From the AAPS Journal Of American Physiciians and Surgeons Spring 2012.Volume 17 Number 1 

Morton's Fork: Deconstructing the Case for an Insurance Mandate

G. Keith Smith, M.D.

G. Keith Smith, M.D., an anesthesiologist, is co-founder of Surgery Center of Oklahoma in Oklahoma City. Contact: ^{KSmith@surgerycenterok.com.
REFERENCE
1 Zelman W. The conservative case for healthcare reform's individual mandate. Los Angeles Times Nov. 20, 2012}

After winding through the courts for the last two years, the U.S. Supreme Court will finally hear oral arguments concerning the constitutionality of ObamaCare on Monday, Tuesday, and Wednesday of this coming week beginning March 26.

Each day our General Counsel, Andrew Schlafly, Esq., will provide legal analysis of the oral arguments for that day, which you can review at www.FreeMediPedia.org. His comments will also be posted to the AAPS website at www.AAPSonline.org/scotus.

The outcome of this case has enormous implications for the freedom of every American, and public scrutiny of the Court's proceedings is accordingly high. Friday morning, outside the Court, "two individuals started the line at about 9:30 a.m. ¡ª 72 1/2 hours ahead of time," in hopes of being one of the few to view the arguments in person, according to ScotusBlog.com.

AAPS has taken every opportunity to educate the courts about why ObamaCare must be fully thrown out before it does irreparable harm to patients and to the practice of patient-centered medicine.

Three days after the law was signed, AAPS filed a suit in federal court, which is still pending, and has also filed 8 amicus briefs in U.S. Courts of Appeals and the U.S. Supreme Court. Learn more about AAPS efforts before the courts at the AAPS website and at FreeMediPedia.org.

¡Scroll down for a schedule of the hearings.

The New York Times has a useful overview of the schedule and the Heritage Foundation has a summary of the questions that will be heard. The Center for Objective Health Policy has created this easy-to-read and printable infographic, outlining the issues before the court and summarizing the possible outcomes. A final decision is expected by the end of June 2012.

While not allowing TV cameras, the Court has promised to release same-day audio recordings of the arguments which can be found at the court's website, http://www.supremecourt.gov/. Morning arguments should be available by 2pm EDT and afternoon arguments by 4pm EDT, according to the court. CSPAN will also broadcast the audio recordings the same day

AAPS has strongly urged the court for a full revocation of ObamaCare, but regardless of its final decision - AAPS will remain on the front line fighting to make sure socialized medicine is rejected and the patient-physician relationship is preserved.

As an editorial in Thursday's Wall Street Journal concludes, "The stakes are much larger than one law or one President. It is not an exaggeration to say that the Supreme Court's answers may constitute a hinge in the history of American liberty and limited and enumerated government. The Justices must decide if those principles still mean something."Court Schedule:

Monday, March 26 (10am to 11:30am):

Tuesday, March 27 (10am to noon):

Wednesday, March 28 (10am to 11:30am):

Wednesday, March 28 (1pm to 2pm):

In addition:

To help keep the truth about ObamaCare in front of the American people during the Supreme Court arguments, the free online viewing ¡ª sponsored by AAPS ¡ª of the documentary SICK & SICKER has been extended through Wednesday night, March 28. Watch it at http://www.aapsonline.org/sickandsicker and please spread the word to your contacts.

With All The Talk About "Transparency", Medical Prices Are Still A Secret

Click here to read article online and comment

By: Tamzin Rosenwasser, M.D.,

Suppose you went into a grocery store, and found no prices on anything. You ask a clerk how much five pounds of potatoes would be, and he asks you whether you are 65 or older. You’re taken aback, but you tell him you are 64, and he asks whether your income is less than $40,000.00 a year. Startled, you say it is more than that, and then he asks whether you have food insurance. Why would the price of potatoes depend on the buyer’s age, income, and insurance status, rather than on the cost of growing, transporting, and stocking the potatoes? That would be absurd.

Yet that’s how it is with medical care. I would be unable to find out, for example, the cost of an echocardiogram from the hospital where I did my residency. The price is different for different people.

