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Title: Blog by Novelist William S. Frankl, MD

Archive for June, 2009

The Media’s Man

Tuesday, June 30th, 2009

I’m certain many who visit my blog are Democrats and are thoroughly behind president Obama. But . . . hey. Are you certain his policies are good for the nation? Are you certain you understand what he is doing? Do you know what he really stands for? How do you know?
Well, look at these facts and decide if it’s prudent for you to dig a little deeper. Although the blogosphere is a greater and greater source of information, much of what we know about politics and world affairs still come from the media ––– TV, radio, newspapers, and magazines. So, now look at these facts and ask yourself if the media is in love with Obama, and therefore believes he is infallible, and therefore that the media has not represented the facts in an unbiased manner,
Last Wednesday, ABC News aired his entire program from the White House, almost all of it related to the president’s so-called health care ” reform ” efforts. They also held an hour long prime time conversation with Obama about health care “reform.” Please note that ABC refused to allow any dissenting views.
Oh, and is it interesting to you that Linda Douglass, the communications director in the White House’s Office of Health Care Reform is a former ABC News reporter? And, that ABC employees gave 80 times more in contributions to Obama than McCain in the last election? And that ABC News aired stories supporting Obama’s health care reform efforts 55 times, with only 18 against? Isn’t it important to know all the facts?
Last week, CBS News aired two prime time programs entitled “Barack Obama: An American Dad,” and “Barack Obama: The American President.”
Before Obama went on his Middle East tour, NBC News aired four hours of interviews in prime time on two consecutive nights about a day in the life of Obama in the White House.
The print media is also in the tank for Obama. The PBS News Hour, The Washington Post, The New York Times, and Newsweek magazine published or presented positive items 42% of the times during Obama’s first two months in office vs 27% for Clinton and 22% for GW Bush during the same periods in their presidencies.
I guess one can say, ” Why not? ” All these media outlets want to sell things––– they survive on their advertisers and their viewers. If the president is portrayed as a celebrity star, rather than what he is ––– the nation’s prime mover of domestic and foreign policy––– we’ll never hear about those less “sexy” items. But I for one, am not interested about his dates in New York City or Paris, or how he swats flies ––– I want to know about his policies and how they affect me and my family and how they affect the nation as a whole.
An NBC/ Wall Street Journal poll recently found that 56% of the public lacked confidence in Obama’s economic policies; 56% were against the bailout of General Motors; and 52% opposed closing the Guantanamo Bay prison. Why don’t we hear more about these issues in the mainstream press? Do those on charge of these media outlets want to keep us in the dark?
I say let’s drop the celebrity bit. He’s not a film star, sports star, or an astronaut just back from space ––– he’s just our president. What he really up to?
Perhaps I’ve hit on the true Obama phenomenon, for this apparent enchantment with Obama. Perhaps it’s not that the media is in love with him. Perhaps it’s not that they feel he’s infallible. Perhaps it’s because, as the first ” Rock Star President,” if he’s always front and center, cluttering up the news, he’ll sell more products, more advertised thingamabobs, more widgets. Perhaps he’s really a creature of the media, their first ” Rock Star Pitchman” But if that’s the case, what about health care? Energy? The economy? Iraq? Iran? North Korea? Who’s watching the store? HELP!!!

The President and the Doctors

Wednesday, June 17th, 2009

Well, the health care reform ” fat is on the fire.” On June 15th, Obama addressed the AMA’s annual conference in Chicago. He added a paragraph to his stock speech on his vision of health care reform by raising the issue of medical malpractice reform. He provided few details. He said, ” I do think we need to explore a range of ideas.” But he refused to acknowledge that trial lawyers and enormous jury awards and settlements have resulted in skyrocketing medical malpractice premiums that have played a major role in the rise in the cost of health care.
The majority of lawsuits do not involve negligence, and are settled out of court because settlement is less expensive than a jury trial. Besides the cost of the settlements, the doctor or doctors involved are posted on the Physicians National Data Bank, which impugns their professional status as well as resulting in a huge increase in the cost of their malpractice insurance premiums, or cancellation of their policies. Thus, many physicians in high-risk fields ––– neurosurgery, emergency medicine, obstetrics, anesthesiology, and orthopedics ––– are leaving the practice of medicine or moving to states with more congenial malpractice regulations such as California and Texas. Other physicians practice defensive medicine ordering often unnecessary tests so that they don’t end up being sued.
And then Obama demonstrated how deeply he is indebted to (and manipulated by) the trial bar. In response to his initial few words on the malpractice issue, the AMA delegates applauded. And then came these words from the president: ” Don’t get too excited yet. Just hold on to your horses here, guys . . . . I want to be honest with you. I’m not advocating caps on malpractice awards.” In other words, his trial lawyer friends will continue to run the malpractice show. As he has shown since his inauguration, he is a captive of his many liberal interest groups.
Hopefully, the AMA leadership and its grassroots will understand this and resist the president’s blandishments. The imposition of Obamacare on this country will result in government control of medical practice, rationing, and the deterioration of quality while medicine will continue to be a feeding trough for the trial bar.

