Rantings of a Medical Mind

Dr. Big Brother Is Watching You?

2011-09-26T04:26:00.000-05:00

I am laughing. I mean, rolling on the floor, cackling hysterically, ready-for-the-jacket-with-the-sleeves-that-tie-in-the-back laughing. Read this article and then come back. Go on, I'll wait.

Done? Good. So Rep. Tim Huelskamp is afraid of the Federal Government getting its hands on everybody's private medical records because the Federal Government has a bad track record of securing the privacy of the information it collects. He fears it will lead to the loss of insurance company proprietary information that will undermine their competitiveness. Uh, guy, destroying the competitiveness of the insurance companies in order to drive them out of business and collapse the United States into a single-payer, government-run system that the majority of Americans don't want is the whole purpose of ObamaCare. Are you just now figuring this out?

And he spends the majority of his op-ed piece on these issues. But I can tell you know what the real problem is. Why didn't you make that the main emphasis of your article? Afraid of being singled out as the one who starts calling attention to the man behind the curtain? Not ready for the fires of holy hell to be place beneath your feet?
Let's look at some selected quotes from the piece:

It’s par for the course with the federal government, but abstract terms are used to distract from the real objectives of this idea: no matter which “option” is chosen, government bureaucrats would have access to the health records of every American - including you..... With its extensive rule-making decrees, ObamaCare has been an exercise in creating authority out of thin air at the expense of individuals’ rights, freedoms, and liberties. The ability of the federal government to spy on, review, and approve individuals’ private patient-doctor interactions is an excessive power-grab..... No matter what the explanation is, however, this type of data collection is an egregious violation of patient-doctor confidentiality and business privacy. It is like J. Edgar Hoover in a lab coat.

And then you weasel out at the end with the use of that one last wrong word:

....too many people already know what can result when their confidential information gets into the wrong hands, either intentionally or unintentionally.

The wrong word here is the word wrong. From the point of view of the people creating these rules, they think they are finally getting our private medical information into the right hands. But for those of us who love liberty and our God-given rights, we know that it is the Feds who are the most wrong people. And from all these quotes from the article, it is clear that Rep. Huelskamp is aware of this fact also. So why not just say it in so many words when you have such a bully pulpit to shout it from?

The biggest problem we face is not that the Federal Government might accidentlally release your medical records; it is that the Federal Government itself will do nefarious things with your medical records. Like decide that you don't get treated for your heart failure because you belong to the NRA. Or you're a TEA Party member. Or that you donated money to John McCain or Mitt Romney.

It is this kind of grab for power -- the power over individual life and death itself -- that I recognized instantly was the biggest threat from ObamaCare. And I recognized it before Dear Leader was even elected.
I laugh so hard now because I find it so amazing that it is taking so many people this long to understand this.

But I don't find it particularly funny. No, I don't find it very funny at all.

Repealing Just ObamaCare Is Not Enough

2011-09-14T01:40:00.000-05:00

More Federal judges continue to properly find the insurance mandate unconstitutional, though most of them are ignoring the fact that the law being challenged has no severability clause, meaning that technically finding one piece of the legislation unconstitutional should actually negate all of it. But since when has following the letter of the law mattered to a Federal judge? Despite the not-unreasonable expectation that the Supreme Court will kill this nightmare once and for all, legislators on the right continue to call for the repeal of "ObamaCare", and the candidates for the Republican nomination for President are falling over each other (at least most of them) to try to make us think that he or she alone is the one who can best accomplish this task.

I must insist, however, that if we are to repeal "ObamaCare", repealing just ObamaCare is not enough.

In order to make myself clear, we must get technical. When most people, and especially most politicians, refer to "ObamaCare", they are referring to the piece of legislation that is more accurately called the Patient Protection and Affordable Care Act of 2010, or PPACA for short. This is the law that is undergoing all the legal challenges, and the law that public opinion is increasingly opposed to. The PPACA is not the entirety of "ObamaCare", and if we are to get rid of "ObamaCare", the repeal bill needs to address all of it. I have actually discussed this with my Congressman, but it appears that he didn't get the point, as the House has passed a repeal bill for only the PPACA.

There are two additional pieces of legislation that must be disposed of in order to repeal "ObamaCare". Leaving either one in place provides a framework for the reinstitution of this monster. What makes this interesting is that Dear Leader had absolutely nothing to do with the passage of one of these pieces of legislation.
Some explanation of how these laws are connected is required to fully understand why repealing the PPACA alone is insufficient.

PPACA is the final implementation of the Obama "healthcare" reform. It is the law that has everyone so hot and bothered. It is my considered opinion that the PPACA was never intended to function as it is designed, but is actually a veiled program to drive the insurance companies out of the medical insurance business, destabilize the current medical care system, and then force the imposition of a single-payer, government-run system. But whether it works as written or as I suspect, it is built on the foundation of two previous pieces of legislation, without which PPACA makes no sense. Since these two pieces of legislation are fundamental to the intended (or suspected) operation of PPACA, they must be considered to be parts of "ObamaCare". The first of these is the so-called HITECH Act.

The HITECH (Health Information Technology for Economic and Clinical Health) Act is not a separate piece of legislation but rather a section of the American Recovery and Reinvestment Act of 2009, usually referred to as "the Stimulus Bill". This section of the stimulus bill is generally considered to be simply an act to promote the use of electronic medical record systems by doctors' offices and hospitals. Many parts of PPACA do not work without these electronic record systems. PPACA calls for the creation of "Accountable Care Organizations" and calls for a substantial amount of reporting (to the Federal Government) of healthcare "quality measures", both of which are tremendously burdensome if not downright impossible to comply with without the use of electronic record systems. Where the insurance mandate is the financial glue that holds PPACA together, these EMR systems are the operational glue that binds your personal health records to the Federal overseers, uh, holds the PPACA together.

While compliance with HITECH is technically voluntary, meaning doctors are not mandated to adopt these EMR systems, in reality there is nothing very voluntary about it. By offering incentives to act now to install and "meaningfully" use an EMR, and by implementing penalties (in the form of Medicare and Medicaid payment reductions that can be increased without limit if not enough doctors adopt an EMR), few doctors will be able to refuse to comply and still stay in business. But the catch is the "meaningful" use part; the criteria established at present to "meaningfully" use an EMR (required to receive the incentives) are designed around those things needed to funnel information to the Feds, as well as a few other "feel-good" liberal functionalities that do nothing but get in the way of actually caring for patients. There is even talk that the informational needs of operating a PPACA-defined Accountable Care Organization may be substituted for the currently proscribed meaningful use criteria. And if that isn't a way of tying PPACA to HITECH, I don't know what is.

HITECH also makes changes in another, older piece of legislation, making the older bill's penalties stronger. This older legislation is the bedrock upon which all of "ObamaCare" is built. This would be the Health Insurance Portability and Accountability Act of 1996. Yes, good ol' HIPAA, those letters that strung together give us doctors heartburn. And yes, you read that right -- 1996.

What does HIPAA, the so-called Federal Privacy law, have to do with "ObamaCare"? Simply put, HIPAA created the Federal "right" to privacy of medical records while at the same time setting down regulations to secure that new "right". Prior to 1996, the privacy of medical records was a state issue, and HIPAA added no new privacy protections than 50 state legislatures had not already provided; it merely wedged the Federal Government into what had previously been considered a function of the individual states.

So how does HIPAA have anything to do with "ObamaCare"?

HIPAA wedges the Federal Government into medical records privacy and thus into the provision of medical care at all levels, whereas prior to HIPAA the Feds' involvement had been limited to Medicare and Medicaid. Part of HIPAA was to guarantee the standardization and security of the electronic transmission of medical information between providers and insurance companies. (Actually this was all HIPAA was really supposed to do regarding medical records, but the enabling regulations written by the Clinton White House went waaaay beyond this. Don't believe me? Read the law; subsection F starting on page 87 deals with the security rule.) With their feet in the door, the Federal Government creates HITECH as another way to standardize and secure such transmissions. HITECH then serves as the operational conduit of the information that is necessary for PPACA to work as intended (interpret that as you may; you know where I stand on that). A leads to B leads to C, and if you don't think this was planned, then you have not been paying attention for the last 20 years or so.

Repeal only PPACA, and HITECH and HIPAA remain to allow the creation of another monstrosity like PPACA at any time in the future. Repeal PPACA and HITECH, but leave HIPAA, and the Federal Government remains inside the medical house, ready to grow like kudzu.
Only by repealing PPACA, HITECH, and HIPAA can we be truly free of what we refer to as "ObamaCare". Of course, this means that "ObamaCare" really has nothing to do with Obama, as it has been in the works now for over 15 years.

Only after ALL of "ObamaCare" is repealed can we get down to the business of truly fixing what is wrong with our medical care system.

Remembering

2011-09-11T23:55:00.000-05:00

Today, the 10 year anniversary of the 9-11 attacks upon our nation, is a good time for remembering.

I had just gotten out of the shower that morning 10 years ago. As I was drying off, I turned on the TV in my bedroom. This TV was old and the sound came on before the picture. I heard the news anchor say that a plane had struck the World Trade Center in New York. I looked at the screen and as the picture came on, I saw smoke and flames coming from both of the Twin Towers. My mind did the arithmetic before the anchor could repeat the facts. One plane could not have hit both towers. Two planes could not be an accident. Someone had deliberately attacked the United States.

As I continued to get dressed, the news reports came quickly. When a preliminary report came that there were reports of an explosion inside the Beltway in Washington D.C., I said to someone in my home, "My God, how many of them are there going to be?" This was before the news media had confirmed the plane crashing into the Pentagon.

As I ate a quick breakfast, I continued to watch the unfolding events. I observed and commented on the collapse of the first tower before Peter Jennings could stop pontificating long enough to tell us what was happening right before his eyes. As I left to go to my office, I asked the person staying at my house to call me when the second tower collapsed. Not if, but when. The damage to both buildings was identical; to my mind, the collapse of the second tower was inevitable. That phone call came while I was meeting with my bankers to go through the annual review of the office retirement plan.

When I arrived at my office, I told my office staff what was going on. Most of them had left for work and arrived at the office before the first plane had struck, so they were completely unaware of what was happening. It took me a bit of convincing. They all thought that I was pulling some sick practical joke on them. It was only when we got a radio on (the only station we could find covering the event was of all things NPR!) that they really believed me. It was on the radio that we heard the first confusing reports of the explosion in southern Pennsylvania that turned out to be the crash of Flight 93 and its heroic passengers.

At noontime I managed to get a TV brought to the office and was able to watch the reactions of my employees as they saw those horrible images for the first time. Throughout the day, my patients (and unbelievably, I had no cancellations or no-shows that day) could discuss almost nothing else. That afternoon, as I left the office, I looked up at the clear blue sky and saw two parallel, curving jet contrails arcing across the southern sky. By that time all the commercial traffic was on the ground. Those jet trails could only have belonged to the sky cap being flown around Houston. After completing my evening hospital rounds, I came home and watched many hours of the TV coverage that had been recorded for me, repetitive scene after scene of the aftermath of this vicious attack.

That is my 9-11 story. As such stories go, it is not much. I am fortunate to have not personally known anyone who was killed on that day. A couple of the doctors from my community were in Washington and were on their way to go on a tour of the Pentagon that morning. But for the grace of God and timing, they might have been in the building when the plane crashed into it and my connection to the attacks could have been more personal. These events remain ingrained into my psyche nonetheless, and I doubt that I will ever forget them.

But even more than the events themselves, I remember how they made me feel. I was angry -- royally pissed off -- that someone, anyone, had dared to do this to us. Late that evening, when President Bush finally got the Secret Service to let him off Air Force One and make a statement to the nation, I was comforted by his statement that those who had done this to us would be brought to justice. I was comforted because I then knew that we had a President that understood, who was just as angry, and would be resolute in his response, something that I felt his predecessor would not have been. This has taken a lot longer than most of us wanted it to, and that task is still not finished. But I suspect that President Bush and his advisers knew then that we had been forced onto a path the end of which would require decades to reach, but wisely kept this to themselves.

And now we have reached the end of the first and the beginning of the second decade of that journey, and many American are already weary of it. I did not get to watch much of the coverage of the anniversary memorials today, though I expect that I will see parts of them over the coming days. I don't need to have seen much of them to know that they were heavy with remembrance and memorialization of the innocent dead and the heroes who died trying to save them as well as the heroes who followed who have died or been permanently injured in defense of our country and all of her citizens. And that is as it should be. I am equally sure that they were not heavy at all in recalling how we all felt on that day and the days that followed, and that is not how it should be.

Already the horrors of that day are being glossed over so that we can remember the dead but not the anger, and that is not right. We should be reminded regularly of that anger, we should be shown regularly the horrors without editing of the most gruesome parts, so that we can never forget that anger. Not until all of those who did this to us or would do something similar are either apprehended, killed, or so overwhelmed by our resolve that they abandon any further attempts.

For it is when we stop remembering this that it will happen again. And 12-7-41 and 9-11-01 will have a new date of infamy join them.

Waking Up

2011-09-11T22:55:00.000-05:00

This blog has been awake for far too long. Time for it to wake up!

Boldly Not Going Where No Man Has Gone Before

2010-04-17T22:59:00.004-05:00

On Tax Day this year, April 15th, Dear Leader gave a speech at the Kennedy Space Center in Florida in which he announced his plans to end, for all intents and purposes, the American space program.

His announcement of the cancellation of the Constellation program (as misguided as that was; for a better idea, look at Direct Launcher), with no suggestion of a real plan for a replacement for the program, means the end of the American manned space program. The idea of "repurposing" the Orion crew capsule as an escape capsule for the International Space Station is worse than a joke -- since it will be an escape capsule that could not be used; without the Ares I booster, we will have no way of getting Orion to the ISS. Ares I was just barely powerful enough to lift Orion, and then only after Orion's weight was substantially reduced. Does NASA have another booster that can lift that much mass into orbit? (If the answer to this is yes, then why did they need to design Ares I in the first place?)

Dear Leader tossed out a lifeline in the form of a new heavy launch vehicle. But with nothing but vague plans for when it might be built or used, he more or less forgot to hold on to the other end of the lifeline, letting it drift off into space. The minimal increase in NASA's budget, directed to the design of the new heavy launch vehicle and new robotic space probe missions (most of which are climate research satellites), is also another maneuver being used to destroy the American space program.

Why do I say this? Because I remember what happened after the Apollo program was discontinued in the 1970's. While we waited for the space shuttle to make its maiden voyage, NASA's plans for unmanned probes to the planets were slowly, one-by-one, pared down or canceled. The shuttle itself was pared down as well, in addition to being twisted from its original design to satisfy the military who then never used it, leading to some of the obvious difficulties that the STS system has demonstrated over the years -- its high operational cost and slow turn-around time being two of the more obvious ones. In fact, at one point, the entire shuttle program was in danger of being scrapped. (Of course, if that had happened and the technology had been diverted into something similar to Direct Launcher, we would likely be much farther along in space exploration and at a lower cost, but that's a 'what if' that can be endlessly debated for a long time.) I also recall that a number of different interplanetary probes were scaled back or canceled under Clinton; the New Horizons mission to Pluto would have been one of these if not for the public's outcry. For some reason, the American people are very curious about Pluto. Maybe because it's on the frontier, and the frontier spirit of America has yet to be extinguished.

And that's what's going to happen to all these proposals. The robotic missions will be designed and planned but never built or launched -- except, of course, the climate research satellites, which are unnecessary. The heavy launch vehicle will never get off the drawing boards before the budget funds are diverted (to the climate research satellites) or canceled. The ISS will eventually become a victim of the budget ax, all in the name of "deficit reduction" while the US government spends ever more money on union-supporting 'stimulus' bills, 'corporate' bailouts, the exponentially malignant costs of abominable ObamaCare program, and climate research satellites that will show what we already know, that AGW is a myth.

Why? Because the Democrats don't have any desire to explore space. It has been the goal of every Democratic President since Kennedy to kill the space program. (Except for Johnson, who begrudgingly continued the space program as tribute to Kennedy. If he had known that Kennedy's only reason for supporting the space program was its Cold War propaganda value, and that his real attitude was that if not for that reason "we shouldn't be spending this kind of money, because I'm not that interested in space", Johnson may have killed Apollo from the outset and mankind might even now not yet have set foot upon the Moon.)

This decision will also lead to significant increases in unemployment (at a time when jobs are already scarce) -- not just at NASA, but in all the companies that build the rockets and probes and support systems for the missions, and then cascading out into the companies that provide the parts for the other companies, then to the raw material providers, and finally out into the retail an service sectors which will no longer be getting the monies spent by all these newly unemployed workers. Government spending on the space program is the only place where that spending actually does create jobs. So naturally this is the program that Dear Leader wants to cut.

The other ridiculous part of Dear Leader's plans is the idea that we are going to let private companies take over the job of providing access to low earth orbit (where ISS resides). This ideas is bone headed in many ways. First off, only one company, Space Exploration Technologies (aka SpaceX) has ever launched anything into orbit, and they have a 40% success rate. You want to be an astronaut on top of that rocket? Didn't think so. Only the government can accept the liability of a manned space program, and without some kind of legal protection, probably the unmanned variety as well. Let just one of these private companies kill an astronaut or, God forbid, drop a booster onto a populated area, and the resulting court judgements will effectively kill the entire private space industry instantaneously. I live right along the path where the pieces of Columbia came to Earth after it disintegrated on reentry, and I can assure you it was only by the grace and mercy of God that no one on the ground was hurt or killed. So it can, and will, happen.

There are several commentaries on the Web praising Obama for his bold new plan. For example, look at The Martian Chronicles, Phil Plait's Bad Astronomy blog, and at Quantum Rocketry. These are written by people who haven't seemed to learn that what Dear Leader promises and what he delivers are two very different things. (Transparency and bipartisanship ring any bells?) Other sites such as National Review Online and Gizmodo (here and here). I particularly agree with the opinions at the first Gizmodo link about the benefits from the technological investment in the manned space program that we will lose under this new program and the loss of any kind of inspiration for our society for anyone to want to go into this field. I also will direct you to the comments in this link, especially the one from "Stevox" who says:

Let me put it this way: to assume that private industry could properly step in and replace in any meaningful way the space-travel capabilities of NASA would be like saying that some dude in his basement could take over some of Google's cloud-computing needs with a broadband connection and a few networked VPS'es.

Go to the National Air and Space Museum's Steven F. Udvar-Hazy Center at Dulles Airport in D.C. and stand underneath the Enterprise in absolute awe of the sheer size of the Shuttle and you'll know exactly what "Stevox" is talking about.

We put men on the moon; we routinely hurl small skyscrapers into orbit; and soon, we'll be reduced to watching popguns toss little cargo packets into the air while the Russians carry up our astronauts. Yeah, I know, the process that led to this state of affairs began long before Dear Leader got involved. His new plan simply seals the deal for decades into the future.

Time To Light Up the World Again

2010-03-27T15:37:00.002-05:00

Short notice here, but the WWF is once again sponsoring that ridiculous event, Earth Hour, at 8:30 PM local time.

As I have commented on before, this is nothing more than a feel-good notion, something to try to manipulate people into believing -- or at least pretending to believe, which is no better -- in the socialist-inspired, scientifically-unsound, so-called theory of AGW (Anthropogenic Global Warming, for those of you who haven't wandered deep into my older rantings).

So, like I said last year, it's time to light up the world. Turn on the lights! Run the A/C and the heat together! Mow your lawn -- well, it'll be nighttime, so just run your lawn mower! Idle your car in the driveway with the lights on bright! Fire up the barbecue grill!

I'm going to also have all my outdoor lights on and be standing outside. Maybe the astronauts on the International Space Station can take my picture.

Senate "Health Care" Reform Bill Passes; American Health Care to Follow

2010-03-21T23:25:00.001-05:00

The House of Representatives passed the Senate "health care" reform bill today, and it is a certainty that President Obama will sign it. The only thing that will delay that signature is arranging the ceremony in the Rose Garden. Whether or not the "fixes" in the so-called reconciliation bill pass or not, this marks the darkest day for American medical care ever, even darker than the day Medicare was passed in 1965.

I have expounded my initial thoughts on this 'momentous' occasion on my companion blog on RedState. It will hopefully get a wider readership there.

In a related vein, I also direct you to this from Walter Williams, re-emphasizing what I have said previously.

There is now a much more important target for my ranting:

OBAMACARE DELENDA EST!!!!!

Coming Down to the Wire -- Stop ObamaCare NOW!!!

2010-03-15T00:10:00.002-05:00

Sometime this week, supposedly, the House of Representatives will vote upon the previously passed Senate "health care" reform bill. The time to stop this obscenity is now. Contact your CongressCritter now -- call, write, email, text, Tweet, send up smoke signals, whatever. Tell them not just to vote no, but what you will be doing for them if they do not vote no, namely voting for whoever is running against them this November.

While you're at it, do the same for your Senators, and if your Senator(s) voted for this monster, let them know that you hope that they have enjoyed their time in the Senate for it will soon be coming to an end.

American Solutions has linked a video from a new organization of physicians and surgeons called Docs 4 Patient Care. This group was formed last year as a response to the AMA's incomprehensible support for ObamaCare and to let the public know that the majority of doctors in this country do NOT support this reform plan. In addition to the video linked by American Solutions, I would recommend this video, made by the organization's founder and president, Dr. Hal Scherz.

I encourage everyone to spread the word and these videos as widely and as quickly as possible.

There is no time to waste.

Snow Falling on Never-Actually-Endangered States

2010-02-13T23:31:00.002-06:00

Yes, I'm reusing a post title. The pun is too good not to reuse.

Courtesy of Marc Sheppard at American Thinker comes this notification of the fact that on Feb. 12, 2010 an unprecedented event occurred. There was measurable snowfall on the ground in all 50 states of the United States.

University of Oklahoma meteorology graduate student Patrick Marsh is assembling a slide show of photographs of the snow in each state. So far he has pictures from 49 of the 50 states. The only unphotographed snow is in Hawaii, where there are apparently small patches on the steep north slope of Mauna Kea; photographs of this snow are still being sought and/or verified.

Mr. Marsh is going to place these photos on Google Earth eventually. For now, they are viewable at his blog.

My only question is how many years in a row are we going to have to have winters like this one before the AGW zealots give up on their cockamamie theory? Especially since even the revelation that the data and research supporting their theory was essentially cooked up out of sheer desperation and is wholly unreliable? (If you haven't heard about the Climategate scandal by now, no link from me is going to help. Use Google. Or Bing. Or Yahoo. Take your pick.)

They Took Health Care Reform Out Back and Shot It in the Head

2010-01-21T23:47:00.001-06:00

I made the comment yesterday that following the miraculous and historic election of Scott Brown (R-MA - just had to type that to see what it felt like!), they (meaning the Democrats) took 'health care' reform out back and shot it in the head.

Basically, with the restoration of the Republican minority's ability to filibuster any attempt to pass an obnoxious 'health care' reform package, the impetus for all Democrats to fall in line and support the bill disappeared. Those few Democrats that were not happy with the bills being debated, for whatever reason, now no longer feel compelled to respond to the arm twisting from the Democratic leadership. Thus, you are now seeing enough Democrats backing away from these bills that there is no longer enough votes to pass them. Just like in 1993-94, the 'health care' reform process is dying the slow death of progressive overreach, as well as the fact that the hyper-liberals can never gain enough support for a bill that is communistic enough to suit them. Couldn't be happening to a nicer piece of legislation.

I think we must all continue to listen for the footsteps of the process coming back to life, zombie-like. But the chances are slim; the momentum has been reversed, and all the steam is leaking out of the engine that was driving it forward. The Republic is saved, at least for now.

Referring back to my call for brinkmanship, I am a little concerned that this 'victory', such as it is, might result in defusing the anger at the overreach and overspending of the Democrats. This is something we simply must not allow to happen. Even though this process may have been stopped for now, we must go on as if it has not. The only difference is that where before we had the threat of imminent socialism, we now have only the spectre of the threat. Don't think for a moment that if the progressives are not beaten back now, that they will not very quickly be back for another attempt to try again.

It is helpful that that Democrats cannot help but give us new ammunition to replace that we just lost. The Democrats are now debating a bill to increase the federal debt ceiling by another $1.9 trillion dollars to a staggering total of $14.3 trillion.

The Democrats complained that George W. Bush ran up massive deficits. As you can see here, Bush raised the debt by $1.885 trillion in his first term and another $3.014 trillion in his second, for a total of $4.889 trillion in his 8 years as President. President Obama has increased the debt by $1.573 trillion in his first 365 days as President; when combined with the $1.9 trillion increase now under debate, he will have reached $3.473 trillion in under 13 months.

That's 71% of Bush's increase in essentially just his first year!! And no substantial improvement in economic performance or unemployment has come from it.

I'd call that some pretty powerful ammunition, wouldn't you?

The Fundamental Flaw of ObamaCare in a Nutshell

2010-01-16T16:55:00.002-06:00

Ken Blackwell made a startlingly succinct appraisal of the current plans by the Obama Administration to 'reform' the medical care system in a post on RedState today. I think the reason that so many people in this country are opposing this plan is really on the basis of this particular aspect of it -- they feel in their hearts and souls what is wrong with it without being able to put it into words. Ken Blackwell has found the words.

In a post discussing the special election for the U.S. Senate seat in Massachusetts left open by the death of Ted Kennedy (I will not call it Kennedy's seat; that seat belongs to no one person)between Martha Coakley (D) and Scott Brown (R), Blackwell was discussing the statement made by Coakley that Roman Catholics should not work in certain jobs in health care because of their conscientious objections to certain procedures (read abortion):

Pittman specifically asked Coakley about the rights of conscience of health-care providers, and segued into a query on Roman Catholics in Massachusetts’s hospitals....
(Coakley's) response to Pittman was to denounce the idea of any allowance for individual conscience in federal healthcare legislation. Then she uttered the line that alone ought to sink her campaign: “The law says that people are allowed to have that. You can have religious freedom but you probably shouldn’t work in the emergency room.”

Blackwell responds by stating:

The logical consequences of Martha Coakley’s statement are both grotesque and stupid.
Martha Coakley does not exist in a vacuum. Her belief that conscience and its protections must be forced out of the healthcare sector are tightly bound up with the ideology underlying the President’s push for healthcare reform. That reform threatens ever-greater government involvement in healthcare, and probably portends its takeover if passed.
With that comes the precedence of government priorities — and there’s little room for individual conscience then..... President Obama is taking the first step toward forcing healthcare professionals to follow the government’s ethical agenda rather than their own.

And it won't just be 'health care' professionals' ethical positions that will be subjugated to that of the ruling party (as it will be the ruling party, not the "government" making these ethical decisions). The ethical positions of every individual patient must also bow down to the edicts of those who have placed themselves over us because they are convinced they know better how to run our lives than we ourselves do.

This is the ethical, nay the moral bankruptcy of the reform plans that are being rammed down our throats and of all of those who are doing the ramming and anyone else who does not stand up against this travesty.

Almost every action taken so far from Dear Leader has had at its core this issue, but in the 'health care' reform debate, it is openly, glaringly clear:

We are engaged in a fundamental battle between liberty and tyranny.

And in this war, there is no middle ground, no fence to sit on.

I know which side of this battle I am on. Which side do you choose?

A Time for Brinkmanship

2010-01-10T00:00:00.004-06:00

The third chapter of Ecclesiastes begins:

1To every thing there is a season, and a time to every purpose under the heaven:
2A time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted;
3A time to kill, and a time to heal; a time to break down, and a time to build up;
4A time to weep, and a time to laugh; a time to mourn, and a time to dance;
5A time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing;
6A time to get, and a time to lose; a time to keep, and a time to cast away;
7A time to rend, and a time to sew; a time to keep silence, and a time to speak;
8A time to love, and a time to hate; a time of war, and a time of peace.

To this I feel it is time to add "a time for brinkmanship.

Through discussions with various people, I have discovered that not many people really know this word, much less what it means. So, from Dictionary.com:

brink⋅man⋅ship
–noun
the technique or practice of maneuvering a dangerous situation to the limits of tolerance or safety in order to secure the greatest advantage

I suspect that many of my loyal readers (especially my first and so far only Follower!) have been wondering where I have been lately, considering the intense debate that has been going on over the matter of 'health care reform'. Well, I have been away, tending to another project and doing my day job (you were aware that more people get sick in the winter?).

Besides, after my first round of fury at the AMA's insane endorsement of H.R. 3200 and the Senate's protracted debate over their much-different 'reform' bill, I realized that to expend a great deal of breath, energy and angst extolling the dangers of these bills while they were being bent and twisted and melted and metamorphosed into their final forms would not be terribly productive. It is the final bill, the merger of the House and Senate bills, which really matters and which should be the target of all of our criticisms. What this final bill will look like after it emerges from the ping-pong match between Senator Reid and Speaker Pelosi (but not from anything as open as a Conference Committee, oh no, not for this 'transparent' administration) is anyone's guess; my guess is that it will be a blend of the worst parts of both earlier bills. And given how our august bodies of legislators have been behaving lately, we will have precious little time in which to criticize it, for I suspect this will be another one of those pieces of legislative legerdemain that simply must be voted on before the bill can actually be read (or even seen) by those voting on it, much less the rest of us.

I have, moreover, come to another realization over the past month or so. The legislation isn't really the problem. Now before you think I've gone completely mad (note to my readers: having gone postal long ago, I left 'completely mad' behind some time in the Cretaceous period), let me tell you that I have not changed my mind about what Dear Leader and his ilk are trying to do to our medical care system and the rest of the economy. But I have determined that the 'health care reform' legislation and the so-called stimulus bill and the 'cap-and-trade' carbon tax and all the rest are just the symptoms of the disease. And to fight only the symptoms of the disease is doomed to failure, just as much as if all you did for someone's pneumonia would be to give them Tylenol for their fever and neglect to give antibiotics to treat the real cause of the disease.

