HEALTHPLANUSA . NET
Community For Affordable Health Care
Vol VI, No 3, October, 2007
Utilizing the $1.5 Trillion Information Technology Industry
To Transform the $2 Trillion HealthCare Industry into Affordable HealthCare
In This Issue:
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This Is Your Brain on the Job By PHRED DVORAK and JACLYNE BADAL, WSJ, September 20, 2007
Neuroscientists Are Finding That Business Leaders Really May Think Differently
After he completes 500 such
Mr. Balthazard says the first
50 scans, of local luminaries, suggest that visionary leaders use their brains
differently than others. In the past month, he added 20
"We're coming up with the genome -- the brain map -- of the leader," says Mr. Balthazard from his ASU office, one littered with brain diagrams, plastic models and a windup toy brain with chattering teeth.
Mr. Balthazard is among a growing number of researchers looking inside the brain for business insights. The surge in interest among researchers is fueled by more powerful diagnostic tools and an improved understanding of how the brain influences character, personality and behavior.
Researchers have applied
neuroscience to areas like economics, finance and marketing. Academics from
Executive coaches and researchers are increasingly tapping neuroscience tidbits to bolster pet management theories. Scientists at Gallup Organization, for example, say brain research helps managers understand why praise works: it boosts levels of dopamine, a chemical linked to joy.
But as more nonspecialists jump
in, it becomes harder to separate science from hype. "A lot of this will
end up science-fiction," says Michael Gazzaniga, a neuroscientist at the
Advances in EEG technology make it easier to "map" a brain's electrical activity. But it isn't clear that leaders exhibit defined brain-wave patterns, or that changing such patterns automatically alters behavior. Not all brains function the same way, neuroscientists say. Nor do people with similar brain patterns necessarily act in similar ways.
Some of Mr. Balthazard's
colleagues are wary, too. David Waldman, an
Mr. Balthazard, 47, is a tall,
chatty Canadian and systems-engineering specialist. In 2001, while studying
ways to measure managers' performance, he met Jeffrey Fannin, a psychologist
and former airline pilot who runs a clinic near the
Mr. Balthazard sought local
leaders to brain-map, including a former dean at
Mr. Thatcher says preliminary analysis of 50 brain maps shows some big differences in activity between managers who rate high on a psychological test of visionary leadership, and those who rate low. The visionary leaders had more efficient left brains, which deal with logic and reasoning, and better connected right brains, which are responsible for social skills.
Mr. Thatcher hopes to find more patterns as Mr. Fannin scans more brains. The patterns could indicate brain activity associated with specific qualities like charisma, or something common to all good leaders. The patterns could just reflect "faster brains -- more processing, more power," he says, adding that once the patterns are found, "you can move people" to them.
Mr. Balthazard is getting
ready. He's seeking funding for hundreds more scans, and will brain-map
The school's marketing
department has supplied Mr. Balthazard with small, rubber brains emblazoned
To read the entire article, go to (subscription required) http://online.wsj.com/article_print/SB119024585835733168.html.
When this gets perfected, whose leadership do you think will be eliminated in the health care debate? Or will it make any difference?
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2. In the News: Rising costs might cripple centrist health reform, by Daniel Weintraub, Sacramento Bee, October 1, 2007
One of the biggest ironies in the debate over how to expand access to health insurance in California is that the compromise plan — or concept — with the greatest chance of success would do so little to solve the problem at the heart of the matter, and might even make it worse.
The problem is that health insurance costs are rising faster than wages and have been for some time. Those rising costs are prompting most employers to ask employees to pay higher premiums, and some employers to drop coverage altogether. The result is a shrinking share of the state's population with private health insurance.
But short of a radical change in the way we get and pay for health care, there is little government can do to slow those rising costs. They are mostly a reflection of demographics (as the population ages, we demand more health care), medical technology, which is both popular and expensive, and labor costs, which have been rising fast in the health care industry.
Since 2001, according to a study by the Kaiser Family Foundation, health insurance premiums have risen by 78 percent nationally, while general wages have grown by only 19 percent.
