Archive for Medicine

Dr. Kill Dare

We’ve covered this story before, but since our president and Secretary of State still seem ignorant of it, let’s hear it again:

“I’m not scared,” said the Syrian, whose name was withheld by the hospital because Israel and Syria are in a state of war. “Nothing worse will happen to me, so who cares if I’m in Israel?”

Despite decades of hostility between Israel and Syria, hundreds of victims of Syria’s 3-year-old civil war have received life-saving treatments in Israeli hospitals. Israeli medical personnel say that while they’re happy to treat Syrians, the wounded pose a unique set of challenges.

“As nurses, it’s unique to deal with wounded like this,” said Refaat Sharf, a nurse at Ziv, which has treated 162 Syrian patients. “We hadn’t been used to these injuries, neither in terms of their character nor their frequency.”

Since last year, more than 700 wounded Syrians have come to Israeli hospitals via the Syria-Israel border crossing on the Golan Heights. The Israel Defense Forces has set up a field hospital there, and transfers patients it cannot care for to nearby hospitals. In some cases it brings a family member as well.

Adi Pachter-Alt, Rambam’s deputy director of social work, said the patients’ reluctance to speak openly about their feelings comes more from the trauma of being injured and less from ill will toward Israel.

“It’s hard for us to give overall emotional support because they mistrust us,” Pachter-Alt said. “It’s not due to the state of war. It’s because you’re in a different state after trauma. You’re very alone, very suspicious.”

Medical personnel said that when they do leave the hospital, Syrians are grateful for the care they received. The Syrian patient in Ziv said his opinion of Israel had flipped during his stay there.

“Before the revolt, the authorities told us Israel was the enemy and we must fight them,” he said. “But after the recent events there, I saw that in Israel they take care of the patients. All of the Israelis I met, Arabs and Jews, seemed unified.”

Don’t tell Oxfam that! They’ll just want to hire Scarlett Johansson back, and they can’t have her!


Cure HIV? Ask Me How!

Who said the Muslim world hasn’t contributed to science in centuries (millennia)?

An Egyptian TV channel recently aired a report on an Egyptian military invention of the first device that cures the HIV and hepatitis C viruses.

Anchor: There have been many reactions to the publications in the media that the Egyptian Military Engineering Department has invented a device that produces electro-magnetic waves, which eliminate the hepatitis C virus within 10 days with no side effects. The device has a 100% success rate.

General Dr. Ibrahim ‘Abd Al-’Aati, head of the team that invented the device: For this device, I was offered two billion dollars. I’m talking dollars! I was offered two billion dollars to forget about it, but I refused. I told them to write “an Arab Muslim Egyptian scientist discovered this.” But they said: “Forget about it. Just take the check, and we will fly you to any country in the world.” I said: “Why should I?” I fled back to Egypt. The Egyptian intelligence agency has protected me here. The intelligence nabbed me and brought me here.

Reporter: In 2010, the Egyptian military successfully invented a device that can identify a hepatitis C virus carrier in a crowd. Today, using the same methods, they have invented a treatment device. The patient’s blood passes through the device, which produces electro-magnetic waves that kill the virus, and turn it into amino acids.

D’oh! Why didn’t we think of that? Heckuva job, Anwar! Now, how about another machine that can turn malignant tumors into lime jello?

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Our Friends, the Nazis

Hey, don’t laugh.

Or cry:

At a secret site in Germany, after World War II ended, Americans used the services of Nazi scientists to develop advanced techniques for the investigation of Soviet prisoners, including the use of “truth serum” (LSD) and mind controlling methods which they would use on prisoners.

The doctors and elite Nazi scientists helped the Central Intelligence Agency (CIA) and the US intelligence system test the use of LSD and other investigative techniques that would help them extract information from the Soviet spies they had caught. The work took place in a German base named “Camp King”, near Frankfurt. In 1945, the site served as a detention center for the German scientists, but within three years, the detainees were the Soviets, while the German scientists became collaborators with the Americans.

