Saturday, May 30, 2009

A Liberty-Loving American MUST READ

At last. Someone has been able to answer some of my most haunting questions about this administration. Remember the now-infamous statement about never letting a crisis "go to waste"?

Read this.

It now becomes apparent that all their apparent idiocy and impotence is intentional.

We must commit this to memory, in the interests of knowing our enemy. Our enemy has a name: the ghost of Saul Alinsky. All that has been fought for is at stake.

Friday, May 29, 2009

No Interlopers Welcome

I've had a very interesting and stimulating bunch of comments on my "The Market Is A Failure...Oh Really?" post from a couple of days ago. One commenter, MaineBob, had a great question, and I thought my response, which goes to the very heart of my whole reason for existence, should be a post in its own right...
MockBadOC you said at the end of your last post..."There are 2 ways to fix this, in my opinion:1. Socialize medicine...[OR]2. Make medicine free of interference, resulting in a price free-fall and a return of power to the patients."I don't understand #2... How would that work? I have been self employed since the late '80s and am "underinsured" with a $15K deductable because this catastrophic "health" insuranceeach year takes more of my financial pie. The US system with health Insurance is broken...and the grass certainly seems greener in other industrial countries. I look forward to your positive solutions for the USA. How would your proposal work if I got a bad "expensive" disease?In the mean time, I am incentivized to avoid the medical care system... I remain healthy, eat right and exercise...Thanks!MaineBob
May 29, 2009 9:08 AM
This question followed my statement that we had two ways to remove the destructive influence of private insurance companies from American Medicine. I had said that we could (1) trade one devil for another by trading the unresponsiveness, insensitivity, and inefficiency of the insurance industry for that of the notoriously unresponsive, insensitive, inefficient federal government, or (2) we could get rid of interference from both of them, allowing the market to work.
I'm going to take this from sort of a reverse direction. Instead of telling you the rare horror stories that can result from our current health care system, I'm going to tell you about the everyday, mundane horror stories.
As you know, I am a family doctor at a local urgent care clinic. This means that we see between 50 and 100 patients each day, on average, divided between 2 to 3 providers.
When we see a patient, he or she has already signed in, payed a copay, had their insurance information verified, updated their records, had their vital signs measured, and had their primary and secondary complaints discussed and recorded by the nurse.
When I see the patient, I discuss the chief complaint, take a more lengthy past medical and surgical history, review systems for any clues to other problems or hints about what might be causing the primary complaint, perform a physical examination, document all of the above, answer the patient's questions, answer the patient's family members' questions, write prescriptions, write work and school excuses, and then discharge the patient. I also routinely will call the patient after a couple of days to check on their progress.
Now for all this work, I genuinely believe that my patients believe that their $25 co-pay is simply the tip of the iceberg with regard to my reimbursement for all the work I've described above. They sincerely believe that once I submit the appropriate paperwork to the insurance company, I am payed some phenomenal sum of money for a job well-done. I am told by my patients that they like and appreciate me very much. I believe them. I think that they believe I am worth the $75 to $100 I charge their insurance company for taking care of them and their families.
I think they would be genuinely shocked to learn the truth. The truth is that once they pay their $25 co-pay, that's it. I can submit whatever I want to Blue Cross or to Aetna or to whomever. The answer is always the same. "No". You heard me right. The co-pay is all I get paid. This is frustrating to me, of course. The people that really should be frustrated, if not downright outraged, are the people paying money for insurance.
How much do you pay each month for health coverage? And what are you expecting to get for that money? I would assume that you, like me, assume that if you get sick, the insurance will help to cover the costs of visits to the doctor, medicines, etc. Sadly, this is not the case. You are picking up the whole tab. You are paying several hundred dollars to the insurance company, who then gives you nothing back for the money. If you want a non-generic medicine? No. If you need an MRI? Too damn bad.
You are being robbed. In the end, what you're paying for is insurance against the unthinkable - the horrifying - the prospect that you or a loved one might end up in the hospital.
The thing is, there is already insurance like this - insurance that covers the "worst-case scenario". It has a high deductible and correspondingly, a low monthly premium. In my utopia, a world without insurance interference, this kind of insurance would be sufficient for most people's needs.
Now in MaineBob's situation, he has this type of insurance, but finds that the cost of paying for routine care out-of-pocket is untenable. There is a reason for this, and once again, I go back to the routine every-day experience at my clinic.
Let's say I see a patient for something easy - a case of hay fever, for instance. We still have to go through all the steps outlined above, or insurance will give us a slap on the wrist. I have to document that I've asked certain questions, looked at certain things, considered certain possibilities, or I'll get a slap on the wrist from the insurance people. Then, in an act that I find disgusting and demented, I have to charge $75 for a 99213 (a routine, medium-complexity visit).
Why do I have to charge $75? Is there something intrinsic about a visit for hay fever that makes it worth $75? Of course not. And I'd better hope not. I only make $25 for it. No, the reason I charge $75 is that this is the way to get insurance to approve a fee of $25. Makes perfect sense, right? No, I don't think so either.
So what if insurance disappeared altogether? Wait just a minute while I relish this sweet thought....
Okay. I feel better now. If insurance disappeared, then I could charge what it really is worth to me (and what I think I'm worth to my patients) for a routine visit. I personally think that $50 is reasonable for a routine office visit. Shots and x-rays cost a bit more, of course. And I think that most people would find $50 to be a very doable amount of money for an occasional doctor visit. But wait! It gets better!
What is the most expensive part about a trip to the doctor's office, usually? The medicines. It's the meds that cause the most consternation on the part of patients. What they don't realize is that medications are subject to the same market forces as doctor visits - at least when they're left the hell alone.
Some of the more complicated, "inside-baseball" reasons for the high prices of prescriptions will be addressed in a future blog, but for now, let's just look at the big picture. Why does it cost $125 for a month's worth of Drug X? Because that's what insurance has agreed to pay for it. It has little or nothing to do with the cost of manufacture of the drug or anything else.
So if insurance was out of it, drugs would have to compete with each other on the open market for shares. Augmentin and Avelox would duke it out mano a mano. If people found the increased cost of Avelox to be worth it because of the decreased number of stomach upset cases, for example, then Avelox might win. Or maybe Augmentin would. Regardless, the doctors and patients would have the final say on what drugs were best - this just makes sense. Are doctors perfect? Of course not. But I dare say we have more experience choosing drugs that work for people than $8/hr employees at Blue Cross, or professional politicians in Washington.
This is simply the beginning of how a reduction in interference, rather than an increase in it, could result in the very best outcomes for patients, doctors, etc. You'd still have your insurance safety net, but for the vast majority of us, it'd be like our car insurance - we'd rarely if ever use it. This is how insurance ought to be, right?
Finally, you should know that the "greener grass" in the "other industrialized countries" has been greatly exaggerated, MaineBob.
  • In France, for instance, over 90% of their citizens have to have supplemental insurance, purchased at their own expense, over and above their massive taxation for a health scheme that's supposed to pay for everything.
  • In the U.K., the socialized health service has such long waiting lists for routine necessary procedures and appointments that the government has had to stoop to enlisting the help of the very private health industry they demonized in order to get the NHS going in the first place. They've discovered the awful truth that the government can never come up with enough money to take care of all the people all the time.
  • Canada has long been a favorite of health care Utopians like Michael Moore. What they don't tell you is that people have been extremely unsatisfied with waiting lists and poor care. The government, having originally outlawed the use of private, cash-only clinics, has had to look the other way now, allowing their use to clean out the back log of patients they have neither the money nor the facilities to see.
  • Another interesting fact about our frozen northern friends. Two of their loudest and most vitreolic opponents of the so-called "two-tier" system described immediately above (because, they said, it was unfair to the poor and everybody should float or drown together in the same boat) were members of the Canadian parliament. When they each got cancer, they left Canada to seek treatment in the U.S.
  • Canadian women routinely cross the border into the U.S. to have babies because of the critical shortage of facilities in Canada. You see, when the government runs health care, there are only two ways to cut costs: Cut services or cut the numbers of people you cover. Canada has chosen the former, of course. It'd be inhumane to leave anybody out of their superb health scheme.
  • Germany can't hold on to doctors because of the crappy pay and lousy working conditions. There is such a "brain drain" that patients have to wait weeks, months, even years to see a doctor.

