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  • A Corona Virus Timeline.

    Posted by Michael Kennedy on 1st April 2020 (All posts by )

    It is now becoming a theme on the left that Trump was not quick enough to recognize the coming epidemic.

    For that reason, I think it valuable to keep a record of the time line.

    Here is the January 12, 2020 WHO report on the virus epidemic in China.

    The evidence is highly suggestive that the outbreak is associated with exposures in one seafood market in Wuhan. The market was closed on 1 January 2020. At this stage, there is no infection among healthcare workers, and no clear evidence of human to human transmission. The Chinese authorities continue their work of intensive surveillance and follow up measures, as well as further epidemiological investigations.

    Here is the January 30, 2020 report by WHO on the epidemic in China.

    The Committee believes that it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk. It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent and reduce spread of the infection. The Committee agreed that the outbreak now meets the criteria for a Public Health Emergency of International Concern and proposed the following advice to be issued as Temporary Recommendations.

    The Committee emphasized that the declaration of a PHEIC should be seen in the spirit of support and appreciation for China, its people, and the actions China has taken on the frontlines of this outbreak, with transparency, and, it is to be hoped, with success.

    Trump stopped incoming flights from China on January 31, 2020.

    Read the rest of this entry »

    Posted in Big Government, Bioethics, China, Civil Liberties, Current Events, Health Care | 36 Comments »

    It is time to start the economy again.

    Posted by Michael Kennedy on 21st March 2020 (All posts by )

    I have previously described the COVID 19 virus, which is also referred to as Wuhan virus, to the annoyance of the China friendly US Media. The consequences for the US economy have been severe. The most affected states, New York, California, Illinois and Washington, have virtually shut down their population. Arizona is less affected with 78 positives cases as of today, and no deaths.

    Italy and China have had the most deaths. There are a number of factors that probably affect these cases. China is notorious for air pollution and smoking, especially men smoking. There has been a dearth, so far, of listing comorbidities but age has been a major one.

    One study lists mortality at age 80+ at 15%. The overall death rate in China was listed at 2.3%, which may reflect smoking and air pollution. South Korea, which has had a big spike as testing progressed much more rapidly than in the US, has a case mortality of less than 1%

    South Korea has the dubious distinction of suffering the second-highest number of Covid-19 infections after China – but can also boast the lowest death ratio among countries with significant numbers of cases.

    According to the WHO on March 6, the crude mortality ratio for Covid-19 – that is, the number of reported deaths divided by the number of reported cases – is between 3-4%. In Korea, as of March 9, that figure was a mere 0.7%.

    AS US testing finally gets going, after the FDA and CDC delayed matters for a month, we will see a big spike in number of cases but, I am convinced, a big drop in mortality rate.

    Telephone consulting services, drive-through test centers and thermal cameras – which, set up in buildings and public places to detect fever, swiftly came online. South Korea has undertaken approximately 190,000 tests thus far, according to KCDC Deputy Director General Kwon Jun-wook, and has the capacity to undertake 20,000 per day. Turnaround times are six-24 hours.

    Tests are highly affordable. “The test kit is about $130, and about half is covered by insurance the other half by individual,” Kwon said. Those who test positive get the test free, “So there is no reason for suspected cases to hide their symptoms,” he said.

    We should be doing the same.

    At the same time, we are risking severe economic damage to the country by shutting down business activity. I believe that much of the drastic steps taken by governors, especially in New York and California, is unnecessary. High density cities like New York City and Chicago may have more reason to fear spread of the virus. Most of the country, a source of annoyance to left wing politicians, is of low population density.

    Read the rest of this entry »

    Posted in COVID-19, Current Events, Medicine | 46 Comments »

    Russia to healthcare in one day. What now ?

    Posted by Michael Kennedy on 30th March 2019 (All posts by )

    Last Friday, the Mueller report was submitted to the DOJ. Monday, left wing media saw ratings collapse.

    What next ? Why Healthcare, of course.

    Obamacare, which is a form of expanded Medicaid, costs too much and provides too little care (high deductibles) unless you are a Medicaid recipient. It was designed to shift costs to the insured from the poor. It also was a gift to certain sectors of the healthcare industry. Ted Kennedy criticized healthcare as a “cottage industry” with lots of independent doctors doing their own thing as small businesspeople. That is why doctors have traditionally been conservative. Obamacare changed that. Healthcare is now an industry with doctors mostly on salary and controlled by administrators.

    I talked to a young ophthalmologist last week, who had treated a mild eye disorder. He told me he moved to Tucson to work at U of Arizona medical center, which used to be called “UMC” by everybody in Arizona. He explained that the UMC administrators had gotten deeply into debt installing a new “Electronic Health Record” system and sold the UMC to Banner Health. This is a chain that runs the former UMC and has seen an exodus of university faculty physicians. Even my barber noticed. He told me several weeks ago that his surgeon, who had operated on him, got tired of constantly being told he only had 15 minutes to see each patient and left for the VA. The ophthalmologist was disappointed as he had looked forward to working at the academic center.

    Traditionally, administrators hated doctors. We made their lives more difficult by advocating for patients. I once told an administrator that if the hospital did not reduce the markup on pacemakers, I would testify for the patient if they sued him for the balance of the bill. They didn’t like it but knew I could go elsewhere,and take my patients there. If I had been an employee, I would not have that choice. Several years ago, I explained how we started a trauma center in our hospital. Since then, the hospital has been sold to a non-profit run by nuns. The surgical group that ran the trauma center for 35 years was fired two years ago. They had declined to sell the group to the hospital. They were replaced by six female surgeons no one had ever heard of and who had never applied for privileges at the hospital or been evaluated by the Surgery Department. No one knew anything about them except one member of this new group had applied for a job at the trauma group and been turned down.

    There were a few comments about some less satisfactory results on trauma cases but that has quickly gotten quiet.

    Read the rest of this entry »

    Posted in Big Government, Health Care, Medicine | 2 Comments »

    Where is health care going ?

    Posted by Michael Kennedy on 28th August 2018 (All posts by )

    UPDATE: A new analysis of Obamacare’s role in the conversion of American Medicine to an industry with corporate ethics.

    The health system is now like a cocaine junkie hooked on federal payments.

    This addiction explains why the insurance companies are lobbying furiously for these funds alongside their new found friends at left-wing interest groups like Center for American Progress. The irony of this alliance is that the left-wing allies the insurers have united with hate insurance companies and want to abolish them. The insurance lobby is selling rope to their hangman.

    Hospital groups, the American Medical Association, the AARP and groups like them are on board too. They are joined by the Catholic Bishops and groups like the American Heart Association and the American Lung Association. (If you are donating money to any of these groups you might want to think again.) This multi-billion dollar health industrial complex has only one solution to every Obamacare crack-up: more regulation and more tax dollars.I practiced during what is more and more seen as a golden age of medical care. Certainly the poor had problems with access. Still, most got adequate care, either through Medicaid after 1965, or from public hospitals, many of which were wrecked by Medicaid rules and by the flood of illegal aliens the past 40 years.

    Obamacare destroyed, probably on purpose, the healthcare system we had. It had been referred to by Teddy Kennedy, the saint of the Democrats Party as “a cottage industry.” As far as primary care was concerned, he was correct. What we have now is industrial type medicine for primary care and many primary care doctors are quitting.

