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NEWS YOU MAY HAVE MISSES
COOK BOOK MEDICINE IN THE WORKS
The Voice for Private Physicians
AAPS NEWS
ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS
Volume 67. no. 7 Julv 2011
"NUMBERS"
The Accountable Care Act (ACA) expands and rigidifies the trend to practice medicine by the numbers. Drug ads exhort patients to "know their numbers." With interoperable electronic health records (EHRs), insurers and government agencies will know them also. Health information technology (HIT) will enable the czars to evaluate compliance with various disparity and quality metrics, and to calculate permitted payments. It will also provide the data set for "comparative effectiveness research" (CER).
Like the Fourth Book of Moses, the new ACA bible is full of enumerations, categorizations, rules, and penalties. ACA, however, does not lead to a Promised Land or to the fulfillment of a covenant, but rather to nowhere (utopia) and to the destruction of the patient-physician relationship and existing medical institutions. If ACA is not stopped, we will not be wandering in the wilderness for a mere 40 years. The Soviet Union took 75 years to fall, and the society destroyed by Communism may never recover.
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NEWS YOU MAY HAVE MISSED
OBITUARY ROBERT J ALBO MD FACS
Robert Albo Obituary: Robert Albo's Obituary by the Inside Bay Area.
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Robert J. ALbo BOARD MEMBER HEALTH CARE REFORM EDUCATIONAL INSTITUTE
Robert Albo Obituary: Robert Albo's Obituary by the Inside Bay Area.
Page 1 of 1
Robert J. ALbo
Robert James Albo M.D. May 8, 1932- Feb. 21, 2011 Resident of Piedmont, CA Robert J. Albo passed away peacefully with his family by his side on February 21, 2011. Bob is survived by his loving wife of 55 years, Wlarjorie, his son Bob and wife Sarah, daughter Debbie and husband Robb Jacobs and son Douglas and wife to be Keri. He also has 8 grand children Timothy, Danielle and Julia Albo; Jordan, Jennifer and Jillian Jacobs and Calista and Brianna Thompson. Bob was the son of Yolanda and stepfather John Albo and is survived by his younger sisters, Diane Kett and Londa Patch and his Aunt Nella Aiis.
Bob was born in Oakland and grew up in Berkeley • He attended Berkeley High School -where he was president of his senior class and valedictorian. He went on to UC Berkeley where he played basketball and baseball, earning 3 letters in each sport. He had the rare distinction of being elected co-captain of both sports in his senior year. He received Cal's Jake Gimble award for having the best combination of athletics and academics among graduating seniors. During his graduate year at UC Berkeley, Bob coached the freshman basketball and baseball teams to undefeated seasons. Players from both of those teams would go on later to play for Pete Newell's NCAA Championship basketball team in 1959 and Cal's championship baseball team in 1957. Bob was inducted into the Class of 1954 Hall of Fame in 1960 and then into the UC Athletic Hall of Fame in 2000.
In 1954, Bob met his wife to be, Marjorie Stanley, at the "Lair of the Bear" where they were both on staff and where Bob later became Lair director. They were married in 1956 and had recently celebrated their 55th wedding anniversary.
Bob practiced surgery in the San Francisco Bay Area for over 40 years before retiring in 2005. He had a special gift with people and took a personal interest in each patient, many of whom would later become close friends. Bob went to medical school at University of California San Francisco (UCSF) from 1955 to 1959 and did his residency at UC Moffett Hospital. His office was on "Pill Hill" in Oakland and during his years as a practicing physician, he was Chief of Surgery at Summit Hospital, a clinical professor at UCSF and Chief of Surgical Services for student health at UC Berkeley.
Bob also loved sports and was the head team physician for the Oakland Raiders and Golden State Warriors for many years as well as the Oakland Oaks (ABA Basketball) and Oakland Seals (Hockey). He was an avid East Bay sports fan and his passionate loyalty to his teams could often be heard courtside or on the field. He was honored to have been a part of 4 world championships, 3 with the Raiders in 1976, 1980 and 1983 and once with the Warriors in 1975. He was known and respected by many professional athletes, coaches and staff.
Bob was a world renowned magician, magic collector and author. His interest in magic began when his parents gave him a Mysto Magic set for Christmas at age 9. Over the past 70 years he collected magic, performed shows, gave lectures and wrote 15 volumes of books, many of which are renowned for their documentation of magic apparatus and history of the magical arts. He did most of the work himself, illustrating, photographing and writing the books from his personal collection which was the largest private collection of magic in the world. His first book, "Oriental Magic of the Bambergs", was published in 1973 and his last and greatest achievement was "The Ultimate Thayer" published in 2009. Bob's collection of magic now belongs to David Copperfield and is displayed in his museum in Las Vegas.
Bob was a member of the Bohemian Club, Claremont Country Club, Pacific Union Club and Silverado Country Club. Bob truly lived a 'magical' life and he will be sorely missed by all who knew and loved him. The family would like to thank the staff at Summit Medical Center for their professional care and kindness and a special thanks to Jen.
In honor of Bob's love for the University of California, donations can be made in his name to "The UC Regents in Memory of Robert Albo" - UC Athletic Dept, 195 Haas Pavilion, Berkeley, CA 94720. A celebration of Bob's life will be held at Claremont Country Club, 5295 Broadway Terrace, Oakland on Sunday, March 13th between 2:00-4:00 PM (coat required).
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EFFECT OF LOW BIRT RATES #2
GLOBAL GRAYING AND CRISIS OF 2020s
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Global Aging and the Crisis of the 2020s?
From the fall of the Roman and the Mayan empires to the Black Death to the colonization of the New World and the youth-driven revolutions of the twentieth century, demographic trends have played a decisive role in many of the great invasions, political upheavals, migrations, and environmental catastrophes of history. By the 2020s, an ominous new conjuncture of demographic trends may once again threaten widespread disruption. I am, of course, talking about global aging, which is likely to have a profound effect on economic growth, living standards, and the shape of the world order.
Long-time readers of Outside the Box are familiar with the work of Neil Howe, co-author of one of the most prescient books of the last few decades, The Fourth Turning (written in 1997), which described and indeed virtually nailed our current social climate. When Neil writes, it pays to pay attention. He has recently written a piece called "Global Aging and the Crisis of the 2020s," an article he co-authored with Richard Jackson. They work with the Center for Strategic and International Studies on the Global Aging Initiative. This week’s OTB was just published in the January 2011 issue of Current History, who have given me permission to send it to you.
Howe and Jackson are also the authors of “The Graying of the Great Powers” and other commentary on the impact that demographics will have on our future. You can see that paper and others at http://csis.org/publication/graying-great-powers-0.
Here in Cabo San Lucas we are staying at Casa Oliver (www.cabocasaoliver.com), which was recently featured in the Robb Report. The owner, Dene Oliver, is a very generous man who donates the use of his home to various charities, which is how Jon Sundt and his partners at Altegris secured the place, at a charity auction for an anti-drug organization sponsored by Jon.
The whales are cavorting a little way off the beach . The kids are in the pool. The sun is setting over the Pacific. Jon Sundt and company have picked a great place for our annual meeting. A great place to kick back and reflect on the future, which seems to be coming at us ever faster.
They are calling dinner, prepared by a serious world-class chef, Pia Quintana, so it’s time to go. Sushi night.
Your living larger than usual analyst,
John Mauldin
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Global Aging and the Crisis of the 2020s
By Neil Howe and Richard Jackson
“The risk of social and political upheaval could grow throughout the developing world—even as the developed world’s capacity to deal with such threats declines.”
From the fall of the Roman and the Mayan empires to the Black Death to the colonization of the New World and the youth-driven revolutions of the twentieth century, demographic trends have played a decisive role in many of the great invasions, political upheavals, migrations, and environmental catastrophes of history. By the 2020s, an ominous new conjuncture of demographic trends may once again threaten widespread disruption. We are talking about global aging, which is likely to have a profound effect on economic growth, living standards, and the shape of the world order.
For the world’s wealthy nations, the 2020s are set to be a decade of rapid population aging and population decline. The developed world has been aging for decades, due to falling birthrates and rising life expectancy. But in the 2020s, this aging will get an extra kick as large postwar baby boom generations move fully into retirement. According to the United Nations Population Division (whose projections are cited throughout this article), the median ages of Western Europe and Japan, which were 34 and 33 respectively as recently as 1980, will soar to 47 and 52 by 2030, assuming no increase in fertility. In Italy, Spain, and Japan, more than half of all adults will be older than the official retirement age—and there will be more people in their 70s than in their 20s.
Falling birthrates are not only transforming traditional population pyramids, leaving them top-heavy with elders, but are also ushering in a new era of workforce and population decline. The working-age population has already begun to contract in several large developed countries, including Germany and Japan. By 2030, it will be stagnant or contracting in nearly all developed countries, the only major exception being the United States. In a growing number of nations, total population will begin a gathering decline as well. Unless immigration or birthrates surge, Japan and some European nations are on track to lose nearly one-half of their total current populations by the end of the century.
These trends threaten to undermine the ability of today’s developed countries to maintain global security. To begin with, they directly affect population size and GDP size, and hence the manpower and economic resources that nations can deploy. This is what RAND scholar Brian Nichiporuk calls “the bucket of capabilities” perspective. But population aging and decline can also indirectly affect capabilities—or even alter national goals themselves.
Rising pension and health care costs will place intense pressure on government budgets, potentially crowding out spending on other priorities, including national defense and foreign assistance. Economic performance may suffer as workforces gray and rates of savings and investment decline. As societies and electorates age, growing risk aversion and shorter time horizons may weaken not just the ability of the developed countries to play a major geopolitical role, but also their will.
The weakening of the developed countries might not be a cause for concern if we knew that the world as a whole were likely to become more pacific. But unfortunately, just the opposite may be the case. During the 2020s, the developing world will be buffeted by its own potentially destabilizing demographic storms. China will face a massive age wave that could slow economic growth and precipitate political crisis just as that country is overtaking America as the world’s leading economic power. Russia will be in the midst of the steepest and most protracted population implosion of any major power since the plague-ridden Middle Ages. Meanwhile, many other developing countries, especially in the Muslim world, will experience a sudden new resurgence of youth whose aspirations they are unlikely to be able to meet.
The risk of social and political upheaval could grow throughout the developing world—even as the developed world’s capacity to deal with such threats declines. Yet, if the developed world seems destined to see its geopolitical stature diminish, there is one partial but important exception to the trend: the United States. While it is fashionable to argue that US power has peaked, demography suggests America will play as important a role in shaping the world order in this century as it did in the last.
Graying Economies
Although population size alone does not confer geopolitical stature, no one disputes that population size and economic size together constitute a potent double engine of national power. A larger population allows greater numbers of young adults to serve in war and to occupy and pacify territory. A larger economy allows more spending on the hard power of national defense and the semi-hard power of foreign assistance. It can also enhance what political scientist Joseph Nye calls “soft power” by promoting business dominance, leverage with nongovernmental organizations and philanthropies, social envy and emulation, and cultural clout in the global media and popular culture.
The expectation that global aging will diminish the geopolitical stature of the developed world is thus based in part on simple arithmetic. By the 2020s and 2030s, the working-age population of Japan and many European countries will be contracting by between 0.5 and 1.5 percent per year. Even at full employment, growth in real GDP could stagnate or decline, since the number of workers may be falling faster than productivity is rising. Unless economic performance improves, some countries could face a future of secular economic stagnation—in other words, of zero real GDP growth from peak to peak of the business cycle.
Economic performance, in fact, is more likely to deteriorate than improve. Workforces in most developed countries will not only be stagnating or contracting, but also graying. A vast literature in the social and behavioral sciences establishes that worker productivity typically declines at older ages, especially in eras of rapid technological and market change.
Economies with graying workforces are also likely to be less entrepreneurial. According to the Global Entrepreneurship Monitor’s 2007 survey of 53 countries, new business start-ups in high-income countries are heavily tilted toward the young. Of all “new entrepreneurs” in the survey (defined as owners of a business founded within the past three and one-half years), 40 percent were under age 35 and 69 percent under age 45. Only 9 percent were 55 or older.
At the same time, savings rates in the developed world will decline as a larger share of the population moves into the retirement years. If savings fall more than investment demand, as much macroeconomic modeling suggests is likely, either businesses will starve for investment funds or the developed economies’ dependence on capital from higher-saving emerging markets will grow. In the first case, the penalty will be lower output. In the second, it will be higher debt service costs and the loss of political leverage, which history teaches is always ceded to creditor nations.
Even as economic growth slows, the developed countries will have to transfer a rising share of society’s economic resources from working-age adults to nonworking elders. Graying means paying—more for pensions, more for health care, more for nursing homes for the frail elderly. According to projections by the Center for Strategic and International Studies, the cost of maintaining the current generosity of today’s public old-age benefit systems would, on average across the developed countries, add an extra 7 percent of GDP to government budgets by 2030.
Yet the old-age benefit systems of most developed countries are already pushing the limits of fiscal and economic affordability. By the 2020s, political conflict over deep benefit cuts seems unavoidable. On one side will be young adults who face stagnant or declining after-tax earnings. On the other side will be retirees, who are often wholly dependent on pay-as-you-go public plans. In the 2020s, young people in developed countries will have the future on their side. Elders will have the votes on theirs.
Faced with the choice between economically ruinous tax hikes and politically impossible benefit cuts, many governments will choose a third option: cannibalizing other spending on everything from education and the environment to foreign assistance and national defense. As time goes by, the fiscal squeeze will make it progressively more difficult to pursue the obvious response to military manpower shortages—investing massively in military technology, and thereby substituting capital for labor.
Diminished Stature
The impact of global aging on the collective temperament of the developed countries is more difficult to quantify than its impact on their economies, but the consequences could be just as important—or even more so. With the size of domestic markets fixed or shrinking in many countries, businesses and unions may lobby for anticompetitive changes in the economy. We may see growing cartel behavior to protect market share and more restrictive rules on hiring and firing to protect jobs.
We may also see increasing pressure on govern>ments to block foreign competition. Historically, eras of stagnant population and market growth— think of the 1930s—have been characterized by rising tariff barriers, autarky, corporatism, and other anticompetitive policies that tend to shut the door on free trade and free markets.
This shift in business psychology could be mirrored by a broader shift in social mood. Psychologically, older societies are likely to become more conservative in outlook and possibly more risk-averse in electoral and leadership behavior. Elder-dominated electorates may tend to lock in current public spending commitments at the expense of new priorities and shun decisive confrontations in favor of ad hoc settlements. Smaller families may be less willing to risk scarce youth in war.
We know that extremely youthful societies are in some ways dysfunctional—prone to violence, instability, and state failure. But extremely aged societies may also prove dysfunctional in some ways, favoring consumption over investment, the past over the future, and the old over the young.
Meanwhile, the rapid growth in ethnic and religious minority populations, due to ongoing immigration and higher-than-average minority fertility, could strain civic cohesion and foster a new diaspora politics. With the demand for low-wage labor rising, immigration (at its current rate) is on track by 2030 to double the percentage of Muslims in France and triple it in Germany. Some large European cities, including Amsterdam, Marseille, Birmingham, and Cologne, may be majority Muslim.
In Europe, the demographic ebb tide may deepen the crisis of confidence that is reflected in such best-selling books as France Is Falling by Nicolas Baverez, Can Germany Be Saved? by Hans-Werner Sinn, and The Last Days of Europe by Walter Laqueur. The media in Europe are already rife with dolorous stories about the closing of schools and maternity wards, the abandonment of rural towns, and the lawlessness of immigrant youths in large cities. In Japan, the government has half-seriously projected the date at which only one Japanese citizen will be left alive.
Over the next few decades, the outlook in the United States will increasingly diverge from that in the rest of the developed world. Yes, America is also graying, but to a lesser extent. Aside from Israel and Iceland, the United States is the only developed nation where fertility is at or above the replacement rate of 2.1 average lifetime births per woman. By 2030, its median age, now 37, will rise to only 39. Its working-age population, according to both US Census Bureau and UN projections, will also continue to grow through the 2020s and beyond, both because of its higher fertility rate and because of substantial net immigration, which America assimilates better than most other developed countries.
The United States faces serious structural challenges, including a bloated health care sector, a chronically low savings rate, and a political system that has difficulty making meaningful trade-offs among competing priorities. All of these problems threaten to become growing handicaps as the country’s population ages. Yet, unlike Europe and Japan, the United States will still have the youth and the economic resources to play a major geopolitical role. The real challenge facing America by the 2020s may not be so much its inability to lead the developed world as the inability of the other developed nations to lend much assistance.
Perilous Transitions
Although the world’s wealthy nations are leading the way into humanity’s graying future, aging is a global phenomenon. Most of the developing world is also progressing through the so-called demographic transition—the shift from high mortality and high fertility to low mortality and low fertility that inevitably accompanies development and modernization. Since 1975, the average fertility rate in the developing world has dropped from 5.1 to 2.7 children per woman, the rate of population growth has decelerated from 2.2 to 1.3 percent per year, and the median age has risen from 21 to 28.
The demographic outlook in the developing world, however, is shaping up to be one of extraordinary diversity. In many of the poorest and least stable countries (especially in sub-Saharan Africa), the demographic transition has failed to gain traction, leaving countries burdened with large youth bulges. By contrast, in many of the most rapidly modernizing countries (especially in East Asia), the population shift from young and growing to old and stagnant or declining is occurring at a breathtaking pace—far more rapidly than it did in any of today’s developed countries.
Notwithstanding this diversity, some demographers and political scientists believe that the unfolding of the transition is ushering in a new era in which demographic trends will promote global stability . This “demographic peace” thesis, as we dub it, begins with the observation that societies with rapidly growing populations and young age structures are often mired in poverty and prone to civil violence and state failure, while those with no or slow population growth and older age structures tend to be more affluent and stable. As the demographic transition progresses—and population growth slows, median ages rise, and child dependency burdens fall—the demographic peace thesis predicts that economic growth and social and political stability will follow.
We believe this thesis is deeply flawed. It fails to take into account the huge variation in the timing and pace of the demographic transition in the developing world. It tends to focus exclusively on the threat of state failure, which indeed is closely and negatively correlated with the degree of demographic transition, while ignoring the threat of “neo-authoritarian” state success, which is more likely to occur in societies in which the transition is well under way. We are, in other words, not talking just about a hostile version of the Somalia model, but also about a potentially hostile version of the China or Russia model, which appears to enjoy growing appeal among political leaders in many developing countries.
More fundamentally, the demographic peace thesis lacks any realistic sense of historical process. It is possible (though by no means assured) that the global security environment that emerges after the demographic transition has run its course will be safer than today’s. It is very unlikely, however, that the transition will make the security environment progressively safer along the way. Journeys can be more dangerous than destinations.
Economists, sociologists, and historians who have studied the development process agree that societies, as they move from the traditional to the modern, are buffeted by powerful and disorienting social, cultural, and economic crosswinds. As countries are integrated into the global marketplace and global culture, traditional economic and social structures are overturned and traditional value systems are challenged.
Along with the economic benefits of rising living standards, development also brings the social costs of rapid urbanization, growing income inequality, and environmental degradation. When plotted against development, these stresses exhibit a hump-shaped or inverted-U pattern, meaning that they become most acute midway through the demographic transition.
The demographic transition can trigger a rise in extremism. Religious and cultural revitalization movements may seek to reaffirm traditional identities that are threatened by modernization and try to fill the void left when development uproots communities and fragments extended families. It is well documented that international terrorism, among the developing countries, is positively correlated with income, education, and urbanization. States that sponsor terrorism are rarely among the youngest and poorest countries; nor do the terrorists themselves usually originate in the youngest and poorest countries. Indeed, they are often disaffected members of the middle class in middle-income countries that are midway through the demographic transition.
Ethnic tensions can also grow. In many societies, some ethnic groups are more successful in the marketplace than others—which means that, as development accelerates and the market economy grows, rising inequality often falls along ethnic lines. The sociologist Amy Chua documents how the concentration of wealth among “market-dominant minorities” has triggered violent backlashes by majority populations in many developing countries, from Indonesia, Malaysia, and the Philippines (against the Chinese) to Sierra Leone (against the Lebanese) to the former Yugoslavia (against the Croats and Slovenes).
We have in fact only one historical example of a large group of countries that has completed the entire demographic transition—today’s (mostly Western) developed nations. And their experience during that transition, from the late 1700s to the late 1900s, was filled with the most destructive revolutions, civil wars, and total wars in the history of civilization. The nations that engaged in World War II had a higher median age and a lower fertility rate—and thus were situated at a later stage of the transition—than most of today’s developing world is projected to have over the next 20 years. Even if global aging breeds peace, in other words, we are not out of the woods yet.
Storms Ahead
A number of demographic storms are now brewing in different parts of the developing world. The moment of maximum risk still lies ahead—just a decade away, in the 2020s. Ominously, this is the same decade when the developed world will itself be experiencing its moment of greatest demographic stress.
Consider China, which may be the first country to grow old before it grows rich. For the past quarter-century, China has been peacefully rising,” thanks in part to a one-child-per-couple policy that has lowered dependency burdens and allowed both parents to work and contribute to China’s boom. By the 2020s, however, the huge Red Guard generation, which was born before the country’s fertility decline, will move into retirement, heavily taxing the resources of their children and the state.
China’s coming age wave—by 2030 it will be an older country than the United States—may weaken the two pillars of the current regime’s legitimacy: rapidly rising GDP and social stability. Imagine workforce growth slowing to zero while tens of millions of elders sink into indigence without pensions, without health care, and without large extended families to support them. China could careen toward social collapse—or, in reaction, toward an authoritarian clampdown. The arrival of China’s age wave, and the turmoil it may bring, will coincide with its expected displacement of the United States as the world’s largest economy in the 2020s. According to “power transition” theories of global conflict, this moment could be quite perilous.
By the 2020s, Russia, along with the rest of Eastern Europe, will be in the midst of an extended population decline as steep or steeper than any in the developed world. The Russian fertility rate has plunged far beneath the replacement level even as life expectancy has collapsed amid a widening health crisis. Russian men today can expect to live to 60—16 years less than American men and marginally less than their Red Army grandfathers at the end of World War II. By 2050, Russia is due to fall to 16th place in world population rankings, down from 4th place in 1950 (or third place, if we include all the territories of the former Soviet Union). Prime Minister Vladimir Putin flatly calls Russia’s demographic implosion “the most acute problem facing our country today.” If the problem is not solved, Russia will weaken progressively, raising the nightmarish specter of a failing or failed state with nuclear weapons. Or this cornered bear may lash out in revanchist fury rather than meekly accept its demographic fate.
Of course, some regions of the developing world will remain extremely young in the 2020s. Sub-Saharan Africa, which is burdened by the world’s highest fertility rates and is also ravaged by AIDS, will still be racked by large youth bulges. So will a scattering of impoverished and chronically unstable Muslim-majority countries, including Afghanistan, the Palestinian territories, Somalia, Sudan, and Yemen. If the correlation between extreme youth and violence endures, chronic unrest and state failure could persist in much of sub-Saharan Africa and parts of the Muslim world through the 2020s, or even longer if fertility rates fail to drop.
Meanwhile, many fast-modernizing countries where fertility has fallen very recently and very steeply will experience a sudden resurgence of youth in the 2020s. It is a law of demography that, when a population boom is followed by a bust, it causes a ripple effect, with a gradually fading cycle of echo booms and busts. In the 2010s, a bust generation will be coming of age in much of Latin America, South Asia, and the Muslim world. But by the 2020s, an echo boom will follow—dashing economic expectations and perhaps fueling political violence, religious extremism, and ethnic strife.
These echo booms will be especially large in Pakistan and Iran. In Pakistan, the decade-over-decade percentage growth in the number of people in the volatile 15- to 24-year-old age bracket is projected to drop from 32 percent in the 2000s to just 10 percent in the 2010s, but then leap upward again to 19 percent in the 2020s. In Iran, the swing in the size of the youth bulge population is projected to be even larger: minus 33 percent in the 2010s and plus 23 percent in the 2020s. These echo booms will be occurring in countries whose social fabric is already strained by rapid development. One country teeters on the brink of chaos, while the other aspires to regional hegemony. One already has nuclear weapons, while the other seems likely to obtain them.
Pax Americana Redux?
The demographer Nicholas Eberstadt has warned that demographic change may be “even more menacing to the security prospects of the Western alliance than was the cold war for the past generation.” Although it would be fair to point out that such change usually presents opportunities as well as dangers, his basic point is incontestable: Planning national strategy for the next several decades with no regard for population projections is like setting sail without a map or a compass. It is likely to be an ill-fated voyage. In this sense, demography is the geopolitical cartography of the twenty-first century.
Although tomorrow’s geopolitical map will surely be shaped in important ways by political choices yet to be made, the basic contours are already emerging. During the era of the Industrial Revolution, the population of what we now call the developed world grew faster than the rest of the world’s population, peaking at 25 percent of the world total in 1930. Since then, its share has declined. By 2010, it stood at just 13 percent, and it is projected to decline still further, to 10 percent by 2050.
The collective GDP of the developed countries will also decline as a share of the world total—and much more steeply. According to new projections by the Carnegie Endowment for International Peace, the Group of 7 industrialized nations’ share of the Group of 20 leading economies’ total GDP will fall from 72 percent in 2009 to 40 percent in 2050. Driving this decline will be not just the slower growth of the developed world, as work-forces age and stagnate or contract, but also the expansion of large, newly market-oriented economies, especially in East and South Asia.
Again, there is only one large country in the developed world that does not face a future of stunning relative demographic and economic decline: the United States. Thanks to its relatively high fertility rate and substantial net immigration, its current global population share will remain virtually unchanged in the coming decades. According to the Carnegie projections, the US share of total G-20 GDP will drop significantly, from 34 percent in 2009 to 24 percent in 2050. The combined share of Canada, France, Germany, Italy, Japan, and the United Kingdom, however, will plunge from 38 percent to 16 percent.
By the middle of the twenty-first century, the dominant strength of the US economy within the developed world will have only one historical parallel: the immediate aftermath of World War II, exactly 100 years earlier, at the birth of the “Pax Americana.”
The UN regularly publishes a table ranking the world’s most populous countries over time. In 1950,
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PRESIDENT OBAMA TO ADDRESS NOTRE DAME GR
OPEN LETTER TO PRESIDENT OBAMA
----- Original Message -----
Subject:Open Letter from Superior General of Notre Dame to Pres. Obama
THE CONGREGATION OF HOLY CROSS
General Administration
Via Framura, 85
00168 Rome , Italy
March 22, 2009
President Barack Obama
The White House
1600 Pennsylvania Avenue N.W.
Washington, D.C. 20500
The United States of America
Dear Mr. President,
Congratulations on being awarded an honorary Doctor of Laws degree from the University of Notre Dame!
