Trump, the doer

Long time friend, fellow retired Army officer, and occasional writer Mike Ford has another great piece in the American Thinker. Enjoy.

Trump, the doer

The Democrats have once again rolled the Republicans. They did it, as always, by controlling the terms of the discussion.

All throughout the Obama era, Republicans (quite rightly) complained about Obamacare. They passed a seemingly unending series of repeal bills, some of which made it through the Senate and one of which actually made it to President Obama's desk...for an ultimate veto.

How did the Democrats win this time? By constantly harping on the Republican Party: So what's your plan, Republicans? The Republicans, true to form, backed down and bought into the Democrat/Statist narrative of the necessity for federal involvement intervention in medicine and promised a replacement plan. Their campaign slogan changed from Repeal! to Repeal and Replace. Thus, no matter what, the least that would happen is that medical care in the United States would remain to the left of where it was in 2008, giving the Statists the win. Prime Minister Margaret Thatcher once referred to this as the "ratchet effect."

Speaker Ryan owns a large chunk of this, along with his long serving establishment posse. However, President Trump also has some ownership, and here is why. Donald J. Trump has two major attributes. On the upside, he is a doer. He knows and has demonstrated that he can get things done...on time and under budget. Not only was he a success in the business community, but as a political novice, he beat the well funded Clinton machine...a machine that spent almost twice what he did and employed over six times as many paid operatives. Any way you look at it, President Trump is a guy who gets stuff done, does it in a cost-effective way, and does so with his very own form of panache.

On the downside, there is Trump's attribute: he's a doer. When confronted with a problem, his first instinct is to jump right in and begin to solve it. And, as I mentioned above, he is usually, or should I say unusually, successful. However, as president of our constitutional republic, this might not always be the best method, as recently demonstrated by his active support of the failed Ryan plan to "repeal and replace" Obamacare. Ryan's plan, often referred to as "Obamacare Lite," failed to garner enough votes, forcing him to pull it from consideration on the floor of the House.

In his remarks after Speaker Ryan pulled the bill, President Trump spoke of the future, saying, "But I want to have a great health care bill and plan, and we will. It will happen. And it won't be in the very distant future."

Although Trump's remarks and earlier actions were those of a doer, conservatives have issue with this philosophy when applied to federal legislation in general and health care specifically. It's a big reason why Ryan's plan failed to garner support from the House Freedom Caucus. Conservatives don't want a (Trump's words in italics) "Big beautiful (federal) health care plan." Such a plan would, by necessity, be run from D.C., continuing the growth of the federal government and its pervasive influence in our daily lives. Conservatives want full repeal of Obamacare – and, after that, a series of standalone bills that remove the federal government from health care decision-making and funding, constraining it to its constitutional functions while allowing the free market to regulate innovation, quality, and costs.

In the future, Trump, the doer, might consider asking one question before jumping in to fix a problem, whether it be health care or anything else. The first thing he should ask is, "What part of this problem, if any, is a federal (per the U.S. Constitution) issue?" Had he done this with Obamacare, he might have found that the "federal issue" with Obamacare and the rest of health care environment in the United States is that the federal government is way too involved in the first place. Instead of a federal plan that does things, the plan might have been simply for the federal government to stop doing some things.

Mike Ford is a sometime contributor to American Thinker who has learned over multiple decades that the first step in the Problem Solving Process is to Identify the Problem. As Ronaldus Magnus opined, "Government is the problem."

Arteries getting cleaner....

I spend a few hours this afternoon with my wife and 17 year old at the Bodyworlds exhibit at the Houston Health Museum. If you haven't seen it, do yourself a favor and spend some time there if you can. Even for a non-medical nerd like me it is fascinating, seeing the parts of the human anatomy and how they interact. Here is the "Split Lady" exhibit:

I was just surfing Facebook and I found this interesting took being worked on for treating blocked arteries. It is nothing short of incredibly in how we can treat ailments these days. Take a look at this. It's still in development, but damn, it look promising.

New wound treatment technology...

A serious issue for cops everywhere is quick treatment of trauma. I live in Houston and we have 3 level one trauma centers (we actually need 5-6), an incredible hospital district, and over 50 hospitals in the area. But even with a quick pickup with from an ambulance, the possibility of bleeding out is real. Since the Boston Marathon Bombing, I've carried multiple tourniquet kits and other equipment for to stop bleeding.

Now look at these new toys. Rather interesting.

Thank you Rock D-Bo for the link!

Trauma on the battlefield and The Watch

Earlier this week I went though crowd control training and one of the items covered was use of a tourniquet in case of a major injury. And we were told, in the era of the Boston Bombings, etc, we should expect more of this. Personally I started carrying on tourniquet in my body armor a couple of years ago, and after this class I'll carry two. Better to have and not need, that to need and not have.

From PoliceOne, a good review of lessons learned from the front, lessons that can help us on The Watch.

6 life-saving lessons for cops learned on the battlefield

In a critical incident, there is an unspecified amount of time where even the best intentioned EMTs may not be able to get to you — you are on your own

Mar 16, 2016

Much of what we do as police officers today in self-aid/buddy-aid was passed on by our military troops who paid a high price for the lessons learned. But what is now accepted practice for them is still somewhat of a hard sell for law enforcement. Many officers fall prey to complacency and an “it will never happen to me” attitude.

Calls for service are “come as you are” events. Absent the proper training and the necessary equipment on your person, the potential for a bad outcome is high. There are generally three categories of injuries in the field:

1. Injuries that no matter where you are or what resources are available, you are going to die

2. Injuries that no matter where you are or what resources are available, you're going to live

3. Injuries where what you do — or don’t do — before more definitive medical care is available will be the difference between whether you live or die

The third category of injuries is the area we must focus on. In a critical incident, there is an unspecified amount of time where even the best intentioned EMTs and paramedics may not be able to get to you — you are on your own. You must be prepared with the necessary training and equipment. Let’s look to a lesson learned in Iraq for an example of precisely how important this training and equipment is.

An Attack in Iraq
On September 11, 2004 — while deployed to Iraq — U.S. Army Staff Sergeant/Medic (ret.) Chris Cook was en route to the “Green Zone” hospital with blood samples from his unit's medical facility. A three-vehicle convoy was stopped by US forces due to a hidden Improvised Explosive Device (IED) that had been buried in the roadside and blocked their path. The convoy commander elected to stop (breaking a cardinal rule) and provide perimeter security while awaiting an Explosive Ordnance Disposal (EOD) team.

The convoy, consisting of three 1/2 armored Humvees armed with .50 caliber and M249 SAW machine guns, formed a 360 degree perimeter. Cook was positioned on the road side of the convoy. After approximately 30 minutes, a lone vehicle broke out of the normal traffic flow and drove in the direction of the convoy at a high rate of speed.

A little voice inside Cook’s head told him this was a bad thing — a very bad thing. His training kicked in as he raised his M16A2 rifle and aligned his sights on the forehead of the driver and squeezed off two rounds. Immediately after firing the second round, the vehicle exploded approximately 25-30 yards from Cook’s position. He doesn’t recall hearing the explosion, but saw a bright orange ball of flames and felt the heat from it. The force of the blast slammed him to the ground next to his Humvee which was engulfed in flames.

He grabbed the brush guards in an attempt to stand, but couldn’t. His vision was blurred as he looked down through his protective glasses. He flicked off his eyewear to see his left leg from the knee down twisted and backwards. Blood was visible on his camouflage uniform and he could read the blood type marked on the back of his boots. His right ankle had swollen to the size of a softball.

He tried to stand again, but couldn’t. Then the pain started — intense pain as if his legs were on fire. He flashed back to his training and heard his instructor’s voice yelling “ambush…ambush…ambush.”

One of his buddies came to his aid and dragged him clear of the burning vehicles. Cook — at over 200 lbs. fully kitted — was dead weight. As he rolled onto his back, he remembered that about a week prior, he’d been issued a Combat Application Tourniquet (CAT). CATs were issued to all medics with instructions to keep them handy at all times. He rolled onto his back, removed the CAT from a pocket on his body armor, and attempted to open it from the factory wrapper.

His heart was racing, his hands were shaking, his leg was visibly a mess, and he no longer had the fine motor skills to remove the CAT from its packaging. Fearing he would soon go unconscious and bleed out, he began to gnaw at the packaging. He was finally able to remove the CAT and apply it to his injured leg in time to save his life.