These are just a few examples of how socialized health care fails to solve the problem - it just (a) compounds it or (b) trades one set of unacceptables for another set.

I hope this has been helpful. It has certainly helped my feelings to write it. Best wishes to you and your family, MaineBob. I hope and pray that we will someday live in a country where I am free to provide health care to people like you without interference - even giving it away to needy people when necessary. That's why I became a doctor in the first place.

Your pal,


Wednesday, May 27, 2009


Okay. This Sotomayor deal is all abuzz right now, so I guess I'll weigh in.

She's a woman. Big deal. I think anybody born since about 1900 probably feels like a woman in the Supreme Court isn't going to stop Earth's rotation.

She's Latina. Yawn. Shameless political pandering, and altogether typical.

I will simply say this: there were probably hundreds, if not thousands, of white judges and male judges and even white male judges who were at least as qualified as she. If this were not so, I feel certain that she could simply stand on her own merits. The panderers wouldn't have to be reminding us 24 hours each day that she "has had a rough time" and "was raised in a Bronx housing project" and "knows about the typical American struggle". We aren't picking the most interesting people here. We are picking a person who should be the most qualified to be a Justice of the SCOTUS. Give the sob stories a rest, already. Maybe it made her a strong person. Maybe it made her a really great person. I see strong and great people as patients every day who have overcome obstacles as well. That doesn't qualify them for a position as a Supreme Court Justice.

The only important thing that's been said about Judge Sotomayor is that she tends to lean toward judicial activism. That is simply unacceptable. The SCOTUS is not where laws are made. It is where the only law that matters - the Constitution of the United States - is interpreted to decide matters between parties. It's not a platform from which social engineering is to take place. Activism has no place there. That's why Justice is supposed to be blind. Justice doesn't care if you are gay or straight, male or female, white or black or hispanic. If she plans to use her position as a Justice to make laws, then she is a lousy choice.