Among other things, the plan would probably require insurance companies to issue policies to anyone who applies, regardless of their pre-existing health conditions.
Such an agreement would guarantee access to comprehensive coverage for poor people without children, who do not qualify for subsidized care today, and to working poor families who earn too much to qualify for assistance under current law. Under the governor's proposal, for instance, anyone making less than about $50,000 a year for a family of four would get full benefits and pay no more than 6 percent of their income for premiums. The Democrats' plan would be even more generous.
But while both approaches seek to cap health care costs for individuals, they can't, or don't, limit the real costs of that care.
Just to put the problem in perspective, consider that the governor's plan represents a $12 billion commitment in new taxes, new federal aid and a reordering of state spending priorities. But if health costs continue to rise during the next six years as they have over the past six years, that $12 billion price tag would grow to more than $21 billion, while the sources of funding for the plan would almost certainly grow at a slower rate.
The gap that results would have to be covered by more subsidies. In the Democrats' plan, that means a higher payroll tax than the 7.5 percent of wages the proposal now envisions. The governor's plan relies on a mixture of payroll taxes and fees on hospitals and perhaps doctors. And as part of a compromise, both sides are considering an increase in the state sales tax.
The scary thing is that the fixes being considered might actually make the problem worse.
According to the California HealthCare Foundation, the uninsured use about half the services they would if they were fully insured.
So by giving them coverage, the state might be adding to the total cost as more services are delivered to those who lacked insurance before.
And while both the governor and the Democrats are calling for an expansion of preventive care, that, too, could drive costs higher.
Prevention is great when it catches a health problem early, potentially saving lives and money. But it is not necessarily cost-effective. For every case of cancer found early, hundreds or thousands of people might get a test that finds nothing. Even the positive results can lead to expensive treatments.
So while these proposals might improve the quality of life for many people, they will do little to slow the growth in health care costs, which means the programs would almost certainly run short of money within a few years. . .
Unfortunately, it's a solution that would face serious new hurdles almost from the moment it is adopted.
To read the full Weintraub Commentary, go to www.sacbee.com/815/v-print/story/409486.html.
[Wintraub gives us good arguments why government should get out of health care before the unintended consequences of their meddling into our personal lives destroy our health.]
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3. International Medicine: 'Single Payer' Health Care Is Hardly Free, By Paul Hsieh
Michael Moore’s latest movie “SiCKO” sings the praises
of the Canadian “single-payer” socialized medical system. Some Americans want a
similar system implemented in the
Defenders of the Canadian system frequently claim that patients don’t have to worry about money when they’re sick — the health care is free. But is this really true?
First, it is ludicrous to think the system is free.
Each citizen is forced to pay for his neighbors’ medical care in the form of
high taxes. (As a percentage of GDP, total taxation is 28 percent higher in
Even worse, in the name of “equal access” the government generally forbids patients from purchasing medical services outside of its system. Canadian law makes it difficult or impossible for citizens to spend their own honestly earned money on medically necessary care for themselves or their loved ones, even when both the doctor and the patient are willing.
To control costs, the government restricts access to crucial medical services via infamous waiting lists. This imposes a second, hidden, cost on patients: their time.
According to the Vancouver-based Fraser Institute, “Canadian doctors say patients wait almost twice as long for treatment than is clinically reasonable, . . . almost 18 weeks between the time they see their family physician and the time they receive treatment from a specialist.”
Because of the waiting lists, mortality rates for
treatable conditions such as breast cancer and prostate cancer are
significantly higher in
A Canadian woman who discovers a lump in her breast
might wait for months before she receives the surgery and chemotherapy she
needs, with the cancer cells multiplying rapidly as each week goes by. If she
lived in the
This tax on time is especially cruel because the burden falls hardest on the sickest patients, i.e., those with the least time to spare.
Consequently, Canadian patients routinely suffer and
die while waiting for their “free” health care. The
To guarantee “free” health care, a government must force the individual to pay for everyone else’s medical care and limit his freedom to pay voluntarily for his own.