The University of Notre Dame was founded by the Congregation of Holy Cross and in 1844 it was established as a civil moral person by a legislative act of the state of Indiana . On March 6, 1967, with the consent of the Holy Father Pope Paul VI, in the spirit of Vatican Council II with its clarion call for all Catholics to take greater responsibility for living and strengthening the life of the Church, the Congregation of Holy Cross ceded its ownership of the University of Notre Dame to a Board of Fellows. The University remains, however, under the continuous sponsorship of the Congregation of Holy Cross of which I am the Superior General.
The dramatic alienation of ownership of the University of Notre Dame from the Congregation of Holy Cross took place in light of the Second Vatican Council’s recommendation that competent laity play a more significant role in the administration of religious and ecclesiastical property. Through this unprecedented gesture the Congregation of Holy Cross sought to offer competent lay Catholics broader responsibility for Catholic higher education without jeopardizing the authentic Catholic character of the institution.
President Obama, the University of Notre Dame is honored to have you, as President of the United States of America , deliver the commencement address to the graduating class of 2009. Personally, in so many ways, I admire you as a great American, a person endowed with extraordinarily well developed intellectual gifts, and, in my opinion, a man whose enormous compassion characterizes the goodness of his heart. Mr. President, you have the potential for greatness; I pray it be realized.
As you know the University of Notre Dame’s decision to award you the honorary degree and to invite you to deliver the commencement address is fraught with controversy. As Superior General of the Congregation of Holy Cross I have been deluged with angry e-mails regarding Notre Dame’s decision to invite you to campus for the honors you are to receive.
Because of the University’s legal civil alienation from the Congregation, I have no authority over its decision making – those responsibilities are now directed by a Board of Fellows and a Board of Trustees. Nevertheless I do hold personal authority over all of the Holy Cross priests and brothers of the Congregation who serve at the University of Notre Dame including its president who is always a Holy Cross priest.
President Obama, you are superbly versed in the issues of our day. I have no doubt that your policy convictions are grounded in rigorous study and that all your important decisions are supported by your conscience. Therefore, through this open letter, I would like to take advantage of the occasion of your receiving an honorary degree from Notre Dame, to ask you to rethink, through prayerful wrestling with your own conscience, your stated positions on the vital “life issues” of our day, particularly in regard to abortion, embryonic forms of stem cell research and your position on the Freedom of Choice Act before Congress.
Perhaps such an impertinent request rings with insolence. I mean you neither rudeness nor disrespect. I ask you this directly because as a Catholic, in this critical area of life and death issues, I hold and promote contrary views to your own as to what is right and just for the common good of our nation.
In a very real sense your presence at Notre Dame offers us a kind of seminar, a stimulus of mind and heart, to quicken and incite conscience formation. None of us want to be stubborn and yet we have clear convictions. We want to be open to a variety of perspectives yet it is our principled beliefs that define us. We Catholics are always battling the vagrancies of “relativism.” It is clear, however, that your positions on some of the fundamental “life issues” of our nation can neither be supported by the mission and ministry of the Congregation of Holy Cross, the University of Notre Dame nor the faithful Catholic community.
Mr. President, in thinking of your coming visit to Notre Dame, I am reminded of the way you seized the opportunity, in the heat of your campaign for president, to address the issue of racial bigotry in our American culture. Your courage in addressing a history of the racism and violent discrimination in a nation grounded in human rights and freedom for all, confronted us with the inconsistency and hypocrisy of our words and actions. In addressing the issue of racism head on with passionate convictions and sterling logic you not only benefited politically during a critical point of the campaign but you also used this precarious opportunity as a teachable moment for the nation, calling us to our best selves, to live truly who we say we are.
In a similar way your presence at Notre Dame affords all of us a teachable moment. We Catholics will not modify or compromise our essential faith convictions but we do need help in developing our skills of communication and organization to express our faith convictions in American society so as to be heard and taken seriously. How are we Catholics to participate in all levels of government without betraying our consciences or without being coerced by potential laws that would violate our consciences? This is a colossal concern for us with far reaching consequences that go to the core of who we are as a nation, as human beings and people of faith.
Father John Jenkins, C.S.C., President of Notre Dame, reminded students recently that that the University of Notre Dame aspires to help them grow in faith and moral character. He gave them points to ponder. In a list of six smidgens of wisdom, Father Jenkins first urged them to wrestle with the largest questions of life such as: “What is a truly good, worthy human life and how do I live it?” Perhaps the largest question of all is: “What, if anything, am I willing to die for?”
Will we die for our essential beliefs?
Most Catholics, who disagree with the decision of the University to offer you this award, are rooted deeply in their faith, however imperfect we may be. We often fail, we are sinners, no doubt about it. Trusting in God’s love we try to pick ourselves up, seek forgiveness and try to do better. Our faith means everything to us; we have a faith we will die for.
Sadly today, many faithful Catholics now feel out of the mainstream of our nation’s direction and decision-making. Sometimes it seems many legislators, judges and executives, and even yourself, Mr. President, dismiss our views too off-handedly, without giving them the serious attention and reflection they deserve. How are we Catholics to go about getting ourselves to be taken seriously by our government leaders?
President Obama, your presence at Notre Dame, a premier Catholic institution, is regarded by many good Catholics as scandalous because of your support of abortion rights, regarded by us as an intrinsic evil. In awarding you this degree, they experience Notre Dame as undermining essential, intrinsic Catholic dogma which upholds the dignity of human life. They believe that in honoring you or in giving you a platform to speak, the University of Notre Dame is selling her soul for who knows what: perhaps, at best, for the prestige and glory of having the President of the United States on campus during his first year in office or perhaps at worst, giving an endorsement to your “anti-life policies.”
I do not believe this outrage is simply a demonstration of partisan politics. I sincerely want to rejoice in your presence at Notre Dame as President of the United States . But really, can I? In all sincerity, President Obama, how are we Catholics to deal with you, or any other government leader, who upholds what we believe to be the intrinsic evil of abortion and who is willing to sign the FOCA legislation? How are we to confront Catholic leaders in your own Administration by whom we feel so abandoned? Are we to use tactics of shunning you and dismissing you as we feel shunned and dismissed? This is a far from frivolous question. Shunning seems to be the growing trend among many Catholic leaders and institutions today. It seems to be the only recourse left open. It is, of course, a tactic many politicians have used on occasion, including yourself.
During the campaign for example, you went to great and painful lengths to distance yourself from your pastor over extremely controversial issues. Our Catholic concern for the right to life motivates us to go to great and painful lengths to distance ourselves from you because of your position on many of the “life issues.”
There are also politicians on both sides of the aisle who say we as a nation can never meet or negotiate with our enemies until they first change their ways. Your predecessor, for example, shunned political leaders of nations who sponsored state terrorism. Your administration has taken a different tact. You have indicated your willingness to engage our nation’s foes in dialogue, yet Iran ’s supreme leader, Ayatollah Ali Khamenei, states that he will continue to shun you until the United States changes behavior toward Iran . “Change only in words is not enough. Change must be real,” he said.
Likewise, there is no way you could possibly invite the Iranian President Mohammad Khatami to the United States to address a joint session of the Congress. It is unthinkable. Many Catholics find a parallel situation in your being invited to speak at a Catholic institution like Notre Dame. They are scandalized beyond measure that Notre Dame would do such a thing.
Mr. President, as you know the “life issues” before us are quite matter of fact, yet exceedingly complex. Our most essential faith conviction is straight-forward. You yourself expressed it so well in your remarks at the National Prayer Breakfast this past February 5th, when you said: “No matter what we choose to believe, let us remember that there is no religion whose central tenet is hate. There is no God who condones taking the life an innocent human being. This much we know.”
This much we know, Mr. President, your statement on the taking of an innocent life is our belief. It is the kind of clear, straightforward talk of your conscience convictions that we find so appealing. But sadly for us Catholics, your words do not express our meaning when you speak of “taking the life of an innocent human being.”
President Obama, I found the entirety of your remarks at the prayer breakfast truly inspiring and motivating. In your words I found, in summary form, the reason of my admiration and esteem for you and the root of my patriotism. With your words, however, I also found, in summary form, the reason I could vote neither for you nor the Democratic ticket nor the Republican ticket. In fact, as a Catholic I believe myself disenfranchised from my government and disillusioned with what I perceive as a great gap between the rhetoric of our founding national ideals and the hubris of our so-called national convictions which more and more seem simply to enshrine our self-interest for prosperity over democracy. As an American Catholic, will I ever be able to vote again for a nominee of a major political party when each party, in my view, fails the consistency test in promoting the rights and dignity of all human beings from conception to natural death?
I am embarrassed to confess that I sat out the last election cycle. I am finding it more and more difficult to vote for the candidates of our major political parties. My friends tell me to vote by all means, vote for the lesser of the evils. Unfortunately today’s evils seem so much larger than my conscience can bear, whether they be on abortion, the death penalty, euthanasia, immigration, the economy, housing for the poor, health care for the uninsured, the environment, war or weapons of mass destruction. I do love my country and I do want to vote. I just don’t know how to vote while remaining true to my conscience formed by my faith convictions.
But to return to your simple truth: “There is no God who condones taking the life of an innocent human being.”
Catholic dogma insists that life begins at conception. Innocent human life is conceived through sexual intercourse meant to be the most intimate, expression of love possible between two human beings, save giving up one’s life for the other. In his first encyclical, “God Is Love,” Pope Benedict XVI taught that “one meaning in love, amid a multiplicity of meanings, stands out in particular: the love between man and woman, where body and soul are inseparably joined and human beings glimpse an apparently irresistible promise of happiness. This would seem to be the very epitome of love.”
It is true that sometimes, tragically, life is formed in the brutality of rape or in the shame of incest. Likewise life is often unintentionally conceived within the process of people solely seeking sexual pleasures.
But in Catholic dogma, human life is human life. Abortion is considered an unspeakable crime, the taking of an innocent human life. As you so well stated “no God condones taking the life of an innocent human being.” As Catholics, that much we know. You prayed “let us remember that there is no religion whose central tenet is hate.” Just as love begets love, hate begets hate.
There are some people who hate the life of a child in the womb due to the unwanted consequences of sheltering, nurturing and forming that new “intruder,” that new guest, who is now forever altering the agenda of one’s personal life as well as the life of our larger society.
There are some religious people who now hate Notre Dame for inviting you to speak at the 2009 graduation and receive an honorary degree. I fear their hate will beget further hate. Will their hatred ultimately destroy their souls in the guise of self-righteousness, just as powerfully as abortion destroys the physical life of a newly conceived child?
Embedded in the civil laws framing our United States cultural values, and even among some Christian believers, an embryo growing in a woman’s womb is not considered to be a human life; “it” is regarded simply as new tissue, a kind of cancerous, biological growth infecting a woman’s body and threatening a woman’s independent way of life. Legalized abortion clearly implies that a person’s choice for personal freedom supersedes the natural human obligation to protect and nurture human life. Biological destiny has its challenges for both women and men in making our choices. The Hebrew Scripture emphatically expresses the right decision in the choice between life and death: “choose life!”
Faithful Catholics believe that the fetus, the embryo, growing in the womb is a distinct human being. We believe that the new child’s mother is the guardian of her baby’s life within her womb. She is offering this new creation precious hospitality, just as a Christian might give a journeying pilgrim the respite of hospitality within one’s own home.
This much we know, Mr. President, in our culture, dictated by the law of the land, a newly conceived embryo is not offered the dignity and rights of an independent, innocent human being. “There is no God who condones taking the life an innocent human being.” As Catholics, this much we know, abortion is taking the life of an innocent human being. Nothing will ever change that.
President Obama, would you really sign into law a bill like FOCA which would force faith-based hospitals and healthcare facilities to perform abortions? Would you deny doctors and health care professionals their most precious human freedom in choosing life?
The issue of choice in American law looms large before us: in your logic it will be lawful to choose abortion but it will be a crime to choose life. In Catholic logic one cannot choose to murder in any circumstance, even in punishment for crime. One can choose life but not death. I am not so naïve as to believe that passing such ill-advised, contemptible legislation such as FOCA will “end the culture wars” as you have stated. On the contrary it will be considered by many of us as a persecution of the Catholic Church.
Tragically, we have a tradition in our United States culture which gives us permission to define the parameters of human life when it suits our self-interest. Did we not justify our tradition of slavery by denying that a black human being of African decent was fully human? To call a slave a human being would have interrupted the economic progress and well being of our country’s self-interest. Many leaders of the nation believed we could not afford to do that. As I understand it, President Lincoln had a contrary view and took us to civil war for the sake of unifying our country’s conscience in terms of the rights and dignity of all human life. Or was it simply a war fought over the nation’s economy?
And so now today we are engaged in a great civil war over conscience formation. The defense of human life is an obligation for all humanity, not just for Catholics. Or is this war simply a war over the right to defend our self-interest without regard for promoting the responsibility we have for others?
An “unwanted” child comes in many forms: an untimely presence; a disabled or deformed creature; an embryo of the wrong sex; a child conceived out of wedlock; a child conceived through a hideous crime. We today have an unparalleled capacity through our scientific know-how, unlike the limited knowledge at the disposal of Adolf Hitler, to create a super race, free of any spot or wrinkle. The new laws of our society seem to aspire toward creating genetic purity within the human species, hoping to assure a problem-free future for the sake of human happiness, pleasure, prosperity and peace.
There is no doubt in my mind, Mr. President, that in the not too distant future we will have godlike powers to form the perfect human species. The Towerof Babelwill have had nothing on us when it comes to asserting our god-like greatness.
Surely future laws will require us to remove any genetic tendency toward weakness and imperfection; we will soon have a nation (and world?) of perfect “Stepford Wives” and perhaps “Stepford Husbands” and “Stepford Children.” We will soon become quite adept in the art of putting people out of their misery; particularly if they are causing us misery!
On a very personal level, Mr. President, as a young man I was scandalized by the Republican agenda after the Roe vs. Wade decision. As I recall, perhaps mistakenly but I sincerely believe accurately, that some powerful Republican governors introduced the country’s most liberal abortion laws in their populous states. I seem to recall hearing one Republican Senator say in a television interview that he favored abortion because it was cheaper than welfare. I also recall hearing an influential Democrat calling abortion “black genocide.” Somewhere along the line, I suppose in the defense of women’s rights and in the rise of Christian fundamentalism as a political power, the agendas flip-flopped, one side to the other. How did that ever happen? But when it did, given my faith convictions and my conscience, I had no choice but to surrender my political affiliation as a Democrat and become an Independent.
In all sincerity, Mr. President, how am I to conduct myself as an American Catholic? If the “Freedom of Choice Act” were to be passed, would it mean that I flee to Canada in protest, the way so many of my peers did during the Vietnam War? Should I flee to the desert as did Christians of old to escape the fabric of a sinful society seemingly beyond conversion?
In my humble opinion, Mr. President, it doesn’t do us any good to withdraw from society; and it surely doesn’t do us any good to throw things at one another, be they shoes or missiles or ugly words. Does it do us any good as Catholics to honor with honorary degrees those who disagree with us over essential matters of life and death? In my opinion it doesn’t do the conscience of Catholic politicians any good to state that while they are personally opposed to abortion, they will nevertheless uphold the law of the land.
When the Honorable Mario Cuomo was Governor of New York, a Catholic civil servant, for example, he said that although he was opposed to abortion he would support abortion rights as the law of the land. Yet in promoting opposition to the death penalty, and in this I fully agreed with him, he was willing to fight with all his political might to change the law of the land. Where was his consistency? Where is any Catholic’s consistency in living faith as a public servant or in honoring a public servant who chooses death over life, whether it be through abortion or through punishment for crime?
President Obama, what good will it do for Catholic politicians to bring his or her faith convictions into the culture wars of legislating for the common good? Surely they will lose their next election; the secular industrial news media complex will see to that. >From what platform, then, ought Catholics to speak? Can we only shun the political world and thereby risk losing our souls to a possible spiritual death through indifference or self-righteousness? It seems shunning has become our only choice. Surely we can do better than that. Our sins as a Catholic Church are well known, we cannot dare be self-righteous. But we dare not remain silent either, even in the face of our own sins. Repentance and conversion, mercy and forgiveness are the only healing remedies for all of us.
And how are Catholics to relate with Catholics who seem so indifferent to these fundamental life issues? I agree with Archbishop Charles Chaput, who complained: ”Too many Catholics just don’t really care. That’s the truth of it. If they cared, our political environment would be different. If 65 million Catholics really cared about their faith and cared about what it teaches, neither political party could ignore what we believe about justice for the poor, or the homeless, or immigrants, or the unborn child. If 65 million American Catholics really understood their faith, we wouldn’t need to waste each other’s time arguing about whether the legalized killing of an unborn child is somehow ‘balanced out’ or excused by three other good social policies.”
Mr. President, may I digress for a moment and risk trying your patience? May I share with you a great personal gripe with our American free press? The big business of our industrial news media complex seems hardly free to me. The industrial news media complex seems no more than a huge business monopoly whose owners have become the new teaching hierarchy of the culture wars. The Catholic Church’s magisterium, teaching authority, cannot hold a candle to themagisterium of the powerful lords of the industrial news media complex.
When it comes to reporting news of the Catholic Church our infamous free press seems more than eager to employ yellow journalism sound bytes to make news and money while promulgating their self-centered values in the formation of our American culture. Let me give you a current example: the Pope’s recent visit to Africa . On March 17th, while on the plane to Cameroon , Pope Benedict was asked about the effectiveness of condoms in the fight against AIDS and the Church’s position on the use of condoms. The Pope responded with what I perceived to be a thoughtful and gracious answer. What the church teaches in regard to healing is the "humanization of sexuality" through the promotion of sexual responsibility and dignity on the one hand, and on the other hand, “a willingness to be present with those who are suffering.” He spoke of the many church programs and dedicated care givers currently helping people with AIDS.
As you well know, Mr. President, the news media make the news. Their story reduced the Pope’s visit to Africa as a condemnation of condoms, ignoring completely his eloquent message for justice, peace and mercy at every level of life on the African continent.
How can the media play up condoms and downplay encouraging words such as these of Pope Benedict XVI which offer so much challenge and inspiration that can enrich us all?
“ Angola knows that the time has come for Africa to be the Continent of Hope! All upright human conduct is hope in action. Our actions are never indifferent before God. Nor are they indifferent for the unfolding of history. Friends, armed with integrity, magnanimity and compassion, you can transform this continent, freeing your people from the scourges of greed, violence and unrest and leading them along the path marked with the principles indispensable to every modern civic democracy: respect and promotion of human rights, transparent governance, an independent judiciary, a free press, a civil service of integrity, a properly functioning network of schools and hospitals, and – most pressing – a determination born from the conversion of hearts to excise corruption once and for all.”
Mr. President, I am quite sure you will find in the Pope a kindred spirit when you meet him. Both of you have keen intellects and compassionate hearts.
Unfortunately, the current newsmakers clearly find Catholic bashing in vogue. They ridicule the Church’s rich social and spiritual teaching with inane sound bytes meant to undermine the teaching authority of the Church in fostering a good and just civilization of love.
Mr. President, what advice would you give someone like me who wants to respect a wide diversity of opinion yet who seeks to live faith convictions that relate to the essential common good of our American Society?
Like so many Americans, and people of good will around the world, I find such great hope in you. I pray my hope will be realized; however, I fear disillusionment, I fear being let down, with a thud. I mentioned that I believe you have the potential for greatness. I sincerely pray for the realization of your potential because, selfishly, in the process, you will help me and many others to fulfill our potential as human beings created in the image and likeness of God.
When sharing smidgens of wisdom with Notre Dame Students, one point Father Jenkins made, which I like very much, concerned the risk of their making mistakes while striving for excellence in all they do. He said that our mistakes can often be great teachers, for they offer us great sources of insight and motivation. He quoted Chief Justice John Roberts who once said, “Failure is a more effective stimulus than success – because you don’t get to do it over, but you do get the chance to do it better next time.”
Mr. President, may I be so audacious as to suggest that you have made a mistake in your position supporting abortion rights as the law of the land. May I suggest, with all humility for I am far from perfect, that you give your conscience a fresh opportunity to be formed anew in a holy awe and reverence before human life in every form at every stage – from conception to natural death. For we are all the Children of God.
I believe, President Obama, as I am sure you do, that love makes the world go round. I gained the greatest appreciation for the meaning of salvation through God’s love lived out in human beings in the holy words of Reverend Doctor Martin Luther King, Jr. They reinforced for me the nature of Christ’s death on the cross for the sake of our salvation; they taught me what it is to be Christ-like. Permit me to share them with you. You are more than likely familiar with them already. He said:
“To our most bitter opponents we say: We will match your capacity to inflict suffering by our capacity to endure suffering. We shall meet your physical force with soul force. Do to us what you will and we shall continue to love you. Throw us in jail and we shall still love you. Bomb our homes and our churches and we will still love you. Threaten our children and we will still love you. Send your hooded perpetrators of violence into our communities in the night hours. Beat us and leave us half dead, and we shall still love you. But be assured we will wear you down by our capacity to suffer. One day we shall win freedom, not only for ourselves but for you as well. Appealing to your consciences and your heart, we shall win you over in love in the process of gaining our freedom. Our victory will be a double victory.”
Mr. President, I pray that Catholics, through the grace of God’s love in their passionate determination to love all people, will help win over our American society and our world culture to reverence the inherent dignity of all human life, without exception.
I don’t want sound bytes to determine the kind of relationship of respect I have for you or the quality of fidelity the University of Notre Dame has with the larger Church. I want simply to be respectful of you as my brother and my President to dialogue with you and my country without betraying my fundamental faith convictions. We live in a pluralistic society,
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ARE WE GETTING WHAT WE CAN PAY FOR?
Ten years of Life
WHAT SHOULD 10 YEARS OF LIFE COST?
10 MORE YEARS, DOES ANYONE KNOW HOW MUCH IT SHOULD COST?
To this date he's enjoyed ten additional years of active life, the result of new surgical procedures and expensive but effective medicines,
Did it cost him a lot? Of course it did, he's a Senior and payed taxes for many years in order to get Medicare. On top of that, he has private insurance to help pay for his medicines, "a fistful of pills twice a day, for the past 10 years.", as he said.
How does he feel about it? "OK, but I'm not supposed to, according to politicians and many of my friends, who say it should have been free or, at least, cost less than I paid. Yet, if I think about it, how could it be free when it required the help of lots of people, to get me those extra 10 years. They had to work, pay taxes and provide for their families while they were helping me."
So if we agree, they should be paid for their help. Then, the next question would be, "Where does the money come from to pay for this free care"?
After thinking about it, he said, "As I see it, the only way we can do it is to tax the people who can work and then ask them to put up with increases in their taxes. when we need more to keep the 'free of charge' system going".
"I hope they'll agree", he added, " I'd like another ten years,"
..
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Abortion Breast Cancer link
Abortion Breast Cancer Link in News
The possiblity of a link between Abortions and Breast Cancer [ABC Link} in later life has been reported in different news articles published in the past few months.
I first learned of this relationship from a report in a Scotland newpaper [discussed on this web-site in an earlier article in this section]
Also, reported on The World Net Daily News [www.worldnetdaily.com] on 1/2/'03. An article entitled "Ex-Abortionists Expose America's greatest Scandal"
Today, 11/13/03, a new article on the World Net Daily web-site reminds us of the growing controversy regarding this issue. It urges that Doctors warn women seeking abortion of this possibility; tell us that 2 states, Texas and Minnesota now have laws laws mandating that Doctors inform patients of this controversy. see "Women have a right to know".
The Association of Physicians and Surgeons in Tuscon, Arizona has taken a strong position on this matter and urges their members [several thousand Physicians and other health care professionals] of the need to inform patients or risk a lawsuit. See [www.aapsonline.org]
Additional reports stating "no linkage can be found" were published in the SanFrancisco Chronicle [SFC] on 2/24 and 2/28/'03.
SFC on 5/22/'03 reported that the State of Texas passed a law mandating that Doctors discuss this possibility with patients requesting abortion.[Now, also a law in the State of Minnesota and being considered for Legislation in the State of Massachusetts and others]
This week [10/21/'03] one colleague heard a discussion, concerning this matter, on National Public Radio; and www.worldnetdaily.com on 10/23/03 reported that a mother won a landmark case against a High School in Pennsylvania who referred her daughter to an Abortion Clinic in New Jersey: and also against the Clinic where abortions are performed on minors without parental consent
Additional information on this matter can be found at www.aapsonline.org or www.abortionbreastcancer.com.
To those ladies who are concerned an annual Mammogram is the right thing to do, regardless of cost.
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Hypnosis for Cancer Patients
Hypnosis Relieves Pain of Cancer
Cancer Victims can derive great benefit from training in the use of Self-Hypnosis to control pain and stress encountered during their treatment and especially when suffering from a Cancer that has not reponded to treatment.
Research has demonstrated that 'Fear of the unknown' can intensify the pain and mental stress suffered by the patient who has been diagnosed with, is under treatment for or who has been told their tumor is not responding to treatment,
Self-Hypnosis, allows the patient to carry within themselves, at all times, the ability to reduce that fear. It can reduce or remove pain and control the way one feels. It's an advantage over the prescription that runs out or the injection that is requested too soon or is not readily available.
In my four decades of experience with the use of Medical Hypnosis I've learned that patients diagnosed with Cancer are eager to learn and then pleased and greatful to be able to help themselves when they feel the need. This is especially true of patients diagnosed with Terminal Cancer.
Ask your Doctor to help you or to refer you to someone who is trained to teach Medical Self Hypnosis
Be sure to read a more detailed report of the HCREI Director's experience, of more than 45 years, with the use of Hypnosis to relieve pain and anxiety in patients with Cancer written in the Articles on Health Care Reform Section of this website.
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Privacy of Personal Medical Records
Medical Records Open to Government
Starting on April 14,2003 our personal/private medical records will be open to government agencies, insurance companies, direct mail marketers and law enforcement agencies.
Your knowledge or your permission will not be necessary before a record is sent out. Your Doctor must release your record to the proper agencies and is not required to seek your signature.
Hospitals will be forced to make changes concerning what they will reveal concerning a hospital patient, especially over the telephone. They may not tell you if or where a patient is in the hospital nor comment on the condition of the patient.
Listing of names of patients in the hospital, usually available at the hospital information desk, may have to be discontiued.
There will be a great deal of confusion until the government makes available the new rules needed to avoid fines and jail penalties for violating several hundred page of new rules and regulations.
There are three earlier bulletins concerning medical record privacy and the potential consequences of these new rules. [See Below]
Remember, your Doctors are subject to the new rules just as you are.
