Culture & Society Archives - Page 5 of 15

Culture & Society, Current Events, Health Policy, Healthcare Reform, Politics, What's New

America Out Loud PULSE: Six Lessons in Healthcare Mythology

May 30, 2023 No Comments

From my America Out Loud Pulse podcast with Robert Graboyes, PhD – https://www.americaoutloud.com/six-lessons-in-healthcare-mythology/

The cost of medical care is a big topic in healthcare policy discussions – whether in Congress or in think tanks. Over the last few years costs for medical care have continued to rise. Until 2021 with the out-of-control inflation medical care prices have generally grown faster than overall consumer prices. From 2000 to 2022, the price of medical care, including services, insurance, drugs, and medical equipment, has increased by 115.1 percent, whereas prices for all consumer goods and services increased by 78.2 percent.

Hospitals “facility fees” are of particular concern. Facility fees are generally the price for using the hospital premises – the overhead charge in addition to professional charges. Some hospitals are charging such fees for telemedicine. Additionally, one large private insurance data analysis showed that the facility fees for emergency department use from 2004 to 2021 increased four times faster (531%) than professional fees (132%) for emergency department evaluation and management services. And until 2021 with the out-of-control inflation medical care prices have generally grown faster than overall consumer prices.

Healthcare policy isn’t just about saving money. Otherwise, we would simply ration care. Real human beings underlie the reason we provide medical care in the first place. Accordingly, we have to look at limitations on access for certain groups, the impact of cost-cutting on quality, the ethics of rationing, and many other factors affecting the individual patient.

My guest taught the economics and ethics of healthcare for 20 years and his overriding theme throughout those years was, “Always be skeptical.” He notes that “healthcare policy debates tend to be drenched through-and-through with myths, opinions, and politics—all masquerading about as scientific facts.”

America Out Loud PULSE: Has the Fear of Nuclear War Tainted the Benefits of Clean Nuclear Energy?

May 12, 2023 No Comments

From my America Out Loud Pulse podcast with Dr. Yehoshua Socol –https://www.americaoutloud.com/has-the-fear-of-nuclear-war-tainted-the-benefits-of-clean-nuclear-energy/

When I was in grammar school, we practiced every Monday at noon hiding under our desks in case an atomic bomb was dropped. Looking back, being in a navy town and the school near a navy base that likely would take a direct hit, the desk was pretty useless. I’m glad I was in Catholic school and we had plenty of prayers and a fast track to heaven.

By the time I started high school there was the October 1962 Cuban Missile Crisis where the USSR deployed nuclear armed missiles in Cuba. Then there was the threat of terrorists’ “dirty bombs” after 9-11. Now the saber rattling over Ukraine has put nuclear war worries in the forefront.

Thousands of nuclear weapons, 20 to 30 times more powerful than those used on Japan, reside all around the world. Russia and the U.S. each have between 5,000 and 6,000 nuclear weapons, while China has 350, France has 290, the U.K. has 225, and India and Pakistan each have around 160.

In the 1983 movie War Games, the NORAD (North American Aerospace Defense Command) War Operation Plan Response supercomputer learns over time that nuclear war is as futile as winning a game of tic-tac-toe between two good players. In case anyone hasn’t played, tic-tac-toe is a zero-sum game, which means that if both players are playing their best, then neither player will win. The computer concludes that the only winning move is not to play.

Adding to our Armageddon fear level, we have people going on and on about climate change and stopping the use of fossil fuels like oil and gas ASAP in order to save Mother Earth. They suggest windmills. Unfortunately, they are unreliable, inefficient and kill birds and perhaps sea life. And solar users may find that they have to pay $12,000 to $22,000 for a battery system if they discover that the solar panels are inadequate during non-sunlight hours. Why aren’t we talking about reliable, clean nuclear energy? Because nuclear is a word that pushes the fear button.

Everyone on Earth is exposed to low levels of ionizing radiation from, soil, the atmosphere, and oceans. When should we be afraid of being poisoned? My guest and I will talk about all things nuclear today.

America Out Loud PULSE: What Do Roe, Doe, and Dobbs Really Mean?

April 26, 2023 No Comments

From my America Out Loud Pulse podcast with Brian Johnston – https://www.americaoutloud.com/what-do-roe-doe-and-dobbs-really-mean/

Ever since the Supreme Court opinion in Roe v Wade making privacy—which included abortion—a federal Constitutional right in 1973, the right to life debate has come and gone out of the public eye. At this point, most people who paid attention to the Roe opinion knew was not based on anything in the Constitution. It was more of a sociological and cultural decision than a legal one.

