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Title: Blog by Novelist William S. Frankl, MD

Archive for October, 2010

The Critical Election: November 2, 2010!

Sunday, October 31st, 2010

My posts have been few and late this month. I’ve been wrestling with my novel, “Donovan’s Run,” which I hope to complete before the end of the year.
But let us return to important items. On November 2nd, the big election is on and I want to make a few observations.
First: I want to quote from Barack Hussein Obama who is supposed to be President of ALL the people of the United States. Into a final week of midterm election campaigning, he said Republicans had driven the economy into a ditch and then stood by and criticized while Democrats pulled it out. Now that progress has been made, he said, “we can’t have special interests sitting shotgun. We gotta have middle class families up in front. We don’t mind the Republicans joining us. They can come for the ride, but they GOTTA SIT IN BACK.”
Second: To a Latino radio audience, he proclaimed we need to “PUNISH OUR ENEMIES AND . . . REWARD OUR FRIENDS!” (caps are mine).
So, if the Republicans don’t take the House and possibly the Senate, this arrogant president and his toadies in Congress will relegate any opposition to his policies to the trash heap of American politics. We must win, and win big if the nation is to survive.

There are so many problems with Obama’s Administration: the stimulus bill that did nothing to deal with the recession; the attempt to pass Cap and Trade; his insults aimed at the Supreme Court; his hideous reform of the banking system; his abject foreign policy that has severely weakened us in the world;  but most egregious and against the will of the people ––– his abominable health care bill, OBAMACARE. And I wish to write about this last one specifically.
On the eve of the mid-term election, McDonald’s and 29 other companies have been granted a one-year waiver from an ObamaCare mandate that would’ve cost up to 1 million workers their healthcare coverage. The biggest single waiver went to a New York teachers union.
ObamaCare requires a medical-lost ratio (MLR) as high as 85%. McDonald’s and other trade groups have indicated it is unrealistic to expect that “mini-med” plans can provide this high percentage on benefits because of the large administrative costs associated with frequent worker turnover.
To block the repeal effort if the Republicans re-take the House, the Administration need to stave off bad  publicity from an early spike in the number of uninsured. Thus, groups sympathetic to ObamaCare plan to spend $125 million in advertising for it over the next five years ––– in addition to the taxpayer-funded promotions. These include four-color mailings to all Medicare beneficiaries, in addition to television commercials and Parade magazine ads featuring Andy Griffiths.
HHS Secretary Sebelius provided a return of $156 million to policyholders of Blue Cross Blue Shield of North Carolina as a result of the “new accountability” in healthcare reform. Actually, BC/BS is liquidating reserves that will no longer be needed when it terminates most of its current individual business. Policies purchased or substantially modified between now and 2014 won’t be grandfathered. BC/BS didn’t get a waiver.
Also not getting a waiver from MLR requirements are consumer-directed health plans. A traditional policy that spends $3400 on patient care and costs $4000 has an MLR of 85%. If the patient takes control of $800 more in spending to a higher deductible and the premium goes down $800, theMLR becomes 81.25%. There is no real difference, but the accounting looks worse and penalties will be charged. Therefore there is no equality under the law. Obama care is discriminatory in nature.
Obama care gives the secretary of HHS the authority to exempt some from the law. Or to subject others to ruinous rules. The remedy for a law that doesn’t work is repeal, not selective non-enforcement! Let us hope that the popular anger engendered by this law will descend on the Administration and those in the Congress who generated it, and that repeal is on the way on November 2nd.

VOTE! VOTE! VOTE! Get out there and VOTE! VOTE to reclaim our country!!!

The Thousand Autumns of Jacob De Zoet: A Review

Wednesday, October 6th, 2010

One of the finest writers of our time is David Mitchell. I’ve just completed his novel, THE THOUSAND AUTUMNS OF JACOB DE ZOET. Random House Publishers, New York, 2010, 479 pages. This is a short review of the book

David Mitchell was born and raised in England, and educated at the University of Kent, where he studied for a degree in English and American Literature followed by an M.A. in Comparative Literature. He lived for a year in Sicily, and then moved to Hiroshima, Japan where he taught English to technical students for eight years, before returning to England. He currently lives in Ireland with his wife, Keiko, and their two children.
His first novel, Ghostwritten (1999), won the John Llewellyn Rhys Prize for the best work of British literature written by an author under 35, and was shortlisted for the Guardian First Book Award. His two subsequent novels, Number9Dream (2001) and Cloud Atlas (2004), were both shortlisted for the Man Booker Prize. In 2003, he was selected by the literary magazine, Granta, as one of the Best Young British Novelists. In 2007, Mitchell was listed among Time magazine’s 100 most influential people in the world.

THE THOUSAND AUTUMNS JACOB DE ZOET is David Mitchell’s fifth novel. It’s a historical romance set in Shogunate Japan at a time when the country was closed to all but a handful of foreigners, mostly Dutch and Chinese traders confined to the tiny artificial island of Deshima in Nagasaki Bay. The story begins,unexpectedly, with the attempted delivery of a baby in the breech position. A young Japanese midwife, Orito Aibawa, performs the difficult delivery of a living, normal baby. De Zoet falls in love with her, but Japanese mores of the time present a severe obstacle.
We then encounter Unico Vorstenbosch, a new chief sent by the Dutch East India Company to clean up Deshima’s corruption. He is accompanied by Jacob de Zoet, a poor, pious young man eager to earn enough money to return to Holland and marry his sweetheart. What follows is a drama of love,war, theft, deception, betrayal, and the graphic depictions of midwifery and kidney stone removal, plus games of cards, billiards, and go. There is also a daring raid on a mountain abbey where unspeakable practices are undertaken to sustain the life of monks.
The depiction of late 18th and early 19th century Japan is told with great insight by Mitchell. His major characters: de Zoet, Orito, Vorstenbosch, Dr. Marinus, and Captain Penhaligon are clearly drawn and come alive in the narrative.
This book is a historical novel and cultural study filled with intrigue, mystery, and suspense. The dramatic construction, characterizations, and insight into historical conflict make it a must read novel.