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Abortion Breast Cancer Link 2005
Discussion abortion breast cancer link
MAJOR NEWS BREAK--ABORTION BREAST CANCER LINK
Total News Report Reprinted below
Posted: May 16, 2005
1:00 a.m. Eastern
WorldNetDaily.com
"MATTERS OF LIFE AND DEATH
Abortion-breast cancer link covered up by scientists?
Researcher says 'pro-choice' bias has hidden deadly risks to women
A pioneer researcher into the connection between abortion and breast cancer says an overwhelming amount of evidence collected in nearly 50 years of studies demonstrating a conclusive link has been systematically covered up by biased scientists, government agencies and the news media using fraudulent data to deceive women about potentially life-and-death decisions.
Joel Brind, a Ph.D. and professor of human biology and endocrinology at Baruch College, City University of New York and president of the Breast Cancer Prevention Institute, has authored a paper for the National Catholic Bioethics Quarterly refuting several recent studies downplaying the abortion-breast cancer link.
In particular, Brind cites a widely noticed paper published by Valerie Beral and four other Oxford University scientists in The Lancet in 2004 and statements of the National Cancer Institute in 2003.
The Beral study finding was unequivocal: "Pregnancies that end as a spontaneous or induced abortion do not increase a woman's risk of developing breast cancer." The NCI has stated on its website since 2003 "having an abortion or miscarriage does not increase a woman's subsequent risk of developing breast cancer."
"The trouble is, to accept this conclusion, one needs to dismiss almost half a century's worth of data which do show a significant link between abortion and an increased risk of breast cancer," writes Brind.
Brind says "denial of the ABC link has become the party line of all major governmental agencies (including the World Health Organization), mainstream medical associations (including the American College of Obstetricians and Gynecologists and Royal College of Obstetricians and Gynaecologists) and the most prestigious medical journals (including the New England Journal of Medicine)."
The first study done on the link was in 1957 in Japan, published in the Japanese Journal of Cancer Research, and found breast cancer had a three-fold higher frequency in women who had abortions. Again in 1979, the World Health Organization commissioned a high-profile study based at Harvard and published in the WHO Bulletin that reported a disturbing trend "in the direction which suggested increased risk associated with abortion – contrary to the reduction in risk with full-term births."
"The fact that the WHO findings never entered the debate reveals a disturbing – and continuing – disconnect between the so-called women's health advocates pushing for legalized abortion and any genuine concern for women's health," writes Brind.
Those studies were followed by the first based on American women in 1981 by Malcolm Pike and his colleagues at the University of Southern California. The results showed women who had an abortion before they had any children were at a 2.4-fold increased risk for breast cancer.
"One would think, especially given the overwhelmingly elective nature of the induced abortion, that the precautionary principle would prevail, if not in terms of legal regulation, then at least in terms of recommendations by medical societies and public health agencies," writes Brind. "That is to say, even one or two studies showing a significant association between induced abortion and future breast cancer risk would surely raise some red flags about the procedure's safety. Yet not only was a statistical connection showing up in the vast majority of studies that had examined the issue, but by the early 1980s, a clear picture of the physiological events explaining that connection was beginning to emerge."
Brind points out that the connection went beyond statistics. In the 1970s, the science explaining the connection was becoming understood through laboratory research into reproductive endocrinology. In 1976, the British Journal of Obstetrics and Gynaecology published a study documenting the difference between the enormous rise of estrogen and progesterone in the first trimester of viable pregnancies and the stunted and short-lived rise of these hormones during pregnancies destined to abort spontaneously through miscarriage. These findings, he says, dovetail perfectly with the patterns of differences in breast cancer risk following different pregnancy outcomes.
Tests during the 1970s on research animals again demonstrated the link between abortions and breast cancer risk, connecting it conclusively with the estrogen and progesterone levels produced in early stages of pregnancy.
"Knowledge of the actions of estrogen and progesterone in terms of their effects upon breast growth completes the coherent picture of induced – but not spontaneous – abortion and breast cancer risk," explains Brind.
During the 1980s and 1990s, Brind asserts that study after study – in Japan, Europe and the U.S. – continued to report significant increased breast cancer risk in women who had an induced abortion.
"By 1994, six epidemiological studies out of seven in the United States, on women of both black and white ethnicity, had reported increased risk with induced abortion," he writes.
Then in 1994, Janet Daling and colleagues of the Fred Hutchinson Cancer Research Center in Seattle published a study in the Journal of the National Cancer Institute showing a 50 percent increase in the risk of breast cancer among women who had chosen abortion. It also showed an increase of more than 100 percent for women who had an abortion prior to the age of 18 or after age 30. The risk was compounded for those who had family histories of breast cancer.
"But forces were already set in motion to make sure the news was short-lived," explains Brind. "For one thing, the Daling study was accompanied by a most unusual JNCI editorial. It was unusual because most medical journal editorials, written by a scientist who has peer-reviewed the study, are published by the journal in order to highlight the importance of a major study on a subject of wide public interest. Such editorials typically make it easier for reporters – usually non-scientists working on short deadlines – to glean the major points of a study and render it understandable to the general public. Instead, Dr. Lynn Rosenberg, of Boston University School of Medicine, took the opportunity to write an editorial which sandbagged the Daling study, concluding – among other things – that "... the overall results as well as the particulars are far from conclusive, and it is difficult to see how they will be informative to the public." Rosenberg even speculated the study may have been faulty because of "reporting bias" that generated false positive results.
Brind accuses Rosenberg of misrepresenting the Daling study, "an act which by itself satisfies most definitions of scientific misconduct."
Brind even suggests a possible motive: "Rosenberg has also shown herself to take a stance that appears to go beyond 'pro-choice' (as Janet Darlin has described herself), and that is radically pro-abortion. In 1999, for example, she served on behalf of a group of Florida abortion clinics as an expert witness in their (ultimately successful) facial challenge of a new parental notification law in Florida for minors seking an abortion. Such minimal restrictions on abortions are supported by the vast majority of even 'pro-choice' citizens, but not by the likes of Rosenberg."
Brind points out that when Rosenberg served as editor of the American Journal of Epidemiology in 1988, a study on breast cancer in South American women was published. Only seven years later was it revealed in the British Journal of Cancer that the study found abortion was the biggest risk factor in that study – a point not revealed under Rosenberg's watch.
Government agencies such as the NCI, some volunteer organizations such as the American Cancer Society and major medical journals all seem determined, Brind asserts, to downplay and conceal the breast cancer links with abortion.
"The only effective counterweight to such unified enforcement of the party line (in this case, 'safe abortion') is an independent media," he says.
In 1996, Brind, along with three colleagues, published a comprehensive review and meta-analysis of the ABC link in the British Medical Association's epidemiology journal, the Journal of Epidemiology and Community Health. It reported data compiled from 23 previous studies. It found there was a 30 percent increase in risk of breast cancer among women who had an induced abortion with no significant link to miscarriages.
Three months later, a new paper widely hailed as the definitive disproof of the ABC link appeared in the New England Journal of Medicine. It was funded by the U.S. Department of Defense and focused exclusively on women in Denmark. Nevertheless, an editorial in the journal by a senior NCI scientist concluded: "In short, a woman need not worry about the risk of breast cancer when facing the difficult decision of whether to terminate a pregnancy."
"Just how, one may reasonably ask, could one single study's result nullify almost half a century's data from dozens of studies?" writes Brind.
But he goes further, pointing out what appears to be a serious flaw in the methodology – the misclassification of some 60,000 women in the study who had abortions but were categorized as not having the procedure.
Yet, Brind contends the raw data of the study still shows a 44 percent increase in breast cancer risk with induced abortion – an increase that did not appear in print in the study "and which was made to disappear with statistical adjustment."
"Despite the worst efforts of scientists, doctors, politicians, journalists and judges to quash public knowledge of the ABC link, the fact that published evidence of it abounds would make it a daunting task to convince a jury of its nonexistence, given a well-resented case," writes Brind.
He says two recent court cases have found in favor of plaintiffs who did not receive warnings about breast cancer risk before their abortions.
"It is indeed unfortunate that – even assuming the truth will eventually win out – it may not occur until the issue is forces into the courtroom," he concludes. "We have estimated that upwards of 10,000 cases of breast cancer each year presently, and up to 25,000 per year in 20 or 30 years hence, are or will be attributable to induced abortion. How many thousands of women will be subjected to the pain and suffering of this horrible life-threatening disease, only because doctors, the public health agencies, the media and even voluntary anti-cancer organizations are under the thumb of the 'safe abortion' lobby?"
Brind says there is new – even stronger – evidence to link abortion to premature births in subsequent pregnancies, "which in turn raises the risk of breast cancer and cerebral palsy in the prematurely born children."
"Many adjectives may be used to properly describe induced abortion, but 'safe' is assuredly not one of them," he concludes. "The day will surely come when this is common knowledge, and for every day sooner that this happens, thousands of lives may be saved."
ROUTINE MAMMOGRAMS ESSENTIAL
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ELEMENTARY SCHOOL ENROLLMENT DECLINES
WORLD BIRTH RATE DECLINING
Elementary school enrollment in the Sacramento area of California has declined by 13% OVER THE PAST 5 YEARS.
This news supports the bulletin written earlier on this website concerning the low birth rate being reported by many major nations throughout the world.
HCREI now located in Northern California will be back to work soon. Thanks for your patience The Director
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We Need To Be More Responsible
We Must Take Better Care of Ourselves
From Linda Tofanelli, Editor for HCREI
Even though our nation's health care tries to provide for everyone, whenever they need it, it's never enough; and when this system fails, it makes the headlines. It's easy to lay the blame if we believe that universal care for everyone is possible - if only that idea could be feasible.
Unfortunately, it cannot and we are still consumed by our desire to provide this invaluable gift of care when in essence, there is not enough money to cover it all.
A unique policy has been initiated in one nation, where patients need to stop smoking, quit alcohol and drug abuse and lose weight before they will select you for non-emergency surgery, from their long waiting list of patients.
Harsh, but in reality they, nor we can continue to pick up the cost for people who repeatedly abuse their bodies.
In demanding universal care, we fail to realize that in some nations, all those eligible to register for health care insurance get a card which entitles them to get in line and wait their turn. Some die waiting. Some nations only insure the workers with health insurance, their families are not included, and they too must wait.
Canada has been in the spotlight as the answer to our nation's healthcare crisis. This is a Government only system which is "One-tier "and if you want more than what that system offers, you have the choice of buying insurance and going to the United States for medical care. In nations with a "Two-tier" system, every one must get government coverage, however, many buy a private policy, out of pocket, in order to get prompt attention.
There is no current solution to these problems and answers need to be found to improve what we currently have in place.
We, too, can adopt Canada's system of a single payer; however, be aware you will have no other choices; i.e. another nation to turn to for health care. Before we abandon our system of health care, which is far superior, ask why.
Why are we replacing it with a system that is failing in another nation? We need to understand that other nation's have tried single payer and it does not work for them. How ironic that these same nations are now desperately trying to adopt a system comparable to our current one - the one some of us are willing to throw away.
[Also read Linda's poems in the Poet's Corner Section of this website]
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We Need A Recount
We Must Demand A Recount
see new section Latest News Bulletins
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The Uninsured are unsettled
We Should Request A Recount
see new section Latest News Bulletins
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How Your Money Is Being Spent
Who Paid For This Study???
A new study concerning the use of HRT, Estrogen [with or without Progesterone]in younger Menopausal women was reported in the respected medical journal "Archives of Internal Medicine,8/9/04 issue.
The study according to WebMD.com suggests "that short-term [2 years] menopausal hormone therapy shortens life expectancy but improves the quality of life for those women with mild or severe menopausal symptoms.
The study showed that when quality of life issues are not considered, the average 50 year old woman, who takes hormone therapy for two years, can expect an almost TWO WEEK shorter life span.. A 50 year old woman at high risk for heart disease would expect a loss of life expectancy of more than FIVE WEEKS, whereas women at low risk for heart diseae would expect a loss of SIX DAYS."
Such calculations must be computer produced---how they relate to real life is open to question.
Nevertheless, women will have to decide if menopausal relief is worth from six days to five weeks of life, overall.
After more than 40 years of medical practice I can think of many women who would laugh as they take their HRT tablet. This is a moment when the men should remain silent since most of us won't live long enough to see the final outcome.
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Changes In Our Health Care
Endless Dilemma Surrounds Health Care
8/10/04--Ongoing health care problem are often not found on the front page of your newspaper. Most revolve around three issues. 1] The new Medicare Law with drug coverage; 2]Providing medical insurance for those who don't have it, regardless of whether they are illegal aliens, or Americans who don't want it; and 3] Whether or not these add ons will require an increase in taxes?
President Bush's proposal, according to Dr.Thorpe of Emery U., would cost ten billion dollars over ten years and would cover an additional 2.5 million more Americans. Senator Kerry plans to cover close to everyone and cover the cost, 650 billion dollars over 10 years, by rescinding the Bush tax cuts for anyone with an income over $200,000 per year.[from Business Week 8/10/04]
While keeping those figures in mind, I suggest you read earlier articles on this website that report disagreement between the US Government Accounting Office, who estimate 20 million medically unisured; and the US Census Bureau who estimate 40 million.
Add to that, money provided to California, during the Clinton Administration, for a plan to provide health insurance for 2 million medically uninsured children that found only about 100,000. I read a recent report of California families with insured children and uninsured parents.
The Standard Journal in Idaho [7/23/04] reported a federal/state program designed to provide health insurance for 50 to 60 thousand uuninsured children that has enrolled less tha six thousand to date.
The bottom line should be "Who is in charge?"--- "Where do they get their information?" and "Should we get some new people in there!!!"
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The New Medicare Law
Guessing about the New Medicare Law
see new section Latest News Bulletins
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Those Nasty Words--We Need Money
Donations Requested for HCREI
If you like what we're doing:
HCREI is asking for visitor donations to cover on going expenses. We have no sponsors or income other than your donations.
Send checks or money order [sorry,no credit cards] to HCREI,3017 Summit Street, Oakland, Ca. 94609. Donations are Federal and State tax deductible.
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No Seniors Freedom from Medicare
HSA--New Insurance for Americans--Update
see new section Latest News Bulletins
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Ongoing Medical Practice dilemma
We're Losing More of Our Best
see this article in Latest News Bulletins section
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Medicare Drug Coverage
Information on New Medicare Drug Cards
Look at -- www.webmd.com-- for additonal and new information about Medicare Discount Drug Cards.
This site gives information for the State in which you live. The most detail I've seen to date.
For a summary of research concerning the impact of the discount card see: www.heritage.org/research/healthcare.
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Crisis in Heath Care
We're Losing Many Of Our Best
I have taken this bulletin from the AM News [7/5/2004] entitled "Massachusettes Earns a Dubious Distinction."
The American Medical Association [AMA] has added Massachusettes to its list of states experiencing a full-blown medical liability crisis, raising the number to 20. Other states are Arkansas, Connecticut, Florida, Georgia, Illinois, Kentucky, Mississippi, Missouri, Nevada, New Jersey, New York, North Carolina, Ohio, Oregon, Pennsylvania, Texas, Washington, West Virginia and Wyoming.
In crisis states, physicians are retiring early, discontinuing high risk services or leaving the state altogether because of high medical liability insurance rates. A confluence of factors led the AMA to add Massachusetts to the list. Among them:
50% of Neurosurgeons, 41% of Orthopedic Surgeons, 36% of Obstetricians and 29% of its General Surgeons have reduced their scope of practice.
The number of jury awards of more than $2 million quadrupled over five years.
Median settlements in medical negligence case increased to $925,000 in 2002, up from $600,000 in 2000.
Be aware, most doctor cannot raise their fees [set by the insurance companies and or the government] in order to cover the increased practice overhead expense.
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Just Another Way To Cut Costs
Women Should Know This!!!
Taken from the SF Chronicle,6/21/04: "In 1996, the US Preventive Services Task Force said routine Pap test are unnecessary for women who have had both their cervix and uterus removed for reasons other than Cervical Cancer".
In 2002, Veterans Affairs Researchers found that almost 46% of such women were still getting Pap tests.
These tests were designated as "unnecessary" and added to the total of 10 million needless-[their word]-medical test performed each year in the U.S. Women should be aware that such a report supports many Doctors who agree, some due to the constraints of office time.
Women should, in my opinion, envy the 46% who did receive an annual Pap smear, requiring a pelvic examination, that could uncover an "early enough to treat" Cancers in the Ovaries, Vagina and Vulvar area [the tissue at the entrance to the Vagina]; or an unsuspected sexually transmitted disease [STD]; as well as a non-STD vaginal infection, inflammation or hormonal deficiency. [A properly done Pap Smear can help detect these diseases].
Ladies should request, even demand an annual pelvic exam which can improve their health and save some lives.
Don't permit the cost of an annual Pap Smear to interfere with that.
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Recent Event You Must Know
UPDATES ON IMPORTANT EVENTS
A Federal Appeals Court in Chicago said NO to opening medical records of patients who have had an Abortion.
Recent British report of NO increase in Breast Cancer for 60,000 women who had abortions referred to women who were pregnant and had spontaneous miscarriages [Natural Abortions].
Little Known Facts
A substantial number of natural miscarriages [20%+] are never recorded because,in many cases, a woman may not realize that her recent heavy menstrual flow was, in reality, a spontaneous [natural]miscarriage.
Spontaneous natural abortions usually occur 5-6 weeks before the event becomes evident to the patient. This allows ample time for the changing/pregnant breast cells to revert to normal, thus reducing the risk of Breast Cancer, in later life.
The events in natural spontaneous abortions [miscarriages] are so variable as to make Breast Cancer Studies based on recorded Spontaneous Natural] abortions less reliable.
The good news from the British study, where medical records are available, is "There is a low risk of Breast Cancer resullting from Spontaneous Abortions" [Miscarriages].
Bogus Health Insurance Carriers are on the increase. You can obtain more information/help from your employer or, with your health insurance policy, from the US Dept of Labor or your State Insurance Regulators. Contacts: www.dol.gov/ebsa and 1-866-444-3272
Taken From SF Chronicle 3/27/'04
Prescription drug discount cards mark the first stage of a planned Medicare prescription drug benefit. Seniors who use the cards can expect to buy prescription medicine at discounts between 10 percent and 25 percent.
Medicare beneficiaries can now enroll in a discount card plan [started on June 1, 2004].
Seniors should compare the programs' enrollment fees and the costs of the drugs they take.
Seniors can get help by calling 1-800-Medicare.
The Health and Human Services Department informs us that 28 companies were given approval to offer prescription drug discount cards.
"Medicare plans an education campaign to teach seniors about drug card options. The plans include an advertising campaign, a short publication mailed to every Medicare recipient and community assistance through state health insurance assistance programs.
The companies that participate in the discount card program must offer drugs in 209 categories and offer three choices in each category. Officials said generic drugs will be offered where available.
Medicare beneficiaries can enroll in only one approved card program. Change to a different card will be allowed, annually, during an open enrollment period between Nov.15 and Dec.31st. HOWEVER, the cost of your drugs can change during that year.
BE CAREFUL, BOGUS CARDS ARE EXPECTED TO APPEAR. REREAD SOURCES FOR HELP NOTED ABOVE,
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Importing Drugs-- an International Issue
A Complex Issue--Drugs From Canada
Read these headlines taken from Canadian Newspapers and the Boston Globe on [4/13/04].
"Rhode Island became the fourth State to give residents data on ordering prescription drugs from Canada...even though the US Government prohibits the sale of imported drugs.[Boston Globe]. Other states including California are considering similar legislation
Health groups who oppose exporting Canadian pharmaceutical drugs will appear before the USA Federal Drug Authority on 4/14/04. They represent the interests of millions of Canadian patients who are concerned with internet pharmacies, including their negative impact on Canadian's access to prescription drugs...and the threat they pose to Canada's drug pricing system.[PRNewswire]
Canadian health care consumers are being encouraged by a non-profit organization in the United States to help document cases where they are unable to get prescription medications due to supply cutbacks by drug companies seeking to discourage U.S. citzens from buying lower priced Canadian drugs.[PRNewswire]
Toronto--"It is appaling for us to contemplate a scenario under which U.S. drug companies create artificial shortages of life saving medicines in another country in the hopes of drying up the supply of lower priced medications for American citizens...this approach hurts Canadian consumers..."[By AP and CP]
Washington..."the Partnership for Safe Medicines, a non-profit coalition of of more than 40 healthcare and anti-counterfeiting groups, called widespread prescription drug importation an unacceptably dangerous and inherently unsafe practice that should remain illegal. The FDA "has recently seen an increase in counterfeiting activities as well as increased sophistication in the methods used to introduce finished dosage formed counterfeits..."[PRNewsire} Our FDA is studying this dilemma [in cooperation with the Canadian and other National Authorities] as mandated by the Medicare Prescription Drug Improvement and Modernization Act of 2003.
This is a beginning---not the end.
NB: This from New York AP wire 4/14/04 Canadian Internet Pharmacies are turning to Europe for supplies, as American pharmaceutical companies cut back the flow of prescription drugs to Canada to stop their return to the Unites States at lower prices..."We have to stay ahead of the drug companies," saif Jeff Yhi, President of universaldrugstores.com. "We have to scour the world for a safe supply for our customers."
A reminder, "Buyer beware" of counterfeit drugs.
A Bill is moving through the U.S. Senate that will "ensure safety by allowing only drugs [to be imported]that are approved by the FDA and manufactured in FDA inspected plants.
[LosAngeles Times 4/22/'04.
I believe this will do little to solve the problem, rather it will in my opinion, increase the anger of the Canadian people and the Canadian Government [see Canadian newspaper headlines noted above]
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Medical Profession Brought To Its Knees
Destructive Insurance Premiums
The annual Malpractice Insurance premium for an Obstetrician and Gynecologist in California is 41,000 dollars a year: similar insurance in Dade County, Florida is $277,000. For a California Neurosurgeon it's 51,000 dollars a year and $344,000 in Florida.
Annual insurance premiums, for most Doctors, throughout the nation, are many times the cost in California where a State law sets limits on the size of malpractice settlements.
Needless to say, it is impossible for the nation's Physicians to pay such high insurance costs each year, when private and government health insurance companies, as well as HMO's control Physician's incomes and don't allow for increases in their operating expenses.
Many Doctors are retiring earlier while others are refusing to accept high risk patients. Many seek employed positions or are practicing without malpractice insurance in order to continue administering to the sick. [Experience demonstrates that Lawyers are less likely to sue the uninsured Doctor]
The situation is reaching a crisis point. In Arizona, highway billboards ask drivers, according to the Chicago Tribune, "How far away is the nearest Obstetrician?"; or in Illinois where billboards caution motorists to drive safely, since there are no Brain or Chest Surgeons in some of the Illinois counties.
A 10-year study in West Virginia reported 941 dismissals of lawsuits against Physicians and 291 physicians were found innocent of malpractice, who went to trial. The cost of defending these cases amounted to more than 42 million dollars and that's only ONE state!!!]
The US Congress has twice failed to pass relieving legislation, and only three additional States, to this time, have passed the legislation needed to ease this crisis.
A Doctor shortage is certain to occur.
More information is available at www.aapsonline.org or www.ama-assn.org
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Things to think about
Stay Vigillant ,All Is Not Well
Back-page news items serve to remind us that Viral Infections, such as AIDS, are still a serious problem.
Nations in Europe are concerned because of a relaxed attitudes toward Safe Sex and an increased incidence of the AIDS Virus in females. In Asia???
SARS is still alive according to reports from different nations. Few details, but such reports remind us to be careful.
West Nile Virus found in a dead bird in Sothern California.
Pneumonia cases found in our troops in Iraq may prove to be a new virus.
The U.S. Flu season, will soon be upon us. Same precautions help there as well.
Wash hands frequently since in our modern way of life, many items such as phones, door knobs, escalator rails and public transportation vehicles expose us to potential infections, every day.
Farmers in my family shouldn't boast about being safer on the farm. Too often, now, animals and birds spread the diseases.
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Report on Health Care in Russia
Russia--Little Change in 3 Decades
I was invited to present the results of my research in Laparoscopic Surgery at a Medical Conference in Moscow,USSR in 1973.[Iron Curtain Days]. It was that experience that motivated me to begin a study of health care delivery systems in more than twenty-five nations throughout the world.
The report below was published in a newletter: "Notes from FFE- May 2004" [The Foundation for Economic Education]. It varies little from my observations three decades ago.
The report entitled "The Government Dream and The Soviet Reality" was written by Anna Ebeling, a former Russian Citizen. Her words are shown within quotation marks.
"In 1917, like everything else, medical services were nationalized by the new Socialist government. Gradually, small medical practices disappeared and a network of big factory-like hospitals and out-patient clinics began to appear."
"One of the greatest myths about the Soviet Union was its supposed equality for all. No society was so divided into privileged groups and classes as was the Soviet society".
"Special hospitals were created all around the Soviet Union. They were reserved for members of the Central Committee of the Communist Party, the Council of Ministers, the local and regional Party elites and so forth.
These 'servants of the people', as a result,received a qualitatively different level of medical care than the masses. The privileged few had access not only to Soviet-made drugs and medications but also to Western European and American medicines and equipment which could never be within reach of the 'proletarian' patient."
For the others,"...hospital wards were crowded and far from antiseptically clean. Anesthetics and pain-killers were frequently unavailable [sold on the black-market??,Director's comment]'
.
The crying of patients in pain were sometimes heard from outside a hospital by passersby.
Indifferent and often hostile nurses and orderlies had to be bribed to change a patient's bedpan or to provide ordinary attention that any American would take for granted during a stay in the hospital."
"Connections, bribes, class, gender and ethnicity heavily determined who were admitted into and graduated from medical shools throughout the Soviet Union. Thus, the supplies of hospitals, physicians, medical equipment and pharmaceutcals all became victims of socialist planning and political priorities just like everything else in the 'workers paradise'."
"...There are always lessons to be learned from history. Sometimes your neighbor's experience warns you which path never to follow."
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Canada Healthcare In Trouble
Canadian's Waiting Longer For Care
Hospital waiting times in Canada have almost doubled over the past decade, according to a new survey that found most Canadians are waiting longer than ever for new hips, cataract surgery and other treatments despite recent tax increases promising to solve their problems.
Canadians are waiting an average of 17.7 weeks from a referral by their GP to the specialist. A 7% longer wait than last year, according to the Canadian Fraser Institute's latest annual survey, "Waiting Your Turn...in Canada".
The median wait means the average length of time people have to wait for non-emergency surgery. [That means the other half wait longer]
The longest Canada-wide wait was for orthopedic surgery (32.2 weeks from an appointment with a family doctor to surgery-that's half of a year). The shortest wait was for Cancer Chemotherapy, at 6.1 weeks.