A couple of years ago, New York’s Catholic Democratic Governor had the World Trade Center in lights to celebrate its abortion-on-demand-until-the-day-of-birth law. This law was framed as empowering women through guaranteeing “reproductive health.” This and eight other similar state laws were largely ignored as merely codifying Roe v Wade. But the state of Virginia’s pediatrician former governor’s ghoulish advocacy for abortion until delivery of the infant was jaw-dropping as he explained that killing the infant after birth was allowed. Adding insult to injury, in California minors can obtain abortions without parental consent.

The normalization of the intentional killing of human beings weaved its way into our culture. Life was not only cheap for the unborn, but for other vulnerable or unwanted persons such as the elderly. Half the states have laws that charge a person for two murders if he or she kills a woman in any stage of pregnancy.

Fortunately for unborn children, the recent Supreme Court case, Dobbs v Jackson brought the abortion debate into the forefront. The pro Roe crowd went so far as to surround the homes of conservative Supreme Court justices. The media could not continue to ignore the large numbers of people participating in marches for life. More and more people publicly admitted that aborting a baby is not the solution for an unplanned pregnancy.

We can only hope that more and more physicians prefer to practice medicine in the mode of Dr. Mildred Jefferson, the first black woman accepted to Harvard Medical School: “I became a physician in order to help save lives. … I am not willing to stand aside and allow the concept of expendable human lives to turn this great land of ours into just another exclusive reservation where only the perfect, the privileged, and the planned have the right to live.”

Culture & Society, Doctors, Featured, Health Policy, Healthcare Reform, Medicine, Politics, What's New

America Out Loud PULSE: Medical Care Is About Patients, Not Politics

April 21, 2023 No Comments

From my America Out Loud Pulse podcast: Medical Care Is About Patients, Not Politics with Dr. Richard Amerling – https://www.americaoutloud.com/medical-care-is-about-patients-not-politics-w-dr-richard-amerling/

Several years ago the Association of American Physicians and Surgeons publish a Patient Bill of Rights. In this age of more government and corporate control of medical care, it’s time we remembered those rights.

“All patients should be guaranteed the following freedoms:

To seek consultation with the physician(s) of their choice;
To contract with their physician(s) on mutually agreeable terms;
To be treated confidentially, with access to their records limited to those involved in their care or designated by the patient;
To use their own resources to purchase the care of their choice;
To refuse medical treatment even if it is recommended by their physician(s);
To be informed about their medical condition, the risks and benefits of treatment and appropriate alternatives;
To refuse third-party interference in their medical care, and to be confident that their actions in seeking or declining medical care will not result in third-party-imposed penalties for patients or physicians;
To receive full disclosure of their insurance plan in plain language, including:
- CONTRACTS: A copy of the contract between the physician and health care plan, and between the patient or employer and the plan
- INCENTIVES: Whether participating physicians are offered financial incentives to reduce treatment or ration care;
- COST: The full cost of the plan, including copayments, coinsurance, and deductibles;
- COVERAGE: Benefits covered and excluded, including availability and location of 24-hour emergency care;
- QUALIFICATIONS: A roster and qualifications of participating physicians;
- APPROVAL PROCEDURES: Authorization procedures for services, whether doctors need approval of a committee or any other individual, and who decides what is medically necessary;
- REFERRALS: Procedures for consulting a specialist, and who must authorize the referral;
- APPEALS: Grievance procedures for claim or treatment denials;
- GAG RULE: Whether physicians are subject to a gag rule, preventing criticism of the plan.”

COVID-19, Culture & Society, Guest Column, Health Policy, What's New

How to Prevent Another Pandemic

April 13, 2023 No Comments

Courtesy of Millions Against Medical Mandates

Culture & Society, Current Events, Featured, Law, Medicine, Politics, What's New

America Out Loud PULSE: Stopping Government Tyranny Through the Courts

April 12, 2023 No Comments

From my America Out Loud Pulse podcast with Andy Schlafly, JD https://www.americaoutloud.com/stopping-government-tyranny-through-the-courts/

The United States Constitution, the ultimate law of our land is under assault. George Washington said “The Constitution is the guide, which I will never abandon.” President Calvin Coolidge, a strong proponent of limited government, believed that “in order for the Constitution and self-government to survive, the people had to be vigilant in its preservation.”

