|
HEALTHPLANUSA . NET |
QUARTERLY NEWSLETTER |
|
Community
For Affordable Health Care |
Vol VI, No 2, July, 2007 |
Utilizing the $1.4 Trillion Information Technology Industry
To
Transform the $2 Trillion HealthCare Industry into Affordable HealthCare
In This Issue:
1. Featured Article: Is Living Longer Worth It? Reason
Magazine
2. In the News: Global
Health Spending Rises
3. International
Medicine: Private Health Insurance Well on the Way to Recovery in the UK
4. Medicare: Medicaid Patients Get the Short End
of the Government's Stick
5. Lean HealthCare: Trouble When Medical Test Doesn't
Serve Medical Need
6. Medical Myths:
Health Care For All
7. Overheard on Capital Hill: State
Efforts to Increase Transparency in Government Spending
8. What's New in US
Health Care: Insurance Folly,
By JOHN C. GOODMAN, PhD, WSJ
9. Health Plan USA: Single-Payer Health Care By Any Other
Name Is Still A Monopoly
* * * * *
1. Feature
Article: Is Living Longer Worth It? Reason
Magazine
Pursuing the longevity
dividend at Transvision 2007 in Chicago, Ronald Bailey | July 24,
2007
CHICAGO—In advance of the World Transhumanist
Society's annual confab, Transvision
2007, the Institute
for Ethics and Emerging Technologies (IEET) held a pre-conference meeting
in a non-descript ballroom at the Fairmont Hotel. The room was packed with 50
or so people interested in the issue of securing the "longevity
dividend." Not everyone in the audience would call themselves
"transhumanists" but all were interested in figuring out how to sell
longer lives to the public. This was not a crowd of wild-eyed utopians. The
audience was diverse—about one third women and two-thirds men, and ranged from
doctors, professors, and economists to people who had lived in alternative
communities and even a few high school students. One might think that longer,
healthier lives should be an easy sell, but, in fact, there are people who
believe that dramatically extending human lives would be a bad idea.
I attended the IEET conference as a speaker,
to give a talk on the political economy of the longevity dividend. What is the
longevity dividend? It's a way of rebranding the quest for extending human
lives in a politically palatable way. The idea behind the longevity dividend
was expressed in an article in The Scientist which argued that
research should be directly targeted at slowing the aging process by seven
years. As University of Illinois-Chicago demographer Jay Olshansky put it at
the conference: It is a new paradigm for health promotion and disease
prevention in the 21st century. Olshansky, one of the co-authors of
the article in The Scientist unveiling the campaign to push for the longevity dividend,
argues that slowing the aging process by seven years would mean that
age-related diseases-cancer, cardiovascular disease, Alzheimer's-would be cut
in half at every age. "If we succeed in delaying aging, the bonuses will
be an extension of healthy life and a drastic reduction in health care
costs," said Olshansky.
Olshansky argues that the old paradigm of
directly targeting diseases is about to run out of steam. Even if all cancer,
all heart disease and all diabetes were eliminated, it would add only 3 more
years to average life expectancy in the United States. So if researchers want
to achieve big gains in lifespan and healthspan they have to go after the aging
process itself. For adults the doubling time for risk of death is seven years.
If you slow aging by seven years, you cut the risk of death at any age in half,
and cut the risk everything else that goes wrong with the body in half too. The
idea is not to make people older longer, but to make them younger longer. Not
being libertarians, Olshansky and other advocates for the longevity dividend
want to reprogram $3 billion in federal biomedical research to target aging
itself.
At the conference, David Meltzer, a medical
economist from the University of Chicago, warned that the longevity dividend
could have downsides too. For example, one should consider what follow on costs
may flow any particular intervention. If someone is saved from a heart attack,
he or she may now live long enough to get cancer which could cost more to
treat. In addition, Meltzer noted that most analyses of the benefits of medical
interventions measure only future medical costs. But that fails to account for
total costs by including future consumption—food, clothing, housing—in the
calculations as well . . .