So if the legislation is just the fever, what is the disease? Socialism, communism, statism -- take your pick; they are all equally noxious. And continuing the pneumonia metaphor, we need to direct our criticism -- our antibiotics -- at the bacteria of all these noxious -isms, namely, the legislators and the supporters of the legislators who are pushing this socialist agenda. To put it most bluntly, our target is the Democratic Party.

So where does brinkmanship come into play? The Tea Party movement and the raucous townhall meetings of this past summer should give you an idea. These protests were caused by the rising anger of a large segment of the American people at what our elected representatives are trying to do to us instead of for us. This anger comes from an unconscious (but becoming increasingly more and more conscious) realization that the socialist movement is trying to subvert the fundamental principles upon which the American nation is founded. In other words, the people are beginning to see that the country they live in and love is being systematically dismantled and turned into a something else that they did not sign up for and decidedly do not want!

In order to stop this process, there has to be a clear majority of people willing to stand up and not just say but shout "No more! This stops now!" But the inertia of the masses is great and it will take a tremendous motivation to get them all up and shouting. That's where the idea of brinkmanship comes in -- maneuvering a dangerous situation to the limits of tolerance or safety in order to secure the greatest advantage. So the maneuvering that I propose is this:

Let the Democrats pass the 'health care reform' bill. Oh, we'll protest and complain, but let them pass it. (If they can marshall their votes, they'll be able to pass it regardless of our protests.) Let that bill be the most bloated, government-regulated, tax-laden, expensive bill they can imagine. Let it pay for abortion on demand, sex-change operations, and health care for illegal aliens. Let it be packed with truckloads of obnoxious pork to cater to whims of the elitist Senators and Representatives who, like Senator Ben Nelson of Nebraska, have to have their egos stroked in order to secure (read 'buy') their votes. Let it slash Medicare and Medicaid to the bone, establishing the need for rationing and the subsequent 'death panels' that such rationing will require. Let it pass with the minimal number of votes necessary in the House and the minimum number in the Senate. And let's make sure that every one of those votes is that of a Democrat.

And while they're at it, they (the Democrats) can go ahead and pass the multi-trillion dollar, industry-destroying, economy-collapsing 'cap-and-trade' carbon tax; a second government-make-work stimulus bill; and any other boondoggle program they can think of. (Anything and everything except Card Check.)

Let them pass all the bills they are debating, which are crafted to piss off the greatest number of people possible -- and particularly the senior citizens of this country, who are the single most reliable voting bloc in the electorate.

And let them do it all by the end of January. Or at least February.

What we do then is spend every waking moment after that until the November 2010 elections making sure that everyone knows and no one forgets just how much control of their own lives they have just lost, how much of their Constitutionally-enshrined freedoms have been forcibly taken from them, and how much they and their children and their children's children and their children's children's children's children's grandchildren will be paying for this unique privilege for the foreseeable forever. And of course, we must also make sure that everyone who is made furious by this knows just exactly who to blame for all of it, and what they can do about it.

My goal with this game of brinkmanship is not to stop a piece of legislation. It is not to just take back the House or the Senate or even both.

My goal is to break the back of socialism in this country for this century and even longer by breaking the Democratic Party. I want the backlash against the Democrats to be so huge and pervasive that the conservative and the moderate members of the party have to bail out of the party to try to save their political hides (though such will likely be a futile maneuver). I want the Democratic Party to become so unpopular that it will be left representing only the 15-20% lunatic leftist fringe in this country who have taken control of the current party and have set it on this path of destruction. I want the word 'Democrat' to properly assume the pejorative connotation that 'Communist' now enjoys (since they have become basically synonyms anyway). The rest of us, the majority, can then go ahead with fixing all the things that these Communist-Democrats have screwed up, starting with repealing all the legislation that was used to engender the flames of fury that were used to break the Democrats.

But don't think for a moment that the proper alternative to the Democrats are the Republicans. For most of the last 20 years or longer, the Republicans have been just as bad as the Democrats, only not quite so much. Just who will be the alternative I cannot at this time say, but I think we may be living in historic times in which we will see the birth of a new and long-lasting political party, something that has not happened in over 170 years.

I am not alone in thinking that the seeds of anger at the destruction of American liberty have been sewn, are growing, and have a chance at coming to fruition in order to save the system that our Founding Fathers created more than 22 decades ago. And the only way this will happen is if the anger that is building is not dissipated by something like the defeat of this or that bill, or the apparent rebirth of Republican 'conservatism'. It is going to take a lot to push the American people to finally go through with the oft-expressed plan to "throw all the bums out", but since that is what is required for the salvation of American liberty, and by extension, liberty throughout the world, the great risk of such political brinkmanship is necessary.

If you want to understand a little bit more about one (in my opinion, fairly astute) person's analysis of the Tea Party movement and what it is really all about, read "Obama’s Atomic Bomb:The Ideological Clarity of the Democratic Agenda" by John David Lewis at The Objective Standard. It's a long essay but well worth the read. For a detailed look at what the Founding Fathers created for us and what we are allowing the socialist-statists to cast asunder, read The 5000 Year Leap: A Miracle That Changed the World. This book is not sub-sub-titled Principles of Freedom 101 for nothing. If you can read this book and not be absolutely furious (or even a little bit postal) about what is going on in Washington not just now but for most of the past 100 years, then you have no conception of what America is really all about.

Cross-posted at Redstate.com

Baffled By Their Own Minds

2009-11-20T00:17:00.003-06:00

This is just too precious to pass up.

In an article entitled "Climatologists Baffled by Global Warming Time-Out", Spiegel Online International reports that climatologists are puzzled as to why global temperatures have not been rising over the last ten years. With climate centers (staffed by those that long ago ingested the AGW koolaid) around the world reaching the same conclusion, that the average global temperature increase over the last decade is exactly zero degrees, even leading experts are now saying things like "We don't really know why this stagnation is taking place at this point." (Very soon they will be forced to admit that they don't really know what is going on, period, and that that is why they made their ridiculous predictions in the first place.)

But even with the documented global temperature change standing indisputably at zero, there are those that still think the planet continues to warm. There is a reason I have in the past and continue now to refer to these people as zealots.

Some of these mental giants are even now publicly admitting that no one can really predict what the climate will be like in even 5 0r 6 years, much less 50 or 100 years, because of the "natural factors" that are involved. Natural factors like the ocean currents, volcanoes, and the sun itself. Exactly what we deniers and critics have been trying to tell these geniuses all along.

The article even states: "The fact is that the sun is weakening slightly. Its radiation activity is currently at a minimum, as evidenced by the small number of sunspots on its surface. According to calculations made by a group of NASA scientists... this reduced solar activity is the most important cause of stagnating global warming." Allow me just one moment to speak off the record: No shit, Sherlock! The sun is the energy source for everything that goes on on this planet, which automatically makes it the most important cause for any climate change, and you guys are just now figuring this out???

But do you think that this will change what they intend to do at the United Nations Climate Change Conference in Copenhagen next month? Not on your life.

A Chill Wind Blows From Copenhagen

2009-10-25T04:01:00.002-05:00

An international conference is set to begin in Copenhagen in December of this year, regarding the United Nations Climate Change Treaty, scheduled to be signed in Copenhagen. Lord Christopher Monckton, the noted AGW skeptic who has repeatedly and so-far unsuccessfully challenged Al Gore to a climate change debate, spoke recently about this meeting and this treaty, and what he had to say was chilling. The following link is to the blog Global Climate Scan, and I thank them for posting this:

http://www.globalclimatescam.com/?p=572

The video is only about 4 minutes long and I encourage you to listen to it.

Lord Monckton is concerned that this treaty will create a "world government" that will serve to redistribute wealth from the richer, developed nations to the poorer, less developed ones. It also will supersede our own Constitution, according to his interpretation of Article VI, paragraph 2. This interpretation, unfortunately, is shared by other constitutional scholars and by many judges, and there are judicial precedents establishing the fact that treaties can override state and Federal laws and even the Constitution itself. (See this discussion of the failed Bricker amendment from the 1950's.)

I have skimmed the draft copy of the treaty linked by Global Climate Scam. The treaty establishes a set of international goals and obligations, among which is the diminishment of CO2 production by the developed nations and the provision of funds to the less developed nations to develop energy sources that are CO2 friendly as well as provision of funds to help the less developed nations with adaptation to the adverse effects of "climate change", as these less developed nations will likely be the ones most seriously affected by the predicted effects of such "change".

The word "government" is used in the sense of setting up a governance system to control the vast bureaucracies overseeing the large number of carbon mitigation programs, compliance programs, financial funds for various projects, and adaptation processes called for in the treaty. There is no call for anything that one would recognize as a government, with bodies like a legislature, judiciary and the like. Rather there is the "Conference of the Parties", a reference to a committee to be made up by representatives of the signatories to the treaty.

This webwork of bureaucracies and what-not, controlled by the Conference of the Parties, would have under their thumbs a vast portion of the economies of the world. It wouldn't be a complete world government, but it would be a governing structure over a significant portion of the world's economies and thus its peoples. And it would not be directly responsive to any elected body or body of electors. A democracy this isn't; it isn't even close to a democratic republic. But it sounds like it could easily become a demagogic oligarchy.

The draft treaty is 181 pages of scintillating prose --not! It is mind numbing. As a document to establish a government, it is not anywhere near as inspiring as our Constitution, and certainly not as brief. It is also full of placeholders and alternate clauses and even alternate goal levels, which I'm sure are thing that are intended to be finally determined during the meeting in Copenhagen in December. But the overall framework is easy to see (if you don't fall asleep too often while reading it). Let's look at some of the more memorable passages.

Any lack of full scientific certainty should not be used as a reason to postpone or scale down action on adaptation.

Acknowledging that current atmospheric concentrations are principally the result of historical emissions of greenhouse gases, the most significant share of which has originated in developed countries.

Further acknowledging that developed countries have a historical responsibility for their disproportionate contribution to the causes and consequences of climate change, reflecting their disproportionate historical use of a shared global carbon space since 1850 as well as their proposed continuing disproportionate use of the remaining global carbon space.

Warming of the climate system, as a consequence of human activity, is unequivocal.

These are just a few examples of the heavy-handedness of this document. In actuality, the document is separated into sections, and each section has a preamble of sorts in which these ideas are repeated with only minor modifications in the wording. 'Climate change is real, dammit! Man is responsible! And especially those evil developed countries!'

So what are the developed nations to do? A lot, actually. This is a treaty to reduce CO2 levels, and it sets out these goals ad infinitum, but without getting into technical details. If they did that, they'd need to talk to the engineers and the real scientists, who would tell them they have their craniums firmly placed up their rectums, that what they're planning isn't possible. But let's not let technical possibility get in the way of feel-good notions.

For this purpose, Parties shall collectively reduce global emissions by at least 45 per cent from 1990 levels by 2020 and by at least 95 per cent from 1990 levels by 2050.

The long-term global goal for emission reductions should be set as a statistically robust ceiling for the average global temperature increase strictly attributable to anthropogenic interference having a global effect, of [x] degrees Centigrade above mid-19th century levels, with per capita accumulative emission convergence between all Parties.

By global emissions they mean CO2. If we have to reduce CO2 emissions to 95% of 1990 levels by 2050, can we do this and still let all 400+ million (by that time) of us breathe? If not, who gets to exhale and who doesn't? Or will we do it on an odd-even day rotation based on birthdates? And when they set that temperature target of x degrees Celsius (come on guys, get with it -- Centigrade was disposed of a couple of decades ago) above mid-19th century levels, I hope they remember that there was a mini-Ice Age just ending in the mid-19th century.

Guess who gets to pay for all this, by the way? If you guessed the developed countries, you win! Now take a look at your prize. These are just at few of the proposals that are offered in the treaty, and I wouldn't be surprised it they decided to use all of them.

An assessed contribution from developed country Parties based on the principles of equity, common but differentiated responsibilities, respective capabilities, GDP, GDP per capita, the polluter pays principle historical responsibility of Annex I Parties, historical climate debt, including adaptation debt, amounting to [[0.5–1][0.8][2] per cent of gross national product] at least [0.5–1 per cent of GDP]].

Assessed contributions [of at least 0.7% of the annual GDP of developed country Parties] [from developed country Parties and other developed Parties included in Annex II to the Convention] [taking into account historical contribution to concentrations of greenhouse gases in the atmosphere]

By 2020 the scale of financial flows to support adaptation in developing countries must be [at least USD 67 billion] [in the range of USD 70–140 billion] per year. [Sources of new and additional financial support for adaptation [must meet the full agreed incremental costs of adaptation and initially be within a minimum range of USD 50–86 billion per annum and regularly updated in the light of new emerging science, financial estimates and the degree of emission reductions achieved.]

A uniform global levy of USD 2 per tonne of CO2 for all countries with per capita emissions higher than [1.5][2.0] tonnes of CO2; the LDCs shall be exempt.

A [global] levy of 2 per cent on international financial market [monetary] transactions to Annex I Parties.

Agreed penalties or fines on non-compliance of developed country Parties with their commitments to reduce emissions and provide support in the form of financial resources, technology transfer and capacity-building.

Limited/reduced time patents on climate friendly technologies.

Those first three look like they are the same thing, and they are. But they are mentioned in the funding process of different parts of the treaty, so I would assume that we are talking about national levies of anywhere from 2-3.5% of GDP, plus hundreds of billions more. The US GDP in 2008 was 14.4 trillion dollars, so 2-3.5% of that would be in the range of 280-500 billion dollars. If I'm wrong and the maximum is only 0.8% of GDP that would still be 115 billion dollars. Per year.

Calculate your carbon footprint! Mine is at least 18 tons of CO2 per year. I was disappointed. I thought it would be bigger than that. My business activities aren't included, however, which is why I said at least 18 tons. Take your number and multiply it by $2. That's your share of the United States' carbon levy. Do you think the USA will pay this for you? Or do you imagine that it will be added on as a line on your 1040?

The limitations on patents is designed to facilitate (read steal) CO2 reduction and energy efficiency technologies so that they can be given to less developed nations to exploit. And of course there would be provisions to fine countries who aren't following the rules.

But what do the less developed countries get to do? They're exempt from the CO2 levy, they (supposedly; think China) don't have CO2 emissions to reduce. So what is their responsibility under this treaty?

Recalling that economic and social development and poverty eradication are the first and overriding priorities of the developing countries.

So why do these nations get this Get-Out-of-Jail-Free card?

Recognizing that the right to development is a basic human right that is undeprivable.

Funny, I don't remember seeing that one in our Constitution. Our Constitution only guarantees us liberty with which we have the freedom to develop through our own efforts, but not on the backs of anyone else. But I forget that this is being written by the refugees from the discredited global communism movement.

The good news is that none of this nonsense applies to any nation sensible enough to tell these idiots where they can put their freaking treaty. But our President is Barack Obama, and our Senate is dominated by whacked-out weirdo liberal Democrats.

We have been worried about "health care reform" and the Cap and Tax scheme. This lunacy tops them all. We all must do everything in our power to fight this. And we only have a couple of months to do it in.

Blog Action Day 10-15-2009 --- Climate Change, or AGW Twists in the Wind

2009-10-15T00:03:00.004-05:00

Blog Action Day #3 is now upon us, and the operators of the movement have chosen, supposedly by a user vote, climate change as the topic for this year. (This did not get my vote.) Though my views on this will not surprise any regular readers (you are out there, aren't you?), I will soldier on. Let's see now -- year 1 was the environment, year 2 was poverty, and now we have climate change. I'm beginning to think that this movement is being run by a bunch of leftists.......

The AGW proponents are running for cover. The cover, in this instance, is by renaming their pet theory climate change as opposed to anthropogenic global warming. The reasons are fairly obvious. First, climate change is shorter, easier to remember and easier to spell, and the supporters of this poor idea certainly have little enough gray matter to spare on such trivial concerns. Second, as the underpinnings of their original theory, that the Earth is rolling up an exponential temperature curve, is giving way beneath them as the planet has been cooling off over the past decade, they can no longer decry the crisis of global warming and not get ridiculed. Third, calling it climate change gives them the ability to claim that they were correct no matter which way the thermometer moves.

That third point so amply demonstrates the absolute bankruptcy of their position ('no matter what happens, we're right, and we all have to do as we say to make things better') that I really don't have to go any further in discrediting them. However, as I am a firm believer in the flogging of dead horses and the blistering incineration of willful ignorance, I shall go on.

To begin, we'll start with recent headlines. Bloomberg News reports: U.S. Northeast May Have Coldest Winter in a Decade. From KTVB.com in Idaho: Quick Cold Snap Fills Up Homeless Shelters -- Boise, ID is already having sub-freezing temperatures before October 1. In Daytona Beach, FL the record low of 58 degrees F was tied on October 1, 17 days early compared to average. Port Huron, MI broke a 74 year old low temperature record on the same date. Both Montana and Idaho are also breaking cold temperature records already this early in the year. Even Pennsylvania is being forecast to have a "possibly damaging early-season snow" at the end of this week.

Game 3 of the MLB National League Division playoff between the Colorado Rockies and the Philadelphia Phillies, scheduled to be played in Denver on October 10, had to be postponed because of bitter cold, sleet and snow. The temperature dipped to 17 degrees F, easily breaking the 104 year old record of 25 degrees set in 1905.

Yes, this is climate change -- changing back to what is normal from more than a decade of abnormally warm temperatures. But since the CO2 levels are not dropping, why are temperatures decreasing? Because the temperature increases had nothing to do with the increased CO2 levels in the first place. (More on this below.)

Two prominent meteorologists have recently gone public in a big way regarding their opposition to the theory of AGW.

Matt Rogers of The Washington Post's Capitol Weather Gang blog a Top Ten list of why he questions the 'consensus' view of AGW. Among these are many items I have covered in previous posts, such as the lack of warming over the last 10 years despite continued increases in CO2 levels, the inadequacies of the AGW computer models (which he believes "are over-estimating anthropogenic (human) forcing influences and under-estimating natural variability (like the current cold-phase Pacific Decadal Oscillation and solar cycles)", and the recent lowering of solar irradiance as indicated by the profound lack of sunspots recently. He adds in a few new wrinkles, like the effect of chaos theory making long-term predictions extraordinarily problematic. And like a true scientist, he complains about the vehement way that any dissenters from the AGW dogma are treated.

Joe Bastardi, Expert Senior Forecaster at AccuWeather and considered to be one of the premier meteorologists in the country, was on The O'Reilly Factor in late September showing several pieces of hard evidence debunking the AGW theory, primarily by revealing that real-world data are contrary to what the AGW computer models say they should be. (The video of that appearance is at the bottom of the page of that link.) In a followup statement posted as an open letter to AccuWeather.com readers, he went on to say:

Unlike many people, I am well acquainted and respect the co2 warming idea, but in its pure form, which actually allows for the cooling coming now! Therein lies the problem. We can't know till after the period that is coming up through 2030 whether co2 is really a player or not. The threat of not only oceanic cycles cooling the earth, but the suns lack of intensity and increased volcanic and seismic activity could mean that as some papers in the early 90s (and dismissed by many) opined we would be as cold as back in the early 1800s. What you see now may just be the beginning. One thing we do know, that we should be skeptical of any future event, no matter what we believe.

I will leave you with this. Common sense dictates that a trace gas needed for life on the planet would not be the cause for destroying life on the planet. Common sense dictates that what has happened before without man can happen again with man. Common sense would dictate that you not believe me, or any one else, but go look for YOURSELF. If its important enough for you to be happy with what I said, or to be mad as all get out at what I said, you owe it to yourself to go read all sides of the argument. To be informed, and not to simply throw stones.

The response of the AGW zealots was what one would expect from zealots. They resorted to name-calling ("Deniers!"), questioning of the intelligence and credentials of the critics, and continued pronouncements that the science is settled without engaging in any kind of reasoned debate. In other words, they simply threw stones. Or they simply refuse to defend their own views against reasoned criticisms:

In what organizers said was a rarity, Gore took half a dozen questions from journalists, including one from Phelim McAleer, an Irish filmmaker who asked Gore to address nine errors in his film identified by a British court in 2007.

Gore responded that the court ruling supported the showing of his film in British schools. When McAleer tried to debate further, his microphone was cut off by the moderators.

The BBC asks "What Happened to Global Warming?" They go on to elaborate that the predicted warming hasn't happened and then to discuss why. They mention solar scientist Piers Corbyn who "claims that solar charged particles impact us far more than is currently accepted, so much so he says that they are almost entirely responsible for what happens to global temperatures. He is so excited by what he has discovered that he plans to tell the international scientific community at a conference in London at the end of the month." (I wish I could hear more about this now!) Next they mention Professor Don Easterbrook from Western Washington University, who believes that ocean cycles, particularly the Pacific Decadal Oscillation, are responsible for most of the temperature changes that we have observed so far and what we will see in the future. Says Professor Easterbrook:

The PDO cool mode has replaced the warm mode in the Pacific Ocean, virtually assuring us of about 30 years of global cooling.

From down-under New Zealand/Australia way comes a study by Chris de Freitas (University of Auckland in New Zealand), John McLean (Melbourne) and Bob Carter (James Cook University) which states that “little or none of the late 20th century global warming and cooling can be attributed to human activity". It is discussed in more non-climatologist language here. The gist of the study is that a shift in the climate in the Pacific Ocean in 1976 altered El Niño and La Niña patterns, resulting in more warming El Niños and fewer cooling La Niñas, thus producing the changes in the observed global temperatures over the last 50 years. This phenomenon of alternating El Niños and La Niñas, called ENSO [El Niño-Southern Oscillation], has been occurring with varying intensities for at least 300 years (see the section on Cultural History and Pre-historic Information), so it seems unlikely that it is being caused solely by the current increase in atmospheric CO2 levels, though scientists continue to debate what actually does cause the phenomenon.

The effects of El Niño and La Niña are well known to even laymen and the two year study has concluded that ENSO is directly related to global temperature rises in recent decades. The authors have been able to directly correlate the past 50 years of average global temperatures with ENSO cycles. Temperatures were found to have lagged ENSO events by approximately seven months consistently. De Freitas said, “We have shown that internal global climate-system variability accounts for at least 80% of the observed global climate variation over the past half-century.”

Our Southern Hemisphere neighbors also criticize the current state of computer climate models, stating:

Co-author McLean drew attention to the fact that current climate models cannot even accurately reproduce known temperature changes. Previous studies have shown that the climate models used by the Intergovernmental Panel on Climate Change (IPCC) fall outside acceptable scientific boundaries. McLean said, “When climate models failed to retrospectively produce the temperatures since 1950 the modelers added some estimated influences of carbon dioxide to make up the shortfall.”

They further conclude:

If ENSO is indeed responsible for 80% of global temperature changes, manmade contributions to global warming would appear to be highly insignificant, much like a growing chorus of scientists have been claiming for some time. Australia, much like the United States, is considering cap and trade legislation that would attempt to limit carbon dioxide (CO2) emissions by forcing businesses to buy credits for their emissions.

Concerns about the cost to consumers and the negligible effect it would have has the measure stalled in the United States Senate for the time being. Carter specifically addressed carbon trading schemes saying “No scientific justification exists for emissions regulation, and that, irrespective of the severity of the cuts proposed, ETS (emission trading scheme) will exert no measurable effect on future climate."

So what are the geniuses in the U.S. Senate up to? Why, proposing an emission trading scheme, of course! And that particular genius-who-would've-been-President John Kerry said this:

I don't know what 'cap and trade' means. I don't think the average American does. This is not a cap-and-trade bill, it's a pollution reduction bill.

Willful ignorance, Mr. Kerry, willful ignorance. Sure, you don't know what cap and trade means. Because you know it's really a hidden tax, and one of the biggest taxes the Congress has ever considered. So you want to call it a pollution reduction bill, thinking that might hide its true nature. Sorry, Senator, the American people are smarter than that.

Climate change, indeed!

The only climate change we need right now is one where the scientific process once again supersedes ideological dogma, and that scientists are free to announce their findings without ending up in the hot seat. Unfortunately, it seems like it will be a cold day in Hell before that happens anytime soon.

Senate Committee Passes Baucus Bill

2009-10-13T23:48:00.000-05:00

The Senate Finance Committee today passed a "health care" reform bill, commonly referred to as the Baucus Bill, along straight party-line votes. (Yes, I know that Olympia Snowe voted for the bill, but as she is only nominally a Republican, my comment stands correct as far as I'm concerned.)

I haven't said much about this bill so far. This is mainly because it's hard to comment on a bill that isn't technically written yet, even after it has been voted on. Who knows what will be in the bill when a paper version of it finally shows up? From what little concrete information I have heard about it, it sounds like a pot pourri bill -- let's throw a little bit of everything into a pot and stir it up and see what we get! Unfortunately, since most of what was thrown in the pot was old, worn out, rancid, decaying, or just plain rotten, what they got was something that just smells bad. I've also refrained from paying much attention to this bill as I realize it is simply a starting point for debate, and that the final bill that will ooze out of the Senate to the House-Senate Conference Committee will likely bear little resemblance to the Baucus Bill but will rather be quite like the odious monster that is H.R. 3200.

National Review Online has two good articles currently regarding the current debate.

The first is entitled Obamacare Dissected: Ten things that probably will be in the health-care bill (but shouldn’t), written by Stephen Spruiell. It discusses ten of the more major flaws in the proposals currently being debated (all collectively being referred to as Obamacare, as a convenient shorthand). I'm sure that Mr. Spruiell could write a sequel tomorrow with ten more problems that would be just as critical.

The second is called Real Health-Care Reform: Ten things that ought to be in the health-care bill (but probably won’t), written by Kevin Williamson. Mr. Williamson takes the opposite tack, listing those things we need in a "health care" reform bill but which the Left won't allow or even consider. The first few paragraphs of this article constitute one of the best and easiest-to-understand arguments for why a free-market approach to "health care" reform would be superior that I have ever seen. Wish I'd written it! I do, however, have to laugh when in point# 7 he mentions "the AMA's cartel status" (a cartel that only controls 17% of the market ain't much of a cartel) and "an AMA-certified physician" -- where did this idea that the AMA certifies anything come from? For God's sake, the AMA is a professional association -- it's more like a fancy club than anything else. It has no regulatory authority, and never has had any. And regarding his point #9, Texas Congressman Louie Gohmert has already introduced legislation to try to get this to happen, though that bill won't go anywhere in the current Congress.

Both of these articles are must-reads. So go read them now.

While your there, read this article as well. It has nothing to do with health care, but everything to do with where we are as a country right now, and exactly in how much of the wrong direction we are heading.

Another Potential Casualty of ObamaCare -- Nobel Prizes

2009-10-05T23:55:00.001-05:00

Three Americans were awarded the Nobel Prize in Medicine today for their work in discovering the mechanism of how chromosomes protect themselves from degrading when cells divide.

Aaron Gee at American Thinker (be sure to read the comments!) makes some very interesting observations regarding how President Obama's proposed 'health care' reforms will jeopardize the winning of future Nobel Prizes by Americans. His basic point is that we are winning the preponderance of the Nobels for medicine because so much medical research is done here. And so much medical research is done here precisely because the profit margins of the private marketplace for new medical innovations provide both the motivations and the capital with which this research can be done.

I loved his statement of the fact that "The top 10 U.S. hospitals that conduct clinical trials carry out more trials than all the hospitals in the rest of the world - combined." That gives you an idea of just how far ahead of the rest of the world we are in this regard -- the rest of the world here meaning, for all practical purposes, Europe. (Once you exclude Japan, Israel, and probably Australia, the remainder of the non-European world contributes little to this field.)

So why is Europe so far behind? Gee says it's because "No other country has a working structure that has as much potential for medical research as the US." But the main reason for this is European price controls on the products (drugs, devices, and the like) of that research. It is these price controls that make the European 'health care' systems appear to be so much less expensive than ours. However, one can now see that there is a very substantial hidden cost (to Europe) for being so penny-wise and pound-foolish. (And if you think about it, that expression, referring to pennies and [British] pounds [sterling], coming as it does from England, is just so doubly ironic.)

Gee concludes saying, "The other symptom of a broken marketplace you should expect is fewer US Nobel Laureates in the field of Medicine." But it's what that portends that is more ominous. Not just fewer accolades from Stockholm. Obama's desire for the US to have a more European-style medical care system will mean we'll also have a more European-style medical research system.

By taking away the profit system that funds the research machine of the United States, the advancement of medical innovation will slow to a virtual standstill. No new medicines, no new technologies, no new surgeries will be forthcoming. The continuous increase in life expectancy we have come to expect will come to a grinding halt and may start moving backwards as the waiting lines and rationing this plan must result in leads to delays in and even prevention of life saving care.

How do I know that this is part of the actual goal of the reform plan? Because one of its main developers, Obama 'health care' advisor Tom Daschle, said so much in his book, Critical: What We Can Do About the Health-Care Crisis. As explained in the book, one of the goals is to slow the development and use of new medications and technologies because they are driving up costs.

Mr. Daschle and Mr. Obama have absolutely no conception of what price they are going to make all of us pay for their "cost-savings".

But Aaron Gee does. And now so do you.

Why 'Health Care' Reform Cannot Work

2009-08-30T01:06:00.005-05:00

I have for several months now been referring to the current national debate as a 'health care' reform debate --using quotation marks around the words health care. Though I have made oblique references as to why I am doing this, it is time now to explain why.

But first you have to take a little trip with me.

That trip is one in both time and space. The time is June 2009. The place is Nashville, Tennessee.

One of the hospitals in my community is in the multi-year process of installing a fully-electronic health information system, with the ultimate goal of becoming as paperless of a hospital as a hospital can be. And they embarked on this path even before the HITECH Act was even thought of, much less passed. The time had come in this process to start gearing up for the conversion to computerized physician order entry, or CPOE. As part of that endeavor, the computer vendor sent a delegation from the hospital to a seminar at Vanderbilt University. This seminar involved more than just how to set up CPOE; it involved the why of CPOE and how to start thinking in a CPOE way. As a member of the information technology advisory council, I was a member of this delegation. In fact, I had to finagle my way onto the trip, as I was not one of the physicians originally chosen to go.