The situation in the Province of Quebec is deteriorating faster than the rest of the country: In 1993, Quebec had the shortest total "GP-to-treatment" wait for medical care for any province, at just more than seven weeks. This year, the total wait in Quebec reached 20.1 weeks, up from 16 weeks a year earlier.
As a result, untold numbers of Canadians buy American health care policies and come to the USA to obtain prompt and timely private care which isn't available in the Single Payer model.
Ironically, here at home, certain 2004 Presidential Candidates are pushing for Single Payer Care, using Canada as their example despite the information that is available to show its failings. Neither Single Payer or Universal Health Care have been successful, anywhere in the world, where they've been tried, unless private medical care is available for those who want to pay the difference.
Where do these Candidates get their information? Some must read my local paper where they describe Single Payer as the answer to our problems.
Why this reluctance to learn from history? What "Gene" makes us this way?
Since we are so trusting of Canadian medicines why aren't we equally trusting of their reported experience with "Single Payer Disaster". And, another thing, if we choose Single Payer here at home, where could we go when we can't wait any longer"?
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Things We Need To Know
People Of All Ages BE AWARE
3/17/'04. Our Center For Disease Control [CDC] reports that 48% of all sexually transmitted disease [STD] occurs in our 15-24 year old age group.This includes 74% of Chlamydia,60% of Gonorrhea and 74% of Herpes cases.
A recent announcement indicated there was a dramatic drop in teen-age pregnancies which might suggest a decrease in teen-age sexual activity.
That's possible, yet, voluntary abortions and "Morning After Pills"are available in most communities; and birth Control pills are now available without a Doctor's Prescription from the Internet and Pharmacies in the State of Washington.
A more serious concern, hopefully not overlooked, should be the possible infertility [inability to ever have a child] as a result of the damage done to a women's reproductive organs by STD. This possibility should increase our concerns about the declining birth rate which is proving inadequate to support the nation's economy, tax structure and growing number of America's Senior citizens. {see earlier article on this subject]
Our FDA and US Customs Departments warn us of an increase in the number of counterfeit drugs [imported and domestic] being sold in the US. Such activity has increased five fold in the last few years.
Check as best you can your source of drugs, notify your Doctor if you are suspicious of fraud. Exact dosage of the correct medicines is important to all patients but especially critical to heart patients, diabetics and patients with mental disorders.
Employers are warned to be aware of insurance agents selling bogus medical insurance coverage. 200,000 individuals have been victims of this new criminal ativity.
The new Medicare Reform Law allows anyone, except Seniors already enrolled in Medicare, to open a Health Savings Account [HSA] which permits the purchase of a lower cost and tax deductible catastrophic health insurance policy which takes effect after the patient spends a specified annual amount out of pocket, for health care. Money saved can roll over in a tax-free account for later use. Check with well known health insurance companies or your insurance agent for details. The HSA allows freedom of choice of Doctors and discourages frivilous and unnecessary ER and Doctor visits.
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Another Failure To Communicate?
Why Don't They Talk To Each other?
The Congressional Budget Office recently reported the number of Americans without health insurance to be 20 million.
A few days ago the US Census Bureau reported that 43 million Americans didn't have health insurance.
Why don't these two organizations compare notes, and get it right? They both work for the same Boss and live in the same town.
I've followed this uninsured discussion for a many years and believe it has created a "national guilt reaction" for many Americans. To repeat the number "40 million", though not correct, intensifies the guilt felt by those who are covered [280 million?].
From what I've learned, travelling throughout the world, all a Government controlled system does is give every citizens [that's all of us] a membership card that guarantees we can get on line and wait our turn. In Canada, at last count, the wait for care is measured in months. I heard words of anger that appeared to have replace any guilt.
Why would it be any different here
While I'm on this subject, why is it we're seldom told that 93-94% of our work force is employed, when daily, we are reminded 6-7% are unemployed. Is that also designed to make Americans feel guilty? Would a single employer system solve that problem?
A few years ago former President Clinton reported that 2 million children in California were without health insurance. Our government made money available for that need. When enrollment was completed they located about 100 thousand.
I cant help but wonder who decided it was 2 million; and what happened to that money that wasn't spent on the children?
To add to the irony of this situation, a recent study found families in which the children have health insurance and the parents don't.
Am I to believe that that the Boss who would be in charge of Single Payer or Universal Health Care will solve these problems?
Should I ask the US Mail Carrier who parks a truck on the street near the FEDEX, UPS and AIRBORNE trucks that got there earlier?
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New Medicare Law Unfolds
More Details on Drug Coverage
Be aware that Congress allowed 3 years for the writing of the final regulations that guide the administration and execution of the near 1000 pages of the new Medicare law.
It's an ongoing pun to say that sometimes the "final regs" seem not to resemble the Bill that was passed by Congress and signed by the President.
In the meatime, we'll have to deal with law as best we can, while realizing what's said/planned now may be changed in the final "regs" when published for our use in 2006.
Concerning Medicare Drug Coverage there are two phases to recognize.
From now to 2006 Medicare will "sell" DRUG DISCOUNT CARD to those Seniors whose incomes are above the poverty level. These will require a monthly premium, a fixed amount for all, then a deductible and percentage discount that varies with the cost of the card that you choose.
BUYER BEWARE of bogus cards and bogus drugs [ref. WebMD.com] Others: Read carefully, know who you are dealing with: see sources of more information listed below, ask your Doctor and your Pharamacist for help. [For some criminal elements this could be a license to steal]
Then,in 2006, the Medicare Drug Coverage Plan called for in the new law goes into effect. While one can only speculate, now, on the text of the "final regs", the cost of the program will likely exceed even the most outrageous predictions.
More information is available on the internet: www.medicare.gov or call 1-800-MEDICARE.
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News You May Have Missed
Important Developments In Health Care
On 4/27/'04 news reports remind us that many imporant health care issues are on the back burner or back pages of our Media. Issues that are worthy of close watch by all, young and old alike.
A well known sexually transmitted disease [STD], Gonorrhea, is resistant to all oral antibiotics. Now, only front line injectible antibiotics work. The bugs have adapted ["Adaptation of the fittest"]. They know about it too.
Our news media reports that the birth rates in many well developed nations is too low to sustain their existence. Proof that population/ birth control efforts have been successful. Not to be ignored are female sterility as a result of STDs; voluntary abortions and the elimination of female infants which is the practice in some nations.
Soon to be seen are the drug discount cards needed to reduce the cost of Doctor prescribed medicines. Their will be more than 70 cards to choose from. Competition for your dollars could be fierce and some questionable. GET HELP WITH THIS. AARP, Social Security offices and your local Pharmacies will have helpful information. [see earlier bulletin for Email addresses]
Many companies with a large number of retired employees want to or are removing drug coverage from their retirement packages for former employees who are eligible for Medicare coverage [which may be less generous]. Check it out.
The Independant Institute of Oakland,Ca reports that approximately 25% of taxes collected in Canada are designated for health care. Despite this, their single payer health care system has longer waiting lines according to their recent Fraser Institute study. Many Canadians buy our health care insurance policies and come across the border to receive prompt care.
Despite what some think, the American health care delivery system is still the best in the world. As I see it, we have a good car with a flat tire. let's fix it, not replace it with one that has broken down anywhere it has been tried.
Think of this, If we adopt a single payer system like Canada where will we go to get prompt medical care?
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Hooray for Men-Women too
Dramatic Discoveries for Longer Life
Finally, they're discovering new drugs that make it possible for men and women to live longer. Reactions to this are mixed [any man surprised to hear that please raise your hand]. Nevertheless, it's true and long overdue.
One recent announcement is for men only, STRIANT, a Testosterone buccal tablet for treatment of the male menopause, [IMPORTANT!!! You dont swallow it, you let it dissolve in your mouth.]
This discovery should allow men to live longer and healthier lives, as Estrogen does for the ladies, while giving Viagra some competition.
Be aware, we've known, for a long time, swallowing Testosterone tablets can cause Cancer of the Liver so the race was on to get it into our bodies another way, one which bypasses the liver.
Dissolving Testosterone tablets in the mouth or absorbing it from a skin patch appears to solve the problem. Ask your Doctor about it.
Be careful of overdosing, Not sure what that will do. Yet, we can bet someone will and we'll see what happens. One man I talked to said "What a way to go" [Suicide??? Somehow,I doubt that's what he had in mind].
The other discovery concerns a medicine that dissolves the plaques that form in our blood vessels [male or female] and lead to heart attacks and strokes.
[Arteriosclerosis does that, the plaques obstruct the smooth flow of blood everywhere. but especially in the heart, brain, kidneys etc.]
They've discovered an injectible medicine [no brand name yet] that reduces the buildup of those dangerous plaques. Research is early, but promising.
Big question could be, "Can Medicare survive this?"
Another thought, in our reform effort we must be careful not to do anything that will cause our drug companies to stop finding all these marvelous new medicines. Extra years of life don't come cheap. I'm sure you know what I mean.
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Increase in Several Infections
Viral and STD Infections Increasing
News of an increase in the number of cases of Sexually Transmitted Diseases [STD] such as AIDS and Syphillis [the vast majority of new cases are being discovered in the 15--24 year old age group]; the discovery of the first case of Mad Cow Disease in the USA; the reemergence of SARS and West Nile Virus together with the expecttation of a severe Flu Epidemic this winter/spring should cause Americans to reevaluate their life styles and concern themselves with disease protection and prevention.
Scroll down through the bulletins listed in the News You May Have Missed section to find reports on many of these diseases and suggestions for your protection.
Check carefully before accepting Vaccines that cannot be verified or certified. Bad/Bogus Vaccines can cause serious or life threatening illness much worse than the less serious infection you are trying to avoid.
Talk to your Doctor or check with your local Public Health Facilities and Clinics for additional information.
This is a time to be extremely careful, to act responsibly for your safety and for the safety of your family and friends as well.
This is serious. Don't underestimate the potentional pain and suffering that could result from irresponsible behvior.
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The Power of Motherhood
The Maternal Instinct is Beyond Measure
Mothers have braved wars, fires, floods and other threats of weather's anomalies, or human failings to save their child, their children, and do.
Then today, we learn that a "mother to be", in Mexico, performed a Caesarean Section operation, upon herself, to save her unborn child, and did.
Such action is immeasureable in human terms. It commands us to stand in awe of the power of the "maternal instinct". Most achievements of man pale by comparison.
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New Rules Of Privacy
Government Seeking Abortion Records
3/21/'04. Another chapter in this unfolding story.
On 3/20/'04 the NY Times reported that a New York Federal Court ruled [thus overruling a SanFrancisco court] that it is appropriate for the Justice Department to obtain medical records of patients receiving Voluntary Abortions.
In order to follow the story read the news bulletins below with the knowledge that on 3/11/'04 THE JUSTICE DEPARTMENT RESCINDED its order to review the abortion records because of the earlier SanFrancisco court ruling.
The story started this way:
Washington -A report in NY Times, 3/06/04 ”The Bush administration has set forth a new, limited views of privacy rights as it tries to force hospitals and clinics to turn over records of hundred and perhaps thousands of abortions.
Federal law "does not recognize a physician-patient privilege," the Justice Department said last month in court papers that sought abortion records from Planned Parenthood clinics in California, Kansas, Missouri, Pennsylvania, New York City and Washington. The department said in another abortion case that patients 'no longer possess a reasonable expectation that their histories will remain completely confidential."
Health lawyers and privacy experts said that position reflected a significant shift after six years in which Bush and Clinton administration officials had promised to strengthen the confidentiality of medical records. [See earlier articles on this web-site reporting new rules concerning privacy of medical records signed into law early in the Bush Administration].]
On Friday 3/05/04, a federal district Judge in San Francisco denied a demand by the Justice Department for access to abortion records from a public hospital there and from six Planned Parenthood affiliates in the country.
The Judge, Phyllis J. Hamilton, said forcing the providers to turn over the records would undermine the privacy right of patients and could dissuade some from seeking treatment. NY Times story filed by Robert Pear and Eric Lichtblau" [end of quote and news report]
Why all this confusion:
I
It is possible a US effort is underway to investigate not only the number of Late Term Abortions but also the relationship between Voluntary Abortion and Cancer of the Breast, in later life, a relationship that is accepted in several nations, where abortion performed are part of the public record.
The new rules of medical record privacy allow our federal government access to all records in matters they feel have impact upon the common good. [they decide what is necessary for the common good.]
The US does need to settle the question "Does Voluntary Abortion increase the risk of Breast Cancer in later life. Review of records is necessary but respect for patient confidentiality and privacy are mandatory.
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Preliminary Results Confusing
Give the Ladies a Break, Part 2
A premature news leak [3/11/'04] concerning a new/better? drug to prevent recurrance of Breast Cancer in patients who have been treated and are taking Tamoxifen has occurred.
The news is premature in that the proper dosage,how long to take it and the potential hazards are not yet clear.
This is cruel/unfair for Breast Cancer patients who will worry that they are taking the wrong medicine: and their Doctors will not be able to answer their questions or calm their fears, until the final results are in.
That could take months even years since time is needed to determine the lomg term effects and safety of the new medicine.
Sometimes we learn that a new medicine that helps with one problem may create others that are worse.
Premature reports can be devastating, misleading and down right cruel.
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Government Health Care Failing
Three Major Nations Having Problems
Reports from three major nations with Two-tier or Single Payer government controlled health care insurance report problems causing their systems to fail.
In France, "The French Health Service [a two-tier program] is threatened with bankruptcy because patients go to the Doctor too often and Doctors prescribe too many drugs, a government commission reported yesterday [2/28/'04].
In England, The NHS [a two-tier program] has been encouraging patients to go to private health care facilities to help shorten LONG WAITING LINES.
NOW, they will contribute 30 British Pounds [app.50 American dollars] to NHS patients and private health facilities who comply.
Dental Care in England is hard to obtain because of a shortage of NHS Dentists and the limits on the care they may provide [they often only extract teeth and provide dentures]. It has been said, "It would be hard to find a British citizen. over the age of 40, with a natural set of teeth".
Fifty percent of new Dentists are foreign trained. Many British Dentists see only private patients in order to have the time needed to deliver proper/quality dental care, according to the British Dental Assoc.
In Canada, necessary medicines for their people are in short supply/on back order because 800 million dollars of their medicines are sold to US citizens.
Both of our governments are unhappy with this situation. Theirs because of the shortage and we because it is illegal to buy their medicines if they have not been certified safe by our FDA.
Bogus drugs are being found by US Customs and some US Pharamaceutical Companies are being shut down for selling non-certified medicines.
Is this what they call a "Catch 22"? Seniors are more likely to remember that book and the film version.
The bottom line is that our FDA is just doing its job and the other reality is that the falling value of the US dollar on the foreign exchange is reducing the cost savings when we buy foreign drugs. A recent study [already old] reported that savings on Canadian drugs was reduced to 14%.
Bogus Lipitor and Viagra [is there no shame?] have been reported. "Buyer, especially the men, Beware"
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Followup on Swedish Report
Does Estrogen Cause Return of Cancer
As Promised I have reviewed the Swedish study suggesting that patients with a former diagnosis of Breast cancer should not take Estrogen for menopausal symptoms. [see my earlier article on this subject]
After my review of the study I have come to the conclusion that the results are not firm and the reason for the abrupt discontinuation of the study may be based on the fear of legal repercussions [lawsuits].
After writing this bulletin, I consulted, as promised, with a highly respected Medical Oncologist [Cancer Specialist], Tom Lee MD of Oakland,Ca who feels the study was well controlled [patients properly chosen] but forced to close because it exceeded the upper limit of all patient's risks agreed to before the study began.
The botom line here for women who want to take Estrogen after being treated for Cancer of the Breast is, consult with your Surgeon, Radiolotherapist and Medical Oncologist before doing so.
In my years of practice, carefully chosen and properly informed patients, who were willing to accept any risk involved, did benefit from LOW DOSE and conscientiously administered oral estrogen tablets.
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A New Kind of Crime
Counterfeit Drugs on the Market
My newspaper had a front page report on counterfeit drugs invading our Pharmacies.
This was predictable in light of the high cost of our most important/life saving, prescribed medicines and the American willingness to buy these drugs wherever they can get a discount.
Modern drug discoveries have added years to our lives [mine too] and it's estimated that 800 million dollars is spent to find each of these miraculous drugs. American drug companies are discovering most of them.
They must recover that cost or stop the research, and I don't think anybody would want them to stop.
Not too many years ago people died from Hypertension, Heart Attacks, Strokes, Tuberculosis and most Cancers. They didn't live as long with numerous other diseases as they do now. Doctors felt helpless when we cared for such people and couldn't prevent their deaths, but it's not that way now. Modern medicnes helped make the difference
There are people who can't afford to pay the total cost of these miraculous medicines. Those truly in need can get help if they contact the drug company who makes the ones they need and explain their circunstances.
Shopping around for lower prices of name brand medicines, at the pharmacies in your area, is also worthwhile.
In the meantime, Congress has passed legislation to modify those costs for some of the people who truly need help.
The drugs that cost less, in other nations, are made and packaged by companies that don't have to recover research and development costs. have lower labor costs, and cannot be guaranteed to meet the quality standards required by our FDA [Food and Drug Administration].
I think you'd agree that adding years to our lives "safely" is worth something. In my opinion, it can't be free.
How much it should cost is currently under debate.
More details on our prescription medicines and their generic equivalents can be found in my book "Health Care Reform--Facts and Fiction". See the "Contact Us" section of this website for more details.]
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Estrogen and Cancer Again
Swedish Report Confusing
A recent report out of Sweden claims that women survivors with Breast Cancer shouldn't take Estrogen>
There is no question that women with a specific genetic structure [a strong family history] should not, but they comprise a small percentage of the women who get cancer of the breast.
This could be determined before treatment and certainly after, their diagnosis and treatment for breast cancer
I have requested a copy of this report to see if the rules of this study conform to the strict guidelines required to avoid choosing women who should not received the Estrogen.
Those guidelines include a family history of breast cancer; genetic evaluation of the tumor; grade and extent of the tumor removed; type of treatment--surgery, radiation and/or chemotherapy; completeness of the removal of all cancer cells if surgery was performed; was there followup chemo or radiation therapy; length of time since the treatment was given; etc.
The big question is: Was all of the cancer removed? Were the recurrent tumors caused by cancer cells that survived the initial treatment.It's a complex issue--following the guidelines is essential before presuming that Estrogen is the cause.
I will report what I learn after review the data.
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Problems In UK's National Health Service
England's NHS Feeling The Pinch
Recent Newspaper Headlines in the United Kingdom [UK]reveal:
Drug Costs have doubled in last three years. NHS [National Health Service] budget feeling the strain.
Adding insult to injury, some of the Viagra, the famous blue pill for men and some ladies, sold by Internet Pharmacies are found to be fakes.
[Is their no limit to man's injustices?]
Violent attacks by hospital patients, verbal or physical, upon Midwives, Nurses and other hospital workers,are increasing. [while some medical journals discuss the loss of respect, by British patients, for the medical profession]
Malpractice settlements totalling millions of British Pounds are being payed to settle lawsuits.
Illegal Aliens and US Tourists when visiting, are finding it more difficult to obtain free care from the NHS.
[Isn't it interesting, some of us go there for their "Free" care while some of them come here willing to pay for ours.
Patients, more often now, can avoid the need of a primary visit to a GP physician before seeing a Specialist. [reduces the waiting time which can be several weeks or months].
NHS hospitals have been described as the source/cause of more infections than hospitals in other European nations.
The House of Lords has yielded on the issue of turning over hospitals to the new Foundations---UK's version of HMO. [Another step in the UK's effort to shorten waiting lines and allow patient's to choose health care, outside of the NHS.]
Remember to return to this website to learn of new developments in health care delivery around the world.
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Understanding The New Medicare Rules
More News On Medicare Reform
The Law became effective on January 1, 2004. We will have to manage, however, until the Regs for the new Medicare Law are written---Congress has allowed three years to complete the job. The Law covers 1100 pages.
While we're waiting, you can expect a lot of confusion. We must trust them to make clear,in the regulations, the intent of the Legislators who wrote the Bill.
After reading this report be sure to visit the Commonly Used Words Section of this website for an explanation of the new HEALTH SAVINGS ACCOUNT [HSA], designed to improve the MSA form of self managed care that was allowed under the old Medicare Rules.
Here, I am quoting from the January 2004 Supplement to the American Association of Physicians and Surgeons [AAPS]in Tuscon, Arizona written by *Robert Moffit, Ph.D.[see aapsonline.org]
"The losers are the middle class retirees with solid private employer- based drug coverage; union retirees with generous drug coverage; retirees with coverage through state and local government employee plans [particularly in those states facing the biggest budget shortfalls]; and all current and future taxpayers,particlarly those under the age of 30; as well as fiscal conservatives and advocates of the original market-based Medicare reform. In the long run, Doctors still locked in Medicare's unreformed system of administrative pricing; and drug companies, facing future price controls, will be losers."
[I believe Doctor Moffit is referring to the fact that in the short run the drug companies will continue to do business as usual, causing price controls to be necessary,later
Out of pocket expenses for all Medicare recipients, except those below the poverty line, will increase.
*Doctor Moffit is Director, The Center of Health Policy Studies at The Heritage Foundation, Washington, D.C.
Now, look in the Commonly Used Words Section for more details on MSA and HSA
This website will continue to report on developments in this most important matter.
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Imported Drug Pricing Varies
Only 14% Saving on Canadian Drugs
Two studies reported in the Health Affairs Journal state that "Overall average {Drug} price variation may not be as large as widely perceived" in all but two of the nations which were studied.
They found that "Exchange rates and purchasing power contribute to price differentials". [The fall of the value of the US dollar in the world market is reducing the amount of money saved when buying imported drugs.]
The range of savings found in eight nations that were studied varied from 6 to 33 percent less than US prices. In Japan prices are higher or the same as ours and figuring in exchange rates there is only a 14% saving on Canadian imports
Some major US pharmaceutical companies are warning Canada that they may be reducing supplies available for purchase by Cnaada.
I've learned that some/many foreign nations lease the drug formula from the US drug houses, then make and package the drugs in their pharmaceuticals houses. This relieves American companies of any liability and therefore makes it impossible/very expensive for our FDA to check and OK the imported drug. In addition, it is illegal to sell such non-certified medicines in the US. So buyer be aware.
All this serves to remind us that life saving and life extending medicines are not cheap to discover and nations that don't do the discovering can't reduce prices, for us, as much as we would like.
All those readers 'surprised' when they read this, raise your hands.
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Is Estrogen Getting A Break
Media Quiet About; Estrogen/Cancer
I believe there has been less discussion, by the news media in recent weeks, concerning Estrogen as a cause of Breast Cancer.
During this time, there has been an increase in reporting that Abortions and Breast Cancer may be related. I am aware of such discussions on the radio and in the news Media and recently, three states passed laws requiring Doctors to discuss this possibility with any patient requesting a Voluntary Abortion.
Here is a new report, with more information concerning this matter, scheduled to appear in the Summer Edition, of the Journal of the American Association of Physicians and Surgeons.[AAPS]
THE CONTENTS OF THE E-MAIL I RECEIVED:
-- News from AAPS:The Summer Issue of our Journal Exposes a Suppression of Evidence of the Abortion – Breast Cancer Link.
"MEDICAL JOURNAL: POLITICAL CORRECTNESS PREVENTS WOMEN FROM LEARNING ABOUT ABORTION RISKS"
Politics Trumps Science in Abortion – Breast Cancer Link
Media contact: Kathryn Serkes 202. 333. 3855 kaserkes@att.net www.jpands.org
For Immediate Release:
Washington – Aug 14, 2003
Scientists, women’s groups, and the media have consistently suppressed or ignored research that establishes a direct link between abortion and breast cancer for their own political purposes. Further, women considering abortion are not given true informed consent about the real risks of the procedure as a result of withholding this evidence.
Those are the conclusions of the new study published in the Summer 2003 Issue of the peer-reviewed Journal of American Physicians and Surgeons (JP&S) titled "The Abortion-Breast Cancer Link: How Politics Trumped Science and Informed Consent."
The article discusses the epidemiologic evidence of an ABC link; the silence and denial of the National Cancer Institute, the American Cancer Society, the American Medical Association and women's groups; media bias; the bitter opposition of pro-abortion politicians; the implications for patient care; and medical malpractice issues.
A companion article documents at least 49 studies that demonstrate a statistically significant increase in premature births or low birth weight with prior induced abortions.
Karen Malec, author of the article on the abortion-breast cancer link,, suggests that the U.S. Supreme Court might have come to a different finding in Roe vs. Wade if the science had been available to them while making their decision: "A reason cited for the decision was that modern aseptic technique and antibiotics made it possible for abortions to be performed safely. The court’s opinion might have been different if the justices had been aware of earlier epidemiological research supporting a relationship between abortion and breast cancer."
Malec shows how several studies conducted as early as 1957 showing the link were suppressed or ignored, as were later post-Roe studies that showed significantly higher rates of breast cancer in the "Roe Generation."
For example, Brind et al estimated that in 1996 an excess of 5,000 cases of breast cancer were attributable to abortion, and that the annual excess would increase by 500 cases each year. They predicted 25,000 excess cases in the year 2036.
Authors of studies actually denied their own findings when political heat was applied. One lead author of a record-linkage case study in 1989 worked with a group of American Cancer Society ACS) researchers who reviewed the research. By then 11 of 12 US studies indicated increased risk, but she still stated the research – including her own – was "inconsistent" and that she could not arrive at "definitive conclusions."
The scientific and medical community admits that the reasons for the suppression are political. The President of the American Society of Breast Surgeons said that she presented her concerns about getting information to the public about the abortion-breast cancer link, but the board felt it was "too political."
The director of the Miami Breast Cancer Conference explained that there was no presentation on the program because it was "too political."
The author found that the web pages of the National Cancer Institute (NCI) and leading American and Canadian cancer organizations contain false statements, misrepresentation, and omissions in their discussions. Yet when pressured by scientists to post studies that show a 2.4 fold increase in breast cancer risk, pro-choice activist cried foul, accusing them of using "pro-life scare tactics."
Equally astounding is the fact that most of the 15 American studies were funded at least in part by the NCI, and 13 of them found increased risk.
For their efforts to inform women about the studies that the NCI forgot to mention, the Coalition on Abortion/Breast Cancer was compared to the Taliban in a newspaper.
In conclusion, the author writes that in the end, it may be the trial lawyers, not the medical community, who force full disclosure through liability litigation against those who perform abortions without providing women with fully informed disclosure about the elevated risk".
For further information:
Email www.aapsonline.org.