    So why is there waning interest in being a physician? A recent report from the Association of American Medical Colleges projected a shortage of 42,600 to 121,300 physicians by 2030, up from its 2017 projected shortage of 40,800 to 104,900 doctors.

    There appear to be two main factors driving this anticipated doctor drought: First, young people are becoming less interested in pursuing medical careers with the rise of STEM jobs, a shift that Craig Fowler, regional VP of The Medicus Firm, a national physician search and consulting agency based in Dallas, has noticed.

    “There are definitely fewer people going to [med school] and more going into careers like engineering,” Fowler told NBC News.

    There are several reasons, I think. I have talked to younger physicians and have yet to find one that enjoys his or her practice if they are in primary care. That applies to both men and women. Women are now 60% of medical students. This has contributed to the doctor shortage as they tend to work fewer hours than male physicians.

    A long analysis of physician incomes shows that 22% of females report part time work vs 12% of males.

    Physicians are the most highly regulated profession on earth. The Electronic Health Record has been made mandatory for those treating Medicare patients and it has contributed a lot to the dissatisfaction of physicians.

    THE MOUNTING BUREAUCRACY
    This “bottleneck effect” doesn’t usually sour grads on staying the course, Fowler finds, but he does see plenty of doctors in the later stages of their careers hang up their stethoscopes earlier than expected. Some cite electronic health records (EHRs) as part of the reason — especially old school doctors who don’t pride themselves on their computer skills. New research by Stanford Medicine, conducted by The Harris Poll, found that 59 percent think EHRs “need a complete overhaul;” while 40 percent see “more challenges with EHRs than benefits.”

    If I remember my arithmetic, that adds up to 99% unhappy with the EHR.

    Most primary care physicians I know are on salary, employed by a hospital or a corporate firm. They are require to crank out the office visits and are held to a tight schedule that does not allow much personal relationships with patients. The job satisfaction that was once a big part of a medical career is gone.

    Posted in Health Care, Medicine, Obama, Politics | 43 Comments »

    What will we see if Hillary wins the election ?

    Posted by Michael Kennedy on 18th October 2016 (All posts by )

    The election news is starting to suggest to me that Trump may well lose the election to Hillary. What would that mean?

    Hillary Clinton is the most corrupt person to get this close to the presidency since Aaron Burr.

    he blamed Hamilton for besmirching him as a candidate, and, eager to defend his honor, challenged Hamilton to a duel. Hamilton accepted, and the face-off took place on the morning of July 11, 1804; it ended when Burr shot Hamilton to death. Though the public cried murder, Burr was let off, and after laying low for a while, he was able to complete his vice-presidential term.

    What then?

    In 1807, Burr was brought to trial on charges of conspiracy and high misdemeanor, for leading a military charge against Spanish territory and for trying to separate territories from the United States. Chief Justice John Marshall acquitted Burr on the treason charge and eventually revoked his misdemeanor indictment, but the conspiracy scandal left Burr’s political career in ruins.

    Final Years

    Burr spent the four years following his trial traveling throughout Europe, attempting unsuccessfully to garner support for revolutionizing Mexico and freeing the Spanish colonies.

    Burr was a traitor after having his ambitions thwarted.

    We all know Hillary’s story. She was a student radical at Wellesley and her senior thesis was on Saul Alinsky.

    The thesis was sympathetic to Alinsky’s critiques of government antipoverty programs, but criticized Alinsky’s methods as largely ineffective, all the while describing Alinsky’s personality as appealing.[4] The thesis sought to fit Alinsky into a line of American social activists, including Eugene V. Debs, Martin Luther King, Jr., and Walt Whitman. Written in formal academic language, the thesis concluded that “[Alinsky’s] power/conflict model is rendered inapplicable by existing social conflicts” and that Alinsky’s model had not expanded nationally due to “the anachronistic nature of small autonomous conflict.”

    Her sympathies are clear. What will she be like as president if she wins?

    We know she is dishonest by most definitions of the term.

    She evaded the law on security when she accepted the position of Secretary of State. Her security detail at State, rebelled at her ignoring security rules, and her personal abusive style. The latter was well known from her time in the White House as First Lady.

    During her interview, the agent said Clinton treated agents rudely and with contempt, and was so unpleasant that senior agents typically avoided being on her security detail.

    “[Redacted] explained that CLINTON’s treatment of DS agents on her protective detail was so contemptuous that many of them sought reassignment or employment elsewhere,” the interview summary says. “Prior to CLINTON’s tenure, being an agent on the Secretary of State’s protective detail was seen as an honor and privilege reserved for senior agents. However, by the end of CLINTON’s tenure, it was staffed largely with new agents because it was difficult to find senior agents willing to work for her.”

    Read the rest of this entry »

    Posted in Big Government, Elections, Politics, Trump | 22 Comments »

    Does Hillary Clinton Have Parkinson’s Disease?

    Posted by Michael Kennedy on 18th September 2016 (All posts by )

    The Hillary collpase last Sunday has prompted a lot of speculation on her condition. Early on I was inclined to blame her neurological condition on her history of concussion and cerebral vein thrombosis.

    That seemed logical, given her history. However, it does not explain her quick recovery. It also has nothing to do with pneumonia.

    This video has now convinced me that she has Parkinson’s Disease, and it is fairly advanced. In the video, the physician mentions Apomorphine, which is not morphine but an alpha adrenergic drug used in Parkinson’s Disease.

    Currently, apomorphine is used in the treatment of Parkinson’s disease.

    What use does it have in Parkinson’s? It is used for “Non-motor symptoms.”

    What does that mean ? Parkinson’s Disease is characterized by a serious of motor disabilities.

    The cardinal symptoms of Parkinson’s disease are resting tremor, slowness of movement (bradykinesia) and rigidity. Many people also experience balance problems (postural instability). These symptoms, which often appear gradually and with increasing severity over time, are usually what first bring patients to a neurologist for help. Typically, symptoms begin on one side of the body and migrate over time to the other side.

    These symptoms are typically controlled with Dopamine like drugs, such as L-Dopa. There are other symptoms less easily controlled.

    For example, in advanced cases, difficulty swallowing can cause Parkinson’s patients to aspirate food into the lungs, leading to pneumonia or other pulmonary conditions. Loss of balance can cause falls that result in serious injuries or death. The seriousness of these incidents depends greatly on the patient’s age, overall health and disease stage.

    Hmmmm.

    There are also side effects of L Dopa.

    L-DOPA therapy is further complicated by the development of movement disorders called dyskinesias after 5 – 10 years of use in most cases.

    Dyskinesias are movement disorders in which neurological discoordination results in uncontrollable, involuntary movements. This discoordination can also affect the autonomic nervous system, resulting in, for example, respiratory irregularities (Rice 2002). Dyskinesia is the result of L-DOPA-induced synaptic dysfunction and inappropriate signaling between areas of the brain that normally coordinate movement, namely the motor cortex and the striatum (Jenner 2008).

    Read the rest of this entry »

    Posted in Elections, Medicine | 18 Comments »

    Why Importing Foreign Doctors May Not Solve the Shortage.