The government instituted this ridiculous situation, in 1965, with Medicare and Medicaid. There is a lot of mythology about these programs, but few people understand them like the physicians who are on the front lines actually seeing the patients. For some of them, it has been a gravy train. They game the system. For others, it has been a disaster to go through medical school and residency, and come out a de facto servant to government programs, but of course, without "benefits" or retirement. If you are scrupulously honest, these programs will bankrupt you—even while turning you into Public Enemy #1.

Senators Ron Wyden and Charles Grassley have put forth the Medicare Data Access for Transparency and Accountability Act (the DATA Act) to open a database so that everyone can see how much money Medicare has sent to any physician enrolled in it. Regardless of the cost to provide medical services, the price the taxpayers are forced by the government to pay for other people’s medical care has gone down and down per procedure, per diagnosis, per office visit.

The public won’t see that, but it will hear about some isolated cases; for example, an Oregon neurosurgeon who allegedly performed multiple spine surgeries on the same patient, or a Florida physician accused of $3 million dollars in Medicare fraud.

Gaming the system is fraud. But the biggest fraud is the one perpetrated on the working people of this nation who are forced to pay for other people’s medical problems. When Medicare was first instituted, Americans were reassured that it would never cost the taxpayers more than $9 billion a year. It is more like $500 billion a year now.

Patients learn to game the system too. Workers must pay through their taxes for even the most trivial complaint when someone on Medicare makes an appointment for it—say for a cosmetic skin lesion that has been present for 30 years without causing any problem. Working people are also forced to pay for the consequences of other people’s smoking, excess drinking, or risky lifestyle choices. That’s fraud, perpetrated by the government on taxpayers. It’s hidden behind political smoke and mirrors.

Amazingly, we managed somehow for 189 years after 1776 without Medicare and Medicaid, and things were getting better and better—until Lyndon Johnson came up with a good fraudulent vote-buying scheme, and then a lot of people decided there was money to be made off medical problems with the taxpayers the losers.

So, Wyden and Grassley, open your database. But include a list of all the procedures and diagnoses, and what Medicare and Medicaid actually send the physicians as "reimbursement" so people can see that physicians—who spent years of their life in training while incurring tremendous debt—are paid about the same as auto mechanics. And also account for where the rest (about 80%) of the $500 billion goes.

That would be a good start for medical price transparency. And a good precedent for another database, one detailing just how much value politicians give taxpayers who pay their salaries.

Jemma Weymouth (301) 652-1558 jweymouth@burnesscommunications.com Sue Ducat Director of Communications (301) 841-9962 sducat@projecthope.org

A Lung Cancer Screening Insurance Benefit Would Save Lives at Relatively Low Cost, says Health Affairs Study If long-term smokers age 50 or more underwent careful CT screening and follow-up care, the cost per life saved would compare favorably with screening for cervical, breast, and colorectal cancers

