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Title: Blog by Novelist William S. Frankl, MD

Archive for February, 2017

Optimism In The Trump Era?

Tuesday, February 28th, 2017

An interesting article.One can only hope he is right

Washington Examiner 2/28/2017
Eight Reasons for optimism in the Trump Era
2/27/2001
Dan Hannan

I said some hard things about President Trump during the primaries, and I’m sure I will again. Nothing he has done in office has alleviated my chief concern about him: that he regards himself as bigger than the presidency.

Still, I remain sanguine about America’s prospects. Oddly enough, my optimism contrasts vividly with the continuing fury of some of Trump’s supporters. You’d have thought that, with their guy in office, they’d be delighted. But a great many of them have simply transferred their rage from Hillary Clinton to the media. Perhaps that rage is a character trait rather than a response to specific circumstances.

Be that as it may, there are solid reasons for conservatives to be optimistic. Not since 1928 has the GOP controlled both chambers and the White House. Ninety years is a long time for a system to be clogged up with useless laws. If that great and underrated New Englander Calvin Coolidge could be transported from 1928 to our own era, he would be so horrified by the size of the state that he might manage to squawk out more than three or four consecutive words.

Opportunities like this don’t come often, and Republicans know it. Here are eight reasons why right-of-center Americans should look forward to the current session.

1.) Scrapping Obamacare

As his opponents predicted, Barack Obama’s healthcare reforms have proved byzantine, cumbersome and costly. They suck money from the private sector and discourage businesses from growing. Firms are reluctant to take on more than 49 employees. Bosses hesitate before offering a contract of more than 30 hours a week.

Replacing Obamacare with a cheaper, simpler system — ideally one based on individual healthcare accounts — will do far more to stimulate the economy than all the TARP boondoggles put together.

2.) Sacking regulators

Talking of stimulating the economy, how about getting rid of federal bureaucracies? Not just getting rid of expensive regulations; getting rid of expensive regulators. Let the 50 states set their own standards, so as to encourage benign competition. Ronald Reagan dreamed of scrapping the education and environment departments. Although total abolition is unlikely, these agencies may well face their first serious reduction in personnel since their founding.

3.) States’ rights

The principle of competition among states goes much further than regulation. The key to America’s success, down the ages, was the diversity of its constituent states. Ideas could be piloted; good practice could spread. The only truly successful reform of welfare was the one drafted by Newt Gingrich’s Congress and signed into law by Bill Clinton. Its secret? To return responsibility to the states.

That same principle should apply across the board — in healthcare, education, law enforcement, taxation and the rest.

4.) Cheap energy

The United States is blessed with ample energy reserves, yet the Obama administration went out of its way to discourage their exploitation. Let people get at the treasures in America’s earth and prices will fall. Factories will become immediately more productive, transportation cheaper. More jobs will come into existence and revenues will rise as the economy grows.

5.) Lower taxes

Devolving taxation to state level, as the founders envisioned, will lead to jurisdictional competition and, in turn, downward pressure on rates. The U.S. badly needs to lower corporate taxes. There’s a global race out there, and it makes no sense to handicap yourself with the heaviest business taxes in the industrialized world.

6.) Anglosphere trade

Regular readers will know that I loathe Trump’s protectionism. Threatening a 20 percent tariff on Mexican imports won’t “pay for the wall.” It won’t pay for anything. It will drive up prices, reduce economic activity and cut Treasury income. Then again, the Donald does seem serious about a free trade deal with the U.K. If this can be done quickly and cleanly, the benefits will be palpable and, with luck, the appetite for protectionism vis-a-vis Mexico and China will dissipate.

7.) Straightforward judges

How odd to watch Democrats howl with fury because Trump wants to appoint a Supreme Court judge who will interpret the law as it is written rather than seeking to advance leftist causes from the bench. A few more such appointments and America may again have judges who rule on the basis of what the law says rather than what they wish it said.

8.) Mike Pence

The vice president is a good and humble man, in politics from the best of motives. As long as his health is good, conservatives should sleep soundly.

Dan Hannan is a British Conservative MEP.

Travel Ban is Revealing ––––but Does Not Threaten American Medicine

Sunday, February 12th, 2017

This essay is a response to the hand wringing of many academic and corporate medical workers lamenting the potential effect of the recent travel ban, which was blocked in a most absurd and unconstitutional manner by           a 3-judge panel of the 9th circuit court of appeals.

 

Travel Ban is Revealing ––––but Does Not Threaten American Medicine

 

Jane Orient, M.D.

2/9/2017

 

A 90-day ban on travel from seven countries has sparked tremendous outpourings of “worry” or outright opposition by some 33 medical organizations.

 

“The community is reeling over the order, fearing that it will have devastating repercussions for research and advances in science and medicine,” states an article in Modern Healthcare.

 

Certainly the order is disrupting the lives of individual physicians who have won coveted positions in American medical institutions and were not already in the U.S. when the order was issued. Also their employers have a gap in the work schedule to fill. War tears people’s lives apart, however innocent they may be. And countries that sponsor terrorism have effectively declared war on the U.S.

 

But is American medicine so fragile that it can’t survive a 90-day delay in the arrival of physicians, most of them trainees, from Iran, Iraq, Libya, Syria, Yemen, Somalia, and Sudan? After all, every year more than a thousand seniors in U.S. medical schools do not land a position in a post-graduate training program through the annual computerized “Match” of graduates with internships. After another chance through the Supplemental Offer and Acceptance Program, or SOAP, hundreds of seniors are still without a job. This means that they cannot get a license to practice in the U.S., however desperate rural communities or inner-city hospitals are to find a physician, and their four years of rigorous, costly post-college education are wasted. Yet James Madara, CEO of the American Medical Association (AMA), is worried about vacant residency slots, according to a Feb 3 article in MedScape by Robert Lowes.