An important asset for the Americans was Dr. Walter Schreiber, the Third Reich’s former Surgeon General who was later moved to an Air Force base in the US. The services of former Deputy Surgeon General of the Third Reich Dr. Kurt Blome, who was involved in biological warfare research, were also used in the base.

Ew. It’s one thing to plunder German rocket ingenuity, as we did with Werner von Braun (“A man whose allegiance/Is ruled by expedience”). But the Nazi eugenicists? What possible common cause would we have with the likes of Mengele’s bosses? (The very idea of a Surgeon General for the Third Reich should make us sick. It does.)

The motive behind the establishment of “Operation Paperclip” was a suspicion raised by top security and military American leadership’s memos – that the US and the Soviet Union may enter a “total war” in 1952, a war that will include the use of nuclear, chemical and biological weapons. For that reason, the Americans decided to use every means at their disposal, including Adolf Hitler’s top scientists and the chemical warfare they developed under the Third Reich, including sarin gas and biological weapons.

[T]he CIA soon showed an interest in using LSD outside of the battlefield, and in intelligence warfare. At the time, Americans were examining options of mind manipulation by using drugs, hypnosis and electric shock, in an attempt to match similar Soviet techniques of interrogation.

Take a second here. The Soviets were our allies in WWII (hard not to use “” around allies); the Nazis, the most evil regime the world had ever seen (until Mao?), were our enemies. (I’m going to excuse Genghis Khan out of multicultural sensitivity.) Yet we were cuddling Nazi “doctors” (had to use “” there) before the last mortar was fired, the last camp liberated.

It can’t have been because we didn’t know. Our interest in them meant of course we knew. What else did we want from the “Surgeon General” of the Third Reich? Cold remedies? Come on.

We were expecting “total war” (from ‘shrooms to mushroom clouds) with our “ally” less than a decade after celebrating victory in the ETO with them. There had to be a reason. Maybe we knew something there too.

Maybe we knew that Stalin had been ally of the Nazis too. (No need for “”; they signed a nonaggression pact.) Maybe we knew something about Lenin’s and Stalin’s “cleansing” of any reactionary forces or beliefs (which process was anything but clean). Maybe we knew something about Stalin’s role in the Ukraine famine that took millions of lives (not that we learned anything about it in the New York Times).

Churchill knew:

‘Terrible things have happened. A tide of Russian domination is sweeping forward . . . After it is over, the territories under Russian control will include the Baltic provinces, all of eastern Germany, all Czechoslovakia, a large part of Austria, the whole of Yugoslavia, Hungary, Romania and Bulgaria.

‘This constitutes one of the most melancholy events in the history of Europe and one to which there has been no parallel.

He got that right. He even wanted to go to war with the Soviets to push them back—even using German forces as they surrendered! But no one else had the strength or the nerve. Instead, they hunkered down for forty-five years of Cold War. Eastern Europe—half a continent—was lost to freedom for two generations. The wounds are still raw today.

Every war is dirty, ugly, cruel. The dogs of war maul the innocent as well as the guilty. It’s no different in a Cold War, even if no (or few) shots are fired. Maybe the “Surgeon General” of the Third Reich had clean hands.

Maybe. Doubtful. Nah…

They may have been Nazis, but they were our Nazis. That was not right, but when presented with the monsters of Hitler and Stalin (and later Mao), what the [bleep] was one supposed to do?


Eye Candy From Israel

Readers Jeanette and Yerushalimey sent us some pretty cool news from Israel.

Jeanette’s story:

Women have proudly served in the IDF since the very beginning. Israel’s first Prime Minister, David Ben Gurion, wrote an impassioned letter to religious communities outlining the necessity of women serving and protecting Israel. Since then, women have taken increasingly high-level positions in the IDF. These female Israeli soldiers challenge stereotypes through the work they do every day.