My own talk looked at research done by two
University of Chicago economists, Kevin Murphy and Robert Topel, who tried to
put a dollar figure on the value of health and longevity. I began by pointing
out that the quest for longer healthier lives has some formidable opponents,
including Johns Hopkins University professor and author of Our Posthuman
Future, Francis
Fukuyama, bioethicist Daniel
Callahan, and former chairman of President Bush's Council on Bioethics, Leon
Kass. Opposition to slowing the approach of the grim reaper also got a
hearing the mainstream with The Atlantic Monthly's 2005 article
decrying, "The Coming
Death Shortage." Of course, they are wrong . . .
Transhumanist George Dvorsky, one of the
honchos responsible for the Betterhumans
portal, did a quick run through of the objections to attempting to boost
healthy human life expectancy, including the appeal to nature (death is natural
therefore good); undesirable psychological consequences (long-lived people
would be bored); and undesirable social consequences (nursing home world). If
you want at thorough debunking of these and other objections to life extension,
may I suggest that you read my book Liberation
Biology?
Finally, theoretical biogerontologist Aubrey
de Grey, critiqued the idea of the longevity dividend from the point of view of
someone who is pushing for a more comprehensive research attack on aging
itself. De Grey's new book, Ending
Aging: The Rejuvenation Breakthroughs that Could Reverse Human Aging in Our
Lifetime is out in September. De Grey said, "I am pessimistic
about the longevity dividend, but I strongly support it." Why pessimistic?
First, he is not pessimistic about the prospects of increasing life expectancy.
But De Grey is pessimistic about the idea that the way the campaigners for the
longevity dividend want to pursue it will result in reduced medical costs. Why?
Because he pointed out that American life expectancy has already increased by
about seven years since 1960 and medical costs have obviously not gone down.
Inherent in the idea of the longevity dividend is the notion of compressed
mortality, that is, the period of decrepitude at the end of life will be
shortened. De Grey argues that this not biologically plausible. Medical
interventions can reduce the risk of death and disability at various ages, but
eventually, frailty will come—it will just come later. As Murphy and Topel
note, American men are about 6 years "younger" in 2000 than they were
in 1970-a 55 year old in 2000 is equivalent to a 49 year old from 1970. Frailty
may be unavoidable, but pushing it off for as long as possible is still a great
idea . . .
I will be covering the rest of the World
Transhumanist Assocation's Transvision 2007 conference through Thursday.
Luminaries such as William Shatner, Ariana Huffington, Ray Kurzweil, Ed Begly
Jr., and Peter Diamandis are scheduled to speak.
To read the entire article, go to www.reason.com/news/printer/121564.html.
Ronald
Bailey is Reason's science correspondent. His book Liberation
Biology: The Scientific and Moral Case for the Biotech Revolution is
now available from Prometheus Books.
* * * * *
2. In the News: Global health spending rises, FT, By Nicholas
Timmins, July 19 2007
Global
spending on health is continuing to outpace economic growth, with most
countries having seen a near doubling of expenditure as a share of national
income over the past 25 years, the Organisation for Economic Co-operation and
Development reported yesterday.
Per
capita health spending has risen more than 80 per cent in real terms between
1990 and 2005, outpacing the 37 per cent rise in gross domestic product per
head.
In
1970, across the OECD nations, health accounted for just 5 per cent of GDP. By
2005 that had reached 9 per cent, with a quarter of OECD countries spending
more than 10 per cent of national income on health.
www.ft.com/cms/s/a5f5dfe6-358f-11dc-bb16-0000779fd2ac.html
* * * * *
3. International
Medicine: Private Health Insurance Well on the Way to Recovery in the UK
The number of people with private insuranace has
risen significantly for the first time in five years.
Bupa Hospitals lures NHS patients By
Nicholas Timmins, Public Policy Editor, FT, July 13 2007
Bupa
Hospitals is launching an advertising campaign designed to persuade National
Health Service patients to have operations in their local Bupa hospital. The
drive comes as ministers press ahead with promoting choice in the NHS.
The
£450,000 campaign marks the first time the private sector has advertised
directly to NHS patients. Slots in local newspapers will tell readers that
there is now “somewhere surprising you could go on the NHS: Bupa Hospitals”.