Bethesda, MD -- Lung cancer screening would save thousands of lives at a relatively low cost if such tests were routinely covered by commercial insurers, according to a first-of-its-kind actuarial study in the April issue of Health Affairs. Lung cancer causes more than 150,000 deaths each year, making it the most lethal cancer in the United States, according to the authors of the study. Yet most insurance companies do not offer coverage for lung cancer screening for high-risk individuals, even though these tests can pick up early stage tumors. "These results demonstrate the cost efficiency of offering this benefit to people who are at high risk of lung cancer," said lead author Bruce Pyenson, an actuary and principal at the New York office of Milliman, a consulting and actuarial firm. "The evidence of the value of advanced screening technology for lung cancer has accumulated to the point where we can show very strong cost-effectiveness for the commercial population. We can also jump the needle on cancer mortality for the first time in years, and do so in a cost-effective manner." This study examined the costs and benefits of providing lung cancer screening through widely available low-dose spiral computed tomography (CT) to smokers and long-term former smokers ages 50 to 64--people at high risk of developing lung cancer. Most private insurers do not cover this screening because the evidence on the cost-benefit front has been scarce or conflicting, until now. The team of authors modeled insurer costs, assuming about 18 million people fell into that high-risk category and about half would get the screening if it were a covered benefit. Managed care reimbursement for a spiral CT, for example, can be as low as $180. Assuming costs around that level, the researchers found that the screening would cost insurance companies about $247 per member tested annually. When the total expense of screening was spread over the commercially insured population, the cost was under $1 per insured member per month. The study found that, if such screening in place for the last 15 years, today 130,000 more people would be alive under age 65, plus additional people alive over age 65. The cost per life-year saved would be lower than screening for cervical and breast cancer and comparable to the cost per life-year saved of screening for colorectal cancer. "This screening process offers a good value for the money and it saves lives," Pyenson said. "Late stage lung cancer is deadly, but if treated at early stage, survival is very good--that's what makes early detection so promising." Just last year, for example, the National Cancer Institute published results from a large randomized controlled trial that showed that screening with a technology called computed tomography or CT scans can reduce the risk of dying from lung cancer. Such CT technology has rapidly evolved over the last 15 years and now can both identify small, suspicious nodules and be used to determine growth patterns that indicate likely malignancies, Pyenson said. This study includes limitations. For example, the cost could be higher and the benefits lower if screening tests are not conducted according to best practice guidelines for price and follow-up. Accordingly, the authors emphasize the importance of efficient implementation of lung cancer screening, including insurers' selection of high-quality providers; use of best practices for managing clinical aspects of screening, especially if lesions are found; and rigorous tracking of outcomes. "Rolling out lung cancer screening with embedded continuous quality improvement can prove how care breakthroughs and advanced technology do not have to feed cost escalation," Pyenson added.

INVESTORS BUSINESS DAILY REPORTS

INSIDE MEDICINE By Dr. Michael Wilkes

Should care in foreign countries differ?I

Michael Wilkes, M.D., is a professor of medicine at the University of California, Davis. Reach him at drwilkes@sacbee.com.

From the Medical Director

READ THE AAPS ANALYSIS OF SUPREME COURT HEARINGS [3/26-28/2012]  OF PRESIDENT OBAMA'S HEALTH CARE REFORM LAW AND MEDICAID    See the lead article in the    "NEWS YOU MAY HAVE MISSED"      section of this website. [Too lengthy an article for this section]

From CMA ALERT issue2224--Jan 9, 2012

State budget shortfall to extend Medi-Cal cuts

When the California Legislature passed the 2011-12 State Budget in June, they assumed a sizable ($10 billion) increase in revenue based on projections of an improving economy. But early projections show the state will face a $12.8 billion deficit for the coming fiscal year.

To account for the uncertainty of tax revenue, the Legislature included a set of automatic “trigger” cuts that would be implemented if revenues fell short. The trigger cuts were divided into two tiers, depending on how far revenues fell short.

On December 13, California Governor Jerry Brown announced that, while revenues are higher than last year, they are not high as projected. He therefore pulled the budget trigger on the “Tier 1” cuts.

Of the scheduled reductions, the extension of the March 2011 cuts to Medi-Cal managed care plans – expected to yield a $15 million reduction to the Medi-Cal program – is the most likely to affect physicians.

When the 10 percent cut was passed, the Program of All-Inclusive Care for the Elderly (PACE), Senior Care Action Network (SCAN) and AIDS Healthcare Foundation were exempted. They are now included in the cut. Doctors working with those plans may see reductions.

The official list of trigger cuts also includes the following:

• $100 million to the University of California
• $100 million to the California State Universities
• $100 million to the Department of Developmental Services
• $110 million to the In-Home Supportive Services program, including $100 million in service hour cuts, and $10 million for local anti-fraud efforts
• $92 million to the Department of Corrections and Rehabilitation (CDCR)
• $72.1 million in increased county charges for youthful offenders sent to CDCR
• $30 million to the California Community Colleges backfilled with a $10 per unit fee increase
• $23 million to the Department of Education related to childcare funding
• $16 million to the California State Library related to library grants
• $15 million to the California Emergency Management Agency related to local vertical prosecution grants

All of the cuts listed above were effective January 1, 2012.

