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Title: Blog by Novelist William S. Frankl, MD


The Christmas/Hanukah celebrations are for family and friends and every statement of one’s religious beliefs. It is a time for reflection and peace. Therefore, I decided to leave the cannon balls for 2011. Nevertheless, so many things occurred since my last postings that I decided to take a few shots before the new year.


In the lame duck session, I want to draw attention to 13 Republican U.S. senators who voted with the Democrats on a key issue. I should remind those up for re-election of the possibility of primary challenges to their re-nomination.

The START treaty concedes a permanent edge in nuclear weaponry to Russia. While the treaty provides for equal and reduced stockpiles of strategic warheads, it did nothing to address the vast stockpiles of tactical nuclear warheads held by the Russians. They have 10,000 of these battlefield nuclear weapons piled up, much of them in Europe, while we have only a few hundred.

Also, START’s preamble blocks the U.S. from developing missile defenses, now especially important in light of North Korea’s and Iran’s expanding capacities.

Two senators, in particular, deserve to have primary challengers take them on in 2012 & 2014. Tennessee’s Bob Corker and Mississippi’s Thad Cochran. Corker and Cochran face re-election in 2012 and 2014 respectively. They should both be challenged for the nomination by men who put our need for national security above appeasing the Russians.

Bob Corker sits on the Senate Foreign Affairs Committee along with Sen. Johnny Isakson of Georgia. Thy are both on the Republican minority on the committee, led by Sen. Richard Lugar, the ranking GOP member on the panel. All three voted for START.

Unfortunately, Isakson is not up for re-election until 2016. When he does come up for re-election, we hope that the citizens of Georgia’s Republican party hold him to account.

Lamar Alexander, also of Tennessee, backed START and faces re-election in 2014.

So who all sold out? Which Republicans vote for this Treaty? Well, here are the Republican turncoats:

Lamar Alexander (R-TN)
Bob Bennett (R-UT)
Scott Brown (R-MA)
Thad Cochran (R-MS)
Susan Collins (R-ME)
Bob Corker (R-TN)
Judd Gregg (R-NH)
Johnny Isakson (R-GA)
Mike Johanns (R-NE)
Richard Lugar (R-IN)
Lisa Murkowski (R-AK)
Olympia Snowe (R-ME)
George Voinovich (R-OH)

Should Republican Senators Voting for START Ratification be Punished by The Voters?

There is little point in focusing any animosity against those Republican senators who are retiring from the Senate this year. However, what if anything can be done about the remaining Republican senators who voted for the Treaty. These Senators, especially, should be made to face a primary opponent in their bid for a new Senate term in 2012/2014:

Lamar Alexander (R-TN)
Scott Brown (R-MA)
Thad Cochran (R-MS)
Bob Corker (R-TN)
Richard Lugar (R-IN)
Olympia Snowe (R-ME)

Five of these should be vigorously opposed in their states by the TEA Party and by Republican conservatives. I urge conservative Republican activists in Tennessee, Indiana, Mississippi and Maine to find strong opponents to run against Bob Corker, Richard Lugar, Olympia Snowe, and Thad Cochran respectively.

In particular, Richard Lugar must be defeated. In the Senate since 1977, now in his sixth Senate term, he’ll be 80 years old in 2012. Enough already! The people spoke on November 2nd. It’s too bad everybody hasn’t listened. But we, the voting public have. Keep a close eye on all of these politicians, keep a fire under them, and vote out those who are turncoats.


End of life planning touched off a political storm over so-called “Death Panels.” While this proposal was part of the House of Representatives Bill, it was dropped in the Senate bill, which became essentially the final version of ObamaCare. But now the Obama administration looks to achieve the same goal by regulation starting January 1, 2011. Under the new policy outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which might include advanced directives to avoid aggressive life-sustaining treatment. Those in Congress who support this new regulation are pleased by have kept it quiet because they are afraid of lighting a fire of revived opposition.

The final ObamaCare legislation authorized Medicare coverage of yearly physical examinations or so-called wellness visits. This new regulation has been injected into this benefit indicates that Medicare will cover “voluntary advance care planning” to discuss end-of-life treatment as part of the annual visit.