Richard
Jones, Bupa Hospitals’ commercial director, said: “This a sign of the way the
NHS is changing and a bold move into the new world. Our core business remains
private healthcare. But there are growing opportunities to do NHS business that
are terribly important to us.”
The
campaign will run in two phases: the first will run immediately for three
months; a second big campaign will start in autumn as Bupa Hospitals changes
its name to Spire Healthcare following the £1.44bn private equity purchase by
Cinven of the hospitals from Bupa.
The
advertising campaign, approved by the health department under its new
advertising code for the private sector and the NHS, was bitterly attacked by
Unison, the largest health union.
Karen
Jennings, Unison’s head of health, said the campaign “is another example of the
damage being caused by bringing private companies into the NHS”.
“The
NHS will lose out twice because money will be diverted into the pockets of
private providers and NHS hospitals will be forced to use taxpayers’ money to
compete for business”.
In
the past, Capio hospitals has advertised its NHS treatment centres to family
doctors through the trade press but not to the public. . .
William
Laing of the analysts Laing and Buisson said that, if patients chose them,
private hospitals could probably accommodate some 250,000 to 300,000 NHS
treatments a year - including some diagnostic procedures - without raising
their occupancy rates above 70 per cent or so. He said private hospitals were
reluctant to exceed this figure for fear it reduced rapid availability for
private patients . . .
Bupa
Hospitals has to change its name following its sale by the Bupa Group. Mr Jones
said the choice of Spire Healthcare reflected the company’s desire to spread
its business outside hospital into diagnostics, community and primary care,
both for private patients and the health service. The name change is scheduled
to take full effect in the autumn.
To
read the entire article, go to www.ft.com/cms/s/cef82450-30d8-11dc-9a81-0000779fd2ac.html.
The NHS does not give timely access to healthcare,
it only gives access to a waiting list.
* * * * *
4. Medicare: Medicaid Patients
Get the Short End of the Government's Stick, WSJ,
July 27, 2007
Your page-one article "Note
to Medicaid Patients: The Doctor Won't See You1," July 19, provides
a shocking commentary on the difference in attitudes and behavior to two
populations, the elderly and the poor.
As the first chairman of the
Secretary's Medicaid Advisory Committee in the mid- and late-1960s, I can
attest that these differences existed from the first days of Medicare and
Medicaid.
Of course it is shocking to find
the difference in payment -- and treatment -- for the two populations by the
same government.
If $357.58, the amount paid by
Medicare, is the "correct" payment for the treatment of a broken arm,
then how can $184.51 be the correct payment for a Medicaid patient? Either
Medicaid is underpaying or Medicare is overpaying. We all know which.
Even so, it is also shocking that
so few physicians will see Medicaid patients given that these physicians were
more than willing to accept and be the beneficiaries of the large subsidy by
government to their medical education.
I would suggest that each person
entering medical school be given a choice: Don't take the subsidy (somewhere in
the neighborhood of $150,000 to $200,000) and be free to choose your patients
as you see fit, or accept the subsidy and in return agree to treat all patients
who need your help. This isn't involuntary servitude. In the words so dear to
all, the prospective physician would be "free to choose."
http://online.wsj.com/article/SB118550067282079877.html?mod=todays_us_page_one
Rashi Fein, Professor of the Economics of Medicine, Department of
Social Medicine,
Harvard Medical School, Boston
Government is not the solution
to our problems, government is the problem.
- Ronald Reagan
* * * * *
5. Lean HealthCare: Trouble when medical test doesn't serve medical need, By Dr. Michael
Wilkes – Sacramento Bee, Saturday, July 21, 2007
Kim and Robby have lived in the United States for
nearly seven years and have been married for five years. They share a
two-family home with their extended family. They are very eager for children, and
Kim recently learned she is pregnant.
When the couple sit down to talk about the pregnancy,
Kim is silent; her husband explains that she doesn't speak English. Robby is
friendly, engaging and crystal-clear about the purpose of their visit. He says
that his wife has been pregnant four times, and each time she's had "an
elective miscarriage."
The couple -- or at least the husband -- are eager for
a boy. Each of the past pregnancies has been a girl. Today, they are asking for
a test that will determine the sex of their fetus.