Lessons Learned
Cook was subsequently rescued by members of another unit who arrived on scene. He was taken to the 31st Combat Surgical Hospital in the “Green Zone,” which ironically was where he was headed before the explosion. There, he would undergo the first of 21 surgeries to repair the near amputation of his left leg, a fractured right ankle, and numerous other shrapnel injuries. This was the start of a long and arduous road to physical and mental recovery.

Many thoughts went through his mind during those critical moments. He offers the following key learning points:

1. Stop the threat. The best medical care in the world is of no value if you’re dead. That day, my training saved my life.

2. If you are going to carry a piece of equipment, whether it be in the military or law enforcement, train with it. Don’t just put it into a fancy MOLLE pouch and forget about it. In doing so, when the time comes, you will not have the necessary skills to use it effectively and efficiently.

3. Tourniquets must be placed on your kit so that they can be accessed with either hand. In the event one arm is incapacitated, it would be a shame to bleed to death from survivable extremity wound with a tourniquet only an arms-length away.

4. Unless the medical kit has to remain in the factory packaging to maintain sterility, remove it. Under stress, it’s unlikely you will possess the fine motor skills necessary to remove a tourniquet from its packaging.

5. Have a proven system in place for moving/dragging a casualty to safety and train with dead weight consistent with a real operator in full gear. This is not easy, but it’s absolutely essential.

6. Develop and maintain BUSHIDO — the “way of the warrior.” This mindset can and will help you triumph over your adversary, no matter your location, mission or circumstance...

I can't recall who said it, but it fits with this story: "Any fool can learn from his own mistakes. I want to learn from other men's mistakes."

Be safe out there.

A remote control drone that can carry 1100 pounds...

The potential for this is great. They are mentioning how you can airlift men from the battlefield. There is also the potential for airlifting injured civilians in distant rural areas to trauma centers at a fraction of the cost of standard helicopters.

Military drone ambulance can carry loads of up to 500kg

The Israeli company Urban Aeronautics created AirMule, a drone capable of carrying loads of up to half a ton. The equipment was developed primarily for military use, to be used in missions in hard to reach places where conventional helicopters can’t access.

“[It could fly to] anyone out in the field who needs water, food, batteries, supplies, medical equipment and so forth,” Rafi Yoeli told the BBC. “Later, it could be used to fetch soldiers that you don’t want to leave behind or are wounded. There are plenty of situations where you cannot send a helicopter – for example, in the middle of fighting where you want to evacuate people from a street or from a narrow roof. Eventually, there could be civilian applications, such as rescue missions in the mountains or flying into disaster areas – for example, nuclear facilities where no person in a helicopter could get in.”

Still in testing phase, AirMule flies completely autonomously: take-off, maneuvers, landing, everything is done by the device’s navigation system and the Israeli aircraft can reach speeds of up to 180 km/h.

Despite the interesting proposal of carrying people in a drone that can be remote-controlled, one must keep in mind some obstacles that involve drones in general. Like the flight distance which is limited to 49 km, while helicopters have no distance limits as long as the fuel lasts. According to the creators, the drone has incredible flight capacity even in turbulent weather, resisting winds of up to 50 knots, a significant improvement over existing helicopters.

Thank you Mike K for the link.

OK, these are the guys some people want running health care....

You can't make this one up.

14,000 draft notices mistakenly sent to men born in 1800s

No, the United States isn’t trying to build a military force of centenarians.

It just seems that way after the Selective Service System mistakenly sent notices to more than 14,000 Pennsylvania men born between 1893 and 1897, ordering them to register for the nation’s military draft and warning that failure to do so is “punishable by a fine and imprisonment.”

The agency realized the error when it began receiving calls from bewildered relatives last week.

Chuck Huey, 73, of Kingston, Pa., said he got a notice addressed to his late grandfather Bert Huey, a World War I veteran who was born in 1894 and died in 1995 at age 100.

“I said, ‘Geez, what the hell is this about?’ It said he was subject to heavy fines and imprisonment if he didn’t sign up for the draft board,” he said. “We were just totally dumbfounded.”

Huey said he tried calling the Selective Service but couldn’t get a live person on the line. That frustrated him even more because he wanted to make sure the agency knew there had been a mistake.

“You just never know. You don’t want to mess around with the federal government,” he said...

Such a screw up, what can be said but Yes We can!

New York Pravda strikes again.....

I really despise The New York Times. All the news that's fit to print is supposedly the motto. If you define news as leftist propaganda for radicals in this country. Now here we find the editors of the Times telling the Republicans on what they need to do with Obamacare. You're going to be shocked, they say reform, do not repeal it.

GOP challenged by what to do next

WASHINGTON — With the first enrollment deadline now passed, Republicans who have made the repeal of President Barack Obama’s health care law their central aim are confronting a new reality: More than 2 million Americans are expected to be getting their health insurance through the Affordable Care Act come Jan. 1.

The enrollment figures may be well short of what the Obama administration had hoped for. But the fact that a significant number of Americans are now benefiting from the program is resulting in a subtle shift among Republicans...

That is a bold faced lie. Obamacare is sending people into Medicaid, not private health insurance. And that was the purpose all along. B Hussein Obama's scheme was to get bankrupt private insurance and then there would be nothing left except single payer. And if he hurts millions along the way to more pain, oh well.

...“It’s no longer just a piece of paper that you can repeal and it goes away,” said Sen. Ron Johnson, R-Wis., a tea party favorite. “There’s something there. We have to recognize that reality. We have to deal with the people that are currently covered under Obama-care.”

And that underscores a central fact of U.S. politics since Franklin D. Roosevelt signed the Social Security Act during the Depression: Once a benefit has been bestowed, it is nearly impossible to take it away.

Republicans are considering several ideas for how to proceed. Johnson argued that Congress should do away with the mandate that most people obtain insurance, but not the online exchanges.

Instead, he said, the options in the marketplaces should be augmented by other choices that fall short of the law’s coverage standards, such as catastrophic health plans. (Many policy analysts and insurance companies say such a move would not work, because the mandates are essential to delivering to a diverse pool of uninsured people.)

One, Johnson was a Tea Party mistake. He has turned into a RINO, or he was one and a really good actor. And I really love the "policy analysts and insurance companies" statement. See the linked Washington Post article that most people are not going into private care but Medicaid, so the process of destroying the private health care industry is going merrily along it's way.

And this is a "news story".

The rest will infuriate any intelligent person. If you want to, read the rest but it will only annoy you. Happy New Year.

Sunday morning…..

Got started off after a long night. Finished my final paper for my class on Collection Management. Got the draft next to me and after a few checks should be ready to turn it. For the first time I’m not pulling it out my ass with less than an hour to go before I’m late. I’m not used to this!

Got the morning started with some excellent Community Coffee, a shot of 1865 Bourbon in it (medicinal purposed only) and Saturday Night Live is back for it’s 39th Season. Great opening, really love it shows the problem of Obamacare with comedy. I wish the rest of the media would publish that with more seriousness.


Speaking of propaganda, I read the Houston Chronicle and even for that rag, this was bad. Granted, a lot of the articles they have in here are from other sources, but come on:

Southern states move to tighten voting laws
MIAMI — Emboldened by the Supreme Court decision that struck down the heart of the Voting Rights Act in June, a growing number of Republican-led states are moving aggressively to tighten voting rules. Lawsuits by the Obama administration and voting rights activists say those efforts disproportionately affect minorities.

At least five Southern states, no longer required to ask Washington’s permission before changing election procedures, are adopting strict voter identification laws or toughening existing requirements.

Got it. Having to show an ID is strict. Having to show an ID to get your Obamaphone while talking on your iPhone is not a problem.

Also, the "heart of the Voting Rights Act." The fact they cannot use demographic data from 1970, that reviews of voting districts should show who is actually there, not who was there in the 1960s, that's really racist. Pathetic.

Texas officials are battling the U.S. Justice Department to put in place a voter ID law that a federal court has ruled was discriminatory. In North Carolina, the GOP-controlled Legislature scaled back early voting and ended a pre-registration program for students.

Got it. It’s discriminatory to not allow people to register on voting day or allow them to vote a month ahead of election. We all know the purpose it to allow people to vote as different people at differ location’s. The dead rise all month. And for some read son they all vote as Democrats. I wonder if there is a pattern?

Nowhere is the debate more heated than in Florida, where the chaotic recount in the disputed 2000 presidential race took place.

x
Yes, it’s disputed because the Florida Supreme Court stuck it’s nose into it and tried to rewrite Florida election law after the election had already been decided. Gotta give these leftist this, they don’t take their toys and walk home after they loose an election. They fight to the bitter end.

Now my favorite.