ObamaCare Rationing Begins With Anti-Cancer Drugs

Wednesday, October 6th, 2010

By December, the FDA will likely revoke approval of the drug Avastin for the treatment of advanced breast cancer.  U.S. Senator David Vitter (R) of Louisiana described the anticipated move as “the beginning of a slippery slope leading to more and more rationing under the government takeover of health care,” (Sally C. Pipes, “The Era of Rationing Begins,” Pacific Research Institute, September 27, 2010):

1. The FDA claims its decision won’t be based on cost. However, Avastin is expensive — a full regimen costs about $100,000 a year.

2. Avastin has proven to be a wonder drug for many women with stage IV breast cancer. The drug slows the progression of the disease and dramatically extends life.

3. But when no significant increase in “overall survivability” was reported this summer, an FDA advisory panel recommended that Avastin’s approval be withdrawn.

4. No cancer drug has ever been withdrawn based only on “overall survivability.”  Determination of a drug’s effectiveness have always been based on tumor response and progression-free survival rates.

Avastin is a remarkable anti-cancer agent:

1. In the critical phase III of the study, tumors shrank in nearly 50% of patients on the drug.

2. Patients who received Avastin in conjunction with other chemotherapeutic agents lived almost twice as long as would otherwise be expected without their disease worsening.

3. For some patients on Avastin it means many years of additional life.

However, Government rationing doesn’t stop at Avastin.

1. Medicare coverage for Provenge, a drug for advanced prostate cancer might also be withdrawn.

2. Like Avastin, Provenge is expensive. It costs $93,000 a year.

3. The FDA has already approved Provenge as safe and effective. But Medicare officials are now deciding whether it will pay for the medicine.

So, as indicated above, this is just the beginning. If ObamaCare is not repealed and replaced, distant, faceless bureaucrats will be making all of Americans’ health care decisions in the very near future.

Please link to the Pacific Research Institutes Website for Ms. Pipes article: http://www.pacificresearch.org/press/the-era-of-rationing-begins

ObamaCare’s Redistribution Of Health

Wednesday, October 6th, 2010

Betsy McCaughey, former lieutenant governor of New York, paints a stark picture of the impact of ObamaCare: A massive redistribution of health resources according to new projections from the federal Centers for Medicare and Medicaid (Betsy McCaughey, “ObamaCare’s Redistribution of Health,” New York Post, September 27, 2010).

President Obama pledged to decrease the numbers of uninsured by making health plans affordable — but that’s not how his law does it. Instead, it loosens Medicaid eligibility by raising the income ceiling and barring asset tests. Here’s what will likely happen:

1. By 2014, 85.2 million people — 31% of all nonelderly Americans — will be on Medicaid and the Children’s Health Insurance Program (CHIP).

2. This accounts for the majority of Americans who’d gain health coverage.

3. But, only 3% more people will have private insurance.

ObamaCare also stipulates that Medicaid recipients get the same benefits that employers are required to provide workers, diminishing the incentive to work. It raises the question: why stay on the job if the benefits are just as good in Medicaid?
To expand Medicaid, the ObamaCare literally disembowels Medicare.

1. In 2019, for example, ObamaCare cuts Medicare funding by $86.4 billion — which works out to $1,428 less for each Medicare recipient that year.

2. Baby boomers will have difficulty accessing care that seniors now get.

3. Richard Foster, chief actuary for Medicare, has spoken out about the possible impact of these issues and warned that some hospitals and physicians might stop taking Medicare patients.

This is a grim picture of the future. We must push hard for repeal and replace this awful law.

Please see link to McCaughey’s article in the New York Post

Why ObamaCare Can Be Held Unconstitutional

Wednesday, October 6th, 2010

ObamaCare, requires every American to purchase health insurance or pay a fine.  The administration claims this unprecedented requirement is permitted by the Constitution’s Commerce Clause, which allows Congress “to regulate commerce…among the several states.”   Robert A. Levy, a distinguished legal scholar who chairs the Cato Institute board of directors, discussed the legitimacy of this legal interpretation in an article in Reason Magazine (“ObamaCare and the Constitution,” Reason Magazine, August-September 2010). He gave three reasons why the individual mandate should not pass constitutional review:

1.The Commerce Clause was never intended, and has never been used, to compel the purchase of a private product.  If Congress can force individuals to buy health insurance, then Congress can mandate the purchase of exercise equipment, diet foods, etc., etc., etc.,––––– extending the authority of the federal government over all manner of human conduct and nonconduct.

2. The penalty for violating the mandate is not a tax.  That means Congress’s power “to lay and collect taxes” does not apply.  To justify this mandate, Congress cited the commerce power but not the taxing power.

3. Even if the penalty is judged to be a tax, the Constitution does not authorize it.  The Supreme Court has held that Congress cannot use its taxing power as a backdoor means of regulating, unless the regulation is authorized elsewhere in the Constitution.  In this case, there is no other constitutional authorization.

For text: http://reason.com/archives/2010/06/17/obamacare-and-the-constitution

William S. Frankl, MD, All Rights Reserved