(As an aside, let me say that this seminar was one of the most innovative, exciting, thought-provoking conferences that I have ever had the good fortune to attend. I don't want to mention the name of the software vendor involved, but if you, dear reader, ever get a chance to go to this seminar [if you get involved with this company, you will hear of this seminar as it's an important part of booting up their CPOE], fight, scrape, and claw your way onto the trip. It's worth it.)

At this conference, one of the 'why' lectures was being given by one of the first people to start seriously thinking about the need for computers in medicine. The basic gist of the talk was that, due to the increasing depth of medical knowledge and medical technology, the number of pieces of information necessary to make a rational medical decision is increasing. And it is increasing at a rapid pace; so rapid, in fact, that within 5 to 10 years, the number will exceed the ability of the human brain to hold all that information and do anything with it. And it will still keep on increasing with no end in sight. So we will need computers to keep track of all that information and organize it in a way that our brains can make sense of it.

While the professor was lecturing, one of his associates was writing on a huge mark-sense board behind him. Ostensibly he was charting the important points, but about half of what he wrote on the board was only peripherally related to the talk at hand. The following is a near-direct quote of one of these peripherally related comments:

The U.S. spends $3k-$4K more per capita on our health care than France does. We have the best rescue care system in the world, but we are no better at treating chronic disease than is France.

I read this, and then I read it again and again. It wasn't just a light bulb that went off in my head -- it was a full-blown supernova. I even lost track of the lecture for a few moments. In that moment, with that statement, the true nature of the national debate became apparent. And it also became apparent that 'health care' reform was doomed to fail, could not work, cannot work, will never work, no matter whose plan is implemented or who implements it or how much money we do or do not spend doing it.

That's because we do not have a health care system. We never have had one. Since you cannot 'reform' something that doesn't exist, it follows that any such 'reform plan cannot work.

The statement above crystallized my thoughts on this matter in a blinding flash, but obviously my subconscious had been processing its way toward this conclusion for a long time. Otherwise I wouldn't have had such a sudden epiphany. For those whose subconscious is not as postally twisted as mine, let me explain.

The obvious point of the statement written on that wall was that we are spending more money on our 'health care' and not getting anything for it -- "we are no better at treating chronic disease than is France". But I chose to look not at the money but at the outcomes -- not "The US spends $3K to $4K more per capita than France does", but "We have the best rescue care system in the world..."

I'm sure that when most people hear the phrase 'rescue care system', the first thing that comes to mind is paramedics, fireman, ambulances, the Jaws of Life, and the like. But that's not what's being referenced here by 'rescue care'. What rescue care means here is 'emergency care' or 'acute care' -- what happens after you get to the hospital or emergency room.

Despite what you hear in the news (from the liberal press doing everything in their power to promote the programs of Dear Leader), if you have an illness in the United States, you have the best chances in the world of surviving. If you show up in the ER having a heart attack, in the throes of acute heart failure, or with a severe pneumonia, you have a better chance of surviving than anywhere else in the world. If your physician diagnoses you with cancer, your survival (in terms of percentages and duration) is better here than anywhere else. I could go on and on with examples. But none of this has anything to do with health care. It's medical care.

What's the difference? Medical care is what gets you over that acute MI, CHF, pneumonia, or cancer. It's the care provided by physicians and surgeons based on a tradition of treating acute medical problems that dates back more than two thousand years, to well before the time of Hippocrates. It's treatment based on anecdotal and then scientific observations of medical illnesses and treatments performed during those two thousand-plus years. It's the application of chemicals and fluids and electromagnetic radiation and invasive interventions to find the cause of a deranged physiological process and correct it.

Health care is none of these things. Health care does not involve fixing a deranged physiology. It involves maintaining a normal or optimal physiology for as long a time as possible. This rarely involves chemicals (other than vitamins), radiation, or invasive interventions. It does involve diet, exercise, avoidance of unsafe activities and toxic agents such as illicit drugs and excessive alcohol, the use of proper safety equipment, and the like. These are not the things that physicians and surgeons do. They are the things that each and every one of us should be individually doing but most of us do not, or do not do well.

Physicians and hospitals and home health nurses and physical therapists provide 'rescue' care -- medical care, not 'health' care. We have a medical care system, not a 'health care' system. This country doesn't have a health care system and has never had one! So there's no way we can reform it.

Trying to 'reform' the medical care system to try to be simultaneously a health care system will not improve health, as the medical care system and the people who work in it have no real training in it (such is not part of the system's two millenia-long tradition), and it will degrade the quality of the medical care system we have now, as these people cannot do that job and a second even more difficult one and not have the first job suffer.

It might be to the benefit of our nation to create a new system to encourage, support, cajole and reward health care. Exactly how to do this is beyond me; recall I am a physician and a member of the medical care system. Shoehorning it into the medical care system is a bad idea and is unlikely to work. And it's going to have to be a system that works at an individual level, as that problem starts at the level of the individual.

Let's reword the statement that was written on that wall in Nashville:

France spends $3K-$4K less per capita on health care than the U.S. does. France is no better at treating chronic disease than is the U.S., and its rescue care system is not as good.

When you look at it that way, France doesn't look that good any more, does it? You could replace France in that statement with any other country in the world and it would be just as true.

But look at both statements. France spends less and the U.S. spends more, and neither country is better at treating chronic disease (most of which is caused by poor health care choices) than the other. This tells you that spending more or less money is not the root of the problem. And it tells you one other thing.

France doesn't have a health care system either.

A Legacy We Can Live Without

2009-08-29T21:54:00.002-05:00

The forces of the left are now trying to argue that Senator Edward Kennedy's death is another, new, powerful reason that we must pass H.R. 3200 (or something like it) as a tribute to the "great Senator", or as his last great legacy, or something else equally foolish. They even want to rename the bill in his honor (something that I expected to actually happen before his death and am surprised that it didn't happen).

If H.R. 3200 (or any other similar Democratic version of 'health care' reform) is to be Senator Kennedy's legacy, then it needs to be a legacy that goes to the grave with him.

John Donne said, "No man is an island, entire of itself...any man's death diminishes me, because I am involved in mankind..." I will not debate this philosophy, but if Senator Kennedy's death diminishes me, I am having a hard time seeing exactly how. I will lament the death of a fellow human being, but at the same time I will rejoice in his personal and permanent absence from the U.S. Senate, which should have happened long ago. America can sleep sounder since Thursday night, for she is safer now. "The Lion of the Senate" -- give me a break.

I also have a hard time understanding, much less accepting, why Kennedy's death makes a hill of beans difference in the fundamental arguments and problems that the majority of Americans have with this reform plan. Mr. Kennedy was in the Senate for nearly 46 years. If he didn't manage to make his 'legacy' in that length of time, then I propose that he wasn't effective enough to deserve having this travesty being passed as a tribute to him.

The last time the US passed legislation as a tribute to the legacy of a deceased Kennedy, we got the Civil Rights Act (good) and the Medicare Act (bad, as it has led us to where we are today). That's 50-50 odds on the outcome of passing H.R. 3200, and since this is a health care bill, the past presents an ominous omen for the future.

Let us ridicule the notion of passing this 'tribute' or 'legacy' at each and every opportunity. And let's certainly not pass another piece of crappy legislation to honor a political dynasty that rightfully should have been a relic of history by now.

If we want to pay tribute to the man, let's rename a bridge for him. I hear there's one near Chappaquiddick that's quite appropriate. Though it probably ought to be named after someone else.

The True Face of Liberalism

2009-08-22T01:05:00.003-05:00

If you did not see On the Record with Greta van Susteren on Fox News on the evening of August 20, 2009, you missed something very special. On that program, the true face of liberalism showed itself.

Fortunately, in this age of the Internet and YouTube, you have a chance to see it. Here it is, preserved for all posterity, or at least until either YouTube goes away or the Fox News lawyers have their say.

The setting is a debate about the recent comments by Whole Foods Market, Inc. CEO John Mackey's recent editorial in the Wall Street Journal regarding his opposition to President Obama's medical care reform bill.

While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead we should be trying to achieve reforms by moving in the opposite direction -- toward less government control and more individual empowerment....

Many promoters of health-care reform believe that people have an intrinsic ethical right to health care -- to equal access to doctors, medicines, and hospitals..... A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food, or shelter. That's because there isn't any. This "right" has never existed in America.

Mr. Mackey also explains how such a right does not exist in any other country either, especially in those countries with government-controlled medical care systems, where governmental restrictions actually block individuals from exercising their actual right to seek the treatments that they desire. He continues with a short (and correct) assessment regarding the current state of affairs in the United States where the vast majority of our medical problems are the result of self-inflicted unhealthy lifestyle choices; in other words, our illnesses are in large part because each of us is not owning up to the responsibility to live in a more healthy manner.

Sounds like my kind of guy. Goes right along with what I have been saying for years. If there was a Whole Foods Market near me (there isn't), I might have to start shopping there just to support his views. (Though I doubt I'd ever get past the fact that I could get essentially the same merchandise much cheaper at Walmart.)

Mr. Mackey does not just criticize the President's plan. He lays out succinctly
eight reforms that would dramatically improve the ability of everyone to have better access to medical care. I not only do not disagree with any of these eight reforms -- I would wholeheartedly endorse all of them. The problem, as it were, with these ideas is that they fly in the face of the whole socialist concept of taking over the 'healthcare' industry. And Greta van Susteren was able to find someone who could not prevent the true face of liberalism from showing.

Fox News has a transcript of this encounter on Greta's show if you'd like to read it. But the video is so much more revealing, as it is the attitude and emotions of the liberal opposition to Mr. Mackey that is impressive. This gentleman's (and I use that term loosely) name is Russell Mokhiber, and I want you to pay attention to his voice and his facial expressions. Listen to the venom in his voice; look at the sneer and the scowl on his face; note that he does not smile nor even come close to smiling during this entire segment. He gets into a shouting match with Greta over this issue. And why? Simply because Mr. Mackey's editorial dares to oppose his and the liberals' ideal solution of the government controlled single payer system.

Mr. Mokhiber is the epitome, the classic example of the face of liberalism, driven by anger, seeing no joy in anything, being opposed vehemently to anything that deviates even slightly from what liberalism demands, loudly and angrily shouting down any voice of dissenting opinion.

Amazingly, Greta even calls him on this, chiding him that his only issue is that Mr. Mackey disagrees with him, and criticizing him for not seeing the good Mr. Mackey has done for his employees and the fact that he made concrete proposals for reform and was not calling for the maintenance of the status quo. (This is amazing because Greta van Susteren is a registered Democrat, but is apparently one of the few Democrats willing to give consideration to the other side of an argument.) Mr. Mokhiber gives Mr. Mackey no credit for Greta's points, as Mr. Mackey's 'heresy' cannot be tolerated.

I will take issue with Mr. Mokhiber on a couple of other issues.

He states that "the majority of doctors" now see single payer as the "only way" to fix the system. His debate opponent, Crystal Jones, says, "That's false. I want to see a source for that." I'm with her. Don't make that kind of assertion without hard evidence. I haven't yet run into any other doctor who is anything less than scared spitless about what ObamaCare is going to do to us.

Mr. Mokhiber also states:

...and 60 Americans are dying every day because of lack of health insurance -- when you cross over into Canada and that number is zero....

Is this the same Canada that Mr. Mackey reports has 830,000 people on a waiting list to be admitted to a hospital or receive treatment for their illnesses? (Though that's better than England where there are 1,800,000 people on the list.)

Now let's take on that "60 Americans are dying every day for lack of health insurance" bit. If one compares the 5-year survival rate for cancer patients in the US vs Europe, one will find some sobering statistics. In the US, 66.3% of men and 62.9% of women survive for five years, while in Europe (collectively) the rates are 47.3% for men and 55.8% for women. (Intriguingly, the rates for the UK, whose system so enthralls Obama adviser Tom Daschle, is amongst the lowest in Western Europe.)

Now, the number of people in the US who develop cancer each year is 766,130 men and 713,220 women (taken from an American Cancer Society PowerPoint presentation linked above). I won't bore you with the math, but if you apply government-controlled-healthcare-system European survival rates to the American numbers and figure out the excess mortality, that would result in 145,568 more men and 50,639 more women dying of cancer each year -- or 196,207 more American deaths, for an average of 537 deaths per day. This is 895% higher than what Mr. Mokhiber has his panties all in a wad about. And this is just taking cancer mortality into account; it doesn't consider cardiovascular disease or diabetes or any other cause of death, most of which would also increase under a European-style single-payer system.

So is it really that "60 Americans are dying every day because of lack of health insurance" that is what bothers Mr. Mokhiber? If it is, then he needs to educate himself about the reality of the situation so he'll know what to really worry about. However, I think that pointing this out to him would not alter his position, as he is using his statistic merely as a emotional debating tactic.

And that showing him data that his position would lead to more Americans dying would not change his position reveals even more clearly just how ugly the true face of liberalism really is.

Where Did Anybody Get The Idea That There Were Going To Be Death Panels?

2009-08-15T02:03:00.010-05:00

Proponents of the misguided "health care" reform bill H.R. 3200, and particularly the members of the Obama Administration, from the Big O on down, continue to play damage control in trying to get their plan back on track. However, they are not doing to well so far, as noted by the Financial Times of London. [This site's policies won't allow excerpting, so I'll just have to link and direct you to paragraphs 9-11.]

The gist of these paragraphs is that by having to utilize time and resources beating back what they see as "myths and facts" that they had planned to use to extol the 'virtues' of their plan, the Administration has lost control of the debate and losing support for their program.

The hardest blow they've taken so far is Sarah Palin's devastating designation of the coming rationing in their plan as "death panels". AJStrata at The Strata-Sphere points out just why this little two word label is so devastating -- because it is extremely accurate. I cannot excerpt enough from AJStrata's post to do it justice without being accused of plagiarism, so go to the link above right now and read it.

Okay, so for those of you to lazy to jump to the link, I'll try to summarize.

The liberals are now all up in arms because someone (i.e., Governor Sarah Palin) was finally able to label the core problem with any and all government run health care options. That label is “death panels”, and it is very appropriate and accurate, and is only marginally attached to end-of-life consultations....

Interestingly, right now the opponents of the liberals’ government run dreams of conquest don’t need to theorize or extrapolate about the possible outcomes, because the UK clearly shows us all where a government run health care ‘option’ will lead us. What they are going through now, in terms of ‘cost savings’, is what ANY government controlled health spending program for individuals will end up. And realize, this is not about consultations – it is about cost savings (aka ‘cheap healthcare’, ‘affordable health care’, ‘universal access’, etc) and how the liberal inquisitors will chose the worthy.....

It is no secret the prime intent of the government run system is to ’save money’, which everyone with two brain cells to rub together knows actually means to NOT SPEND money. They take our money and determine how not to spend it for us. Voilà! Health care cost savings.

So, how do they not spend money? AJ quotes one of President Obama's "health care" advisers, Dr. Ezekiel Emanuel, brother of White House chief of staff Rahm Emanuel, who bluntly states that all the vaunted savings from eliminating fraud and waste, using electronic medical records, improving 'quality', and increasing preventive care is all for show, since it will actually save very little money. The real cost savings comes from using the idea of “communitarianism” (not specifically defined but clearly meaning spending resources on only those whose value to the community at large is worth the expenditure) "to achieve a just allocation of scarce medical interventions". And what is just? Look at this graph:

As AJStrata concludes, "This is not rationing, this is worse. Under rationing everyone gets an equal share, but to allocate is to distribute unequally."

Under advanced triage, which is the essence of the liberal government run plans as outlined above, a panel of bureaucrats and appointed ‘experts’ decide what is a ‘just allocation’....
Yes, there is even a formal definition of what these panels do when cutting costs. They decide who lives or dies by deciding who to spend money on (see graph above). This ‘advanced triage ‘ or ‘communitarianism’ process or ’complete lives system’ is rightfully summed up as a government ‘death panel’. The liberals will try and hide its true nature under pleasant sounding words strung together to lull the poor victims to sleep, but the label ‘death panel’ makes sense. And that is why it is sticking.
Most importantly, this has NOTHING to do with end of life consultations.

As stated above, the National Health Service in England is the prime example of what happens when government decides to begin justly allocating medical resources. Hospitals delay and deny orthopedic procedures to those just a bit obese or who smoke; those over 55 cannot get coronary angioplasty stents; back pain patients can no longer get epidural steroid injections because the government has decided that it can afford only 3000 per year (in a population of over 60 million!) instead of the 60,000 per year currently being performed. Americans are bright people; they intuitively understand this, and as I said before, they are worried about who's going to be making the decisions and how can they make sure they're not going to get shafted?

The Wall Street Journal has an editorial in their August 14th edition which is subtitled, "Why the elderly are right to worry when the government rations medical care". From the outset they state:

While claims about euthanasia and "death panels" are over the top, senior fears have exposed a fundamental truth about what Mr. Obama is proposing: Namely, once health care is nationalized, or mostly nationalized, rationing care is inevitable, and those who have lived the longest will find their care the most restricted.

Far from being a scare tactic, this is a logical conclusion based on experience and common-sense.

I also like the way the WSJ addresses the idea that our current system rations by the ability to pay (an idea that Peter Singer found unacceptable, as you will recall).

Yes, the U.S. "rations" by ability to pay (though in the end no one is denied actual care). This is true of every good or service in a free economy and a world of finite resources but infinite wants. Yet no one would say we "ration" houses or gasoline because those goods are allocated by prices. The problem is that governments ration through brute force—either explicitly restricting the use of medicine or lowering payments below market rates. Both methods lead to waiting lines, lower quality, or less innovation—and usually all three.

Of course, one might argue that to use the position of Dr. Emanuel as a criticism of the Obama reform plan is misleading, as Dr. Emanuel is merely a presidential adviser and not a decision maker. What if someone else higher up actually said something like this:

"Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now." (emphasis added)

An independent group like the National Institute for Health and Clinical Excellence? Oh, wait, that's what they call the agency in England that makes all the coverage decisions like the ones I listed above. Here we're going to call it the Center for Comparative Effectiveness Research.

By the way, the quote above came from one of the decision makers. It's from an interview in the New York Times with President Barack Obama on May 3, 2009.

I agree with Tom Maguire at the blog JustOneMinute when he says in regarding the idea that these panels will just be offering 'guidance':

And how voluntary will these imagined guidelines be? Doctors that are currently free to prescribe painkillers volunteer not to, to avoid hassles from the DEA. Mightn't doctors prefer to follow the "voluntary" end-of-life guidelines rather than risk Federal examination of their taxes, expenses, hiring decisions, and payroll? That would depend in large part on how aggressively the government chose to push the "voluntary" guidelines.

Government guidelines don't stay that way very long. They have a way of quickly becoming requirements and then mandates. Sometimes, like with seatbelts, that's a good thing. But usually it's not that good, either because the idea was bad to begin with, or just due to the law of unintended consequences.

Now you can see why the Administration is battling the 'death panel' rumor so vigorously. Because it is fundamentally true. In this case, the truth will set us, the American people, free. And that's not acceptable to our dear leaders.

A Warning from the Past from the Gipper

2009-08-14T22:39:00.004-05:00

Almost 50 years ago, a B-grade movie star and TV actor made a 10 minute recording warning the American people about the coming of socialism to our great nation and how it would establish its beachhead in the guise of 'universal' medical care.

That actor would later go on to become quite possibly the greatest President of the 20th Century. His name was Ronald Reagan.

It is worth the time to listen to the whole 10 minutes of this audio recording. It is worth listening to again and again. It is worth sending the link on to everyone we know, to make it go viral 48 years after it was first recorded, to once again spread the warning of the coming of socialized medicine. Because now we are no longer trying to prevent the establishment of the beachhead. That was done long ago. Now we are trying to stop the evil of that beachhead from breaking out and destroying the country that oh so many patriots in the past have given their blood and their treasure to create and defend.

What Reagan was warning against in this message from 1961 was a bill that would ultimately be passed, in expanded form, as the Social Security Act of 1965, the legislation that created Medicare and Medicaid. And Reagan was correct. Medicare is for all intents and purposes a socialized medical care system. It isn't voluntary for senior citizens unless they are immensely wealthy. It dictates how much a doctor will earn for caring for those the system covers without regard to whether that fee covers the true cost of the care provided. The only system more socialized in this country today is the VA system -- and it is also run by the government.

Reagan's message rings even more true today than it did then -- that the beachhead of socialism would allow it to grow by gradual expansion until all of our liberties have been quietly taken from us. It rings more true today because we can see in the actions of the Obama Administration the final reach for the establishment of complete socialism.

Reagan speaks of a world in which the government, as the controller of medical care, dictates where a doctor will work, how many patients he will see, and even how much he can earn. Fortunately, this situation does not yet exist today -- in the medical care system. But look around at other parts of our economy. Hasn't this Administration dictated who the CEO of General Motors will be? Isn't the (Democratic) Congress openly discussing placing limits on how much corporate leaders of banks and other companies can earn? Is Congress not debating the creation of a medical 'reform' plan that is nothing more than a veiled way of sliding us down the slippery slope into a socialized, government-run system, exactly like Reagan was warning us about 48 years ago?

Where in our Constitution was either Congress or the President given these powers? Read the document and you will see the answer -- nowhere!

And when the leaders of government exceed the powers granted to them by the people through the Constitution, that very act starts the process of taking away our liberties.

But Reagan also tells us what we can do to stop this. At the 8:30 mark in the video, Reagan quotes 1950's Indiana Congressman Charles Halleck as saying

"When the American people want something from Congress, regardless of its political complexity, if they make their wants known, Congress does what the people want."

In other words, all it takes is for us to say "No!! Not now, not ever!!"

Reagan goes on to encourage us to contact our Congressmen "even if we believe he is on our side to begin with. Write to strengthen his hand, to give him the ability to stand before his colleagues in Congress and say 'I have heard from my constituents and this is what they want'."

This is what we must do.

It is already starting. Hundreds of people are being turned away from townhall meetings because the facilities cannot handle them. Daily on the news we see videos of ordinary people venting their frustrations at legislators who do not seem to understand that their job is to represent the views of their constituents and not to try to change the minds of those constituents. And even though the Administration and its communication department (aka "the main stream media") is doing their best to convince everyone these protests are being manufactured by various and rotating corporate and political bogeymen, the American people -- and the foreign press -- know the truth about how real this protest is.

What encourages me the most, however, is this article indicating that even now, at least one month before this plan goes to a vote, the Congressional email system is already starting to sag under the strain of the emails being sent through it, despite the use of "load balancing" technology to try to keep the system running.

Now is not the time to let up. Now is the time to pour it on. The protests and letters and videos and emails need to increase in number progressively and inexorably until after H.R. 3200 has gone down to defeat.

Let's see just how good that new load balancing system is. I'll bet we can break it.

Health Care via the Post Office Redux

2009-08-13T19:15:00.002-05:00

This is too good to pass up.

Follow the link and get ready to sing along.

A Must-Read from Sarah Palin

2009-08-13T09:48:00.002-05:00

Former Alaskan Governor Sarah Palin came out a few days ago decrying what she called "death panels" which will be authorized by H.R. 3200. Many on the hard right have been complaining about this provision, incorrectly portraying these end-of-life counseling sessions as mandatory, when the legislation does not specifically create such a mandate. (BTW, we physicians have been doing this for a long time, particularly when there has been a "change in status" of a patient's health; we just don't get specifically paid for it.)

President Obama quickly responded to her statement, addressing the non-mandatory status of these consultations. (Funny how he doesn't respond so quickly to other criticisms, just when it's from Sarah Palin.... The left must really fear her.)

Sarah Palin has countered Obama's reply, and where the President's response was a dismissive slap, Palin's reply is a hard right cross to the jaw. Go and read her new statement --THIS is how we fight this socialist takeover of the medical care industry.

There is no time to waste! Call/write/fax/email your Congressman and Senators and let them know in no uncertain terms that you want H.R. 3200 to suffer a first-term abortion. Contact them daily.

Health Care via the United States Post Office, per President Obama

2009-08-11T22:25:00.004-05:00

It's obvious that President Obama never had to make a living in sales (though that's an interesting observation about someone who makes his living selling himself in the world of politics). Otherwise he wouldn't have made the blunder he made today.

Now, we know that Mr. Obama is really pushing for a single-payer, government-controlled "health care" system. He's said so much in the past. And lest you think that his plan, being given birth in the form of H.R. 3200, is not a back door to a single payer government system, take a look at what Congressman Barney Frank had to say about this.

So why did Obama make this comparison, like he did today?:

"UPS and FedEx are doin' just fine.... It's the Post Office that's always havin' problems..."

So he compares his public option insurance plan (and thus the single-payer he's really after) to the Post Office -- that shining example of government 'efficiency' that is chronically slow, always loses money, stresses its employees such that everyone recognizes the phrase "going postal", and is now talking about having to cut back on services (i.e., rationing).

Meanwhile, everyone also recognizes that private, free-enterprise firms such as UPS and FedEx are faster, more efficient, and in the long run cheaper than the 'public option'.

Do the American people want a public, government-run "health care" system guaranteed to make us wait, fail to deliver on time, constantly becoming more and more expensive, and having to ration services just to function?

The opinions being expressed at townhall meetings across the country are a clear answer to that question. And that answer is not just no, but hell no!

There is no time to waste! Call/write/fax/email your Congressman and Senators and let them know in no uncertain terms that you want H.R. 3200 to suffer a first-term abortion. Contact them daily. Shut down Washington the way we did when we successfully killed that bastard of an immigration bill two years ago.

Hooray for Alexis Glick!

2009-07-28T23:26:00.001-05:00

On Fox News' Hannity tonight (7/28), Fox Business VP Alexis Glick briefly mentioned the need to "address ERISA", meaning to fix the unintentionally created shield against liability that Congress gave the insurance industry when they tried to provide protection for employee pension plans in the 1970's.

It's about time someone brought this issue to the forefront. Good for you, Alexis! And thank you for confirming my opinion that a fix of ERISA is long overdue.

Rationing Debate or Debating Rationing

2009-07-19T23:14:00.005-05:00

I found an editorial in The New York Times today that was published in the July 15 edition. (To think that I would ever be quoting from The New York Times, of all places!) The editorial is entitled Why We Must Ration Health Care, and I actually found it an interesting read, despite the fact that is somewhat long. (Yeah, me complaining that something is long; pot, meet kettle.)

What I found interesting about this article is that the majority of it is actually a reasoned discussion of the factors that need to be and usually are considered in any kind of consideration of rationing. Since these concepts are going to be brought up again and again in the future as we head into the brave new world of "health care reform", I think it is important that everyone be up to speed on the terminology.

The editorial is written by a bioethicist, Peter Singer. Like most discussions that I have read by other ethicists, I can take issue with a few of his points. But I will also acknowledge that some of his points are unquestionably valid, and I have already broached some of these, such as when I said, "for the reality really is we cannot afford to continue doing things the way we have been"; this was just another way of stating that, at some point, rationing of some kind would eventually come into play -- the only issue is whether it is going to be controlled rationing under established rules or rationing controlled by the twisting winds of random fate.

Mr. Singer starts out by outlining that 'health care' resources are "scarce"; I'll dispute that word, but they are finite, and that eventually leads to the same thing. Such scarce resources end up being rationed in one way or another, and the debate is about trying to use these resources in the most beneficial way.

The debate over health care reform in the United States should start from the premise that some form of health care rationing is both inescapable and desirable. Then we can ask, What is the best way to do it?

This is the first point where I take issue with Mr. Singer. I don't think that there are too many thinking persons in this country who believe that we can provide unlimited medical care to all comers. Most people accept (if only subconsciously and reluctantly) that rationing is "inescapable". I will argue that most people do not feel it is desirable. And that is because most people start with the premise that okay, there's going to be rationing, but who's going to be making the decisions and how can I make sure I'm not going to get shafted?

Mr. Singer then spends a few paragraphs beating the dead horse of de facto rationing because of high costs, using drugs such as Sutent and Temodar and Gleevac as examples. Of course the tacit implication is that under rationing some people wouldn't get these drugs. The concept of trying to eliminate some of the factors (such as class-action lawsuits, insurance company formularies, and the glacially slow FDA drug approval process) that might make these drugs cheaper doesn't occur to him, as it doesn't support his argument.

He then tries to claim that lack of insurance coverage itself is killing people:

But even in emergency rooms, people without health insurance may receive less health care than those with insurance. Joseph Doyle, a professor of economics at the Sloan School of Management at M.I.T., studied the records of people in Wisconsin who were injured in severe automobile accidents and had no choice but to go to the hospital. He estimated that those who had no health insurance received 20 percent less care and had a death rate 37 percent higher than those with health insurance. This difference held up even when those without health insurance were compared with those without automobile insurance, and with those on Medicaid — groups with whom they share some characteristics that might affect treatment. The lack of insurance seems to be what caused the greater number of deaths.

I would love to see this study to see how they reached this conclusion. Most people brought in from major trauma events don't even stop at the registration desk. Medical care begins immediately, and the medical team working on the patient has no idea what kind of coverage or lack of coverage any patient has. Since the advent of EMTALA, most of the hospitals I've worked at don't even let the info on a patient's coverage or lack thereof onto the ER chart until after emergency stabilization has been completed. So how is lack of insurance causing this higher death rate? Could there be some other reason?

Those who died were on average around 30 years old ......

Aha! One of the young invincibles! Young, not sick, refuses insurance even when offered by his employer -- a risk taker. And that risk taking likely extends to how he drives. Could it be that the higher death rate has something to do with more severe trauma? Was this even considered in the study? We aren't told. And were the insured trauma victims age and gender matched to the non-insured? Again we aren't told. Since this study was an economics study and not a medical one, I have my doubts.