Robby understands that sex-determination testing is
expensive and not covered by his insurance, but he willingly agrees to pay for
the procedure in cash. A doctor can legally order the test, but is this an
appropriate reason for a "medical" test -- even if the only benefit
is personal preference?
Some people request gender selection to avoid serious,
life-threatening genetic diseases that run in a family. These diseases are
often found only in males (they are sex-linked), and couples choose to avoid
these diseases by gender selection.
Others wish to select their baby's sex for social or
cultural reasons. For example, one family I care for has five girls and the
parents want their next child to be a boy.
When sex selection is used to prevent a genetic
disease, its indication is considered medical and is well accepted. If the
decision to select a child's sex is done to balance a family, for cultural or
personal purposes, then the process is considered social. Is there a difference
between the two?
In the United States, we have a strong legal and
ethical tradition that favors reproductive choice. We routinely offer prenatal
screening for a host of diseases with the option of early termination. Is
selection of sex so different that we want to prohibit this type of
reproductive choice?
Opponents -- including many leading medical groups --
say the practice devalues women. In nations such as India, nearly all elective
terminations are of females in part due to cultural traditions such as the requirement
of a dowry. This is not the case here.
Some may feel uncomfortable using pregnancy
termination as a method of gender selection, but what about using sperm
sorting, which occurs prior to fertilization? Because it is the male's sperm
that determines the sex of the offspring (the female provides two X chromosomes
while the male can provide either an X or a Y chromosome), attention has
focused on separating male sperm from female sperm. The process was initially
developed to sort animal sperm (namely bulls), but has evolved into a process
that is effective and generally safe for humans.
No matter what technique is used to select gender, the
process raises social and ethical problems now and in the future.
This is a case in which technology has moved ahead by
leaps and bounds but we've not yet had the debate and discussion to develop a
rational approach to use of the technology. The doctor's job is not merely to
order tests requested by patients. Our integrity is based on reasoned, rational
logic and not cultural preference. . .
To read the entire article, go to www.sacbee.com/107/story/281917.html.
Michael Wilkes, M.D., is a professor of medicine at the University of
California, Davis. Identifying characteristics of patients mentioned in his
column are changed to protect their confidentiality. Reach him at drwilkes@sacbee.com.
* * * * *
6. Medical Myths: Health Care For All
Editorial: Health care
for all? Affordability grows ever more ephemeral, Sacramento Bee, Wednesday,
June 13, 2007
There has been no shortage of health care plans in the
Legislature this year. Gov. Arnold Schwarzenegger, legislative leaders from both
parties and individual lawmakers are proposing various means of expanding
access to health insurance and health care.
But none looks seriously enough at the underlying
problem that prevents people from gaining access to care in the first place: It
costs more than they can afford to pay.
With health care inflation rising at a faster rate
than the cost of living, that problem is only getting worse. Requiring more
employers to buy insurance for their workers, regulating insurance companies or
raising taxes to finance health care for all will not solve the problem as long
as the core costs keep going up.
Part of this is inevitable. An aging population uses
more care, and new technology and drugs cost more. But there are some things
that could be done on the margins.
The governor's plan comes closest to attacking the
issue head-on. Schwarzenegger wants to increase payments to doctors and
hospitals that care for the poor so that those costs are no longer shifted to
paying customers through higher insurance premiums. And he wants to boost
prevention and wellness by giving people incentives to avoid behavior that is
bad for their health.
But more could be done.
One key step in controlling costs is gathering more
information, so consumers and people who buy coverage for them can know which
doctors, hospitals and labs are doing the best job for the least money.
If the state would collect more raw information on
doctor and hospital performance, the government, through its provision of care to
the poor, could use it to create incentives for the most effective, efficient
care. Private payers could do the same.
Rather than being rewarded only for ordering expensive
procedures and tests, doctors might earn more by spending more time with their
patients or using their office staff to coach chronically ill people to better
manage their diseases.
[Would you, Mr. Editor, spend more time on the job,
say an extra hour for no additional pay? If the doctor saw fewer patients to
give this extra time to another patient, would Medicare or Medicaid or Blue
Cross pay more per patient to keep the income level? Would Congress or the
Legislature appropriate more money per patient to allow this to happen? Those
that don’t understand the practice of medicine, are using their podium to
pontificate from the editorial page total nonsense that further confuses the
issues.]