Just two examples:


First Sgt. Monaliza Abdo is an Arab-Israeli woman who proudly served her country as a combat soldier. She wasn’t required to enlist, but her determination to protect Israel motivated her to volunteer. As a fighter on Israel’s southern border, she rose through the ranks to become a commander, teaching soldiers how to combat terrorism and other threats. Just a few weeks ago, she honorably completed three years of service – one more than the required number for Israeli women.

Lt. Amit Danon was the Israeli national champion in rhythmic gymnastics when she enlisted in the IDF. After embarking on her path as a soldier, she decided to leave her previous life behind and became a combat officer in the mixed-gender Caracal Battalion. Lt. Danon now leads other soldiers as platoon commander.

Six other pretty neat stories at the link. Before I move on to Yerushalimey’s story, can I just mention to any fashion designers in our readership that the military look is molten hot on women? Take it to the bank.

Yerushalimey’s story:

University’s Professor Zeev Zalevsky created a contact lens that, when attached to electrodes, creates sensations in the retina of the eye that can be translated into images. The contact lens receives signals from a regular “off the shelf” camera or smartphone, which the wearer either holds or wears. When a blind person wearing the fitted contact lens looks at an object or points the camera towards it, the camera converts the image into electronic Braille by sending tactile sensations to the retina. The communication system between the camera and the lens operates by Radio Frequency Identification, or RFID.

Although still in the prototype stage, the system has been successfully tried out on animals. One of the results of those studies shows that the animals could actually see their way through an obstacle course in the dark. Nighttime vision is one of the challenges that Zalevsky hopes to overcome next. He speculates that by connecting an infrared camera to a transponder delivering sensations to the contact lens, wearers would be able to see in the dark.

Okay, maybe other bloggers would have led off with the miracle of sight over pictures of hot chicks firing automatic weapons. You’re welcome to read those blogs. We go to the important stuff eventually.

Maybe I’m the weird one (ahem), but I kind of like being an ally of a country like Israel. Those were the days.

News like this daily at Good News From Israel.

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Feel Good Story

My last post of the day will be a heartwarming one.

Trust me:

This week saw Israel deliver vital medical services to Syrian patient number 200. Last month, a twenty-year-old Syrian refugee gave birth to a boy in the Rebecca Seiff Hospital in Safed, making the baby’s delivery the first Syrian refugee birth in an Israeli medical facility.

The biggest winner of 2013 was not one individual; rather a group of health care professionals in northern Israel from Ziv Medical Center in Safed and Sieff hospital who cared for wounded Syrians.

The endless misery unfolding in Syria has produced few moments of optimism.

A telling example is the pregnancy in Sieff hospital. Mira Eli, the nurse in charge of the maternity delivery ward at Sieff, described the care provided to the pregnant Syrian woman: “We gave her a hug, a shower and food. We gave her postnatal advice. She’s a very young woman who came without her husband or anyone else accompanying her, and it was her first delivery. Our job is to ensure that every new mother remembers her delivery as an unforgettable positive experience, whatever her ethnic, national or religious background.”

The young Syrian mother said, “I don’t feel like I am in an enemy country. The staff are all helping me and worrying about me. My baby, too, is getting wonderful, devoted care.”

Dr. Oscar Embon, the director of Sieff hospital, told BBC’s Kevin Connolly, “I don’t expect them [Syrians] to become lovers of Israel and ambassadors for what we do here, but in the interim I expect they will reflect on what was their experience here and that they will reflect differently on what the regime tells them about Israelis and Syrians being enemies.”

There’s always hope.

But maybe not for everyone:

Major European news organization devoted fair and balanced coverage of Israel delivering medical services to Syrians. There was, however, commentary that attributed a typical wildly conspiratorial thinking to Israel’s role in Syria.