While discussing years of life saved and Quality-Adjusted Life Years, (see the editorial!) Mr. Singer also covers the fact that human beings are not very good at intuitively comprehending the dimensions of risk reductions from taking certain actions. For example, consider the patient who is excessively worried about his borderline elevated triglyceride level (a minor risk factor for coronary artery disease) while refusing to even consider stopping smoking (probably the biggest risk factor for cardiovascular disease there is). He also discusses, in the concept of QALY, the perceived cost of disabilities by those not disabled and by those that are. And here things get interesting and we get to the heart of the rationing debate -- who's making the decision and how am I going to make sure I don't get shafted?

If we return to the hypothetical assumption that a year with quadriplegia is valued at only half as much as a year without it, then a treatment that extends the lives of people without disabilities will be seen as providing twice the value of one that extends, for a similar period, the lives of quadriplegics. That clashes with the idea that all human lives are of equal value. The problem... [lies]...with the judgment that, if faced with 10 years as a quadriplegic, one would prefer a shorter lifespan without a disability..... If [we ask quadriplegics themselves to evaluate life with quadriplegia,] and we find that quadriplegics would not give up even one year of life as a quadriplegic in order to have their disability cured, then the QALY method does not justify giving preference to procedures that extend the lives of people without disabilities over... the lives of people with disabilities....... This method of preserving our belief that everyone has an equal right to life is... a double-edged sword. If life with quadriplegia is as good as life without it, there is no health benefit to be gained by curing it. That implication ... would have been vigorously rejected by someone like Christopher Reeve, who, after being paralyzed in an accident, campaigned for more research into ways of overcoming spinal-cord injuries. Disability advocates, it seems, are forced to choose between insisting that extending their lives is just as important as extending the lives of people without disabilities, and seeking public support for research into a cure for their condition.

The real problem here is that Mr. Singer thinks it is a paradox that persons with disabilities want both their disabled lives prolonged and their disabilities cured. The man off the street wouldn't see this as contradictory. This would only occur to ivory tower eggheads. And maybe to eugenicists. Everyone else recognizes that people with disabilities are first and foremost people.

Mr. Singer himself nails the real sticking point in this rationing debate when he says:

...but if there is a social consensus that we should give priority to those....

The point is that there is no social consensus on this idea of rationing. That's why it's so contentious. And that's why trying to do it should wait until there is a consensus, or at least the beginnings of one. That will require a debate that we haven't had yet and that we may not even be ready for. The current crisis it that the Obama administration is full of people who want to force their views on everyone, because they think they know better.

Well, Mr. President, know this: How you and your people want to ration medical care is NOT how I would do it. And how I would want to do it is NOT how you, my good reader, would want to do it. How do I know without asking you?

Simple. We are nowhere near a consensus on this.

My Response to the AMA

2009-07-19T02:47:00.002-05:00

The AMA, after previously stating that they were not in favor of any health care reform plan that included a public option, has recently and surprisingly done a 180 degree reverse course and effectively endorsed the House of Representatives (Democrat) health care reform bill, H.R. 3200, "America's Affordable Health Choices Act of 2009". I am flabbergasted; I am sick; I am angry; I am more postal than I have ever been before. Good thing I don't own a gun.

I have expressed my displeasure in an email to James Rohack, M.D., the current president of the AMA. Following is the text of that letter:

I am completely aghast at the AMA’s endorsement of H.R. 3200, “America's (so-called) Affordable Health Choices Act of 2009". I cannot believe that the leaders of the AMA could have been led so astray by this misbegotten piece of legislation that they could endorse a plan that is tantamount to the premeditated murder of the greatest medical care system in the world.

I am not opposed to the concept of reform of what we call our ‘healthcare’ system, even though it is not now and never has been a healthcare system -- we have a medical care system, the best in the world, and this is significantly different from a system to promote health, a distinction that is crucially important but is being completely ignored. However, increasing government control of the medical care system (which H.R. 3200 does) will make matters worse rather than better. This is reform only if you consider tightening the garrote around one’s neck to be reform. Even cursory examination of the bill reveals that it calls for the creation of at least 31 new federal programs, agencies, and commissions (and the necessary bureaucracies to support each one) all to increase the regulation of medical care. These new programs and agencies include such horrors as a new Health Choice Administration (sitting alongside the Centers for Medicare and Medicaid Services and the Department of Health and Human Services) and a new National Health Care Workforce Commission, whose task will be to decide when and where medical care workforces can and will be altered (and likely decreased as the need for rationing becomes ever more necessary under this plan). Complying with the new regulations to be promulgated by all these bureaucracies will increase both the cost and the hassle of operating a medical practice at a time when practice revenues will be going down. And yes, I said down.

In an editorial posted on the Heritage Foundation website, John O’Shea M.D. discusses testimony presented before the House Energy and Commerce Committee by The Lewin Group. In this testimony, they estimated that “if the public plan is open to individuals and all employers using Medicare payment levels plus 5 percent, as planned, physician net income would fall by 5.4 percent. The loss of net-income would average about $16,207 per physician.” Furthermore, this decrease is probably underestimated, since The Lewin Group predicts that 113.5 million people would be shifted by their employers from private insurance to the public plan, with the concurrent decrease in revenue that would subsequently entail. With the fines to employers set at no more than 8% of payroll if employers do not provide insurance (and even lower for small businesses with smaller payrolls), I feel that the estimate of only 113.5 million people being moved to the public option is decidedly too low. H.R. 3200 will therefore serve as the back door into a de facto government-controlled, single-payer system to which AMA policy is supposedly opposed.

H.R. 3200 does not provide for any improvement in the runaway costs of the medical care system. The Congressional Budget Office’s initial estimate of the cost of this program is set at over $1 trillion dollars over the first ten years. The CBO also specifically notes, “It is important to note that the figures presented here do not represent a complete cost estimate for the coverage provisions of the legislation. They reflect specifications provided by the committee staff rather than detailed analysis of the legislative language.” In other words, it is based on an analysis of only part of the proposed legislation; if all of it were analyzed, the costs would likely be higher. This will add at least $219 billion more to the federal deficit at a time when it is already at unprecedented highs. The CBO also states in their analysis that nothing in H.R. 3200 will reduce the rate of growth of medical costs, despite that being its sole reason for being proposed.

The CBO estimate also covers only the first ten years, with most of the expenditures in the second half of that ten year period. The cost of the second ten years (and so on) is not addressed. Recall that the first-ten-year estimates for Medicare Part D were only $400 billion, but the estimates for the second ten years are at least $1 trillion for Medicare Part D alone. Also remember that the AMA opposed the creation of Medicare and Medicaid in the first place, back in the 1960’s, with one of the objections being that the cost estimates were woefully low. The AMA was correct then: in its first year Medicare cost $64 million, while it has now ballooned to a $500 billion/yr program, while Medicaid has expanded from $770 million in its first year to $264 billion/yr today. Government predictions of the cost of programs are always inaccurate to the low side. If the rate of growth of the cost of H.R. 3200 is the 6% stated by the CBO, then within 25 years this program will be costing the USA as much more again as Medicare costs now. The CBO is right -- it is unsustainable.

This does not even consider the fact that the Virginia-based Council for Affordable Health Insurance has estimated that the administrative expenses of both Medicare and Medicaid over the last decade were 66% higher than those of private sector health insurance companies. There is no reason to suspect that the administrative expenses of H.R. 3200 will be any less and every reason to expect that they will be greater.

True reform is not the expansion of governmental regulation and control of the medical care system. True reform is the reduction if not elimination of unnecessary governmental regulation and control of the medical care system. True reform is a return to a situation in which patient care is delivered and decided upon by a patient and his or here physician without the intrusion of the government or an insurance company. True reform is a system in which the financial aspects of medical care are also between the patient and the physician, with the insurance company only dealing financially with the patient. True reform is a system in which insurance is permanently and irrevocably detached from employment, with the tax incentives for buying insurance granted to the individual, and the employer giving the employee the funds to pay for that insurance through higher wages. True reform allows the power of the free market, which has been kept in chains for the last 70 or more years by ever-increasing governmental regulations, to be turned loose and increase efficiency and quality. True reform requires the government to step in only to eliminate predatory practices and to help out those few individuals who truly cannot provide for themselves. (And this last only because the USA is a Christian and charitable society, and not because there is some bogus universal “right” to medical care.)

H.R. 3200 does none of these things. It in fact does the exact opposite of every one of them.

Since I entered medical school 24 years ago, I have been a member of the AMA. I joined because I thought it was important for physicians to have an organization to speak for them collectively, to fight for what we need and what our patients need -- to fight against primarily the government as I recognized even then that it was the government from which we physicians have the most to fear. Repeatedly I have been let down by the AMA as I watched the organization walk away from contest after contest with the government, not bloodied and beaten, but whimpering and skulking away without even engaging in the battle. For ten years or more I have waited for the AMA to bring the issue of the SGR to a crisis point by walking away from the negotiating table and saying ‘call us back when you’re willing to talk seriously -- and by the way, we’ll enjoy watching you try to provide medical care without any physicians’, only to be disappointed year after year with temporary fixes which provided little relief from the increasing inflation affecting the cost of running a practice and no resolution to the problem with the SGR. We have always had the power to fix the SGR, but you -- the AMA -- refused to use it. And now to get a fix for the SGR, the AMA is swallowing a poisoned pill that will kill everything that is great about the American medical care system. It was my belief that the AMA was supposed to stand behind me. I didn't expect it was so they could stab me in the back with a dagger, not just once, but dozens or hundreds of times.

I insist that the AMA reverse this decision on supporting H.R. 3200 and that the AMA go on the offensive opposing this abomination before it is too late -- too late for the medical profession, too late for our patients, and too late for the greatest medical care system ever created by mankind.

If the AMA will not change course on this issue, I will have no other recourse but to cancel my membership and demand that all money that I have ever donated to AMPAC be returned to me. I do not wish for any of the funding that has led to this looming catastrophe to have come from me. And I will urgently encourage all of my colleagues to do the same.

One Last Parting Shot at Jack

2009-07-08T20:00:00.002-05:00

I can't resist taking one last shot at you, Jacksmith.

From your blog:

You see, one of the most important aspects of a universal healthcare system is easy access, and patient protection. This is accomplished by having a single payer without a conflict of interest in patient care. And by having a payer who has the power to enforce minimum standards of excellence in healthcare delivery for everyone in the plan.

Obviously, you are not covered by Medicare and you do not receive your care from the VA Medical System. Otherwise you would not have made such an incredibly foolish statement as this one.

The only payer without a conflict of interest in patient care is the PATIENT. Any third party payer will always have a conflict of interest in paying for a patient's care, and that conflict is always monetary. Any third party payer, including the government, has the desire to spend as little as possible for a patient's care. For an insurance company, this is motivated by the desire for corporate profit. For a governmental agency, the motivation is to try to minimize the "waste" of tax dollars, for the agency will always be operating within a limited budget given it by the legislative body creating the agency. See the first few pages of Chapter 20 of Newt Gingrich's Real Change for a very good description of this topic.

If you think that the corporate world is more ruthlessly brutal in its mission than a governmental agency, then you must live in an alternate reality from the rest of us. If you think a governmental agency will ever have your best interests at heart, you must be certifiably insane.

Corporations can only go so far before they run off their customers and the physicians and other health care providers that they must have working with them in order to be able to sell their product. A governmental agency need not cajole cooperation -- it can mandate it through the power of bureaucratic or legislative action. A governmental agency need care only about what it wants, not what anybody else needs. And a governmental agency created as the single provider of "health care" will quickly become supremely ruthless in this endeavor.

After all, isn't this supposedly why we're entertaining this foolishness -- because "we're spending too much of our GDP on health care"? If this is the true motivation, then the created bureaucracy's only goal, and only interest, will be reducing the total outlay of dollars, patient care be damned.

That is the difference between you and me, Jack. You see government as a savior, as a benevolent parent which will always do what is best for its children. I see government as a bureaucratic version of kudzu, choking the life out of every aspect of our society that it intrudes itself upon.

As we know here in the South, kudzu must be fought against constantly to keep it from taking over. The same goes for government. But I forget -- you are a Communist. You are kudzu.

Jacksmith, Here is My Response

2009-07-05T01:02:00.007-05:00

In my last post, I linked to a very concise and powerful critique of the Obama "health care" reform plan. I got a response to this posting, which you can see at the link, but which I will repeat here for posterity:

"AMERICA’S NATIONAL HEALTHCARE EMERGENCY!
It’s official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.
STAND READY AMERICA TO SEIZE CONTROL OF YOUR NATIONAL HEALTHCARE SYSTEM.
We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.
And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.
Progressive democrats and others should stand firm in their demand for a robust public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and request that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).
Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.
In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don’t even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!
If President Obama has to declare a NATIONAL STATE OF EMERGENCY to rescue the American people from our healthcare crisis, he will need all the sustained support you can give him. STICK WITH HIM! He’s doing a brilliant job.
THIS IS THE BIG ONE!
THE BATTLE OF GOOD Vs EVIL!
Join the fight.Contact congress and your representatives NOW! AND SPREAD THE WORD!
God Bless You
Jacksmith – WORKING CLASS"

I have not altered this in anyway, though copying it here did cause it to lose most of its formatting which is unfortunate. Please, go to the link above and look at this comment in its glorious original. I replied briefly, saying that I would respond in detail to this comment later. This post is my response. I also said that the writer, Jacksmith, had won a special prize.

Your prize, Jacksmith, is the formal recognition that you have contributed the first idiot comment in the history of Rantings of a Medical Mind.

Now, I have received a tiny number of spam comments. Those did not see the light of day. But your comment, Jacksmith, is the first comment that I have received (and I have received precious few comments) that violates the rule that I set out at the very outset of my blog. In my very first post I stated that "I will welcome your comments and critiques of my thoughts. I enjoy a spirited debate on the issues." Your comment, Jacksmith -- may I call you Jack? -- provides neither a critique of my thoughts nor is it a spirited debate on the issues.

Jack, your comment is merely a regurgitation of talking points designed to fear-monger and create distress amongst those unfortunate enough to read it. It also contains so much garbage in terms of what passes for "information" that it cannot be taken seriously.

BTW, Jack, I did find you. With your oh-so-common nom de plume, I wasn't sure that I'd be able to run you down, but find you I did. Let's take a look at this posting on Slate -- same stupid arguments, same violation of netiquette by SCREAMING ALL THE TIME, same signature (Jack Smith -- Working Class) -- yep, that's gotta be you. And you have your own blog! But come on, you've only put up one post? I'm well up into the sixties. I will say though, at least it's good to get confirmation that other people are reading my writings, even if it is someone whose brain cells no longer function properly.

Let's begin the autopsy of your comment.

First, we'll cover what you inadvertently happened to get right. Since my post regarded President Obama's public option, and your diatribe did cover that, it was on topic. You mentioned the global H1N1 pandemic -- okay, I'll accept the WHO proclamation on this (even though if the current Mexican flu outbreak defines a pandemic, we need a new word for something like the Spanish flu or the Medieval Black Death). And by the quoted numbers, we do spend something like two times as much of our GDP on "health care" as many other nations, though that number is always in flux. That's about it. Everything else is wrong. Or a lie. And really, what's the difference, except in intent? If you're just mistaken, it means you're an idiot. If you're lying, it means you're a tool of people who are using you to push their agenda, even though you, and everyone else right along with you, will ultimately pay for it in the end (literally and figuratively). I'll choose to be kind and call you an idiot, for in my book, being a tool is far worse.

On second thought, after reading your single blog post, I will have to retract my assessment of you. You are both an idiot and a tool.

Your concern about the Mexican flu is not totally warranted. As of July 3, 2009 (2 days ago), WHO has confirmed worldwide 89,921 cases of H1N1 with 382 deaths. This is a case fatality rate of 0.43%, much lower than that of the regular seasonal flu. The CDC reports, as of July 2, 2009, that in the US there have been 33,902 cases with 170 deaths, for a case fatality rate of 0.50%, again lower than that of the regular seasonal flu. So, currently, this flu is not something to get all hot and bothered about. It is true that the first cases of Tamiflu-resistant H1N1 have just now been reported, but you couldn't have known that when you posted your comment, so you get no points for that. Besides, we have medicines we can use other than Tamiflu.

In regards to your discussion of the H1N1 cases in Mexico, I don't know where you are getting your information, since the Mexican health authorities have been incredibly tight-lipped about what has been going on there. WHO reports only 10,262 confirmed cases in Mexico with 119 deaths, for a case fatality rate of 1.16%, higher than elsewhere, but still not terribly high (the Third World nature of the Mexican health care system may have something to do with this). Also, as reported in this article from Reuters, the higher case fatality rate in the area of origin of the epidemic is consistent with what has been seen with other epidemics in the past. This article also mentions that the majority of deaths in Mexico are among people under the age of 59, which is unusual for influenza and is NOT the pattern being seen elsewhere in the world. Investigators think this may be because people above age 52 may have some residual partial immunity from the last H1N1 strain that circulated before 1957.

[Yes, I am calling it the Mexican flu. Naming convention for influenza epidemics in the past have named the outbreak with the name of the country in which the outbreak was first publicly identified. In this case, Mexico drew the short straw. There is nothing racist about it. I'm sure that Spain doesn't like that the Spanish flu was named thusly, since the virus most likely originated in the American and European soldiers fighting World War I, but since the first public information about the outbreak came from Spain, the name became Spanish flu. By the same token, this flu is the Mexican flu.]

In your comment, Jack, you strongly push for the adoption of President Obama's health reform plan. Have you even read the plan? "Coverage can begin immediately through our current medicare system" -- Obama's plan doesn't change Medicare and does not involve enrolling anyone into Medicare. "Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan" -- Obama's plan doesn't call for the institution of direct payroll deductions for the public option, but rather the payment by the employer into the public pool, from which non-covered workers will receive funds to buy insurance from the Exchange. "With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry" -- Obama's plan doesn't call for the cancellation of the private insurance industry......

But I see from your blog post that what you are really after is a single payer, government controlled system. And you are too stupid to see that Obama's plan doesn't call for that -- oh, now I see. You are shilling for Obama's plan, a plan you favor, because you want a single payer system, and you also see Obama's plan as a way into a single payer system. Thank you for making that point crystal clear. (This was supposed to be a secret! For a tool, you really aren't very sharp, you know that?)

Furthermore, you want President Obama to declare a national health emergency if your precious plan doesn't pass, during which he is to seize all the insurance companies and impose the single payer system that the American people, through Congress, have just rejected. Now I know that certain laws were passed after 9/11 that allow the President (and even the state governors) to declare such emergencies and impose things like quarantines, forced vaccinations, forced redistribution of medical supplies, and the like, but these bills do not give the President the power to seize industries and impose radical system change. But you want him to have these powers. Because you are a "progressive Democrat". You are a "World Citizen" (from your blog). You are a member of the "Working Class". (Shouldn't that last one really be "Proletariat"?)

You really hate privately run "health care" systems, don't you, Jack? Look at the way you just shriek those hateful words -- "GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE". Is it just the profit driven "health care" system you hate, or is it any for-profit endeavor? How about taking over the computer industry, or the auto industry -- wait, bad example. President Obama has already done that. Bet that made you feel really good inside, didn't it? While the rest of America had to fight to keep from retching. And then there's this, from your blog:

"Health care is NOT! a private for profit business. Healthcare is an essential public service. Like police, and fire. And healthcare is also a human right! PRIVATE FOR PROFIT HEALTHCARE IS AN OXYMORON, AND AN IMMORAL AND UNETHICAL PERVERSION OF HEALTHCARE AND HUMAN RIGHTS."

Health care is a public service?? Not even electricity and water are public services. Regulated utilites, yes, but not public services. Just try not paying your electric or water bills for a while and see what happens. Making health care a public service puts me and all other health care workers at your disposal -- making us your servants, or worse. And I will repeat once more -- Healthcare is Not a Right!

It's time to pull back the curtains and let the purifying light of truth shine upon you, Jack. You are a Communist (and yes, I meant that to be with a capital 'C'). You are a relic of an outmoded political ideology that was completely discredited with the collapse of the Berlin Wall and the disintegration of the Soviet Union. Even China is slowly moving away from the true Communist structure. You are so blinded by your ideology that you do not realize that you are being used by other people to advance their agendas, not yours, and that when you finally realize this and you protest, you will be discarded like the used, empty and crushed beer can that you are.

I pray that God blesses you, Jack. I pray that He gives you the ability to clearly see the truth and the wisdom to be able to correct the errors of your ways.

As always, I welcome critiques of my thoughts and rants, and I eagerly look forward to a spirited discussion of the issues.

But Jack, if you come back at me with another regurgitation of talking points or a pile of useless drivel with no thought behind it and no evidence to back it up, I will be forced to wipe it from my blog and throw it away, just like I wipe up and throw away the hairballs that my cat spits up. Spitting up the hairballs at least serves a useful purpose, if only for the cat. Your droppings don't even make good manure.

A Concise Critique of Obama's "Health Care" Reform

2009-06-28T14:14:00.000-05:00

John Hinderaker at the blog Power Line has a concise critique on the fundamenal problems with President Obama's "health care" reform plan. I would love to just quote the whole thing, but such activity is frowned upon in the blogosphere, so I strongly encourage you to go read the whole thing.

For anyone who thinks that this plan is not a back door into a single payer, government-controlled system, take a look at this statement:

What is being overlooked this time around compared to 1993 is this: to prevent "leakage" from the system, draining of supply to other providers of insurance/purchasers of health care services...the "public option" has to effectively outlaw them.

Of course, if other options are outlawed, then only the public option is left -- voila! a single payer system.

I saw this the first time I analyzed his proposals during the campaign. (Which is well before I posted this.) Anybody who believes otherwise is just deluding themselves. Or they are too stupid to be allowed to make decisions for themselves.

The World Moves Right, and the US Moves Wrong

2009-06-27T01:09:00.003-05:00

I sit here despondent. I had hopes that the House of Representatives was not this stupid. And it almost wasn't; H.R. 2454, The American Clean Energy and Security Act of 2009, passed by 7 votes, and really only 1 vote, as the 219 votes for the bill was only 1 vote over 50% of the entire House. It seems there were 5 votes not cast.

Meanwhile, the rest of the world is moving away from AGW lunacy. As this editorial in The Wall Street Journal reports, Australia is voting to kill their cap and trade system, the new government in New Zealand has suspended their weeks-old program before it could do any damage. Poland and the Czech Republic both have taken positions opposed to AGW, and even France appears to be appointing a commission (or assigning the task to a ministry) to look at the science behind AGW again.

Here in the US, the tide is turning as well, though you'd be hard pressed to tell from our "objective" news media.

The number of skeptics, far from shrinking, is swelling. Oklahoma Sen. Jim Inhofe now counts more than 700 scientists who disagree with the U.N. -- 13 times the number who authored the U.N.'s 2007 climate summary for policymakers.... A group of 54 noted physicists, led by Princeton's Will Happer, is demanding the American Physical Society revise its position that the science is settled. (Both Nature and Science magazines have refused to run the physicists' open letter.)

Why is this happening?

The collapse of the "consensus" has been driven by reality. The inconvenient truth is that the earth's temperatures have flat-lined since 2001, despite growing concentrations of C02. Peer-reviewed research has debunked doomsday scenarios about the polar ice caps, hurricanes, malaria, extinctions, rising oceans.

In Australia, the credit is being given principally to one man.

Credit for Australia's own era of renewed enlightenment goes to Dr. Ian Plimer, a well-known Australian geologist. Earlier this year he published "Heaven and Earth," a damning critique of the "evidence" underpinning man-made global warming. The book is already in its fifth printing. So compelling is it that Paul Sheehan, a noted Australian columnist -- and ardent global warming believer -- in April humbly pronounced it "an evidence-based attack on conformity and orthodoxy, including my own, and a reminder to respect informed dissent and beware of ideology subverting
evidence." Australian polls have shown a sharp uptick in public skepticism; the press is back to questioning scientific dogma; blogs are having a field day.

Senator Jim Inhofe continues to lead the battle against AGW in the Senate. I heard part of a speech he was giving regarding HR 2454 earlier this week. He rightfully pointed out that the US unilaterally restricting our CO2 emissions (with the subsequent frightful damage to our economy which would ensue) while other nations, particularly India and China, did nothing to restrict their emissions, would mean that our efforts would be in vain. He estimates that what little American manufacturing that still remains would move to China, where they would escape our oppressive taxation, and that the increased number of coal-fired power plants the Chinese would need to power these new manufacturing plants would ultimately lead to an increased global CO2 levels.

Not that it matters that much, since CO2 is not the cause of the warming we saw in the 1990's.

Current observations indicate that the global temperature peaked in 1998 and has been flat ever since, except for a possible trend toward decreasing over the past 18 months or so. If historical trends, revised computer models, and sunspot minimum factors can be trusted, the temperature will definitely be going down in the years to come.

What depresses me further is that when the temperature does come down, these AGW imbeciles will think that The American Clean Energy and Security Act had something to do with it, thereby reinforcing their delusions of grandeur. And then we may never be able to get rid of this piece of excrement.

Michael Jackson Did Not Die of a Cardiac Arrest!

2009-06-25T23:17:00.001-05:00

This drives me nuts! I mean literally insane! And that's not a good thing when you're already postal.

The news media is reporting today that Michael Jackson died of a cardiac arrest. This is not the first time I have seen this on the TV or in the newspaper. Unfortunately, I have even seen it listed as the cause of death on death certificates, put there by professionals who really ought to know better.

Nobody dies of cardiac arrest. Cardiac arrest is a mechanism of death, it is a definition of death, but it is not a cause. Saying Michael Jackson died because of cardiac arrest is equivalent to saying Helio Castronevas won the Indy 500 because he crossed the finish line first.

Of course, Helio did win the Indy 500 because he crossed the finish line first, but that's because crossing the finish line first is the definition of winning. Similarly, Michael didn't die of cardiac arrest because cardiac arrest is the definition of death. (Or at least one definition of death, the one that is most incontrovertible.)

Cardiac arrest is caused by something else. That something else could be a coronary thrombus, a primary ventricular arrhythmia, anoxia, penetrating trauma, or any number of things. But there is a something else, and that something else is the cause of death.

If anyone out there knows of someone who is dead and has not had cardiac arrest, please let me know. I've been looking for something unique to write up in a medical journal.

Before anybody throws a brain death case at me, do note that when you take a brain dead patient off life support, they progress to cardiac arrest. I also do not want any references to your favorite zombie movie, unless you have access to the actual zombies.

Michael Jackson experienced cardiac arrest and now meets the definition of being dead. But that is not what killed him. We must all wait for the autopsy results to find out what that something is.

Fire in the Sky

2009-06-25T19:39:00.006-05:00

We're going off on a science jaunt today.

Courtesy of the London Daily Mail Online come these pictures (only one shown here; more at the link) of a volcanic eruption as viewed by the astronauts aboard the International Space Station. Scientists are theorizing that the hole in the clouds was caused by the shockwave of the initial eruption, but I'll opine that the real cause is the heat of the volcanic plume evaporating the clouds as it passes through -- quite literally fire in the sky.

In other space news, the Japanese lunar probe Kayuga was crashed into the Moon June 11, ending its two-year mission of making high definition maps of the lunar surface. One of its last photos is below. Video of the crash, as well as a video of a high-def Earthrise, is available here. Amazingly, Australian astronomers actually got pictures of the flash of the crash on the moon, also at the link above.

Addendum 6/27/09 -- Here is a link to a NASA video of the volcanic eruption above. It almost has a 3-D effect to it.

http://earthobservatory.nasa.gov/images/imagerecords/38000/38985/sarychev_oblique_final_H264.mov

It runs in Quicktime and takes a little while to load.

President Obama Takes His Plan to the New Digital Airwaves

2009-06-24T23:46:00.000-05:00

President Obama went on TV tonight to promote his bastard child of a "health care" reform package. It covered 90 minutes of television, minus commercials, during which little was said that you couldn't have learned from doing a little rudimentary web searching, or even just an occasional visit to the Drudge Report.

I must admit, it was not as much of a puff piece as I thought it was going to be. Charlie Gibson and Diane Sawyer actually asked some real questions regarding some of the problematic issues with Obama's plan. Mind you, they weren't real tough questions, but they were specific questions about the deficiencies of the plan, such as how it is to be paid for, why a public plan wasn't going to just outcompete the private plans in the Exchange, and the like. They even allowed a question from John Sheils, senior vice president of The Lewin Group, a health care policy research and management consulting firm, who estimated that up to 70 percent of those with private insurance would end up on the public plan. (Just as I predicted last October in Presidential Politics 2008: Health Care Proposals.)

The major theme of Obama's discourse was weaseling out of the tough questions and going back to his talking points, which don't sound like they have changed much since the campaign last fall. For example, AMA President J. James Rohack, MD asked a pertinent question about how this plan was going to guarantee that medical decision making was going to be left to the doctor and his patient and not by some governmental overseer whose main concern would be bean-counting. Obama replied by going off-question to his talking points about how the Exchange would operate. Furthermore, in answering the question from John Sheils, he avoided the intent of the question by going into nitpicking about how there would be a firewall to prevent individuals from choosing the public option over their employer-provided plan, ignoring the obvious fact that the question was about preventing employers from dropping their coverage for their employees in lieu of the public option as it will likely save them (the employers) money -- just as I outlined in my previous post.

A few more observations:

President Obama used the Mayo Clinic as an example of a system that is able to provide care in a more cost-effective manner, primarily by reductions in duplicative testing. Of course they can do that! The Mayo Clinic is a giant group practice, complete with a unified record system that all members of the group can access. We doctors not in that kind of a practice could do that too, if it were not for pesky little things like state and federal privacy laws, not to mention HIPAA. And lest we forget, the Mayo Clinic is in Minnesota, a state that has been dominated by managed care for decades, forcing the Mayo Clinic to develop its efficiencies simply in order to survive. (A medical version of Darwinian survival of the fit.) I do give kudos to ABC for airing that they have been receiving emails using the Mayo Clinic as an example of how the free market can provide less expensive, high quality care if only given a chance, and that more government intervention was not needed.