With bureaucrats deciding who receives what, the individual is therefore forbidden from spending his money according to his own rational judgment (and the advice of his doctors) as to what’s best for his health.
When a government forces people to act against their own interests, it’s no surprise that the results are misery and death.
Fortunately, Canadians are starting to recognize the
problems inherent in “single-payer” health care and are taking very small steps
towards limited private medicine.
As P. J. O’Rourke said, “If you think health care is expensive now, wait until you see what it costs when it’s free.”
Hsieh, MD, is a practicing physician in the south Denver metro area
and a guest writer for the Ayn
Rand Institute in Irvine, CA. He is a founding member of the
Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.
--Canada’s Supreme Court
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Lean Government, Kevin Meyer, Founder & Editor, Superfactory, http://www.superfactory.com/
Current budget constraints in the public sector require an innovative response from executives, legislators, public administrators and government employees. Legislators must set the course with directive policy, administrators must develop the management plan and government employees must remain flexible and committed to the personal transformation required to do public business in a new leaner way.
Citizens are demanding ethical and responsible government. Now, more than ever it is extremely important that programs and services using public funds are accountable and effective. Anything less is unacceptable. We need to ask those who seek to lead our government some tough questions. How will government become accountable and effective? How can we maintain some compassion without encouraging unhealthy dependency? How can we as citizens know that our government is not spending money on unnecessary items, staffing or projects with little value to our citizens, communities and economy? Government functions must be measured against standards, but what standards do we use?
There are multiple ways to answer these questions. The most crucial factor is how we determine the standards to measure our progress. Business and public administration, statistics and accounting academic worlds can offer a myriad of possible measurement tools. Six Sigma, Total Quality Management, World Class Service, GASB, and Management by Objectives to just name a few. Many of these tools have been proven in the private sector. One particular approach, called lean thinking has been very successful in manufacturing and has in recent years been successfully adapted for use in the public sector.
Government is not the solution to our problems, government is the problem.
- Ronald Reagan
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5. Lean HealthCare: Doing More with Less, Kevin Meyer, Founder & Editor, Superfactory
There's a lot of excitement today in the health care field about the benefits that Lean practice can bring. This is especially critical in an environment where patient care needs are climbing while the pool of skilled resources and reimbursement for services shrink. Lean Advisors Inc. is working in the healthcare industry to help them implement Lean in order to be able to do more with less while doing it better. The key is to apply Lean methods in an environment driven by the unique values that surround patient care.
As the population ages, healthcare must find new ways to meet the demand for their services. Turnaround time becomes a primary measurement that must improve whether it is in the hospital facilities or their testing laboratories. Further, space is at a critical premium in running all the functions within a hospital facility. Only Lean can provide a solution to space issues without either downsizing staff or incurring large scale capital building costs.
Healthcare has a tremendous opportunity to deploy Lean
Healthcare concepts to reduce internal/external costs, improve patient safety,
increase profits, reduce litigation and decrease the dependence on Government
and Insurance. To accomplish this monumental task, Healthcare providers will
need to turn the microscope inside and do what others,
As in other industries, the customer should come first. In healthcare that customer is the patient, the regulatory bodies and maybe even the Insurers. They all define and drive the definition of value (i.e. what is not adding value to their needs). The product (Laboratory results) or service (patient care) can make the difference between life and death. The needs of the patient are paramount and give new meaning to Lean Healthcare. This then makes Lean even more important in this industry over manufacturing or other services.
Today healthcare is not designed to make the value stream of care flow smoothly . As with manufacturing, healthcare services are often “batch and queue”, with patients spending most of their time waiting until the right process (skilled healthcare practitioner) is available. As a result, the value added processes are disconnected leaving the patient and the caregiver all disillusioned. The working environment is one driven by shared values and passion in delivering top quality products and services to the patient.