    Posted by Michael Kennedy on 17th April 2016 (All posts by )

    MoS2 Template Master

    The coming doctor shortage that I have previously written about might be dealt with as Canada did with theirs some years ago, by importing foreign medical graduates. Britain has adopted a similar plan as thousands of younger doctors plan to leave Britain.

    How is the plan to import foreign doctors working out ?

    Not very well.

    Nearly three-quarters of doctors struck off the medical register in Britain are foreign, according to shocking figures uncovered in a Mail on Sunday investigation.
    Medics who trained overseas have been banned from practising for a series of shocking blunders and misdemeanours.
    Cases include an Indian GP who ran an immigration scam from his surgery, a Ghanaian neurosurgeon who pretended he had removed a patient’s brain tumour, and a Malaysian doctor who used 007-style watches to secretly film intimate examinations with his female patients.

    First of all, foreign medical schools are often limited in real experience and students often graduate with nothing beyond classroom lectures.

    Read the rest of this entry »

    Posted in Big Government, Education, Health Care, Immigration, Medicine | 15 Comments »

    The Doctor Shortage revisited.

    Posted by Michael Kennedy on 1st April 2016 (All posts by )

    33 - Lister

    I have previously written posts about a coming doctor shortage.

    They assume that primary care will be delivered by nurse practitioners and physician assistants. They are probably correct as we see with the new Wal Mart primary care clinics.

    The company has opened five primary care locations in South Carolina and Texas, and plans to open a sixth clinic in Palestine, Tex., on Friday and another six by the end of the year. The clinics, it says, can offer a broader range of services, like chronic disease management, than the 100 or so acute care clinics leased by hospital operators at Walmarts across the country. Unlike CVS or Walgreens, which also offer some similar services, or Costco, which offers eye care, Walmart is marketing itself as a primary medical provider.

    This is all well and good. What happens when a patient comes in with a serious condition ?

    The health policy “experts” have been concerned to train “lesser licensed practitioners” and have pretty much ignored primary care MDs except to burden them with clumsy electronic medical record systems that take up time and make life miserable.

    I repeatedly ask medical students if they would choose a career in primary care if it would completely erase their student loan debt. A few hands go up, but not many. In fact, for a while now, the federal government has dedicated millions of dollars to repaying loans for students who choose primary care. Yet residency match numbers show that the percentage of students choosing primary care is not increasing. Though loan forgiveness is a step in the right direction, medical students realize that by choosing a more lucrative specialty, they can pay off their loans just fine.

    I proposed years ago, a health reform that resembled that of France where medical school is free. It could be arranged that service in primary care, low income clinics would give credit against student loans. Nothing happened. Except physician income has declined. And tuition has increased.

    Read the rest of this entry »

    Posted in Big Government, Education, Entrepreneurship, Health Care, Medicine | 19 Comments »

    More evidence that Obamacare is just expanded Medicaid.

    Posted by Michael Kennedy on 2nd November 2015 (All posts by )

    I have been saying that Obama care is just Medicaid for all. As time goes by, here is more and more evidence that this is the case.

    The latest evidence is in The Wall Street Journal and behind a pay wall but I will quote some of it.

    But a new paper from the Heritage Foundation, however, suggests that nearly all of the increase came from adding nearly nine million people to the Medicaid rolls.

    In other words, ObamaCare expanded coverage in 2014 to the extent that it gave people free or nearly free insurance. That goal could have been accomplished without the Affordable Care Act. To justify its existence, ObamaCare must make affordable private insurance available to a broad cross-section of uninsured Americans who are ineligible for Medicaid.

    But with fewer people buying insurance through the exchanges, the economics aren’t holding up. Ten of the 23 innovative health-insurance plans known as co-ops—established with $2.4 billion in ObamaCare loans—will be out of business by the end of 2015 because of weak balance sheets.

    And while rates vary widely by state, the cost for private insurance through the exchanges is also increasing dramatically. An analysis by consulting firm Avalere Health released on Friday shows that some of the most popular insurance plans in the ObamaCare exchanges will experience double-digit premium hikes in 2016.

    My earlier objections to Obamacare were that it promises too much and pays too little.

    As it turns out, Medicaid patients can’t get appointments with physicians.

    “America has severe primary care physician shortages, and many physicians will not accept Medicaid patients because Medicaid pays so inadequately,” said Michael Gerardi, MD, FAAP, FACEP, president of the ACEP.

    Read the rest of this entry »

    Posted in Big Government, Health Care, Medicine | 6 Comments »

    A Day at Ypres

    Posted by Michael Kennedy on 13th September 2015 (All posts by )

    We spent today at Ypres an the huge military cemeteries from the battles of the Ypres Salient.

    This was an early battle of WWI and the “first battle of Ypres” occurred at the end of “The Race to the Channel.” I have read a bit about the First World War but it really comes home when you are standing the place that consumed the British youth in 1914 to 1918. The First Battle ended the Race to the Sea and began the trench warfare of the next four years.

    We visited the “Sanctuary Wood Museum today, and I took some photos of the trenches which were preserved all these years by then owner of the small cafe where we had a beer.

    OLYMPUS DIGITAL CAMERA

    Ypres

    These trenches are the originals preserved by the property owner who probably has cleaned out debris over the years. The owners of the cafe are the children of the original owners of the property who preserved these relics. Their museum has many objects no doubt excavated from the fields around.

    Recent highway construction, which has now been suspended, has bodies buried in a trench during the war, which are preserved.

    The bodies of 21 German soldiers entombed in a perfectly preserved World War One shelter have been discovered 94 years after they were killed.
    The men were part of a larger group of 34 who were buried alive when a huge Allied shell exploded above the tunnel in 1918, causing it to cave in.
    Thirteen bodies were recovered from the underground shelter, but the remaining men had to be left under a mountain of mud as it was too dangerous to retrieve them.
    Nearly a century later, French archaeologists stumbled upon the mass grave on the former Western Front in eastern France during excavation work for a road building project.

    The road building has been suspended for now but every construction project in this area uncovered evidence of war dead. Today we visited an enormous memorial for the war dead whose bodies were never recovered. It is called the Menin Gate Memorial and the names of 54,000 dead are posted on the walls representing most of the dead from the Ypres Salient who could not be identified.

    Menin Arch Memorial

    The sheer number of dead whose bodies were destroyed, or lost, is staggering.

    The city of Ypres (pronounced by our hosts as “eep” has been rebuilt as it was destroyed in the war.

    Ypres

    The cathedral was rebuilt from a stump of the tower. The bottom 20 feet to so was protected by rubble and is in better shape. The entire city was rebuilt completely.

    British WW1 Cemetery, Ypres

    The city is surrounded by British war cemeteries of which there are about 150, each with about 500 to 1,000 graves.

    Osler Grave

    One grave that particularly interested me was that of Sir William Osler’s only son who was killed by shrapnel while serving as an artillery officer in 1917. His fathers friends had tried to save him and his last words, reflecting many young men who were wounded, “Surely this (wound) will get me home. ” His last words.

    Today, we arrived at Brussels and will do some touring tomorrow of the Waterloo Battlefield. We passed on the road one of Wellington’s battle fields from the 18th century.

