Michael Kennedy

An Update on healthcare reform.

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Cash medical practice or, in the phrase favored by leftists critics, “Concierge Medicine,” seems to be growing.

Becker is shifting to a new style of practice, sometimes called concierge or retainer medicine. With the help of a company that has been helping physicians make such shifts for over 13 years, he will cease caring for a total of 2,500 patients and instead cut back to about 600. These patients will pay an annual fee of $1,650. In exchange, they will receive a two-hour annual visit with a complete physical exam, same-day appointments, 24-hour physician phone access, and personalized, web-based resources to promote wellness.

The article suggest that all these doctors choosing to drop insurance and Medicare are primary care. Many are but I know orthopedists and even general surgeons who are dropping all insurance.

The concierge model of practice is growing, and it is estimated that more than 4,000 U.S. physicians have adopted some variation of it. Most are general internists, with family practitioners second. It is attractive to physicians because they are relieved of much of the pressure to move patients through quickly, and they can devote more time to prevention and wellness.

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Is Israel winning the Global War on Terror for us ?

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Hamas has attacked Israel, first with the kidnapping of three teenagers, now with rockets aimed, for example, at Tel Aviv and its airport.

GAZA: Islamist Hamas’ armed wing has warned airlines that it intends to target Israel’s Ben Gurion International Airport with its rockets from Gaza and has told them not to fly there, a statement by the group said Friday.

So far, Israel’s Iron Dome antimissile system has been successful in intercepting those that are a risk to populated places.

Israel’s astonishingly effective Iron Dome air defense has prevented Hamas from killing Israeli Jews and spreading terror in the civilian population. Ironically, though, the better Iron Dome works, the less sympathy the rest of the world has for a nation that remains under rocket attack.

That sentiment is to be expected as even the Presbyterian Church is anti-Israel.

David Goldman, who has been writing as “Spengler” for years, reports on the situation in Israel.

the thumbnail version is that Hamas is making a demonstration out of weakness. Money is tight, 44,000 Gaza civil servants haven’t been paid for weeks, and the IDF did significant damage to its infrastructure on the West Bank after the kidnapping-murder of the three yeshiva boys. Netanyahu will look indecisive and confused, because he has to deal with an openly hostile U.S. administration on one side and his nationalist camp on the other. Time, though, is on Israel’s side: economically, demographically, strategically. The proportion of Jewish births continues to soar. The fruits of a decade of venture capital investing are ripening into high-valuation companies. And the Arab world is disintegrating all around Israel’s borders.

Israel has been in mortal danger for 50 years. They have survived and thrived. The Arab countries are collapsing into chaos. Iran is still a threat but its demographic future is grim.

There will be no Intifada on the West Bank: the Palestinian Arabs are older, more resigned and less inclined to destroy their livelihoods than in 2000. Syria and Iraq continue to disintegrate, Lebanon is inundated with Syrian Sunni refugees (weakening Hezbollah’s relative position), and Jordan is looking to Israel to protect it against ISIS. Egypt is busy trying to survive economically.

Israel is becoming a huge economic success under Netanyahu. Just think of our future had we elected his friend, Mitt Romney.

Obama promised a “pivot to Asia” but Israel may in fact be the one doing the pivot, leaving us in the dreary Socialist past.

Richard Fernandez notes that in the view of the world press and elites being rich makes you “white.” Everybody knows that white people, even if they are Asian like John Derbyshire’s Eurasian children, are the root of all evil.

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Prediction: Romney 2016.

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I have been predicting this, especially since these polls.

Even the Washington Post has second thoughts.

Romney would hold a slight lead on President Obama if the 2012 election were replayed today, according to a new Washington Post-ABC News poll.

The poll of registered voters shows Romney at 49 percent and Obama at 45 percent in the rematch, a mirror image of Romney’s four-point (51-47) popular-vote loss in 2012.

Now, we have this.

What can I say except I told you so.

Will Romney be different from these other failed nominees? Could he defy the odds and make a comeback presidential bid capturing the GOP nomination after all the doubt, second-guessing and blame that accompany such a loss? According to the latest Quinnipiac poll, many Americans seem to think so—45 percent of voters said the United States would be better off today with Romney as president.

I donated more to the Romney campaign than I have in any other election and I was a volunteer for McCain in 2000.

I told you so. I think there is a case that the 2012 election was stolen.

The knowledge that the 1960 election was probably stolen helped Nixon in 1968. That and the failure of the Johnson Administration in Vietnam. Anyway, I have been predicting this for a while at Althouse and I can’t remember if I have posted this opinion here. Obama, with the time he has left, will make this more and more attractive. I thought we were doomed after 2012. I still think so but maybe I was wrong. The Megyn Kelly interviews with Bill Ayers might even help although she never got into the Ayers-Obama relationship.