Entry to medical school is highly competitive, so presumably all the students are well-qualified. Can it be that graduates from Sudan are better trained? Does the U.S. have so few young people capable of and interested in a medical career that we have to depend on a brain drain from countries that are themselves desperately short of physicians?

 

For all the emphasis on “cultural competence” in American medical schools, and onerous regulations regarding interpreters for non-English speakers, what about familiarity with American culture and ability to communicate effectively with American English speakers? Some foreign-born graduates are doubtless excellent, but many American patients do complain about a communication gap. So why do some big institutions seem to prefer foreigners? Could it be that they want cheap, and above all compliant labor? Physicians here on an employment-related visa dare not object to hospital policy.

 

Whatever the reasons for them, here are some facts about the American medical work force:

  • One-fourth of practicing physicians in this country are international medical graduates (IMGs), who are more likely to work in underserved areas, especially in primary care, according to Madara.
  • According to the Accreditation Council for Graduate Medical Education (ACGME), 10,000 IMGs licensed in the United States graduated from medical schools in the seven countries affected by the ban.
  • Immigrants account for 28% of U.S. physicians and surgeons, 40% of medical scientists in manufacturing research and development, and 15% of registered nurses, according to the Institute for Immigration Research at George Mason University. More than 60,000 of the 14 million workers in health-related fields were from the seven countries affected by the ban.

Is medicine, like agriculture, now filled with “jobs that Americans won’t do”? Actually, we have more than enough Americans who love medical work. But some of best doctors are being driven out by endless bureaucratic requirements, including costly “Maintenance of Certification™” programs that line the pockets of self-accredited “experts” but contribute nothing to patient care. They are being replaced (substituted for) by “mid-levels” with far less training. Then there are thousands of independent physicians having to retire or become employees because they can’t afford the regulatory requirements—soon to be greatly worsened by MACRA, the new Medicare payment system. Physician “burnout” is becoming so bad that we lose up to 400 physicians—the equivalent of a large medical school class—to suicide every year.

 

The U.S. should be a beacon to attract the best and brightest, and it should welcome those who want to become Americans. Unfortunately, the lives of Americans, as well as the opportunities of aspiring foreign-born doctors, are threatened by those who desire to kill Americans and destroy our culture. These must be screened out.

Meanwhile, the reaction of organized medical groups to the travel ban is spotlighting serious problems in American medicine.

 

 

Jane M. Orient, M.D.obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989.  Dr. Orient is the 2017 recipient of The Edward Annis award for medical leadership.

Angle for Anglo-Saxon, or Enlighten with Latin?

Monday, February 6th, 2017

For those who read my blog and who are writers, this short article should be quite helpful. Sent to me by my good friend, Stephen Dubel.

http://www.dailywritingtips.com/should-you-angle-for-anglo-saxon-or-enlighten-with-latin/

Should You Angle for Anglo-Saxon, or Enlighten with Latin?

By Mark Nichol

Arguments for and against favoring Latinate words over Germanic ones, or vice versa (or, if you prefer a non-Latinate phrase, the other way around), have been heard over the years. What’s best? How about the status quo?

The vocabulary of Modern English is the result of a unique admixture of words (and phrases) from a variety of languages. But only about one-fourth derive directly from Old English, or Anglo-Saxon, and other Germanic languages. More than that come from Latin — and Latin’s progeny (mostly Spanish and French) account for as many more words. Admittedly, many Latin words are used primarily in legal, scientific, and medical contexts, whereas Germanic words tend to be more practical for everyday life, but the Latinate contribution is still predominant over native words, and the language is richer for the widespread borrowings.

Given the choice between words from the Germanic root and those of Latin origin, which should one choose? How about one or the other, on an ad hoc basis, or as your mood strikes you? Various movements have attempted to eradicate non-Germanic vocabulary from the English word-hoard, or at least minimize it, but these absurd endeavors, which have sometimes included efforts to create or calque (translate) new words, have been prompted by nationalism, not by any sensible motive.

To communicate plainly, Germanic words, which tend to be shorter, are often preferable, but the Latinate pain, for example, is as simple as the Germanic ache, and Germanic anger and wrath are slightly more complicated than ire and rage, both of which are of Latin provenance but could easily be misidentified as Germanic words.

If you do want to introduce more Germanic words into your writing, it’s easy, for instance, to target classes of words with specific suffixes: For example, words that end in the Latinate suffix -age have more concise synonyms: Think of advantage (gain), marriage (wedlock), savage (wild), and voyage (trip). But where would we be without parentage? “Mother and father” may be more concrete, but the Latinate term is more concise, more precise, and more flexible when it comes to nontraditional families.

For another example, words ending in -ity are often more complicated; why not, for example, write selfhood instead of identity? Unfortunately, identity often refers to a collective, rather than individual, impression. (And often, when one considers alternatives for Latinate words, the first synonym that comes to mind is non-Germanic, too: Quick, what’s another word for fidelity? Loyalty? That’s from French. Allegiance? French.) For yet another example, though words ending in -ology are of Latin origin, there’s no suitable Germanic equivalent for the suffix.

Ultimately, word choice depends on various factors, but the ground a word sprang up in shouldn’t be one of them.


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