Ladies remember, annual Mammograms find changes in the breast, early. while they can be treated with a high percentage of success.
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SARS Continues in Asia
SARS BACK IN THE NEWS
Media reports new SARS cases in Asia
Former announcements by World Health Org.[WHO] that there are no new reports of SARS should be corrected.
We need to be careful of both SARS and West Nile Virus [WNV]. The first WNV case found in San Francisco area was contracted in Colorado. Either way, it's has been diagnosed here. in the USA.
Remember wash your hands frequently because of frequent contact with public phones, door handles, escalator and elevator rails etc.
Now, dirty hands are the most likely way to catch many viral diseases. Also be careful of contact with people who have flu like symptoms.
Be observant--be careful. This is especially important for world travellers.
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Major Changes in Health Care Derlivery
News Items to Think/Worry?? About
1. Our Federal Drug Agebcy [FDA] is cracking down on distributors of drugs imported from Canada.
They state that it is against the law to sell these drugs in the U.S. since their quality and safety cannot be assured. The Canadian Government is cooperating with the FDA in this effort.
Read more on this subject in subsequent articles on this web-site
2. Privately operated Managed Care Companies are being forced to raise premiums and co-pays because of an endless number of lawsuits that prevent them from pursuing new or revised cost cutting measures.
They promised good care at less cost but are being frustrated in their attempts to comply with that request. Good care doesn't come cheap in a nation that insures total care despite selfr-destructive lifestyles.
"Americans must realize they can't expect Champagne for the price of Beer". The Courts won't allow it.
The real tragedy in this situation would occur if the public were to demand a Single Payer model, like the Canadian Plan, in their attempt to get what they want. [The Government is the only possible single payer]
Read subsequent articles on Canada's Single Payer experience--it's not good and their only solution is to come to the U.S. and pay for the care they need.
3. Striking workers in Southern California believe that health care insurance is their "Right" and should be provided by their employers. How long before they are convinced that housing, food and clothing should also be provided.
4. Be aware, the news media sometimes delivers erroneous and misleading information on these subjects whch can cause us and our elected representatives to make serious mistakes in our efforts to solve these problems.
Get your news from more than any one source. The effort will be worth it.
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Headlines Can Be Confusing
News Headlines Can Mislead You-- Read On
Recent news reports concerning Cholesterol reducing medicines; and the use of Testosterone by men, raise questions but don't provide answers.
It is always disappointing to learn that newly discovered "miracle drugs" don't help everyone to the same degree.
The early results of such studies, when reported too soon, lead to news headlines that are confusing and discouraging.
In many cases, if you read the entire newspaper report, you'll learn that most people benefit from the new discovery but more time is required to settle the issue concerning who will or will not benefit.
Remember, we are all individuals with our own Genetic Structures [Genes, and I don't mean Levy's]. Since we are not Clones we react differently.
In the health care business 2+2 equals 3,4 or 5 depending on your Genes, family history and life style. The results are not always the same.
We'll just have to wait, "time will tell".
In the meantime, dont settle for the headlines. That's one person's opinion and usually someone who believes that 2+2 ALWAYS equals four.
If you can't wait, talk to your Doctor about it.
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Major Reform of Medicare
Medicare- What Will Change?
The Medicare Reform Bill has been signed by the President. It is a law.
Now the law goes to the those who write the "REGS" [The Regulation Writers describe how the law will be administered.]
Sometimes the "Regs" make it difficult to recognize the Law that was actually passed.
Be prepared for major changes. Seniors will like some changes and not others.
I believe it is safe to say that Seniors with higher incomes will pay more and have more choices of coverage; full benefits may not begin until a later age, such as 67.
Drug Coverage, a complex package, will require a great deal of explanation.
It seems sure, the greater the coverage the higher the premium.
Rather than guess now, it's wiser to wait until the Regs are published. More later.
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High Cost of Prescribed Medicines
We Need to Shop For Best Price
According to a report from the Independant Institute of Oakland, California, The Pharmaceutical Industry claims the average cost of marketing a new drug is $800 Million dollars because of the need of years of research, animal and human trials and FDA approval before they can begin to retieve that cost.
At the same time, Congress is struggling to find a way of reducing the price of medicines for welfare recipients and seniors whose annual income falls below an agreed upon level. A solution will be complex and expensive.
In the mean time, people should shop around for the best price for their drugs as they do for other major purchases. Prices in your area may differ by 20 to 30 percent depending on the drug store they use. Discounts may be available from the Drug company that produces your medicine, write and ask. Be careful of drugs obtained from Internet sources, by mail order, or from Email pharmacies. [see articles below]
Generic medicines are an alternative but by law can vary from the stated dosage by a considerable percentage. The name brand drug must be exact. Exact dosages are important for the treatment of Diabetes, heart disease or mental disaorders. These patients should consult with Doctor before using generic substitutes.
Further information on prices of drugs can be obtained from AARP by calling 1-800-424-3410; or Health Insurance Counselling and Advocacy Program [HICAP] at 1-800-434-0222 or the Department of Health Services at 1-916-657-4302.
The cost of looking around may be easily recovered by the savings that one is likely to realize.
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Bound To Happen
FDA Finds Counterfeit Medicines
The Associated Press reported on June 4, 2003, that "Federal investigators found more than 30,000 bottles of fake Lipitor, a top selling anticholesterol pill,as they worked to crack a huge case of medical counterfeiting". It went on to say "counterfeit medicines are increasingly turning up in the United States. At this time the FDA is investigating more than half a dozen cases"
This is sad news for patients who are having trouble paying for the medicines they need and are turning to alternate sources, some in foreign countries, which sell popular medicines at discounted prices.
Name Brand medicines are expensive because of the cost of reasearch and development needed to find these medicines [most done in the USA]; for the cost of producing such drugs, at accurate doses, needed especially for heart diseases, diabetes and mental disorders and for the cost of liability insurance guaranteeing that you are getting exactly what it says on the bottle.
Patients need to "shop around" when buying name-brand medicines in the USA. There is the benefit of "competition" amongst Drug Stores. Also be aware that major Drug manufactures will give discounts to patients who can prove their need and inability to pay. Write to them and request their assistance
Some medicines are worth the extra cost or effort when our lives are at risk.
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Will They Ever Get It Straight
Media Adds To The Confusion
Media not Helping as much as it could
Important medical research and legislative issues concerning our nation's health care delivery system have not been, in my opinion, accurately and/or adequately reported by the News Media.
My concern is that the proper resolutions necessary to guarantee the continued delivery of good quality health care will be compromised.
All of the following issues have been discussed, to a varying degree, on this web-site.
The issues I refer to are as follows:
1.The media has not adequately reported that our Congressional Budget Office [CBO] recently changed its estimate of the number of medically uninsured in our nation from 43 to 20 million Americans. The economic implications of such a major revision [a 50% reduction] should be news-worthy.
2 The CBO also reports that 75% of Medicare Recipients are satisfied with their Prescription Drug Coverage obtained through supplemental insurance.
CBO reports that only 25% of our Seniors need help in purchasing their prescribed medicines, another fact with enormous economic implications, while Congress is talking of covering everybody whether they need it or not
3.National Single Payer Health Insurance Programs have failed to deliver timely and adequate health care in any nation where they have been put into place.
The Canadian Press reports wide spread dissatisfaction with their Single Payer system. Many Canadians buy American health care insurance policies and in England the Private Practice of Medicine is being encouraged by their government because of the deficiencies and long waiting lines created by the British National Health Service [NHS].
A Pilot Single Payer Program instituted in our State of Tennessee declared bankruptcy after 10 years of existence because it was trying to take care of too many ineligible recipients---a common problem in any government run program .
4.The benefits of the use of Estrogen for Post Menopausal Women have been compromised by Media reports of its relationship to an increase in the incidence of Breast Cancer alone or when taken in combination with Progesterone. At the same time, they indicate that women who no longer have a Uterus may continue taking Estrogen alone, even though they still have breasts that are supposed to get Cancer!!!.
??? Isn't that called contradicting yourself.
These reports fly in the face of several research studies based on 40 years of use by millions of women who have taken Birth Control Pills [a combination of Estrogen with Progesterone] without an increased incidence of Breast Cancer.
So which is the bad guy, Estrogen or Progesterone? I believe neither one is guilty.
5.Although the Media reports frequently concerning women using post menopausal hormones, I have yet to see an article reporting the recent approval by the Federal Drug Administration [FDA] of a Testosterone preparation for men to use for the male menopause [true, we do have one].
This approval represents a long sought break through for the men. The drug is called Striant and may add years to the life span of men?
List to be continued.
[With a Presidential election coming up there will be plenty to talk about.]
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Canada Revisited
Single Payer Plan in Trouble
Growing dissatisfaction continues with Canada's Single Payer Health Care Delivery System [one of three remaining in the modern world]. Interviews with Canadian citizens demonstrate problems that are fueling the demand for faster service and the return of a private alternative to the inefficiency and inadequacy of the current system.See other articles below.
One expressed disappointment when, despite a higher premium for expanded benefits and drug coverage with a growing Co-Pay, he was told there would be a six months wait for an MRI to determine if he had heart damage.
Unable to accept this lengthy period of "not knowing" he arranged for a private facility [beginning to appear on the Canadian horizon] to perform the MRI for an out of pocket cost of 850 dollars.
Another, dissatisfied with the diagnosis and care received from her Primary Care Physician and the Specialist to whom she was referred, sought another opinion which proved their diagnosis to be incorrect.
It is believed, by many Canadians, that their better Physicians are emigrating to the U.S in order to escape the existing system and increase their incomes from medical practice.
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In a Far Away Nation
Where People Die With Appendicitis
On October 2 2003, I learned that some people still die from Appendicitis. Would you believe that possible, today, when you think of the advances in medical science.?
"How could that be"? I asked when I visited a small and impoverished nation in the center of the Western Hemisphere. The answer was easy to understand but difficult to accept.
"When your people receive very little education, earn barely enough for food and shelter, usually walk or ride a bicycle to work, rely on government supported medical clinics with poorly trained Doctors where pain relieving or life saving medicines must be purchased by the patients themselves, some will die."
A story repeated all to often tells of a young child complaining of a stomach ache. The parents, with "not yet serious" concern, console the child, offer their
favorite foods which go uneaten but seems reasonable for one day or even two.
Continued pain motivates a visit to the local medical clinic. There, they are advised that another day or two should correct the situation. Medicines prescribed are too expensive, home remedies are used.
Two days later, with increasing abdominal pain and no sign of improvement, a trip to the hospital becomes necessary. There is no family car and an ambulance may not be readily available. A friend or family member is able to help.
At the hospital, many miles away, the child is found to have a ruptured Appendix and Peritonitis [a bowel infection]. Surgery is not possible and the necessary medicines are not available in the hospital. Can the family buy them at the local Pharmacy?
In the year 2003, it is possible to die from a ruptured Appendix.
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Things to think about
When Cutting Costs is the Goal
Here are some important developments you should know concerning current and future problems facing OUR health care system.
Certain HMOs are notifying their Primary Care Physicians [FP] they will no longer be allowed to take care of their patients,when admitted to the hospital,if they exceed the quota [number of hospital days] allowed for their HMO practice.
This is a new cost control measure.
Should the FPs lose their hospital admitting privilege, they may visit their HMO patients but will not be paid for their services
A new group of Doctors called "Hospitalist Physicians", assigned by the HMO, will take over the care of the patient when admitted to the hospital and until they leave.
This development [as taught to us by British experience] will result in a disconnect between the two professional groups and results in a loss to both, the Patients and the Doctors
The Specialist will know little about the patients habits and lifestyle [critical to proper care] and office bound FPs will lose their best source of knowledge concerning new discoveries important to the diagnosis and treatment of diseases.
We are developing a system similar to that that has been used by England's National Health Service for half a century---It hasn't worked there, why are we doing it here?
Medical School applications have dropped 22% this year. Apparently our young citizens are losing interest in becoming members of the Medical Profession. [Nursing Schools doing better] If you are surprised you may not be paying attention to the liability exposure, the administrative frustrations and the relentless efforts to reduce the Doctor's image and compensation for their work.
The young approriate students must be asking themselves "who needs that"?
Our Congressional Budget Office cautions Congress on the cost of drug coverage for the Seniors--420 billion dollars or about four thousand dollars per household over ten years.
Reminds them that 75% of Seniors are satisfied with their coverge so a complete overhaul is not necessary.
Reminds me, "it's costs less to repair the flat tire than to replace the car".
People are surprised to learn that providing health care insurance for the less than the 20 million who are uninsured will require an increase in TAXES to cover the cost.
Remember the State of Tennessee's effort to achieve this goal ended in bankruptcy when it was ten years old.[admitted that too many people on the list didn't belong there].Those who are surprised when they read this, please raise your hands.
Government is relieving Hospitals with Emergency Rooms of the obligation to have Specialists on Call 24/7 because of the expense and difficulty of finding enough Specialist to comply with the rule.
It would be wise to find out which E.R.s, in your area, have Specialists available and hope you will be conscious enough to tell the ambulance driver where you want to go.
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Patriot Act EXtends Government Power
New Power For Secretary of Health
8/29/03 Update on Emergency Health Power in the event of a national bioterror threat.
As formerly reported on this website
HHS Secretary of Health Tommy Thompson was urging State Legislatures to adopt the Model State Emergency Health Powers Act.
This Act would grant unprecedented powers to the Governor to quarantine and vaccinate individuals; and allow government authorities to commandeer such items as drugs, firearms and private property.
For more information on this model Emergency Health Powers Act see www.aapsonline.com and/or a copy can be downloaded from www.publichealthlaw.net
It now appears that the Patriot Acts will make State decisions irrelevent in the event of a bioterror disater. The Secretary of health could be empowered to take control of the nation in such matters which were formerly under State Jurisdiction.
Copies of the Patriot Acts can be found through www.google.com
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Seniors Increasing--Youths Decreasing
Birth Rates Not Adequate
The World Health Organization [WHO] reports that birth rates, in many nations, have decreased to a point inadequate for the maintainance of the work force and taxbase needed to support longer living retirees.
Knowing that the fertility rate of 2.1 births per family unit is the average needed to maintain a nations population base, the WHO reports: Germany at 1.35, Spain 1.15, Romania 1.32. Italy 1.32, France 1.89, Sweden 1.64. UK 1.60. Switzerland 1.41, Russia 1.14 and Austria at 1.28.
In America, the population is increasing based on a fertlity rate of 3.11 in the Latino population group. 2.19 in the black and 2.1 in the white population group.
The decline is almost entirely due to Contraception and Abortions [Medical and Surgical] which are safe and effective and widely used either to avoid or end a pregnancy.
At least one major nation has increased resrictions on the availability of Abortions. Others are likely to follow.
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"Medicare Considered Rationing"
Medicare FacingTough Choices
Cutbacks in Medicare funding raises the question of future rationing of health care services.
Public pressure appears to have caused Medicare to reverse their recent position concerning the rationing of a new surgical procedure costing sixty thousand dollars per patient.[An estimated two million Medicare recipients need this surgery for a Lung Disease called Emphysema-caused by inhaling Asbestos,tobacco products, etc.]
New technical procedure can be so expensive, at some future date, Medicare will be forced to make choices as to who may or may not be eligible.
The British National Health Service [NHS] has been dealing with this for years. They have special committees [often referred to as "God Squads"] who decide "who gets what". A painful reality when national health care funds are limited.
How do they break the news?
They may say, "We didn't say you couldn't have it, We said , We can't afford to pay for it"
In England, a patient can turn to the private sector of Health care and pay for the procedure. As a Two-tier System, private care and health Insurance are allowed, even encouraged.
Canada has the "Single Payer System" which discourages private care.
The patient may be forced to seek help in another country, often in the USA.
For now this Medicare reversal avoids that difficult question, but not for long.
It would be wise for Americans to realize that a healthy life style is their best defense.
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A long Overdue Discussion
Abortion-Breast Cancer Link In News
The State of Texas just passed a Law requiring their Doctors to inform patients of the suspected link between Abortions and Breast Cancer in later life. [Also see earlier bulletin on this website]
Today, I received notice of an article to appear in the 2003 Summer Edition of the Journal of the American Association of Physicians and Surgeons supporting this concern.[AAPS]
THE CONTENTS OF THE E-MAIL I RECEIVED ARE WRITTEN BELOW
8/14/03 -- News from AAPS: Summer Issue of Journal Exposes Suppression of Evidence of Abortion – Breast Cancer Link.
MEDICAL JOURNAL: POLITICAL CORRECTNESS PREVENTS WOMEN
FROM LEARNING ABOUT ABORTION RISKS
Politics Trumps Science in Abortion – Breast Cancer Link
Media contact: Kathryn Serkes 202. 333. 3855 kaserkes@att.net www.jpands.org
For Immediate Release:
Washington – Aug 14, 2003
Scientists, women’s groups, and the media have consistently suppressed or ignored research that establishes a direct link between abortion and breast cancer for their own political purposes. Further, women considering abortion are not given true informed consent about the real risks of the procedure as a result of withholding this evidence.
Those are the conclusions of the new study published in the Summer 2003 Issue of the peer-reviewed Journal of American Physicians and Surgeons (JP&S) titled "The Abortion-Breast Cancer Link: How Politics Trumped Science and Informed Consent."
The article discusses the epidemiologic evidence of an ABC link; the silence and denial of the National Cancer Institute, the American Cancer Society, the American Medical Association and women's groups; media bias; the bitter opposition of pro-abortion politicians; the implications for patient care; and medical malpractice issues.
A companion article documents at least 49 studies that demonstrate a statistically significant increase in premature births or low birth weight with prior induced abortions.
Karen Malec, author of the article on the abortion-breast cancer link,, suggests that the U.S. Supreme Court might have come to a different finding in Roe vs. Wade if the science had been available to them while making their decision: "A reason cited for the decision was that modern aseptic technique and antibiotics made it possible for abortions to be performed safely. The court’s opinion might have been different if the justices had been aware of earlier epidemiological research supporting a relationship between abortion and breast cancer."
Malec shows how several studies conducted as early as 1957 showing the link were suppressed or ignored, as were later post-Roe studies that showed significantly higher rates of breast cancer in the "Roe Generation."
For example, Brind et al estimated that in 1996 an excess of 5,000 cases of breast cancer were attributable to abortion, and that the annual excess would increase by 500 cases each year. They predicted 25,000 excess cases in the year 2036.
Authors of studies actually denied their own findings when political heat was applied. One lead author of a record-linkage case study in 1989 worked with a group of American Cancer Society ACS) researchers who reviewed the research. By then 11 of 12 US studies indicated increased risk, but she still stated the research – including her own – was "inconsistent" and that she could not arrive at "definitive conclusions."
The scientific and medical community admits that the reasons for the suppression are political. The President of the American Society of Breast Surgeons said that she presented her concerns about getting information to the public about the abortion-breast cancer link, but the board felt it was "too political."
The director of the Miami Breast Cancer Conference explained that there was no presentation on the program because it was "too political."
The author found that the web pages of the National Cancer Institute (NCI) and leading American and Canadian cancer organizations contain false statements, misrepresentation, and omissions in their discussions. Yet when pressured by scientists to post studies that show a 2.4 fold increase in breast cancer risk, pro-choice activist cried foul, accusing them of using "pro-life scare tactics."
Equally astounding is the fact that most of the 15 American studies were funded at least in part by the NCI, and 13 of them found increased risk.
For their efforts to inform women about the studies that the NCI forgot to mention, the Coalition on Abortion/Breast Cancer was compared to the Taliban in a newspaper.
In conclusion, the author writes that in the end, it may be the trial lawyers, not the medical community, who force full disclosure through liability litigation against those who perform abortions without providing women with fully informed disclosure about the elevated risk.[end of article that will appear in the summer edition]
For further information: Association of American Physicians and Surgeons
Email www.aapsonline.org
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What are they trying to do
The Women Don't Deserve This
A new study completed in England found 19 additional Breast Cancers per 1000 women, between the ages of 50 to 64, during a ten year study of the effects of post-menopausal HRT [Estrogen with Progesterone] and five new cases per one thousand in those who took Estrogen alone.
This report was surprising in light of many other studies that do not support these findings.
In an attempt to explain this new information let's start by talking about what we do know.
It is estimated that 10 years is necessary to develop Breast Cancer. Therefore, it would be correct to presume that some of the women who proved to have Cancer of the Breast, during this study period, had an early stage of Breast Cancer when they entered the study.
In order to make the study worthwhile all women accepted into the study should have been screened for Breast Cancer before being accepted. I saw no evidence of that being done.
I do know, after several trips to the UK, Europe and Asia, annual Mammograms are not easily obtained in nations with national health care systems where there are long delays and may be available only to women between the ages between 50 and 64 years of age. Many women go to private clinics and pay out of pocket for Mammograms and Pap Smears, while many others can't afford the cost.
Studies done in the USA found that women who took birth control pills [also a combination of Estrogen and Progesterone] for as long as 35 years showed a decrease in Ovarian Cancer and no increase in Breast Cancer. Therefore the question arises, "Why does taking HRT appear to cause an increase in Breast Cancer only after the menopause?" A question yet to be answered.
Annual Mammograms, starting at the age 35, and Pap Smears, starting in the teen years, find early cancers and save lives. These procedures have been available in the USA during my years in private practice. As I traveled the world, I found most nations unable to match our record.
Be aware, Progesterone, for the post-menopausal women, was added to Estrogen several years ago to protect them from Cancer of the Uterus. Initially, it was given once or twice per year, usually by injection, to reduce that risk. The risk was reduced dramatically but the addition of Progesterone caused vaginal bleeding in some women, and when that occurs further tests are needed to rule out the presence of Cancer of the Uterus.
When Researchers found the bleeding occurred less often if a combination of both hormones was given daily, their recommendation was welcomed and has been followed throughout the world for approximately the past 20 to 25 years. Now that regimen is in dispute. Are women receiving too much Progesterone, more than is needed to protect them from Cancer of the Uterus? Should they be taking less?
Add to this discussion this fact: In several nations of Europe and Asia [15] including the UK, a causal relationship between natural miscarriage or voluntary Abortion and Breast Cancer in later life, has been reported and verified. Could that account for some of cases of Breast Cancer, found during this study since several million Miscarriages and Voluntary Abortions occur, or are performed, each year throughout the world.<
Despite the fact that the Abortion and Breast Cancer connection is not accepted by our National Cancer Institute [NCI], the State of Texas recently passed a Law requiring their Physicians to notify patients, requesting an Abortion or having a Miscarriage of the possible connection. What prompted this action?
Obviously, these questions must be answered before this issue of post-menopausal HRT can be resolved.
It's long past due for America's women to be spared from the endless attacks on the safety of post menopausal HRT when so many important/related questions are as yet unanswered.
Concerned women should seek consultation with their Physicians or referral to a Specialist well informed on this subject. It will be well worth the time and/or added expense if required.
I, for one, feel that this British study and the Women's Health Initiative Study [WHI], which was abruptly halted in 2002, merely added to the confusion surrounding this issue.
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Something For The Men
Men--Maybe This Is Your HRT
An email report from the PDR [Physician Desk Reference] the Doctor's guide to most anything that has to do with available/approved drugs arrived this morning.
New Drug Approvals [by the FDA]
STRIANT---(testosterone buccal system) The first transbuccal [let it dissolve in the mouth] treatment for testosterone replacement therapy in men for conditions associated with a deficiency or absence of endogenous testosterone [male Menopause], including hypogonadism [under developed glands].
That's all I know at this time.
This may be the breakthrough for a male HRT that has been sought for many tears [years]
Those who are interested should consult with their Physicians for further information.
What will the Media will do with this one?
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Presidential Candidates and Health Care
Health Care Reform Proposals
The media is off and running with Presidential hopefuls and their promises. Changes in our health care delivery system is high on their lists.
Universal health Insurance is the "new and more appealing theme" being used to describe government controlled health care. It hides the unpopular names of Socialized Medicine and/or another called The Single Payer Insurance System when the only possible single payer is the Federal Government.
Be aware, the citizens of the State of Oregon. in November 2002, voted 3 to 1--against a single payer system for their State. Last year the single payer system of Tennessee filed for Bankruptcy after 10 years of trying to make it work. When asked why, the answer I heard was that too many people on the list didn't belong there.
In Canada, despite Single Payer Health, some patients are being referred to private clinics to get their care. In England private medical practice is being supported by the National Health Service where a million of their citizens are on waiting lines for the care they need.
Despite these realities, one our candidates would completely remove private health care. Others promise Universal Insurance for all including those now uninsured. One Candidate promises to pay for it all by eliminating President Bush's tax cut [of approximately 50 billion dollar] to help pay the 220 billion dollar cost for one year of his proposed Universal Care. Be aware, the projected cost of Medicare,has increased ten times over projections made in the '60's, It would be wise to figure that projections of the cost of Universal Care will do the same, not to mention the long waiting lines these systems create.
One candidate sees health care coverage, for all Americans, as their right. Doesn't a right require an obligations which, in this case, should be that each of us take proper care of ourselves or the contract is null and void. In that case, life might not be be much fun.
More details on this subject can be found in my book "Marching Toward A Single Payer...." described in the Contact Us Section of this website.
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MEDICARE REFORM-A MESS IN THE MAKING?
WHAT HAVE THEY DONE TO MEDICARE?
The Medicare Reform Bill will be on the President's desk in a matter of days. The word is, despite some reservations he will sign it into law.
Senators were given two days to review this document of nearly 700 pages before voting on the measure.
What began as an attempt to solve two major issues: Help low income Seniors pay for their life sustaining medicines [estimated to be 25% of those covered]; and Secondly, to give more choices to Seniors as to where and from whom they receive their care, has evolved into a controversial new system which some predict will "self-destruct" within 10 years.
The cost of drugs alone is expected to add hundred of millions of dollars to the cost of a program that is near bankruptcy now, though a Zogbe Poll reported 75% of Seniors were content with their current drug coverage.]
As far as more choices of care for Seniors, that doesn't look good either.
There are so many rules and regulations placed upon private insurers, very few will be interested in the business, and
our CBO [Congressional Budget Office]fears that millions of Seniors with employer based coverage will be forced out and will have to accept government coverage.
This reform effort is reminiscent of the man who destroyed a good automobile because it had a flat tire.
More details on this subject can be found in my book "The Falling Giants--America's Private Practicing Physicians" described in the Contact Us Section of this website.
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Contradiction in Health Care Insurance
"They Won't Pay For It"
Is their any insurance that covers repairs to a product that we have repeatedly abused and are likely to continue to abuse as long as we wish?
The only answer I can think of is Health Care Insurance.