I just hope we avoid the worst of the blowback from inept foreign policy before 2016.

More. This is amazing.

All this is weird, unprecedented. The president shows no sign—none—of being overwhelmingly concerned and anxious at his predicaments or challenges. Every president before him would have been. They’d be questioning what they’re doing wrong, changing tack. They’d be ordering frantic aides to meet and come up with what to change, how to change it, how to find find common ground not only with Congress but with the electorate.

Instead he seems disinterested, disengaged almost to the point of disembodied. He is fatalistic, passive, minimalist. He talks about hitting “singles” and “doubles” in foreign policy.

“The world seems to disappoint him,” says The New Yorker’s liberal and sympathetic editor, David Remnick.

Just weird.

Nautical Book Review- Overboard

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Overboard by Hank Searls

This is one of several cover designs for this book, written in 1977. Much of the non-sailing information in the book is dated badly. The protagonist is a lawyer who wins a medical malpractice judgement of $1.5 million, “The largest judgement in California history.” Obviously that is dated.

The novel opens when the wife falls overboard. She gets up to check for traffic in the night and does not fasten her safety belt although she knows she must. A simple moment of carelessness and she is in the water. They are between Tahiti and Bora Bora in the Society Islands. They have been cruising for months. The backstory is told in flash backs.

Mitch the husband is a sailor who navigates for her father, a racing skipper who is getting old and is too competitive for Mitch. Mitch was a pre-med student in college who switched to pre-law and graduated from Boalt Hall, the UC law school. Lindy, his wife, did not finish college as she became pregnant with their oldest child at age 18. The two children are rather aimless in the way many college age children were in the early 70s.

Mitch is sailing with her father on San Francisco Bay, the author is rather contemptuous of racing, when he sees a Colin Archer ketch crossing the race course and nearly colliding with them as her father refuses to give way to the right-of-way boat until Mitch forces the helm over. He is entranced with this beautiful cruising ketch and spends considerable time searching for it and the owner.

A Colin Archer ketch under full sail.

As a racer myself, I am not enamored of Colin Archer designs as they are very slow sailers. San Francisco with its 25 knot afternoon breeze, would be a good place for one. Mitch searches for the ketch and, finally, Lindy’s father Shawn tells Mitch he knows where the boat is in a yard in Sausalito. Mitch goes to the yard and finds the owner, a salty old boatbuilder who looks like he has lost weight, possible due to illness, and who is very reluctant to sell. The discussion of what a buyer should look for and how a builder might feel about his boat are all authentic. The discussion ends with a tentative decision to sell.

Mitch is a trial lawyer and is suing a young doctor in a case where the patient suffered catastrophic injury but the doctor may not have been at fault. He is tortured by his conscience as his father was a surgeon (as was Searls’ father) and he dreads the censure of other doctors. The malpractice crisis was just arriving as this book was published. He wins the case but decides to quit and go cruising with his new boat. His wife is a reluctant first mate but is gamely enthusiastic.

The story alternates flashbacks with the present crisis of the wife overboard. Part of the story is told from her point of view in the water and part from his point of view as he searches desperately for her. There is an undercurrent that she was not enthusiastic about going cruising and she has had a probable affair with a fictional character who is obviously Bernard Moitessier, a famous yachtsman who circumnavigated several times, most notably in a single handed round the world race which he was leading near the finish when he decided to quit and sail to the south Pacific instead of to the finish in England.

The author, who lived aboard his own yacht for many years, has many novels to his credit and many movies including Jaws2. Searls also wrote the novelizations for the films Jaws 2 (1978) starring Roy Scheider and Murray Hamilton and Jaws: The Revenge (1987) starring Michael Caine and Lorraine Gary.

His meticulous research is famous among writers. Born in 1922, he is too old to be living aboard although he was when he wrote “Overboard.” In 1988, he was ashore, probably for good.

The couple now share a cozy, two-bedroom condo overlooking a golf course in Newport Beach. One bedroom serves as Searls’s office, and there he begins work each day shortly after 6:30 a.m. A nearby garage holds cartons of research materials, and a rented storage room several miles away contains 700 cubic feet of carefully labeled files—enough for “five different novelists,” he says. Although Searls is “easy to live with,” says Bunny, “he’s always researching, even if we go away on vacation.”