The Der Spiegel online magazine columnist Jakob Augstein, who previously blamed Israel for the post-Arab Spring violence in Libya, Sudan, and Yemen, quoted Prime Minister Binyamin Netanyahu as saying that “Israel has its finger on the trigger” in the Syria conflict, suggesting Israel controls the contours — and outcome — of the Syrian civil war.

In fact, Netanyahu’s correct statement was “Our finger must always be on the pulse. Ours is a responsible finger and if necessary, it will also be on the trigger. We will always know to defend our people and our state against whoever attacks us, tries to attack us or has attacked us.”

Herr Augstein almost gives Germany a bad name, doesn’t he?

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Medical Privacy

The check’s in the mail… and your patients can keep you!

Two months before enrollment began in the Obamacare exchanges, the administration’s top health care official heaped praise on WebMD for launching an online resource to help Americans navigate the complex law.

The consumer health care site had the occasional nice thing to say about Obamacare, too. In one article, it predicted doctors might pick up more patients and crowed in an article titled “7 Surprising Things About the Affordable Care Act” that many consumers already had received insurance refunds under the law.

But what neither Health and Human Services Secretary Kathleen Sebelius nor WebMD mentioned at the time was that the company, which millions of Americans regularly read for health news, also stood to earn millions of dollars from a federal contract to teach doctors about Obamacare.

The contract documents, reviewed by The Washington Times, reward WebMD handsomely.

WebMD says it doesn’t believe it had an obligation to disclose to its broad consumer base its $4.8 million contract with the government.

You can see the lumps from the wads of cash stuffed inside the pockets of the White House-provided lab coats. Don’t spend all thirty pieces of silver in one place!


How Many Lies Are There in the “Patient Protection Affordable Care Act”?

Spoiler Alert: Every word, including “the”.

Obamacare does nothing to link doctors’ fees to their performance and reduce health-care costs, the head of the Mayo Clinic told CNBC on Friday.

“The Affordable Care Act is basically insurance reform—eligibility and access—and basically, they are going to pay for that by reducing the reimbursement. It doesn’t modernize how we drive to higher quality care,” Dr. John Noseworthy said in a “Squawk Box” interview.

He said that updating reimbursement methods to reflect better outcomes will lower health-care costs. “Right now, we’re in a system where we’re reimbursing volume of care not quality and outcomes of care—safety, efficiency and so on. And that’s where most of the costs are.”

Noseworthy sppoke a day after the head of The Cleveland Clinic, Dr. Toby Cosgrove, told “Squawk Box” that Obamacare is going to have “unintended consequences” that will need to be addressed…

The current way physicians are paid has “nothing in there to really motivate and stimulate moving towards a more efficient system,” he said.

Obama thinks doctors sever limbs for generous reimbursements (see here). Real doctors, however—not those wrapped in hastily-distributed lab coats stitched with the names “Marcus Welby” and “Ben Casey” for a photo-op—are concerned with cost and care.

“It’s an experiment that we’ve never done before. So unfortunately I don’t think we say how this is going to turn out,” Dr. Toby Cosgrove said on “Squawk Box.”

“We know we need to take cost out of the [health] system. That’s what’s happening right now,” said Cosgrove, who heads a $6 billion hospital and health system.

“This is probably as big a social change that’s happened since the New Deal came along, because it affects 100 percent of the people in the United States and their health care and the cost of that,” he said.

“It’s obviously disappointing that we’re having so many problems getting this organized. But it has not had major effect,” Cosgrove said. “If they can get these problems cleared up by the end of the year, hopefully we’ll go forward with the program.”

I’m reassured, how about you? Anyway, what do the Cleveland and Mayo Clinics know about medicine? As one famous physician said, “We have to cut open the patient to find out what’s in him.”

It’s a metaphorical cut-throat world among hospitals, trying to keep costs competitive while also employing all the advanced knowledge and technology at hand in this first-plus world. Also, docs who invest more than a decade of their youth in education and training on the healing of our bodies are entitled to generous rewards for their efforts and sacrifices.