It covers medical care for the damage we do to ourselves through overeating, illegal drug or alcohol addiction, smoking tobacco products, self inflicted wounds, damage by avoidable accident including life styles that contract fatal sexually transmitted disease. Add to that, the fact that we are likely to return to the same body damaging way of life as soon as our health care system makes it possible.
Yet, we expect the care we receive to be the best available regardless of our ability to pay all or any of the cost and would sue the Doctors and the Hospitals that fail to meet our expectations.
To make it worse, our legal profession is willing to carry the matter to court to exact a monetary penalty to compensate both the patient and the attorney for their time and effort.
Ironically, this set of circumstances is destroying the very system that makes it possible. It's breaking the bank in every nation that supports it, even ours.
However, one nation is making a major move to correct the situation. In that nation, with a two tier health care system [government and private], the national health service will not perform an elective [non-emergency] procedure until the patient corrects the offending life behavior.
Should the patient ask "You mean you're going to let me go on suffering like this"? Then, he/she is told, "We didn't say you couldn't have it, we just said we won't pay for it"
Hopefully, only the first step,---- best we prepare for more.
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Canada Health Care Crisis
Canada's Single Payer Plan In Trouble
As reported by David Gratzer of the Canada's National Post on 7/10/03
"For those interested in sweeping reforms [in health care], these are frustrating times. The growing waiting lists and the STALE political rhetoric exhaust us. We want to see some fast changes and are disappointed. But change does occur, in British Columbia, the biggest regional Health authority contracts out-patient surgeries to "for profit" clinics. In Calgary, public-private partnerships are the norm. The newly elected Premier of Quebec promises similar reforms in his province."
From Dennis Bueckert in Canadian Press 7/10/03
"In face of an unravelling national health accord, Health Minister Anne McClellan remains hopeful that the Provinces will uphold the crucial deal, reached only five months ago.....
She denied that their federal-provincial plan for health reform is in jeopardy, despite assertions that the Provinces of Alberta; and indications from the Province of Ontario that they will back away from key elements of the plan.
For example, why does it take six months, in some cases, to get a family physician? Why does it take six months to get a hip replacement in some hospitals. Why is it improving in some places and not in others?"
[A RECENT Tax INCREASE was supposed to solve these problems. author's comment]
Remember, Single Payer Systems [Canada]; Universal Health Care and Socialized Medicine are the same. They are Federal Government controlled health Insurance systems that are failing to do what they promise in more than the 20 nations I've visited.
In the so called "two tier system the private practice of medicine is available to those who are willing to pay for it.
Canada, the single payer model, based on the news reports quoted above, appears to be considering a change to the two tier model.
As America struggles with health care reform many would have us abandon our current system and try one of the government controlled models that are failing where ever they exist. "That's like abandoning your new car rather than repair its flat tire".
Our system, undoubtedly the best the world has ever seen, was failing to cover everyone at a reasonable cost. Let's fix it, and not replace it.
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America's Women Should be heard
Ladies-When Is Enough-Enough?
The women of America should unite and fight back. The Media is doing a number on this HRT [Post Menopausal Estrogen] thing and just won't quit. America's women are the victims of this confusion.
After more than four decades of taking care of you Ladies I wish you would say, "We won't put up with this "Anti-woman vendetta any longer-enough is enough-knock it off" or something like that
To those who are interested I suggest you talk to a women who have stopped Estrogen after taking it for awhile and ask how they feel without it. You'll get an education.
I've written many articles on the subject of HRT in this section of the HCREI website based on my experience of more than 40 years of caring for women who have taken birth control pills [Estrogen combined with Progesterone] or HRT [Hormone Replacement Therapy [Estrogen with or without Progesterone.
Rather than repeat how I feel about it here, I advise that you scroll down the list of articles in this section of the HCREI website where I discuss the use of these hormones.
In my opinion, it would be a blessing if they could discover something as good for "us" men. [I wonder if that is what this is all about]
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Interesting Contradictions
Who's In Charge Of The News
The media reports that 1.5 billion dollars will be needed to provide medical care for 40 million uninsured citizens, for just one year---when, just a few weeks ago our Congressional Budget Office [CBO] announced there are only 20 million medically uninsured, and several surveys, by non-profit Institutes, find it's even less.
Wonder what they'll do with all the money we're going to save?
Maybe we could use it to care for the two million medically uninsured children President Clinton was concerned about. We'll have to wait though, according to reports I've read, they've only found 80,000 of them.
LA County Hospital E.R, One of the largest we have, is on the verge of bankruptcy and forced to refuse care to illegal aliens. That will be difficult for the mother, in Labor, whose baby is about to be born on American soil [in the hospital parking lot or the ER waiting room?]. Don't worry about Mom, the newborn child is automatically an American citizen, therefore, mother will be entitled to medical care along with her newborn American baby.
The President asks Congress to approve a measure that would cover the cost of Generic Drugs for Medicare patients, even though generics drugs substitutes are allowed, by law, to be 30% off the mark as compared to Name Brands drugs which must be the "exact dosage", or face a lawsuit.
Such variations in doses are not recommended for Diabetic, Cardiac and Mental diseases that occur most often in Seniors. Exact dosages are essential for their proper care.
Now, I hear that our Senators, concerned about the cost of the Name Brand drugs, agreed to allow the cost of generic drugs to be covered and, in addition, voted in favor of the importation of cheaper Canadian drugs into the US. [Our Federal Drug Agency [FDA] and Canadian authorities may block this move because of quality concerns for Americans; and to prevent drug shortages for Canadian citizens.]
Who is this supposed to scare the most, the Name Brand Drug Companies or the Seniors? Did I hear someone say, "all of the above"?
The new rules generated from the Law called HIPPA, concerning privacy of your medical records, does not require your signature [to approve transfer] when the records are requested by numerous parties, empowered by law, to review your records. Someone descibed the new rules of privacy as "painting the front porch while the back of the house is on fire."
That sounds about right.
Even though some national cancer organizations deny the connection, between Abortion and the increase of Cancer of the Breast, the State of Texas just passed a law requiring Physicians to warn patients, requesting an Abortion, of this possibility which, incidentally, is accepted by several nations throughout the world.
Hard to research such a question here, so many abortions are kept secret. That's not true in nations with national health care systems where they record just about everything about everybody.
Too few Americans appear aware of the increases in Physicians Malpractice Insurance which can be as high as $200,000 per year for Obstetricians [in some States and somewhat less for other Surgical Specialists].
Without immediate help, many Physicians will be forced to close their offices and seek jobs or change careers. This constitutes an emergency for the people in States with such high annual premiums.
I wonder where does a nation, such as ours, find the determination necessary to cripple its Medical Profession, at a time, when deadly [untreatable] viral infections threaten the lives of so many of us.
Is this what is called a "Death Wish"?
I'm concerned about truth in reporting the numbers of new cases of SARS, by some nations, when the economic penalty for having new cases is so severe. Punishing members of their news media may be resorted to and that would be unfortunate for all of us, should it occur.
Can you imagine anyone doing a thing like that? .
Will add to this list as necessary.
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Save The Medical Profession
Good Doctors Quitting
Our medical profession is staggering under the weight of rising insurance premiums and the additional cost generated by new rules and regulations that provide very little benefit to our patients health.
Many of our good Doctors are quitting practice and looking for other ways to use their intellegence and provide for their families. The medical schools are witnessing a drop in applications as nursing schools report an increase.
How many people realize that Nurses [and we need them desperately] because of their unity and ability to negotiate [Doctors aren't allowed to do that] can expect incomes greater than many Doctors?
OUR nation is facing the possibility of widespraed disease of epidemic proportion with many deaths possible and countless business enterprises likely to fail.
Protect your medical profession from this umremitting series of attacks that are causing us to lose many of our best and represent very little benefit to you whom we are dedicated to serve.
If there ever was a time when we are most needed, it is now.
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Number of Uinsured Revised
Uninsured 20 million or Less
The Los Angeles Times reports that the Congressional Budget Office [CBO] has revised its figures on the number of medically uninsured people in the U.S. They corrected the number of 40 million used by the media since 1987. New estimates report that 20 million is more accurate.
I've written, earlier. about the error in the original estimates, which were verified by several independent studies beginning with The Urban Institute Study reported in 1987.
Presidential candidates will have to adjust/modify their criticism of the current medical delivery system as a result of this revelation.
See other reports, in this section and in the Articles on Reform Section of the website, written since the Urban Institute Study of 1987.
Thankfully, we're getting closer to the truth of the matter.
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SARS a Nasty Situation
SARS -- A PLAGUE??? See Updates
SARS
Update June 12,2003--- SARS is still a concern with a report of near 200 cases in the US.
Now, a new concern over Monkey Pox [a former viral disease in animals] which can be caught from some pet animals.
If you're concerned talk to your Vetinarian.
Wash your hands frequently, I mean "every day". We may go back to gloves before this is over.
Whether it's a terror tool is yet unsettled. Protect yourself and your children until sources and treatments are found. Follow the media closely on this. New Vaccines [like a Flu shot] the likely answer. We don't have medicines that kill the virus.
They're working hard to solve this.
Update May 28---Transfer of the SARS animal virus from animals to humans has been established in China.[see below] I have attempted to learn if an equivalent transfer has been established in the USA.
The Center for Disease Control [CDC] in Atlanta answers "0" to that question on this date. I will check again and keep you informed.
Update May 27---New York Times reports that tests in China suggest that some humans with SARS don't become ill. Tests on people who worked with exotic animals in markets in Southern China show that some had been infected with the SARS virus and subsequently developed an immunity.This finding answers some of the questions that were puzzling scientists and make it possible to prepare a vaccine sooner than originally thought possible.
Update May 11---reports from different nations hard to follow. Check with U.S. Customs and Public Health Authorities before travel to nations with reported cases of SARS.
Consequences of reporting SARS to the World Health Org.[WHO] can be devaststing to a nation's economy. So accurate information is critical.
Travellers must be careful and should gather as much information as possible to insure their safety and consider their risk.
Update May 2nd---new cases include a 9 year old: some patients sent home are reentering hospital. Is this due to a recurrent infection? Virus found in urine and bowel movment samples and on plastic surfaces of hospital equipment. May be able to survive and remain infectious for several days.
This virus is going to be difficult to treat.
All citizens will have to help. Watch for State Deprtment Bulletins that concern world travel. Wearing a face mask may not be enough. Wash your hands frequently if using public phones, public transportation or public buildings. Consider wearing gloves in public places---Keep masks and gloves as dry as possible, wash both after use. Donot remove gloves using your teeth as is commonly done. Be cautious and be careful
Virus may be able to change[mutate]rapidly making it more difficult to develop a vaccine or a an effective medicine.This question as yet unsettled
Public Helth Authorities are concerned that SARS may develop into a "world wide plague".
We now believe SARS: is an animal virus which has mutated in a way that allows it to attack humans WHY? HOW?
We have no immunity, vaccine or treatment for this infection since it's new in humans. There has been no time to prepare for it.
Be as careful as you can . Masks are of questionable value once they become wet, as a result of our breathing through them. Check with your Doctor for his/her advice.
Wash your hands after using a public telephone, escalator railings, door knobs and handles in public buildings etc.
Check with your Doctor if you have Flu like symptoms and follow the media for new information.
Will continue updates on this website.
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Time for Political Promises
Presidential Candidates and Health Care
The media is off and running with Presidential hopefuls and their promises if elected. Changes in the way we would receive health care is high on the list.
Universal health Insurance is the "new and more appealing name" being used to describe government controlled health care. It hides the unpopular names of Socialized Medicine and another called Single Payer Insurance [since the only possible single payer is the Federal Government>.
Be aware, the residents of the State of Oregon. in November 2002, voted 3 to 1--75%, against a single payer system for their State. Last year the single payer system of Tennessee filed for Bankruptcy after 10 years of trying to make it work. When asked why, the answer I heard was that too many people on the list, for what was called "Tenn Care", should not have been on it at all [broke the bank as some say].
Despite these events, the early running Presidential hopefuls send up test balloons promising Universal Insurance and insurance for all the Uninsured. One Candidate, at least, promises to pay for it all by eliminating President Bush's tax cut [of approximately 50 billion dollar] to help pay the 220 billion dollar cost for one year of Universal Care. Here, I'll remind you that the projected cost of Medicare, when it started in the 1960's, has risen ten fold over their projections. You would be wise to figure that early projections of the cost of Universal Care will do the same, not to mention the long waiting lines,for needed care, that will come with such a system.
You dont have to be an Economist to know that, just read Canadian and British reports of their health care systems. Good quality health care can't and won't be cheap in cost. Americans would be the first to know the truth of that statement. It applies to homes, automobiles, jewelry and health care. To all things we really value.
For a more detailed discussion of possible changes in health care delivery see "Turning Back To Find The Future" in the Articles on Reform Section of this website.
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Estrogen Prevents Alzheimer's Disease
10 yrs. of Estrogen needed?
The Journal of the American Medical Association [AMA] reported,on Nov.10,2002, that a John Hopkin's University Study found that Estrogen protects some women from Alzheimer Disease. The only problem is "You don't get the benefit if you haven't been on Estrogen for at least 10 years"
"Oh My" said the lady, "According to my newspaper,I wont live that long if I do take Estrogen. What am I to do??"
"Why not cancel the newspaper subscription and buy Estrogen with the money you save". said her husband.
Based on my experience of more than 4 decades in the Doctor Business I have to agree with the husband.
[Ref. JAMA, 11/6/2002,Vol.228, No.17]for those who wont believe it 'till they read it for themselves.
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HMOs Take a Big Hit
HMOs Must Pay Any Physician
The Supreme Court has ruled that HMOs must follow the, already in place, "Any Willing Provider" Laws that exist in several States
What that means is that HMO patients are free to go to any Doctor and/or Hospital, of their choice, so long as each agrees to abide by the rules and pay scale of the HMO in which the patient is enrolled.
At the present time, the recent "wiiling Provider" ruling will have limited effect in California because of State Laws that overrule the Supreme Court ruling. Be aware, in matters of health care State Laws prevail over federal rulings which can only effect citizens who are covered by federal health insurance programs.
This gives an HMO patient a "freedom to choose" not previously allowed.
Those Americans who may be confused by the news that England is turning toward the HMO concept of health care must realize they see HMO service as an improvement over the National Health Service [NHS] and its long waiting lines.
Putting it another way, The British are moving up from a compact car to a full size sedan---they like the change. HMOs to Americans represented a step down from a luxury vehicle to a lower cost model and many are not pleased
Could be that some Americans will be more comfortable with HMO care as a result of the new Supreme Court ruling. Time will tell.
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NHS looking for private help
England increasing private control
The National Health Service [NHS}is struggling with the increasing cost of delivering health care to its citizens. This is largely due to the increase of the senior citizen population and the inflationary pressures in the health care market.
As is true in the USA, the cost of drugs is a problem. In the early years the NHS supplied drugs at no charge---now, filling a prescription can cost the patient as much as 10 dollars [6£30p].
UK workers are unhappy with the new 11% deduction from each pay check for their health care insurance while putting up with long waits for Emergency or hospital care.
Newspapers reported today that virtually all hospitals will be placed under the authority of Primary Care Trusts [PCTs] over the next 5 years. PCTs are similar to our HMOs and will stress preventive medical care [my thought-been there,tried that, good luck]
One of longest running government controlled health care systems is turning toward a "more privately/Physician operated" system with the hope of achieveing its promise of proper health care for all.
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Activity on the Doctor's Side
Short Notes On New Developments
Health care has been on the back burner because of the Iraq discussions
Much is being done about health care reform that doesn't get much media coverage. That will end as we get closer to election time. Most candidates will have it on their agendas.
Talk of drug coverage for seniors---where will the money come from when we face an expensive war and are promised a tax cut?
Seniors allowed to leave Medicare and buy private health insurance---how many can afford to after the stock market fall and the drastic reduction in interest rates on government bonds?
Health care coverage for 75 million uninsured---where did that number come from, used to be 40 million?
Doctors law suit against large health insurance companies for violation of the RICO statutes [fraud and deception]---advancing in the federal courts.
Proposals for Single Payer Health Insurance will be discussed despite the fact that in the State of Tennessee their program declared bankruptcy and in the State of Oregon voters turned the single payer idea down 4 to 1
Be prepared to hear many interesting discussions on these vital subjects. Remember, the big question will be where will we/they get the money.
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RICO Case Returned To Florida Court
Followup Doctor's RICO Lawsuit.
As previously reported by HCREI.
Federal Judge, Federico Moreno, orders discovery in physician's landmark racketeering case against HMOs.
The Judge issued a major ruling in the racketeering lawsuit brought by the California's Physicians against some of the nation's largest for profit HMOs.
The lawsuit accuses the HMOs of fraud, extortion and racketteering.
CMA[California Medical Association] President Frank Staggers said "It will show that these plans have engaged in serious violations of federal anti-racketeering laws, that they have enriched themselves as part of a scheme to defraud physiians and their patients, and that they have been trying to force the nation's physicians to do their dirty work."
The State Medical Associations of Florida, Georgia,Louisiana and Texas have joined California in this suit.
Now this report from CMA Alert of 2/27/2003
In the latest news related to CMA’s RICO lawsuit against health plans, a federal judiciary panel this week ordered Cigna’s proposed settlement of a class-action lawsuit reached in an Illinois federal court be transferred to the court of U.S. District Judge Federico Moreno in Miami.
In December, Judge Moreno had ordered a halt to the settlement, saying that he refused to be "snookered" by one of the country’s largest profit-driven health plans. The settlement, Judge Moreno said, was an obvious attempt to avoid his jurisdiction.<
Cigna had engaged in a complex and questionable series of legal maneuvers to reach the settlement, which, if accepted by the court, would have precluded most of the pending claims against Cigna in CMA’s class-action civil racketeering (RICO) case that is being heard in Judge Moreno’s court.
The RICO case, involving 700,000 physicians nationwide and eight of the nation’s largest health plans, alleges that Cigna and other HMO defendants violated RICO laws by using coercive, unfair, and fraudulent means to control physician-patient relationships.
The Illinois case—which accuses CIGNA of bundling, downcoding, and arbitrarily denying claims—was brought by two physician plaintiffs, who, by virtue of class-action laws, represent all other Cigna physicians across the nation.
With the panel’s decision, Judge Moreno will now rule on the fairness of the Illinois settlement.
By some estimates, each participating Cigna physician could receive as little as $30 in the settlement.
CMA and the medical societies from 18 other states have publicly condemned the proposed settlement as doing woefully little to change the underhanded business practices of many HMOs.
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A Question Yet Unresolved
Does Abortion Lead to Breast Cancer?
The Washington Post reports in the San Francisco Chronicle on 2/28/03 "Having an Abortion does not appear to increase a woman's chance of developing breast cancer, according to a report to be presented, Monday, to the National Cancer Institute [NCI]. The findings could help end a long standing debate on the question."
Later in the same news report, the writer goes on to say, "The NCI Web site--which posts 100 facts sheets on cancer for consumers, as well as a variety of information on cancer detection, prevention and treatments for both the lay public and health professionals--first developed a fact sheet on the question of abortion and breast cancer in October,1994 and has revised it six times".
Now, information for health professionals, on the site, notes "that studies on the relationship between abortions and the risk of breast cancer 'have been inconsistent' and reflect under-reporting of abortions because of a social stigma and short comings in scientific design"
Readers should be aware that attention was drawn to the possible relationship of abortion and breast cancer by European health researchers-- where government controlled health care systems record most, if not all, voluntary abortions.
In America, the number of abortions performed cannot/will never be correctly reported as long as privacy, of one's medical record, is maintained.
Inconsistency is not a problem for the women in Europe and America, they are consistent. It's the health care systems and their records that are inconsistent and the reason why news reporters are confused.
Women, who may be concerned, should be sure to get their annual mammogram, and earlier than the age of 40, if that's what it takes to have peace of mind.
The standard Mammogram, with the addition of followup ultrasound or MRI, when the Radiologist feels it's necessary, saves lives through early detection despite any thing you may have read/heard to the contrary.
While they sort it out [and never is possible] you do the right thing.
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Attorney Overstates The Case
An Unfair Appraisal of Doctors
Letter To the Editor of the Sacramento Bee
Mr. Baker's Editorial entitled "Medical mistakes, not lawsuits are the problem". published in your paper on
Sunday, February 2, 2003 deserves a "second opinion", not from a Physician but from a patient.
Not all doctors, in my opinion, can be so callously classified as non-compassionate; as members of a profession who need to commit fewer medical errors.
For a judgment to be made that a tragic accident was the result of a Surgeon’s misdiagnosis or incompetent use of a scalpel [Medical malpractice] it would be necessary to determine that a tragic outcome was not the result of an innocent/accidental error in a Breast Biopsy or Laboratory report.
Either way it is a tragedy for which the patient deserves to be properly cared for and monetarily compensated. Too often what is labeled Medical Malpractice is the result of human error that leads to improper care. Too often, the Doctor involved is labeled as an incompetent and malicious Physician, whose reputation will be severely damaged, with the intent of obtaining a larger settlement for the injured patient when records show that too often only 20% of the money awarded reaches the patient.
My family has lost loved ones that Medical Doctors and Science could not cure even though they did everything possible to keep them alive. Errors should be compensated but we need to avoid pointing fingers until all facts are known. There are good and bad in every profession but to label all Doctors as Mr. Baker has is unwarranted.
Editor, HCREI, Linda Tofanelli.
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Medical Privacy Threatened
Maintain Medical Privacy
Can you still save some privacy in your health care?
The federal and state governments control the health care of our seniors, the poor, the military and many children. That’s close to 100 million of our citizens whose medical records are hardly private.
If you think your managed care [HMO"s, PPO’s, PSO’s etc] records are confidential, think again. These programs, currently regulated by state rules and regulations, will soon be further regulated by the federal and state government with new bioterror concerns and national public health regulations. That means less privacy there as well.
What’s critical is that an open medical record could cost you your present job and/or make it difficult to find another. Insurance companies, could cancel or refuse to renew your present health coverage; could charge you a higher premium or limit, and exclude coverage for certain conditions.
One way to insure greater privacy [not total]is to open a Medical Savings Account [MSA]. The MSA is a less expensive, high-deductible health insurance policy together with a tax-deductible savings account that must be used to cover the deductible [money out of pocket] portion of your policy.
These policies,often called a medical IRA, allow for an annual deposit [tax free]of up to $2250 per individual or $4500 per family [check these estimates with your accountant]. Whatever money not spent for care, in any one year, stays in the account and can be rolled-over, tax-free, till age 65. Then the money saved is yours to use as you wish, with payment of the deferred tax, of course.
Those insured with an MSA can choose their doctors and the insurance policy is activated only if you spend more than the annual deductible in any one year.
This gives you more privacy than any other program currently available.
Talk to your insurance agent or to an established health insurance company to see if you qualify.
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The President's Plan
Improvement of Health Care ???
Our President's plan to improve our health care system while reducing its cost prompts me to share with you some observations and conclusions recorded during my efforts, over the past thirty years, to visit and study the health care delivery systems in more than twenty nations throughout the world.
TODAY
A majority of Americans are outraged by "immoral conduct" in the corporate world, "excessive" profits in the Pharmaceutical Industry and "rising costs" and salaries reported by "privately operated" Managed Health Care Plans--as we watch our retirement plans "vanish"; find it "impossible" to afford life-preserving medicines and are expected to settle for a "diminishing quality and quantity" of the health care "provided" when we are in need.
With polls reporting that 70% of Americans favor a Single Payer Health Care System [such as exists in Canada?] the Federal Government could take control of health care delivery with the formation of a new bureaucracy or by using the system, in place, but financed and controlled by government regulation.
Suggestions that "the Federal Government doesn’t want that" should be dismissed. Federal Bureau records expressing the belief that Federal Government control is needed to solve the nation’s health care delivery problems have been heard since 1972. [ref: Forward Plan Of Health, FY 1978-82, US Department of HEW, page 1, publ. August 1976]
Providers [Doctors, Hospital Workers and other health care professionals] who would have resisted a takeover, then, are more likely to welcome it, now, as they become increasingly concerned with their financial survival rather than the provision of quality patient care.
After visiting several nations in North and Central America, Europe and Asia to study their systems, those in existence are very much alike as are the problems they encounter/create. Sickness is the same anywhere no matter who has it, pain hurts no matter how you spell it and blood is red no matter where it's spilled. The outstanding similarity in all the systems is promptly delivered, non-emergency care of good quality is available, only, outside of the system, in private offices or hospitals, for cash or supplemental private health insurance. This was true in all the nations I visited except for one, Canada.
Traditionally, a "fee for service" system flourishes in a free society that is economically sound. Today, as both individual and corporate economic security decline the demand for less costly health care intensifies without any less intensity in the belief that access to total care is a right that should be guaranteed to all regardless of ability to pay.
It is precisely this concept, "equal care for all regardless of ability to pay" that is causing many hospitals to close their doors, for lack of funds. It's effecting physicians as well. Many have been forced to retire or look for salaried positions rather than continue in, or open an office for, the private practice of medicine.
In my Opinion:
1. As the years pass, the public's demand for quality health care for all, regardless of one's ability to pay diminishes as the rising cost, coupled with the necessary increase in taxes, weakens their concern for the needs of the poor.
2. National health care systems employ a large number of citizens, estimated to be more than 5 million people in Great Britain. Though this may appear attractive at first glance it can, later, become the obstacle that makes the system impossible to remove when proven unsatisfactory.
3. As the tax burden increased the efficiency of these systems declined and the private practice of medicine increased. For example: despite the intent of a U.S. Postal Service, the development of UPS, Federal Express and other delivery services have become profitable.
4. Other Nations spend proportionately as much on health care as we do in America, but, they spend it differently. Several Nations had fewer Senior Citizens as a result of lives lost during WW II. Now, Germany, Japan and Great Britain report rapidly increasing health care costs.
Be aware, Seniors in Germany are cared for in another budget, not the health care budget.
5.I see too, an irony in the fact that many Americans act as if the Medical Profession invented the concept of greater personal satisfaction and financial reward for hard work and intellectual achievement. These rules of achievement have always been, and will never cease to be amongst the basic building blocks of a free society operating in a system of free enterprise. Should a Nation chooses to abandon such principles it will be but a short space of time before they reappear.
6. Too many Americans seems more concerned with reducing the cost of health care while getting rid of incompetent, greedy and dishonest Doctors. Pity, if it doesn't turn out that way. For, if we don't do it right, we will pay more, get less, and bad Doctors like bad people, won't go away either.
Finally, I believe "He who fails to learn from history is doomed to repeat it", prompting me to ask, "Why do so many of us, who hear those words, act as if they must be meant for someone else's ears?" <
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Doctors Facing Insurance Crisis
Doctors Forced to End Practice
Many practicing Doctors, in several States, are unable to afford the cost of malpractice insurance along with a reduction in fees they are to receive from Medicare, Medicaid and privately operated Managed Care Health Insurance Plans.