Florida election officials are set to resume an effort to remove noncitizens from the state’s voting rolls. A purge last year ended in embarrassment after hundreds of American citizens, most of whom were black or Hispanic, were asked to prove their citizenship or risk losing their right to vote.

Hey morons, if the are not citizens, they cannot vote.

Next was on the front page. Here is the Chron showing it’s still boot licking the regieme of B Hussein and being a propaganda piece for Obamacare. From the front page.

What the new health care law means to you
Enrollment opens Tuesday. Here are answers to the most frequent questions

Right. The fact your employer’s insurance company has stopped issuing policies in your state, the new policies are 2-3 times more expensive, no, that don’t affect you.

…Q: I’ve heard that states were supposed to expand Medicaid coverage under this law and that Texas did not. How does that affect who can buy insurance?
A: You’re right. When Congress approved the law, it was believed that most states would expand Medicaid coverage for the poor. The federal government offered states billions of dollars to pay for the expansion. However, some states, like Texas, opted out of the expansion because of objections to expanding the Medicaid program. That left many low-income people ineligible for coverage under the Affordable Care Act.
Q: Who will be left out because Texas did not expand Medicaid?
A: Individuals who will not receive expanded Medicaid coverage earn roughly between $11,500 and about $15,870. Families of four earn between an estimated $23,500 and $31,800.

For some reason this leaves out the fact the “billions of dollars to pay for” Medicaid expansion is only temporary and the states that agree with it are going to be stuck with the full bill in a few years. Then again they are probably booking on the transition to single payer to relieve them of these cost.

Here is a classic:

…Q: What’s the penalty if I do not sign up?
A: The individual penalty will be 1 percent of a person’s income or $95 — whichever is higher. The penalty will grow to 2.5 percent of income or $695 per adult by 2016. The penalty for a child will be half that of an adult. The penalty will be due at the time of the 2014 federal income tax filing.
Q: If I’m low-income and don’t qualify for Medicaid, yet I still can’t afford to buy insurance on the exchange, am I going to be penalized if I don’t buy it?
A: No.

But you will have a penalty of 1 percent of a person’s income….

What a waste of electrons.

Well, at least my class finished. Final checks on my paper, uploaded it, DONE A LAST! DONE A LAST! THANK GOD ALMIGHTY, DONE A LAST!

Football, Texans are giving me a heart attack but hopefully they still pull this out. And Chicago got its ass handed to itself. Gotta love it. Saints tomorrow which means I'll be dead on Tuesday afternoon. But hey, it's football….some sacrafices must be made.

Hope you have a great week.

PS: Thanks Texans...

You may find a pattern here.....

New York, New Jersey, etc used to be the industrial heartland of this country, where people made money. Not anymore.

I found this article about why doctors are leaving New Jersey and you will be shocked why:

New Jersey’s Disappearing Doctors

New Jersey is experiencing a shortage of doctors. In fact, it’s projected that by 2020 the state will be about 3,000 primary care physicians short of what is needed to give optimal health care.

So why are doctors fleeing the Garden State?

According to Deborah Briggs, the President and CEO of the Council of Teaching Hospitals, New Jersey loses nearly 70% of the doctors it educates to other states. This is well below the national average of a 48% retention rate.

In other words, in 2013 New Jersey only kept about 34% of the doctors who were educated and trained in the state.

The Council of Teaching Hospitals and a nationwide study done by Merritt Hawkins, says New Jersey is just not competitive when it comes to keeping doctors in state.

The top five reasons for physicians leaving are:

Better salary offered outside of New Jersey

Cost of living in New Jersey

Better job/practice opportunities in desired locations outside of New Jersey

Taxes in New Jersey

Affordable Housing

...The room was filled with 40 or so doctors who also added malpractice insurance issues to the list, explaining that it’s just too expensive to start a practice here.

Malpractice reform has greatly helped Texas retain doctors by limiting putative damages to 250K while while not limiting actual damages. Lawyers hate that but it makes doctors want to stay.

Now granted, MD's are in high demand (that will only get worse) and other areas offer higher salaries and there is a high cost of living. But of all the things listed, is anyone specific to the practice of medicine? A mechanic can take his skills and get a job in Texas where housing is less than half that of the NE corridor, there is no state income tax and you don't have to pay 11 dollars on a toll road for five miles (sticker shock from a vacation a few years ago).

But again, I wonder if the powers that be in the area would look at this list and say maybe that's why people are leaving the NE and moving west and south. If you make it too damned high (like the the rent) to live there, people will move. And moving they are.

The selling of Obamacare and other tripe....

I found this on HotAir.com this morning and after reading it I was reminded of discussion i had with a college friend on Time and Newsweek. He recalled the time he was with a person he knew at a medical center getting a treatment and he just had to kill a few hours. There were piles of recent issues of both Time and Newsweek and he said "After a while I found I was reading more of the Newsweek and less of the Time." After that I tried it at a library and he was right. Newsweek sucked less that Time (this was over twenty years ago.)

Now we have the propaganda rag of the left explaining the latest problem with Obamacare (excuse me, the Affordable Care Act...pardon me, while I puke.) The problem is not the piece of legislation, just the fact it hasn't been sold right

And Now, The Selling of Obamacare

Stephen Lam

In a windowless office in the basement of the West Wing, behind a utility room and next to a fire-alarm panel, David Simas is marking up another whiteboard with blue ink, hoping to explain one more time just how the President’s health care reform law will work when the time comes for uninusured Americans to sign up this fall.

The abstraction of Obamacare is about to become reality. But will anyone know what to do? An estimated 7 million Americans will join the first health exchanges from Oct. 1, 2013, to April 1, 2014, and most have no idea how to do that. And for the millions who are already covered by some early Obamacare benefits, Simas adds, “We need to continue to remind them of what they’re getting.”

If Simas, 42, has the nervous energy of the 2012 campaign, where he served as opinion-research director, there is a good reason. Though Barack Obama has competed in his last election, he has one more campaign ahead of him. This fall, Obamacare will go into full effect, with the promise of insuring as many as 40 million Americans if it succeeds. But it could still fail.

No Stephen, it's designed to fail. Without people just falling in line and paying multiple times what they do now, the system will collapse. And Stephen, in case you haven't figured it out, that is the purpose.

...the law is increasingly unpopular. According to an NBC News–Wall Street Journal poll released earlier this month, 49% of Americans now believe the law is a bad idea, the highest percentage recorded, with only 37% saying it is a good thing. Many states have already opted out of key provisions to expand Medicaid. In Washington, Republicans continue to lay siege to the law; they have voted to repeal it 37 times in the U.S. House.

That unpopularity threatens one of the law’s most ambitious goals—establishing health care exchanges allowing uninsured Americans to purchase affordable coverage. The exchanges need roughly 2.7 million healthy 18-t0-35-year-olds to sign up to be solvent. The majority of that group is nonwhite and male, according to Simas’ data, and a third are located in just three states: California, Texas and Florida. If too few choose to enroll because they don’t know about the law, don’t like it, or feel they don’t need insurance, the exchanges will fail. And so will the law.

The Administration has plotted an extensive social-media campaign designed to reach the young and healthy and is soliciting sports teams to help raise awareness. More than 10 staffers in the Office of Public Engagement are marshalling the help of Latino and African American groups and community nonprofits. And Simas has spent countless hours surrounded by maps of media markets and demographic data on the uninsured trying to remind prospective enrollees of the benefits available to them: “It’s that guy in Dallas, it’s the woman in Los Angeles, it’s the family in Miami-Dade,” he says.

Obama aides have been saying such things for years, with little effect. But now the clock is ticking, and Obama is running out of time to make his signature achievement stick.

Again Stephen, that is the purpose. Obama's signature achievement is yet to come and Obamacare is just one of the means to that end. Obama (and his ilk) hate this country as it was founded and they want it changed into a second rate nation, the United States of Europe if you will. He thinks we made it to the top of the international pyramid by cheating and taking the wealth of other nations. As if the people of the Middle East would know what the hell to do with oil without the work of the British and Americans. But B Hussein want to fundamentally transform this nation into a second rate power and moving to a single payer system for health care is a means to that end. Destroying the finest health care system on earth will leave the people of this country with no choice but having the government running it and if people are hurt or die during the implementation, so be it. The means justify the end in his mind and you should just go alone. B Hussein Obama will have his goal met of turing this country from a republic into a semi-solaist nation with no opposition. And the "leadership" of the Republican party have no stomach to fight him.

God help us all.