    The TV tonight is all about the “refugees” which we saw a few of today in Brussels.

    Posted in Europe, France, Health Care, Military Affairs, Personal Narrative, Photos | 6 Comments »

    The Coming Shortage of Doctors.

    Posted by Michael Kennedy on 3rd August 2015 (All posts by )

    33 - Lister

    I’m sure everyone is tired of my pessimism about politics so I thought I would try something new. Here is a piece on pessimism about health care.

    This Brietbart article discusses the looming doctor shortage.

    Lieb notes, that the U.S. is only seeing 350 new general surgeons a year. That is not even a replacement rate, she observed.

    A few years ago, I was talking to a woman general surgeon in San Francisco who told me that she did not know a general surgeon under 50 years old. The “reformers” who designed Obamacare and the other new developments in medicine are, if they are MDs, not in practice and they are almost all in primary care specialties in academic settings. They know nothing about surgical specialties.

    They assume that primary care will be delivered by nurse practitioners and physician assistants. They are probably correct as we see with the new Wal Mart primary care clinics.

    The company has opened five primary care locations in South Carolina and Texas, and plans to open a sixth clinic in Palestine, Tex., on Friday and another six by the end of the year. The clinics, it says, can offer a broader range of services, like chronic disease management, than the 100 or so acute care clinics leased by hospital operators at Walmarts across the country. Unlike CVS or Walgreens, which also offer some similar services, or Costco, which offers eye care, Walmart is marketing itself as a primary medical provider.

    This is all well and good. What happens when a patient comes in with a serious condition ?

    Read the rest of this entry »

    Posted in Health Care, Medicine, Politics | 22 Comments »

    Obamacare Lives !

    Posted by Michael Kennedy on 25th June 2015 (All posts by )

    obamacare

    UPDATE: The decision is analyzed at Powerline today with quotes from the decision.

    The Affordable Care Act contains more than a few examples of inartful drafting. (To cite just one, the Act creates three separate Section 1563s. See 124 Stat. 270, 911, 912.) Several features of the Act’s passage contributed to that unfortunate reality. Congress wrote key parts of the Act behind closed doors, rather than through “the traditional legislative process.” Cannan, A Legislative History of the Affordable Care Act: How Legislative Procedure Shapes Legislative History, 105 L. Lib. J. 131, 163 (2013). And Congress passed much of the Act using a complicated budgetary procedure known as “reconciliation,” which limited opportunities for debate and amendment, and bypassed the Senate’s normal 60-vote filibuster requirement. Id., at 159–167.

    Therefore, Roberts rewrote it. Nice !

    Today, the Supreme Court upheld the Obamacare state exchange subsidies.

    The Supreme Court has justified the contempt held for the American people by Jonathan Gruber. He was widely quoted as saying that the “stupidity of the American people “ was a feature of the Obamacare debate. This does not bother the left one whit.

    Like my counterparts, I have relied heavily on Gruber’s expertise over the years and have come to know him very well. He’s served as an explainer of basic economic concepts, he’s delivered data at my request, and he’s even published articles here at the New Republic. My feelings about Gruber, in other words, are not that of a distant observer. They are, for better or worse, the views of somebody who holds him and his work in high esteem.

    The New Republic is fine with him and his concepts.

    It’s possible that Gruber offered informal advice along the way, particularly when it came to positions he held strongly—like his well-known and sometimes controversial preference for a strong individual mandate. Paul Starr, the Princeton sociologist and highly regarded policy expert, once called the mandate Gruber’s “baby.” He didn’t mean it charitably.

    Read the rest of this entry »

    Posted in Big Government, Civil Society, Conservatism, Current Events, Economics & Finance, Health Care, Leftism, Medicine, Obama, Politics | 30 Comments »

    A Bleg.

    Posted by Michael Kennedy on 16th June 2015 (All posts by )

    cover.

    I have a new book out on Kindle that is now published. It is called “War Stories: 50 Years in Medicine.”

    I’ve been working on this for 20 years and kept having to revise it as I would put it down and then go back to it after ten years. I finally decided to rework it and publish it two years ago. My students were reading the draft on my laptop while I was editing so maybe it will be interesting.

    It is a memoir of patients. They are all patients’ stories that I have tried to describe accurately and to describe what we did then. Sometimes I screwed up and I tell those, too. Sometimes we did the best we could and we now know better. Some of these cases are still hard to explain.

    Two of them, in the chapter on Melanoma, are about young women who developed major melanoma metastases years after the primary was excised but when they had become pregnant. The melanoma went wild in pregnancy, in one case ten years later. In the other, three years after I had removed the primary, she developed extensive metastases while pregnant. She refused abortion and I thought it would cost her her life. In both cases the melanoma vanished after pregnancy ended. In one case, the woman, last I heard, was free of melanoma 25 years later. The other was free ten years later. The medical literature says pregnancy has no effect on melanoma. Neither ever became pregnant again.

    Another case is an example of the only supernatural near-death experience I have ever heard.

    The book starts when I began medical school in 1961 and describes experiences with patients, including my summer working with schizophrenic men in 1962. I have a series of stories about patients I saw as a student and sometimes intersperse stories from later that are about similar cases and events. One that is amusing, I guess, is about my very first pelvic exam, on a 40 year old prostitute who had just gotten out of prison and enjoyed it thoroughly. I had a dozen student nurses as witnesses. I do have some biography in it but try to keep it to minimum.

    After the first eight chapters, I go on to residency and then finally to private practice. I continued to teach and there are a few of those stories. There is a chapter on ethics including my thoughts on euthanasia and “benign neglect.” Toward the end of my career, I started and ran a trauma center in our community hospital. I also did a fair amount of testifying in court in both trauma cases and some civil cases where I testified for plaintiffs and for defense. I consider it a compliment that Kaiser Permanente had me testify for their defense even though I had also testified against them.

    Anyway, the book is on Kindle and I hope somebody is interested. It has some similarity to my medical history book, which I plan to do a Kindle version of once this one is launched. In this one, I spend some time explaining the diseases in a way that I used to explain to patients and I still do to students. Without some basic understanding, most of these stories would not make sense and I hope the explanations are not too dull. If so, all comments are welcome. If anyone likes it, feel free to post a review on Amazon. Two reviewers from the first book in 2004 told me to let them know if I did another one and I have contacted them.

    If anyone wants to discuss the book here, feel free to add comments.

    Posted in Biography, Blegs, Book Notes, Health Care, Medicine, Personal Narrative | 16 Comments »

    Why Doctors Quit.

    Posted by Michael Kennedy on 29th May 2015 (All posts by )

    Today, Charles Krauthammer has an excellent column on the electronic medical record. He has not been in practice for many years but he is obviously talking to other physicians. It is a subject much discussed in medical circles these days.