Contact: David Ford, (916) 551-2554 or dford@cmanet.org.

By Penny Starr

January 3, 2012 (CNSNews.com) – According to its latest annual report, the Planned Parenthood Federation of America (PPFA) received $487.4 million in tax dollars over a twelve-month period and performed 329,455 abortions.

Marjorie Dannenfelser, president of the Susan B. Anthony List, a pro-life organization that lobbies Congress to defund Planned Parenthood, called the organization an "abortion giant."

"With over a billion in net assets and a business model centered on abortion and government subsidies, it is time for Planned Parenthood to end its reliance on taxpayer dollars," Dannenfelser said in a statement. "Despite an unprecedented effort by statewide and federal leaders to defund them, a wave of former employees willing to testify against them, and uniform agreement amongst Republican presidential candidates that they should be defunded, Planned Parenthood continues full-steam ahead."

"They are unwilling to answer to the pro-life American majority that wants out of this business," Dannenfelser said.

As reported earlier by CNSNews.com, a spokesperson with Planned Parenthood told Bloomberg’s Businessweek last year that 90 percent of government funding the organization gets is from the federal government or from Medicaid.

¡¡LINDENHURST, N.Y. (CBSNewYork) An alarming rise in a potentially fatal bacterial infection known as whooping cough has prompted a warning from the Suffolk County Health Department.

It's a tell-tale sign winter is coming for children and their colds.

But what is going around this year is a potentially fatal bacterial cough known as pertussis or whooping cough, reports CBS .

It's a chronic cough, almost a barking sound, that can last more than three months, and it is spread easily through droplets.

"My wife is on a bus, educational bus, so she is with kids all the time every day. But she hasn't been sick yet," local resident Steven Piering said Tuesday.

WCBS 880 Long Island Bureau Chief Mike Xirinachs On The Story. The whooping cough outbreak started with 13 cases in Smithtown on Long Island in June. Since then it has spread to more than a dozen districts in Suffolk County.

The most recent case of whooping cough involves a student at 5th Avenue Elementary in Northport, where 11 cases have already been reported. On Tuesday night, parents told CBS's Hazel Sanchez they are growing concerned.

"That's kind of scary. I wonder what's going on, why this outbreak started. What's going on?" one resident asked.

"They get colds at home. They bring it on the bus. They bring it to school. They're bringing it home," a school bus driver told WCBS 880 Long Island Bureau Chief Mike Xirinachs.

And what's particularly concerning to health officials is this most recent outbreak has the highest number of cases reported since 2006 when there were 110 for the year. Now it's 216 cases of whooping cough for the year so far.

What's causing this sudden and sharp rise in whooping cough has yet to be determined, said Dr. Dennis Russo with the Suffolk County Health Department. He said it might be as simple as more doctors are detecting and diagnosing it, or it could be an increase in some parent's decision to forgo vaccinating their kids.

"We like to have everyone vaccinated and create a cocoon effect, so that everyone around them is vaccinated and the disease is milder," Dr. Russo said.

"I'm not too concerned because my son has the vaccine," added Maria Sangiorgi of Lindenhurst.

Health officials said early detection and antibiotic treatment are the keys to better health and preventing the spread of whooping cough.

The majority of the students who have been infected with whooping cough had been immunized, which health officials said may account for their milder illness.

Babies who are not yet fully immunized are the most at risk of death from the infection.

It began with a massive national system of health planning designed to do precisely the wrong thing — reduce services at a time of growing demand due to the advent of Medicare and Medicaid. This was predicated on a bumper sticker slogan, “A Built Bed is a Filled Bed,” that was certifiably wrong both in theory and in practice. Health planning failed and was soon repealed.

Then we moved on to all-payer hospital rate setting at the state level that was adopted by thirty states despite the lack of evidence that it could work in anything but the highest cost locations. These, too, were repealed in all but one state (Maryland) because the regulations were “incomprehensible” according to one supporter and failed to work.