Portable Battlefield Surgery Kit

One of the good things of working in Houston is we have multiple Level One Trauma Centers in case of major injury. If you get shot, stabbed, crushed or burned, you go to Ben Taub or Hermann Memorial. Now I found this interesting and one of the bad things for smaller departments (or state police units) is they may not have emergency facilities available nearby. Time can mean life. Something like this may very useful to smaller, more isolated agencies.

Nicole Ribeiro, an anesthesiologist, demonstrates how a tablet
computer can help evaluate a burn patient when used with other
miniaturized medical tools. Nick de la Torre / Houston Chronicle

Dr. George Kramer shows a miniaturized high-rate IV pump, which is
used to help burn patients in John Sealy hospital in Galveston.

Emergency room in backpack being developed for battlefield

GALVESTON — Marines seriously wounded in remote areas of the world, hours or even days from emergency room care, can find their lives slipping away.

New tactics developed by the Marine Corps that emphasize smaller, highly mobile units operating in distant lands make the need for better medical care closer to the battlefront even more important.

That care is on its way in the form of an emergency room in a backpack being developed in part by a team of doctors at the University of Texas Medical Branch. It’s part of an effort to bring close to the front lines treatment normally found only in the best hospital emergency rooms. The effort already has produced life-saving equipment.

“This is really a big breakthrough,” said Dr. Kim Bentley, program officer at the Office of Naval Research in Arlington, Va.

The object of the effort is to reduce the size of bulky monitors and other life-saving equipment normally found in a hospital emergency room so that they can fit in a backpack. Eventually wounded Marines could be hooked up to the automated system and it would keep them alive while they were transported to the nearest aid station.

One possibility under consideration is attaching the equipment, known as the Automated Critical Care System, to a drone that would carry the patient to a hospital ship.

“It’s robot airplanes and robot medical care at the extreme part of this vision,” said Dr. George Kramer, a researcher who pioneered two key components of the system. Although the Office of Naval Research is leading the development of the system, it would be available to all branches of the service and eventually to civilian first responders, Bentley said.

Small enough to carry

The idea is for miniaturized medical devices to be connected to a core computer. Devices would monitor vital functions such as breathing and heart rate as well as administering blood and saline solution, drugs and anesthetics, among other medical tasks.

The entire system must be small enough to fit into a backpack. The device could work on its own without human intervention or give information to a caretaker. It could also link to specialists.

University of Texas Medical Branch is developing the devices that monitor and dispense fluids and drugs, the University of Cincinnati is working on devices that assist with breathing, and Iowa-based Athena GTX is working on the core computer, Bentley said.

A helicopter picking up wounded could be equipped with the system, which would give doctors information about the injury earlier than was previously possible.

“The great thing about this whole setup is that it provides a medical record from the point of injury onwards,” said researcher Dr. Michael Kinsky. “We don’t have any information now at the point of injury. It’s a big black box.”

Vital signs monitor

Kramer developed a component known as the Burn Navigator, which monitors a burn patient’s fluids and automatically replaces them. The device was recently approved for use by the U.S. Food and Drug Administration. He developed a second device to monitor blood pressure and replace blood. The device consists of a wireless vital-signs monitor with a cuff that transmits information to a computer tablet about the size of an iPad. The computer analyzes information from the monitor and sends instructions to a small pump.

Kinsky is testing the blood system on volunteers and the results are promising, with no complications in about 50 experiments, he said.

Another group of the hospital’s researchers is turning the best available medical knowledge into algorithms — mathematical computations that can create software for the Automated Critical Care System.

Houston-based Arcos Inc. has adapted the rugged Panasonic Toughbooks for use as the trauma tablets to control the blood system device. Arcos is using the hospital algorithms to develop the tablet software.

The device can operate on its own, but it will know when human assistance is needed, Arcos CEO Chris Meador said. Arcos is manufacturing the Burn Navigator and will manufacture the blood system device....

A doctor who seems to not a have clue.

On patrol you often receive calls from people who want us to handle something that is no way a matter of law enforcement. A classic example is when a single mother called me because her children refused to do their homework. Sorry lady, I'm not here to raise your kids. Maybe you should have their father's get over here and do their jobs.

Now this is interesting. OK doctor, what do you want us to do here?

Doctor Threatens To Call Cops On Pregnant Woman If She Doesn’t Have Emergency C-Section

TAMPA (CBS Tampa) — A Florida doctor told a pregnant patient that he would call the cops on her if she didn’t have an emergency caesarean section because the baby was a week past his due date.

The Tampa Bay Times reports that Dr. Jerry Yankowitz, chairman of the obstetrics and gynecology at the University of Southern Florida, sent the threatening email to 35-year-old Lisa Epsteen.

“I feel abandoned. There has to be a level of trust between provider and patient, and that has been betrayed,” Epsteen told the Times. “It’s circumstances like this that make women feel like they have no options but to birth their babies on their own — and put themselves in more dangerous circumstances — because they feel bullied.”

The email stated: “I am deeply concerned that you are contributing to a very high probability that your fetus will die or your child will incur brain damage if born alive. At this time, you must come in for delivery. I would hate to move to the most extreme option, which is having law enforcement pick you up at your home and bring you in, but you are leaving the providers of USF/TGH no choice.”

Epsteen reached out to the National Advocates for Pregnant Women after receiving the email. The group sent a letter to the hospital questioning their medical ethics.

“Any attempt to force her to undergo the surgery by means of arrest and detention in the hospital is without legal justification and in defiance of a clear medical consensus that such threats and actions undermine maternal, fetal, and child health,” Lynn Paltrow, executive director of NAPW, said in a statement on the group’s website....

Doctor, you may have forgotten something. A crime is only a crime because a level of government (local, county, state or federal) has passed legislation making that act a crime. This woman may be showing poor judgement in this matter but a cop has no authority to make her into custody and "bring you in". And bring you in to where? I generally bring prisoners into a jail, not a hospital. They are in jail because they have broken a law.

Doctor, use a bit of judgement before you write an empty threat like this.

Security Weekly: Bioterrorism and the Pandemic Potential, March 7, 2013

I was reading this quote, "general hygienic measures -- avoiding mass gatherings, thoroughly washing hands and even wearing masks in specific, high-risk situations.", and recall something the wifie said about how her fellow nursing students reacted to a virus going around the school. "DID YOU WASH YOUR HANDS?! AND DON'T TOUCH ME!"

But a good general look at a more likely threat of mass effect than nuclear or chemical weapons.

By Rebecca Keller

Periodic media reports of bird flu, a new SARS-like virus and a case of drug-resistant tuberculosis have kept the world informed, but they have also contributed to a distorted perception of the true threat such contagions pose. Perhaps the greatest value of the media coverage is the opportunity it provides to discuss the uncertainties and the best ways to prepare for biological threats, both natural and man-made.

It is important to remember that the risk of biological attack is very low and that, partly because viruses can mutate easily, the potential for natural outbreaks is unpredictable. The key is having the right tools in case of an outbreak, epidemic or pandemic, and these include a plan for containment, open channels of communication, scientific research and knowledge sharing. In most cases involving a potential pathogen, the news can appear far worse than the actual threat.

Infectious Disease Propagation

Since the beginning of February there have been occurrences of H5N1 (bird flu) in Cambodia, H1N1 (swine flu) in India and a new, or novel, coronavirus (a member of the same virus family as SARS) in the United Kingdom. In the past week, a man from Nepal traveled through several countries and eventually ended up in the United States, where it was discovered he had a drug-resistant form of tuberculosis, and the Centers for Disease Control and Prevention released a report stating that antibiotic-resistant infections in hospitals are on the rise. In addition, the United States is experiencing a worse-than-normal flu season, bringing more attention to the influenza virus and other infectious diseases.

The potential for a disease to spread is measured by its effective reproduction number, or R-value, a numerical score that indicates whether a disease will propagate or die out. When the disease first occurs and no preventive measures are in place, the reproductive potential of the disease is referred to as R0, the basic reproduction rate. The numerical value is the number of cases a single case can cause on average during its infectious period. An R0 above 1 means the disease will likely spread (many influenza viruses have an R0 between 2 and 3, while measles had an R0 value of between 12 and 18), while an R-value of less than 1 indicates a disease will likely die out. Factors contributing to the spread of the disease include the length of time people are contagious, how mobile they are when they are contagious, how the disease spreads (through the air or bodily fluids) and how susceptible the population is. The initial R0, which assumes no inherent immunity, can be decreased through control measures that bring the value either near or below 1, stopping the further spread of the disease.