As long as your Princeton and Yale education has prepared you to read the words in the Constitution, Judge Sotomayor, and as long as you are prepared to use that document alone - not your vast wealth of personal experiences you speak about ad nauseum - to make your judgments, then you're okay with me.

Somehow I suspect you'll be unable to live up to that simple job description.

Healthcare-NOW: Cowards

I checked the Healthcare-NOW! website to see if anybody had responded to my comments on the unvarnished lies contained in a recent propaganda piece written by Dr. Marcia Angell. Not surprisingly, they had simply deleted my comments.

Apparently, they are terrified to have counterpoints placed on their website. These are the people who have been continuously whining and moaning about having 8 of their members arrested for disrupting a recent Congressional meeting to protest not having a seat at the table to discuss their particular plan for ruining American medicine.

I think it is ironically entertaining that they find it so unfair to have their point of view squelched, but then turn around and do the same to me.

And I find it absolutely delicious that the government they claim will be so responsive to our concerns when they control our life-and-death health care decisions is so unresponsive to them.

You see, this is one of the main problems with government-run health care. If you aren't happy with it, what can you do? The bureaucracy is impenetrable. It's not like you can carry a complaint up the chain. At least now if you hate Blue Cross and think the coverage is lousy, you can choose Aetna or someone else. We won't have the same latitude when the feds are involved. We can't simply fire our government.

You want to see what changing our health care will be like if Healthcare-NOW! gets their way? Look no further than what happened to the self-proclaimed "Baucus Eight".

Well done, liberals. You are like a self-contained humor factory.

Tuesday, May 26, 2009

Healthcare-NOW: Our Counter-Demonstration

The socialist group Healthcare-NOW has planned a nationwide protest on May 30, 2009. You should check with your local sources to see if they are coming to your area to pretend to care about the poor.

These communists, whose only real objective is to place even more power - the power of life and death - in the hands of a government who gives our hard-earned tax revenue to Wall Street, bails out the United Auto Workers but lets the non-union automotive industry employees get bent, habitually and ritualistically rape the Constitution they swore to uphold...shall I go on?

Anyway, they are going to be protesting this week, and I would encourage all the readers of my blog to activate and counter-protest. DON'T SAY ANYTHING. This is not about giving the communist media another opportunity to take you out of context and make you a laughing stock a la teaparties. This is about exercising our God-given right to assemble and peacefully protest this bunch of academic eggheads who want to make us into a larger, dumber France. They are in bed with the unions, so don't be surprised to be confronted by professional layabouts, ne'er-do-wells, and loafing protesters-by-trade.

If you are in health care, wear your uniform (white coat, scrubs, whatever) and a pair of handcuffs. Anything you want to say should be put on a placard. I repeat - DO NOT ENGAGE. Our argument will be made even more powerful when these loudmouthed hatred-mongers try and attack you for doing exactly what they are doing. It makes their hypocrisy even more palpable.

A little info on the idiots...they are largely made up of academics and government insiders most of whom (surprise) never had a real job. Check out their website (, and that of their brothers and sisters in arms, the thoroughly communist-infiltrated Physicians for a National Healthcare Program (

Hopefully, we can make at least a little impact and let people out there know that there are still a few of us who believe in personal Liberty and responsibility.

They are all counting on us, whether they know it or not.

The Market is a Failure? Oh, really?

One of the most consistent Leftist complaints about the current U.S. health care system is that the "free market" has failed to produce acceptable results.

I have two responses to this argument:

1. When, in recent memory, has the market actually been allowed to work? At least since the beginning of President Johnson's Medicare program in the mid 1960s, the government has been interfering in the market. Nowadays, the only Medicare I know as a physician is the Medicare that consistently says "no" to paying for routine and necessary tests like EKGs, and continually threatens to lower its reimbursements to physicians to a level that makes it impossible for us to see their patients. Additionally, their entry into the so-called "free market" served to set the tone for the private insurers to lower their reimbursements as well. The government has created a scenario in which they have their cake and eat it too - they compete unfairly in a "market" by changing the rules to suit themselves, then blaming the industry they are destroying for the lousy coverage the rest of us get. I might point out that they are only able to compete at all by draining the productive members of society of their income to support an ever-increasing number of unproductive ones.

2. I would also point out that "all the other industrialized countries" (you know...the ones the Left incessantly talks about having socialized health care in order to shame us for not being openly and unapologetically socialist) have ALL had to begin to allow filthy, stinking capitalism and "the market" to help them out of their mess.

The U.K., the grandfather of all Western socialist health care programs, in response to decades of criticism about year-long waiting lists for necessary procedures, unfairness in the delivery of care, and a tax burden that seems never to be enough to do what the socialists promised, has recently had to start subcontracting health care delivery to private (FOR PROFIT) entities.

Canada, the supposed health care paradise immortalized by Michael Moore, has had to rescind its long-standing policy of criminalizing doctors who provide alternatives to the long waiting lists and poor care by taking cash for services rendered. Where is the great alternative provided by socialism here?