When Dr. BozObama enters the room, the patient has every reason to be panicked.


Syrian Exports (aka Apartheid State Upate)

Why shouldn’t Syria send its chemical weapons to Iraq? Where do you think they got them in the first place?

Syria has moved 20 trucks worth of equipment and material used for the manufacturing of chemical weapons into neighboring Iraq, the Lebanese daily Al-Mustaqbal reported on Sunday.

The government in Baghdad has denied allegations that it is helping the Syrian government conceal chemical stockpiles.

The report came just a day after the United States and Russia struck a deal stipulating that Syrian President Bashar Assad’s regime would destroy its chemical arsenal to avert an American military assault.

The newspaper reported that the trucks crossed the boundary separating Syria with Iraq over the course of Thursday and Friday. Border guards did not inspect the contents of the trucks, which raises suspicions that they contained illicit cargo, according to Al-Mustaqbal.

Last week, the head of the Free Syrian Army told CNN that opposition intelligence indicated Assad was moving chemical arms out of the country.

“Today, we have information that the regime began to move chemical materials and chemical weapons to Lebanon and to Iraq,” General Salim Idriss told CNN.

“We have told our friends that the regime has begun moving a part of its chemical weapons arsenal to Lebanon and Iraq. We told them do not be fooled,” Idris told reporters in Istanbul.

Hard for fools not to be fooled, General. It’s their nature.

But on a happier note, Syria exports more than sarin and VX:

Less than 160 km. from Damascus, a Syrian rebel lies in a hospital bed, an Israeli sentry at the door. Nearby a Syrian mother sits next to her daughter, shot in the back by a sniper.

What started this year as a trickle is now a steady flow of Syrians, scores of civilians and fighters wounded in the civil war and being discreetly brought across the Golan front line into Israel.

For all the advantages it brings of excellent medical care, it is a journey fraught with risk for those who fear the wrath of President Bashar Assad’s government.

“There was one man, where I am from, who was treated in Israel. The regime forces killed his three brothers,” the teenage girl’s mother said. “They will kill my sons and my husband if they ever find out we were here.”

For fear of retribution back home, Syrians in Israeli clinics who spoke to Reuters asked not to be named.

The woman’s 16-year-old daughter, whose wounds have left her paralyzed in both legs, lies stone-faced as an Israeli hospital clown juggles and dances, trying in vain to raise a smile.

I’ve given up wishing the whole world wake from its Jew-hating slumber to see Israel not only as a better nation relative to its neighbors, but as a good nation on an absolute scale. Such visions on my part are hallucinations, not wishes.

All I ask for is each person who reads these dispatches keep an open mind and judge for herself. It’s not too much to ask, and my ultimate wish may yet be granted.

Israel refuses to accept refugees from a country with which it is at war. But it does provide medical care, and it has made no secret of doing so.

The Nahariya hospital has treated more than 80 Syrians since March, around the time the Israeli military began taking in wounded Syrians who reach its lines seeking help.

The army does not reveal how the Syrians are brought over, nor whether it coordinates with rebels or others who deliver them into Israeli hands.

“This is a very sensitive issue and people’s lives are at stake,” a military spokeswoman said.

The Israeli army has set up a field hospital on a mountain ridge that overlooks a cluster of Syrian villages on the plain.

“We don’t know how they come in,” said Shukri Kassis, a doctor at Ziv Medical Center in Safed, 40 km. from the Syrian front line. “We just get notified by the army doctors that they are bringing them here.”

Kassis said his clinic had taken in more than 90 Syrians since February.

“They could be al-Qaida. We just don’t know,” one staff member said, adding that the men were being guarded for their own safety too – in case of disputes among patients.

“For us, Israel was always the enemy,” one Syrian woman from the southern city of Deraa said at Ziv, where she and her eight-year-old daughter were being treated after being caught in an explosion. “Thank God, I am happy here. I am well treated.”