Both the coronavirus family and the influenza virus are RNA viruses, meaning they replicate using only RNA (which can be thought of as a single-stranded version of DNA, the more commonly known double helix containing genetic makeup). The rapid RNA replication used by many viruses is very susceptible to mutations, which are simply errors in the replication process. Some mutations can alter the behavior of a virus, including the severity of infection and how the virus is transmitted. The combination of two different strains of a virus, through a process known as antigenic shift, can result in what is essentially a new virus. Influenza, because it infects multiple species, is the hallmark example of this kind of evolution.

Mutations can make the virus unfamiliar to the body's immune system. The lack of established immunity within a population enables a disease to spread more rapidly because the population is less equipped to battle the disease. The trajectory of a mutated virus (or any other infectious disease) can reach three basic levels of magnitude. An outbreak is a small, localized occurrence of a pathogen. An epidemic indicates a more widespread infection that is still regional, while a pandemic indicates that the disease has spread to a global level.

Virologists are able to track mutations by deciphering the genetic sequence of new infections. It is this technology that helped scientists to determine last year that a smattering of respiratory infections discovered in the Middle East was actually a novel coronavirus. And it is possible that through a series of mutations a virus like H5N1 could change in such a way to become easily transmitted between humans.

Lessons Learned

There have been several influenza pandemics throughout history. The 1918 Spanish Flu pandemic is often cited as a worst-case scenario, since it infected between 20 and 40 percent of the world's population, killing roughly 2 percent of those infected. In more recent history, smaller incidents, including an epidemic of the SARS virus in 2003 and what was technically defined as a pandemic of the swine flu (H1N1) in 2009, caused fear of another pandemic like the 1918 occurrence. The spread of these two diseases was contained before reaching catastrophic levels, although the economic impact from fear of the diseases reached beyond the infected areas.

Previous pandemics have underscored the importance of preparation, which is essential to effective disease management. The World Health Organization lays out a set of guidelines for pandemic prevention and containment. The general principles of preparedness include stockpiling vaccines, which is done by both the United States and the European Union (although the possibility exists that the vaccines may not be effective against a new virus). In the event of an outbreak, the guidelines call for developed nations to share vaccines with developing nations. Containment strategies beyond vaccines include quarantine of exposed individuals, limited travel and additional screenings at places where the virus could easily spread, such as airports. Further measures include the closing of businesses, schools and borders.

Individual measures can also be taken to guard against infection. These involve general hygienic measures -- avoiding mass gatherings, thoroughly washing hands and even wearing masks in specific, high-risk situations. However, airborne viruses such as influenza are still the most difficult to contain because of the method of transmission. Diseases like noroviruses, HIV or cholera are more serious but have to be transmitted by blood, other bodily fluids or fecal matter. The threat of a rapid pandemic is thereby slowed because it is easier to identify potential contaminates and either avoid or sterilize them.

Research is another important aspect of overall preparedness. Knowledge gained from studying the viruses and the ready availability of information can be instrumental in tracking diseases. For example, the genomic sequence of the novel coronavirus was made available, helping scientists and doctors in different countries to readily identify the infection in limited cases and implement quarantine procedures as necessary. There have been only 13 documented cases of the novel coronavirus, so much is unknown regarding the disease. Recent cases in the United Kingdom indicate possible human-to-human transmission. Further sharing of information relating to the novel coronavirus can aid in both treatment and containment.

Ongoing research into viruses can also help make future vaccines more efficient against possible mutations, though this type of research is not without controversy. A case in point is research on the H5N1 virus.

H5N1 first appeared in humans in 1997. Of the more than 600 cases that have appeared since then, more than half have resulted in death. However, the virus is not easily transmitted because it must cross from bird to human. Human-to-human transmission of H5N1 is very rare, with only a few suspected incidents in the known history of the disease. While there is an H5N1 vaccine, it is possible that a new variation of the vaccine would be needed were the virus to mutate into a form that was transmittable between humans. Vaccines can take months or even years to develop, but preliminary research on the virus, before an outbreak, can help speed up development.

In December 2011, two separate research labs, one in the United States and one in the Netherlands, sought to publish their research on the H5N1 virus. Over the course of their research, these labs had created mutations in the virus that allowed for airborne transmission between ferrets. These mutations also caused other changes, including a decrease in the virus's lethality and robustness (the ability to survive outside the carrier). Publication of the research was delayed due to concerns that the results could increase the risk of accidental release of the virus by encouraging further research, or that the information could be used by terrorist organizations to conduct a biological attack. Eventually, publication of papers by both labs was allowed.

However, the scientific community imposed a voluntary moratorium in order to allow the community and regulatory bodies to determine the best practices moving forward. This voluntary ban was lifted for much of the world on Jan. 24, 2013. On Feb. 21, the National Institutes of Health in the United States issued proposed guidelines for federally funded labs working with H5N1. Once standards are set, decisions will likely be made on a case-by-case basis to allow research to continue.

Fear of a pandemic resulting from research on H5N1 continues even after the moratorium was lifted. Opponents of the research cite the possibility that the virus will be accidentally released or intentionally used as a bioweapon, since information in scientific publications would be considered readily available.

The Risk-Reward Equation

The risk of an accidental release of H5N1 is similar to that of other infectious pathogens currently being studied. Proper safety standards are key, of course, and experts in the field have had a year to determine the best way to proceed, balancing safety and research benefits. Previous work with the virus was conducted at biosafety level three out of four, which requires researchers wearing respirators and disposable gowns to work in pairs in a negative pressure environment. While many of these labs are part of universities, access is controlled either through keyed entry or even palm scanners. There are roughly 40 labs that submitted to the voluntary ban. Those wishing to resume work after the ban was lifted must comply with guidelines requiring strict national oversight and close communication and collaboration with national authorities. The risk of release either through accident or theft cannot be completely eliminated, but given the established parameters the risk is minimal.

The use of the pathogen as a biological weapon requires an assessment of whether a non-state actor would have the capabilities to isolate the virulent strain, then weaponize and distribute it. Stratfor has long held the position that while terrorist organizations may have rudimentary capabilities regarding biological weapons, the likelihood of a successful attack is very low.

Given that the laboratory version of H5N1 -- or any influenza virus, for that matter -- is a contagious pathogen, there would be two possible modes that a non-state actor would have to instigate an attack. The virus could be refined and then aerosolized and released into a populated area, or an individual could be infected with the virus and sent to freely circulate within a population.

There are severe constraints that make success using either of these methods unlikely. The technology needed to refine and aerosolize a pathogen for a biological attack is beyond the capability of most non-state actors. Even if they were able to develop a weapon, other factors such as wind patterns and humidity can render an attack ineffective. Using a human carrier is a less expensive method, but it requires that the biological agent be a contagion. Additionally, in order to infect the large number of people necessary to start an outbreak, the infected carrier must be mobile while contagious, something that is doubtful with a serious disease like small pox. The carrier also cannot be visibly ill because that would limit the necessary human contact.

As far as continued research is concerned, there is a risk-reward equation to consider. The threat of a terrorist attack using biological weapons is very low. And while it is impossible to predict viral outbreaks, it is important to be able to recognize a new strain of virus that could result in an epidemic or even a pandemic, enabling countries to respond more effectively. All of this hinges on the level of preparedness of developed nations and their ability to rapidly exchange information, conduct research and promote individual awareness of the threat.

Bioterrorism and the Pandemic Potential is republished with permission of Stratfor.

To all the Obamaites out there, thanks!

Remember when B Hussein Obama said Obamacare would lower the cost of health insurance for all and if you wanted to keep your policy you could. Well there's a few "bumps in the road" now

Health Insurance Brokers Prepare Clients For Obamacare Sticker Shock

By Dr. Scott Gottlieb, M.D.

A California insurance broker, who sells health plans to individuals and small businesses, told me that she’s prepping her clients for a sticker shock. Her local carriers are hinting to her that premiums may triple this fall, when the plans unveil how they’ll billet the full brunt of Obamacare’s new regulations and mandates.

California is hardly alone. Around the country, insurers are fixing to raise rates by double digits. They’re privately briefing politicians in Washington on what’s in store. Those briefings are leaving a lot of folks up and down Pennsylvania Avenue jumpy.

What’s gives? President Obama, after all, said he’d prevent these sorts of prices. His new health law gave state regulators the power to block premium increases. It even created a federal agency to oversee insurance rates. But these bureaucrats are spectators to the price hikes. They’re mere wallflowers. Even in the bluest of states.

Their silence is the best evidence of who is culpable for the increases. It’s the policymakers. It’s Obamacare. The President is accepting the premium hikes as an allowable consequence of his healthcare policies.