Lawyers can be a big part of preserving our liberty. The state and federal governments took advantage of Covid-19 to further sink their claws into our lives and manipulate our behavior. Who cares if ivermectin was beneficial to many patients? The doctor is still wrong. Isn’t it a physician’s duty to help patients no matter what? And of course, the government is still touting Covid vaccines even though there are reams of negative findings about their adverse effects and lack of effectiveness.

The legal fights to reign in government overreach are about more than Covid. Lawyers are here to help protect the rights of the individual citizens. They are our last defense against government oppression and corporate corruption.

My guest today is Andy Schlafly who among other things, is the Association of American Physicians and Surgeons General Counsel. We’ll discuss some the recent victories and other legal issues.

Culture & Society, Featured, Health Policy, What's New

America Out Loud PULSE: Can “Bad” Parents Be Better Than Foster Care?

April 7, 2023 No Comments

From my America Out Loud Pulse podcast with Jay Rosenthal – https://www.americaoutloud.com/can-bad-parents-be-better-than-foster-care/

Children are our most precious gifts and we appreciate that the state and federal government recognizes the importance of keeping them safe. In 1974, Congress passed the Child Abuse Prevention and Treatment Act (CAPTA). The Act gives federal dollars to the states for the prevention, investigation, and prosecution of child “maltreatment.” CAPTA defines child maltreatment as serious harm caused to children by parents or primary caregivers, such as extended family members or babysitters. Child maltreatment also can include harm that a caregiver allows to happen to a child or does not prevent from happening.

Any concerned person—even anonymously—can report suspicions of child abuse or neglect. Health care professionals as well as many others are mandated by state law to report their suspicions of child abuse in its many forms to the government. Examples are physical abuse (which does not include physical discipline), sexual abuse, emotional abuse, abandonment, parental substance abuse. Neglect is by far the most common form of child maltreatment. It can include physical, educational, medical, and emotional neglect. It is important to note that living in poverty is not considered child abuse or neglect.

Confidentiality, or “privileged communications,” is a core ethical principle of medicine. However mandatory reporting statutes in most states do not allow this privilege to be grounds for failing to report.

Child Protective Services (CPS) is legally obligated to investigate every report, even false ones. Many times, children are sent to foster care during the investigation. But foster care may not be the best solution for many reasons. A Government Accountability Office (GAO) audit of foster care records from 2008 in five representative states found that 39 percent of foster children are being prescribed psychiatric medications in contrast to 10 percent of non-foster children. Although the actual percentages of children who received five or more psychiatric drugs concurrently were low, foster children were on average 25 times more likely than non-foster children to be prescribed five or more medications, despite the increased medical risk for children. Foster children were also over nine times more likely than non-foster children to be prescribed drugs in doses exceeding FDA-approved maximum levels. Certainly, children entering foster care likely have more emotional and behavioral issues than do non-foster children but drugs may be viewed as less time consuming and less costly than more behavioral therapy.

My guest today will discuss the process and how targets of an investigation can protect their children from the long arms of the government.

Culture & Society, Doctors, Health Policy, Medical Ethics, Medicine, Politics, What's New

America Out Loud PULSE: Patients and Physicians Reclaiming Choice in Medical Treatment

March 30, 2023 No Comments

From my America Out Loud Pulse podcast with Shibrah Jamil, MD – https://www.americaoutloud.com/patients-and-physicians-reclaiming-choice-in-medical-treatment/

For years the health insurance industry has been increasingly dictating the quality and quantity of medical treatments. High insurance premiums, co-pays, and out-of-pocket deductibles are squeezing patients out of the market. Even so, physicians and patients begrudgingly acquiesced. Now, not only is private equity taking over the health care industry but the administrative state is making hard for physicians to serve their patients fully satisfactory for both parties.

The Oath of Hippocrates has upheld the sanctity of the patient-physician relationship for thousands of years. Mandates intrude into that relationship. Mandates rely on coercion rather than informed consent. Various laws in, particularly in California, are squelching choice for patients and free speech for physicians even with threats of loss of their licenses. Consequently, patients are losing their choice in medical treatment.

For example, many colleges have mandated Covid vaccines, even in the face of mounting evidence of an association with myocarditis (heart inflammation). California now has an immunization registry invading our privacy. Another law would punish physicians for telling their patients Covid “misinformation” – a term that is about as clear as mud.

The silver lining? Medical tyranny has gone so far that more and more patients and physicians are becoming activists.

Today’s guest is one of those physicians who is taking to the streets to reclaim medicine for patients and physicians.