The Free Syrian Army fighter said word of Israeli treatment was spreading back home: “I was happy when I found I was here,” he said. “Most fighters know they will get good care in Israel.”

Come on, if Syrian rebels accept Israel as decent and humane, how hard is it for the rest of you?

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Surgical Strike

Earlier today, we learned how well lobbyists (who wrote the poxy thing) were doing under ObamaCare.

Doctors… not so much:

Some 10,000 baby boomers will retire every day for the next 19 years, including many doctors. But at the same time, more people will be looking for health providers under ObamaCare — meaning there could be a potentially wide numbers gap between those seeking treatment and those available to provide it.

Dr. Jeff Cain, President of the American Academy of Family Physicians, explains,”we have an increasing population, we have more Americans that are getting older that need more health care. And with the 30 million Americans that are newly insured with the affordable health care act, more people are looking for primary care.”

In fact, medical colleges predict a huge shortage — of more than 90,000 physicians by 2020 and a whopping 130,000 or more by 2025.

Avik Roy of the Manhattan Institute for Policy Research, a conservative think tank, adds that on top of retiring baby boomer physicians, “there are a lot of doctors who are just so frustrated; today with all the bureaucracy involved in taking care of patients that they’re retiring early.”

Dr. Ramin Oskoui, president of the medical staff at Sibley Hospital in Washington, says “one of the great misconceptions about ObamaCare is that just because you have health insurance, you’ll therefore get adequate health care and you’ll have access to it. I think nothing could be further from the truth.”

But Dr. Obama has just the solution!

The president praised the role of nurses recently and said, “there’s a lot of stuff they can do in a way that, frankly, is cheaper than having a doctor do it, but the outcomes are just as good.”

We all have our nurse fetishes (don’t we?), we just don’t write them into law. But I’ll stipulate that they can do “a lot of stuff”. Which is why every doctor’s office I know of already has nurse practitioners and physician’s assistants. What doctor’s offices won’t have (soon enough) is doctors.

John Goodman of the National Center for Policy Analysis in Dallas points to Massachusetts as an example, noting that “in Boston right now, where they say have universal coverage, the wait for a patient to see a new doctor is two months and that’s the longest wait in the whole country.”

Sen. John Barrasso, R-WY, who is also a doctor, argues “the health care law put a lot of money into hiring more IRS agents to enforce the law, but not that same kind of focus on training more doctors and nurses and others to take care of patients.”


Breathing Easier

Let’s catch up with the little girl who refused to become the first victim of President Obama’s and Kathleen Sebelius’ “death panels” (©Sarah Palin):

Sarah Murnaghan fully understands all she’s been through: her lifelong battle with cystic fibrosis that led to her deteriorating lungs, the campaign her parents waged that temporarily changed national policy surrounding organ transplants, and the fact that she came so close to death in the days leading up to her two double lung transplants.

“She said, ‘Mommy, I knew I was dying,’ ” Janet Murnaghan recalls. “That was like a very crushing moment for me. And she said ‘I just didn’t want to tell you I was dying because I didn’t want to upset you.’ ”

Her parents say that was the toughest part.

“She asked, ‘If I go to sleep, will I wake up the next morning?’ ” remembers her father, Fran Murnaghan.

Today, spirits are vastly different than they were two months ago, when Sarah — who’s had cystic fibrosis since birth — was in dire shape after being on the waiting list for pediatric lungs for 18 months. Her first transplant was a failure. After keeping Sarah alive for days by circulating her blood outside of her body to keep oxygen flowing, she received a second transplant. Aside from a brief scare with pneumonia, this one was a success.

Now Sarah and her family are preparing to head home for the first time in half a year.