There’s buzz in Washington that to ease the price hikes, the Obama team may slow down some of the most expensive regulations. This might include the law’s mandatory community rating. One approach they’re said to be considering is allowing some of the historically based underwriting to stay in place for a time.

But premiums will still rise because, in the end, everything has a price. The law’s prohibition against traditional insurance underwriting is just one of its costly provisions. Washington can try to force health plans to price insurance below the cost of these mandates. But then the health plans will simply lose money and move out of markets. To keep the insurers whole, and accommodate new rules, the cost of insurance must get re-priced higher. That re-pricing is what’s coming this fall.

This lesson was learned by Massachusetts, after it adopted its own skinny version of Obamacare. To meet the law’s costs, insurers hiked premiums. Massachusetts’s regulators blocked the increases. All the plans reported losses the very next quarter.

This simple economic axiom doesn’t mean the higher premiums were tolerated in Massachusetts, or will be embraced by Washington. What Massachusetts did afterwards is a lesson for where the entire nation is heading under Obamacare.

Massachusetts regulators went after the underlying source of spending – peoples’ use of medical services. First and foremost, that meant taking on the providers. Massachusetts moved to regulate the prices that doctors and hospitals could charge and the kind of services that they could offer. Rates are rising nationally because, like Massachusetts, Obamacare guarantees more free medical services while doing nothing to make the market for these things more efficient, or competitive. Like Massachusetts, some form of price controls is the next political chapter.

The Obama team can’t merely squeeze the insurers. That’s why our political elite will tolerate many of the looming premium hikes. In the end, health plans are mostly just passing along the costs of the underlying services. That’s even truer today now that Washington is directly regulating insurance company profit margins.

To try and get a handle on rising costs, the Obama Administration will start to go after the healthcare providers. The President seemed to hint about all this when he referenced the need to “lower the cost” of healthcare in his inaugural address.

Simply cutting payment rates has consequences, or course. It reduces reimbursement without regard to value or need. But indiscriminate cuts to fixed rate schedules for everything from doctor visits to hospital stays are Washington’s standard approach for sanding down Medicare costs. The Affordable Care Act will institutionalize these same political tactics across the rest of the healthcare market.

This is the next iteration of healthcare reform. Call it Obamacare 2.0. Doctors will become the next bogyman in Washington. The target is already being fixed to their hide. As for the rest of us, our health insurance will become increasingly illusory.

The prices Washington pays for medical services will gradually fall below the rates where things will be readily supplied. That’s the legacy of Medicaid, and increasingly Medicare as well. Don’t worry, though. The medical services that you’ll have a hard time accessing are mostly the stuff you’ll only need if you get really sick.

Dr. Gottlieb is a physician and Resident Fellow at the American Enterprise Institute.

Anyone with their head out of their ass knows what the purpose of Obamacare is. It's the bridge to single payer health care. The cost of insurance will continue to rise until people cannot afford it, the fines or taxes or whatever the hell else it's called this week will incentivize businesses to drop insurance. Without clients, insurance companies go broke. And before you know it, people have only one choice, Mericare.

To the Obamaites out there don't breed please. We can't take anymore.

I thought this wasn't supposed to happen with socialized medicine

Europe stared transitioning to public funded health care after WWII because, in the thinking of a leftist, health care is a right. So just turn over health care to the government and you have no problems. Right?

Germany accused of 'deporting' its elderly: Rising numbers moved to Asia and Eastern Europe because of sky-high care costs

Country's elderly and sick being sent abroad due to rising care costs

Situation described as 'inhumane deportation' and a huge 'alarm signal'

German pensioners are being sent to care homes in Eastern Europe and Asia in what has been described as an ‘inhumane deportation’.

Rising numbers of the elderly and sick are moved overseas for long-term care because of sky-high costs at home.

Some private healthcare providers are even building homes overseas, while state insurers are also investigating whether they can care for their clients abroad.

Experts describe a time bomb’ of increasing numbers unable to afford the growing costs of retirement homes....

Fascinating little article. But I find this really of interest.

...And they say the situation should be a warning to Britain, where rising numbers of pensioners are forced to sell their homes to pay for care...

I thought the NHS was going to guarantee older people financial security in their older age. They would go into their golden years knowing they would have their health expenses paid for. You mean that's the people of Britain were sold a bill of goods by the Labour Party, the ruling class of England and the Best and Brightest out there?

Is it possible the left in the US could be doing the same?????? Naaaaa, you can trust B Hussein Obama et all.

According to leftists, this is impossible

Every time the leftists in Congress and the media say "just raise taxes on the rich" or words to that effect they say it will raise so much money. They say it because no one actually reacts to an increase in taxes. No one shifts their money to less profitable but tax sheltered investments, moves money off shore where it will not produce American jobs, etc. No, that never happens.

Or does it?

Democrats urge delay for ‘job-killing’ Obamacare tax

Sixteen Democratic senators who voted for the Affordable Care Act are asking that one of its fundraising mechanisms, a 2.3 percent tax on medical devices scheduled to take effect January 1, be delayed. Echoing arguments made by Republicans against Obamacare, the Democratic senators say the levy will cost jobs — in a statement Monday, Sen. Al Franken called it a “job-killing tax” — and also impair American competitiveness in the medical device field....

...“The medical technology industry directly employs over 400,000 people in the United States and is responsible for a total of two million skilled manufacturing jobs,” the senators wrote in a December 4 letter to Reid. “We must do all we can to ensure that our country maintains its global leadership position in the medical technology industry and keeps good jobs here at home.”

Beyond that, the senators say, the medical device industry “has received little guidance about how to comply with the tax” — a reference to the apparently confused and halting nature of the Obama administration’s implementation of Obamacare.

Several of the senators, many of whom have medical device manufacturers in their states, have opposed the tax for a long time. During the Obamacare debate, for example, Franken and Klobuchar were among a group of senators who successfully pushed to reduce the tax. (The device giant Medtronic is headquartered in Minnesota.)

On Monday, Franken again expressed his opposition to the tax he voted for. “I want to repeal the medical device tax altogether,” the senator and former comedian said in a statement. “But I am concerned that we are running out of time before this job-killing tax goes into effect. So, for now, the best thing to do to ensure that this important industry continues to create jobs and producing life-saving devices is to delay this unwise tax.” Franken and other want Reid to include a provision to delay the tax in the ongoing fiscal cliff negotiations...

So Al, a cluster f$%^ you proudly voted for (but will not be subject to, conveniently) will hinder American productivity and hurt people other than "the rich". And now you want it cut out of Obamacare. Why did you vote for it? Well, before that, maybe you should have read it.

I hope this crap is ripped out. Beth called for eye exams for her and the kids and the clerk at the eye doctor said everyone is trying to get an exam before the end of the month. Why? Because glasses and contacts are now "medical devices".

To all the Obamaites out there who voted for this, thanks!

Interesting looks at health care

As the nationalization of the finest health care system in history goes merrily on it's way I found these two articles interesting.

Dealing With Doctors Who Take Only Cash

A few weeks ago, my wife and I were at our wits' end: our 4-month-old daughter wouldn't sleep for more than an hour at a time at night. We had consulted books and seen our pediatrician, but nothing was working. So my wife called a pediatrician who specializes in babies who struggle with sleep problems.

The next day, he drove an hour from Brooklyn to our house. He then spent an hour and a half talking to us and examining our daughter in her nursery. He prescribed some medicine for her and suggested some changes to my wife's diet. Within two days, our baby was sleeping through the night and we were all feeling better.

The only catch was this pediatrician did not accept insurance. He had taken our credit card information before his visit and given us a form to submit to our insurance company as he left, saying insurance usually paid a portion of his fee, which was $650.

A couple of weeks later, our insurance company said it wouldn't pay anything. Here's how the company figured it: First, it said a fair price for our doctor's fee was $285, about 60 percent less, because that was the going rate for our town. Then, it said the lower fee was not enough to meet our out-of-network deductible.

While we were none too happy with the insurance company, we remained impressed by the doctor: he had made our baby better and was compensated for it, all the while avoiding the hassle of dealing with insurance.

Last year, I wrote about doctors who catered only to the richest of the rich and charged accordingly. But after my experience, I became interested in doctors for the average person who take only cash. What pushes a doctor to go this route, often called concierge medicine? And how hard is it to make a living?

As to why doctors decide to switch to a concierge practice, the answer is almost always frustration.