Those are only a few of the possible changes that
might restrain some growth in health costs. While legislative leaders and the
governor negotiate on the big question of expanding access to insurance, it
would be great if some rank-and-file lawmakers spent the time to develop a
comprehensive, credible plan to contain costs. That way, whatever program to
expand access is approved might actually have a chance of succeeding.
[The best way to contain costs is to get the lawmakers
busy doing something besides health care. They have too much time on their
hands being busybodies about issues they don’t understand. Can we go forward to
a part-time legislature? Say meet in January every other year for a month or
two and then go home and experience life including healthcare in the trenches?]
www.sacbee.com/110/v-print/story/219021.html
* * * * *
7. Overheard on Capital
Hill: State Efforts to Increase Transparency in Government
Spending
Last
year, thanks to the leadership of Senator Tom Coburn (R-OK), Congress passed
and
President Bush signed into law the Federal
Funding Accountability and Transparency Act
(S.2590) which passed House and Senate in September of 2006.
The bill creates a free, publicly searchable website for all federal contracts
and grants. It would
provide access to data on all payments of more than $25,000, with exceptions
for classified
information and federal assistance payments made to individuals. Also excluded
are federal
employees. The OMB has set up the interim website and is requesting feedback
at:
www.federalspending.gov.
The federal effort has inspired elected officials at the state level to work to
empower taxpayers to become fiscal watchdogs by making expenditures available
on the Internet.
Kansas became the first state in 2007
to sign into law comprehensive legislation mandating
the creation of a website
detailing state expenditure information. Minnesota quickly followed
and Gov. Pawlenty signed legislation
at the beginning of May. Oklahoma Gov. signed
legislation on June 5th,
and Governor Perry signed transparency legislation into law on June
15. Hawaii has passed similar
legislation. Governor Lingle has until July 10 to veto all bills
sent to her, but since the bill
was not on the list of potential vetoes, she is expected to sign the bill soon.
"That is the problem with government
these days. They want to do things all the time; they are always busy thinking
of what things they can do next. This is not what people want. People want to
be left alone to look after their cattle."
--Obed
Ramotse, father of Precious Ramotswe, head of The No.1 Ladies' Detective Agency
"The No. 1 Ladies' Detective Agency" by Alexander McCall Smith
A Detective Novel
* * * * *
8. What's New in US
Health Care: Insurance Folly, By JOHN C. GOODMAN,
WSJ,
July 27, 2007
The State Children's Health
Insurance Program (Schip) was originally a Republican program to provide health
insurance to children in near-poor families who did not qualify for Medicaid.
Democrats now want to expand Schip to children of the middle class.
Their efforts to do so are
rightly being resisted by the White House, but Senate Finance Committee
Republicans have already caved on an unwise compromise to make more people
eligible for Schip.
On the surface, congressional
Democrats appear to be rescuing children from the scourge of uninsurance. The
reality is quite different. If they get their way, millions of children will
have less access to health care than they do today, and the same will
surprisingly be true for many low-income seniors.
Studies by MIT economist Jonathan
Gruber show that public insurance substitutes for private insurance and the
crowd-out rate is high. In general, for every extra dollar spent on Medicaid,
private insurance contracts by 50 cents to 75 cents. For Schip, depending on
how it is implemented, private insurance could contract by about 60 cents.
These findings make sense. Why
pay for something if the government offers it for free? Under congressional
proposals to expand Schip, the crowd out would likely be much worse. The
reason: Almost all the newly eligible beneficiaries already have insurance.
The Senate bill would expand the
eligibility for coverage under Schip to families with incomes 300% above the
federal poverty level ($62,000), from its present ceiling, 200% above the
poverty level. House Democrats want to push coverage to 400% ($83,000 annual
income).
Yet almost eight of every 10
children whose parents earn from 200%-300% more than the poverty level already
have private health-care coverage, according to the Congressional Budget office
(CBO). At incomes between 300% and 400% more than poverty, nine of every 10
children are already insured.
