1. I See A Trend
2. Health Courts
3. Placebo Journal Update
4. Bacharach’s Beliefs by Ted Bacharach MD, retired
5. Am I Missing Something?
6. Transparency
7. Now That’s A Lottery
8. Feedback About The Placebo Gazette

I believe a national or socialized healthcare system will be pushed in our faces over the next few years.  It is happening already.   Massachusetts has their own plan and now California is also doing the same.  In fact, I can’t even quote one particular article here in the Placebo Gazette because there have been so many either published or editorialized in all the big newspapers that I wouldn’t know where to start.  But I will give you this quick summary on California’s plan on what one Wall Street writer called Terminatorcare:

·        How Much: Annual Cost $12 billion

·        How Many: 7.2 million or 20% of population

·        For Whom: Those with earnings less than $9804 get free care; if they earn between this and around $25K then they will get monetary subsidy for their care

·        Penalty: loss of personal state income tax exemption for those who don’t buy insurance

·        Contributors: businesses with more than 10 employees that don’t offer health insurance have to pay 4% workers’ wages into the state plan

At first glance it seems interesting.  I predict that that a whole hell of a lot of companies will fire some people to get their cap under 10 employers.  Can you say “outsource to India”?  The California law also “is targeting powerful interest groups that were relatively unscathed by the Massachussetts law. For example, doctors will be required to pay 2% of their (gross) revenue, and hospitals 4%, to help pay for treatment of those using Medi-Cal, the state’s Medicaid program for low-income and disabled residents”.  That quote came from a Boston Globe article.   When I first read it, I blew through the whole paragraph and literally had to do a double-take; the kind you would see some B-rated actor do.  In fact, I heard myself say, “Wait……what?!”

You read that right.  Greedy doctors will have to pay into a system for patients who come to see them.  These are the same patients that pay next to nothing themselves.  Even better, the Medicaid system, which is supposed to pay for them, doesn’t really pay either.  Are you kidding me?

What other business pays a tax through the government with the proceeds going right back to those customers who use that business?  This is insane.  Now I know others in my business are going to be very careful about how they respond.  You see, every medical organization doesn’t want to look bad and a poor response from them would be very politically incorrect.  Physicians are easy targets and we are running scared. 

Now for some more ranting because I am still not done on this topic.  Most of the articles describing he California law are using the Massachusetts law like it is some great success.  It hasn’t even really started yet!  Quotes like “blazed a trail for the national discussion on healthcare reform” are so bogus because there is no good data.  The Maine Dirigo Plan has been around for a while.  Why don’t we hear about that?  Because it sucks and it is losing money hand over fist. 

Someone explain to me why the American people are not allowed to shop all the different health insurance companies from state to state?  Let real competition take over so people can bargain shop a little bit.  Look at cell phones.  AMD, Motorola, and SAP are all working their asses off to compete in the different parts of this market and the prices of plans and phones have come down nicely.  I signed up for a cell phone plan.  The price was reasonable and there were a ton of choices.  Why can’t the healthcare system be the same?   You want government intervention?  Let the government watch over these HMOs from colluding and keeping the prices up.  Unfortunately, this won’t happen and the trend does not seem to be going this way.  Romney from Mass and Arnold from Cali are Republicans.  I guarantee the Dems are licking their chops and will run with this. 

2. Health Courts

Philip Howard is a lawyer and chair for an organization called Common Good.  He did a great piece in the WSJ on Specialized Healthcare Courts.  Look it up.  We all know that anyone can sue a doctor for any reason.  It has been shown that juries get it wrong 25% of the time.  The direct costs of the malpractice system cost $28 billion a year.  Defensive medicine, not so much for the good of the patient but to prevent lawsuits, costs much more than that.  Specialized Health Courts can change a lot of this.  Let me summarize their benefits:

• There are other specialty courts in America already (bankruptcy, tax, patent, workers comp, vaccine).
• There would be no juries but trained administrative judges
• There would be neutral experts who would be paid by the court
• Compensation would be given using some basic standards based on whether the injury should have been avoidable
• An individual injured by malpractice would receive 100% of ACTUAL monetary losses including future lost income
• PAIN and SUFFERING would be paid based on a preset standard (like other countries do)
• Settlements would occur sooner (instead of the average 5 years to get a claim now)

I think this is a great plan.  Why isn’t it happening yet?  Trial lawyers.  They insist on only juries to make the final decision.  It’s about money.  As Mr. Howard states (who again is a lawyer), “the civil jury was never supposed to decide standards of care as a matter of law; it is intended to resolve disputed facts.”