"About four years ago, one insurance company was driving me crazy saying I had to fax documents to show I had done a visit," said Stanford Owen, an internal medical doctor in Gulfport, Miss. "At 2 a.m., I woke up and said, 'This is it.' "

Dr. Owen stopped accepting all insurance and now charges his 1,000 patients $38 a month.

"When I decided to abandon insurance, I didn't want to lose my patient base and make it unaffordable," he said. "I have everything from waitresses and shrimpers to international businessmen. It's a concierge model, but it's also the personal doctor model."

Dr. Owen, who once had three nurses and 10 examining rooms, said it was now just him and a receptionist. He has become obsessed with keeping overhead low, but he said that, for the first time since the 1990s, his income was going up.

Interesting read all in all. When I was in my second misguided college youth during the 90s I went to a doctor from time to time and paid him directly. Once I paid for a fifty dollar fee with three twenty dollar bills. The clerk had a bit of a problem. She had no cash to make change. Fortunately one of the other clerks has change and the crisis was averted.

However I find the term "concierge model" strange. Why is it a doctor must take insurance? For most of man's history doctor's were paid like this. You come in for something, you pay for the service at the time of the service or soon afterwards. Seems to work with mechanics, groceries, etc. Why is medicine different? I know many wil scream "You have a right to health care regardless of ability to pay!" or some such dribble as that. But do you? Can you take the fruits of my labor (college, medical school, etc) at a much lower rate than I am willing to pay for it.

One of the predictable side effects of Obamacare/Single Payer System (assuming they are not killed off) is the increased shortage of doctors. If you want proof, look at England and Canada. One thing these libtards don't get is Medicine is a Science and an Art. But it is also a business. Now you take a sharp kid in high school who says "I wanna be a doctor..." we know one of the reasons is the money. Then tell him if he wants to to be a MD he can look forward to four years of college in an actual major where you spend your time in the library studying. Then four years of medical school all the while building up hundreds of thousands of dollars of debt. Then residency of four to seven years. Then after all that the government will tell you how much you can make, where you can work, how many patients you will see, etc.

Or the kid can major in business and make a fortune in the market.

Now remember when B Hussein Obama said "If you like your doctor you can keep him. If you like your insurance plan, you can keep it." Well, that looks like it's "nonoperative':

Small Employers Weigh Impact of Providing Health Insurance

Like many franchisees, Robert U. Mayfield, who owns five Dairy Queens in and around Austin, Tex., is always eager to expand and — no surprise — has had his eyes on opening a sixth DQ. But he said concerns about the new federal health care law had persuaded him to hold off.

"I'm scared to death of it," he said. "I'm one of the ones sitting on the sidelines to see what's really going to happen."

Mr. Mayfield, who has 99 employees, said he was worried he would face penalties of $40,000 or more because he did not offer health insurance to many of his full-time workers — generally defined as those working an average of 30 hours a week or more. Ever since the law was enacted in 2010, opponents have argued that employers who were forced to offer health insurance would lay off workers or shift more people to part-time status to compensate for the additional cost. Those claims have drawn considerable attention — and considerable anger in response — in recent weeks.

John H. Schnatter, the chief executive of Papa John's, the pizza chain, said some franchisees were likely to reduce their employees' hours to avoid having to provide coverage. And an unhappy Denny's franchise owner in Florida warned that he would raise prices 5 percent as a "surcharge," adding that disgruntled customers could offset that by reducing their tips.

Some health care experts said comments like those came from outliers and sometimes resulted from confusion about a highly complicated new law, the Patient Protection and Affordable Care Act. Many of the provisions do not go into effect until 2014. Federal officials are still tweaking the fine print, like defining exactly what constitutes a 30-hour workweek. Even so, restaurants and hotels are among the industries likely to be squeezed the hardest by the law because they are low-wage industries that do not offer coverage to most of their workers.

Most employers, even small businesses, already offer health insurance, and the federal law is not expected to have a significant impact on what they do over the next year or so. But businesses that rely heavily on low-income workers, many of whom do not make enough to afford their share of the cost of the insurance premiums, are being forced to rethink their business models...

Anyone who looked at this clusf%^& of legislation saw all this coming. Everything that could have been done to lower cost (law suit reform, letting insurance companies sell across state lines) was kept of out of it. Mandating things often times not needed (like pap smears for men), stopping the construction of more hospitals, etc will do nothing but limit the supply of medical services and raise cost. And the government will be there to ration care.

Again, to all the Obamaites out there, thanks!

What is Obamacare all about

I've often said the purpose of Obamacare has nothing to do with providing health care, lowering care cost, etc. It's a bridge to single payer health care. An interesting article on this issue. Worth the few minutes it take to read but here are the highlights:

The Democrats' Fallback Plan For When Obamacare Inevitably Fails

Will Single Payer Healthcare Emerge as the Next Battleground?

With the reelection of President Obama, the Affordability Care Act known as ObamaCare will begin its implementation. The voters have ensured that ObamaCare will now move forward, even though this election was really not a referendum on the unpopular law; only five percent of voters ultimately said the ACA was the biggest factor in determining their vote for president, and the electorate, although divided, still generally opposes the law. Predictably, since the election, the president’s favorability ratings have improved, and along with that, the unpopularity of ObamaCare among Americans has diminished, with the margin of “for repeal” over “against repeal” narrowing down to single digits. Perhaps Americans are beginning to accept what seems inevitable, or maybe they are experiencing some fatigue about the political battles on this issue. Time will tell, and sooner than most voters realize, the next congressional elections and the chance to express an opinion where it counts will be upon us...

...But there also seems to be a naïve misunderstanding by many about the consequences of the state-by-state resistance. Regardless of who sets up the health insurance exchanges, the federal government will now define the details of coverage for the majority of health insurance policies. Massive taxpayer money will now be funneled into subsidizing health insurance, while medical care access will diminish with the reductions in payments to doctors and hospitals. More Americans will be shifted to Medicaid, even though some states will reject its expansion. More employers will reduce their health benefits or shift away from scenarios where they are required to offer the coverage. More employees will be forced to change their coverage and, necessarily, their doctors too. Many private health insurance options, including some of the most popular lower cost plans, will be eliminated by the actuarial and benefits-design dictates of the law. Most policy experts on both sides of the aisle understand these realities.

Even if the actions by the states weaken ObamaCare and hasten its failure, the truth is that its failure will not open the door for reconsideration of alternative reforms advocated by the Republican opposition. The notion that refusal to advance the ObamaCare implementation at the state level will generate a sincere discussion of meaningful compromises by this Administration is naïve, given this president’s method of passing the bill in the first place, let alone his now characteristic pretense of repeating the hollow promise of “compromise” to a sycophantic press corps while failing to offer even a single concession. No, none of the predictable failures of ObamaCare in reducing health care expenditures, in providing meaningful access to quality health care beyond simply labeling someone as insured, in improving the economic prospects of individual Americans and their families, and eventually in maintaining the excellence of U.S. health care will provide major leverage for compromise.

Even focusing on the possibility that compromise is forthcoming misses the bigger, more important point. To the contrary, looming over health care but ignored by those whose arguments focus only on ObamaCare is the next step in President Obama’s plan for transforming America. The unspoken reality is that President Obama and the Democrats’ fallback plan for ObamaCare’s failure is fully nationalized, single payer health care.

As the evidence rolls in after ObamaCare takes hold, proving its failure to reduce health care expenditures, combined with the predictable decrease in access to care for those with government insurance and the non-viability of private insurance, Americans will understandably voice an increasing dislike of the reformed system. So, specifically, what might we expect during the next phase of this transformative presidency, either from this administration or more likely the next Democrat to profess expertise about health care reform?

First and foremost, watch out for the reemergence of a “public option” likely marketed by Democrats as “Medicare for all”, as Democrats revive their already stated original goal of forging a single payer, wholly government-controlled system. We know that President Obama wants it. In June 2003, Obama said “I happen to be a proponent of a single-payer health care program … a single-payer health care plan, a universal health care plan. And that’s what I’d like to see.” And we know that Senator Max Baucus, the chair of the Senate Finance Committee during crafting of the ACA and its ramming through Congress by Democrats, admitted in February 2009 that “There may come a time when we can push for single-payer. At this time, it’s not going to get to first base in Congress,” a sentiment echoed by then House Speaker Nancy Pelosi who said “For 30 years I have supported a single payer plan, but our next best choice is to support an exchange and a public option.” There is no secret about the ultimate goal of the president and leading Democrats.