    It’s one thing to say we need to improve quality. But what does that really mean? Defining healthcare quality can be a challenging task, but there are frameworks out there that help us better understand the concept of healthcare quality. One of these was put forth by the Institute of Medicine in their landmark report, Crossing the Quality Chasm. The report describes six domains that encompass quality. According to them, high-quality care is:

    1) Safe: Avoids injuries to patients from care intended to help them
    2) Equitable: Doesn’t vary because of personal characteristics
    3) Patient-centered: Is respectful of and responsive to individual patient preferences, needs and values
    4) Timely: Reduces waits and potentially harmful delays
    5) Efficient: Avoids waste of equipment, supplies, ideas and energy
    6) Effective: Services are based on scientific knowledge to all who could benefit, and it accomplishes what it sets out to accomplish

    In 1994, I moved to New Hampshire and obtained a Master’s Degree in “Evaluative Clinical Sciences” to learn how to measure, and hopefully improve, medical quality. I had been working around this for years, serving on the Medicare Peer Review Organization for California and serving in several positions in organized medicine.

    I spent a few years trying to work with the system, with a medical school for example, and finally gave up. A friend of mine had set up a medical group for managed care called CAPPCare, which was to be a Preferred Provider Organization when California set up “managed care.” It is now a meaningless hospital adjunct. In 1995, he told me, “Mike you are two years too early. Nobody cares about quality.” Two years later, we had lunch again and he laughed and said “You are still too years too early.”

    Read the rest of this entry »

    Posted in Big Government, Health Care, Medicine, Politics, Science | 17 Comments »

    Obamacare = Medicaid

    Posted by Michael Kennedy on 8th May 2015 (All posts by )

    emergency

    I have been interested in health care reform for some time and have proposed a plan for reform. It is now too late for such a reform as Obamacare has engaged the political apparatus and sides have been taken. The Obamacare rollout was worse than anticipated and it was hoped that the Supreme Court would have mercy on the country, but that didn’t happen and it has been the law for two years.

    What has it accomplished ? Well, the forecast drop in ER visits hasn’t happened. It also didn’t happen in Massachusetts when that plan took effect.

    Wasn’t Obamacare supposed to solve the problem of people going to the ER for routine medical problems? We were told that if everyone had “healthcare” — either through the ACA exchanges or through Medicaid expansion — people would be able to go to their family doctors for routine care and emergency rooms would no longer be overrun by individuals who aren’t actually experiencing emergencies.

    As it turns out, Medicaid patients can’t get appointments with physicians.

    “America has severe primary care physician shortages, and many physicians will not accept Medicaid patients because Medicaid pays so inadequately,” said Michael Gerardi, MD, FAAP, FACEP, president of the ACEP.

    Read the rest of this entry »

    Posted in Business, Health Care, Law Enforcement, Leftism, Medicine, Obama, Politics | 7 Comments »

    Myopia and why it is increasing.

    Posted by Michael Kennedy on 25th April 2015 (All posts by )

    myopia

    A couple of interesting articles about the increasing incidence of myopia in children.

    Myopia isn’t an infectious disease, but it has reached nearly epidemic proportions in parts of Asia. In Taiwan, for example, the percentage of 7-year-old children suffering from nearsightedness increased from 5.8 percent in 1983 to 21 percent in 2000. An incredible 81 percent of Taiwanese 15-year-olds are myopic.

    The first thought is that this is an Asian genetic thing. It isn’t.

    In 2008 orthoptics professor Kathryn Rose found that only 3.3 percent of 6- and 7-year-olds of Chinese descent living in Sydney, Australia, suffered myopia, compared with 29.1 percent of those living in Singapore. The usual suspects, reading and time in front of an electronic screen, couldn’t account for the discrepancy. The Australian cohort read a few more books and spent slightly more time in front of the computer, but the Singaporean children watched a little more television. On the whole, the differences were small and probably canceled each other out. The most glaring difference between the groups was that the Australian kids spent 13.75 hours per week outdoors compared with a rather sad 3.05 hours for the children in Singapore.

    This week the Wall Street Journal had more. There are some attempts to deal with the natural light effect.

    Children in this small southern Chinese city sit and recite their vocabulary words in an experimental cube of a classroom built with translucent walls and ceilings. Sunlight lights up the room from all directions.

    The goal of this unusual learning space: to test whether natural, bright light can help prevent nearsightedness, a problem for growing numbers of children, especially in Asia.

    The schools have tried to get Chinese parents to send the kids outdoors more but it doesn’t seem to work.

    And it isn’t limited to Asians.

    In the U.S., the rate of nearsightedness in people 12 to 54 years old increased by nearly two-thirds between studies nearly three decades apart ending in 2004, to an estimated 41.6%, according to a National Eye Institute study.

    But Asians with their focus on education are the most effected.

    A full 80% of 4,798 Beijing teenagers tested as nearsighted in a study published in the journal PLOS One in March. Similar numbers plague teens in Singapore and Taiwan. In one 2012 survey in Seoul, nearly all of the 24,000 teenage males surveyed were nearsighted.

    So, what to do ?

    Though glasses can correct vision in most myopic children, many aren’t getting them. Sometimes this is because parents don’t know their children need glasses or don’t understand how important they are for education. Other times, cultural beliefs lead parents to discourage their children from wearing them, according to Nathan Congdon, professor at Queen’s University Belfast and senior adviser to Orbis International, a nonprofit focused on preventing blindness. Many parents believe glasses weaken the eyes—they don’t.

    Getting kids to spend even small amounts of time outdoors makes a difference.

    Why myopia rates have soared isn’t entirely clear, but one factor that keeps cropping up in research is how much time children spend outdoors. The longer they’re outside, the less likely they are to become nearsighted, according to more than a dozen studies in various countries world-wide.

    One preliminary study of 2,000 children under review for publication showed a 23% reduction in myopia in the group of Chinese children who spent an additional 40 minutes more outside each day, according to Ian Morgan, one of the researchers involved in the study and a retired professor at Australian National University in Canberra. (He still conducts research with Sun Yat-sen University in the Chinese city of Guangzhou.)

    That is a very significant effect of small changes in behavior. Now the researchers are trying something new.

    Dr. Morgan, Dr. Congdon and a team from Sun Yat-sen are now testing, as reported recently in the science magazine Nature, a so-called bright-light classroom made of translucent plastic walls in Yangjiang to see if the children can focus and sit comfortably in the classroom. So far it appears the answer is yes.

    In 2007, Donald Mutti and his colleagues at the Ohio State University College of Optometry in Columbus reported the results of a study that tracked more than 500 eight- and nine-year-olds in California who started out with healthy vision6. The team examined how the children spent their days, and “sort of as an afterthought at the time, we asked about sports and outdoorsy stuff”, says Mutti.

    It was a good thing they did. After five years, one in five of the children had developed myopia, and the only environmental factor that was strongly associated with risk was time spent outdoors6. “We thought it was an odd finding,” recalls Mutti, “but it just kept coming up as we did the analyses.” A year later, Rose and her colleagues arrived at much the same conclusion in Australia7. After studying more than 4,000 children at Sydney primary and secondary schools for three years, they found that children who spent less time outside were at greater risk of developing myopia.

    What is the mechanism ? Maybe it is this.

    The leading hypothesis is that light stimulates the release of dopamine in the retina, and this neurotransmitter in turn blocks the elongation of the eye during development. The best evidence for the ‘light–dopamine’ hypothesis comes — again — from chicks. In 2010, Ashby and Schaeffel showed that injecting a dopamine-inhibiting drug called spiperone into chicks’ eyes could abolish the protective effect of bright light11.