Obama dodged the partially formed question about the 99 year old mother who got a pacemaker after one electrophysiologist turned her down due to her age. She is now a 105 year old mother and still going strong and enjoying her life. Obama wants medicine to be evidence-based; that's what his Office of Comparative Effectiveness Research is all about. There is no study on the effectiveness of pacemakers in 100 year old people. If one were to be performed, I'd wager that it would show little or no benefit of using pacemakers in 100 year olds, because the mortality rate at that age from all causes would likely mask any beneficial effect provided by the pacemaker. EBM would likely have led to this woman not receiving a pacemaker, and Obama knows this; that's why he looked so uncomfortable answering the question. And this extraordinary woman would have come to a premature end. This did not happen because the patient/family and their doctors were allowed to make a decision in contradiction to EBM, suspecting that in this one case EBM did not apply. They were right -- but only because they were free from government interference in making that decision. Under Obama's plan, they would not have been so free.

Obama also gave a list of things he thinks will free up money to pay for this monstrosity:
1. Preventive health care -- nope, this will cost more in the long run. Only politicians think this is a cost saver.
2. Improved efficiency of health information technology -- not yet proven; and if it can, it will only be after privacy rules have been relaxed, which no one seems to want and which the stimulus bill actually made more stringent.
3. Eliminating all of the paperwork and bureaucracy -- in a government system??? ROTFLMAOF!
4. Evidence-based care -- again, there's no proof that this will reduce costs, and every likelihood to suspect it may increase them overall.
5. Changes in reimbursement -- A-ha!! Here it is! The only one on the list that he can guarantee will save money, because it's the only one that is directly controllable. Of course, changes in reimbursement must in this event mean lower reimbursements, to doctors, hospitals, et cetera. And as reimbursements go down, so does the supply of doctors overall, as older practitioners retire, and fewer young people enter the medical field. And as the supply of doctors goes down, so does your chance of getting an easy appointment, followed by waiting lines, followed by rationing.

I hope that this little spectacle tonight has the opposite effect from what was intended. I hope that those watching now have more questions and are more critical of what is about to be done to them. Time will tell.

The End of Prosperity is Coming

2009-06-24T19:32:00.001-05:00

The House of Representatives votes Friday, June 26, on H.R. 2454, The American Clean Energy and Security Act of 2009. This is the euphemistic name given to the carbon cap and trade tax bill that will increase the energy bills (electric, gas, gasoline, coal) of all Americans, as well as increase the cost to the consumer of everything that requires energy in its manufacture or delivery to market, which of course means the cost of literally everything.

This will lead quickly and irrevocably to a massive downturn in the economy right when we don't need it the most.

As I said in the title, the end of prosperity is coming. The first arrival announcement will be this coming Friday, assuming this bill passes. I have faith in the Democratically controlled Congress to always do the exact wrong thing, so its passage is assured.

I implore you to call your Congressman and Senators and demand that they vote against this bill. After it has been killed, then they need to burn the body and scatter the ashes. (You see, the bill is printed on paper, and burning it will release CO2 into the atmosphere and ...... oh, forget it. If you have to explain a joke......)

CNBC Takes on the "45 Million"

2009-06-19T21:20:00.000-05:00

As I have covered before, the oft-quoted figure of 45 million uninsured is a complete fabrication. Certainly one would expect a conservative blogger to explain this as we head into the muck of "health care" reform, but I never expected to see it on the Obama-worshipping Peacock Network.

So imagine my surprise as I sat in the doctor's lounge at lunch today and saw this report on CNBC:

http://www.cnbc.com/id/15840232?video=1158405259&play=1

Fox Business has covered this as well. But Fox News covering this is no big surprise. (The links to the Fox videos are harder to get to. Go to www.foxbusiness.com/video/index.html and in the video search box [the one above the video list] type in "uninsured". From the resultant list watch the videos entitled "Is the Number of...." and "Study: 25-75% of....")

The important thing to note is that these reports, citing different studies and surveys, all reach the same conclusion -- the number of the truly uninsured is around 8-13 million. Not even close to 45 million.

In a semi-related video from last fall, a study by the Harvard School of Economics indicates that the overcrowding in our nation's emergency departments comes not from the unwashed sea of the uninsured but rather from the insured, most of whom are either seeking medical care at a time that they won't miss work or are trying to avoid paying an office co-pay. This video is on the Fox Business site, on the Uninsured search list, and is entitled "Uninsured not Res...."

Trying to Comprehend President Obama's Fantasyland

2009-06-15T21:25:00.002-05:00

President Obama gave his speech before the AMA House of Delegates today. I can only hope the delegates gave as warm a welcome to his statements as I did when I read them this evening. (Hint: they'd be warmer on Pluto.) Let's go through the speech with a little contemporaneous editorializing on my part, shall we?

"Today, we are spending over $2 trillion a year on health care – almost 50 percent more per person than the next most costly nation. And yet, for all this spending, more of our citizens are uninsured; the quality of our care is often lower; and we aren't any healthier. In fact, citizens in some countries that spend less than we do are actually living longer than we do. "

Of course, much of the reason for this is because of the heterogeneous nature of our population, and the higher levels of poverty here than in, say, Sweden. It has to do with a lot more than dollars spent on "health care". (More on why I am putting that in quotation marks later.) If you were to compare our system to say, Mexico and not Canada, or Zimbabwe rather than Japan, our system would seem to prove that spending more on "health care" does make us healthier. But it would be an unfair comparison, just as comparing us to Canada, Japan, Sweden, etc. is an unfair comparison. There are actually no other countries that really could serve as an adequate comparison to the USA.

"It is unsustainable for Americans like Laura Klitzka, a young mother I met in.... Our costly health care system is unsustainable for doctors like Michael Kahn in.... Small business owners like Chris and Becky Link in Nashville are...."

I hate this oratorical technique. Picking random, supposedly real (I suspect that they really are real, however; it would be too easy to prove otherwise to risk making these people up) people who have fallen on hard times to "personalize" the crisis is a common technique of the socialist left. What they don't do, however, is back up their example with statistics showing how common this one individual's particular problem is. It pulls at your heartstrings without giving your brain a handhold on the problem, thus motivating you to accept the proffered solution without a lot of thought. That's why I hate it so. It offends the logical scientist in me. And it's pretty hard to offend me.

"If we fail to act, one out of every five dollars we earn will be spent on health care within a decade. In thirty years, it will be about one out of every three – a trend that will mean lost jobs, lower take-home pay, shuttered businesses, and a lower standard of living for all Americans. "

Naturally not taking into account that as the "health care" spending increases, the "health care" industry will expand, providing new jobs as others are lost. This is especially true as more and more of those dollars will be government dollars and not private-industry dollars. But politicians of both parties never consider a job gained in an industry they don't care for as a job gained.

President Obama then spends the next several paragraphs demonizing the opposition forces that have so far stood in the way of "health care reform", an excellent example of setting up the straw man he will later (not in this speech but in the days and weeks to come) use to try to marginalize those (like the AMA even!) who oppose part or all of his plan.

"Despite this long history of failure, I am standing here today because I think we are in a different time. One sign that things are different is that just this past week, the Senate passed a bill that will protect children from the dangers of smoking... "

Mark my words. This piece of legislation will be ruled unconstitutional. Because it is. I am a rabid anti-smoker and one would expect me to actually be in favor of this regulation. But if it subverts the Constitution, well, then, we need to find another way. Let's not set that precedent.

"So let me begin by saying this: I know that there are millions of Americans who are content with their health care coverage – they like their plan and they value their relationship with their doctor. And that means that no matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what. My view is that health care reform should be guided by a simple principle: fix what's broken and build on what works."

Yet earlier he said:

"Our costly health care system is unsustainable for doctors like Michael Kahn in New Hampshire, who, as he puts it, spends 20 percent of each day supervising a staff explaining insurance problems to patients, completing authorization forms, and writing appeal letters; a routine that he calls disruptive and distracting, giving him less time to do what he became a doctor to do and actually care for his patients. "

But isn't it the "health care" plans that he is going to allow us to keep if we like them the very plans that are running the systems that are forcing the doctors to spend "20 percent of each day" doing these non-medical tasks he lists above? How are we going to get rid of these administrative hassles if we don't change the system that creates them? I point this out not because I am championing Obama's reforms, but to point out the hypocrisy in his statements. These two positions are contradictory and cannot be reconciled. The only way to remove these hassles is to abolish them and replace them with something else, and the only something else that he is considering is his 'new public option', which can only provide this 'relief' if it becomes ever-expanding. So when Obama says:

"Now, I know there's some concern about a public option..... What are not legitimate concerns are those being put forward claiming a public option is somehow a Trojan horse for a single-payer system..... So, when you hear the naysayers claim that I'm trying to bring about government-run health care, know this – they are not telling the truth. "

he is either stupid, naive, trying to pull an entire sheep-herd's worth of wool over our eyes, or he is just out and out lying.

"The question now is, how do we finish the job? How do we permanently bring down costs and make quality, affordable health care available to every American? "

The answer is, you can't. Quality costs money. Just try to build a Lexus for the costs of a Honda Fit. It can't be done. It can't be done in the automotive world, and it can't be done in "health care". One dollar can only buy so much, and when it's used up, another dollar will be needed if you want to do more. I will be the first to admit that there are some wastes, inefficiencies, and outright fraud in the "health care" system. But there aren't enough to pay for the kind of changes President Obama is proposing, especially if he insists on keeping it budget-neutral. We in the medical profession hate the term 'budget neutral'. Every time it is used in altering Medicare payments, we end up getting paid less.

"First, we need to upgrade our medical records by switching from a paper to an electronic system of record keeping. "

The research on whether this will actually lead to improved quality, much less lower costs, is so far equivocal. The most well-done study to date suggests that the electronic records introduce as many errors as they eliminate; they are just different kinds of errors. And in Medicare's own pilot program for pay-for-performance (another example of governmental oxymoronic double-speak), the practices using paper records met more of the quality benchmarks than did the practices using electronic record systems.

"You shouldn't have to tell every new doctor you see about your medical history...."

No competent doctor should accept at face value anything he sees in a chart, paper or electronic, that is not hard, objective data. To do otherwise risks compounding someone else's errors. Though I hate to admit it, there are too many practicing physicians whose documentation skills are deficient.

"The second step that we can all agree on is to invest more in preventive care so that we can avoid illness and disease in the first place."

This deserves more space than I can allow here, but very briefly, the only kind of so-called preventative care that saves money is vaccinations. (This can be amply demonstrated by economic modeling.) Increasing what we currently call preventative care is a good thing. It will make people healthier to a degree (and this statement gets awfully close to why I'm putting "health care" in quotes). But it will cost more. It will not save money.

"That starts with each of us taking more responsibility for our health and the health of our children. It means quitting smoking, going in for that mammogram or colon cancer screening. It means going for a run or hitting the gym, and raising our children to step away from the video games and spend more time playing outside."

The socialist proposing that individuals actually take personal responsibilities for their own actions and lives? How very conservative of him! This is one of the few lines in the speech I can wholeheartedly concur with. It is also the very crux of the problem we are dealing with, which neither Obama's or anybody else's "health care reform" ideas will actually impact in any meaningful way.

"Our federal government also has to step up its efforts to advance the cause of healthy living. Five of the costliest illnesses and conditions – cancer, cardiovascular disease, diabetes, lung disease, and strokes – can be prevented. "

Obama has now led us deep into the interior of his Fantasyland. PREVENT diabetes? PREVENT cancer? PREVENT cardiovascular disease and strokes? These are all heavily influenced by genetics, and though each are impacted by lifestyle choices, to claim that by modifying those lifestyle choices we can prevent any of them is hysterical. Certainly we will be able to mitigate against the genetic risks and reduce the incidence rates of these diseases, but prevent them? Never. Not in this century. Maybe not in this millennium. Lung disease, namely COPD and lung cancer, will be the most modifiable through smoking elimination. But not asthma, which for all intents appears to be an autoimmune disease for which, like all other autoimmune diseases, we have pathetically few treatments and no options for mitigation, much less prevention.

"A recent article in the New Yorker, for example, showed how McAllen, Texas is spending twice as much as El Paso County...."

Of course let's not mention that McAllen, in the Rio Grande Valley, is one of the four biggest hotbeds of medical malpractice abuse in Texas, which our vaunted tort reform of 2003 has not completely reversed. I have not read the New Yorker article, but I can easily surmise that the increased need for defensive medicine in McAllen is not even mentioned.

President Obama then extols the benefits of evidence-based medicine (without using the term, though he does use that abomination 'best practices') for a number of paragraphs. I will not quibble here. EBM is a good idea. Spending time and money figuring out what currently works best and implementing it as quickly as possible is imperative; it will result in the fastest increases in patient care quality and outcomes of anything else we can do right now in the "health care" system, though it may not save money if it turns out that those 'best' practices cost more in the long run than the less effective things we now do. (My only fear is that EBM could easily turn into a doctrine rather than suggestion, at which point patient care could be threatened. But that again is another rant.) I intend to hold Obama to this one:

"Let me be clear: identifying what works is not about dictating what kind of care should be provided. It's about providing patients and doctors with the information they need to make the best medical decisions. "

"Any legislation sent to my desk that does not achieve these goals does not earn the title of reform. But my signature on a bill is not enough. I need your help, doctors.... That is why I will listen to you and work with you to pursue reform that works for you."

The President then proceeds to push hard on his public option plan, which the very House of Delegates he is talking to has already passed a position statement in opposition to. Gotta give him credit for trying.

"That is why we need to end the practice of denying coverage on the basis of preexisting conditions. "

Hallelujah, baby!! You are preaching to the choir now! Just add universal nationwide community rating to the insurance industry and you are finally on your way to some real beneficial useful reform.

Next we go visit the bank in Fantasyland, where quality is free and we can expand coverage to the "46 million uninsured" while being budget-neutral (and of course thus paying the doctors less). First, we are going to cut Medicare payments while the number of Medicare beneficiaries increases dramatically with the passage of the Baby Boomers into retirement. Then,

"...we need to use Medicare reimbursements to reduce preventable hospital readmissions. Right now, almost 20 percent of Medicare patients discharged from hospitals are readmitted within a month, often because they are not getting the comprehensive care they need."

And why is this? Because current Medicare hospital payments discourage comprehensive care while hospitalized. So what is the proposed solution? (Sorry, you won't find this in the speech.) To refuse to pay for readmissions within 30 days without changing the system that restricts doctors and hospitals from providing the comprehensive care he's calling for! I treat sick patients. I have had many patients readmitted in under 30 days. And it is rarely, or maybe never, because of inadequate care during their first hospitalization. It is because something else happens to them --- they fall and break a hip 3 weeks after discharge for treatment of pneumonia, for example --- or their underlying medical problems are such that the only resolution to the cycle of frequent readmissions is death. This group includes people with end-stage COPD, CHF, cancer, dementia, etc. Some of these people would actually be better served by hospice care, but as I have previously addressed, our society is not quite ready for the option of quickly accepting the end is near.

"Another way we can achieve savings is by reducing payments to hospitals for treating uninsured people. I know hospitals rely on these payments now because of the large number of uninsured patients they treat. But as the number of uninsured people goes down with our reforms, the amount we pay hospitals to treat uninsured people should go down, as well. Reducing these payments gradually as more and more people have coverage will save us over $106 billion...."

No it won't! It won't save any money. None. Obama's 'reforms' will cover these uninsured patients with insurance paid for out of public money. The 'savings' from the decreased payments to hospitals for caring for the uninsured will be more than taken up by the public costs of providing the coverage for the same people. There's no savings here. It's just a bookkeeping maneuver. And not a very good one at that. See my earlier paragraph. Is he stupid, naive, wool-pulling, or just straight lying?

I can't comprehend Obama's Fantasyland. I live in the real world, where services cost money, quality is not cheap, defensive medicine is a reality, and sick patients are really, really sick. I have no time for the dreams of someone who has spent no time at all working in the "health care" trenches.

Limbaugh on Health Care Reform

2009-05-24T13:33:00.002-05:00

I will link to this because I couldn't cover this any better; indeed, I couldn't cover this half as well.

David Limbaugh points out the real issues involved in the coming health care reform battle, and it the forces of the left win, the rest of America will lose.

None of this matters to Obama and congressional Democrats, who are ideologically hellbent on socializing medicine.

He goes through in detail the true nature of the "45 million" uninsured as I have previously ranted upon.

He then goes on to explain why the coming socialization of our health care system will be a tragic mistake.

But Sowell's more sobering observation is that government-provided care is inevitably an exercise in price control.... "Artificially lower prices, created by government order rather than supply and demand, encourage more use of goods or services, while discouraging the production of those same goods and services. Increased consumption and reduced production mean a shortage." ... The scarcity will lead to waiting lists, increases in illnesses and death from the inadequacy and untimeliness of care. It will lead to rationing and decisions made by Big Brother's heartless bureaucrats as to who gets health care at all.

And he hints at what would be a preferable solution.

The sad reality is that the social planners, as usual, are prescribing exactly the wrong solutions. The main problem with soaring health care costs is not too much free market, but too little; it's not too little government control, but too much. As the brilliant Thomas Sowell tells us in his book "Applied Economics," "Only 13 percent of Americans' medical care costs are paid for directly out of pocket," which gives us an indication of how little market forces are at work in the system.

Read the whole thing. It's short, but cuts straight to the point as to what Obama and his ilk are trying to do to us and what we must organize against.

The Courage of Their Convictions??

2009-04-26T10:00:00.002-05:00

Clearly the AGW community consists of a bunch of cowards. How can I say this without fear of refutation? If they were so sure of their "consensus view" that their "science" is correct, they wouldn't fear having their ideas being taken on in open debate. But they obviously know just how poorly they'd do in a free and open debate, so they run away from it at each and every opportunity.

The most recent such loss at the game of Chicken was April 24, 2009, when the prophet-in-his-own-mind Al Gore gave testimony before the House Subcommittee on Energy and the Environment. Representative Joe Barton (R) had invited Lord Christopher Monckton, one of England's renowned AGW critics, to also testify there the same day. But the Democrats refused to allow him to testify.

Said Monckton about being stiffed, "The House Democrats don't want Gore humiliated, so they slammed the door of the Capitol in my face. They are cowards."

Take heart though: Lord Monckton has testified before Congress earlier this year. The only real question is whether Congress listened.

Recall also the cowardly name-calling that the AGW zealots use to discredit their critics. Al Gore has for several years compared AGW critics to those who claim the Moon landings were a hoax. However, someone who has actually walked on the Moon, astronaut Jack Schmitt, has come out as a AGW 'denier':

"The ‘global warming scare’ is being used as a political tool to increase government control over American lives, incomes and decision making. It has no place in the Society's activities," Schmitt wrote on November 17, 2008. "As a geologist, I love Earth observations. But it is ridiculous to tie this objective to a "consensus" that humans are causing global warming when human experience, geologic data and history, and current cooling can argue otherwise. ‘Consensus,’ as many have said, merely represents the absence of definitive science," Schmitt explained.

(I love that this last link was to a US Senate website!)

Meanwhile, while we are debating a carbon tax, oops, cap and trade system that will further damage our ailing economy, low temperature records that have stood for almost 130 years have fallen in Canada, and Australia is waking up to the dangers posed by this ridiculous idea and is becoming a denier nation.

Hopefully we will wake up in the USA before we do something really stupid while we're sleepwalking.

The Fault Lies Not Within the Stars, But Within Thyself

2009-03-27T22:03:00.000-05:00

Martha Zoller created an incredible treasure trove of discussion points when she posted to Pajamas Media on March 12. I am now going back to this wellspring of fascinating comments for the third time.

In "Can We Still Afford to Cheat Death", I wrote off of her comment:

Fifty percent of health-care costs are incurred in the last month of life and those costs rarely change the outcome of the patient’s illness.

But immediately after this, she went on to say:

In addition, most ailments in this society are brought on by behavioral choices. The amount of money we have spent over the years treating ailments brought on by abuse of alcohol, food, and nicotine is alarming. The government shouldn’t regulate the purchase or intake of these things. People must take responsibility for their own actions.

It is true beyond any question that the vast majority of the medical problems that I or any other doctor takes care of on a daily/weekly/monthly/yearly basis is caused or significantly aggravated in whole or in substantial part by lifestyle choices. Or rather, the wrong lifestyle choices.

Type 2 diabetes mellitus (aka adult onset), which accounts for approximately 85% of cases of diabetes, is in large part a lifestyle disease, brought on by years of overeating the wrong kinds of foods and then not exercising enough or at all. Diabetes then contributes to coronary artery disease, peripheral arterial disease, renal failure, retinopathy, et cetera, et cetera, leading to blindness, dialysis, limb ischemia/chronic wounds/amputations/cerebral strokes, myocardial infarctions/congestive heart failure, and above all death, as well as all the costs associated with caring for all this morbidity.

Use of tobacco, the delivery system of nicotine, is the leading cause of cancer in this country. top of the list is lung cancer, which is now the leading form of cancer and cancer death in both men and women. (It has been estimated that if genus Nicotiana had never existed, there might be only 5000 cases of lung cancer a year in the entire United States.) But it also contributes to increasing the rates of many different cancers, including but not limited to cancers of the breast, esophagus, stomach, colon, mouth, head and neck, and just about any other body part you might want to mention. In addition, good ol' tobacco is the primary cause of emphysema/COPD, another leading cause of morbidity and mortality. Anyone who has any exposure to what is entailed in treating a person with any kind of cancer can just begin to grasp the immense sums used to treat this nationwide.

Alcohol is a special case. It not only causes medical problems when overused, most notably cirrhosis but also brain damage, increased risk of cancer of the esophagus and breast, and even heart muscle injury, but it also causes injury, in the form of trauma from falls, motor vehicle accidents, and other injuries from the poor judgment of inebriation, both to the user and to anyone who might have the misfortune of being at the wrong place at the wrong time. I'll throw in with alcohol the misuse of other drugs of abuse, both illicit and prescription, though the direct medical effects of these are somewhat less problematic than their effect on increasing traumatic injuries.

And this just addresses the poor lifestyle choices Ms Zoller mentioned. There are many others that I could discuss -- unsafe sexual practices, daredevil stunts and other risky behavior, use of stereo equipment and headphones at levels louder than jackhammers, cell phone use while driving, et cetera -- but you get the idea.

Ms Zoller adds:

If you’ve smoked for 50 years and Medicaid stops paying for your $400-a-month respiratory medicine, you shouldn’t complain. You had the money to smoke all those years; don’t expect the government to take care of you when you did this to yourself. So while the government is having this debate, you should quit smoking, start walking, moderate your vices, and we’ll all do better.

I have said something similar to this before. I like the way she said it better.

Moralistically, ethically, legalistically, is it right for someone, anyone, to abuse their bodies and then expect everyone else to pick up the tab? Of course not. You infringe on my rights when you request or even worse require me to pay for your care (through taxes) against my will or without my consent. Yet this is where President Obama's healthcare "reform" is taking us. (I am going to have to find another word to use for his plan; reform implies an improvement in that being reformed, and Mr. Obama's plan is definitely not going to be any kind of improvement.)

The big problem that we must face with all of this is that what we currently consider the healthcare system is NOT designed to deal with this problem. In this point, Mike Huckabee almost has it right. He says that we must try to improve health, as opposed to improving healthcare. Be aware that what we call healthcare or the healthcare system is nothing of the sort. It is actually a medical care system with a centuries-old tradition and legacy of diagnosing and then treating medical and surgical illnesses. The emphasis of this system has never been to try to improve health but rather to restore health as best as that can be done. To ask this system to take on the more Herculean task of improving health while continuing to serve as the nation's medical care system and while "reducing costs" (cutting payments to healthcare providers) is not only asking more from these providers than human beings can be expected to give, it is also a recipe for mediocrity at best and utter failure at worst.

No matter how hard I try or how much I might wish to have the ability or the power to do so, I cannot improve your health. Only you can do that. Each and every one of you. Only you can put down the fork, get out of the chair and exercise, throw away the cigarettes and pour out the booze. And even then there's no guarantee. Sometimes bad things will still happen to you, and you won't be healthy. You'll be sick. That's when my job begins. But even so, I still try to cajole you into taking better care of yourself. And maybe 5% of the time, usually less, I am successful in getting you to do it.

Why don't you? What does it take to get somebody to take on their responsibility to themselves? I wish I knew. Because that's what it's going to take to improve health -- figuring out how to incentivize people to take better care of themselves. I can tell you from experience that trying to motivate them by promises of better health or warnings of dire consequences is not enough for most people. But I'll be damned if I know exactly what it's going to take to fix this problem.

But I do have an inkling of what it's going to involve. Money. Figuring out some way that a person can achieve a monetary gain from taking care of themselves is what it's going to take. Appealing to someone's higher nature isn't going to work when the food, tobacco and alcohol are appealing to the baser instincts. To win this fight, we're going to have to win over the reptilian core at the center of all of our brains. The only two things left to work with are sex and money. And somehow, I don't see sex as being a societally acceptable solution.

I Agree with The Light of the World!

2009-03-26T01:12:00.002-05:00

It feels good to know that I am not alone in my stand.

mailloux on the blog RedState agrees with my plan on how to handle "Earth Hour":

Between 7:30pm and 8:30pm on March 28, I will throw financial caution to the wind and turn on as many of my home’s lights and electrical appliances as possible. I might even break out a string or two of blinking Christmas lights. I’ll put on a DVD for the kids, pop some popcorn in the microwave, do a load of laundry, and . . . wait for it ... set the thermostat to 73 degrees! (Gasp!).

My interest is political in nature. On Saturday March 28th, 2009 . . . between 7:30pm and 8:30pm . . . I’ll be voting with light switches and appliances. My vote will be against the maniacal, oppressive, and utterly divorced from reality lunacy of Global Warming. You see, “EarthHour.org” wants you to vote for the Earth and against Global Warming by turning off all your lights at the designated hour. I plan to do the opposite and vote for Anthropomorphic Global Warming only because I know it’s a crock . . . Earth won’t be taking any hurt by my turning on a few extra lights.

And from the looks of the comments on RedState, we won't be alone.

But remember, time for lights on is 8:30-9:30 PM local time.

Saving the Earth by Plunging It Into Darkness

2009-03-16T23:24:00.006-05:00

The enviro-wackos are at it again. This time the inanity comes under the name of "Earth Hour".

As described on the site run by the World Wildlife Fund, the organization promoting this nonsense and whose own website obscures their organization's actual name behind the acronym WWF:

Earth Hour began in Sydney in 2007, when 2.2 million homes and businesses switched off their lights for one hour. In 2008 the message had grown into a global sustainability movement, with 50 million people switching off their lights.

Demonstrating once again the liberal tendency to prefer symbolism over substance, they have now turned this "protest" into a "vote" (and they even use the word "symbolize" in the process!):

A global event created to symbolize (emphasis added) that each one of us, working together, can make a positive impact on climate change...

This year, Earth Hour has been transformed into the world’s first global election, between Earth and global warming..... Switching off your lights is a vote for Earth, or leaving them on is a vote for global warming. WWF are urging the world to VOTE EARTH and reach the target of 1 billion votes.... It is the chance for the people of the world to make their voice heard.

So we're supposed to turn off our lights (all of them) and sit in the dark for an hour so we can feel good about "doing something" to fight AGW. Why just lights? Why not turn off the heat or the air conditioner? Unplug the TV and the computer -- they use power even in the idle mode. Your relative in the back room using the mechanical ventilator? They can get by without it for an hour, can't they?

WWF is hoping for a billion people to participate in this tripe to send a message that something more serious must be done to avert this tragedy. Meanwhile, what kind of message is being sent by the other 5 billion people (a number I note that is 500% greater) who are not participating in this dog and pony show?

If you have a house, like mine, with 14 rooms (counting hallways as rooms) and each room is lit with the equivalent of 4 100 watt lightbulbs (an overestimate based on my house), then turning off all these lights is going to "save" 4 x 14 x 100 x 1hr = 5600 W/hrs, or 5.6 kWh. Replacing only one of these bulbs with a CFL bulb which you run only one hour a day will "save" the same amount of electricity in only a little over 75 days. Or 4.8 times as much electricity over 1 year. For each bulb you replace, multiply the savings by the number of bulbs. Since most CFL multipacks come with 5 bulbs, buying and using just these 5 bulbs would save in one year 24 times as much energy (134 kWh). For those of you deluded enough to actually believe in this AGW nonsense, which action would have more of an effect on reducing AGW? Changing out the bulbs, naturally. But without making the big symbolic "statement". And if you've already changed out all your bulbs to CFLs, then just how much of a statement are you really making?

I however would only advocate changing these bulbs if you want to save the money on your electric bill, though I haven't taken the time to see if the extra cost of the CFL bulbs ever gets recouped. I suspect that it would not. But then, since the incandescent bulbs are being phased out anyway......

Let's make a mockery out of this ridiculous example of political theater. "Switching off your lights is a vote for Earth" -- Horse rot! "Leaving them on is a vote for global warming" -- no, leaving them on is an act of defiance, a shout to the heavens and all who will listen that you have not bought into this doomsday farce.

On Saturday March 28, 2009, from 8:30 PM to 9:30 PM (local time), I encourage you to turn on every light in your house. Turn on every device you own that uses electricity. Turn up the heat or turn down the air conditioner. Light a fire in your fireplace. Leave your relative on the ventilator. Start up your car and let it idle in the driveway for that hour. Lights on bright of course!

Join me in my protest! My house will be the one you can see from Mars.

