than living in an assisted-living home and was much more fun.  She got to meet new people all the time, always had great food and always had her bed turned down for her when it was time to sleep -- with a mint to boot.

"We were blown away, but even more so when she told us of at least 20 other people she knew who did the same, except a lot of them change ships every once in a while to add a little variety."

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AUGUST 2003

HEALTH CARE FORUM
By Maureen Rudel

I received a letter from Rep. Dale Sheltrown advising me that he and Congressman Bart Stupak (both Democrats) will be holding the Northern Michigan Health Care Forum in Ogemaw County's Horton Township Hall on August 22, 2003 from 9 a.m. to noon.

The forum will be an open discussion of the problems with the delivery of health care, focusing on group coverage for small businesses and other small groups, prescription drugs, the working uninsured and Medicaid/public health funding.

Members of local government, health care specialists, business owners, workers and other interested members of the public are welcome to attend and discuss potential solutions.

If you are interested in attending or would like further information, contact Rep. Sheltrown at toll-free 1-888-347-8103.

Here is my response:

Thank you for inviting me to the forum that you and Mr. Stupak will be having on August 22, 2003.  Unfortunately, I will be unable to attend.

I would ask that you consider my views in your further dealing with the issues you raised.  It is of great importance to both my husband and I, since we pay for our own health insurance without the benefit of any contribution from anyone else.

First, I would ask that both the state and federal governments recognize medical savings accounts for all taxpayers, without requiring that they be exhausted every year or spent on any particular kind of insurance policy or expense.  If we could put money into an account which could be used to pay premiums (without having to meet some percentage of our income), we could spend it as we thought best for us.  If we didn’t spend it in one year, we could continue to accumulate it to expend on medical expenses in our later years when we will probably have more of them.  As long as the money was in an account or used for medical expenses or insurance, it would not be taxable.

Next, if individuals had the right to form groups for the purchase of insurance without being a member of a certain group, i.e. lawyers, farmers, members of the chamber, etc. then the rules of large numbers could be applied to provide actuarially sound rates which would most probably produce lower rates.

Don’t require every policy to be a Cadillac.  Senior citizens should be able to buy an insurance policy which does not provide maternity coverage.  Every time a politician hears about a problem, he passes a law. 

In Lansing, this year, a bill was passed to prevent insurers from offering lower rates to lower risks.  This was done specifically at the request of Blue Cross, which has over 50% of the business in Michigan.  They didn’t like it that some other insurers offered policies at lower rates to people who had lower risks.  This was a stupid bill.  It now requires insurers to offer rates which are within a set range.  It will raise the cost to those young people who present lower risks.  Now, instead of buying a cheap insurance policy, they will go without.  This is real progress.

In Washington D.C., a law was passed requiring that new mothers must be allowed to stay overnight, whether they needed to or not.  This increased the cost of coverage.

Now the Washington politicians are trying to require that all insurance policies provide the same coverage for mental health problems as for physical problems.  This will unbelievably increase the cost, unless insurers decide to lower the physical benefits.

Why does everyone have to have the same policy?  That is not required for home owners policies and shouldn’t be required for health policies.  In general, medical policies cover too much.  Homeowners’ policies do not cover window washing, new carpets, or normal maintenance.  They are designed to cover the catastrophic losses which normal families cannot absorb.  Health policies should do likewise.

If many of the lab tests, normal exams, etc. were not covered by insurance, the providers would not have to process the paperwork which goes with the claims.  That would actually cost less and could be reflected in the cost to the customer.

I actually approve of the bill which is working its way through Congress which will allow reimportation of prescription drugs.  I do not have any great faith in the FDA and noting that a bunch of pharmacists in Florida were just charged with adultering drugs and selling them, it is clear that this risk exists.  I am a great believer in the “buyer beware” theory of marketing.  Letting people buy from whomever they wish, whatever they wish, wherever they wish is freedom.  We don’t need the “nanny state” telling us about which drugs we should take and where we can buy them.  Underwriters Laboratory is not a government institution and privately tests and approves electrical devices. 