In case you forgot the heartless (and very nearly lungless!) cruelty of ObamaCare (ha!):

For a vivid illustration of the extent to which life-and-death medical decisions have already been usurped by government bureaucrats, consider the recent refusal by Health and Human Services Secretary Kathleen Sebelius to waive the rules barring access by 10-year old Sarah Murnaghan to the adult lung-transplant list. A judge ultimately intervened and Sarah received a lifesaving transplant June 12. But the grip of the bureaucracy will clamp much harder once the Independent Payment Advisory Board gets going in the next two years.

The board, which will control more than a half-trillion dollars of federal spending annually, is directed to “develop detailed and specific proposals related to the Medicare program,” including proposals cutting Medicare spending below a statutorily prescribed level. In addition, the board is encouraged to make rules “related to” Medicare.

The ObamaCare law also stipulates that there “shall be no administrative or judicial review” of the board’s decisions.

Sarah Murnaghan doesn’t know how lucky she is. Or maybe she does:

Janet says when things get difficult, she and Fran do their best not to let their emotions show, especially around Sarah. But they admit it’s happened.

“She’ll say, ‘Mom what’s wrong?’ I said, ‘It’s just hard Sarah. You worked so hard today, and you’re obviously so exhausted. I wish life were easier for you.’ And she said to me, ‘But it’s not easy, and that’s OK.’ ”

And that’s been Sarah’s mantra: “I’m not going for easy, I’m just going for possible… And what’s in front of me right now is possible.”

Strong, clear-headed women named Sarah: I just have a thing for them.


The Health Care System We Have…

And the system we could have had:

Every so often I have an extraordinary and surprising experience with a patient—the kind that makes us both say, “Wow, we’ve learned something from this.” One such moment occurred recently.

The insurance policy, the clerk said, would pay up to $2,500 for the surgeon—more than enough—and up to $2,500 for the hospital’s charges for the operating room, nursing, recovery room, etc. The estimated hospital charge was $23,000. She asked him to pay roughly $20,000 upfront to cover the estimated balance.

My patient was stunned. I received a call from the admitting clerk informing me that he wanted to cancel the surgery, and explaining why.

I explained that just because he had health insurance didn’t mean he had to use it in every situation. After all, when people have a minor fender-bender, they often settle it privately rather than file an insurance claim. Because of the nature of this man’s policy, he could do the same thing for his medical procedure. However, had I been bound by a preferred-provider contract or by Medicare, I wouldn’t have been able to enlighten him.

Most people are unaware that if they don’t use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the “list” price. Doctors are happy to do this. We get paid promptly, without paying office staff to wade through the insurance-payment morass.

So we canceled the surgery and started the scheduling process all over again, this time classifying my patient as a “self-pay” (or uninsured) patient. I quoted him a reasonable upfront cash price, as did the anesthesiologist. We contacted a different hospital and they quoted him a reasonable upfront cash price for the outpatient surgical/nursing services. He underwent his operation the very next day, with a total bill of just a little over $3,000, including doctor and hospital fees. He ended up saving $17,000 by not using insurance

This process taught us a few things. First, most people these days don’t have health “insurance.” They have prepaid health plans. They pay premiums to take advantage of a pre-negotiated fee schedule arranged for and administered by a third party. My patient, on the other hand, had insurance.

Second, even with the markdown for upfront “cash-pay” patients, none of the providers was losing money on my patient. Otherwise they wouldn’t have agreed to the prices. With the third-party payer taken out of the picture, we got a better idea of the market prices for the services. It is the third-party payment system that interferes with true price competition, so “market clearing prices” can’t develop.

Take the examples of Lasik eye surgery or cosmetic surgery. These services are not covered by insurance. Providers compete on the basis of quality, outcomes and price. And prices have continually dropped as quality and services have improved—unlike the rest of health care.

When my patient returned for his post-op visit we discussed the experience. It was clear to both of us that the only way to make health care more affordable is to diminish the role of third-party payers. Let consumers and providers interact through market forces to drive down prices and drive up quality, like we do when we buy groceries, clothing, cars, computers, etc. Drop the focus on prepaid health plans and return to the days of real health insurance—that covers major, unforeseen events, leaving the everyday expenses to the consumer—just like auto and homeowners’ insurance.