Addendum 3-17-09: I am not the only one decrying the insanity of this idea. James Hudnall takes on Earth Hour and AGW at Big Hollywood Blog. And let's not forget eSurance and all their enviro-wacko ads. It was one of their commercials that turned me on to this scam (pun intended). Boycott them, please. What has environmental politcal correctness got to do with insuring cars anyway?

Can We Still Afford to Cheat Death?

2009-03-15T02:17:00.001-05:00

In my last post, I issued the first in what I guarantee will be a multitude of diatribes against the Obama Administration's misguided attempts to deconstruct and destroy the greatest healthcare system in the history of mankind. In that post, I referenced a blog post discussing the early stages of this process. But at the end of this post, the author, Martha Zoller, went off on an interesting tangent:

Fifty percent of health-care costs are incurred in the last month of life and those costs rarely change the outcome of the patient’s illness.

I am not quite sure that the statistic of "50% of healthcare costs are incurred in the last month of life" is exactly correct. I have previously heard that it is more like 50% in the last six months of life. Either way, the point is that for most people, the majority of the dollars spent on their healthcare will be spent right before they die. This is, however, a rather specious statistic. Of course one's healthcare costs go up right before one dies! It would be much more remarkable if the costs went down. Most people get sick with the illness that eventually kills them right before they die. Saying "these costs rarely change the outcome of the patient's illness" is also specious. If the costs (i.e., treatment) changed the outcome of the illness, it wouldn't be the last months of your life; those months, and the costs accompanying them, would come later.

But let's ignore the speciousness of this argument and acknowledge that the point being made is that in this country we spend a tremendous amount of resources and money on care that ultimately turns out to be futile. The dirty little secret is that most of the time -- not all the time, mind you, but most of the time -- the doctors providing this futile care know, or at least have a pretty good idea, that this care will be futile almost from the get-go. So why do we not say so?

Would you, if you were the patient or the family member of the patient, want us to?

Be honest now. Think before you answer that question. I am sure that most readers here will respond to that question with an immediate "Yes, of course I would want my doctor to be honest and up front with me!" But put yourself mentally into that position, especially in the position of being the family member, and turn off your brain and let your heart answer the question. Because that is how you are going to answer the question when your time comes to answer it. For your time will come. I've been there as the family member -- twice. And being a physician doesn't change the fact that I am a human being as well and I respond with my heart just like all the rest of you.

I am not going to go into the details of my personal experiences with this type of situation. For one thing, it's none of your business. For another, the details don't matter. It's the decision making process that's the issue. Anyone -- everyone -- can look at these situations when they are the dispassionate outside observer and easily say that it is clear what the 'right' decision to make should be. But when you are faced with making those decisions for yourself, or for someone you love (which in my experience as a doctor seems to be more common and more difficult), it's not that easy. Because you need time to come to grips with the fact that you are face-to-face with the ultimate no-win situation, and the very last thing the human heart gives up is hope.

So now imagine that I come to you, the emotional, brain-deactivated relative, at the outset of some horrendous disease process for your cherished loved one, which almost universally you have had no preparation for, and say to you, "I know that what I have just told you comes as quite a surprise. But we have to think about how we are going to address this problem. In my experience and training as a physician, this condition has virtually no chance of recovery. The most reasonable thing to do at this time is to consult the hospice service and keep him as comfortable as possible." How do you think you'll be likely to react? I'll tell you how you'll react. You'll think I am the most callous human being you have ever had the misfortune to meet. You'll ask for a second opinion. You'll fire me. You'll tell me to go to hell. You might even take a swing at me. And I would deserve it.

Why is it this way? It has to do with how the human mind deals with grief. Because when faced with the inevitable loss of one's own life or the life of a loved one, there is grief involved. I cannot describe this any better than it was outlined by Dr. Elisabeth Kubler-Ross. This process cannot be rushed, and every person goes through it in their own time. Biological reality often forces some people to have to deal with such an issue in a compressed time period, and those poor souls are usually devastated. Believe me when I tell you that you would handle being told that your relative had died in a car crash better than if I told you that your relative was going to die in a short number of hours or days and there was nothing that could be done to stop it. Why? In the first instance, the loss is instantaneous, and there is nothing you can do about it. In the second, the loss is still at a point in the future, and your heart refuses to accept that the situation is hopeless.

And now we have the Obama Administration seemingly heading down the road to creating a healthcare system that will arbitrarily say what can be done and when it can be done. By arbitrarily, I mean based on factors that you would not consider were it you making the decision, and that is primarily the factor of cost. This is unfortunate, because they are going about this in the wrong way. And the only really unfortunate thing about it is the way they are going about it, for the reality really is we cannot afford to continue doing things the way we have been.

I have a colleague who has been pushing for quite some time for organized medicine (e.g. the AMA) to call for the establishment of rules regarding futile care. He proposes that when a doctor determines that care for a condition will likely be futile, that he tell the patient/family, and at that point if the patient/family wants to pursue that care, it will become solely their financial responsibility, that they can expect no assistance from insurance or the government (whose monies are the confiscated property of other people). I think this is a dreadful idea, because it puts the doctor in the position of deciding what should or shouldn't be done, and I feel is should always be the patient doing that. Besides, it sounds callous, and I rightly predicted that the first group to make such a proposal (of de facto rationing) would receive a firestorm of criticism regarding it. Just look at the opposition the current reform plan is generating (even from me!) just because it hints at rationing. It's best to leave that job and the subsequent fan-propelled feces to the politicians!

The sad part of this is that to a great extent this situation was brought about by us doctors, by our stubborn refusal to accept death as an acceptable outcome (for it is and always shall be inevitable), even at a time in the past when we were truly impotent. And now, when we have more abilities to try to intervene and cheat death than we ever have before (as puny as they are), a growing number of us are coming to the realization that to do so is often a disservice to our patients, but we have a great deal of difficulty saying this because we have (or rather, or forefathers have) convinced the public that we are nearly omnipotent. So the public, our patients, can't accept it when we might suggest that there is no point to fighting to the bitter end -- what's going on here, this isn't what the doctors used to say!

So, how do we change this situation? It isn't going to be easy.

My suggestion has always been that the AMA, and now I will include the government, begin an educational campaign to teach doctors how to have realistic end of life discussions with their patients. I would hope that the medical schools and the residency programs would have already started this. When I went through my training, such a thing didn't exist in a formalized way at all, and it was more or less on-the-job training. Some doctors learned it well, and some didn't. My observation of some of my younger colleagues doesn't give me a lot of encouragement in this regard. This education needs to extend, at first subtly and later more overtly, to the general public at large as well. As one example, TV shows give a totally unrealistic expectation of how successful CPR will be; it seems as if the majority of patients survive the attempt, when the reality is that CPR even in the hospital (much less outside the hospital) leads to a patient leaving the hospital only about 3% of the time. (This statistic is for CPR for conditions other than the setting of an acute coronary event like a heart attack, where the odds are much better, around 55% or so.)

But in addition, there needs to be a change in our society's attitude toward death. Currently, death is seen as an enemy to be feared and fought against with all our might. But this is a fight that we all must someday lose. Death is merely the final stage of life that we all must go through. For me, and I hope for you, death does not mean an end but rather a new beginning. The results of this poll, however, are not hopeful on this idea, and I fear that as fewer people believe there is a life after this one, protecting and extending earthly life will become ever more crucial. Whatever your religious views or lack thereof, my hope is that we can all begin to cherish each day of life we have, whatever their number, and make the most of each and every one.

Health Care Reform School

2009-03-13T00:20:00.004-05:00

Well, it has begun. He promised us that he would reform the healthcare system, even though we have the greatest healthcare system in the world (though, as I have said previously, we could stand to fix some of the problems we have in financing it), and he has started the process.

The "he" I refer to is of course President Obama. (I had no idea how hard it was going to be to type those words: President Obama. My fingers locked up in protest.) You will recall what I thought about his healthcare reform plan before the election. It's a pity we can't send him and his cronies to reform school.

My county medical society just had a meeting at which our state medical society president attended and spoke to us at length about the process that is now unfolding. It was somewhat vague and lacking details about the plan, mainly because the details haven't been fleshed out yet. However, this hasn't stopped people from speculating about what the plan will be like, based mostly on the fact that, though kept out of a direct leadership position in the debate due to his seeming inability to report and pay income tax on over half million dollars of income, Tom Daschle will still be having a significant behind-the-scenes influence on the plan. And unfortunately, he will likely be more dangerous in this new, non-public position. Why do those of us who prefer a free-market healthcare system (though we haven't had one in this country in over a half century) fear Daschle so? Because he's already told us where he wants to take healthcare in this country, and it's a place most reasoning people don't want to go.

Take a look at this speculation. I love some of the statements made here.

But tucked into the 700+ billion dollar “stimulus” plan is the digitizing of medical records and a board that will decide whether a type of care is necessary. This is merely code for the rationing of health care.

No, this is a description of how they intend to carry out rationing. It is a promise, not code words.

Larry Summers of the National Economics Council chaired a session on tackling costs, which included suggestions to change the way doctors and hospitals are paid and even placing limits on how much and what kind of care patients can receive. Again, this is simply code for rationing.

Again, not so much code words as a promise that care will be rationed.

Tort reform has got to be part of any health care reform package but at the “summit,” it wasn’t discussed.

Anyone holding their breath waiting for that to be a part of this reform package is going to die of hypoxia. When the party of the trial lawyers is in charge of the reform, does anyone really expect there to be any limitations on the ability of the sharks to feed? No, by limiting what we doctors can do to protect ourselves, this "reform" will be more akin to throwing chum in the waters to attract more of the sharks. Our state medical society president holds the opinion that tort reform will be considered. I'm watching her to see when she's going to start turning blue.

Finally, the article quotes Democratic Senator Max Baucus:

"...so we have to have our uniquely American health care solution, it has to be both public and private. My goal is to keep that mix of public and private, that uniquely American result with which a lot of Americans, the vast majority of Americans are very comfortable.”

I don't hold out much hope here. I expect these idiots to ram down our throats a system that will be completely run or at least under the complete control of the government. Furthermore, I expect this system will be set up such that no doctor will be allowed to operate outside of the system (because otherwise they couldn't control the costs) and that any doctor that tries will be hunted down and prosecuted with a fanaticism that we could only wish had ever been applied to the war on illegal drugs.

There's an even more interesting passage in this essay that comes toward the end. I'll take that on in my next post.

When Is 45 Million Not 45 Million?

2009-03-03T23:44:00.006-06:00

Been gone a while -- my day job keeps getting in the way of new posts. (Winter: the busy season for a doctor. Who'd've thunk it?)

Hat tip to Laura at Pursuing Holiness for putting me on to this video. It's worth the nine or so minutes of your time. (One of these days I'm going to figure out how to embed or link YouTube videos into my blog. I just can't seem to get it to work. Follow the link or the rest of this post won't make much sense.)

Don't try to add up the numbers in this video without making some adjustments. Otherwise, you'll come up with 78 million uninsured. The quoted numbers for the "young invincibles", >75K and >50K incomes, the government-program eligibles who fail to apply, and even likely the illegal aliens must have some overlap built into them. I have seen other statistics quoted in the American Medical News (the AMA's newspaper) that agree with the bottom line of 6-8 million hard-core uninsured -- those who simply cannot afford, cannot get [due to pre-existing conditions], or are not functional enough to obtain insurance on their own.

The video is enlightening, and infuriating, mostly due to the quotes from the interviewees. The worst offender is the young woman we are introduced to at the beginning of the clip. I'll call her Ms Freeloader. Why? She can't recall how much her hospital bill was after being hit by a car on her bicycle as she "didn't bother to pay for it" -- most likely because she thinks "it's ridiculous that you have to pay for basic health care in this country". Being hit by a car is "basic health care"? Since when? And what about the driver's auto liability insurance? All of the interview subjects admit to spending large amounts of their income on dining out and entertainment, with nary a care about what's going to happen to them when their health luck runs out; the reason they're referred to as "invincibles" is because in their own minds they are healthy and this isn't going to change so why do they need insurance? Though I'll bet they insure their car or motorcycle or wave-runner or whatever.

Then there's the policy analyst. If his figure is correct, that the system spends an average of $1000/yr for every one of these uninsured individuals, then that means the system is taking on $45 billion per year in non-reimbursed care. This $45 billion is either absorbed by the system -- that means written off as uncollectable by hospitals and doctors (who alone among all businesses cannot legally deduct that loss from their taxes) -- or is passed on to the responsible people who pay their bills in the form of higher healthcare costs. A certain small portion is covered in whole or in part by governmental programs. Very little of this cost is paid by the health insurance industry, which goes out of its way to try not to pay that which they actually owe, much less what isn't properly their responsibility. $37 billion of this is for people who for whatever reason have chosen to shirk their responsibilities. If that does bring your blood to a rolling boil, then consider the compassionate entry program, where foreign nationals are brought into this country to receive uncompensated care that adds to our tab even more. My blood transitioned completely to the vapor state long ago, so this merely increases the pressure in my steam-powered circulatory system.

So let's consider some numbers. If we accept the 45 million figure as the uninsured, with an American population of 300 million, that means there is a 15% uninsured rate. If the number is only 8 million, the rate is only 2.7% Since the American population is actually almost 306 million as of this posting, those rates are really 14.7% and 2.6%. With the current economic collapse and increasing unemployment, I'll accept that these numbers are the lower end of the estimate and that the real numbers are actually higher, but it's hard to pin them down as the unemployment rate is still fluctuating.

For a problem that is costing us $45 billion max (mostly because of the shirkers), with an underlying core of 2.7% truly uninsured individuals, we are now being asked by the new 'enlightened' Administration to pony up hundreds of billions of dollars to 'reform' the healthcare system. At last count this includes $643 billion in the 2010 budget, with more to follow in 2011 and beyond, as well as untold billions in the so-called stimulus spending bill (I haven't seen a solid number for how much in that bill is for "healthcare", if you consider creating a national healthcare network healthcare, which I don't). Once again the numbers don't add up, but this time it's because the money isn't really going to "healthcare".

This 45 million (and climbing!) figure that we've been hammered with for all these years is just a bunch of smoke and mirrors, part of the (Democrat/Liberal) plot to seize more power and control over you by taking more control over more and more of your life. And like lambs being led to the slaughterhouse, most of the American people don't see what's coming. It won't be pretty. But then, slaughterhouses rarely are.

Freezing Heat Chills Theory of AGW

2008-11-16T23:31:00.005-06:00

If someone were to try to make this up, they wouldn't be this surreal. They wouldn't because restraint would hold them back -- the understanding that they couldn't stretch things that far without becoming unbelievable.

What I am referring to is the recent debacle regarding October 2008 being the "hottest October on record". This was the proclamation by NASA's Goddard Institute for Space Studies (GISS), headed by none other than Dr. James Hansen. You know Dr. Hansen. Or at least you've likely seen or heard him before. He's the NASA scientist who was all over the news a few years back decrying the fact that the Bush Administration had made him rewrite his reports (or rewrote them for him) in order to hide the "fact" that mankind was turning up the thermostat on good ol' Earth.

You simply must read this article. I cannot adequately summarize it without taking away some of its glory. Basically, the GISS made their conclusion on the basis of data from Russia that was actually September data that had just been carried forward for inexplicable reasons. Once the error was pointed out to them and they obtained the correct data, they had to retract their statement, for as anyone paying attention has noticed, it wasn't that particularly warm last month -- as reports came in from around the world "of unseasonal snow and plummeting temperatures last month, from the American Great Plains to China, and from the Alps to New Zealand. China's official news agency reported that Tibet had suffered its "worst snowstorm ever". In the US, the National Oceanic and Atmospheric Administration registered 63 local snowfall records and 115 lowest-ever temperatures for the month, and ranked it as only the 70th-warmest October in 114 years."

Of course, this has not been the first time that Dr. Hansen has been shown the error of his ways: "Yet last week's latest episode is far from the first time Dr Hansen's methodology has been called in question. In 2007 he was forced by Mr Watts and Mr McIntyre to revise his published figures for US surface temperatures, to show that the hottest decade of the 20th century was not the 1990s, as he had claimed, but the 1930s." I have pointed this out before, on Blog Action Day 2007.

So at least twice now, we can see how the AGW zealots have played fast and loose with the data when it supports their position. It makes sense that they do this, as the real data don't support them at all. And if we've caught them twice, how many other times have they done it and gotten away with it? Don't forget that they have no qualms about suppressing contrary data and theories as well.

Previously I have mentioned the fact that the sun has been clear of sunspots for a good long while now, and that this is not a good thing. Here, courtesy of the orbiting Solar and Heliospheric Observatory, is a photo of the sun from November 16, 2008:

Notice the continued lack of sunspots. This is not a good thing.

Washington State Slides Down the Slippery Slope

2008-11-05T22:36:00.000-06:00

The state of Washington voted yesterday to allow physician-assisted suicide.

Another state thus joins Oregon in sliding down the slippery slope first foreseen by Hippocrates and into the morass of allowing imperfect humans to decide when others get to die.

First it's the terminally ill. Then it's the severely depressed. Next it's the people that we healthy people decide are 'existing' in a 'life not worth living' -- the mentally retarded, the infirm, those with physical disabilities. Finally it's those people around us that are merely inconvenient -- the chronically ill and the frail elderly.

For all intents and purposes, this is eugenics. The Nazis did this.

That's why it's called the slippery slope. The best course of action is to not even start to go down it. No one can without slipping.

Presidential Politics 2008: Health Care Proposals

2008-10-30T23:54:00.001-05:00

With the election drawing near, I have decided to attempt to discuss the current Presidential election,restricting myself to the two candidates' healthcare proposals. Besides, as a working physician (16 hour days and the like), I don't have time to go into much else.

I had initially contemplated doing an objective detailed analysis of each of the proposals by Senator Obama and Senator McCain, and then providing my opinions and analysis of each one. However, while doing my research, I realized that I could not do objective justice to one of these proposals, as it violates the fundamental idea that healthcare is not a right. So I will not provide detailed analyses. I will present a brief summary of each plan.

Both candidates include in their plans the expected and now-standard political boilerplate of trying to save money through preventive healthcare and through the use of "health information technology". Preventive healthcare, with the notable exception of vaccinations, actually costs more in the long run, something that flies in the face of logic but which can be easily shown through economic modeling, something that exists in the medical literature as far back as at least 1991, when I first encountered it. Healthcare information technology, meaning for the most part what most laypeople would call electronic medical record systems, is another of those thought experiments in cost reduction which theoretically ought to work, but which has yet to be proved true in the real world, and then the theoretical savings accrue only to the payers (i.e., the insurance companies and the government), with all the costs devolving onto the providers (the doctors and hospitals). It is remarkable how much of the peripheral fluffy stuff around the centerpieces of these two men's plans are similar. But the centerpieces are where the real meat is.

The main part of the McCain plan centers on the idea of transferring the tax benefits of providing health insurance to workers from the employer to the employee. This would take the form of a refundable tax credit of $2500 for an individual and $5000 for a family. The employer costs of the health insurance would be passed on to the employee as a taxable benefit. Since the national average for a family plan in the USA is $12,000, this at first glance seems to not be in the employee's favor. But let's do the math. Assuming the employee is in the 25% marginal tax bracket, his added income tax for this $12,000 is $3000. The employee thus spends "$12,000" on his family plan, pays his $3000 extra income tax, but then he gets back a $5000 tax credit, thus netting him $2000 (extra take home pay) which he must save in a tax deferred Health Savings Account to be used to pay for healthcare expenses not covered by insurance. All the usual benefits of using the HSA system continue to apply -- tax deferred, interest accumulates, can be used later in life, and can be passed on to his heirs upon his death. If one does further math work, one will see that as employee income goes down into lower marginal tax rates, the amount of tax paid decreases and the amount left over for the HSA actually increases. The converse is also true; as salary increases, the amount left over for the HSA decreases. Thus lower paid employees actually benefit more under this plan.

The McCain plan also includes proposals to allow people to buy health insurance from companies not located in their home states (something not currently permitted) and to thus be able to shop for better rates, and to allow small businesses to form associations or cooperatives so that they can get better group rates for their employees. There are some other somewhat important proposals, but this is the most important part of his plan.

The Obama plan centers upon a mandate for all "large" (not defined on the candidate's website; how large is large?) employers to provide health insurance meeting specific government-determined benefit levels. Any employer not wishing to provide employees with insurance will be required to pay into (i.e., they get fined) what is called "the new public plan". The "new public plan" is never specifically described in the proposal on the website, but it is implied (very important to remember that this is implied) that this plan will in some way entail allowing such non-covered employees the ability to buy insurance from plans offered through the Federal Employee Benefits system, using the money from the pool of collected fines. "Small" employers (again not defined; how small is small?) would be provided specific tax incentives in the form of business tax credits equalling the cost of the insurance premiums to encourage them to provide their employees with coverage.

Have you ever wondered why there is a Medicare Part A (hospitalization) and a Medicare Part B (outpatient services) and a Medicare Part D (the accursed drug benefit), but there isn't a Medicare Part C? Wonder no more. There actually is a Medicare Part C, but it hasn't been activated yet. The government, at the instruction of legislation which I'll bet was passed by Democrats (and I'd even be willing to name the specific Democrat, but I won't until I can verify it), has assigned the name of Medicare Part C to that future system that will provide government healthcare to those people who are not eligible for coverage under Medicare Parts A, B, and D or Medicaid. It is the name assigned (well over ten or fifteen years ago) to that system they intend to create to plaster the gap between Medicaid and current Medicare, thus establishing a defacto single-payer government controlled system.

How much do you want to bet that Obama's "new public plan" is not a smorgasbord of insurance plan options but is actually the now-activated Medicare Part C?

Independent analysis by the Cato Institute, the Heritage Foundation, and others have concluded that the telling feature of the Obama plan is the fine that is to be levied. If it's set at a level such that the fine costs the same as the health insurance, there is no impetus for "change". If it's set too high, employers are encouraged to provide private insurance to their employees. And if it's set too low, employers are enticed to dump their employees into the "new public plan". If the "new public plan" is Medicare Part C, then this simply is a huge, poorly disguised back door into a single-payer government controlled healthcare system, something that has been the goal of the liberal left for many, many years. We know Senator Obama is the most liberal member of the Senate. Thus one can logically conclude that his healthcare reform proposal is nothing more than a way of achieving that goal.

In my opinion, this would then be the beginning of the long, inevitable, and irrevocable decline of the greatest healthcare system on Earth.

Now, the McCain plan isn't perfect. It has its fair share of defects and holes. For example, the system in the plan allowing states to work together, either in cooperatives or by copying the state system that seems to work best, in order to provide a back up system for people who can't get or can't afford insurance (e.g., the unemployed or unemployable) lacks guaranteed funding and seems not-well-thought out. Some critics complain that by taking the tax benefits away from the employers, they will lack incentive to provide the insurance and the number of uninsured will increase. But in my opinion, this criticism fails to consider that the employees are not going to take the loss of this benefit without something in return, likely higher wages, with which they can still buy insurance on the open market and still get the tax credit.

I believe that the most important thing that can be done to help reform the current healthcare financing problem we have in this country is to dissociate health insurance from employment. Right now, employees don't own their health insurance; their employers do. So who do you think the insurance companies are responsive to? The employers, who want reduced costs even at the price of fewer benefits, higher copays, or both. Dissociating insurance from employment, thus giving ownership of the insurance to the employees, will make the employees the proper client of the insurance companies, who will then have to be responsive to the needs and demands of the employees, not the employers. Not to mention the fact that if employees own their own policies, their insurance is ultimately portable from job to job with no gaps in coverage and no fear of the dreaded pre-existing conditions exclusions clause.

The McCain plan is the first small step toward separating health insurance from employment. for that reason alone, it gets my vote. The Obama plan is nothing more than a slide downward into mediocrity and rationing, and will lead to the end of any further innovation in the healthcare industry.

Blog Action Day - 10/15/08 - Poverty and Health -- Lack of Money May Not Be the Real Problem

2008-10-15T00:40:00.006-05:00

Once again it is October 15, and Blog Action Day has rolled around for the second time. This year the issue for discussion is poverty. This blog, focusing on medical and scientific issues from a usually political point of view, doesn't exactly lend itself to this issue, but let's see what I can do.

Debility due to malnutrition.

That is the definition of poverty.

What's that you say? You think poverty has a different definition? Well, that's because you don't use my dictionary.

The medical definition of poverty is exactly that: debility due to malnutrition. Says so right in the medical dictionary. I can't blame you for thinking I've gone off my rocker (but do recall I am certifiable and could go postal on you at a moment's notice). The word poverty had a different meaning to me as well until about two minutes ago when I looked it up in the medical dictionary. The definition that first came to my mind was probably the same you thought of: the state or condition of having little or no money, goods, or means of support; condition of being poor; indigence. Believe it or not, the medical world is actually concerned about this more common definition, as poverty affects the health of our patients in many ways.

Researchers are also focusing on how poverty ('low socioeconomic status') influences health. From the Center for the Advancement of Health:

Socioeconomic status is one of the strongest predictors of health and longevity. It is not poverty or wealth alone that is the factor: researchers have found that at each step down the socioeconomic ladder, health is poorer on average and people die younger.

The most obvious way that this could happen is through less access to medical care. But this is apparently not the only reason:

The influence of socioeconomic status on personal health cannot be explained solely by access to good health care. Also playing significant roles are health behaviors (diet, exercise, smoking, abuse of alcohol and drugs) and stress associated with disparities in income, wealth, education, and occupation.

Further analysis uncovers more surprising findings. Lack of money isn't the real problem either:

When people think about socioeconomic status and health, they assume it's abject poverty, that there's a threshold at the poverty level, a point above which your needs are met and everything should flatten out. But that's not how it is.... Even at the upper socioeconomic levels, where everyone has good housing and adequate nutrition and their physiological needs are met, there is still a difference in health and well-being between those at the top and those just near the top, and there's a gradient that follows on down to the bottom of the economic ladder.

And it isn't just where you are right now. There is a cumulative effect of being economically disadvantaged that follows you throughout your life:

We've learned that the health of older individuals today shows the strong footprints of their economic histories from decades earlier. My colleagues and I asked how many times over the last 29 years they had been living at income levels below 200 percent of the poverty line, which used to be the standard cutoff for "disadvantaged" levels. Then we looked at their current health and found that the cumulative burden of economic disadvantage was visible in all of the outcomes.

It even begins before you are born:

We see the intrauterine transmission of social class as a biological phenomenon: children born with lower birth weights, less than optimal placental weight and head circumference have worse futures. These often represent the effects of prenatal malnutrition and poor medical care, stress and a whole variety of other things experienced by people who are poor. We think that what these studies are showing is the tracking of disadvantage through the uterus into birth outcomes and subsequent disease.

What causes this? Stress, or rather, a particular kind of stress:

There's this gnawing issue of social ordering, about being higher or lower in the social hierarchy, that affects health. You find it no matter what indicator you use, whether you use income, occupation, or education. We're studying this in animals, because animals on the low end of their hierarchy also display worse health than higher-ranked animals.

How does this work? It isn't clear. It may be through more than one mechanism:

One concept is what we call reactive responding. The lower you are in the socioeconomic hierarchy, the more you have to respond to stimuli that are immediate and emotion-driven and that don't give you much chance to plan your response. Often, the stimuli involve some kind of threat. So your immediate response is quite negative.
You develop negative expectations that may become self-fulfilling prophecies, which themselves create more physiological arousal. The system can become hyperactive and not turn off. Or, it may give up and not turn on at all, so you have almost no reaction to even serious threats. That also turns down the immune response and puts you at risk. We need to understand a lot more about the mechanisms involved.

But what does this do to the individual? Is this it -- or only one aspect of it?:

According to the article, the question Farah et al. set out to investigate is the extent of low socioeconomic status on neural structure.
She and her colleagues have investigated the issue by trying to tease out which aspects of poverty alter specific cognitive skills, such as memory, language, and the ability to delay gratification. The researchers studied a group of African-American children of low socioeconomic status, who had been tracked from birth through high-school graduation by Hallam Hurt, a pediatrician at Penn.
Over the years, Dr. Hurt's team had assessed the home environments of the children, monitoring how nurturing parents were, and how intellectually stimulating the homes were—for example, whether the children had access to books and visited museums.
Farah et al. reportedly found that cognitive skills were linked with particular features of the environment, such as how "intellectually stimulating" the home environment was.
To test why, the researchers did MRI scans of the children. They found that students raised in nurturing homes generally had bigger hippocampi, the portion of the brain associated with forming and retrieving memories. The discovery dovetails with previous research in rodents, which showed that rats raised in a stressful environment develop smaller hippocampi.

And even more troubling is this finding:

In recent years there's new literature that shows that it's not just how much money the people in a particular area have that predicts how healthy that population will be. It's also how fairly the income and wealth are distributed. In geographic areas with more egalitarian distribution of income there's better health, and that effect is actually independent of the average level of income or the relative poverty rates in the area.

Of course, all of this does not provide any solutions or cures for this problem. In fact, if health disparities follow a gradient up the socioeconomic spectrum from bottom to top as suggested above, it may not matter if we get rid of abject poverty (for lack of a better term). The only thing that will change is the types of problems we'll see along the raised-up spectrum. But at least this information points in some intriguing directions about how to help reduce suffering. And points out that, at least in regards to health, in poverty, a lack of money may not be the real problem.

I Couldn't Say It Any Better -- Listen Up, Obama

2008-10-09T23:06:00.005-05:00

I couldn't say it any better, so I won't try. From National Review Online, Bill Whittle says:

… what is a right? How do we know? What’s the difference between the right to free speech — which is enshrined in the Constitution — versus the “right” to health care, which is not? Well, back in the day, we would simply say that a right has legal authority — it’s in the Constitution and therefore it’s a not just a right, it’s a birthright. So why shouldn’t we amend the Constitution to include the rights to health care, food, housing, education — all the rest? What’s the difference between the rights we have and the “rights” Obama wants to give us? Simply this: Constitutional rights protect us from things: intimidation, illegal search and seizure, self-incrimination, and so on. The revolutionary idea of our Founding Fathers was that people had a God-given right to live as they saw fit. Our constitutional rights protect us from the power of government.