    Retinal dopamine is normally produced on a diurnal cycle — ramping up during the day — and it tells the eye to switch from rod-based, nighttime vision to cone-based, daytime vision. Researchers now suspect that under dim (typically indoor) lighting, the cycle is disrupted, with consequences for eye growth. “If our system does not get a strong enough diurnal rhythm, things go out of control,” says Ashby, who is now at the University of Canberra. “The system starts to get a bit noisy and noisy means that it just grows in its own irregular fashion.”

    Another possible treatment is the use of atropine drops in the eye.

    Atropine, a drug used for decades to dilate the pupils, appears to slow the progression of myopia once it has started, according to several randomized, controlled trials. But used daily at the typical concentration of 1%, there are side effects, most notably sensitivity to light, as well as difficulty focusing on up-close images.

    In recent years, studies in Singapore and Taiwan found that a lower dose of atropine reduces myopia progression by 50% to 60% in children without those side effects, says Donald Tan, professor of ophthalmology at the Singapore National Eye Centre. He has spearheaded many of the studies. Large-scale trials on low-dose atropine are expected to start soon in Japan and in Europe, he says.

    More than a century ago, Henry Edward Juler, a renowned British eye surgeon, offered similar advice. In 1904, he wrote in A Handbook of Ophthalmic Science and Practice that when “the myopia had become stationary, change of air — a sea voyage if possible — should be prescribed”.

    Posted in China, Education, Health Care, Medicine, Science | 5 Comments »

    Why Gruber has to lie

    Posted by Michael Kennedy on 10th December 2014 (All posts by )

    The left does not do economics. They do politics and elections and lying to get past the “stupid voters” but, when pressed, nothing they do qualifies as numerically or mathematically sound. Social Security worked until everyone found the queue and until Congress raided the trust fund in the 90s.

    Obama and the Democrat leaders knew that Hillary made enemies of the insurance companies in 1992. The insurance companies funded devastating TV ads with “Harry and Louise” that cost the Democrats Congress in 1994. Therefore, they had to do what was necessary to get the insurance companies “inside the tent pissing out and not outside the tent pissing in” in Lyndon Johnson’s immortal words.

    Insurance companies have considered health insurance a loser for 25 years now. What they prefer is becoming “Administrative Service Organizations” which administer self funded health plans by employers.

    Corporate benefits include- organizing/ negotiating health insurance, group dental, STD, LTD, life, etc.

    The plan the Democrats came up with, with Gruber’s help, was to make the government the funding entity and pay the insurance companies to run the program. That way everybody is happy, except, of course, the taxpayer. The taxpayer does not like tax increases which would be needed to pay the bills. Therefore the taxpayer has to be fooled.

    The excise tax on high-cost health plans was among the many fees and taxes proposed as offsets to help slow the rate of growth of health costs, particularly premium growth, and finance the nationwide expansion of health coverage. When the Affordable Care Act was signed into law in March 2010, its coverage provisions were estimated to cost more than $900 billion over the next decade, from 2010 to 2019, and were to be paid for by fees and taxes on both individuals and businesses. At the time the health reform bill passed, the excise tax on high-cost plans was estimated to raise roughly $32 billion in revenue over the next decade, or by 2019.

    Without the taxes to pay the bills, the whole plan collapses. At its base, Obamacare is Medicaid for everyone. The employer mandate has been, contrary to the text of the law, postponed as the flaws in implementation appear. If it were to be enforced, there would be a revolution. Basically, Obamacare will destroy the health care plans of the 85% of the population who are satisfied with what they have to enroll everyone in a new program that approximates what Medicaid does. The reason for this is that our betters in Washington have decided that we spend too much on health care. That may even be true. One way to deal with this would be to use a market-based approach that resembles how health care was paid for 60 years ago. I have previously discussed how this worked and how it might be restored.

    Today, the vast majority of Americans get health insurance as a benefit from their employer. How this developed has been discussed at length and began during World War Two. In 2008, John McCain proposed a possible way to disconnect employment, alleged to create “Job Lock” but he lost the election. A hostile analysis of his proposal is here. The McCain campaign’s description is here.

    What became Obamacare is the work of the Democrat staff of Congress when the Democrats had filibuster proof majorities in both houses. The election of Scott Brown in a reaction to the impending passage of the health plan forced them to rush the bill through without amendments before Brown was sworn in January 2010.

    The taxes to fund Obamacare were hidden as “fines and penalties” until exposed by the Supreme Court in its 2012 decision on the constitutionality of Obamacare. All penalties are now taxes. The largest are on employer-funded plans.

    The funding from employee plans is called “The Cadillac Tax which is an excise tax on employer plans that exceed the benefits of Medicaid. The “exchange plans” are increasingly looking like Medicaid, especially in the narrow networks of providers, as doctors are now called.

    As health coverage expands to tens of millions of Americans–through Medicaid expansion in states and the new state health insurance exchanges that will soon begin selling individual health coverage–some Americans with employer-sponsored health coverage are seeing their benefits decrease.

    One of the most significant, and controversial, provisions of the Affordable Care Act is the new excise tax on high-cost health plans proposed to both slow the rate of growth of health costs and finance the expansion of health coverage. The provision is often called the “Cadillac” tax because it targets so-called Cadillac health plans that provide workers the most generous level of health benefits. These high-end health plans’ premiums are paid for mostly by employers. They also have low, if any, deductibles and little cost sharing for employees.

    If this is ever implemented, the Medicaid-for-all nature of Obamacare will become obvious. That’s why it will not happen. The fundamental premise behind Obamacare is not viable. That is why it will fail and the numbers do not add up.

    Gruber can’t say this. All he can do is obfuscate.

    Posted in Elections, Health Care, Law Enforcement, Leftism, Medicine, Taxes | 22 Comments »

    Ebola is now acknowledged to be airborne.

    Posted by Michael Kennedy on 29th October 2014 (All posts by )

    I was just going to add another comment to my previous post on whether Ebola can be airborne but comments are now closed. The CDC has now changed its guidelines on transmission. I linked to Patterico because he has a good post on this. The guidelines are out now as public knowledge.

    “If you are sniffling and sneezing, you produce microorganisms that can get on stuff in a room. If people touch them, they could be” infected, said Dr. Meryl Nass, of the Institute for Public Accuracy in Washington, DC.
    Nass pointed to a poster the Centers for Disease Control and Prevention quietly released on its Web site saying the deadly virus can be spread through “droplets.”

    Why is this stuff coming out in drips (sorry for the pun) like it was Benghazi ?

    “The CDC said it doesn’t spread at all by air, then Friday they came out with this poster,” she said. “They admit that these particles or droplets may land on objects such as doorknobs and that Ebola can be transmitted that way.”

    I won’t duplicate any more of Patterico’s post as he has been on the case nearly as long as I have.

    As for the idiot nurse from Africa who defied authority about quarantine and is suing, she has more trouble today.

    Maine state police were stationed outside the home of Ebola nurse Kaci Hickox Wednesday as Gov. Paul LePage said he was seeking legal authority to force the “unwilling” health care workers to remain quarantined for 21 days.