Congressional Democrats unmistakably anticipate the failure of ObamaCare, given they had already asked the CBO to price a formal public option for 2014. The proposal’s co-sponsor Rep. Raul Grijalva (D-Ariz.), now reelected to a sixth term, said “By reintroducing it, we make sure that people don’t forget this is a viable option…. as the health bill is implemented, more and more people are going to come to the realization that cost containment and competition aren’t as robust as they should be, because of the absence of the public option”. Later, John Conyers (D-Mich.) in 2011 re-introduced his nationalized single payer system called “Expanded and Improved Medicare for All Act” in his H.R. 676 bill to the House of Representatives, following President Obama’s State of the Union in which the president said that the ACA was open to change “if you have ideas about how to improve this law.” Conyers was quite direct when he unabashedly stated the Democrats’ end-game along with their standard canard: “Improved and Expanded Medicare for All is inevitable in America– it is just a matter of when it will happen. Single-payer health care systems have successfully contained health care costs and provided high quality health care in countries in Europe, Taiwan, Japan, and Canada.” And let’s not overlook proposed legislation aiming for total take-over of health care by Democrat-dominated state governments, such as in Vermont and Delaware.

Second, or perhaps in advance of single payer legislation, watch for the federal government to restrict doctors from practicing, or possibly even criminalize them, unless they accept all patients with insurance paying government-defined rates for medical tests and treatments. We know that ObamaCare and its Independent Payment Advisory Board, IPAB, will force prices for medical services lower and lower by direct design, so that by 2019, payments for Medicare will be even lower than Medicaid. While some doctors will swallow government-dictated low reimbursements, undoubtedly more and more physicians will refuse to see patients under such health plans – easy to foresee, since this has already happened to Medicaid and Medicare patients across the country. But this presumably will not be tolerated by HHS Secretary Sebelius and our President. It is not at all unimaginable that the federal government will soon tie all medical licensure to accepting the new edicts, as has already been contemplated in Massachusetts by state legislators...

The gutless wonder Speaker of the House John Boehner has said Obamacare will be part of any negotiations on the "fiscal cliff". If you believe that I have a bridge to sell you. There is a case coming up from the 4th District Court on the Individual and Employee mandates. That is a prayer that a man who made a massive mistake (saying something that is clearly unconstitutional constitutional) will get his head out of his ass. I am not hopeful.

Having to endure socialized medicine I am not hopeful for the country if this continues.

The broken clock stuck the right time

I grew up in a family of cigarette smokers and I was the only member repulsed by it. I tried a cigarette once when I was 10 or so and that probably keep me from trying them again. That being said I love a good cigar and I've recently tried a pipe. No I don't ever see trying a cigarette again. Pipes and cigars don't go into your lungs like the cigs do.

That being said I'm shocked I'm somewhat agreeing with the ACLU of Texas in this matter. From this morning's Houston Chronicle.

Searching for a job? Tobacco users need not apply

Smokers beware: Puffing away could reduce chances of landing a job, particularly at a hospital or a health care facility.

Methodist Hospital System in Houston this month announced it will implement a tobacco-free hiring policy on Jan. 1, joining the Texas Medical Center and Memorial Hermann Healthcare System, which have had similar policies since last year and 2010, respectively.

The policies are straightforward. Applicants who smoke or chew tobacco will not be hired. Existing employees are exempt.

A growing number of hospitals and health care institutions have adopted the policies to promote wellness, improve productivity and rein in rising health care costs, but critics say they discriminate and could lead to punitive actions against other personal habits and vices...

Kinda funny when I read this and when my patrol duties take me to Ben Taub or Herman hospital, cops generally park next to the smoking area. Seeings the doctors and nurses smoke does bring a bit of a smile to me. Hey, we're all human.

“We think this is an invasion of privacy and really overreaching,” said Dotty Griffith, public education director for the American Civil Liberties Union in Texas. “At what point do you give up your rights and autonomy? Will they not employ those who ride motorcycles and drink alcohol?”

I somewhat agree with her. Somewhat. This is not an invasion of rights per say because it's a simple contract between two parties. If you don't agree with the policy of Methodist Hospital, don't apply for a job there. Now Methodist, I personally think you are putting a lot of well qualified people off your applicant pool. Not too bright on your side.

Somewhat similar to the point I made when the Houston City Council banned smoking in bars (the smokers go outside now). I am a bit libertarian on this. If a bar owner wants to allow or not allow smoking (or have separate areas) in his business, that is his business. If I as a consumer do not want to go into a bar that allows smoking, I can go elsewhere. I think it's called liberty and freedom of choice.

However, the point from the ACLU rep is well made. At what point does this stop? I drink and I love my Harley. I also drive a F-150, I have flown a private plane and two of the things on my bucket list I haven't done yet are skydiving and scuba divings. Will those be the next to be on the banned list?

By the way ACLU, you would have more credibility in this issue if you have raised it when the Obamacare bill was up. Just saying. Then again intellectual consistency is not a hallmark of the left.

Now there is some hope out there:

Twenty-nine states and the District of Columbia have statutes that ban employment discrimination against smokers, but 21 states, including Texas, do not.

Another piece of liberty gone. Problem is getting it back.

I for one am shocked, shocked....

One of the many points I make in debates with supporters of Obamacare, or the ACA, aka socialized medicine is a simple question. Where are you going to get the doctors?

Well the paper of records, the New York Times is actually asking that. It would have been nice of them to ask that three years ago when this monstrosity was being rammed through the Congress by using our tax dollars to bribe senators (Hey Many Landrieu, yes you, the biggest whore in the history of Louisiana). Better late than never but I think it will be used for showcasing "objectivity" or some crap like that.

Doctor Shortage Likely to Worsen With Health Law

RIVERSIDE, Calif. — In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014. But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now.

Other places around the country, including the Mississippi Delta, Detroit and suburban Phoenix, face similar problems. The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care. Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.

Health experts, including many who support the law, say there is little that the government or the medical profession will be able to do to close the gap by 2014, when the law begins extending coverage to about 30 million Americans. It typically takes a decade to train a doctor...

...Experts describe a doctor shortage as an “invisible problem.” Patients still get care, but the process is often slow and difficult. In Riverside, it has left residents driving long distances to doctors, languishing on waiting lists, overusing emergency rooms and even forgoing care.

“It results in delayed care and higher levels of acuity,” said Dustin Corcoran, the chief executive of the California Medical Association, which represents 35,000 physicians. People “access the health care system through the emergency department, rather than establishing a relationship with a primary care physician who might keep them from getting sicker.”...

...Moreover, across the country, fewer than half of primary care clinicians were accepting new Medicaid patients as of 2008, making it hard for the poor to find care even when they are eligible for Medicaid. The expansion of Medicaid accounts for more than one-third of the overall growth in coverage in President Obama’s health care law.

Providers say they are bracing for the surge of the newly insured into an already strained system.

Temetry Lindsey, the chief executive of Inland Behavioral & Health Services, which provides medical care to about 12,000 area residents, many of them low income, said she was speeding patient-processing systems, packing doctors’ schedules tighter and seeking to hire more physicians....

...But the provisions within the law are expected to increase the number of primary care doctors by perhaps 3,000 in the coming decade. Communities around the country need about 45,000.

Many health experts in California said that while they welcomed the expansion of coverage, they expected that the state simply would not be ready for the new demand. “It’s going to be necessary to use the resources that we have smarter” in light of the doctor shortages, said Dr. Mark D. Smith, who heads the California HealthCare Foundation, a nonprofit group....

Now you can read the full article and it has some interesting points but I saw this one most interesting. Take a look at this chart.

Notice the shortage of doctors is worse with Obamacare. And an interesting point throughout the article and from the lips of the propagandists who push this crap. The constant use of the term "expansion of coverage" or words to that effect. Funny, there is no expansion of healthcare or medicine but of "coverage" So I'm sick, I've got cancer or diabetes or asthma and now I have coverage. Do I have care is the question. The answer is not as much as before. And you will pay more for less.

On that subject the point not mentioned is the lack of legal reform in Obamacare. Lawsuits are a major cause of medical inflation and until that is controlled by limiting punitive damages (not actual damages) it's a moot point.

Dr Thomas Sowell put it best after the Supreme Court ruled last month, "You said you could not afford to pay for doctors, medicines and hospitals, but you can afford to pay for the doctors, medicines and hospitals and bureaucrats that are coming?"

There are a few good poihts raised in this article such as allowing nurses to do more than they do now. I will add allowing a PA to do a lot more will help with minor case (e.g. flu, sprains, etc) and allow MDs to concentrate on more critical issues. But Obamacare will not increase the number of medial providers. If anything it will make medicine a less attractive career field for smart students.

But remember, you will have coverage.