Now, I know this story will drive Captain Arizona to hurl himself into the deepest chasm of the Grand Canyon (here’s hoping—just kidding, Cap’n!), but it just re-proves Margaret Thatcher’s maxim: the facts of life are conservative.

Cue today’s America!

Sadly, we are heading in the exact opposite direction. ObamaCare expands the role of the third party and practically eliminates the role—and the say—of the patient in the delivery of health care. Will they ever learn?

Remember when candidate Obama likened Republicans to bus drivers landing their vehicles in a ditch? Hasn’t he steered the nation’s omnibus straight off Captain Arizona’s steepest, deepest canyon bluff? It’s a hell of a ride. Until the end.


The Sound of Settled Science

“Would you like fries with that?”

A study commissioned by the Centers for Disease Control and Prevention (CDC) — performed by the Institute of Medicine of the National Academies — has found that there is no benefit of reducing salt intake to below one teaspoon per day. The report reviewed the health benefits of reducing salt intake, as salt consumption was previously considered a substantial health hazard, particularly to those with high blood pressure.

The study, entitled “Sodium Intake In Populations: Assessment of Evidence,” confirms that there is no evidence substantial enough to limit sodium consumption to less than 2,300 milligram daily for Americans. Researchers concluded that one-and-a-half to three tablespoons of salt per day is not detrimental to a person’s health, contrary to past belief.

Previous to this study, a low-salt diet was thought to be as sacrosanct as global warming. Just saying.

Speaking of blood (though not of blood pressure):

On Friday, gay men in 53 cities across the country lined up outside Red Cross centers to give blood, and to get turned away, intentionally. Since 1983, the Food and Drug Administration has banned gay and bisexual men from donating, a policy activists and, on June 18, the American Medical Association, say is discriminatory and reflects outdated medical assumptions.

In Boston, 21 men arrived at the Red Cross donor center on Tremont Street Friday afternoon, got tested for HIV, and brought their results, all negative, with them to try to donate. When they were turned away, they all left quietly, thanking Red Cross screeners politely.

“It isn’t really a sexy LGBT issue,” said Ryan Yezak, a 26-year-old Los Angeles filmmaker who organized the demonstration just weeks after the Supreme Court invalidated the federal Defense of Marriage Act. Yezak will count the number of gay men turned away Friday and send the men’s negative HIV tests to the FDA to ask for a change in the policy.

But for Yezak, the ban recalls rhetoric that called homosexuality a disease and society’s disgusted reaction to gay men during the early years of the AIDS crisis.

When potential donors fill out a medical history survey, male donors are asked if they have “had sexual contact with another man since 1977, even once.”

That means the FDA automatically excludes more than 4 million Americans from donor lists, the number of men identifying as gay or bisexual, according to a 2011 report by the Williams Institute, a lesbian, gay, bisexual, and transgender legal research group. And the number of men reporting any same-sex activity during their lives is higher, the report said.

The FDA regulates donors based on medical history, whether they have traveled somewhere with dangerous blood illnesses recently, and their behavior. A spokeswoman for the agency said in an e-mail that gay men fall under the last category, along with “intravenous drug abusers and commercial sex workers.”

She said the agency opposes donations from gay men who test negative because the virus is difficult to detect in its early stages. The policy is “currently under evaluation,” the spokeswoman said, and the FDA may “consider new approaches.”

Having lived in the UK (20 years ago), my blood is traif too: exposure to mad cow disease. It doesn’t make sense to me either, but I’m sure it would to a blood recipient. I’m being “discriminated against” for having eaten British beef, not for having lived in Britain—just as these men are being “discriminated against” for behavior that may have inadvertently infected them, not for for being gay. We both exposed ourselves to pathogens no one else wants. Pretty simple.

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