    The 33-year-old nurse, who has shown no symptoms of the deadly virus, arrived in Maine on Monday after being forcibly held in an isolation tent in New Jersey for three days under that state’s strict new law for health care workers who have recently treated Ebola patients in West Africa.

    There is actually little risk as she is a CDC Epidemiology Fellow with little contact with patient care.

    She is also a lefty Obama supporter.

    It turns out that Kaci Hickox is a registered democrat and Obama supporter who works for the CDC. “The nurse currently quarantined in New Jersey is an employee for the Centers for Disease Control and a registered Democrat with a history of left-wing advocacy,” reports GotNews.com.

    The CDC Epidemiology Fellowships are http://www.cdc.gov/eis/index.html not patient care positions.

    EIS officers are on the public health frontlines, conducting epidemiologic investigations, research, and public health surveillance both nationally and internationally.

    She has an number of published papers on epidemiology that are statistical studies, not clinical care.

    Posted in Ebola, Health Care, Medicine, Politics | 17 Comments »

    Treatment of the Ebola contact.

    Posted by Michael Kennedy on 3rd October 2014 (All posts by )

    The early information of the Ebola patients in Dallas seems to suggest that competence has not been high on the list of priorities. First, the patent seems to have known about his illness before he got on the plane to the US. He lied to the authorities in Liberia but that is not that unusual. All it takes is ibuprofen to evade the screening at the airport.

    Second the treatment of the relatives Has finally become humane after days of cruel treatment including quarantine in a contaminated apartment.

    The initial treatment was not a model of infectious disease protocol. Why he was sent home with a GI illness and a history of travel to Liberia is still not explained. My medical students are all told to take a history of travel with any GI illness symptom. It’s not clear who he saw but many ERs use Nurse practitioners or PAs to see ER patients.

    He is not doing well and he seems to be declining. We will see how he does but his relatives are still in serious trouble. We are still in trouble.

    The promised treatment program is still inadequate. Tomorrow will bring more bad news.

    A CDC official said the agency realized that many hospitals remain confused and unsure about how they are supposed to react when a suspected patient shows up. The agency sent additional guidance to health-care facilities around the country this week, just as it has numerous times in recent months, on everything from training personnel to spot the symptoms of Ebola to using protective gear.

    This is only the first case.

    UPDATE: More news from Bookworm.

    Ebola can transmit through people’s skin. It’s not enough to keep your hands away from your nose and mouth. If someone’s infected blood, vomit, fecal matter, semen, spit, or sweat just touches you, you can become infected. Even picking up a stained sheet can pass the infection. Additionally, scientists do not know how long the virus will survive on a surface once it’s become dehydrated. The current guess is that Ebola, unlike other viruses, can survive for quite a while away from its original host.

    Oh oh. This explains the infection of hospital workers in Nigeria from urine.

    The good news, if any, is this:

    If patients get Western medicine that treats the symptoms — drugs to reduce fever and to control vomiting and diarrhea, proper treatment if the body goes into shock, and blood transfusions — the mortality rate is “only” 25% — which is still high, but is significantly lower than the 70%-90% morality in Africa, where patients get little to no treatment.

    I will update this as news becomes available.

    UPDATE #2

    Now we have a possible case #2

    A patient with Ebola-like symptoms is being treated at Howard University Hospital in Washington, D.C., a hospital spokesperson confirmed late Friday morning.

    The patient had traveled to Nigeria recently.

    That person has been admitted to the hospital in stable condition, and is being isolated. The medical team is working with the CDC and other authorities to monitor the patient’s condition.

    “In an abundance of caution, we have activated the appropriate infection control protocols, including isolating the patient,” said hospital spokesperson Kerry-Ann Hamilton in a statement. “Our medical team continues to evaluate and monitor progress in close collaboration with the CDC and the Department of Health.”

    No final word yet. Then, of course, we have the NBC case.

    Thursday, news broke that a freelance NBC cameraman covering the outbreak in Monrovia, Liberia had tested positive for Ebola after experiencing symptoms of the disease.

    The cameraman, Ashoka Mukpo, had been working with chief medical correspondent Dr. Nancy Snyderman. NBC News is flying Mukpo and the entire team back to the U.S. so Mukpo can be treated and the team can be quarantined for 21 days.

    Posted in Ebola, Health Care, Immigration, Medicine, Science | 21 Comments »

    Is Ebola airborne ?

    Posted by Michael Kennedy on 13th September 2014 (All posts by )

    Ebola has become an uncontrolled epidemic in Africa. I have previously posted on Ebola.

    UPDATE: A new CDC report has now been provided on precautions. Somebody is worried. The document, itself, is here (pdf)

    Now, we are going to send 3,000 military personnel to Africa to help. I sure hope none of these US people are infected. They did not volunteer for this and the training to protect themselves will take time.

    Now the German epidemiology community has concluded that Liberia and Sierra Leone are lost.

    Jonas Schmidt-Chanasit of the Bernhard Nocht Institute for Tropical Medicine in Hamburg told DW that he is losing hope, that Sierra Leone and Liberia will receive the neccessary aid in time. Those are two of the countries worst hit by the recent Ebola epidemic.

    “The right time to get this epidemic under control in these countries has been missed,” he said. That time was May and June. “Now it will be much more difficult.”
    Schmidt-Chanasit expects the virus will “become endemic” in this part of the world, if no massive assistence arrives.

    With other words: It could more or less infect everybody and many people could die.

    This, of course, is from a German site and our own CDC is unwilling to say it.

    For Sierra Leone and Liberia, though, he thinks “it is very difficult to bring enough help there to get a grip on the epidemic.”

    According to the virologist, the most important thing to do now is to prevent the virus from spreading to other countries, “and to help where it is still possible, in Nigeria and Senegal for example.”

    Of course, it is already in Nigeria.

    In the balance therefore, the probability is that the virus is not airborne — yet — but it is more dangerous than its predecessors. This would account for its ability to slip through the protocols designed for less deadly strains of the disease. It’s not World War E time, but it’s time to worry.

    And: This may be a new strain with more virulence.

    The results of full genetic sequencing suggest that the outbreak in Guinea isn’t related to others that have occurred elsewhere in Africa, according to an international team that published its findings online in the New England Journal of Medicine (NEJM). That report was from April 2014.

    Now, we have more news. From 2012, we know transmission in animals may be airborne.

    While primates develop systemic infection associated with immune dysregulation resulting in severe hemorrhagic fever, the EBOV infection in swine affects mainly respiratory tract, implicating a potential for airborne transmission of ZEBOV2, 6. Contact exposure is considered to be the most important route of infection with EBOV in primates7, although there are reports suggesting or suspecting aerosol transmission of EBOV from NHP to NHP8, 9, 10, or in humans based on epidemiological observations11. The present study was design to evaluate EBOV transmission from experimentally infected piglets to NHPs without direct contact.

    The study of this potential explosive development showed:

    The present study provides evidence that infected pigs can efficiently transmit ZEBOV to NHPs in conditions resembling farm setting. Our findings support the hypothesis that airborne transmission may contribute to ZEBOV spread, specifically from pigs to primates, and may need to be considered in assessing transmission from animals to humans in general.

    Now we have more articles appearing about this.