France has also had to begin allowing the private sector to begin supplementing the effort to provide health care. Why? Because their socialized program is failing to provide what it promised.

Sweden, the country with the highest taxation for health care, has also struggled continuously with long waiting lists and patients who have begged for a free market alternative, has also begun to admit defeat and let the dirty capitalist pigs take over. Again.

The list goes on and on. Socialism is a failure. It has always been a failure. It fails because you can't shackle the productive to buy the votes of the unproductive forever, expecting the productive to remain productive despite your best efforts to destroy them. Eventually, they get the idea. Why work for nothing? Slavery doesn't pay.

Friday, May 22, 2009

"Sure 'nuff I got props from the kids on the Hill,
Plus my mom and my pops.
I came to get down.
I came to get down.
So get out your seats and jump around.
Jump around.
Jump up, jump up and get down."

Super Duper

(Please note the symbol chosen by - I find it humorous that of all the symbols available in the whole wide world, they chose the most communist one ever on their very just can't make this stuff up...)

Note that his decision to leave his office after falling for a homosexual illegal alien makes this mayor "honest", and could only be wrong in the eyes of the narrow-minded bigots out there (nice straw man, Rick).
Note also that it is the horrible and totally unfabulous draconian marriage laws that are keeping these love-birds apart. Imagine all those horrible religious fanatics wanting to keep something as beautiful as marriage all to themselves. Next thing you know, they'll be wanting to corner the market on baptism, communion, and the other holy sacraments, too. Selfish jerks. Acting like marriage is some sort of religious invention or something.

Way to go, San Angelo. You must be so proud. You've apparently been awarded the Open-Mindedness Award by the American Socialists. Congrats.

Kalifornia, Dreaming.

The test tube of American Socialism is broke. The state with the highest taxes, largest welfare state, most highly-paid teachers, cops, and firemen...

They are now having to confront the painfully obvious failure of their ideology. The hard fact is that somebody eventually has to pay for all that spending. And when you punish the people who provide the jobs, tax revenue, and industriousness, you get...well...California. When there are no more rich people, there is no more money for social programs, etc. The people who are left now are all needy - there's nobody pulling everybody else's weight.

Grandiose dreamers that they are, they had the "audacity to hope" that we, the other 49 states who have not been quite as irresponsible as they, will just use TARP funds from our paychecks to bail them out. Not so fast. The bail out has been rejected by Californians themselves, and now by Americans at large. I guess "the big one" has finally happened in my lifetime.

I mean, really. Asking the other States to bail out their irresponsibility in the middle of an economic crisis so they can continue to provide the most wide-ranging welfare in the Western world? Gall doesn't even begin to cover it.

There is a valuable lesson in this for all of us. The Libdiots want us to turn our entire nation into one big, happy Kalifornia. One problem: Kalifornia failed. They had more rich people (and therefore a better chance of making it work) than anybody else, and even they couldn't make it happen. Now, why on Earth would we want to be like them???

I say wall the cancer off and let it die a natural death before it infects the rest of us.

Thursday, May 21, 2009

Open Letter to My New Pals at Healthcare-NOW

Dear Socialist Rabble-Rousers:

I am a doctor. I didn't get here by accident. I worked hard. I missed out on all of your marijuana-fueled good times because I was serving in the Marines, then going to college and studying. Why? Because I was trying to better myself, and make a good living. Yes, I said it. Make a living.

Now you have claimed me as a servant to your invented "right" to health care. You believe that the way to lower costs for yourself is to "negotiate" (dictate) what my time is worth by fiat. You deny me the right to ply my trade - a skill I have devoted my life to.

I challenge you to defend this notion of yours about what constitutes a "right". It appears that a "right" is simply something you want and have the numbers to take by force. This makes you no better than an angry, pitchfork-wielding mob of thieves. Want to really make a difference? Want to lower the costs of health care for those who are most affected by its high price? Try educating young women about the poverty that results from teenage pregnancy, instead of encouraging it through funding it with my money. Or how about working to stop expensive smoking habits among many of the very same people who complain that they can't afford their medicines?

You see, if you were truly a friend of the less-fortunate in our society, you would work for a better life for them, instead of simply paying for their irresponsibility with stolen money. You fancy yourselves as modern-day Robin Hoods. You forget that the original Robin Hood returned money to its rightful owners after it had been stolen by a more powerful person. You see, you should be fighting for me and all the other hard-working, self-improving, productive people who stand to (a) lose the good health care we've fought to provide for ourselves and our families, and (b) be taxed into poverty ourselves in order to fund your ever-increasing list of invented "rights".

Finally, I will be interested to see what you say to the hapless victims of your mistake when they all discover that your plan can only be viable for a short time, and that only when drastic cuts are made in services. This has been the case with every single socialized ("single-payer") health care plan in the world. When people are dying at your hands, rather than at the hands of private insurance companies, will you accept the blame you are now so ready to dole out? It'll be interesting to see how you will explain it. Of course, you'll be on to your next mission to save the world with others' money by then. You'll be much too busy to notice, no doubt.

See you on the internet, pals.