But in all these endless discussions about “reforming” health care, the real issues are rarely raised. Meaningful health care reform must include: the preservation of the patient-physician relationship without the government between them; reasonable cost controls without rationing of care; the ability of physicians to provide meaningful individualized patient management without bureaucrats and trial lawyers looking over their shoulders; significant tort reform; no increase in taxes to impose a single payer health system; realistic salaries for doctors and nurses; portability of all medical health insurance, not only from job-to job in the same state, but between states; a change from a defined benefit to a defined contribution by employers; and the provision of health insurance for the uninsured who really need it ( not the 40% who are undocumented aliens or the 20-25% who can afford insurance but decide not to buy it).

All of these can be achieved at a minimal cost and without a federal health insurance plan leading inevitably to a single payer system. But ultimately, in order to succeed with the reform I have outlined, a unified medical profession is necessary to thwart government takeover of health care. Physicians must unite and not fragment into self-serving, single issue groups (primary care vs specialty, surgical vs non-surgical, etc). Without them working together, health care in America is doomed. Doctors, not bureaucrats are the guardians of patients. Their expertise is vital in order to have a vibrant, high quality medical system, which in truth cannot cannot even exist without doctors. They are the key.

What?! Alternatives to ObamaCare??

Wednesday, June 3rd, 2009

All right.  Here’s the scenario.  It’s midnight.  It’s raining.  The roads are slick.  Someone is driving an 18 wheeler.  Just as it gets to the top of the hill and begins to descend, the driver finds that his brakes are dead. And as he frantically pumps away at those dead brakes, he sees you at the bottom of the hill in a stalled vehicle filled with other men, women and children.
Of course, that’s disaster. And that’s ObamaCare.

Okay.  You may remember, I had a post on Obamacare: May 13th. Now lets look at whether there are any alternatives.  There are and that’s what this post is all about.

There are four Republicans, two in the House (Ryan and Nunes), and two in the Senate (Coburn and Burr) who have crafted an alternative to the administration’s plans for reforming the health-care system.  It’s called the Patients’ Choice Act.  The bases for the plan are: redirect present subsidies for health insurance to individuals; and guarantee coverage for those with pre-existing conditions.  What are the details?
First is redirection of the annual $300 billion tax subsidy for employment-based health insurance to individuals in the form of tax credits.  Families would get $5,700/ year and individuals $2,300/year to buy insurance and invest in health savings accounts.  Low-income individuals would get a  $5,000 debit card to help purchase insurance and pay out of pocket costs. 25% of any money left in the accounts at the end of the year would be rolled over to the next year.
States would be able to sponsor one-stop Insurance shopping through Health Care Exchanges instead of allowing the federal government to control the process.  It would free up Medicare dollars and  give more resources to the states to increase the allowances to disabled and low income individuals.
This approach would allow doctors and patients to control the health care system rather than politicians.  Good idea,huh?

And one other item––– the uninsured. Allegedly they are the major reason to reform health care. About 47% of the 47 million uninsured are without insurance for less than four months.  They are people between jobs and are eligible for COBRA coverage for 3.5 months before a premium is due. Many are young people. Many decide to forgo this expense.  Another 4-5 million of the 47 million are really enrolled in Medicaid and are uncounted according to the Congressional Budget Office.  There are millions who are eligible for Medicaid but don’t enroll for various reasons. And, it is estimated that 25 to 40% of the 47 million are undocumented aliens, the group responsible for the progressive increase of the “uninsured.” If these numbers are correct, and I think they are, should we spend billions of dollars to fix a problem that is easily fixable without the expense.

There are ways to avoid that 18 wheeler careening down on us. Will we find them?

Musings on Memorial Day and Other Things

Monday, June 1st, 2009

May was a long month.  Lots on both the front and back burners for me.  So, few posts.  However, there was plenty of time for thinking.  I was struck by the general solemnity of the Memorial Day observances this year.  I think that was appropriate since we are at war, although many seem to ignore this or even deny it ever existed!
Thinking back to the origin of Memorial Day after the Civil war to memorialize the dead of that war, it ultimately became a way to recognize the dead heroes of all our wars.  When I was growing up, it was observed on May 30th of each year, whatever the day.  But its meaning was cheapened when it was moved to the last Monday in May in order to give the public a three or four day holiday. (A similar unfortunate decision was made in combining Washington and Lincoln’s birthdays into a single Monday known as President’s Day in February, and Armistice Day changed to Veterans Day in November).
Nevertheless, I was pleased to see the widespread observance of Memorial Day across the country. And Memorial Day and D-Day (the landing of Allied troops at Normandy Beach on June 6th, 1944) coming so close together should remind us of the great sacrifices of courageous men and women who have given their all for this country. May that patriotic spirit never die.

William S. Frankl, MD, All Rights Reserved