I don’t believe that the poor drug companies will stop developing new drugs.  What will probably happen is that the drug companies will raise the price of their drugs to Canada, Germany, France and all those socialistic countries that have socialized medicine and try to avoid the uncertainties of the marketplace.

You raise questions about Medicaid and Public Health funding.  First, when you provide anything for “free” there is no limit to demand.  I don’t care how poor people are, they should be required to pay something for their health care.  Perhaps, people will choose one less color television, one less pack of cigarettes, one less movie, to pay a dollar or two for a doctor visit.  Also, one might think a little bit before running to the doctor for every sniffle.

If the government got out of the business of fixing prices, prices would fix themselves.  Right now, if you go to a doctor, he never knows the cost of any procedure or medication he recommends.  This is because he doesn’t set the price and there is no comparison shopping.  You wouldn’t accept this from an automobile dealer, and we shouldn’t have to accept it in health care.

If we just got the government out of the business of trying to run the health market, we would be better off. 

If we were able to actually let a market develop for senior citizens by the time that I reach 65, I would be very grateful.  I dread having to be forced into medicare.  Please find out if Mr. Stupak will have to go into medicare when he gets to be 65. 

I surely hope that if the Congressmen and Senators have left themselves a way to opt out of that system, they wouldn’t think twice about providing the same benefit to the people who hire them.

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MAY 2003

SCHIZOPHRENIA AND TEEN BRAINS

A little noted study published in the September 25, 2001 issue of the Proceedings of the National Academy of Sciences commented on the use of a powerful new analysis technique by UCLA brain researchers which shows how a dynamic wave of tissue loss engulfs the brains of schizophrenic patients in their teen-age years.

"This is the first study to visualize how schizophrenia develops in the brain," said Paul Thompson, an assistant professor of neurology at the UCLA School of Medicine and the study's chief investigator.  "Scientists have been perplexed about how schizophrenia progresses and whether there are any physical changes in the brain.  We were stunned to see a spreading wave of tissue loss that began in a small region of the brain.  It moved across the brain like a forest fire, destroying more tissue as the disease progressed."

Using a new analytical technique to read magnetic resonance imaging (MRI) scans of teens as they developed schizophrenia, the scientists noted a loss of gray matter which began in the parietal, or outer, regions of the brain, and then spread to the rest of the brain as the disease progressed.

The researchers are applying this technique for diagnostic purposes.  Future medications might fight the rapid loss of brain tissue, and their effectiveness could be assessed using the imaging technique.

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OCTOBER 2002

BE CAREFUL WHAT YOU WISH FOR

Once again, it is election time.  Once again, the Liberals castigate the Republicans over "universal health care."  Once again, they rail over the failure to provide "free" medical care and prescription drugs for everyone.  While it can be argued that those who cannot afford to buy their prescriptions should be assisted in some way, the actual number of those people is relatively low.  We continue to hear that 40 million Americans don't have access to health care.  That statement is a lie.  By law, hospitals must treat those who show up regardless of means.  What is true is that at sometime during any given year, some number of Americans are without health insurance.  

The poor have Medicaid.  Many people have insurance through their employment.  Many young adults who can afford it, choose not to buy it because they are immortal and would rather have a new fancy car.  Some who are very wealthy do not carry insurance because they can pay for anything they need out of their own pockets.  Some people go for a short amount of time without insurance as they change jobs.  There is no health insurance crisis and never has been.  However, if we don't have a crisis, how can one introduce socialized medicine to America?  Don't you know that we are "only industrialized nation in the free world without universal health care?"  Just  because the rest of these nations have made a big mistake does not mean we should follow.  Most of Europe is Socialist to one degree or another.  The Democrats want the same for us.