Now I have a lot of lawyers that read this Gazette.  I just know you have an opinion on this.   Go ahead and send it in; you just can’t charge me for it. 

3. Placebo Journal Update

Check out our newest cover for our newest issue.  Inside you can find about the Hip Fracture Institute which is the newest research site for pharmaceutical companies with osteoporosis drugs which actually causes the elderly to fall in order to get the data. As they say, “Sometimes science is painful”.  You have until Jan 30^th to sign up or you will miss it.  Hurry!

SUBSCRIBE

4. Bacharach’s Beliefs by Ted Bacharach MD, retired

The reasons behind the rise of Alternative medicine are multiple and complex. Probably at the basis of the entire movement is the fact that the family physicians and even the internists fail to provide either explanations or suggestions for the treatment or amelioration of many ills that plague the patients. This indifference to many ailments has certainly done much to drive patients into the realm of Alternative Medicine where anything goes and liability for promises are without consequences or liability.

Once upon a time in the distant past we were able, even in the University Hospital setting to diagnose a condition with the Number YOO-YOO, this was the number for an “Undiagnosed Condition manifested by:——.  In today’s allowable
classifications this diagnosis is no longer allowed. The insurance companies as well as the government have deemed that all conditions have been discovered and are diagnosable in their latest ICD numbers. All conditions can be treated by
Alternative Medicine but those that don’t have a proper diagnosable ICD number
have no place else to go. I believe that as physicians we should be allowed to treat and advise patients with undiagnosed conditions. We should all be humble enough to realize that all medical conditions have not been given a number and we still will continue to encounter diseases and conditions that require further observation which have not yet been described.

On January 12^th, the Democrats passed a bill (255-170) in the House that would require the government to negotiate prescription prices with the pharmaceutical industry.  Why is Bush going veto this bill?  Why is the inside word that this will never come to fruition?  Why is it a bad thing to negotiate?  The government already does it with Medicaid prescription plans and it has saved a ton of money.  They have done it with the VA and again saved a ton of money.  What am I missing here?

Now we all know I am not the smartest guy but I just haven’t figured this out.  It cannot be just greed and extortion by the Pharmaceutical industry, can it?  And don’t give me that sob story that these guys are losing so much on research.  Waa, waa, waa.  Cry me a river.  How much research is needed for a 4^th “me too” drug in the proton-pump inhibitor class that comes out and yet is only  priced $10 less than the rest of the crew.  No, I need to know answers and if there aren’t any then any congressman voting against this bill should be investigated to see how much money they are getting from the pharmaceutical industry.  Then they should be forced to send it to me because I don’t get squat from them anymore.

You can look at my charges and find out what I charge for a physical, for an injection to the knee, and to take out a grape that is stuck in your kid’s nose.  That is called transparency. What do hospitals charge?  Well, it depends on who they bill.  Self-pay get drilled the most.  The others like Medicare, Medicaid and every different HMO, have their own deal.  Not transparent.  What about those HMOs?  How transparent is their system of charges and payments?  Please.  I say throw it all on the table.  Show us what you pay for drugs and the back room deals you make with big Pharma.  Open your books and let the world grade you.  Doctors aren’t getting double digit profits each year but I know one industry that is.  Hmmm….now which one is it?

John Stossel has been nominated for his book, "Myths, Lies and Downright Stupidity: Get out the Shovel".  His paragraphs about malpractice attorneys get it right on the money.  This book lampoons folks from both the left and right and spares no one -- doctors, chiropractors, therapeutic touch, class action lawsuit attorneys, militant feminists and environmentalists as government bureaucracies gone wild.  To hear a layperson realize that malpractice awards really don't grow on trees or really help anyone but the attorneys was really heartening. 

To learn more about the Placebo Journal Tenesmus Award and to nominate someone, see our website.

There is now a plastic surgery lottery going on in England which offers winners money for face lifts, breast enlargements and tummy tucks.  People there just have to text message or call for a cost of $2.90 to get in on the monthly drawing.  This isn’t even a reality show but more of a marketing gimmick.  The winner of the drawing will be randomly selected and meet directors of the company before being flown to Prague in the Czech Republic for the surgery.  A lot of the medical organizations are ripping this whole thing but I love it.  Before they complain maybe they should take a look at our lottery gimmick here in America:  it’s called the medical malpractice system. 

9. Feedback About The Placebo Gazette

All future feedback will be posted as reviews for each issue.  Please go below and post your thoughts under the WRITE A REVIEW section.

Until next time, keep smiling, keep laughing and keep out of the sample closet.

Doug

King of Medicine