But most states retained some form of Certificate of Need regulations, which even the Department of Justice and Federal Trade Commission said failed to contain costs and were seriously anti-competitive. But that is exactly why the American Hospital Association supported these laws — they did not want to risk having to compete against more efficient rivals.

Then large employers got behind “business coalitions on health” that were based on the idea that sharp-penciled business executives could make doctors practice medicine more efficiently. Ultimately these efforts simply added yet another level of bureaucracy to a system that was already for too bureaucratic and did little to solve the problems of efficiency or cost.

Then the “policy community” discovered the “problem” of uncompensated care. After endless fretting and worrying about this new crisis, nothing happened and the level of uncompensated care, which was always a trivial amount of money, did not change a whit. When first discovered uncompensated care accounted for 6% of hospital costs and 13 years later it was still only 6% of hospital costs.

But the discovery of Uncompensated Care led to another discovery — the uninsured. Now here was an issue that would keep the policy community well-employed for decades and be the rationale for an entire bevy of new programs and initiatives. Yet over the course of the next two decades the level of non-insurance barely changed, in spite of all those programs. When it was first measured in 1987 about 84% of the population was insured and 16% uninsured. Twenty years later it was still 84% and 16%.

Of course, to effectively discuss the problem of the uninsured, policy makers would have to know something about insurance. Unfortunately, they learned just enough of the terminology to be dangerous. They completely misunderstood the meaning of ideas such as “risk pooling” and “adverse selection.”

But they had all the information they thought they needed to tell insurance companies how to run their businesses. They began by endorsing “mandated benefits,” which substituted the judgment of politicians for the buyers and sellers of health insurance in deciding what should and should not be covered in a health insurance policy. Over time over 2,000 specific laws would be enacted by the states. These laws did a lot to raise the price of coverage and make insurance less affordable, but the politicians were never blamed for these added costs. Only insurance companies were blamed.

But mandates did not address the “great problem” of the uninsured, so some progressive states went further. They adopted universal health programs of one sort or another. These programs were adopted with great fanfare by politicians and hailed by publications like the New York Times as great breakthroughs. But one-by-one they all failed and were repealed. In some cases they were never actually implemented or in other cases were repealed only after much damage, but the only thing truly “universal” about them was failure.

Then the states set out to “reform” their insurance markets, and once again ended up not “reforming” them but destroying them. See our posts on the NAIC small group reforms and the more ambitious individual market reforms in New Jersey and other states.

We haven’t yet mentioned The Federal HMO Act or ERISA because these laws wouldn’t have much impact on the market until the mid-1990s, but we will be getting to them in future posts.

All of this was done in a mere twenty years. All of it failed, but only after creating much turmoil and doing real damage to the health care system, the economy, and the lives of families. It all adds up to the greatest experiment in social engineering of our lifetimes.

You may have noticed in this sorry saga that all of it was pushed by academics and politicians, and all of it was imposed upon hospitals, doctors, employers, and insurance companies. Who is missing? The patient/consumer/employee/taxpayer.

All of it was a clash between powerful elite interests who simply used concern for “the folks” as an excuse to gain power. Nobody in this story trusted the people to make their own decisions or control their own destinies.

The pretext of their activities was to control health care costs, improve health care quality, and ensure access to health care services. All of this effort failed to have any impact whatsoever on any of that. The nation would have been better served had none of this happened.

For more information: GMScan@comcast.net

From the Director: Also search "medically uninsured" in this section of the HCREI website for more information concerning this subject.

From the Drudge Report   11/26/2011

An Electronic Eye on Hospital Hand-Washing

Fixes looks at solutions to social problems and why they work.

Tags:

Hospitals, Infections, North Shore University Hospital, Surgery and Surgeons, video

Richard Lee for The New York Times    11/26/2011

A board in the surgical intensive care unit at North Shore University Hospital in Manhasset, N.Y., reminds people to sanitize their hands.    