Without Lean, healthcare will continue to have difficulty meeting the pressure to serve an increasing number of individuals at less cost. As the population ages, healthcare must find new ways to meet the demand for their services. Turnaround time (i.e. patient cycle time, service Takt time) becomes a primary measurement that must improve whether it is in the hospital facilities, post care facilities or laboratories. Further, space is at a critical premium in running all the functions within a hospital facility. Only Lean can provide a solution to all these concerns with minimal expenditures but maximum benefits.
To learn more about Lean, browse at www.superfactory.com/topics/healthcare.htm.
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Activists who denounce any health care reform that is not single (government) payer, often make the ludicrous claim that health care is a human right.
A human right is neither endowed by government nor defined by activists. It is something we are all born with, such as life, liberty and the pursuit (not guarantee) of happiness. Human rights do not require the coerced efforts or labor of others so that you may enjoy them. Health care for all is a noble aspiration, and worthy of pursuit, but medical care is not even a universal need or desire, let alone a human right.
While millions voluntarily opt out of, or even avoid, medical care, who would argue that food, water and shelter are not true human needs? These true needs are not universally provided for by government. Would life be more utopian if they were?
Health care is not a human right by PATRICK J. MCNAMARA, Maratinez, SF Chronicle, Letters
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7. Overheard on Capital Hill: John Stossel’s Reply to Health Insurance for All
What options do we have for improving
Our Crazy Health-Insurance System, By John Stossel, Sept 27, 2007
Almost daily, we’re bombarded with apocalyptic warnings about the 47 million Americans who have no health insurance. Sen. Hillary Clinton wants to require everyone to have it, big companies to pay for it and government to buy it for the poor.
That is a move in the wrong direction.
You have to understand something right from the start. We Americans got hooked on health insurance because the government did the insurance companies a favor during World War II. Wartime wage controls prohibited cash raises, so employers started giving noncash benefits, like health insurance, to attract workers.
The tax code helped this along by treating employer-based health insurance more favorably than coverage you buy yourself. And state governments have made things worse by mandating coverage many people would never buy for themselves.
Competition also pushed companies to offer ever-more attractive policies, such as first-dollar coverage for routine ailments, like ear infections and colds, and coverage for things that are not even illnesses, like pregnancy. We came to expect insurance to cover everything.
That’s the root of our problem. No one wants to pay for his own medical care. “Let the insurance company pay for it.” But if companies pay, they will demand a say in what treatment is — and is not — permitted. Who can blame them?
And who can blame people for feeling frustrated that they aren’t in control of their medical care? Maybe we need to rethink how we pay for less-than-catastrophic illnesses so people can regain control. The system creates perverse incentives for everyone. Government mandates are good at doing things like that.
Steering people to buy lots of health insurance is bad policy. Insurance is a necessary evil. We need it to protect us from the big risks — things most of us can’t afford to pay for, like a serious illness, a major car accident, or a house fire.
But insurance is a lousy way to pay for things. Your premiums go not just to pay for medical care but also for fraud, paperwork and insurance-company employee salaries. This is bad for you and bad for doctors.
The average American doctor now spends 14 percent of
his income on insurance paperwork. A
The paperwork is part of insurance companies’ attempt to protect themselves against fraud. That’s understandable. Many people do cheat. They lie about their history or demand money for unnecessary care or care that never even happened. . .
Imagine if your car insurance covered oil changes and gasoline. You wouldn’t care how much gas you used, and you wouldn’t care what it cost. Mechanics would sell you $100 oil changes. Prices would skyrocket.
That’s how it works in health care. Patients don’t ask how much a test or treatment will cost. They ask if their insurance covers it. They don’t compare prices from different doctors and hospitals. (Prices do vary.) Why should they? They’re not paying. (Although they do in hidden, indirect ways.)
In the end, we all pay more because no one seems to pay anything. It’s why health insurance is not a good idea for anything but serious illnesses and accidents that could bankrupt you. For the rest, we should pay out of our savings.
Next week, we’ll look at alternatives to this crazy system.