What about the eight to nine
million children currently uninsured? Nearly 75% of them are already eligible
for Medicaid or Schip, according to the CBO. So the main result of the
Democrats' proposal to expand Schip will be to shift middle-class children from
private to public plans.
Why is that bad? One reason is
that most Schip programs pay doctors at Medicaid rates -- rates so low that
Medicaid patients are having increasing difficulty getting access to health care.
Anecdotal evidence suggests that U.S. Medicaid patients already must wait as
long for specialist care and hospital surgery as in Canada.
Many doctors won't see Medicaid
patients. Among those that do, many will not accept new patients. As a result,
children who lose private coverage and enroll in Schip are likely to get less
care, not more.
There is also the issue of who
exactly will be covered. Republicans want to restrict Schip to children. The
Democrats want adults covered as well. Even under the current system,
children's health insurance is increasingly a ruse to cover adults. Minnesota
spends 61% of Schip funds on adults. Wisconsin spends 75% . . .
The proposal to expand Schip
comes at a time when health-care spending already poses a serious threat to the
federal budget. The Medicare trustees tell us that the program's unfunded
liability is six times that of Social Security. The CBO predicts that on the
current course, income tax rates paid by the middle class will reach 66% by
midcentury and the top marginal rate will reach 92%.
So what do congressional
Democrats plan to do about this problem? Ignore it.
A key provision of the 2003
Medicare Modernization Act says that when Medicare's finances deteriorate to a
certain level (that level is already reached), the president must propose an
appropriate reform and Congress must fast-track the proposal. Yet one senior
Democratic legislator -- as yet unidentified -- wants the Schip bill to repeal
that provision.
In a way, repeal makes a certain
sense. If the ship is going down anyway, why spoil the fun?
To read the entire article, go to
http://online.wsj.com/article_print/SB118549936022579842.html.
Mr. Goodman is president of
the National Center for Policy Analysis.
* * * * *
9. Health Plan USA: Single-Payer Health Care By Any Other Name Is Still A
Monopoly
Opinion
Editorial
by Pete
du Pont
Over the past decade, self-appointed health care
advocates have talked a lot about health care reform in America, ranging from
issues such as a patients’ bill of rights to reign in HMOs to the plight of the
uninsured. Pundits often refer to these issues collectively as incremental
health care reform, which is spin for the left’s current strategy to push
towards a system of national health insurance (e.g. socialized medicine) one
step at a time.
Americans soundly rejected the idea of “socialized
medicine” back in 1993, when the Clinton administration proposed a wholesale
change of the health care industry. Licking their wounds from that defeat,
proponents of national health insurance have recently seized upon a less
threatening term - a “single-payer system.”
In theory, a single-payer system would reduce the
number of different organizations with which physicians and hospitals must file
claims. From a paperwork sense, this sounds attractive. Many public health
advocates assume the administrative savings would be sufficient to fund
coverage for the uninsured. Likewise, consumer groups would like to pocket any
savings in the form of lower premiums. Yet however logical these arguments
sound, the truth is there will be no “savings” to fight over.
Health economists see inherent problems - similar to those experienced in
Europe and Canada - in all single-payer systems. First and foremost, because it
is paid for through taxation, consumers are insulated from the direct cost of
health care. Consequently, they are not price sensitive and tend to consume
more than they otherwise would. Thus, single-payer systems must employ one of
several tactics to artificially reduce consumption. Options range from the
outright rationing of care, to shortchanging capital investment in facilities
and modern equipment, to reducing the number of physicians available to treat
patients.
Britain and Canada, for example, have fewer physicians
per capita than the U.S. To adopt a single-payer system with resource
allocation similar to Canada, the U.S. would have to fire around 171,000
physicians. Those doctors who remained would have to see, on average, 921
additional patients per year to match the average number of patients seen by
Canadian physicians. As a result, the length of time patients spend with their
physician during an office visit would likely be shorter.
Because of these factors, virtually all countries with
a single-payer system of national health insurance experience chronic equipment
shortages and long waiting lines for treatment (not to mention higher taxes).