On January 26, 2002 The Telegraph (UK) reported on the story of Rose Addis, a 94-year old woman who had shown up in a hospital emergency room with a head wound from a fall.  She was found by her daughter in a chair in her emergency room cubicle 48 hours later, confused, unwashed, and still wearing the clothes she had arrived in, now caked with dried blood.  Her family complained to the press.

In an article on the same date in the New York Times the complaints were featured.  It stated: "Unfortunately for Mr. Blair's Labor government, such accounts are a dime a dozen these days (though they rarely take on the dimensions of this case.)  The National Health Service (NHS) is universally acknowledged to be underfunded and overstretched, and the chief complaints against it include neglect of elderly patients and long, doctorless waits in squalid emergency rooms."

In response to the complaints, The Telegraph reported that Downing Street declared war on patients who make high-profile complaints about mistreatment in NHS hospitals.  It made public Rose Addis' medical conditions and treatments.  Mr. Blairs's spokesman made clear that the Government was no longer prepared to sit back and allow public perceptions of the NHS to be conditioned  by reports of failures in the treatment of individual patients.  He said that hospitals and doctors should be able to "come out fighting" and put their side of the story when their professional integrity was attacked.  

The Scotsman, in an article on August 30, 2002 reported that NHS patients waiting for treatment were increasing.  The average patient waited 57 days for treatment.  Waiting lists are currently covered by a guarantee that the maximum wait for in-patient treatment will be 12 months, which is supposed to fall to 9 months by the end of the year.  The guarantee only covers the time between seeing a specialist - who diagnoses what treatment is needed - and the time the treatment is given.  It does not included the time time the patient has waited to see the specialist after being referred by a GP.  The average wait for an outpatient appointment after referral stands at 55 days.

The Christian Science Monitor, on August 28, 2002 reported on the problems in the Canadian system.  It is the last industrialized nation to rely solely on government funds for its core healthcare system.  "We are no longer the model," said Michael Walker, executive director of the Fraser Institute, a public-policy think tank in Vancouver.  "When you consider that equal access in a country as spread out as Canada would require a greater number of physicians and diagnostic equipment, we're clearly headed in the wrong direction."

Because of a lack of high-tech equipment, wait time for diagnostic assessments can run well over three months.  The strains on the system are already forcing local shifts to alternative models.  Some communities are allowing nurses to treat minor cases without referring patients to a doctor.  77% of the nurses and 60% of the doctors support this approach.

Canadians are divided over the establishment of user fees.  A royal commission has been established to fix the deficiencies.  Solutions would likely include greater home care, user fees for patients who can afford them, and private or semiprivate hospitals.  Should the commission fail to deliver a workable solution, Canada's 10 provinces might be forced to take matters into their own hands.

Just remember, when the government controls all of the health care, the government will decide who will get treatment, when it will happen, and how much will  be available.

Be careful what you wish for. . . .

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AUGUST 2002

POT AND SCHIZOPHRENIA

On July 1, 2001, UPI Science News reported on a Japanese study which tied genetic anomalies with marijuana-activated brain chemicals.  "This result provides genetic evidence that marijuana use can result in schizophrenia or a significantly increased risk of schizophrenia," said lead researcher Hiroshi Ujike, a clinical psychiatrist at Okayama University.

Schizophrenia is one of the greatest mental health challenges in the world, affecting roughly one of every 100 people and filling about a quarter of all hospital beds in the US.  For years, clinical scientists have known that abusing marijuana can trigger hallucinations and delusions similar to symptoms often found in schizophrenia.  Using pot before age 18 raises the risk of schizophrenia six-fold.

The hallucinogenic properties of marijuana are linked to a biochemical found abundantly in the brain.  The cannabinoid receptor protein studs the surfaces of brain cells and latches onto the active chemical within marijuana known as THC.

The researchers examined the gene for the marijuana receptor in 121 Japanese patients with schizophrenia and an average age of 44.  When they compared the same genes in schizophrenics and 148 normal men and women of the same average age, they found distinct abnormalities in the DNA sequences among schizophrenics.