Beeps and blinking lights are the constant chatter of a hospital intensive care unit, but at the I.C.U.’s in North Shore University Hospital in Manhasset, N.Y., the conversation has some unusual contributors.  Two L.E.D. displays adorn the wall across from each nurses’ station.  They show the hand hygiene rate achieved:  last Friday in the surgical I.C.U., the weekly rate was 85 percent and the current shift had a rate of 91 percent.  “Great Shift!!” the sign said.   At the medical I.C.U. next door, the weekly rate was 81 percent, and the current shift 82 percent.

That’s too low for a “Great Shift!!” message.  But by most standards, both I.C.U.’s are doing well.  Those L.E.D. displays are very demanding — health care workers must clean their hands within 10 seconds of entering and exiting a patient’s room, or it doesn’t count.   Three years ago, using the same criteria, the medical I.C.U.’s hand hygiene rate was appalling — it averaged 6.5 percent.   But a video monitoring system that provides instant feedback on success has raised rates of hand-washing or use of alcohol rubs to over 80 percent, and kept them there.

Hospitals do impossible things like heart surgery on a fetus, but they are apparently stymied by the task of getting health care workers to wash their hands. Most hospitals report compliance of around 40 percent — and that’s using a far more lax measure than North Shore uses.   I.C.U.’s, where health care workers are the most harried, usually have the lowest rates — between 30 and 40 percent.  But these are the places where patients are the sickest and most endangered by infection.

How do hospitals even know their rates?   Some hospitals track how much soap and alcohol gel gets used — a very rough measure.  The current standard of care is to send around the hospital equivalent of secret shoppers — staff members who secretly observe their colleagues and record whether they wash their hands.   This has serious drawbacks:  it is expensive and the results are distorted if health care workers figure out they’re being observed.   One reason the North Shore staff was so shocked by the 6.5 percent hand-washing rate the video cameras found was that measured by the secret shoppers, the rate was 60 percent.

Richard Lee for The New York Times

From the Director: Our system of health care needs fixing not replacement by a system that fails everywhere it's been tried.

Supreme Court to Pick Obamacare Lawsuits Next Month
The Supreme Court will take its very first look at the lawsuits challenging Obamacare next month when members of the high court meet on November 10 to decide which, if any of the multiple cases it will consider.

The Obamacare law has come under strong opposition from pro-life groups because it fails to include provisions that would prevent taxpayer financing of abortions and because it prompts concerns about rationing health care for elderly and disabled people. Leading pro-life groups ranging from National Right to Life and Americans United for Life to the nation’s Catholic bishops and the Family Research Council all opposed the bill because of their pro-life concerns.

Today, the SCOTUS blog broke the news about the Supreme Court taking its first look at the various legal challenges to the law.

“Five of the six pending petitions (the sixth is not ready yet) were distributed to the Justices’ chambers on Wednesday, for consideration at that private session,” it reported. “Although a grant of review is not assured, that is highly likely, since all sides agree that the Court should take on the controversy, and the constitutionality of a key provision of the new law has been decided differently by federal appeals courts.”

The high court is expected to announce the results of its preliminary look at the lawsuits by November 14, although it will not be rendering a decision. The announcement will merely indicate which of the lawsuit the Supreme Court will take. With some federal judges upholding the law and some striking it down in full or in part, the decision by the top court on which cases or cases it will take could point to the direction the court may go when it hands down a decision next summer. http://www.lifenews.com/2011/10/26/supreme-court-to-pick-obamacare-lawsuits-next-month/

From the Director;  Supreme Court Promises a Final Decision in June of 2012

WASHINGTON (AP) -- The Drug Enforcement Administration says people turned in more than 188.5 tons of unwanted or expired prescription medications in the agency's third National Prescription Drug Take-Back Day on Oct. 29.

The DEA initiative that began 13 months ago has resulted in almost 500 tons of medications being taken out of circulation, with assistance from state, local and tribal law enforcement partners as well as community groups.

For the most recent collection day, 5,327 sites were set up around the country.

DEA Administrator Michele Leonhart says the amount of drugs collected during the three Take-Back Days held so far speaks volumes about the need to develop a convenient way to rid homes of unwanted or expired prescription drugs, which could fall into the hands of abusers or pollute the environment.