The new law does not mention advance care planning but the Obama administration is now able to achieve its policy goal through the regulation-writing process, a strategy that could become more prevalent in the next two years as the president deals with the strengthend Republican opposition in Congress. This new regulation was included in a huge Medicare regulations setting setting payment rates for thousands of services including arthroscopy, mastectomy, and x-rays.

The rule was issued by Dr. Donald Berwick, interim administrator of the Centers for Medicare and Medicaid services. He is a cancer specialist who has long advocated end-of-life care. According to him, “Using unwanted procedures in terminal illness is a form of assault.” He has also said, “in economic terms, it is waste.” The new Speaker of the House, John Boehner, in the past has said, “Obama’s death panel would decide who was worthy of healthcare. This provision may start us down a treacherous path toward government encouraged euthanasia.”

Eternal vigilance is necessary. This Administration is willing to do almost anything to thwart the will of the people. This behind-the-scenes effort to get around both the people and the Congress is the modus operandi of the Obama regime. As expected, once the news was leaked, denials and half truths came from an Adminisration spokesperson. The Wall Street Journal in its report on this matter on 12/27 indicated that the White House was quick to distinguish the new regulation from the system envisioned originally in the healthcare reform legislation. White House spokesman Reid Cherlin is quoted as saying, “The only thing new here is a regulation allowing the discussions…to happen in the context of the new annual wellness visit created by the Affordable Care Act”( ObamaCare).


I suggest everyone read the article “Inpatient or Outpatient? The Battle to Control Costs.” (Philadelphia Inquirer, Sunday, December 26, 2010. www.philly.com). The article discusses the problems Abington Memorial Hospital (an excellent Philadelphia suburban Hospital) is  encountering in its emergency department regarding admission of patients for inpatient status or observation status. Payment to the hospital by insurance companies for inpatient status is about 2 to 3 times higher than for observation status. This is determined not by the physician but by InterQual.

InterQual was developed in the 1970s but has grown in influence and has been the primary tool that many insurers and hospitals use to determine if a patient qualifies for admission. For almost every ailment, InterQual has two categories: severity of illness (is the patient sick enough to warrant and mission?); and the intensity of service (is the hospital doing enough to warrant admission?). In other words, are you sick enough and is the hospital doing enough?InterQual is absurdly rigid. If the heart rate must exceed 100 beats a minute for inpatient admission, 99 beats are not enough.
This problem is not confined to Abington Hospital. This is a nation-wide problem. The bean counters are beginning to determine life-and-death issues. Welcome to the New Age of American Medical Care.


Because of an Obamacare provision taking effect on Jan. 1, Americans won’t any longer be able to use their flexible spending account (FSA) or health savings account (HSA) pre-tax dollars to purchase non-prescription, over-the-counter medicines (except insulin).

Under current rules, health consumers can use these pre-tax accounts to purchase non-prescription, over-the-counter medicines. But on 1/1/11, the 40 million Americans who use FSAs and HSAs won’t any longer be able to use their accounts to buy over the counter medicines like the following:

* Aspirin
* Antacids
* Laxatives
* Menstrual pain relievers
* Antihistamines
* Stimulants
* Anti-ulcer medicines
* Athlete’s foot cream
* Cough medicine
* Motion sickness medicine
* Anti-diarrheal medicine
* Decongestants
* Hemorrhoid cream
* Anti-flatulence medicine

This provision is just one of Obamacare’s 24 new or higher taxes that total almost $600 billion over this decade.

The tax increase will affect any family with an HSA or FSA. There is no medical insurance program that gives patients freedom of choice in health care that the Obama regime doesn’t want to destroy. Oh, yes, and I forgot Obama’s promise not to raise taxes on any family making less than $250,000/year.


However on the pleasant side of life, I recommend everyone see “THE KING’S SPEECH. It is superb. Don’t miss it.It’s a story about someone acting like a grown up, someone doing his job, someone taking on enormous responsibility. It’s about a time when someone could take on the mantle of leadership as a great and important challenge, someone who was willing to sacrifice his comfort for his country. Someone who was old-school, someone who wasn’t cool. Someone, unfortunately, who is an avis raris in our society, an avis raris in the western world today.


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