    The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.

    If the New York Times is publishing this, somebody is worried.

    Read the rest of this entry »

    Posted in Civil Society, Ebola, Health Care, Immigration, Medicine, Science | 31 Comments »

    The revolution we need might be starting in Britain.

    Posted by Michael Kennedy on 30th August 2014 (All posts by )

    A “Seismic Shock is coming to the British political system.

    Douglas Carswell, a prominent Conservative MP has announced he is switching to UKIP. a new political party that has been attacked as “racist” and has been attracting a larger constituency from the British traditional voters.

    A new political party has appeared in Britain called UK Independent Party. It has been called racist and a number of other things that might sound familiar to Tea Party members here.

    For example:

    News reports about the rising primary school population in England fail to mention the ‘elephant in the room’, said MEP Paul Nuttall.

    “It is accepted that primary schools have increasing numbers of pupils, which causes all manner of problems, but what is frequently not referred to is why we have such a boom in numbers.

    “And the answer is unlimited immigration into this country. It hits some areas harder than others but there cannot be many primary schools in the country which have not been affected at all,” said Mr Nuttall, UKIP Education spokesman.

    Why is this controversial ? In the 1990s, the Labour Party opened the floodgates of immigration from Pakistan. The Conservatives have mentioned reducing this but have done little about it.

    Steven Woolfe, UKIP Migration spokesman, attacks Conservatives for ‘lying to electorate’ on promises to cut migration, adding that ‘it is no wonder their own MPs are losing faith in them and they are haemorrhaging support to UKIP.’

    “These shocking figures today show that the Government does not have a handle on immigration. The Conservative Party promised to cut net migration to tens of thousands and yet it has shot up by a staggering 68,000 in just one year. It is quite simple. They lie to the electorate. They lie to try to keep votes. Well they are being found out.

    This is one reason why UKIP is hated. For example, of the 1400 young girls made sex slaves by “Asian” men, several were taken from foster parents because they had voted for UKIP.

    A couple had their three foster children taken away by a council on the grounds that their membership of the UK Independence Party meant that they supported “racist” policies. The husband and wife, who have been fostering for nearly seven years, said they were made to feel like criminals when a social worker told them that their views on immigration made them unsuitable carers.

    Sounds like the Tea Party to me.

    Read the rest of this entry »

    Posted in Afghanistan/Pakistan, Big Government, Britain, Civil Society, Conservatism, Elections, Europe, Health Care, Immigration, Islam, Political Philosophy, Tea Party | 5 Comments »

    Why Ebola will not stay in Africa.

    Posted by Michael Kennedy on 8th August 2014 (All posts by )

    Today’s Belmont Club has a good explanation of why Ebola will not stay in Africa.

    UPDATE: Patrick Sawyer was planning to visit Minnesota when he got sick.

    UPDATE #2: More from Belmont Club.

    In the balance therefore, the probability is that the virus is not airborne — yet — but it is more dangerous than its predecessors. This would account for its ability to slip through the protocols designed for less deadly strains of the disease. It’s not World War E time, but it’s time to worry.

    And: This may be a new strain with more virulence.

    The results of full genetic sequencing suggest that the outbreak in Guinea isn’t related to others that have occurred elsewhere in Africa, according to an international team that published its findings online in the New England Journal of Medicine (NEJM). That report was from April 2014.

    His wife, Decontee Sawyer, said that she had spoken to him a week earlier and that he had made plans to be stateside in early August to celebrate the birthdays of two of his three young daughters. She said the couple had been separated.

    He is believed to be the first American to have died from the current outbreak, which has killed 672 people since March, according to World Health Organization figures.

    He was American, not African.

    The man who brought the Ebola virus to Nigeria probably knew he was infected. Surveillance video of Patrick Sawyer before boarding his flight at Liberia’s James Sprigg Payne’s Airport showed “Mr. Sawyer lying flat on his stomach on the floor in the corridor of the airport and seemed to be in ‘excruciating pain.’ The footage showed Mr. Sawyer preventing people from touching him.”

    He collapsed upon arrival in Nigeria, after a layover in Togo and was rushed to a Nigerian hospital. Upon being told he had Ebola, he acted with what the Nigerians called “indiscipline”; a burst of rage and despair against the world and everyone in it.

    Upon being told he had Ebola, Mr. Sawyer went into a rage, denying and objecting to the opinion of the medical experts. “He was so adamant and difficult that he took the tubes from his body and took off his pants and urinated on the health workers, forcing them to flee.

    Amazingly, he was even then in the process of being sprung by his political connections before death intervened. Had he lived Sawyer might have gotten out and protected by the juju of expensive watches and status symbols, mingled among the muckety-mucks of ECOWAS.

    Read the rest of this entry »

    Posted in Current Events, Ebola, Health Care, Medicine, Science | 56 Comments »

    Medicine as a government benefit.

    Posted by Michael Kennedy on 3rd August 2014 (All posts by )

    Obamacare is having serious trouble as I have discussed. The success stories, like California, are an example of what I have called Medicaid for All.

    “It’s a total contradiction in terms to spend your public time castigating Medicaid as something that never should have been expanded for poor people and as a broken, problem-riddled system, and then turn around and complain about the length of time to enroll people,” said Sara Rosenbaum, a member of the Medicaid and CHIP Payment and Access Commission, which advises Congress.

    Most of the new enrollees are Medicaid members and those enrolled in “private insurance” learn that they have severely restricted choice of doctor or hospital.

    Now we have a new development.

    Read the rest of this entry »

    Posted in Big Government, Economics & Finance, Health Care, Medicine, Political Philosophy, Science | 5 Comments »

    What next for health reform ?

    Posted by Michael Kennedy on 26th July 2014 (All posts by )

    It looks to me that the Supreme Court will have little justification for continuing the Obamacare program as it exists. The Halbig decision should kill it off. It is clear that the IRS subsidies to federal exchange subscribers are illegal.

    The only statement anyone has found in the legislative history that addresses this point comes from the Act’s lead author, who affirmed that Congress did intend to withhold tax credits in federal Exchanges. During a September 23, 2009, mark-up of his bill, which ultimately became the PPACA, Senate Finance Committee chairman Max Baucus (D-MT) refused to consider a Republican amendment regarding medical malpractice on the grounds it fell outside the Committee’s jurisdiction. Sen. John Ensign (R-NV) protested, asking how Baucus’ bill could do other things that lie outside the Committee’s jurisdiction, like direct states to create Exchanges. Baucus responded the bill creates tax credits, which are within its jurisdiction, and makes eligibility for those tax credits conditional on states creating Exchanges. Conditional necessarily means that Baucus intended to withhold tax credits in states that did not create their own Exchanges.

    I just don’t see how the Court can ignore that history. The political left has been on a rant about Congressional intent since the decision was announced.

    Read the rest of this entry »

    Posted in Economics & Finance, Health Care, Leftism, Medicine, Politics, Taxes | 10 Comments »

    An Update on healthcare reform.

    Posted by Michael Kennedy on 21st July 2014 (All posts by )

    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.

    Read the rest of this entry »

    Posted in Big Government, Bioethics, Crony Capitalism, Health Care, Medicine, Politics, Science | 23 Comments »