John Stossel is co-anchor of ABC News’ “20/20” and the author of Give Me a Break: How I Exposed Hucksters, Cheats, and Scam Artists and Became the Scourge of the Liberal Media (January 2005) as well as Myth, Lies, and Downright Stupidity: Get Out the Shovel — Why Everything You Know Is Wrong (May 2007), which is now available in paperback.
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8. US Health Care: Physicians Make Lousy Advocates by David J. Gibson, MD
Thomasson, MD, national president of Physicians for Social Responsibility (PSR)
was interviewed on Public Radio. A listener responded: “Where is it written that physicians have more
expertise than others in political and moral matters?” Dr. Harry Wang,
president of the
brought considerable Editorial Committee response from “Take Aim at Terrorists,
Physicians Make Lousy Advocates by David J. Gibson, MD
THIS ISSUE of SSV Medicine, www.ssvms.org/magazine/sep_oct_07.asp,
Dr Harry Wang president of Physicians for Social Responsibility in
Arguing the negative is akin to opposing motherhood and apple pie. For the past decade, the CMA [California Medical Association] has organized annual “Leadership Academies.” Their purpose is to educate physicians about public policy issues. One goal is to encourage attendees to stand for election to public office. Furthermore, the two most sought after spokespersons by advertising and activist groups are celebrities and physicians.
To clear the table of non issues, I stipulate that Americans have the freedom to express their opinion on any issue. No matter how tangential, you have the right to express yourself – even if no one cares to listen to your point of view.
What’s more, physician organizations and groups have a vital role to play in expressing expert consensus on issues of the day. Dr. Wang references the AMA Board of Trustees resolution in 1981 that “there is no adequate medical response to a nuclear holocaust.” Few would argue this is not a credible addition to the debate.
My major problem is when individual physicians seek unearned credibility by attaching their academic title to public statements. Mr. Wang does not have the same credibility as Dr. Wang. In the public square, you defend your position based on reason and facts. To short cut your progress to credibility by flashing the MD degree will inevitably leads to defeat in the battle of ideas, with loss of credibility for the profession as collateral damage.
Beyond this central objection to exploiting the degree, physicians have a long and undistinguished history of performing poorly on public policy issues. As Dr. Wang points out, “almost half of registered German physicians were members of the Nazi Party.” The ridiculous racial theories of the Nazis had their roots in an international eugenics movement whose ‘principal supporters included physicians and academics.
In June of
. . . English
intellectual Herbert Spencer articulated the lofty goal of eugenics by announcing
that “all imperfection must disappear.” Margaret Sanger called for forced
sterilization, concentration camps, and birth control for the” creation of a
new race.” The ideals of Planned Parenthood’s founder were partially realized
through the sterilization of nearly 70,000 people by various state governments,
When physicians expand the scope and reach of science in medicine, our accomplishments are unparalleled. When we step outside our area of competence and become activists in the public arena, the results can be tragic. The following admittedly selected list provides but a few infamous examples:
Karl Brandt (1904-1948) – Nazi human experimentation.
Karadzic (b. 1945) - ethnic cleansing in
(“Papa Doc”) Duvalier (1907-71) – President and later dictator of
Josef Mengele (1911-1979) – the “Angel of Death,” Nazi human experimentation.
(1923- ) – convicted of second-degree murder,
Shira Ishii –
Khalid Ahmed, Bilal Talal Abdul Samad Abdulla, Muhammad Haneef, Mohammed Jamil Abdelqader Asha – all physicians arrested for involvement in the failed car bombings in Glasgow and London this year.
To read further comments about “Physicians do not represent the norm in any society” and “We advocate using government’s coercive power to influence fellow citizens to make choices they would make themselves—if only they had our strength of will and sharpness of mind” go to www.ssvms.org/articles/0709gibson.asp.
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[In response to the staff room comments a few weeks ago about Medicare not paying the doctors in Sacramento for five months who had recently moved from an office building where the rent was increased by 80 percent, Lawrence Huntoon, MD, PhD, responded. We publish this response to remind our readers that a government that can be this vindictive to the medical profession would not have a kind ear for sick patients who are unable to fight such a vengeful bureaucracy that harasses their physicians.]