It appears malfunctions in the brain's marijuana-linked circuitry may make one vulnerable to schizophrenia.  This holds especially true for a condition called hebephrenic schizophrenia, which is marked by deterioration of personality, senseless laughter, disorganized thought and lack of motivation.

There is no evidence yet these genetic abnormalities can affect how the marijuana receptor actually acts in the brain.  The scientists would like to replicate their findings with different ethnic population and more people.

The research is described in the scientific journal Molecular Psychiatry.

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MAY 2001

NO QUICK FIX FOR PARKINSON'S

A study published in the New England Journal of Medicine was reported in the Guardian Unlimited on March 13, 2001.  The first full trial of the technique of implanting fetal cells into the brain produced devastating results in some patients which can not be undone.

The American scientists who conducted the research found the therapy did not benefit patients over the age of 60 at all.  Some of the younger patients did improve, but for 15% of those who received  the implants, the outcome was worse than the disease.

The fetal cells which were implanted to produce dopamine, the chemical that is depleted in Parkinson's sufferers, went into overdrive.  The cells appear to have grown too well and are producing excessive amounts of the chemical causing the patients to writhe, jerk their heads uncontrollably and throw their arms about involuntarily.  The scientists have no way of bringing the dopamine levels back down.

Paul Greene, a neurologist from the Columbia University College of Physicians and Surgeons in New York, who was one of the researchers, said the results were "absolutely devastating" for the five patients who cannot control their movements.

Dr. Greene says the technique must go back to the laboratory.  "No more fetal transplants," he said.  "We are absolutely and adamantly convinced that this should be considered for research only.  And whether it should be research in people in an open question."

The surgery in the study was carried out at the University of Colorado School of Medicine in Denver, while the evaluation was done in New York.

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NOVEMBER 2000

MORE NEWS ON SOCIALIZED MEDICINE

As we listen to Al Gore promise the world on a silver platter, let's take another look across the pond where socialized medicine has been around long enough to get it right, if it were ever possible.

The Times of London reported on July 13, 2000 that more than 80,000 cancer patients have been denied vital drugs because the National Health Service (NHS) cannot afford them.  The Department of Health said that its cost effectiveness watchdog, the National Institute for Clinical Excellence, would undertake an intensive program to decide which cancer drugs should be used by the NHS.  However, specialists fear that if the National Institute for Clinical Excellence decides against new drugs on cost grounds, it could be banning effective, life-saving treatments that could save lives for all patients in Britain.

Are you sure Al Gore's government run drug program is a good idea?

How about hospitals?

The Electronic Telegraph reported on August 8, 2000 that the number of people in England waiting to see a consultant for more than three months rose to approximately 1,091,000 people.  The Department of Health immediately blamed seven hospitals which it deemed to be a major part of the problem.  The named hospitals will come under a new "traffic light" scheme which meant that they would be subject to more central control and conditions.

When was the last time more than 1 million Americans (with a much larger population) were waiting to see a consultant?

It is not just England.  The Washington Times National Weekly Edition reported in the June 5-11, 2000 issue that Canada has a major problem.  Canada's best graduate doctors and nurses are moving in droves to the US because of the wages and working conditions.  In order to try to staff their medical facilities, they are bringing in immigrants to fill the void.  However, the best and the brightest of those, in time, seek their green cards and head to the US as well, seeking higher wages and lower taxes. 

The problem with physicians and nurses has become a crisis in British Columbia this summer.  The Vancouver Sun, September 12, 2000 reported in related stories that specialists have withdrawn their services because of an ongoing battle over funding with the province's health ministry.  One of the problems is a lack of operating room time.  When private clinics offered to rent blocks of time in their facilities to help with the immediate problem.  David Levi, chair of the Vancouver/Richmond Health Board refused to consider the offer.  "Once you open the window [to private delivery of medical care] you can't close it."  He believes that waits will only increase in the public system because doctors and nurses will prefer working in the private system, where they may get more money.