He goes on to say:

But these new so-called “rights” are about the government — who the Founders saw as the enemy — giving us things: food, health care, education... And when we have a right to be given stuff that previously we had to work for, then there is no reason — none — to go and work for them. The goody bag has no bottom, except bankruptcy and ruin. Does that ring a little familiar these days? Because isn’t the danger here that if you’re offered something for nothing… you’ll take it?

And then he reaches the only logical conclusion:

Only it’s not something for nothing. “Free” health-care costs us something precious, and no less precious for being invisible. Because there’s a word for someone who has their food, housing and care provided for them… for people who owe their existence to someone else. And that word is “slaves.”

To that final statement I will add the following addendum:

When the people become enslaved by owing their existence to someone else, then that doubly enslaves those that must provide their serivces to the enslaved.

I refuse to be a slave, much less a slave to a slave.

Senator Obama, Hear This!

2008-10-07T23:03:00.000-05:00

Just got through watching the second Presidential debate, and I couldn't believe that Tom Brokaw would point-blank ask whether the candidates thought that healthcare was a right or a responsibility.

Senator Obama said it was a right. Senator McCain said it was a responsibility.

Senator Obama, hear this: Healthcare Is Not a Right!!!!

Not that I needed the assistance, but my choice of who to vote for is now as clear as a CSF beertap.

Third Prophecy Fulfilled

2008-09-01T23:56:00.001-05:00

Previously I hinted at the existence of another prophecy yet to come. Well, the time has come to reveal that, indeed, the third prophecy has been fulfilled. I really wanted to mention this earlier, but I had to wait till the time was ripe.

In November 2004, while watching the election results and waiting to see if George Bush or John Kerry would be the next President, I had a stunning revelation. I had seen Barack Obama give one of the keynote addresses at the Democratic National Convention earlier that year, and was impressed with his oratorical skills, if not what he actually had to say. On Election Night, imagine my surprise when there he was again, being interviewed on camera on every network, after winning his Senate race by a substantial margin (somewhere around 72% of the vote, as I recall) and against token opposition. Initially, and only briefly, I couldn't understand how and why this local nobody was getting such a national stage. Then suddenly, the blinding flashbulb of truth went off in my head and I could see with crystal clarity:

Barack Obama was already running for higher office. And there's really only one office higher than US Senator.

I turned to those watching with me, pointed at the TV screen, and pronounced, "If John Kerry loses tonight, that man right there, Barack Obama, is going to be the Democratic nominee for President in 2008."

I was met with blank stares and dismissive ridicule.

The next four years were somewhat lonely ones (not really) as I held to my position, telling any who would listen (and there weren't many) about my prediction. Every time, the immediate reply would be "Barack Who?"

If there were other people in this country who, like me, were not surprised when Obama announced his candidacy for President, I haven't heard of or from them. And now, with the 2008 Democratic Convention behind us, my prophecy from so long ago is fulfilled. I consider this one to be an even longer shot than the prediction of the GM strike.

Note that I did not predict he would be President, however. That flashbulb hasn't gone off yet.

I Can Die When Someone Hires A Real Science Reporter (So I Expect I'll Live Forever)

2008-04-02T23:53:00.005-05:00

I really hate it when the news media gets a hold of trial results well in advance of when I get my copy of the journal in the mail. For one thing, I'm actually paying for the most important journals, so I feel I should get first shot at the data. For another thing, when the news media starts reporting on these studies, and I don't know anything more than what I (and my patients) have just heard on the TV, it makes me look bad, stupid, or at least ill-informed; after all, I'm supposed to be the medical expert. And for the worst thing, I need to be pre-warned and fully prepared when my patients come in with questions, because the news media ALMOST UNIVERSALLY GETS THINGS COMPLETELY, TOTALLY, HORRIBLY WRONG!!

Excuse me for shouting. Do recall I am postally mad (as in the original sense of the word 'mad' which is 'insane'). You see, I have been dealing with questions from my patients regarding the Zetia/Vytorin issue for about the last two weeks now, ever since the information regarding the so-called ENHANCE trial was "leaked" to the media. And only today have I received my copy of the New England Journal of Medicine and have read the actual study with the actual data and the actual conclusions of the actual authors.

Why is this important? Because media reports of medical studies are virtually without exception reported incorrectly. Usually, as with the ENHANCE trial, reporters reach conclusions from these studies that were not reached by the actual researchers. And they weren't reached by the researchers because the media's conclusions cannot be made on the basis of the data presented by the study. Another classic example of this was the media's handling of the Womens' Health Initiative report from a few years back. You know, the study that killed PremPro/Premarin and likely Wyeth Pharmaceuticals along with them? I could melt your monitor with complaints about how abysmally I think that was handled. Of course, I have more complaints with the actual study itself; I don't think it should have ever been published it was such a bad study. But that's another issue for another time. When your monitor melts, don't blame me; you've been warned.

Why does the media almost always do this? Because "science" reporters have, without notable exception, no apparent knowledge of the scientific process or the area of science they are assigned to cover. It seems as if the journalistic world has fallen into the same trap as the education industry. Where teachers are supposed to be able to teach any subject as long as they know enough about education theory and how to teach, reporters apparently are supposed to be able to report on any topic as long as they know enough journalism theory. Neither of these suppositions is true. If you don't know algebra backwards and forwards, how do you expect to teach it? If you don't know enough science to understand or properly read a scientific paper, how can you write a newspaper article about it and make any sense?

I will to a certain extent even fault the actual doctors that the media hires to cover medical issues. I'm talking about the real doctors they've hired, not the weirdos like Dr. Weil or Dr. Oz, who are just trying to sell their next book. Check out the network medical reporters on ABC,CBS, CNN, NBC and what they are -- gynecologists, neurosurgeons, psychiatrists, you name it -- but never internists. And 99% of the issues they cover are internal medicine based. Among the doctors I know and have met, it has been my experience that, for the most part, gynecologists know gynecology, surgeons know surgery, psychiatrists know psychiatry, cardiologists know cardiology, and they know their fields well. But ask them a good internal medicine question, and they haven't got a clue. So why should the ones on TV be any different?

I don't expect this situation to change anytime soon or ever. But I can die if and when a major media outlet actually hires a scientist to cover a scientific issue. Therefore I expect that I'll be able to live forever, since that event has less chance of occurring than I have of winning the Texas Lottery. And that's assuming I would actually buy tickets regularly, which I don't.

Next time I'll get into the details of the ENHANCE trial and show where the reporters went wrong. I'll point out some interesting data that the reporters missed, probably because they didn't recognize its significance. And I'll tell you what we actually did learn from this study. (PS: It isn't very much.)

And by the way -- if you are currently taking either Zetia or Vytorin on the advice of your physician, please talk to your doctor about it and follow his or her advice. Don't just stop taking it. I'm sure your doctor knows a bit more about what he or she is doing than the reporter from the Associated Press does about that medical paper he just listened to a press conference about and couldn't spell half the words from.

Could It Be? The Final Nail in the AGW Coffin?

2008-03-29T23:03:00.002-05:00

Why can't the people who get paid to report the news find this stuff? I'm not even looking very hard.

Blogger Ace of Spades put me on to the link to what may be the final nail in the coffin of the AGW hypothesis: the computer models are wrong, and someone has figured out what the error is!

Hungarian atmospheric scientist Ferenc Miskolczi discovered that the climate models being used were based on a series of differential equations for modeling greenhouse gases originally derived in 1922 that made the assumption (to simplify the math) that the atmosphere was infinitely thick, which of course it isn't. So he did the logical thing -- he re-derived the equations including terms that described the actual thickness of the atmosphere. And guess what?

The new equations show that as CO2 concentrations go up, negative feedback forces kick in, limiting temperature rises and preventing any runaway global warming.

The new theory also predicts that greenhouse gas increases should result in small, but very rapid, temperature spikes, followed by much longer, slower periods of cooling -- exactly what the paleoclimatic record demonstrates, and what the actual data show appears to be happening right now.

The new model also accurately describes the witnessed global warming on Mars.

Dr. Miskolczi worked for NASA when he figured all this out. As one would expect in this politically correct nation, NASA refused to release the results, and he eventually published his findings in a Hungarian peer-reviewed scientific journal. When he resigned from NASA, his resignation letter stated, "Unfortunately my working relationship with my NASA supervisors eroded to a level that I am not able to tolerate. My idea of the freedom of science cannot coexist with the recent NASA practice of handling new climate change related scientific results."

Global warming advocates dismiss his theory in spite of his model's more accurate fit with the data, the paleoclimate record, and the warming on Mars. After all, the AGW model just can't be wrong. There's too much money already tied up in it.

I thought it would take a while to find the evidence to disprove the AGW hypothesis. It never occurred to me that the hypothesis could be that fundamentally flawed.

So the coffin is now nailed shut. But we've all seen enough vampire movies to know that it won't stay shut, at least for a long while, and that the monsters will continue to plague us for some time.

AGW and the (Foreign) Press

2008-03-29T22:03:00.004-05:00

Once again I bring to your attention the increasing quantity of data and evidence that AGW is a crock of manure and that we may have much more dire things to worry about. And once again this information can only be found in news outlets located outside the USA, or by depending on information obtained from foreign sources.

An editorial in Investor's Business Daily (which I'm sure all of you subscribe to and read daily) reiterates the idea that I've introduced you to before -- that the sun is the driver of the climate and that it overpowers what little (if any) effect man-made CO2 has on temperature. But look closely at where the data are coming from: the Danish Meteorological Institute, Canada's National Research Council and Ottawa-Carleton Geoscience Center of Carleton University, Germany's Max Planck Institute of Solar Research, and a Russian astronomer. Where are the Americans? Cowed by the PC police, that's where.

The better piece comes from the the Australian News regarding a recent interview on Australian radio, revealing that both terrestrial and satellite data are showing that since 1998 the Earth has been cooling -- and that the Intergovernmental Panel on Climate Change (IPCC, that mouth organ of the UN that is the main champion of the AGW cult) is very aware of this data! Of course, the statement is made that the meteorological community is "having trouble digesting the findings" since the data don't fit their beloved computer models, and as we all know, the computer models can't be wrong, can they?

I particularly like the second half of this Australian article, where it talks about the "implications" of the failure of the AGW hypothesis, focusing mainly on the political aspects. But right near the end, the article reveals that even in the foreign press, there is still politically correct censorship -- I mean editing. In republishing an essay from the Sydney Morning Herald, the Australian paper The Age deleted the following statement:

What The Age decided to spare its readers was the following: "Well-meaning intellectual movements, from communism to post-structuralism, have a poor history of absorbing inconvenient fact or challenges to fundamental precepts. We should not ignore or suppress good indicators on the environment, though they have become extremely rare now.

Guess that assessment hit too close to home. It certainly hits too close to home in the USA. Only here, we don't see only the editorial musings of an essayist "edited". Here, the news media edits the facts as well. Thank God there are foreign media outlets that still allow for true freedom of the press. The First Amendment? That only limits the government from censoring the press. It doesn't say anything about censorship by liberal ideologues.

The End of the Fourth Interglacial Period?

2008-02-26T00:50:00.003-06:00

I can't help myself. Just too much good stuff coming in too fast.

The Canadian National Post (gotta love those Canadians, not giving in to the AGW cultists like their "superior" brethren to the immediate south) has an article about the fact that the current Northern Hemisphere snow cover is at its greatest extent since 1966. It goes on to discuss new record low temperature readings and snowfall amounts in various parts of the world this winter. It mentions the apparent restoration of the Arctic ice cap (though they only started measuring it in 1972). Then a new theory accounting for the ice melt is reviewed, with the implication that such melting may be following a 40 year cycle. (And remember, the records started only in 1972, which is just 36 years ago.) It concludes with a brief mention of sunspot inactivity.

So the glaciers are reforming. Another Ice Age is on its way.

Not!

We are just seeing another side of the cycle. You know, the cycle where things, like for example temperature, go up, and then they go down.

If one were to assume that the downs indicate the coming of an ice age, you would be ridiculed. But when the cultists assume that the ups indicate the coming of a runaway global barbecue ("Earth on a spit!"), they are merely being prudent when they demand we implement draconian measures to try to prevent it (especially when such measures won't even slow it down).

Sounds like somebody believes in double standards here.

But then, the liberal left has always believed in double standards, one set for themselves and another for everybody else.

Give me a break.

AGW Indeed! More Like Heliogenic Climate Control

2008-02-17T02:34:00.004-06:00

AGW zealots must be having a great deal of heartburn this winter. Not only has there been record snowfall amounts throughout the Midwest, but now come new reports that futher expose the folly that is AGW.

First comes a report from the Canadian Broadcast Company that the ice cap in the Arctic is expanding back to near normal levels, and that in some places the ice is actually getting thicker. Why? Because of the extended severe cold weather in the Arctic this year.

Also, recent observation of a virtual absence of sunspots for neary two years is making solar researchers uneasy. They feel this indicates some change in the internal workings of the sun. The last two times something like this was seen was in the 1650's and again in the late 1790's-1820's. Both instances presaged decreases in solar irradiation that caused global temperatures to drop; the second one caused what it now called the Little Ice Age. (And a local touch -- an astrophysicist gave a lecture at the University of Texas-Tyler -- yes, right here in Texas! -- saying pretty much the same thing, that the solar variability is the major driver of Earth's climate.)

During both of these periods of global cooling, much more human misery was caused than any AGW prophet of doom has so far predicted. Some of these solar researchers are concerned we are now heading for another such period (possibly as long as a century) of global cooling beginning before or at least by 2020.

I bring to your attention the following quote from the Investor Business Daily article quoted in the blog post I cited above:

As we have noted many times, perhaps the biggest impact on the Earth's climate over time has been the sun.
For instance, researchers at the Max Planck Institute for Solar Research in Germany report the sun has been burning more brightly over the last 60 years, accounting for the 1 degree Celsius increase in Earth's temperature over the last 100 years.
R. Timothy Patterson, professor of geology and director of the Ottawa-Carleton Geoscience Center of Canada's Carleton University, says that "CO2 variations show little correlation with our planet's climate on long, medium and even short time scales."

I thank Thomas Lifson for putting me on to the first of these reports, and Marc Sheppard for the second. Both posts were at a site called American Thinker that I just discovered and to which I will definitely be returning.

I also cannot say this any better than Mr. Sheppard did in his post, so I won't try:

The unremitting mulish refusal to accept the yellow dwarf star at the center of our solar system as the force that drives our climate and weather - despite all overwhelming correlating evidence -- is simply mind-boggling.

I Haven't Forgotten I Have a Medical Mind

2008-02-16T12:20:00.001-06:00

No, I haven't forgotten that I have a medical mind, and that the original purpose of this blog was to discuss issues of somewhat medical matters. Looking back, I see that the last few posts are beginning to make this look like an anti-global warming screed. Rest assured, I shall be soon returning to more medical matters. It's just that when I run across more pieces of the ever accumulating piles of evidence of the absolute insanity of AGW, and I hear more and more of our political leaders falling into lockstep with the AGW zealots, promising to spend more and more of our tax dollars -- no, more importantly, my tax dollars -- on this foolishness..... Well, it just makes me want to go postal in a different direction.

So there will be more discussions of medical issues. I will get around to telling you why your medicines cost too much, hopefully before the elections in November so you'll be able to realize just how clueless most of our leaders and lawmakers are. I plan to take on the presidential candidates misguided proposals for "healthcare reform" (and not a single one of them says "healthcare financing reform"). And I may even be able to crow about another prophecy fulfilled, but I'm still waiting to see if my crystal ball is going to turn out to be cracked or not (hint: it's about the November election).

But I just Tivo'ed National Geographic Channel's Six Degrees Could Change the World and I'm sure it will be as juicy a target for ridicule as was Al Gore's An Inconvenient Election -- oops, sorry -- An Inconvenient Truth. And I just won't be able to resist.

Nothing is But Thinking Makes It So

2007-12-11T09:39:00.000-06:00

AGW is a man-made crisis. Literally. It exists only in the minds of those people deluded with their own visions of man's grandeur. It does not exist in the real world. I am not alone thinking this.

The UN is having a conference in Bali to try to brainwash more of the world's population into believing this hogwash. However, a group of scientific skeptics is there promoting the idea of doing exactly nothing to fix the "problem". That's right, nothing. You see, the best solution to a non-existent problem is to ignore it.

I am there with them in spirit. Go, guys, go!

Snow Falling on (AGW Endangered) Cedars

2007-12-05T01:29:00.000-06:00

I get such wonderful leads from Matt Drudge. Today's link is once again regarding the wonderful fantasy that is AGW. It seems that the Senate will be voting today on an "historic" global warming bill. Obviously it is not historic in that the Senate will be wasting time on issues of absolutely no importance; they are good at that. The historic aspect is that this will mark the first time that the Senate has voted on an AGW bill. The two unfortunate aspects of this is that this will unfortunately not be the first time they will so waste their time, and I suspect that this travesty of a bill will likely pass. I am praying for you, Senator Inhofe.

The hilarious aspect of all of this is that while the Senate debates and votes on global warming, the forecast is for snow in the Washington, D.C. area. Possibly as much as one or two inches.

Meanwhile, look at the comments posted on the blog I linked above. Many, many commenters, and virtually all of them from other people who have refused to drink the Kool-Aid of the Cult of AGW. Keep in mind the original blog post here is a pro-AGW position. And we are led to believe by the MSM that the vast majority of the American people believe in this tripe. It makes me proud to be an American denier.

I particularly like the 15th comment; it makes me look a little less long-winded!

In Good Company Being a "Denier"

2007-11-12T12:12:00.000-06:00

At least I'm in good company in my position as a radical AGW denier.

Recently the founders of the Weather Channel, meteorologist John Coleman, published an article (well, more of an opinion piece) on the ludicrousness of the entire idea of AGW. I cannot say it any better than he does: Global Warming ‘Greatest Scam in History’.

A couple of other guys run a site called LongRangeWeather. They discuss the current trend of global temperatures here. This article accompanies this chart. Looking at the chart, it kind of looks like a repeating pattern -- and it ain't runaway global warming.

It might just be time to go out and invest in some longjohns.

The Truth About SCHIP

2007-11-11T23:38:00.000-06:00

I just have to give this wider attention. It is just so true.

Thanks to the great junior Senator from Texas, John Cornyn, for bringing this to my attention.

http://www.youtube.com/watch?v=2qcypRnDcCo

The Church of Man-Made Global Warming? That's Not Quite Right

2007-10-26T18:42:00.000-05:00

In a speech today in the US Senate, Senator Daniel Inhofe of Oklahoma spent two hours debunking the current state of AGW propaganda and lambasting its disseminators for targeting children with a campaign of fear trying to recruit them and turn them into environmental activists.

In this speech, he refers to this campaign of fear (terror?) as "the Church of Man-Made Global Warming".

Wish I'd thought of that. Of course, it's a church. The AGW militants go at their task with religious zeal, trying to "convert" children to their way. But this is a church that has no god, except for mankind itself, and has only a message of fear and despair.

On second thought, it's hard to give this group the status of a church. Most churches profess to teach the truth. This "church" lies and cheats and terrorizes its way to authority, and then will use that authority to rule with dictatorial and despotic abandon.

Naw, it's not really a church. It's actually a cult.

Only this cult is beginning by forcing us to drink their poisoned Kool-Aid, rather than ending that way.

Blog Action Day 10-15-07-- Al Gore and the Nobel Piece of Fiction Prize

2007-10-15T00:01:00.000-05:00

There is a movement trying to promote environmental awareness through blogs called Blog Action Day, and that day this year is today, October 15, 2007. Well, awareness of environmental stupidity, in my book, is also environmental awareness, so here is my entry. (Hats off to Google Blogger for making me aware of this event.)

Friday, October 12, 2007, was a dark day in the annals of environmental stupidity. (A bright day would be one where environmental stupidity would be diminished, 'bright' pun intended.) This was the day that megalomaniac Alfred Gore, Jr. was awarded a Nobel Prize. And a Peace Prize at that. I could have understood it if it had been the Nobel Prize for literature, as An Inconvenient Truth and the entire anthropogenic global warming movement are some of the most impressive pieces of fiction to have been created in both the 20th and 21st centuries. There appear to be others who share my view as well -- even in New Hampshire, where they seem to be quite good at calling kettles black:

The American public won't accept at face value Gore's self-righteous proclamations or his self-serving predictions of looming global catastrophe. And Gore has to know that, which is why he will almost certainly stick to the world of make-believe -- Hollywood and International Do-Goodery -- where he can pretend to be the great sage and savior he wishes he really were and left-wing Europeans and thespians try to convince us he is.

Any regular reader of this blog (as I continue to delude myself that there are any) knows my opinion of Anthropogenic Global Warming (now and forever in these pages to be abbreviated AGW). For a refresher, take a look at Getting Overheated and its sequel.

There are many other theories regarding why we are seeing apparent changes in the Earth's climate, and almost all of them do not involve human causes, thus making Mr. Gore's Nobel Prize seem more like a cosmic joke. Many of these theories have much more scientific evidence supporting them, and make more sense scientifically, than the AGW hysteria created from the preexisting and unalterable mindset that if something on Earth is changing, then we puny humans must be responsible, since there can be nothing more powerful than humankind. The Norwegian Nobel Committee awarding the prize to Mr. Gore so much as said so, concluding its citation with the statement, “Action is necessary now, before climate change moves beyond man’s control.” (emphasis added). This implies that we are now, however unconsciously, in control. But we are so certainly not in control, not now, not in the past, and not in the foreseeable future.

In fact, even some of the data that the AGW militants have used to build their bandwagon turn out to be wrong. Don't forget that An Inconvenient Truth itself has recently been found by a British court to contain inaccuracies and fallacies. Also, I heard several months ago that NASA's Goddard Institute for Space Studies had been forced to correct some of their temperature data, but I could not find any news report about this until now. Why? Because stupidly I was looking in the American news media, and not even the "conservative" Fox News dares to take on the AGW torchbearers and their pitchforks. Thank God we have the Canadian National Post and its online version, where dissenting views can still be published. The above link to the articles about the AGW "Deniers" (a title I bear proudly) also comes from this source.

Correcting the temperature data reveals that the widely-quoted "fact" that the last ten years have been the hottest on record is actually not correct, and that the hottest ten years of the last 130 years have been scattered seemingly randomly throughout the decades, and that 4 of them occurred in the 1930!s! As Lorne Gunter states in the article, "Claiming that man-made carbon dioxide has caused the natural disasters of recent years makes as much sense as claiming fossil-fuel burning caused the Great Depression." But does this dissuade the AGW militants? Of course not. Anything that does not fit the "theory" is either ignored, dismissed, doesn't matter, or is being misinterpreted -- such as the issue of whether the atmospheric CO2 measurements taken from ice core measurements (which are the fundamental underpinnings of the AGW argument) are accurate. Turns out they probably underestimate the level of CO2 in the ancient atmosphere by up to 50%, which means our current CO2 levels really haven't increased all that much. And I could go on and on....

We do not have to let the AGW militants control the debate and take humanity down the road to darkness and despair with their completely political agenda. Especially when their theory makes as much sense as "Aliens Cause Global Warming" (thank you, Mr. Crichton!). If you aren't sure what to think, or you want a primer on the evidence against AGW, I suggest you start with Climate Skeptic's A Skeptical Layman's Guide to Anthropogenic Global Warming; you can read it online or download (for free!) the entire 83 page PDF from the bottom of the page I linked above. Don't want to read 83 pages? Try the 60 second version. And don't forget his ongoing blog also.

Now, I'm not saying anyone has to do what this guy did, but I admire his chutzpah. But we can stand up and demand that the competing theories be discussed and analyzed, and the real causes of climate change be understood before we go off half-cocked and destroy the economies of the entire world. We can insist that there actually be consensus before anything be done. And for those of us so motivated (like the brave Canadian citizen linked to above) we can take the issue to the streets, the billboards, and the blogs (as I am doing). Alternatively, consider supporting an organization you trust and who feels the way you do. The Competitive Enterprise Institute is one example.

(I know CEI has some connections to other groups and industries that are supposed to be bad and evil -- I can use Google too! -- but that criticism is just part of the militant nature of the AGW supporters; Greenpeace and PETA have equally bad "connections" to groups from the other point of view. If you read this and expect to flame me with comments about how evil CEI or anybody else is, don't bother; comment moderation is turned on and, as I stated in my very first posting, I have zero tolerance for anything but spirited [and intelligent] discussion, and I don't consider regurgitating talking points or spewing venom indiscriminately like a blind cobra to fall under either category.)

Lest anyone think I am just a shill for the oil companies, recall my only connection to them and that I hate myself for not buying Exxon stock about three or more years ago. Also, I hate paying the price I'm paying for gasoline just like everybody else. I'm all for reducing or even eliminating our dependence on oil, especially imported oil, but strictly for national security reasons, not environmental ones. I could be there for economic ones also, if an alternative energy source could be made less expensive than hydrocarbons for me and society. Heck, I'm even toying with the idea of buying an Aptera car, but only because I think it could save me over $1000 a year on gasoline. (And because I'm a bit of a gadget freak; after all, I am a blogger!)

Four times in the recent geological past, that Earth has frozen into an Ice Age, and four times it has thawed out, and all of these changes occurred without the intervention of man or "CO2 spewing SUVs". In each of the preceding three interglacial periods the overall temperature of this planet has gotten several degrees warmer than it is on Earth right now, and this level was usually reached at the end of the interglacial period in a spell of rapid (geologically speaking) warming. The pattern we have seen before in those previous periods appears to be happening once again, and if this is so, it is due to the same non-human factors (such as the sun and interstellar cosmic rays) that caused it to occur three separate times before human civilization existed on this planet. If this is the case, humanity's job is not to stop it (as such is beyond our puny powers); our job, like those of the creatures on Earth during those previous warmups, is to simply adapt -- or die.

Personally, I would rather expend the resources of our society adapting as we need to rather than to waste them on the futile task of trying to stop the inevitable and then bitterly wish we had done otherwise as Homo sapiens sapiens follows the dinosaurs into extinction. But that's just me.

I'm Two for One!

2007-10-13T17:31:00.000-05:00

Never thought about the downstream effect of my prediction of a strike against GM due to healthcare issues. Now this past week, the UAW struck ever so briefly against Chrysler for the same reasons. So I'm now two for one -- a 200% accuracy rate in my precognition!

That leaves Ford of the Big Three auto makers. All expectations are that Ford will be even more problematic for the UAW than was GM and Chrysler. But then healthcare costs are only one of Ford's problems.

Three for one, anybody?

Let's Promote Adherence to Compliance

2007-09-30T23:31:00.000-05:00

While I'm ranting about semantics, I've got another nit to pick, only this one is with an insidious faction lurking within the medical community itself. This issue, which has been showing up in medical journals over the last couple of years, has to do with the replacement of the term compliance with the term adherence when referring to the concept of patients' following the medical plans and recommendations that we physicians provide to them.

Let's start with the definition of these terms, in both English and in "Medicalese":

Adherence -- ENG: the process or condition of adhering; to cause to adhere; make stick; which leads to Adhere -- ENG: def 3 - to carry out a plan, scheme or operation without deviation

Compliance -- ENG: act of complying with a wish, request, or demand; with a
medical definition from an English dictionary stating: "willingness to follow a prescribed course of treatment"

Sound pretty similar, don't they? In fact, they sound like synonyms.

But somehow when these word get translated into "Medicalese", the definitions get deformed. As taken from the online Stedman's Medical Dictionary:

Adherence -- MED: the extent to which the patient continues the
agreed-upon mode of treatment under limited supervision when faced
with conflicting demands, as distinguished from compliance or maintenance

Compliance -- MED: the degree of constance and accuracy with
which apatient follows a prescribed regimen, as distinguished from adherence or maintenance

In the English language dictionary, the two words have very similar meanings, namely, the process of or willingness to carry out an established plan, in this case the medical plan established by the physician.

In the "Medicalese" dictionary, the two words all of a sudden have different meanings; they are actually set against each other (as distinguished from) as being specifically different. is it any wonder that people at large think we physicians speak another language? It's because some of us (the ivory tower academics) think that we do, to the point that they are redefining words! They must have forgotten that these words already have definitions that have been around for centuries.

Adherence loses the property of "without deviation" and becomes a matter of degree or extent; compliance gains the property of "constancy and accuracy", which have nothing to do with compliance, and are more correctly scientifically called "precision".

More to the point, in the "Medicalese" definitions, there is an implied semantic (see def 3b again) difference that is not spelled out in the expressed "Medicalese" definitions. In "Medicalese", compliance semantically retains the idea that following the prescribed course of action is a choice of the patient. Adherence semantically is something that is under the physician's control; it is something he must cajole out of the patient, and if the patient does not adhere, then it is the physician's failure, not the patient's.

Thus adherence is no longer responsibility of the patient. It is the responsibility of the physician. Furthermore, since what the physician is trying to cajole is adherence to compliance, and compliance is now a measurable quantity ("degree of accuracy"), then the degree of adherence (to compliance) is measurable as well. And it is a measurable component of the physician's job performance, not the patient's willingness to get better.

In other words, if the patient doesn't follow the treatment plan, it's the physician's fault for not getting the patient to participate ("adhere") accurately enough (compliance).

I object!!!

I object strenuously to the deformation of the English language ("words mean things"). I object because this alteration of word meanings is not accidental, but is clearly designed to further some nefarious purpose. I object to the use of these terms in their altered states by medical journals because of this nefarious purpose. I object to the transfer of responsibility of following a treatment plan from the patient to the physician to support this nefarious purpose. As I have said before, healthcare is a responsibility of each and every person, which cannot be abrogated or assigned.