Medicare did the same thing to me that they are currently doing to you. Prior to opting out of Medicare, I was always a Non-Par in Medicare.
When I moved and opened a new office, I notified Medicare, via U.S. Mail, of my new address. They wanted me to fill out a 30 page form just to change my address!! The form was basically an initial enrollment form in Medicare which contains all sorts of things that I would not agree to and sign as a Non-Par physician. I had been “enrolled” in Medicare as a Non-Par physician for 18 years at that point.
I refused to fill out and sign their abusive 30-page form.
Medicare retaliated by refusing to pay what they owed (i.e. they force assignment on physicians who treat dual eligible patients - Medicare + Medicaid). Medicare owed me a substantial amount of money.
I stood firm, and would not fill out and sign (agree to) their abusive “enrollment” form.
Within a few months, I opted out of Medicare under Sec. 4507 of the BBA of 1997.
As a result of opting out of Medicare, Medicare was forced to accept the change of address notification that I previously supplied to them - no 30 page form had to be filled out.
After Medicare was forced to acknowledge and accept my notification of change of address, they were then forced to send all the money they owed me.
This is the “standard operating procedure” for this highly abusive and coercive government bureaucracy. The bureaucracy seeks to punish those physicians who refuse to “voluntarily” sign up with their abusive Medicare program which degrades and devalues physicians on an ever increasing basis.
Lawrence R. Huntoon, M.D., Ph.D. is a practicing neurologist and editor-in-chief of the Journal of American Physicians and Surgeons, Contact: firstname.lastname@example.org.For Dr. Huntoon’s Neurology Practice website, please go to http://home.earthlink.net/~doctorlrhuntoon/.
To read other articles by Dr. Huntoon, please go to the following links:
The Psychology of Sham Peer Review, www.jpands.org/vol12no1/huntoon.pdf.
Conflicts of Interest and Quality Care, www.jpands.org/vol12no3/huntoon.pdf.
I Think, Therefore I’m Well: The Amazing Brain, www.jpands.org/vol12no2/huntoon.pdf.
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Editorial comments are in brackets.
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Del Meyer, MD, Editor & Founder
Words of Wisdom
Do Not Go Where the Path may lead. Go instead where there is NO Path and Leave a Trail. –Ralph Waldo Emerson
Decision Making: Start with what is right rather than what is acceptable. –Peter Drucker
Be not the slave of your own
past. Plunge into the sublime seas, dive deep and swim far, so you shall come
back with self-respect, with new power, with an advanced experience that shall
explain and overlook the old. –Ralph
Some Recent/Relevant Postings
CLONING OF THE AMERICAN MIND - Eradicating Morality Through Education, by B. K. Eakman http://healthcarecom.net/bkrev_CloningOfTheAmericanMind.htm
THE GREATEST BENEFIT TO MANKIND - A Medical History of Humanity, by Roy Porter, http://healthcarecom.net/greatest_benefit_to_mankind.htm
Physicians Make Lousy Advocates by David Gibson, www.healthplanusa.net/DGPhysicianAdvocate.htm
This Month in History, October
Leif Erikson allegedly landed his Viking explorer on the North American mainland in about 1000 A.D.
The first television broadcast by a President, Harry S. Truman, from the White House in 1947.
Thanksgiving proclamations were given in 1789 by President Washington in honor of the adoption of the Constitution and in 1863 by President Lincoln designating the last Thursday in November as Thanksgiving Day.
This Month in Future Reality, October 10-13
Be sure to attend the 64th Annual Meeting of the AAPS to be held this week on October 10-13, 2007, in Philadelphia/Cherry Hill, NJ. Important Theme is Collision Course: Medical Ethics and the Law by an illustrious faculty and get 17 CME units credit. The AAPS is one of few remaining organizations strictly dedicated to private practice issues. Most of our professional organizations are now dedicated to enslaving physicians in government medicine. For further information, go to http://www.aapsonline.org/2007am/.