Waiting lists exist simply because there aren’t enough specialists, treatment
beds and operating facilities to accommodate patients needing care. Thus, care
is given to those patients most likely to benefit - at the least cost. For
instance, in England, the shortest waiting lists are often for non-critical
procedures, while life-threatening ones require longer waiting times.
Further, long waits are frequently required for
routine services Americans take for granted. In 1999, for example, the median
wait for a CT scan and an MRI across Canada (both critical for diagnoses) was
five weeks and 12 weeks, respectively.
Finally, a single-payer system would be a bilateral
monopoly. Just as a monopoly can charge what it wishes for the services it
offers, a single-payer system can reduce funding available for particular
services or refuse to cover services deemed too expensive. Because a
single-payer does not have to compete for your business, consumers will likely
get less value for their money. And consumers needing costly non-covered
treatments (or costly medications not included in a drug formulary) would have
to pay out-of-pocket.
Under our current system, if a health insurance
company raised prices and reduced benefits, consumers would switch in droves.
But, when there is only one game in town, consumers would have to accept
whatever costs and benefits were offered. Without the incentives created by
competition, a single-payer system would likely exemplify the innovation,
compassion and efficiency of the Internal Revenue Service in no time.
www.ncpa.org/edo/pd/2002/pd040202.html
* * * * *
10. Restoring Accountability
in Medical Practice by Non Participation in Government Programs and Understanding the Devastating Force Of Government.
·
Grover
Norquist, President of Americans for Tax Reform, www.atr.org/
keeps us apprised of the Cost of
Government Day® Report, Calendar Year 2006 Fourteenth Edition, www.atr.org/content/pdf/2006/July/071206ot-costofgovernmentday.pdf.
Cost of Government Day (COGD) is the date of the calendar year on which the
average American worker has earned enough gross income to pay off his or her
share of spending and regulatory burdens imposed by government on the federal,
state and local levels. Cost of Government Day for 2006 is July 12th, a one day
increase above last year’s revised date of July 11th. With July 12th as the
COGD, working people must toil on average 192.5 days out of the year just to
meet all the costs imposed by government. In other words, the cost of
government consumes 52.7 percent of national income. If we were to put health
care into the public trough, the additional 18 percent would allow the
government to control 70 percent or nearly three-fourths of our productivity
and destroy our health care in the process. We would have almost no
discretionary income.
·
John Berthaud, President of the National Taxpayer’s Union, www.ntu.org/main/, keeps us apprised of all
the taxation challenges our elected officials are trying to foist on us
throughout the United States. To find the organization in your state that’s
trying to keep sanity in our taxation system, click on your state at www.ntu.org/main/groups.php.
·
Ayn Rand, The Creator of a Philosophy for Living on Earth, www.aynrand.org/site/PageServer,
is a veritable storehouse of common sense economics to help us live on earth.
To review the current series of Op-Ed articles, some of which you and I may
disagree on, go to www.aynrand.org/site/PageServer?pagename=media_opeds.
·
John and Alieta
Eck, MDs, for their first-century solution to twenty-first century needs.
With 46 million people in this country uninsured, we need an innovative
solution apart from the place of employment and apart from the government. To
read the rest of the story, go to www.zhcenter.org. Stay tuned for
their next innovative move in designing the healthcare system for the entire
country of Antigua and Barbuda.
·
Michael J.
Harris, MD - www.northernurology.com - an active
member in the American Urological Association, Association of American
Physicians and Surgeons, Societe' Internationale D'Urologie, has an active
cash'n carry practice in urology in Traverse City, Michigan. He has no contracts,
no Medicare, no Medicaid, no HIPAA, just patient care. Dr Harris is also
nationally recognized for his medical care system reform initiatives. To
understand that Medical Bureaucrats and Administrators are basically Medical
Illiterates telling the experts how to practice medicine, be sure to savor his
article on "Administrativectomy: The Cure For Toxic Bureaucratosis"
at www.northernurology.com/articles/healthcarereform/administrativectomy.html.
·
PRIVATE NEUROLOGY is a Third-Party-Free Practice in Derby, NY
with Larry
Huntoon, MD, PhD, FANN. http://home.earthlink.net/~doctorlrhuntoon/.