Tuesday, May 19, 2009

Still Waiting to be Impressed

I've heard it literally dozens of times, from friends of the President and foes alike:
"What do you think of President Obama?"
"Well, he is clearly a highly intelligent man..."
Really? Forgive me if I'm not impressed. Intelligence, it seems to me, would be the ability to respond appropriately to problems, or at least to figure out ways to deliver on one's promises. So far, I've seen neither from this "highly intelligent" man. It suggests that he is either not at all intelligent, or that he is intentionally underperforming in order to achieve some other objective of which we are not aware.
Just a few examples of what I mean...:
1. The country is plunged into economic chaos, resulting in a weakening of the dollar. His response? To increase spending to the point that it is unsustainable by our own efforts - borrowing one half of our budget from the Chinese Communists and printing more money to cover the other half. The result? A critical weakening of the U.S. Dollar, causing inflation, raises in interest rates, and massive unemployment.
His other response? To raise taxes on the productive - the only people who can produce, spend and hire our way out of this mess. Not exactly the actions of a man who bases his entire governmental power on the foundation of his intelligence. In this case, he is doing the exact opposite of what is intelligent.
2. The U.S. Auto Industry is poised on the brink of bankruptcy. His response? To pay six-figure severance packages to laid-off union employees (the cause of the problem in the first place), to give a controlling interest in the auto makers to the unions (foxes guarding the hen house), to raise emission standards to make U.S. cars even more expensive and less competitive in a global market, and to nationalize the means of production at two of the largest auto makers (a move right out of Marx's Das Kapital). Intelligent? I defy you to show me how it is.
3. The limited socialized health care we have in this country, exemplified by the VA medical system, Medicare, and Medicaid, are insolvent, infamously inefficient, and provide care that is envied by no one. His response? To build on this horrible failure by expanding government's role in health care. To shamelessly quote many of my predecessors: "Think health care is expensive now? Just wait until it's 'free'". The socialization of the last liberated health care system in the world, at a time when those who already have socialized medicine are seeking desperately for a way out of the mess they've made, is the hallmark of stupidity, hubris, and the worst sort of pandering to a demented, blindly ideological, and naive political base. But it's not the sign of any sort of intelligence.
4. Government spending is so far out of control, it boggles the mind. Obama ran on a promise to review spending "line by line" to remove wasteful expenditures. His response? After announcing a $4 trillion budget for the next fiscal year, he makes the big announcement that he's been able to cut a measly $21 billion/year through methods that are as inscrutible as the man himself. I won't bore you with the math, but this amounts to about one half of one percent of the budget. In other words, if you had a budget of $100, you would save less than one penny. Intelligent? How exactly?
I await the singing angels announcing the return of intelligence and sanity to Washington. Instead, I only hear the gentle trickling of my will to continue contributing to this failed system, as it goes down the drain, and to quote Ross Perot, the "giant sucking sound" from this liberal dream team as they drive the final stake into the heart of our country's productive class.

Monday, May 18, 2009

Generics: The Big Lie

Imagine this scenario. I am contacted by a representative from a large drug company that makes an expensive new drug. An offer is made. For every prescription for their drug I write, I will receive a monetary reward.
What would you think about me if I wrote that medicine for you? Would you wonder whether it was a decision based on what was really best for you, or it was a decision based on my own selfish interest? You would be right to wonder. I would wonder myself, were I in your position.
It would be possible, of course, that I really felt the medicine was the best one for the particular case at hand. But the appearance of impropriety would remain. That just makes sense for you to wonder.
Sadly, this is exactly the situation occurring every day, at almost every pharmacy in every town in this country. Pharmacists are paid bonuses for prescribing certain medications - generics.
The generic medication industry pays money to insurance companies and to PBMs (pharmaceutical benefit management) companies that provide medicine coverage for insurance companies. Those companies, in turn, pay cash bonuses to pharmacists who change prescriptions written by your doctor for a name brand medicine to a generic alternative. The percentage of name-brand medicines they arbitrarily "switch" to generics is recorded as the generic substitution rate (GSR). In some large pharmacies like Walgreen's and CVS, there is actually a quota that a pharmacist must reach each day in order to make their bonus.
This should give you a shudder. Are the pharmacists switching your doctor's orders out of loyalty to you? Or out of a desire to make more money personally? It is a legitimate question.
This is made more serious by the fact that generics, long touted as being "equivalent" to the name brand medications, are not at all equivalent. In keeping with the original Hatch-Waxman Act of 1984, the Congressional Act that gave birth to the modern generic industry by relaxing the rules leading to their availability to the market, a generic medication only has to be somewhere between 80% and 125% as effective as the name-brand medicine.
What does this mean for safety? Well, in some cases, it's not a huge deal. In other cases, however, it is a critical difference. For some medicines, the accuracy of the dose can have real life-and-death consequences for the unsuspecting patient. Take coumadin (Warfarin), a common anticoagulant medicine, for instance. If I prescribe 10mg of coumadin, it is because the patient needs 10mg. No more, no less. If the patient only receives 8mg (entirely possible under the Hatch-Waxman Act), the patient might develop life-threatening clots. If the patient receives 12.5mg, conversely, they might suffer over-anticoagulation and die from an internal bleed. Not exactly a minor difference, right? It doesn't get much more stark than life or death.
Now Senators Hatch and Waxman are at it again. They want to bring the most advanced new medicines - so called "biologics" - to market at a cheaper price. But because biologic agents are more difficult to copy, they have done away with the inconvenient "bioequivalent" language in the original act. They are only requiring these new generics to be "biosimilar" to the original.
I don't know about you, but I would just as soon not be given a medicine that "may be kind of like" the medicine my doctor prescribed. Maybe it's just me.
So the next time you hear someone griping about the high cost of prescriptions and rallying for cheaper generics to be made available, remember this post. Sometimes you really do get what you pay for.