The story is authentic in every respect I can find and I have been sailing since the 1950s. I even gave serious thought to taking six months off from my medical practice to go cruising in the late 1970s, about the same time as this story. The story is a bit of a downer compared to “Trustee from the Toolroom” but the details of sailing are excellent and the story is very plausible, which “Trustee” lacks a bit. A view of the movie I made of the 1981 Transpac will show that we were almost completely negligent in the matter of safety harnesses but we were a full crew. A single or double handed boat crew at night is almost suicidally careless to ignore safety gear. When we were in heavy weather, we always wore safety harnesses. In a small hurricane in 1977 off Mexico, we spent the night in swim trunks and safety harnesses with the wind at 60 knots plus like a hot shower.

The book is an authentic tale of sailing in the days before satellite telephones and GPS.

Nautical Book Review- Trustee from the Toolroom.

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Trustee from the Toolroom By Nevil Shute

This novel tells of a lifetime adventure by a man whose life had avoided adventure thus far. Keith Stewart spent the Second World War working as a “fitter” or machinist in defense industry. There he met his wife Katie and they bought a home in West Ealing, a suburb of London where Shute the author once lived and which he uses often as a setting. After the War, they settled down and Keith eventually quit his job and began a career as a technical writer for a small magazine that catered to hobbyists who made miniature machinery, like small steam engines. The magazine was called “Miniature Mechanic” and developed a world wide circulation and many devoted fans of Keith’s writing.

Keith had come from an impoverished childhood in Scotland and had one sister named Jo. Jo had raised herself socially by marrying a Royal Navy officer who came from a noble family that was quite wealthy. They had a daughter, Janice, who, at the time of the novel is nine years old. Jo’s husband, John Dermott, has taken early retirement from the Navy and they want to emigrate to Canada. Post-war England is a dreary place, a theme in several of Shute’s novels. One problem of post-war England is that currency controls severely limit funds that may be taken out of the country even on holidays. As late as the 1960s, I remember friends of my in-laws who were dependent on their American friends for travel to the US. Jo and her husband, John, have decided to smuggle their assets out of the country to Canada by converting them to diamonds and secreting the diamonds in the keel of their small sailboat, which they will sail to Canada. Keith helps them, not knowing the purpose, by setting a jewel case into the keel for them. They tell him that this just contains a few of Jo’s jewels they want to take. While they are gone, a matter of six months or so, they will leave Janice with Keith and Katie who have no children of their own. They don’t like the fast life of John’s relatives even for six months and know that Keith and Katie will always be living in the same house and will provide a quiet place for their daughter until they can send for her.

They leave England a bit later than they had planned because they had to get Janice settled and they want to visit Tahiti on the way. Small boat sailing does not follow a great circle course like a ship and Shute knows about sailing from his own experience with his sailboat before the war. A course from the Panama Canal to Canada could very well include Hawaii on the way. The side trip to Tahiti should add a month or so but is well within the capability of a small sailboat. The problem with the late departure is that they have gotten into hurricane season in the southern hemisphere. They encounter a hurricane in the vicinity of the The Tuamotus archipelago a very large group of small islands and atolls east of Tahiti. The islands are low, just above sea level and were a terrible hazard before GPS made navigation more exact. The description of the hurricane and how they deal with it is quite good. I have sailed a small boat (38 feet) through a small hurricane off Mexico. The one they encounter is much larger and it forces them down onto the lee shore of one of the Tuamotus islands. As they realize their predicament, they reassure themselves that Keith will take care of their daughter but then they also realize that all her inheritance is in the sailboat with them.

Keith is notified of their loss by the solicitor who also learns that their assets have been sold. Keith discovers from him about the law banning asset emigration and has some serious thinking to do. He is the trustee and, once he gets more detail about the wreck, suspects that the keel and the diamonds are embedded in the reef that destroyed the sailboat. What can he do ? He has only a small salary and Katie has to work in a shop to support their frugal life. If the diamonds cannot be found and returned, Janice will have to go to the council school and get a job at age 15 like other girls in Keith’s circumstances. He discusses his situation with his publisher who offers a small advance on his salary, an inadequate proposal. He is unable to ask for help because the diamonds were smuggled out of the country and would be confiscated.

He calls on a man he knows through modeling who works for a freight airline. They offer Keith a free trip to Hawaii as an engineer “under instruction.” That will get him half way to his goal and he decides to try it. Once in Hawaii, he finds there are no commercial passages to Tahiti except airline travel which he could not afford. His only possibility is to sail with an illiterate fisherman who has sailed from Oregon in a boat he built himself. Against all the advice of the people he knows, he decides he must do this. What follows is a sailing adventure as the “pasty faced” man with no sailing experience and in the condition one would expect with a sedentary occupation, must learn to sail and navigate while concealing the true purpose of his quixotic quest for his sister’s resting place. From this point it becomes a sailing adventure and then there is more engineering as others come to his aid. It is a very satisfying novel and has been criticized because the characters are unrealistically good and help each other but I find it reassuring when I think I am getting too cynical.