© 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Learn more about our Privacy Policy and Terms of Use.

From the AAPS Newsletter 10/28/2011
Your Medical Privacy–
Another ObamaCare Casualty

CLICK HERE TO READ ARTICLE ONLINE AND COMMENT

by Elizabeth Lee Vliet, M.D.

"...It was a sad day recently when a married menopausal woman learned that her recent Pap test was positive for human papilloma virus (HPV). “How could this happen?” she asked. “I have not had sex with anyone but my husband since we married 30 years ago.”

Over the past year, her husband had several trips overseas for weeks at the time. She suspected the positive HPV indicated he had been unfaithful, but when she asked him, he said, “Oh, it can be latent for a long time.”

I showed her my records from 2008 and 2009: Paps were HPV negative. Her newly positive HPV likely means her husband had had sex with an infected person during his travels. She broke down weeping.

HPV is an increasingly prevalent sexually transmitted disease that can hit women of all ages and increases the risk of invasive cervical cancer—another reason she was upset about becoming HPV positive. She now faced hard decisions. As she left, I felt sad watching her suffer with the impact of this news on her marriage.

This kind of painful situation happens daily in doctors’ offices. Such personal and private pain should remain between the patient, physician, and family.

My patients are horrified at the idea that such personal health information could be released to a government database, open to anyone with access to the system. But your privacy is another casualty of the damage caused by Obamacare’s new rules and regulations governing health professionals.

The U.S. Department of Health and Human Services (HHS) recently released new federal regulation that requires private health insurance companies to give health records of every person they insure to the government.

Although government jargon in the HHS rules distracts from their real goal, the end result is clear: government bureaucrats would have access to the health records from all private insurance companies—including yours—whether you want them to or not.

Under the new rules, the Federal government will own and control your medical records, without your permission. The government will be your new “overlord” controlling your medical information on federal computers in a federal database. You will no longer be able to control who sees your medical information.

The most personal aspects of your life are slated to be sent to Washington by your private insurance carrier for all your medical visits. This provides individual medical data for the federally run Comparative Effectiveness Research coordinating panel of experts. This panel of government-appointed experts, copying the rationing approach in Britain, will decide what treatment is allowed for individuals, based on government criteria such as: 

• cost of treatment
• effectiveness as determined by government experts
• your “quality life years” remaining 

Beyond privacy issues, there is major concern about safety of your medical information when hackers can penetrate even highly secure federal agency computers such as the Pentagon, VA, and Department of Defense. Hackers stole millions of medical records from the Veterans Administration, and patients were at risk for identity theft.

David Blumenthal, M.D., the President’s former “health information czar,” admitted that “no infrastructure exists in most areas of the country for secure health information exchange among providers and between providers and consumers.”

Medical privacy? The Obama administration’s health czars seem more concerned about power and control over your medical care than protection of your private medical information.

In summary, the Obamacare “Patient Protection and Affordable Care Act” of 2010 and the “Stimulus Bill” of 2009 gave the federal government total control of very personal aspects of your life: 

• money that is currently in the private healthcare sector
• your private personal and family health information
• your access to timely medical care
• the types of treatment you will be allowed to have, based on your age and value to society..." 

Elizabeth Lee Vliet, M.D. is a preventive and climacteric medicine specialist with medical practices in Tucson AZ and Dallas TX that take an integrated approach to evaluation and treatment of women and men with complex medical and hormonal problems. Dr. Vliet is also President of International Health Strategies, Ltd., whose mission is twofold: liberty and privacy in treatment options and preservation of the Oath of Hippocrates focus on the individual patient.

Abortion Nearly Triples Breast Cancer Risk, New Study Finds

by Steven Ertelt | Washington, DC | LifeNews.com | 11/28/11 12:12 PM

A new study published by scientists who examined diabetes mellitus type 2, reproductive factors, and breast cancer found a statistically significant association showing a 2.86-fold increased breast cancer risk from one induced abortion.