Malpractice insurance costs can range from as low as $4,000 for some physicians to as high as $250,000 per year in certain surgical specialties.
The practice of medicine is regulated and Doctors are licensed by individual States. Pennsylvania has a unique problem in that Doctors must show evidence of Malpractice Insurance coverage in order to maintain/renew a license to practice in that State.
In other states it’s the hospital that requires evidence of insurance in order to protect themselves from being the only "Deep Pocket" [the only real source of big money if they lose a lawsuit regardless of who is at fault]. Doctors who admit patients to these hospitals do so only if permitted by the Hospital Board of Directors and Malpractice Insurance is required.
The federal government has become involved because approximately one third of our nation is covered by federal health plans such as Medicare, the Federal Employees and our Military personnel. Medicaid is partially financed by the Federal government in conjunction with the States.
Pennsylvania Doctors have a unique problem in their linkage of Malpractice Insurance and license to practice. Doctors who threaten to strike are warned that they can be accused of abandoning their patients [a criminal offense]. Many Doctors are working, at a loss, while they figure out what to do. [Retire from practice, leave the State or look for a job.] The number of practicing physicians has dropped dramatically.
All Doctors and not just the Pennsylvania Doctors, who find they cannot pay for insurance, have an additional problem. When they discontinue practicing and stop paying for malpractice insurance they must pay for "Tail Coverage" which means a premium to cover lawsuits that could come up years later. This is a result of the "Statute of Limitation" which allows a patient to sue within a specified number of years after the medical error is realized. As an example, in cases involving the delivery of a baby the Statute of Limitations can run for more than 20 years. Other kinds of cases are shorter
The Doctor who cannot afford insurance in the first place is unlikely to be able to pay for "Tail Coverage". Which can run as high as 100,000 dollars. In such a case the Doctor is financially ruined and must file for bankruptcy.
It truly is a crisis that cries for a solution. President Bush is asking Congress to become involved. Many Doctors who have never been sued, but are subject to the same premium as those who have, are being forced out of practice. In the final analysis it's often the American citizen who is the real loser.
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New Reasons HIV is Spreading
Controlling The Spread Of HIV
From the San Francisco Public Health Department as found in the Drudge Report of [1/21/2003
25% of new HIV+ cases are found in men who sought the infection from others who were known to be infected. This subculture of males, seeking to become HIV+, describe the experience, of acquiring the infection, as an "Erotic thing".
Be aware that not all patients with HIV+ become ill and die from the dreaded disease called AIDS. However, they are capable of sexually transmitting their infection to others who may develop AIDS and die. Consequently. It 's a serious matter that must be dealt with by the nation's Public Health Departments
Starting in April 2003, the new rules of privacy of medical records, written for The Federal Bureau of HHS [Health and Human Services] will take effect. These rules allow the HHS to review the medical records of any/all Americans in matters effecting the "common good."
In light of this change, it could be only a question of time before they will order the reporting of all Americans with a positive HIV test. Then, Public health officials must decide how to control the further spread of the virus to others.
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Children Requiring Health Care
A New Crisis In Health Insurance
...Our News Media reports that an increasing number of America's children are suffering from Asthma, Diabetes, Behavioral and mental disorders [requiring daily medication], sexually transmitted diseases [some of which are fatal], drug and alcohol abuse/addiction [requiring medical treatment and/or hospital admission].
.
...In addition Obesity is common together with poor nutritional habits, inadequate personal hygiene and care of teeth all of which are breeding grounds for future poor health,
...This list of health problems, now found with more frequency in America's children, while causing much discomfort/pain for parents is not unnoticed by the Health Care Insurance Underwriters, as well.
...The health insurance industry bases premiums on past experience [more premium dollars were spent after the approximate age of 55 years], the list mentioned above guarantees, for the near future, the need for higher premium charges to cover the future/growing health care expenditures required for our younger citizens who will be getting sicker at a younger age than 55.
...Those Americans who believe that adequate health care is one's right when added to those who believe that government control of health care delivery is the only solution will result in a larger number of Americans who can find comfort in the fact that the Department of Health and Human Services [HHS] feels the same as they do.
...This belief that government controlled health care is the solution, held by many despite world history that records it to be failure in any nation where it has been tried, will persist as long as there is a news media that supports it, and political hopefuls who campaign on it.
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National Cancer Institute Reevaluates
Breast Cancer and Abortion in the News
The New York Times reports [SF Chronicle 12/17/'02] "The National Cancer Institute {NCI} which used to say on its web site that the best studies showed 'no association between voluntary abortion and breast cancer' now says the evidence is inconclusive".
That's a major change in the NCI's position, on this matter. America's women need to be made aware of the significance of this change.
They can learn "why?" by looking at the website www.abortionbreastcancer.com. Those women who are not familiar with computers should have a family member or friend pull it up for them to read or to make a copy. It reports on research that has been done to answer the question, "Does a voluntary abortion increase the possibility of Breast Cancer in later life?".
Women who are concerned should be sure to get an annual Mammogram-- they help despite anything you may have read or been told, to the contrary, about the value of Annual Mammograms.
Your Doctor and not the news media is the better source for health care advice.
P.S. also see www.worldnetdaily.com where this news item together with some of the history of Legislation relating to legal abortion are reported, on the Internet, on 1/03/'03
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Health Care Talk Heating Up
New Congress Looks at Old Problems
The new Congress will try to solve some of the chronic problems that have concerned health care delivery for every American since the Clinton Plan failed in 1993.
Universal health care coverage for all Americans continues to be the goal--- but how to achieve it is yet unknown. Every nation who had the same goal has failed to deliver it, yet, many Americans think we should try anyway.
Internet news reported this morning [12/27/'02] that 31 million Americans are now medically uninsured. That's 9 million less than last year. So, Congress should have an easier job to do.
I'm of the opinion that the 31 million should be correctly reported as 10 to 15 million, the number that so many research studies, of this problem, have reported [5 that I know of]. It would be interesting to settle this debate which has gone on since 1987 when the Congressional Budget Office {CBO}reported, on any given day, as many as 40 million people in the USA could be without health care insurance.
Research, motivated by their statement, has been reported by several non-profit study groups and is also discussed in n some detail in the ARTICLES on Reform section of this website.
It was also reported today, that some Generic [Substitute] Medicines were close to costing as much as the "name brand" original does. That's a puzzler, since the generic makers dont spend millions on research and development and they aren't subject to the same quality control regulations that the "name branders" are---so why are their prices getting so high. Congress might want to look into that while they're discussing the rise in health care costs. .
At the same time,The Medical Savings Account [MSA] concept of health care coverage, which allows individuals to control their own health care costs independantly,is planned for discussion in the Senate. [see MSA in the Commonly used Word section of this website for details]. That will cause a real conflict with the Single Payer people who think every body should be under one plan, a federal government plan like the one in Canada.
Reform of Medicare is on the agenda. There's talk of allowing Seniors, now "wards of the State", to leave Medicare and buy insurance privately with government help.
Drug coverage for Seniors promises to be a a tough problem and not easily solved. Allowing Seniors to seek private competing coverage should help.
Well, maybe Congress won't have such an easy time of it, after all.
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Home Land Security Bill and Bioterror
Health Secretary Power over Bioterror
THe House of Representatives approved and sent a modified Homeland Security Bill to the Senate. "Lameduck" Majority Leader Senator Tom Daschle[D] promises quick approval and passage to the President's desk for a likely signature
Congress and concerned citizens appear to have had very little time to review the 400+ pages of this modified version which Fox News refered to as a significant piece of Legislation. [11/13/2002]
Specifically, Section 304, Subsection C "Administration of counter measures agaimst smallpox" gives the Secretary of HHS these unchecked powers [page 76].
Declare an Actual or potential bioterrorist or other kind of incident.
He/She can administer "countermeasures" to a category of individuals or everyone.
HE/She can continually extend the declaration without Consent of Congress.
This is the power structure formerly recommended, by the Secretary of Health, to be given to State Governor's in the Model Emergency Health Powers Act [MEHPA]now under consideration by several State Legislatures.
More information can be obtained from the American Association of Physicians and Surgeons on their website. www. aapsonline.org
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Director Receives an Invitation
Invitation to Discuss Estrogen Dilemma
The Oxford Round Table Conference 2003 Spring Session scheduled at Lincoln College in the University of Oxford, Oxford, England will be hosting a small group of Obstetricians and Gynecologists to review recent controversial findings contained in the Women's Health Initiative Study.
HCREI Director, Vincent W Cangello MD will be attending.
Discussions and conclusions from this six day conference will be published and distributed to Universities throughout the world.
Information will also be posted on this website.
From Linda Tofanelli, Editor
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No Single Payer Health For Oregon
Oregon Strongly Rejects Single Payer
The citizens of Oregon rejected the idea of a Single Payer State Government run health Care system, similar to the Canadian model, by a 4:1 margin, 80% against and 20% For it Vote.
This seems a valid measure that demonstrates America's resistance to the concept of government run health insurance.
Efforts, now, should be directed toward modifying the American model of privately run Managed Care Health Insurance to make it more acceptable to the American Public.
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Established Medical News
30% Less Heart Failure In Women
My newspapes are confusing when it comes to health care news
On October 31,2002, The San Francisco Chronicle reported :..."based on the 54 year old Framingham Heart Study, also showed that the incidence of heart failure among women had dropped by a third [33%] since the 1950s, WHILE HOLDING STEADY FOR THE MEN".
I opened a medical practice in 1959 and since then I have recommended the use of Post Menopausal Estrogen with or without Progesterone and birth control pills which combine Estogen and Progesterone, as needed to treat many medical problems encountered by women. In my opinion, the use of these hormones is largely responsible for the decrease in the rate of heart failure in America's women. I am also aware of numerous studies during those years that were designed to investigate or establish a possible link between Estogen and Breast Cancer and failed to do so. These studies are seldom presented by the media.
Our Media is not the place to get medical advice. In my opinion, They too often report findings that are premature and can be taken out of context, before the final conclusions of the studies are established.
I've told many patients over the years, "In my opinion, the only thing wrong with Estrogen is, THERE'S NOTHING LIKE IT FOR THE MEN" I wonder if that's bothering us [MEN] more than we care to admit.
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Oregon Voters and Single Payer Insurance
Oregon and Socialized Medicine
Watch the election returns of the State of Oregon closely. Their voters will go to the polls, next week, to decide if they want a State Run Single Payer Health Care Plan similar to the system in Canada.
The Oregon plan will cover all Oregon residents regardless of age and guarantees coverage for every kind of health care including Mental, Dental, Eye, Acupuncture and,I believe, Drug coverage as well. The tax burden required will be very heavy
The State of Tennessee just gave up a similar program after 10 years of trying. They did not try to cover everyone as Oregon proposes to do. They reported, in their experience, too many people were put in the program who did not qualify and their requests for care were beyond the State's ability to provide. The program went bankrupt
This form of health care is found only in Cuba, North Korea and Canada. In Canada private practice may be reinstated in order to improve their failing system [many Canadians buy American health care insurance and get their care here].
This vote will be a measure of the desire by Americans for Government Health Care [socialized medicine].It's well worth watching.
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More News on Estrogen Dilemma
Estrogen Prolongs Life In Breast Cancer
New findings from a five year Study conducted at M.D.Anderson Cancer Center in Houston reports that some patients with Breast Cancer, given Estrogen, have a lower rate of recurrance [3.6%] and live longer than a control group of Breast Cancer patients who did not take Estrogen and in whom the recurrance rate was 12%.
At the same time the U.S. Preventive Service Task Force [who/where?] cautions that the use of Estrogen with Progesterone outweighs any potential for benefit. This despite the fact that millions of women throughout the world have been using this combination of hormones for Birth Control for the past 45 years while enjoying a lower rate of Cancer of the Ovary and no significant increase in Cancer of the Breasts.
Confusing, of course it is! It remains for the the Medical Profession to clear up this dilemma and not offer as an excuse for our delay: the fear of lawsuit: the constraints of time dictated by managed care programs: or the lack of reimbursement for extended visit time or we run the risk of a Federal Bureau suggesting that it is time for a National Health Service such as exists in England.
An even greater risk is the loss of trust by America's Women, Mothers and Grandmothers [Dr Moms] who traditionally trusted us to guide them in times of health care confusion and/or crisis such as exists today.
America has been testing a privately operated system of Managed Health Care whose popularity is in decline. Where will they turn next? Keep an eye on the State of Oregon. In the next election their residents will vote for or against a statewide Single Payer Health Care Program similar to the Canadian System. We'll learn a lot from them.
In any case, the Estrogen dilemma is for the Medical Profession to resolve and not the Media, the Congress or a Federal Bureau. The Doctors must do their job. Rest assured, and history will support me in this, the people direct which way the system goes. Let's maintain their trust, and give them reason to ask for our help in choosing which way they'll go next.
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Court Agrees with AAPS
Children Protected by AAPS
Today, The Association of Physicians and Surgeons [AAPS] won what their attorney, Andrew Schlafly, calls a “stunning court victory.” A federal judge has ruled that the FDA overstepped its authority with the “Pediatric Drug Rule.”
This rule would have required pediatric trials of all new drugs, including off-label uses and those intended only for adult use.
AAPS has taken some heat from some prominent members of Congress, and been accused of trying to keep pharmaceuticals from children. But the fact is, their concern has been just the opposite. They filed the suit to prevent children being subjected to unnecessary and potentially dangerous clinical trials. Also, the requirement would have resulted in further delays of drug approvals.
This is another example of the excellent work achieved through the AAPS Legal Foundation, which is funded solely through contributions. Further information is available on www.aapsonline.org
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The Medical Profession Should Act
HRT A Dilemma for America's Women
The American Medical profession must clear up the confusion created for America's Women, concerning the use of Estrogen combined with Progesterone as found in the birth control pill and in hormonal medicines we prescribe to treat/relieve menopausal symptoms.
For the past century they have depended on us to see that they make informed decisions on matters of their personal and family health.
The title of "Doctor Mom" best describes their role as the health director of their personal and their family's life.
Husbands dont tell "MOM" who will deliver their babies, and it is usual for "MOM" to take the children to the Doctor of her choosing and likely she will direct Dad to a Doctor when he needs one as well.
The dilemma concerning the use of hormones must be resolved by Physicians and not the Media, the Courts or any Federal Agency lest we are willing to accept the risk of losing their trust and faith which we have enjoyed for the past century.
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Single Payer For Oregon?
Oregon To Vote on Single Payer Health
In November 2002, residents of the State of Oregon will be able to vote for or against a Single Payer Health Insurasnce Program to be run by their State government.
Recently, a similar program was discontinued in the State of Tennessee, called "Tenn Care", because of over enrollment and insufficient funding.
Be aware, only three nations in the world use such a program, Canada, Cuba and North Korea.
The Canadian program is now having financial problems despite a recent increase in taxes designed to save the program. Canadians, who can afford it, buy American health care insurance and come to the USA when they need care. [We know little about health care in Cuba and N.Korea]
The outcome of this Initiative will be of great interest to all levels of our health care industry since many Americans have expressed a desire to have a Canadian style Single Payer System here in the USA.
You can learn more about this system of health care in the section, of this website, called ARTICLES ON HEALTH CARE REFORM. The article is entitled "LOOKING BACK TO FIND THE FUTURE", in which I describe my research on Single Payer health care, my visits to Canada and the likely outcome should Americans choose this form of government controlled health care.
Additional information on this initiative can be found at www.aapsonline.org
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Emergency Health Powers Act II
Governors May Order State Quarantine
See my earlier report on the Model State Emergency Health Powers Act recommended by the Federal Government to all 50 states. [Our nation's health care is regulated and monitored by State Governments.]
To repeat, The Federal Government recommends that State Governors be given the power to mandate [dictate] by Executive Order: Quarantine of the State {no one in or out], mass Vaccinations [such as Small Pox] and be allowed to confiscate personal property and weapons as he/she sees fit, with or without previous expert consultation. Such an action would not be subject to change or review for 60 days.
At this time 19 States have approved some form of this model bill. At least 11 others are considering its adoption.
Numerous authorities have found fault with these recommendations and point out there are laws in place that already speak to this issue, that a new one is not necessary. In addition, Jail terms for uncooperative Doctors or Citizens are called for in this measure.
Learn more from www.aapsonline.org.
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Media Confusing American Women
Fewer Deaths With Breast Cancer
A Harris Poll reveals that 40% of America's women believe they will die with Breast Cancer--when only 4% actually do--[2% from Ovarian Cancer]. The Poll also found that 19% believe they will die of heart disease when in reality 45% do.
These findings should signal the news media to be extremely careful when reporting news of a relationship between the use of Female Hormones and either Breast or Ovarian Cancer.
My research reveals the recent report of a relationship [in the European Press] between Therapeutic Abortion and Breast Cancer [occurring in later life]; when at the same time, there is little to no change reported in the potential relationship between the use of Pre or Post Menopusal Hormones and Breast or Ovarian Cancer.
The news media will be misleading America's women with news of the causes of Cancer of the Breast unless they present, as well, the results of this research conducted in Europe. More can be learned about this relationship on www.abortionbreastcancer.com
America's women should have an Annual pelvic and breast examination, Pap Smear and Mammogram together with a discussion of this subject with their Doctor.
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What's Going On in Estrogen Trials?
Why Do They Dislike Estrogen?
Whats going on!!!
Millions of Women have been taking Estrogen/Progesterone combinations for the past 40 years. They're called Birth Control Pills
All of a sudden they're portrayed as too dangerous to take. Just because your getting older ???
They were reported to cause less Cancer of the Ovary---yesterday my newspaper said the combination of Estrogen/Progesterone was causing more cancer. I don't understand what's going on. Somebody is confused. America's Physicians needs to settle this dilemma.
In the meantime, I predict many Physicians will advise their patients to discontinue this medicine just to play it safe and avoid a lawsuit.
America's women will be the victims.
Why!!!
Is their a hidden agenda here.......
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Give The Ladies a Break II
Estrogen ---Nothing Like It for MEN
They are playing that song again---Estrogens and Cancer, Heart Disease and Strokes---even worse if you're taking Progesterone.
Ladies don't panic there are many other such studies that will not support these conclusions.
Why do they keep trotting out this sick horse so often, when they know there are many other factors that are involved such as smoking, obesity, alcohol, cholesterol high blood pressure, family genes and diabetes just to name a few.
I practiced Gynecology for more than 40 years and I seldom saw it in my practice even though I prescribed Estrogen with and without Progesterone for many patients. I believe either the media or the scientists may be confused about this item.
Talk to your Doctor ask him/her what their experience has been.
I also suggest you look at a website: abortionbreastcancer.com and ask why you are not being warned, as often, about this relationship---when it is being accepted throughout the world.
Don't panic ---do ask your Doctor to help you and get those annual Pap Smears and Mammograms.
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Someone Had To Get Hurt
Medical Record Privacy Ruling
400 new pages of regulations have been added by President Bush. The government will decide what it needs based on what is best for the common good. They decide what is best for the common good. Some analysts feel there is no longer any privacy. Your permission will seldom, if at all, be needed to open your medical record for inspection.
Recently, A Federal Judge in Houston dismissed a lawsuit brought by the Association of Physicians and Surgeons [AAPS] alleging that the revised rules, concerning privacy of an individual's medical record, contained in the existing Health Information Portability and Privacy Act[HIPPA],are in violation of the 4th Ammendment to our Constitution.
The Judge in the case ruled that since the new rules were not yet in effect [not until 2003]---no one has been injured by these changes and therefore the suit is "not ripe" and not appropriate for review.
My morning newspaper,however, reports that someone appears to have been injured.
I quote from the Oakland Tribune of July 4,2002: WASHINGTON--"A Florida woman opened her mailbox last month to find a freebox of once-a-week Prozac from her pharmacy chain----astonishing, she says, because she didn't use Prozac and hadn't asked her Doctor to switch her from another antidepressant to it."
A patient's personal privacy has been violated. I presume her lawsuit is based on added stress and embarrassment she is suffereing as a result of this disclosure.
How did the pharmacy chain learn of this patient's diagnosis? An investigation is in progress but the damage has been done
Can we expect more of this in the future, when the new rules go into effect? I think so.
Pity the individuals with mental or genetic disorders; or a positive Aids Test. [learn more on www.aapsonline.org]
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Obstetricians Forced To Quit Practice
Pregnant Women in Danger
>New mothers in several states are facing a shortage of qualified Obstericians.
Doctor's Malpractice premiums have increased to as much as $200,000 in parts of Florida.
In States such as Texas,New York, Michigan, Illinois, Ohio, Nevada and West Virginia the premiums vary from as high as $160,000 down to $84,000.
Many Obstericians are filing for Bankruptcy due to inability to meet their overhead expenses. Under such conditions women with complications of their Pregnancy may have to travel many miles for a Consultation or for a "High Risk Delivery Hospital
Obstetricians in California are protected by a State Law that limits awards allowed in such cases. Other states are considering similar Laws.
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Birth Control Pills
Do Pills Cause Cancer
Now the Media reports that birth control pills cause Cancer of the Uterus.
The Media should report that the use of birth control pills allow women to accept multiple-sex partners which increases their risk of becoming infected with the Papilloma Virus. This virus is known to increase the risk of Cancer of the Cervix of the Uterus in later life
Women should insist on the use of a Condom if engaging in sexual intercourse with multiple sex partners. This would reduce their risk of becoming infected with this Virus.
THe birth control pill doesn't cause Cancer of the Uterus any more than a Voluntary Abortion causes Cancer of the Breast. We now know, however, that they may lead to an increase in the risk of Cancer developing some years later.
The solution for concerned women is to have Annual Pap Smears when sexually active and annual Mammograms or as advised by their Doctor.
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New Information on Breast Cancer
Research in Europe On Breast Cancer
THE SCOTSMAN.CO.UK [Dec 5, 2001]and recently World Net Daily reported: "Women who have had an abortion are nearly twice as likely to suffer from breast cancer, scientists claimed yesterday.
The research, which looked at breast cancer and abortion rates in Britain,Finland,Sweden and the Czech Republic draws a direct link between rising cases of breast cancer and an increase in abortion since it was legalised.
More information is avilable at Mnichols@scotsman.com. and abortionbreastcancer.com.
These findings will diminish the argument that the use of Post Menopausal Estrogen causes Cancer of the Breast.
Women who have had an abortion should be sure to advise their Doctors and request Mammograms at least once a year. Be aware that Mammograms and Pap Smears are more difficult to obtain through a national health program.
Many European women pay cash to private clinics to get these tests.
More details on the Estrogen question are available in the "Let's Give the Ladies a Break" article in this section. /
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Dept of Health urging New Legislation
A State Emergency Health Powers Act
HHS Secretary Tommy Thompson is urging State Legislatures to adopt the Model State Emergency Health Powers Act.
This Act would grant unprecedented powers to the Governor to quarantine and vaccinate individuals; and allows government authorities to commandeer such items as drugs, firearms and private property.
For more information on this model Emergency Powers Act see www.aapsonline.com and a copy can be downloaded from www.publichealthlaw.net.
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Your Permission Not Needed
"Unauthorized"??? Record Request
I received a request for a copy of a patient's medical record.
The signature of the patient and her spouse, written on the request form, didn't match those in our office. I didn't send the record
See rest of this story below
Now, based on a recent decision by our President, your signature is no longer needed and your Doctor need only make a "reasonable" attempt to notify you that your record was forwarded, as
requested, to an appropriate party.
Now, back to the earlier story.
A phone call to the family verified they had not signed a request and had no idea who was requesting their record.
I, prior to the President's decision, suggested that people send their Doctor a letter with copies of their signatures and ask that the Doctor notify them if copies of their records are were requested
My suggestion is no longer of any value. Your permission is no longer necessary.
Let me remind you --Your medical record is precious, no less than your Passport. Be concerned by these new developments.
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Federal Health Care Reform
President Bush and Healthcare Reform
President Bush has presented his ideas for health care reform for Seniors, uninsured workers and children.
He proposes an addition of 300 billion dollars over the next decade to improve Medicare coverage for Seniors. There are no details as to the source of this additional funding.
He would increase the availability of tax deductible Medical Savings Accounts [MSA] for those who desire more control and privacy concerning their health care expenditures. This Institute [HCREI] has been a supporter of this form of health care insurance since our inception in 1998.
See a more detailed description of MSA in the Commonly Used Words section of this [HCREI] website.
He proposes 89 million dollars in tax credits fpr those workers not covered by their employers plan and who don't qualify for public health care. He estimates 6 million people in this group. No mention that recent studies show that many in this group refuse insurance even if it's available. [The number 6 million is suspect since studies show there are at least 14 million housewives and 2 to 3 million college students covered by the family policy who dont want another insurance policy.]
See article on "Who Are the Uninsured" in this section of our website.
He proposes pooling of the employees of small businesses so that they can negotiate lower premiums with major insurers. We support this proposal.
He renewed his call for a "Patient Bill Of Rights" now stalled in Congress because of conflict over whether lawsuits against Insurance Companies should be heard in Federal or State Courts.
Federal Courts move slower and pay less while State Courts move faster and pay more. Californians are fortunate in that most provisions of this Bill of Rights already exist in our State because of lobbying by our California Medical Association.
No mention of new rules concerning privacy of our medical records which become effective in a few months that will decrease the privacy we have now. See an article on this subject, also, in this Section our [HCREI] website.
He mentions Medicare Prescription Benefits without details for its achievement. This is a "sticky wicket" that requires a solution while keeping in mind that more than 50% of Seniors already have drug coverage supplements. This matter must be resolved with help for those who need it without raising premium costs for those who don't. Our Congressional Budget Office [CBO] supports this position.
Our President will need all the help he can get. He's embarking on a trail where many great leaders have fallen before him. No nation has ever achieved the lofty goal of health care for anyone who needs it regardless of ability to pay. Let's hope we learn from their mistakes and can do a better job.
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Is Cost Control the Goal here
Mammograms Under Attack Again
News out of Europe suggests Annual Mammograms may not be helping to save lives.
Ladies, dont panic on this news.
The American Cancer Society supports the position that you continue as usual until this announcement is better evaluated.
I've been in active practice for more than 40 years and I don't buy it. Here, we've seen almost 20% benefit in the 40 year age group and 30% in the 50 year age group.
This new study flies in the face of many studies and years of experience in our large nation. One new study doesn't negate our experience. The need for proof falls on them and not on us.
Another thing, not all Doctors are experts at reading Mammograms. Therefore, the evaluation of this report starts with this question "Who is reading these Mammograms---what are there qualification and training". What type of equipment is used and who is in charge of the Technicians who take the Mammograms. Only, when those questions are settled to everyone's satisfaction can we decide on the truth of their findings.