Sunday, May 17, 2009

The Inconvenience of the Bill of Rights

Amendment One: Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

My simple question is this: does this say anything about exceptions in certain cases? More specifically, do we have a right to speak freely or not? What about speech that is inconvenient? What about speech that is treasonous? Despicable? Hateful?

What exactly constitutes "hate speech"? I am assuming that government has not developed the super-human ability to read minds - to see with perfect clarity the intention of a speaker or the true contents of his heart. And if they lack this ability, how do they presume to be able to label something as speech that is motivated out of hatred?

Further, how is it any of their business? When someone says that they oppose marriages between homosexuals, this is inconvenient, even offensive, to some homosexuals. A statement of this type might even be motivated by a sense of hatred toward homosexuals on the part of the speaker. In a similar way, calling a beauty pageant contestant a Nazi because she opposes homosexual marriage might also be offensive. A statement at a recent White House correspondents' dinner (about a wish that a popular radio show talk host with whom the speaker disagreed would die) might also be considered hateful. Unfortunately for the proponents of the belief that some speech is not protected by the First Amendment, all these statements are perfectly legitimate.

"Hate speech" isn't some special category of speech. It's just speech. It is enshrined in the Constitution. It is our right as free people to speak freely about whatever we wish, regardless of the way it makes someone feel.

There have been some who basically agree with me ideologically who have recently made statements to the effect that many of the statements by some on the Left are "hate speech". This is a grave error. What differentiates us from the Left is our belief that we are free people with certain rights, some of which have been specifically named in the Constitution. If we allow ourselves to give legitimacy to their perverse theories by fighting them with their own weapons, we fall into their trap. I oppose pork-barrel spending, even when it is done by my own Congressmen, to my benefit. It is wrong, no matter who is doing it. This belief that we should adopt a "my Senator can beat up your Senator" is only perpetuating the false philosophy of the Left, and we must stop it.

Support speech of all types. Combat stupid and hateful speech by pointing out the inherent flaws in what is said - not by squelching your opponent's right to make such statements. We are either free or we are not. It's that simple.

Saturday, May 16, 2009

"Fixing" Healthcare: A Humble Proposal

I'm no economist. Well, at least not any sort of formal economist - I am a consumer, which may be at least as important. Here's my proposition for fixing healthcare. It will be roundly criticized by all the important players, for a number of reasons. Government will hate it, because it requires that government butt-out, for a change. Insurance companies will hate it because it will deprive them of the ability to continue charging people ridiculous premiums, then not paying for anything. The public will probably hate it, too. They won't really have a good reason to, but they'll be told to hate it by the people who are the paid servants of either the government or the insurance industry. The public always obeys.
Nevertheless, I really believe that this solution would work. I look forward to your comments. At least I'm trying, right? Never let it be said that MOCKBADOC offers no solutions.
The Idea:
1. All U.S. Citizens will have a health savings account (HSA) set up in their name, under their Social Security Number.
2. Contributions to this account will be made with each paycheck, either by the citizen themselves, their employer, or jointly.
3. The account will not be placed in the market, but will be in something stable and safe, so the money can't be lost.
4. The money that would have been spent each month on useless insurance premiums will, instead, be placed into the account, which will be available for use by the citizen in any way they so choose, so long as it's for health-related stuff.
5. A minimum balance will be required for minor emergencies. For example, you couldn't spend down to zero balance on a nose job. You might need to go to the ER the next month.
6. Citizens would then be able to purchase insurance for the unlikely event that they have something catastrophic happen, that would exceed their ability to pay from the HSA. A deductible of at least $10,000 seems reasonable.
1. Brings competition back to medicine: bad doctors lose patients, good ones get more patients.
2. The patient is back in charge of their own health care. They get to make the decisions for themselves without interference.
3. The cost of health care, which is inflated arbitrarily by the presence and interference of insurers and government, would immediately plummet, making things much more affordable.
4. People could carry over their money in the HSA from year-to-year, allowing them to save for expensive but elective things like plastic surgery, etc.
5. The money, which is now making vast amounts of interest for the insurance companies, would instead be making interest for the insured person.
1. What to do about the unemployed, and therefore, uninsured?
2. What if somebody spends all their money and still needs more stuff?
3. What about kids?
Answers to Cons:
1. Unemployed could have their HSA replenished in a number of ways, either through the current COBRA system, which would continue to make deposits for 6 months to the HSA instead of the ridiculously-priced insurance they currently provide. The HSA deposits could be part of unemployment benefits. Better yet, the HSAs would give a superb opportunity for charitable contributions to be made to help a neighbor down on his or her luck.
2. If somebody spent all their money on something irresponsible, they should not be protected from the consequences of their own irresponsibility. They should have to repay whatever they spend over and above that amount for routine care. If, however, they need something that exceeds $10,000 in price, they could tap into the catastrophic care insurance provided by their employer.
3. Kids would have their own HSAs, and contributions could be provided by their parents, their parents' employer(s), or both. Needy children could have their HSAs contributed to by their home state or county. Just like adults, kids would have a safety net above $10,000 - an insurance policy designed to cover more expensive stuff.
I can't take total credit for this idea. It is already working (and working very well) for the Whole Foods grocery chain.
Government isn't the only answer to our problems, guys. It's just the worst possible answer.