The study, led by Lilit Khachatryan, included researchers from Johns Hopkins School of Public Health and the University of Pennsylvania. Khachatryan is from the Department of Public Health, American University of Armenia, Yerevan, Armenia; Robert Scharpfb is from the Johns Hopkins School of Public Health and Sarah Kagan is from the School of Nursing at the University of Pennsylvania.

The study, published in Taylor & Francis, also found that delaying a first full-term pregnancy, which is frequently done by women having abortions, also raises the breast cancer risk wheras giving birth resulted in a 64% reduced risk.

Khachatryan’s team reported a statistically significant 13% increased breast cancer risk for every one year delay of a first full term pregnancy (FFTP), with delayed FFTPs until ages 21-30 or after age 30 resulting in 2.21-fold and 4.95-fold increased risks respectively. On the other hand, women with FFTPs before age 20 did not see a comparable breast cancer risk.

They wrote: “Any birth was protective (adjusted OR = 0.36, 95% CI 0.20–0.66). Each year delay in first pregnancy increased risk (adjusted OR = 1.13, 95% CI 1.01–1.27) as did induced abortions (adjusted OR = 2.86, 95% CI 1.02–8.04).”

Karen Malec of the Coalition on Abortion/Breast Cancer said she is not surprised by the findings because, “Fifty-four of 67 epidemiological studies since 1957 report an abortion-breast cancer link (not counting biological and experimental evidence).”

The study was not without some problems, Malec said, as the authors only one severely criticized study (Melbye et al. 1997) to make a claim that they did not believe there was enough evidence to prove the abortion-breast cancer link. Although Melbye’s team found no overall increased risk, they reported a statistically significant 89% increased risk for those having abortions after 18 weeks gestation.

Malec also noted another problem.

“Khachatryan’s group cited recall bias as a possible limitation of their study, but tellingly provided no citations to support that claim. According to this hypothesis, the only reason that scientists find an ABC link is not because abortion really does raise risk. Rather, more women with breast cancer accurately report their past abortions than do healthy women,” she said.

“Similarly, authors of the Uzbekistan Health Examination Survey (which received financial and technical assistance through the US AID-funded MEASURE DHS+ program) said induced abortion is not negatively stigmatized in former Soviet states and that the collection of data is, therefore, successful,” she added.

“National Cancer Institute (NCI) branch chief Dr. Louise Brinton and her colleagues admitted in a 2009 study led by Jessica Dolle that abortion raises risk,” she said. “”They demonstrated that they know recall bias is a red herring used to prop up abortion. After Brinton and the NCI told women during the agency’s 2003 workshop to disregard retrospective studies because they were flawed due to recall bias, Brinton and Jessica Dolle and their colleagues subsequently used supposedly “flawed” data from their group’s 1994 and 1996 studies for their 2009 study.”

She notes that Dr. Joel Brind, one of the world’s foremost researchers on abortion and breast cancer, says, “The recall bias argument has been repeatedly disproved in the literature.”

Brind concluded that Khachatryan’s team “did not-and perhaps were not allowed to-characterize their findings honestly in the politically correct atmosphere of the U.S. and Europe. The good news is that they were able to report their findings in a prominent peer-reviewed journal at all.”

Almost two decades ago, the state made Sacramento County the testing ground for a new model of delivering dental care to poor children. Officials envisioned a managed care system that would control costs and improve children's ability to see a dentist

Today that model persists - but state data show that the county has consistently produced one of California's worst records for care.

Critics - including local dentists, county officials, school nurses and family members - contend that Sacramento's special model of care forces many children to wait months or even years before receiving needed treatment, even if they have broken or rotting teeth, or are in so much pain that they can't chew.

This was started  in the teaser article on WSJ on-line and I found it in full

I'm not a Catholic but I say  GO POPE!"  by Peggy Noonan

A Battle the President Can't Win

By Peggy Noonan · Saturday, February 4, 2012

His decision on Catholic charities makes Romney's big gaffe look trivial.

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» Wednesday, December 28, 2011 I The Sacramento Bee A9

A good list for hospital shoppers - 405 chances
Sunday, January 15,2012 I The Sacramento Bee