Culture & Society, Current Events, Featured, What's New

America Out Loud PULSE: Woke Antisemitism Hurts All of Us

March 30, 2023 No Comments

From my America Out Loud Pulse podcast with David L. Bernstein – https://www.americaoutloud.com/woke-antisemitism-hurts-all-of-us/

When I was in law school, critical race theory was an academic exercise reserved for graduate school mental gymnastics. Unfortunately, the overlords have used the reality of lingering racism to divide those who have spent years coming together. Improving fairness and living conditions for all in our society has taken an ugly turn. We went from striving for equal opportunity to a contest to see who is the most oppressed victim.

Moreover, people used to be happy that there are all kinds of folks who good works for their communities, no matter their political leanings. Now only those who swear upon the Social Justice gods that our society is driven by the struggle between the oppressors and the oppressed are allowed to be called righteous. To be legitimate, one must reject, “dominant, exploitative systems in the United States, which are largely reliant on anti-Black racism, colonialism, cisheteropatriarchy, white supremacy, and capitalism…” as White Coats for Black Lives instructs.

The recent rise in antisemitism is the canary in the coal mine for the growing hatred of those who are not like you. Ironically, at UC Berkeley, home of the free speech movement of the 1960s, has “woke” campus groups seeking to ban speakers who support Israel. Demonizing others to prop up another group is unjust.

Jewish tradition warns that one must not pursue justice through unjust means. The concept applies to all of us. It is unjust when medical institutions had race as a factor in distributing anti-Covid medications or in the name of reparations favor black heart failure patients for treatment. There are health disparities but we need more open discussion on dealing with them without shortchanging others.

It’s time to remember the line from the 1946 poem by German Lutheran pastor Martin Niemöller: “Then they came for the Jews and I did not speak out—Because I was not a Jew. Then they came for me—and there was no one left to speak for me.” The dangerous path of modern day wokeism fosters group biases rather than focus on an individual’s character. So let’s have more debate. It’s time to speak up.

My guest is a long-time Jewish leader we will discuss how woke ideology shuts down discussion of sensitive topics and is a breeding ground for antisemitism.

David L. Bernstein is the founder if the Jewish Institute for Liberal Values (JILV). The Institute supports viewpoint diversity, counters woke ideology in the Jewish community, and opposes novel forms of antisemitism emerging from woke ideology. He served as president and CEO of the Jewish Council for Public Affairs, as national umbrella for local Jewish advocacy. He has recently written a book, Woke Antisemitism exploring how progressive ideology harms Jews.

Culture & Society, Doctors, Featured, Health Policy, Healthcare Reform, What's New

America Out Loud PULSE: The Physician Shortage and Quality Care for All

March 23, 2023 No Comments

From my America Out Loud Pulse podcast with Nicole Johnson, MD – https://www.americaoutloud.com/the-physician-shortage-and-quality-care-for-all/

As Bain Capital put it, 2021 was a “banner year” for private equity’s healthcare acquisitions. In addition to hospitals and nursing homes, physician practices have become hot targets. Over the past 10 years, private equity firms have moved on from buying physician staffing companies for hospital based practices, such as emergency room physicians, anesthesiologists and radiologists. They are broadening their net to include dermatology, ophthalmology, urology, and orthopedics, women’s health, gastroenterology.

The private equity firm’s main focus is on efficiency, productivity, and short term profits, not patients. Many physicians left independent practice to seek relief from the administrative aspects of private practice but found they became fungible, income-generating drones in a health care “system.” And patients are paying more and more out of pocket for their care with less choice and in some cases, lower quality.

A new study looking at 1,400 acquisitions from 2014 to 2019 found that compared to non-acquired dermatology, ophthalmology, and gastroenterology practices, the acquired practices not only replaced more physicians, but many were replaced with non-physician clinicians. For example Kaiser Health News reported that American Physician Partners, a medical staffing company owned by private equity investors. employs fewer doctors in its ERs as one of its cost-saving initiatives to increase earnings, according to a confidential company document obtained by KHN and NPR. The question arises whether this improves access or decreases quality or a little of both.

Among many reasons, commitment to science and helping patients heal is why we wanted to be physicians. Sadly, with this new landscape, physicians are becoming less satisfied with the practice of medicine. Nurses, nurse practitioners, physician assistants are all valuable parts of the health care team. But does this mean they have the requisite skills to practice without physician supervision and are the primary answer to physician shortages?

My guest today is a fierce advocate for patients and physicians. We’ll discuss solutions to the physician shortage and access to quality medical care for everyone.

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