Friday, May 15, 2009

The View From the Inside: Obama and Tribunals

Hypocrisy in action, once again. How many flip-flops before he's called on it?

Barack Obama. He built an entire campaign...heck, an entire political career on the contention that the terrorists housed at Guantanemo were unfortunates who'd simply been wearing a turban in the wrong place at the wrong time on a battlefield in an illegitimate war for oil.

Barack Obama. The savior of the Guantanemo detainees. Outspoken vitreolic critic of military tribunals. Now the prince of self-righteousness is reinstating the policy of using military tribunals to try terrorist suspects at Guantanemo. See for yourself...:

(I made sure to quote a communist news agency so nobody could claim Fox or Rush Limbaugh put me up to this...all us bloggers for Liberty are just shills, you know)

My initial reaction was anger. Then I felt a strange sense of gratitude that even Obama sees the reality of the situation now. Things look a lot different from inside the Oval Office, apparently. Not so easy to criticize now, I guess.

Oh, before I forget...have you seen all the giant anti-war protests going on about Iraq? Obama promised to get us out of there, and hasn't delivered, and they're furious and protesting. Cindy Sheehan even set up a makeshift compound outside his Chicago home because there's been absolutely no change in anything after 100 days. Now they're carrying signs about detainee torture and abuse at Guantanemo, talking about how his policies aren't any different from Bush's, and how he hasn't delivered on his campaign promises. They've said that they are furious, because their cause of peace and the ending of overseas wars is more important than any campaign, and Obama's failure to act makes him no better than GWB. Have you seen all that?

Neither have I. Nice hypocrisy liberal left. Guess your passion is only skin-deep. Remind me to continue not listening, not giving a crap what you idiots say.

Liars, hypocrites, traitors, thieves and cowards. You disgust me.

Thursday, May 14, 2009

The Philosphy of Self-Destruction

Many would love to see the rich "taken down a notch or two". Not being very productive themselves, they've believed the infernal lie that all their desires have been kept from them by those more productive, and therefore, more wealthy than they are. They believe that their lives will improve if only someone would destroy the rich. This is a self-destructive creed.

With every wealthy person who discovers, at long last, that their increased productivity only exposes them to further harassment from the government, and makes the only logical decision left to them - that they become less productive in order to lower their profile - the system grows poorer.

When the productive become less productive, either through increasingly violent taxation policies directed against them, or through their own willing self-abasement, the system becomes less solvent. Tax rolls shrink. Employment numbers suffer. The dollar becomes less valuable, causing buying power for all citizens to become lower. Non-profit organizations (always a favorite of the liberal elites) can no longer count on the donations that are made exclusively by those with excess money to spend on such things. Artists and their arts suffer. In short, the entire system of our lives changes for the worse. All because of jealousy and misplaced hatred of the so-called "rich".

As for me, I have already decided that I will not submit to socialized medicine. I will not be enslaved by a demonic policy that uses my skills and abilities to enslave both me and my patients. I will not institute a connected electronic medical record (EMR) which subjects my patients' vital health information to review by a government that has shown itself to be unworthy of even the most rudimentary level of trust - much less our most precious medical secrets. When the inevitable happens, I will no longer practice medicine. The "system" will have to go on without my skills, abilities, and tax revenue.

The choice lies with each one of us. Will we willingly submit to the erosion of our personal liberties and the taking over of each element of our lives by a government that sees us as merely tools of their continued existence? Or will we fight to protect ourselves?

Which philosophy do you follow? The one that believes that everyone should have the right to amass a fortune, if possible, through hard work, ability, skill, the value of their work, and sometimes a little luck? Or the one that seeks to destroy the rich in an attempt to reap vengeance against a world that has not rewarded them equally, thereby ensuring the destruction of all of us, in a last, defiant, suicidal gesture? We shall soon see. The pitchfork-wielding mob has called for the heads of the doctors. When we are gone, who will be next?