Dr Huntoon does not allow any HMO or government interference in your medical
care. "Since I am not forced to use CPT codes and ICD-9 codes (coding
numbers required on claim forms) in our practice, I have been able to keep our
fee structure very simple." I have no interest in "playing
games" so as to "run up the bill." My goal is to provide
competent, compassionate, ethical care at a price that patients can afford. I
also believe in an honest day's pay for an honest day's work. Please Note that PAYMENT IS EXPECTED AT
THE TIME OF SERVICE. Private Neurology also guarantees that medical records in our office are kept
totally private and confidential - in accordance with the Oath of Hippocrates.
Since I am a non-covered entity under HIPAA, your medical records are safe from
the increased risk of disclosure under HIPAA law. Ever have a blinding migraine
and couldn't even drive to see a doctor? Dr Huntoon even makes house calls.
Canadian patients are welcomed. Such
a deal.
·
PATMOS
EmergiClinic - where Robert Berry, MD,
an emergency physician and internist states: "Our point-of-care payment
clinic makes acute and chronic primary medical care affordable to the uninsured
of our community by refusing to accept any insurance (along with the hassles
and crushing overhead that inevitably come with it). Read the rest of the story
at www.emergiclinic.com.
* * * * *
Stay Tuned to
the MedicalTuesday and the HealthPlanUSA Networks and have your friends do the
same.
Articles that
appear in MedicalTuesday and HPUSA may not reflect the opinion of the editorial
staff. Sections 1-9 are entirely attributable quotes in the interest of the
health care debate.
Editorial comments
are in brackets.
ALSO NOTE: MedicalTuesday receives no government,
foundation, or private funds. The entire cost of the website URLs, website
posting, distribution, managing editor, email editor, and the research and
writing is solely paid for and donated by the Founding Editor, while continuing
his Pulmonary Practice, as a service to his patients, his profession, and in
the public interest for his country.
* * * * *
Del Meyer
Del Meyer, MD, CEO & Founder
HealthPlanUSA, LLC
6945 Fair Oaks Blvd, Ste A-2, Carmichael, CA 95608
Words
of Wisdom
I predict future
happiness for Americans if they can prevent the government from wasting the
labors of the people under the pretense of taking care of them. --Thomas
Jefferson
What this country needs are more unemployed
politicians. –Edward Langley, Artist
1928-1995
Some
Recent Postings
Harry Potter Battles Big Brother, by James Murtagh, MD, www.healthcarecom.net/JM_HarryPotter.htm
America Alone, The End of the World as we Know It, by Mark
Steyn, reviewed by Del Meyer, MD www.delmeyer.net/bkrev_AmericaAlone.htm
HealthPlanUSA for April 2007, www.healthplanusa.net/April07.htm
This Month in History
During the month of July, we celebrated Independence
Day on the 4th. This was the greatest and grandest experiment to
alter the course of humankind from millennia of government enslavement to
individual human freedom. It worked well for the first 150 years after 1776.
Since that time, forces using the democratic model have slowly hoodwinked the
American public to do what Jefferson warned us against – wasting people’s
industriousness in the pretense of taking care of them. These programs will be
our undoing and in a democracy, it is very difficult to change course. As noted
in Section One above, we have delayed aging in our generation alone by seven
years. By any form of logic, we should have indexed programs for the aged by
the same seven years. If senior citizen status began today at age 72, even the
programs that Jefferson warned us against would not enslave future generations
of Americans. To tax our citizens for an additional seven years of health
benefits is beyond any sustainable tax structure. Can we survive as a nation
devoted to human freedom? That is our mission at MedicalTuesday and HPUSA.
We should also pause to remember three
presidents who died and one president who was born on this date. Two
presidents, Thomas Jefferson and John Adams, whose careers were intertwined and
whose friendship was itself a classic story, died on the fourth of July in
1826, fifty years to the day after they put their signatures on the Declaration
of Independence. James Monroe, another president, died on July 4, 1831. Calvin
Coolidge, another president, was born on July 4, 1872, in Plymouth, Vermont.
Aren’t we fortunate to have so much presidential history associated with
Independence Day? A real celebration!