This new study comes at a time when a four nation European study reports that women who have had a Therapeutic [Voluntary]Abortion have an increased risk of Breast Cancer in later life. A study of this kind is not possible in the US because a high percentage of our Abortions are not recorded. they're private. In foreign nations with National Health Care [socialized medicine] almost every abortion is recorded and accounted for. [Of course, some but not many are secret there, as well].
LADIES, THE SECRET IS GET THOSE ANNUAL MAMMOGRAMS UNTIL WE GET MORE STUDIES THAt SSUPPORT THE ONE WE'RE READING ABOUT TODAY.
I think this news will fade away like so many other in the past. We shall see.
Let's hope that someone isn't trying to discourage America's women from getting annual mammograms in order to save money and reduce health care costs.
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We Still Sell Cadillacs In America
Doctors Offering More Expensive Care
In the AMNews today
"Premium practice: When patients pay top dollar for exclusive care
It's an advanced kind of fee for service -- you charge your patients hundreds or thousands of dollars a year for special access to your practice. It sounds lucrative, but is it ethical?"
By Cheryl Jackson, AMNews staff. Sept. 17, 2001.
The report went on to say:
They cost a little more, and they don't mind saying they're worth it.
Physicians are offering more boutique-style services, promising premium care, to patients who pay annual fees of up to $20,000 per family.
For example:
MDVIP in Boca Raton, Fla., this spring had doctors closing their practices to those who wouldn't pay a $1,500 annual fee.
Platinum Health, also in Boca Raton, Fla., charges up to $1,800 a year for a membership that includes a personal medical concierge to coordinate appointments and insurance, and guarantees same-day visits with primary care doctors.
Health Access in Fort Lauderdale, Fla., is going for a less-affluent clientele with its $100 annual membership fee. But participating physicians are paid in most cases within 48 hours, and billing issues don't exist, the group says.
Interactive Wellness System's Menlo Park, Calif., practice is so exclusive that internists Scott Wood, MD, and Sadick Alsadir, MD, don't even advertise, let alone talk to the press. Patients demand a hush surrounding the practice, explains assistant Mark Jackson. "We honor their decisions," he said. Any marketing is done by word-of-mouth.
The oldest-known such arrangement -- MD2 (pronounced "MD squared") -- fancies itself a Ritz-Carlton of health care. It charges $20,000 per couple, $13,200 for individuals and an extra $2,000 for a child 14 to college age.
Physicians nationwide are considering such moves as a way to deal with high patient loads that they say don't allow for enough time to meet with patients.
The patients pay more, but it allows doctors to spend more time with them, and they get a higher level of service, say proponents of the programs.
Doctors in such practices get more money from fewer patients, as well as more control in practicing health care, they say.
A premium practice can have from 100 to 600 patients.
A friend wrote and asked what I thought of this news and I wrote back
Dennis: This news item was brought to my attention earlier this morning
In my opinion.
We live in a nation that espouses freedom and free enterprise. Yet, I expect the public reaction to this news is likely to be contradictory. After witnessing the attempts to break up Microsoft I suppose it's easier to say "what's new". while wondering if a new era is being born in America that feels like a social kind of thinking.
I suppose this particular news will pass, grudgingly for now. since there's no way, that I know, to stop these American Doctors from selling Cadillac medical care [a common practice throughout the world of socialized medicine.] Despite this reality I suspect. in our future, there will be objections to this kind of private enterprise.
Be aware that in my travels
around the world the only health care systems that work are those that allow
for private practice at an additional cost [in addition to taxes deducted from one's paycheck] to supplement the "universally available" but often inefficient government service.
In support of that fact, in yesterdays news Prime Minister Tony Blair of the UK is reported to be turning over failing [National Health Care] hospitals to private doctor groups in order to take care of more people, and shorten the waiting lines [of more than a million citizens,] where men/women and children are known to die while waiting for the care they need.
Even Canada is encouraging [previously unavailable] private practice to treat
more people in order to reduce unnecessary suffering and decrease the number of deaths while waiting for care. [In addition, many Canadians buy American health Care Insurance and come to the States when they are ill]
I recently reviewed a British publication that compared unsatisfied British patients to those in France and Germany where people are more satisfied because private care is available for those who are willing to pay for it.
The sad truth is universal health care schemes, which look good on paper, fail because of human weakness and greed that develops in such systems. The greed is found amongst the providers as well as the consumers. Such is the case in the State of Tennessee's attempt to form a single payer system. There too, they found that many people in the program did not qualify. As a result that effort is facing bankruptcy.
A former British Health Minister reminded us that whenever a public service is free you will never keep up with the demand.
Why wont we learn from all the history and experience available to us?
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The Media and the Pap Smear
Ladies Don't Panic on Pap Smear News`
Ladies I've been submitting Pap Smears to the Labs for more than three decades. It's uncommon, in my experience, to receive a confusing or misleading final report.
More often, there is the request to repeat the Pap Smear for any one of a number of reasons in order to clear up any confusion.
In my area. if there's suspician of cancer, such a slide may be sent to one or more Labs for additional opinions. If the confusion remains,after a second smear has been submitted,then I would recommend further studies be done by Gynecological Specialist equipped to investigate the problem in more detail.
No need to panic. If you're not comfortable with what you are told then insist on a Consultation. The American system of health care encourages your right to seek the help you need. Let's not fail to use it or allow that right to be taken away.
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Major Change in Medical Reporting
Loss of Privacy of your Medical Records
Major changes are occurring concerning the privacy of our personal medical records. The former Secretary of Health, Donna Shalala wrote new regulations, allowed to go into effect on the order of President Bush. Certain of the new regulations concern the opening of our personal medical files, without your consent, when deemed necessary by the HHS [Department of Health and Human Services], in order to deal with issues that effect the common good, the public's health, medical research or for law enforcement purposes.
The position of the HHS is that our privacy is not absolute when it comes to the circumstances previously mentioned. If our information is correct, once your records are opened by the proper authorities the rules of privacy no longer apply. This law reminds us of a wise old man who said "That's like painting the front porch while the back of the house is on fire".
For more details on this matter of privacy see aapsonline.org the Web Site of the America Association of Physicians and Surgeons in Tuscon Arizona.
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Why Dont We Learn From Others
Single Payor Plan in trouble
The State of Tennessee Health Care Plan must cut benefits
Their Single Payer Health Care is too Expensive according to the
NY Times on 5/1/99 when they reported that this ambitious
Single Payer health care plan, started in the State of
Tennessee 5 years ago, has to cut benefits to stay
alive. Abuse by all involved, consumers and
providers, is the root cause of the problem. Many
people on the plan don't really belong there,
medication costs are rising [some patients cost
$100,000 a year]. The State can't afford the run away costs.
These plans have failed anywhere they've been
tried. Human behavior is the weak link in the chain.
The Health Minister in a foreign system said "When a health care system is free you'll never keep up with the
demands". No different here
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Solutions For Our Health Care Delivery
2002 Conference on Solutions
Later this year 2002 we plan a new Conference to present actual and potential/practical solutions for the chaos in health care delivery.
The Medical Director of a successful low cost medical clinic will participate. An expert [because he is doing it] who will describe this existing facility operating with minmal or no government involvement.
Practicing Physicians, Professors of Public Health, Law, Health Care Insurance and Economics will discuss current political trends, changes in Health Care Law, the variety of health insurance policies becoming available or being planned, tax deductible Medical Savings Accounts {MSA} that give you more freedom and control of your health care costs.
A special segment of the Conference will be devoted to the Phamaceutical Industry and the cost of commonly used medicines. A reresentative from Canada will join this faculty
More is planned--much work still to be done. Return to this web site for additional details.
Attendance will require a registration fee and will be open to all levels of medical providers and interested non-providers [as seating permits].
Direct inquiries to vincanmd@healthcarereform.com or call 510-834-4282
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Patient Bill Of Rights Debate
Patient's Bill of Rights Debate
At this time the Bill of Rights debate is held up in Congress, over disagreement within the legal profession, concerning whether medical care lawsuits should be heard in Federal or State Courts. State courts move faster and allow bigger settlements. The President and the Senate prefer that Federal Courts get the cases. You'll have to wait until the lawyers are in agreement. You can be sure they'll tell you they are concerned for your benefit,not theirs. You decide. Bigger settlements: COULD MEAN MORE MONEY FOR THOSE WHO WIN BUT WILL ALSO DRIVE UP THE COST OF YOUR HEALTH INSURANCE.
Think about this:
California and a few other States are setting the stage for the
Federal Patient Protection Bill--they're discussing what we already have.
Our concern should be that they don't mess up our Law.
One version of the Patient's Rights Bill would have no limits on the
filing of lawsuits or the amount of money paid out--this could lead
to the bankruptcy of many of the HMOs.
Also, it's not clear who pays for the "why can't I have it?" consultations.
If it's your employer he/she may have to stop supplying your
insurance.
Arguments claiming that only a few lawsuits have been filed
are misleading since the ability to sue in some states didn't start
until January of this year,2001.Hardly enough time for more than
a few suits to be filed.
Another obstacle will be the attitude of of the US Supreme Court whose position is the HMO is simply doing what it was asked to do "Cut health
care costs" In other words "Dont expect Champagne for the price of beer" [our words, not theirs]
Another thing, the number of medically uninsured in America is
said by the Media and many other organizations to be 40 million. This has been proven wrong by at least five
independent studies---some say no more than 10 to 15 million.
and many of those are only temporarily uninsured---between jobs,
near Medicare age or self-employed.
Several million, listed as
uninsured, are housewives and college students covered by the
husband or by family's insurance [full time students are covered till the age of 23].
At least 5 million are transients who use Emergency Rooms on a
"only when I need it basis". Even Great Britain has such a group--
referred to as members of the "Knife and Gun Club"
The error in the number of uninsured was proven in another way---When our former President Clinton
made money available for "The 2 million uninsured children"---
less than one hundred thousand children applied.
Return to this web site for additional developments in this important debate. The more you learn the better you will understand how this debate can effect the rest of our lives
For more details see the website of the AAPS www.AAPSonline.org
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How Many are medically uninsured
Media keeps pushing number higher
The Media is at again with Uninsured numbers.
A Better Breakdown is needed of the number of
medically uninsured.
The 40 million uninsured was used during the
Presidsent's Heath Task Force in 1993.
Numerous studies decribed the untruth of the
number[it was really less than 10 million] but we
can't seem to get rid of it.
See more on this dilemma in Articles on Reform section of this website.
The Media keeps adding to it. Now they're talking about 7 million
in California alone and that's another part of the
misleading news
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Estrogen and Breast Cancer
Let's Give the Ladies a Break
The newspaers are at it again
Recently, one of our local newspapers ran a headline warning the women who took birth control pills prior to 1975, and whose mother or sisters had Breast Cancer, that they have a substatially increased risk of developing the disease [read more below]
This week they reported that using Estrogen for more than 10 years increased the risk of Ovarian Cancer. If you keep reading you'll see that long term users of the birth control pills have less Ovarian Cancer [birth control pills contain Estrogen] and some of my patients have been using them for more than 30 years
If you look at the Breast Cancer in families---you'll realize they are referring to fewer than 18,000 women in a nation with nearly 300 million people. It is generally well known that women who have a family history of Breast Cancer should take this news seriously and should see their physicians for regular checkups and annual Mammograms. The public at large should not panic with this news. The important message here is that regular checkups with Mammograms are essential and can save your life
Remember too, the incidence of Ovarian Cancer has been reduced by 50% in women who take birth control pills.
Remember, check with your physician
Now, they tell us that Estogen doesn't help the heart
What they don't say is that they are talking about the heart that
has already been damaged by a heart attack
In other words, it may not help the damaged heart from further damage but it has been proven that it will help protect the undamaged heart.
And remember too, there is one thing wrong with Estrogen---there's
nothing like it for the men.
Here is a new [and early] report of a finding in more than one nation, not just the USA: A Breast cancer increase is being noted in women who have had therapeutic Abortions---they're still collecting data but more than one study suggests that there is a relationship. Don't panic just get your annual mammograms and watch for more news on this reasearch. That mammogram is like a Pap Smear---it saves lives
I find this news interesting because for years they have blamed the increase in Breast Cancer on the use of post-menopausal Estrogen even though it was never proven, with certainty, to be the case. The question is, have they found another piece to complete this puzzle.
This question is not yet fully settled but we're getting closer and I'm sure we'll hear more on this. Remember, get those mammograms beacause they find trouble early---just like Pap Smears.
CONSULT WITH YOUR DOCTORS ON THIS--THEY CAN GUIDE YOU.
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The Value of One's Health
Protect This Valuable Asset
It's not a consumer product - a sought after material item or some
other form one may lust after - yet it should be
Without it, you eventually lose everything. One would forsake everything because nothing is more precious or has a higher value. What price can be
affixed, when such little thought is spent, unless truly needed?
What is this ultimate power that overtakes ones body - your health.
Millions of dollars are spent and made for pleasure and for some the
ultimate achievement of being number one; while sitting in the sidelines
is our own being. For when we feel good, it takes second place. Only
until it hurts or a medical crisis occurs does the mind and all it's
sources turn to finding a cure and feeling better.
The value of life exceeds everything. The evolution and protection of healthcare should not be underestimated
or ignored.
We must become better educated in order to preserve the greatest gift of all,
our health and our medical environment. Linda Tofanelli, Editor
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Cost of Prescription Drugs
Co-Pay for Drugs may not Help
When your health plan allows you to buy
only a one month supply of your precription medicine, the Co-pay
may actually be more than the actual cost of the medicine. Check
this out with the Pharmacist before paying.
In one example--the copay was 25 dollars and the pills were worth,
without insurance help, only 14 dollars.
Former President Clinton's plan to lower the cost of drugs for Seniors could actually have added to the cost because their will be higher premiums
as well as a copay when you fill your prescription. This may add
up to as much as 75% of the cost of the prescrition, according to
the Congressional Budget Office. For many Seniors that's
more than they were paying before the President decided to help
us.
Keep a close watch on this situation, sometimes what your told
is not what you get. Talk to your Doctor and your Pharmacist,
their are big dollars involved here.
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Important Supreme Court decision
HMO's saved by the Supreme Court
A recent US Supreme Court decision supports
HMO's giving bonuses to Plan Physicians for controlling cost
while caring for their patients.
The Court feels that only a reasonable quality of care must be
given to HMO patients, and the HMO's should not be punished for
doing what they were designed to do. "DELIVER HEALTH CARE
AT A LOWER COST
This decision will also derail a recent Media campaign
to discredit lower cost managed care insurance programs. That campaign was designed, in our opinion,
to support greater involvement of the government in the delivery
of the nation's health care.
It does raise the question, however, "If I want a better quality of care than my HMO is giving me, how do
I get it and who will pay for it?"
The Supreme Court decision brings to mind the old saying "Dont
expect Champagne for Beer prices". We suggest the answer for
some will be to set up a tax deductible Medical Savings Account
[MSA]. See MSA in the Commonly Used Word section of this web
site for a detailed desription of MSA's; or talk to your employer if
he/she is paying for your health insurance.
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International Conference on Health Care
We discussrd Health Reform in 3 Nations
Overview of our former International Conference held in February 2001 "CHAOS IN MEDICINE--AN INTERNATIONAL PERSPECTIVE"
There is tremendous interest from both consumers and the medical community concerning what is going to happen to the delivery of health care in the United States. When President Bill Clinton came into office, he and Hillary made health care reform one of their major priorities. At this time, Congress is discussing a Patient Bill of Rights, changes in the Medicare System, reimbursement to seniors for prescription medicines and the possibility of allowing physicians to come together as a collective bargaining unit to negotiate with HMOs
Another idea, one that has been discussed numerous times is the implementation of a single payer concept of health care delivery. Both England and Canada have had government controlled medical care for decades. Therefore it was timely to offer a two day seminar that explored health care reform and looked more closely at the English and Canadian models. This unique forum allowed for a meaningful discussion of the benefits and drawbacks of those systems. The Conference was open to all Health Care Providers, not just Physicians, since reform efforts will effect every one involved in the delivery of health care.
Date:This Confedrence was convened on February 9-10, 2001 at the Health Education Center, Summit Medical Center, 400 Hawthorne Avenue, Oakland, California
Sponsors: (partial list)
· The Health Care Reform Educational Center
Sutter Hospitals
· Summit and Alta Bates Medical Centers
· Samuel Merritt College
Hill Physicians Medical Group
Boehringer Ingelheim Pharmaceutical Inc.
Wyeth Ayerst Pharmaceuticals
· Invited pharmaceutical companies
Speakers:
Henrik Blum, Professor Emeritus, School of Public Health, UC Berkeley. He has consulted for the National Institutes of Health, American Public Health Association, U.S. Public Health Service, U.S. Department of Health and Human Services, USAID and The World Health Association.
· Irwin Hansen, President and CEO, Summit and Alta Bates Medical Centers
Dr. William McArthur, The Fraser Institute, in Canada. He has authored numerous publications dealing with health care policy, health care costs and its delivery in Canada. In January 2000, his editorial describing health care in Canada was published in The Wall Street Journal.
· Edward O'Neil, MPA,PhD, Professor of Family and Community Medicine at the University of California at San Francisco. A much sought after commentator on health care issues to provider organizations, physician and hospital groups, national associations,professional schools, health plans and governmental agencies.
· Jane Orient, MD, Executive Director, American Association of Physicians
· and Surgeons, Tuscon, Arizona .
· Stephen Pollard, Health Care Columnist for the London Times, writer for the NY Times, formerly Head of Research at the Social Market Foundation, Co-author of "A Class Act-The Myth of Britain's Classless Society". Having worked for the Shadow Cabinet when Labour was in opposition, he remains an adviser to the Prime Minister
The following poem offers an opinion on the conference
Draped in Disguise
by Linda Tofanelli
Cries for medical care
equal to Canada or Great Britain
is fair
Everyone's much better there,
so why not us? -We want their care!
NO, they say, it isn't so.
Don't give up what you have
for the lesser care
within our society
Am I to believe
it's a disguise.
A mask claiming to be
better for you and me;
confusion, disorder
split in two
which shall we choose.
One bringing change, or
another bearing mediocrity
Our lives are too precious to be
bound by the arms of bureaucracy.
Other nations have tried and failed
leaving only discontent and disparity
Look forward to what can be.
Not their past except its' history.
Lest the burning desire of what we lust
becomes the aftermath of only dust
If we turn our backs
and pretend not to see,
no more will we
the envy be, and
the failures of others
becomes our destiny
Learn from their failure, for left unexplored
creates another worse than before
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Canadian Health Care in Trouble
Canadians Unhappy With National Health
The Fraser Institute, Canada's respected study group reports
that life expectancy for Canadian women has decreased by
close to 3 years since 1978. This is shocking news in a time of
great advances in medical knowledge and technology
Dr William McArthur, of the Institute, adds that it would be a costly error for
American Seniors to conclude that they would be better served by a
Canadian style health care plan or for American Legislators to
assume that they can selectively opt for price controls of
pharmaceuticals without damage to health care quality.
Canadians over the age of 65 are at a greater disadvantage because
of their greater need. The average hospital spends 80% of its budget
on labor compared to 55% in the US hospitals. When compared to 29
nations Canada ranks 21st in availability of Cat Scans, 19th in availability
of MRIs, 6th in availability of cancer radiation while ranking 5th in
overall spending for health care, in the list of 29 nations.
There is an overall lack of life saving drugs due to the fact that
less than 5% of the health care budget is designated for medications.
Canadians wait 6 weeks to see a Specialist,then an additional 7 weeks before
treatment is available. The average wait is 11 weeks for an MRI and 5
weeks for a Cat Scan.The national insurance is not universal [ 170,000
are uninsured]; not portable [you're not covered outside of your
Province or outside of Canada];not comprehensive [you have to
pay cash for some drugs or operations].
The experience that Canada has had with government oversight of
its health care system suggests that a narrow minded focus on
the cost of particular aspects of health care produces unanticipated
consequences that dircetly effect the health status of the population
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A Half Century of Service
British National Health Care Struggling
A growing number of senior citizens is placing
increasing pressure on the National Health
Service [NHS] to keep up with an increasing
demand for care. Approximately 25 million
non-senior Brits are maintaining the NHS for
approximately 60 million senior citizens. Private
health care has not grown as expected;
approximately 10% of their citizens have such
coverage.
A Professor of Social Policy at the
London School of Economics said, "...it's the
least worse of all health systems. It costs
relatively little,produces a resonable quality of
health care and its health outcomes are not bad"
Yet, recent reports out of England reveal that they spend the least on health care of the 17 major European nations.
The quality of care is rated poorly amongst the nations surveyed. Another proof that good quality health care doesn't come cheap.
Americans shouldn't abandon their Cadillac of care just because it has a flat tire. Repair it rather than replace it.
.
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Don't Panic about Hormones
Jury Still out on Hormones and Cancer
The media has dropped a bomb on the women of
America.
The newspapers report that Progesterone causes Cancer of the
Breast.
This hormone [Progesterone] is produced, naturally, by your body
during all those years you were having menstrual periods. After
the menopause it is prescribed for protection against Cancer of
the Uterus
Now, the Progesterone you've been taking to prevent one Cancer
is accused of causing another.
This new study came out of the National Cancer Institute in
Rockville, Maryland and is the conclusion taken from interviews
and questionnaires, sent to 45,000 women which found 2,000 with
Breast Cancer. Those who conducted the study admit to several
factors that must be further studied such as a patient's weight,
age of menopause,education and history of getting mammograms.
I consider this a weak study whose findings have to be compared
with several others that do not agree with their conclusions.
A spokeswomen for the Cancer Research Center at the University
of Maryland [U of M] said that women should not discontinue their
hormones because of this study,[I will add-- discuss it with your
Doctor, as well].
The spokeswomen added [and I agree] that 50 years
of research have failed to detect a significant increase in the
incidence of Breast Cancer among women taking hormone
replacement therapy [HRT]. She added, "it's time to put this
baby to bed" .
Women should remember that over the years Breast Cancer was
thought to be related to Birth Control Pills, having or not having a
baby, Coffee, eating Chocolate or smoking cigarettes.
All these theories have been abandoned. Now, they've added
another to that list.
Don't panic on this news---talk to your Doctor and ask his advice
Most Doctors were as surprised as you were.
A new study reported today[2/15/00] adds to the confusion
This study states that post menopausal women who took
Progesterone for only half of each month were more at risk than
women who took that hormone every day.
Researchers aren't in agreement and the media sends these mixed
messages,based on the premature release of incomplete data, that
is frightening to women throughout the country
The history of the use of Progesterone is as follows: In the
beginning post menopausal women took Estrogen only; later,
Progesterone was added 3 or 4 times a year to prevent Cancer
of the Uterus; later, Progesterone was added on a daily basis to
prevent the annoyance of irregular bleeding. In the meantime
studies affirmed that there was no increase in Cancer of the
Breast or the Uterus. Now, This HRT program is said to be the
cause of an increase of Breast Cancer.
Confused!!! so are the Doctors who precribe these medicines
Good advice--talk to your Doctor--be sure to get annual Mammogramss
and Pap Smears and hope, as I do, that one day they will discover
something like it for men.
.
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Cost Effective Health Care?
Mammograms for the Elderly
Mammograms for the Elderly???
Experts Question Their Value After Age
65
American Medical News [10/12/98] reported that
a Journal of the National Cancer Institute study
focused on the question, "Is there an age at
which mammograms cease to offer women
benefits that outweigh the test's emotional and
economic costs?" The American Medical
Association [AMA] found that of 1000 women
over the age of seventy [70]; eighty-one [81] had
suspicious findings on a mammogram and of
these 11 had breast cancer. The question really
appears to be "Are we saving enough lives in
women over the age of 65 to justify the cost of
all those mammograms?" In nation's with
managed care, either private or federal, "cost
control" becomes essential. It's usually resolved
by rationing. Americans will soon be forced to
deal with it.
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California Med.l Association's Slam Dunk
CMA strikes paydirt with law suit
Federal Judge, Federico Moreno, orders discovery in physician's landmark racketeering case against HMOs.
The Judge issued a major ruling in the racketeering lawsuit brought by the California's Physicians against some of the nation's largest for profit HMOs.
The lawsuit accuses the HMOs of fraud, extortion and racketteering.
CMA[California Medical Association] President Frank Staggers said "It will show that these plans have engaged in serious violations of federal anti-racketeering laws, that they have enriched themselves as part of a scheme to defraud physiians and their patients, and that they have been trying to force the nation's physicians to do their dirty work."
The State Medical Associations of Florida, Georgia,Louisiana and Texas have joined California in this suit.
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Fraud investigation by Dept. o fHHS
Seniors: check out HMO before joining
Warning for Seniors: before joining a Medicare
HMO: Investigate the HMO Track Record
Seniors are being encouraged to join senior HMO's. If your healthy you'll
have no trouble getting in to the plan. But you'll lose your Medigap
insurance because the HMO "guarantees" total health care. [they
determine what total health care means.]
If you become ill while insured by the HMO and are dissatisfied
with the care you may find it difficult to leave. If you leave the
HMO, with your illness, you may not be able to get another
Medigap policy depending on the illness that caused you to leave
Investigate carefully before enrolling in a Senior HMO plan. Be
sure you have the right to a second opinion and/or the right to
appeal their decisions. Your life savings may be in jeopardy if
you must leave the HMO.
Refer to our section called "Commonly Used Words" for a better
understanding of the terms used by insurance companies.
Recent report in USA Today concerns abuse of funds by
management of some Medicare HMOs. Money being spent
on Perks for mangement and/or other employees. Inspector
General of Dept. of HHS is looking into it. This kind of abuse
means less money for care of the Seniors.
Keep in tpouch with this webpage for further details.
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UK's NHS Attempting Reform
British Foundations Similar To Our HMOS
Former Minister of Health Alan Milburn of the UK in his address to the New Health Network advised the formation of Foundations which are similar to American HMOs
The National Health Service [NHS] is prepared to turn over 60 hospitals which can be run by the new Foundations in order to reduce waiting lines for care, and to give British citizens more freedom to choose.
This recommendation is a giant step in the effort to improve the efficiency of the British NHS.
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Mail order drugs confiscated
Imports - Mail Order Drugs--Buyer Beware
US Customs and the FDA report that imported and mail order drugs may not be effective, exact or even what you ordered. I advise great care in purchasing and using non-FDA approved drugs.
I say it's not worth the savings---your LIFE may be on the line.
Ask your Doctor and your Pharmacict for advice concerning name brand and generic medicines. It's worth the time it takes to learn the truth.
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