Wednesday, May 13, 2009

D-Day: 31 July 2009

The Obama administration and his socialist allies in Congress have announced their intention to ram their socialist health care program down our throats by the end of July. This means that I've only got a little over 2 months to get my side of the story out. If you are in agreement with me that this is not only a colossally idiotic plan, but is also a true threat to our liberty, then I invite you to speak your mind.
We've allowed ourselves to be brow-beaten into submission. It is difficult to face the slings and arrows of our enemies - I know. They own the media. They own the college classrooms. They own the high school classrooms. They like to believe that there is no dissent, since they've been so effective in silencing it.
I happen to believe, however, that there are a lot of us who aren't comfortable with what socialist health care would mean to us and our families. I urge you to fight. Fight with the same courage and conviction that allowed a group of simple colonial merchants to declare their Liberty from their own tyrannical government. Fight with the same knowledge of right. Fight as if your future and the future of your posterity depended on it. Fight as you would fight to defend your home from a jealous and obstinantly lazy mob, armed not with right, but with clubs and torches.
Fight this way because this is in fact our struggle. Our freedom rests on our ability to fight that mob, whose single purpose is to destroy the productive. Our liberty depends on our victory over a tyrannical State, whose purpose is to use the power we've loaned them to make us their slaves. Don't give up until they are thoroughly defeated, or we leave them the rotting wasteland that is the natural outcome of their struggle. A world devoid of the productive, where each man and woman parasitizes his or her neighbor in a misguided attempt to achieve "equality" is a world without law and without hope.

Tuesday, May 12, 2009

Socialized Medicine 2009: What is Choice Worth?

Plumbers. Have you ever called a plumber? Have you ever called one on a weekend? It's expensive. Very expensive. Don't get me wrong - they do a very important job. I would gladly pay for their expertise in an emergency. Busted pipes can definitely ruin a weekend.
But what if you don't like the one you called? What if they rub you the wrong way? What if they are rude or surly? Ask anybody and they'll likely give you the same response. They'd flip open the yellow pages or check the internet and find a new one. No hard feelings. You see, you have a right to spend your money however you see fit. Plumbers know this, so they work to provide a service that is likely to please their customers, lest they get "fired". The arrangement between plumbers and their customers is one of a free association between two free and consenting people.
Medicine, on the other hand, is under assault in this sense. If you don't like your doctor, you have the right to go to another one that suits you better. You can decide not to associate with a doctor for any reason, or for no reason. Under government health care, however, this is destroyed.
Even if President Obama's socialist dreams of large, government-run "super-clinics" fails to come to fruition, you must realize that any professional relationship where one of the parties is forced is problematic. When a doctor is forced to see you, the doctor-patient relationship, one based on mutual respect, market pressures, and a free association is destroyed.
It is interesting to me to note that many of the same people who argue vehemently that gay marriages or civil unions must be respected because government has no right to interfere in the free association between free, consenting adults are the same people who argue with equal vigor that doctors should be forced to see whomever, under whatever circumstances the government mandates.
It is time for you to decide what your rights to free association are worth. Once government runs health care, they will have to contend with the same difficulties that have made health insurers some of the most detested companies on earth. When money is limited, there are only two ways to decrease the cost of services provided: cuts in services or cuts in who is covered.
Since "universal coverage" is the mandate that government has chosen for itself in this endeavor, this leaves cuts in services as the only viable option to cut those costs. Your choice of physicians will be secondary. If there is a doctor available, then their responsibility to you is finished. They couldn't care less if you like him or her. If you don't, you will not have any choice left. After all, it won't be your money paying for it. It will be ours. As for me, I hope they give you the cheapest option, not necessarily the best. It's my money you'll be spending.
What is your choice worth to you? And what is quality worth? What if your child needs an expensive but life-saving operation? The best place to have it done is Kansas City, but you live in Santa Fe. Oh, well. Pray that the inferior but "accredited" program in Santa Fe can get the job done. You're not taking your child to Kansas City.
Are you willing to sacrifice your child on the altar of social justice for others? Are you willing to sacrifice someone else's child? If you are, then you are a fool. If your self-righteousness is so powerful that you are willing to subject an innocent to your social experimentation, if you don't want the best for your child - just the same as everyone else, then I would classify you as a child abuser.
If, on the other hand, you (like me) are not willing to trust someone else with the health of your own child, especially an incompetent and self-interested government, then you know already what course you must take. You must oppose socialized medicine with the same animalistic furor as you would defend your child's room from an intruder, as I do. My choice is worth everything to me. It is one element of my liberty, and I would rather die than live as a subject or a slave.

Saturday, May 2, 2009

You know, it seems there is no end to the meddling. Now our exalted leader even feels it is his responsibility to choose jobs for people.

In a recent interview discussing his plans to rein in "massive risk taking" in the U.S. Financial sector, he made the statement that "We don't want every college graduate with aptitude in mathematics to become a derivatives trader".

He went on to callously say that those who would have found jobs in finance would have to look elsewhere. He suggested they should try engineering.

Okay. First of all, who is the "we" he is so fond of invoking? Does he presume that all of us share his desire to "remake America" in his own image?

And is he so uninformed as to believe that someone with a college degree in finance can be miraculously transformed into an engineer?

It makes sense that he should be so naïve about the working world. In keeping with his now legendary hubris, the "Intelligentsia President" who's never had a real job is now a career expert.