How about this?  Al Gore should move to Canada  or England rather than bringing socialized medicine to us.

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OCTOBER 2000

GORE PEDDLES FALSE HOPES TO SENIORS

On August 27, 2000, U.S. Senator Bill Frist, a Republican heart surgeon from Tennessee, said: "When seniors look at the fine print of Al Gore's prescription drug plan, they're going to be very disappointed."

According to the Kaiser Family Foundation ["The Medicare Program," March, 2000] and the Congressional Budget Office, the average senior spends $673 a year on prescription drugs.

The Gore prescription drug plan requires seniors to make a 50% co-payment to cover the cost of their drugs, or $366 for an average senior (50% of $673).  In addition, the Gore proposal requires seniors to pay a new monthly premium of $24 or $288 a year.  That means an average senior will pay $654 ($366 + $288) to receive $673 worth of prescription drugs, leaving them with a benefit worth only $19 a year, or five cents a day.

"We should allow seniors to choose a program that fits their health care needs and not be forced to choose a one-size-fits-all plan where seniors pay more into the system than they get back in a benefit," Frist said.  He recommended that instead of providing false hope, Gore would serve the nation better by working with him and Sen. John Breaux (D.-LA) to implement the bi-partisan plan to reform Medicare  with a prescription drug benefit.

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AUGUST 2000

PRESCRIPTION DRUG PLANS

The prescription drug benefit plan proposed by the Republican Leadership Coalition and recently introduced by Sen. Bob Smith (R-NH) and Sen. Wayne Allard (R-CO) is overwhelming preferred to that proposed by the Clinton-Gore administration, Zogby International reported on May 1, 2000.

The Republican plan proposes a voluntary prescription drug benefit that would begin next year and cover 50% of up to $5,000 in drug prescriptions per year.  There would be no increase in the Medicare premium.  There would be a new combined $675 deductible that would count toward all hospital, doctor and prescription costs toward the deductible.  The cost to the Medicare Trust Fund would be zero.  

A survey of 570 Independent voters and 519 respondents over 65 (some being both) had a margin of error of 3.2%.  Of these, 68.2% supported the Republican plan and 18.8% opposed it.

The Clinton-Gore plan would begin in 2003 and cost $26 per month.  It would pay 50% of up to $2,000 in prescriptions per year.  By 2009, seniors would pay $15 per month for up to 50% of $5,000 in prescriptions per year.  The $100 deductible would stay the same.  It is estimated that the cost to the Medicare Trust Fund would be $203 billion.  Support for this plan was 27.6% and opposition was 59.3%.

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APRIL 2000

WHO ARE THE UNINSURED

Paul Sperry in Investor's Business Daily, December 7, 1999 reported that contrary to President Clinton's assertions that employers are dropping workers' health benefits, evidence suggests that they are actually expanding them.  Employer based coverage climbed to 62% of the population last year -- and is the highest since 1987's peak of 62.1%.

The answer may lie with young people ages 18 to 24 -- one of the fastest growing age groups in America.  Some 55% of that group went without health insurance for at least one month between 1993 and 1996.  Many of them have access to campus health clinics.  Others are making the move from homes to full-time jobs.

Another explanation is that during the 1995 survey of the Census Bureau, allowances were made for households which had at least one Hispanic member.  That change could help account for the jump in the uninsured, because the Hispanic uninsured rate is more than triple the rate for whites.

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MARCH 2000

FOR THOSE WHO ADVOCATE SOCIALIZED MEDICINE

The Telegraph of the United Kingdom reported on Dec. 6, 1999, that elderly patients in England are dying because of an unspoken policy of "involuntary euthanasia" designed to relieve pressure on the National Health Service (NHS).  