I say, let's promote adherence ("to carry out an operation without deviation") to the true meaning of compliance ("willingness to follow a prescribed course of treatment" by the patient).

And what is this nefarious purpose, you might ask? In the medical world, it's called P4P. More on this later.

American Cancer Society Please Read This

2007-09-28T22:06:00.000-05:00

Four times this morning, I watched as a series of PSA's made by the American Cancer Society played on my TV screen. Now, I like the American Cancer Society. I think overall they have done good work. I've given money and raised money for the American Cancer Society. But I have to take them to task about these new PSA's, and if they continue down the path that they seem to have embarked upon, I soon may no longer be able to support them.

The most egregious of these PSA's begins, "This is what a healthcare crisis looks like to the American Cancer Society." The basic point of these messages is that there are cancer patients who can't get treatment because they don't have any or enough medical insurance. I agree this is a problem. I do not agree with the way they phrase it, however, referring to it as a "healthcare crisis".

American Cancer Society, please read this: There Is No Healthcare Crisis in the United States!

Words mean things. Yes, this is basically an issue of semantics (see particularly definitions 1 and 3b), but it is an important issue of semantics. If people are told enough times that there is a "healthcare crisis", then they will begin to believe there is a fundamental flaw in the actual medical care that is being delivered in this country. And we have the highest quality, most technically advanced healthcare in the world. Qualitatively and quantitatively, the average American receives more healthcare, and higher quality healthcare, than the average citizen of any other country.

Is our healthcare system perfect? No, it's far from it. Let's look at some recent numbers. Of people being treated for hypertension, around 63% are treated to what are recommended as goal levels. Pretty abysmal, huh? Must be a crappy system, right? Well guess what? Almost every other country is far below us, in the range of 31-46% or less. Can we do better? Yes. Must we do better? Yes. But everywhere else in the world has to do better just to catch up with where we are now.

If someone cannot get needed care for a life-threatening illness due to a lack of ability to pay, I would agree that is a tragedy. But the tragedy is not that our healthcare system is in crisis. It is a tragedy because our societal system has led to such high medical costs that many people cannot afford the price.

And the solution to that problem does not involve destroying the best healthcare system in the world. Indeed, we should enhance such a system. It is everything around that system that needs to be changed.

Stay tuned.

President Bush Is Right in Vetoing SCHIP Bill

2007-09-26T23:55:00.000-05:00

To President Bush: Yes, PLEASE veto the SCHIP legislation!

For those not fully in the know, SCHIP is the State Children's Health Insurance Program. This is a program designed to provide Federal government assistance (read "pay for") in providing health insurance to children whose family income was below the poverty level and could not afford to buy commercial insurance for the children. In fact, the original legislation called for signing up children whose family income fell below 200% of the poverty level. That number is currently around $41,ooo/yr. Since it's inception, some states have used their funding to sign up children of families with incomes as high as 350% of the poverty level.

SCHIP is up for renewal now, and the (Democratically-controlled) House and Senate are debating differing bills on expanding the programs. Both houses are calling for dramatically increased funding and increased coverage levels nationally to 35o-400% of the poverty level. (That's up to a family income of $92,000 -- among the top 20% of wage earners in the country.) Meanwhile the original programs are not succeeding at their original purpose, as the percentage of eligible children in families below 200% covered by SCHIP is well less than 90%. Leave it to the Congress (and especially the Democrats) to expand a program that isn't even doing what it was supposed to do.

While the Houses of Congress blather about how much more money to pour down the well, President Bush has moved administratively to limit the ability of states to use Federal dollars on any SCHIP coverage to a family making more than 200% of the poverty level until that state can demonstrate that at least 95% of children in the less-than-200% category have some kind of health coverage. Believe it or not, he's actually trying to make a government program do what its enabling legislation says it's supposed to do -- and he's being soundly criticized for it!

President Bush's position is that the SCHIP is supposed to help those who truly need the assistance, and that to expand the program to cover more and more children at ever-higher income levels is just a way to try to surreptitiously expand government healthcare as a back-door to a single payer system. And he's right about this. This is not a new ploy by the Democrats. Recall Al Gore's healthcare "reform" proposal in the 2000 election: Expand Medicaid up and Medicare down (age-wise) until everybody is covered -- a back door to a government-controlled healthcare system.

And lest we forget: Though SCHIP is technically provided through private insurance companies, the program is administered through Medicaid. The private insurers must contract with Medicaid (in each state), abiding by whatever rules Medicaid puts down. It is essentially just an expansion of the Medicaid program. Expanding SCHIP is just another way of implementing Al Gore's misbegotten idea.

If families making $92,000/yr cannot "afford" to own up to their responsibility to provide for the healthcare of their children, then there is something wrong -- with them! They have problems with their priorities, with their budgeting, or with their mental processes. But they don't have a problem with the lack of Big Brother "helping" them.

The house of cards hasn't even completely fallen yet and the communists are trying to take us down the wrong path. The uphill road seems to be steeper than even I imagine.

UAW Strike Fulfills Prophecy

2007-09-24T19:39:00.000-05:00

I now stand before you a prophet in my own time. Or at least in my own mind.

As I informed you in my last post, I began predicting the disintegration of the current healthcare financing system ten years ago. The prediction was subsequently refined to indicate that the precipitating event would be a labor strike at a major national employer, which three years ago I determined would be General Motors.

So the UAW's strike fills my prophecy in full.

Even though union leaders say that the real reason for the strike is to get guaranteed job security, I think healthcare benefits must be part of this. After all, what comes along with job security? Healthcare benefits security.

Unfortunately, being proven a prophet has its downside. For the prophecy only begins with the strike against GM. What will follow is the complete unraveling of the current healthcare financing system and its ultimate replacement with something else. My powers of foresight have not yet revealed to me how long this process will take, or what we as a society will be left with at the end of the transformation.

I do know this: our American society now faces a choice of which direction to follow. And it is a choice. Do not let anyone tell you that it is not.

Will we choose to go down the easy path of government-controlled, government-regulated, and ultimately government-limited healthcare, where Big Brother tells you how much healthcare you can have, what kind it is, and how it will be done? Where (to horribly paraphrase Henry Ford) you can have any kind of healthcare you want as long as it's bleak? Where the government decides how much your healthcare is going to cost, and this amount will never cover the true cost, and the quality of healthcare progressively suffers as a result?

Or will we choose to go up the harder path of personal choice and personal responsibility, where you choose what healthcare you want, when you want it, and how much of it you want? Where the decisions about your healthcare are made between you and your doctor with no government bureaucrat standing behind you with a prior authorization denial slip? And where you, not the government or an insurance company, decide how much it's going to cost, and what the quality of that healthcare will be, because you, the actual consumer, are the one paying the bills?

Being able to see a train wreck coming and not being able to do anything to stop it is painful. That's where I've been for the last ten years. It's one of the reasons I started this blog. Before any solutions can be found there must be awareness of the real problems. And I will continue to carry my lamp, as feeble as it may be, to try to bring to light what I see as the nature of the real problems so that hopefully we may come to the right solutions.

America deserves a healthcare system of choice, options, dynamism, and innovation. It does not deserve a one-size-fits-no-one system of limits, rationing, stagnancy, and inhibition.

So my ranting will go on.

The Healthcare Financing House of Cards Is About to Collapse

2007-09-17T23:38:00.000-05:00

I was listening to the radio this very morning and suddenly felt very vindicated. Let me explain.

Beginning ten years ago, in 1997, I looked at the state of things in healthcare, particularly healthcare financing, and realized that the whole thing was a house of cards, and not a particularly well-built one at that. I've touched on this in previous posts, but in a nutshell, it goes like this:

Insurance premiums go up and up while covered services get fewer and those covered are restricted through "prior authorization" and the like. Meanwhile, patient copays climb higher and higher, while doctor and hospital payments slide lower and lower. Nobody knows the true cost of a service, not even the doctor providing it, because he's had to adjust his fee so much to make up for what the insurance companies aren't paying him that he no longer recalls what the real cost is anymore. Furthermore, government oversight and insurance company meddling increase the hassle factor of medical practice more and more each year, month, and day. Inflation chops away at doctor and hospital profit from the opposite end from the payors at an ever escalating rate. The liberal elite, controlling the media and thus controlling the argument, proclaims healthcare a "right" (which really it isn't) and leads society into believing more and more that they can have all the healthcare they want, the cost be damned. (Of course what is wanted is not counseling on lifestyle changes to prevent or control chronic disease, or medications to thwart the devastation of diabetes, high cholesterol, hypertension, and the like, but rather cosmetic surgery, Botox for everything, laser facial peels, and other crap that won't add a day to their lives.) Swimming over all of this are the sharks, the malpractice lawyer-jackals, who ravenously feed parasitically off of every part of the healthcare systemwithout any restraint . Looked at globally, the entire thing is unsustainable, and headed for collapse, primarily because the wrong component of the system is in control.

So, ten years ago, I began to predict that ten years hence, in 2007, an event would occur that would make it obvious that the wheels were coming off the cart, that the seams were coming apart, that the house of cards was coming down.

Six years ago I refined my prediction -- I named the event . I predicted that the event would be when a major national employer and its labor union would break off talks on renegotiation of the labor contract, and the union would go on strike, and the camel-back-breaking straw would be the health benefit part of the contract.

About two and a half years ago, I learned that there was a major national employer whose union labor contract would be up for renegotiation in 2007. Even better, this employer was in trouble and had already sought and obtained health-benefit-related concessions from the union. So I modified my prediction even more.

I predicted that the event would be when the union went on strike against General Motors because they could not come to terms on healthcare, the union wanting more, and the employer offering less.

So imagine my lack of surprise when I heard on the radio this morning that the contract between GM and its union had officially terminated last Friday at midnight (three days ago), and it was being continued hour by hour while negotiations continue. And the sticking point?

Healthcare benefits.

I feel vindicated. And a little scared.

Why scared? Because the house of cards is coming down, and with the way things are in this country right now, the obvious solution to the coming crisis will be thought to be the same one that was created for the Medicare drug problem -- let the government take over!

Only that will be the wrong solution. For that will take the control of the system out of the hands of the insurance companies, who have control now, and put it in the hands of the government. Control will go from one set of wrong hands to another set of wrong hands. And those who have the right hands will continue to suffer.

Whose hands are the right hands? My answer might surprise you. It's the patients.

Why Medicines Cost Too Much -- The Government Is Not Here To Help You

2007-09-16T01:34:00.000-05:00

I'm finally back to the series on why your medicines cost too much. This time around we're going to look at what many (and they control the news media) say is the solution to the problem -- the ye olde Federal Government. I maintain It is one of the problems, and in many ways.

First off, let's take the Food and Drug Administration (please!). This agency is tasked with protecting the American public from dangerous drugs, and despite recent events with various drugs (Rezulin, Vioxx, Zelnorm, Propulsid, Avandia), they actually are doing a fairly good job of this. After all, the American drug consumer never saw thalidomide (as a morning sickness agent), whereas in Europe many people were born with deformed limbs because of this. And even though thalidomide is now actually on the market (it does have a use for multiple myeloma and certain kinds of resistant leprosy), it is highly regulated and covered with warnings. I of course have no documentation of this, but I am sure there are other medications that we have been equally protected from. It's hard to prove a negative, after all.

Unlike others, who because of the need to withdraw a small number of medicines from the market feel that the FDA allows medications onto the market too quickly, I hold the opposing view. I think they don't approve medications quickly enough. Most of this is because the FDA will not accept foreign (mostly European) safety data for medications and insists that the drug companies do specific studies in the U.S. for them to review. This adds to the already high cost of bringing a drug to market, which must then be recouped. And since a company's patent (and exclusive right to market a new drug) starts when they first invent the molecule and not when they get it on the market, this delay in getting to market shortens the time the company has to recoup the cost. Higher costs, less exclusivity, up goes the price! Meanwhile, some of these drugs have already been on the market in European nations for up to 10 or 15 years! The post-marketing safety data in these countries (or at least those countries we scientifically trust, like England, France, Germany, Spain....) could be used to show that the drug is safe for America, but to my knowledge, the FDA will not accept this data for review.

Another way the Federal government causes escalating drug prices is through its protection of the managed care system. I strongly feel that managed care has never brought down any costs in the medical field, but it sure has saved a lot of money for the insurance companies! In the 1970s, the Congress passed a law commonly called ERISA -- the Employee Retirement Security Income Act of 1974. Though its name does not immediately suggest this has anything to do with healthcare, the law provides certain regulation of employer-provided health insurance programs. Despite the fact that the law does not explicitly provide for this, the health insurance industry has successfully and repeatedly used ERISA as a shield, arguing in court that the federal regulation preempts any state law to otherwise regulate health insurance, thereby preventing state courts (where most malpractice and liability cases are brought) from using state laws to penalize the insurance companies when they deny payment for obviously needed medical care.

The health insurance companies thus literally get away with murder, with their great lie that they only pay for medical care, they don't decide whether care is or is not provided, and that's because of ERISA. As far as I know, ERISA says nothing of the sort, but legal precedent has interpreted it to provide this shield. And of course, legal precedent by a judge is so much more important than what a law actually says. Or a Constitution for that matter. Meanwhile, the cries of many to amend ERISA to explicitly say what is and is not protected go unheeded. The only instances when the insurance companies have not been able to use ERISA as their shield is when their denial of (payment for) care involves a government employee. You see, like most onerous legislation (the ADA, HIPAA, et cetera), the government exempted itself from ERISA.

The Federal government does not just protect managed care, however. Oh no, It expands it. Just what do you think Medicare and Medicaid are? Let's see, both are programs that contract with "providers" to provide care at a dictated discounted price. Why, that's a PPO! And Medicare Part D? Just another pharmacy benefit management system; just more managed care. It doesn't matter whether the Part D benefit is run by the real managed care industry or the faux one called the government. Managed care is managed care. And it will, it can do nothing but drive up the cost to the consumer. The only other choice for managed care is rationing.

But that's another rant for another time.

Aliens Cause Global Warming and Other Wisdom from Michael Crichton

2007-09-14T00:00:00.000-05:00

I had found this speech in PDF format several months ago, and after my last posting decided to look it up and link to it. And I found a couple of other gems to go along with it. All of these are a little long, but they are well worth reading.

The first is entitled "Aliens Cause Global Warming" and discusses the underpinnings of the pseudoscience of anthropogenic global warming.

The second is called "The Case for Skepticism on Global Warming". This goes into a little more detail about some of the problems with the so-called data on which the whole idea of global warming is based. His discussion of the statistical tweaking needed to create the 'hockey stick' graph that we've all grown to hate from Al Gore's "An Inconvenient Truth" is not (as far as I can tell) original to Mr. Crichton, as I have previous seen this same criticism made elsewhere by the head of the American Statistical Association.

The last speech is "Complexity Theory and Environmental Management", which isn't about global warming per se, but does reference it obliquely. It raises some interesting concepts to consider if mankind is going to wade into trying to "manage" the climate of this world when we only have the glimmer of an inkling of a grasp of the edges of what actually drives the climate. (This is beside the point that all 7 billion of us together are too puny to really affect the climate.)

And speaking of Al Gore's ridiculous movie, if you haven't watched it, then don't! Or at least try to do it in a way that keeps money from going to this poor deluded soul. I saw it on Showtime, and I must admit that I was surprised to see certain scenes included in this serious tome on how we are ruining the planet. You know the scenes -- the ones with Al Gore campaigning for president, talking about the death of his sister and the accident that occurred to his son, and finally culminating in the scenes of him losing the election (and yes, the news media's recount of every vote in Florida still showed he lost). I wasn't initially sure what all these scenes had to do with global warming, but then it finally dawned on me -- the inconvenient truth isn't that we're melting the icecaps; it's that Al Gore really did lose in 2000.

I Am Not Postalmed.com!!!

2007-09-04T01:43:00.000-05:00

Just got through Googling myself to see if I was having an impact on society yet. It was an ill-conceived notion, and I am now considering prescribing myself antidepressants. But I did find that I am being poached upon.

Many of the links on the Google results page referenced an organization calling itself postalmed.com. ( I left off the www. to keep from creating a hyperlink.) This seems to be some sort of an Internet-based pharmaceutical ordering company that, as best as I could tell from the two or three minutes I spent looking at it, is based somewhere in India.

I am not, and have absolutely no association with, "postalmed.com". Furthermore I discourage all of my readers (yes, all three of you!) from ordering anything from this company. If this company is based in India, then the quality of anything from there is highly suspect. Additionally, India allows its pharmaceutical companies to flaunt international law and copyright/patent law and produce medicines in violation of US and other national patents. Such action contributes to the higher prices we pay for medicines in the USA and should not be rewarded. If it is not in India, it is still not headquartered in the United States and utilizing such a service is a violation of Federal law.

Update on Global Warming

2007-09-04T01:10:00.000-05:00

The Canadian National Post continues to expound on the widespread scientific opposition to the idea of anthropogenic global warming. When I first linked to this series of articles, it contained ten articles. The list has now been expanded to 33 articles, with the suggestion that more are to come. Find the current list (and hopefully the ongoing index) here.

If only there were an American media outlet that had the courage to print such a series of articles. But no, like the recent Aug. 13 Newsweek front-cover article (sorry, can't access it online without coughing up money) on the topic, entitled "Global Warming is a Hoax* (with the asterisk leading to a line at the bottom of the cover indicating that the statement was supposed to be a joke), almost all of the coverage in the American media is so pro-global warming it makes me sick. To the writers at Newsweek, let me reiterate: I am a scientist who does not believe in the hypothesis of anthropogenic global warming and I am NOT on the oil industry's payroll.

At least in other countries (which we are being told [erroneously] are more accepting of this fairy tale than we are) the press still sees fit to pursue both sides of an issue to get to the truth. In America, it seems all the so-called journalists have partaken of Al Gore's Kool-Aid.

Is it any wonder that more and more people are getting their news from the Net?

Getting Overheated Over Global Warming

2007-02-04T00:38:00.000-06:00

Not everything here is going to be medical, as I stated in my mission statement. Today we take a detour into another area of science. Though in this case, the more appropriate word is pseudoscience. The area of which I speak is the idea of global warming, or more accurately, the idea of anthropogenic global warming.

I do not intend to debate or deny the issue that our little planet has been getting a little warmer over the past few years. The data collected so far tells us this is true. But let's be truly accurate about this: Earth has been warming up over the past few thousand years (probably the last 14-18 thousand), since the last Ice Age.

What I will take issue with is that our puny little efforts are what's causing all this. When the warming started (14-18 thousand years ago), I doubt there were too many SUVs pouring CO2 into the atmosphere. Yet the glaciers receded. And when scientific estimates reveal that even a Mount Pinatubo size volcanic eruption spews out more "greenhouse gases" in a day than mankind does in a year, and there are volcanoes erupting somewhere on Earth almost every day, then it doesn't take much incredulity to dismiss the anthropogenic part of global warming. In my opinion, it takes a lot more incredulity (or is it gullibility?) to accept it.

Have you noticed, like I have, that every time one of these Global Warming Doomsayers tells us how warm it's going to get, they include a reference to the last time it was that warm on Earth, and that time is always tens, hundreds, or thousands of thousands of years before the first Homo species gave up knuckle walking? To quote John Stossel, "Give me a break!"

Want some more specific criticisms? Want evidence that the anthropogenic global warming critics (who in the typical liberal ad hominem way are derisively referred to as Deniers, thus creating an unjustified reference to Holocaust deniers) are not a bunch of nutjobs but are actually respected, well-credentialed scientists?

Go here to see the first of series of articles in the online Canadian National Post; links to the rest of the series are in the first article. This series introduces us to some of the Deniers, and why they are such. It punches huge, gaping, SUV-sized holes in the idea of anthropogenic global warming (I say idea since I don't feel it even warrants the term hypothesis, much less theory).

As an aside, I have to note that it is of great interest (to me) that I found this wonderful series of articles in a Canadian media outlet. Why hasn't the American news media done this type of investigation instead of swallowing "Global Warming" hook, line and sinker? Oh, yeah, that's right, this is a liberal issue, and the American media is dominated by liberals.

Before I get accused of being a pawn of Big Oil (a classic technique used to ostracize the Deniers), let me issue a disclaimer: I have received no funds, grants, or payments from any manufacturer of fossil fuel energy. I don't even own oil company stock (though I could kick myself repeatedly for not buying some a good many years ago). The closest I ever come to a connection to an oil company is when I have a gasoline nozzle stuck into my SUV.

I am not opposed to reducing our country's dependence on oil. However, I see this as a crucial national security issue, not an environmental one. And let's face it, the dilithium-regulated matter-antimatter generator (or even a workable fusion reactor) is not right around the corner, or even on the horizon. For the foreseeable future, we're going to have to burn oil (and coal, etc.)
By the way, has anyone ever calculated how much CO2 we humans collectively pump into the atmosphere just by breathing? Might make the cars seem insignificant.

ADDENDUM 2-6-07: Orrin Johnson also noted the series of articles in the Canadian National Post and has a very interesting opinion as to why Global Warming is being pushed so hard. Naturally, the reason is political, not scientific. Take a look at it here.

There Is No Healthcare Crisis in the United States

2006-11-26T01:15:00.000-06:00

We've heard it before and we'll hear it again (especially come January when the Democrats -- and from one of my previous posts you know what I think about them -- come back in control of the Congress) --- "We have to fix the healthcare crisis in this country!"

Every time I hear something like this, especially from a politician or a lawyer and particularly from anyone even remotely similar to a journalist, it makes me want to rant and rave. Just what I created this blog for.

Why?

Because there is no crisis in the healthcare industry. Never has been. And there won't be one unless the communist left tries to "fix" healthcare.

I can hear the cries of dissent already. "What about all the people who don't have health insurance? What about the people who can't buy their medications? What about the........"

My ranting is caused not because I think that people who can't get healthcare aren't a problem. The issue here is not an issue. It's semantics.

"Words mean things." (Rush Limbaugh) Yes, words do mean things. If we are to state or believe that there is a healthcare crisis, then we must be stating or believing that there is a crisis in the system that actually is providing care to people; there must be problems with the doctors, nurses, hospitals, medicines, ambulances, stretchers, hospital laundries, et cetera, that make up the healthcare system. I maintain that there is no such problem with these entities. I'll go on to say that the United States has the greatest healthcare system in the world. After all, when the world's rich and powerful get sick, do they go to China for their healthcare? To Russia? To Senegal? Even to Britain or Canada? No. They come to the United States. They know our system is superior.

If you pay attention (and it doesn't have to even be close attention) to the crisis mongers, you'll soon note that their complaints seem to have a common refrain. People don't have insurance to pay for.... people can't afford their.... this (fill-in-the-blank with a medical word) is too expensive.....

The common refrain is money.

I will not deny that there are significant numbers of US citizens who cannot afford or have great difficulty affording healthcare. I do not deny that healthcare in this country is expensive. What I do deny is that this is a crisis -- or that it has anything to do with healthcare. The actual provision of healthcare is provided in a monetary vacuum. Does anyone really think that when someone arrives in an emergency department bleeding profusely in a life-threatening way that there is a single caregiver in that place that says or even thinks, 'Now, hold on a minute -- before we start treating this guy, we need to see how much treatment he can afford'?

Just because we have a problem with healthcare financing in this country does not mean we have a healthcare crisis. Words mean things -- and those two phrases -- healthcare financing problem and healthcare crisis -- mean two different things.

The first exists; the second does not.

Oregon Kills "Physician-Assisted Suicide"

2006-11-05T12:52:00.000-06:00

So the Oregon Department of Human Services has decided to no longer use the term "physician-assisted suicide" to describe the process of allowing physicians to assist patients in committing their own self-murder. This change occurred due to the pressure (and apparently threats of lawsuits) from suicide-advocacy groups. Polls had shown that people were more likely to approve legalizing the practice when the word "suicide" was not used to describe it. These proponents are now suggesting new terms (i.e. euphemisms) such as "physician-assisted death", "physician aid in dying" or "hastened death".

I have a suggestion: how about physician-coordinated execution?

Despite the fact that few medical schools use the actual Hippocratic oath, one of the phrases retained in almost all the modern alternatives is: To please no one will I prescribe a deadly drug nor give advice which may cause his death. Hippocrates had it right 2500 years ago. He understood the concept of the slippery slope and cherished the sanctity of human life.

And this is not "colored" by any modern religious theologies. Hippocrates believed in the pantheon of Greco-Roman gods that today are historic anachronisms. His opposition to this practice by today's terms could not be any more secular (or "human-rights' oriented", if you prefer).

Yes, Hippocrates had it right all those years ago. The state of Oregon continues to have it wrong. Most people understand how wrong such a practice is. And the proponents of this abominable practice tacitly demonstrate how wrong it is by having to rename it with a pleasant-sounding euphemism in order to get anyone else to accept it.

The Lie of Drug Company Profits -- What's the Reason?

2006-08-19T00:16:00.000-05:00

Last time I informed you that the complaint that drug company greed was driving up the costs of drugs was actually untrue, and that it was actually part of a coordinated campaign of lies and manipulations by certain individuals. I then specifically identified this group as being the Democratic Party. Now I will explain the reason for all of this.

The purpose of the manipulation is, of course, to serve as a means to a particular end, in this case more power. Power over other people's lives. The only kind of power that means anything in the political world. Many people think that the end is money, but to these people, money is just another way of wielding power.

This is how the manipulation works: If I can get you upset enough about the "fact" that somebody (else) is taking advantage of you, I can get you angry enough to demand change. If I can get enough people angry enough, then I can create a force for change. And if I have been the one creating the upset, anger and now the force for change, I can suggest the alternative improvement that will fix the problem. And naturally, that solution will ultimately leave me and those like me in charge of ever increasing portions of your life, giving me more and more power over you. Yes, the power that these people want is not the power to change things, it is the power to control you.

In this case, the lie is that the drug companies make too much money, and they make it at your expense. This leads to the upset, and makes you angry. When enough people are angry enough, then they propose the solution -- price controls, managed care, a government controlled Medicare Part D, et cetera. Once they control these things, they can tell you which drugs you can and cannot take (via formularies), thus controlling another little part of your life.

When did this begin? And why do I blame only the Democrats? The seeds were likely planted long ago, but this particular manipulation became blatantly apparent during the Presidential campaign of 1992. During this campaign, Bill Clinton strapped a saddle onto the backs of the drug companies, hounding them (and of all of healthcare only the drug companies) about their prices and their "obscene" profits. He rode the drug companies into the White House. But then he made a big mistake.

Instead of trying to bend to his will the force he had created against only the drug companies, he tried to use it to control all of healthcare by proposing the Clinton Healthcare Plan (aka "Hillary Care"). This plan was a none-too-thinly veiled attempt at a government takeover of the insurance industry. But the American people had not been made angry at the insurance companies, so they wisely stopped this plan in its tracks.

Today, the public at large are finally (and more appropriately) being made angry at the insurance companies, who actually are making obscene profits, enough to make the oil companies jealous. And there are those in the political world ready to offer their radical solution.

A single-payer government healthcare system. Government control over every aspect of your healthcare.

Keep in mind that the only healthcare system that the government knows how to run is the VA Medical System. (Medicare is actually an insurance plan, not a medical system.) The VA system is for all intents and purposes a staff model HMO. Managed care. And managed care saves money in only two ways: rationing and cost shifting.

Why blame only the Democrats? It was they that rode the pharmaceutical industry into office. It was they who tried to take over the health insurance industry. And it is only among the Democrats (and a few fringe liberal groups) that one hears the call for a single payer system.

Hopefully the American people will keep their wisdom and kill this idea also. But I'm afraid, very afraid, that the manipulation this time will succeed.

Think The Drug Companies Are The Problem? Think Again

2006-08-16T00:04:00.000-05:00

Once again it's time to get back to the task of discussing why medicines cost so much. Or in this particular case, why they don't, though you think this is a reason that they do.

If you were to go out on the street and ask people why they think their medicines are so expensive, I suspect the most common response would be something like "Because the drug companies are too greedy!" And it's not surprising that they would blame the drug companies. After all, that's what they've been told is the main problem for years. Unfortunately, what they've been told for all these years is a fabrication. A fabrication constructed for one and only one ultimate purpose -- manipulation to an end.

Now, regular readers here (I am egotistically assuming that there are some regular readers despite the lack of evidence to support this) have already learned about my belief that some things in medicine are done for non-altruistic, power-seeking purposes (see "Medicare Part D Delenda Est!"). This is another one of these purposes.

We have all been led to believe that the drug companies greedily seek exorbitant profits, and that this is what is the major force behind the escalating cost of prescription medicines. This is not really the case. The corporate profits of the drug companies, after expenses including R&D, is no higher and really no lower than that of your average large corporation. (I will fault the drug companies, however, for trying to hide behind the argument 'we need these profits to fund R&D'. R&D is a business expense, everybody else considers it a business expense, you guys consider it a business expense, no one else is ashamed of it and you shouldn't be either.)

The purpose of this fabrication takes a little explanation. In the current twisted field of medical reimbursement, the vast majority of people have no idea what their medical care costs. Medicare or Medicaid or managed care or an insurance company foots the bill, and all most people ever see is the co-pay, if that much. Those few who look at their bills think they are getting a great benefit from how much their doctor charged and got paid by the payor, never realizing that the doctor really only got paid some small percentage of his charges and the rest went away as a "contractual write-off". (This issue itself is another reason I'm nigh on to postal, but that's a different rant.)

Medicine costs are a different matter. Most people either pay for their own medicines or pay a much higher percentage of the costs of their medicines, so they are much more sensitive to this cost. This makes it an excellent target for manipulation. And there is one group that excels at manipulating it.

Some would call this group "liberals". I think this actually maligns some liberals, as little as that is possible. I am more willing to focus down to who it really is that is doing the manipulating with this fabrication, and I am willing to name names.

It is the Democratic Party.

But what is the purpose of this kind of manipulation? What is the goal? What power am I talking about?

More in my next post.