Police and NHS are investigating 60 cases involving pensioners who died after allegedly being deprived of food and water by hospital staff.

Dr. Adrian Treloar, consultant and senior lecturer in geriatrics at Greenwich Hospital and Guy's, King's and St. Thomas medical schools, said: "There are severe pressures on beds and in order to relieve this there may be a tendency to limit care inappropriately where you feel doubtful about the outcome.  Are the elderly being served properly? No, they are not getting what they deserve and I think they are being sold short.  I think that is becoming clearer and clearer.  If old people start to resist early discharge they are seen as an encumbrance."

Recent British Medical Association guidelines say doctors should be allowed to authorize withdrawal of nutrition and hydration by tube for stroke victims and the confused elderly, even when the patient is not terminally ill.

NHS has been recently attacked on other grounds.  The flu epidemic created great overcrowding at the government run hospitals.  The Telegraph reported on Jan. 16, 2000 that NHS patients are remortgaging or even selling their homes to pay for private operations because of the long waiting lists.  One hip replacement patient was told it would be 15 months before he could even discuss his problems with a surgeon and another 18 months before the surgery could be done.  Another man, 49, father of two, was told he needed a triple bypass after a heart attack but discovered the waiting list for urgent cases was 10 months and for non-urgent 14 months.

The Minneapolis Star Tribune reported on Jan. 17, 2000, that Prime Minister Tony Blair acknowledged major problems with the NHS but ruled out US-style private medical insurance as an alternative.   He took this position despite a well-publicized case of a 73-year old woman with throat cancer whose operation was postponed 4 times during the previous 5 weeks.  The cancer has now spread to the point where it is inoperable.

Both Mr. Gore and Mr. Bradley have proposed variations of Socialized Medicine for America.

Who wants to be the first to sign up?

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MARCH 1998

MEDICARE AND PRIVATE CONTRACTING

In the Balanced Budget Act of 1997 (BBA) a provision was inserted which affected the right of doctors and patients to privately contract for services. Until that time the Health Care Financing Administration (HCFA) had adopted a rule that any doctor who accepted Medicare patients could not privately contract with any patient for services which were provided by Medicare. However, over the years Medicare has continued to reduce the amount which doctors could receive for services provided in an effort to improve the solvency of the program. Many doctors have refused to accept new Medicare patients because of the limitation on reimbursement.

To provide some relief for patients and doctors, the Republicans had inserted a provision in the BBA which allowed doctors and patients to privately contract for services which are otherwise provided by Medicare. The Administration and HCFA were violently opposed to that provision because people might be able to go outside the system to obtain services. It is the position of the Democrats that people over 65 should not be allowed to leave the Medicare system for any service which is provided by it. While the Republicans believe that senior citizens should be allowed to make decisions for themselves, the President would not agree to sign the bill as proposed.

Therefore, a provision was placed in the bill which states that any doctor who privately contracts with a patient for services which are provided by Medicare must agree not to accept any funds from Medicare for a two year period after entering into a private contract. This means that, in reality, no private contracts will be allowed since 96% of the doctors participate in the Medicare system.

While HCFA claims that patients are allowed to privately contract for services not provided by Medicare (for example, plastic surgery, a second mammogram, other screening tests), there have been reports that such tests have been denied. There are other occasions where a patient may wish to privately contract. For example, if a particular specialist in your community is not taking new Medicare patients and other available specialists are at a considerable distance away, some patients with the means to pay may wish to use the doctor in their own community.

To deal with these problems, Sen. John Kyl and Rep. Bill Archer have introduced bills, S. 1194 and H. R. 2497 which would allow patients to privately contract if they pay the entire bill for the services and sign a written contract setting forth the agreements and the restrictions on the contract. Both Rep. James Barcia and Sen. Spencer Abraham have co-sponsored these bills. Senator Levin has not. Neither of the bills allow the doctor to accept money from Medicare and charge a patient additional amounts.

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