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Showing posts from April, 2020

Funding the Unfunded, and Their Mandate

The  Unfunded Mandate  is a legal contradiction and humanitarian nightmare that is also antibusiness. It needs a permanent fix, not a modification, adjustment, reconciliation, and most definitely not Washington style “reform.” What is the Unfunded Mandate? In 1986, Congress passed  EMTALA  (Emergency Medical Transport and Active Labor Act), colloquially called the anti-dumping law. Its ostensible purpose was to prevent one hospital from “dumping” (transferring without medical justification) a critically ill patient or women in labor to another hospital because the patient has no money or insurance. Dumping would allow the first hospital to avoid paying the costs of very expensive care for which it will get no payment. EMTALA created a new class of patients called the Unfunded Mandate. These patients receive very expensive care for which neither hospital nor providers will be paid. Of course they — institution and physicians — must still pay their own expenses, from nurses’ sala

Revised CoViD Strategy

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We can now design a CoViD-19 strategy based on fact, not flawed theory. Evidence drives a strategy of stopping lock-downs, allowing normal contacts including work, quarantine of high-risk Americans, and mass testing.  There is NO NEED TO FEAR a return to normalcy, and every reason to do it.  Sign up for more videos and information here:  Fixing US Healthcare 

Attending Doctor Should Decide Life or Death-No One Else!

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Elected officials such as New York and Atlanta mayors as well as clinical physicians, viz., in Maryland and Colorado, are projecting there will be more patients who need life-saving CoViD-19 services than there are facilities--ICU beds and ventilators--available. Such an imbalance between the needs of critically ill patients and healthcare capabilities requires triage, deciding who gets care and who waits. Who should do the triage? Who should make the life or death decision? Triage of the sick or injured started on the battlefield probably during Napoleon's 1799 siege of the ancient city of Acre in northern Israel. Many of his troops became ill from poor sanitation and inadequate food. The soldiers were separated or "triaged" into those fit to fight and those who were not. So, We must protect the direct fiduciary connection between doctors and individual patients. There should be no other person or group making these Solomon-like life or death decisions. The

CoViD-19 Cost/Benefit Analysis Concludes: Let My People Go

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When the CoViD-19 (Corona Virus Disease, 2019) first broke out, there was little-to-no data. Without factual evidence, medical advisers had to depend on mathematical models such as the  MRC Centre for Global Infectious Disease Analysis  from the Imperial College in London. With an estimate of more than 2 million American deaths, a draconian response was instituted with a nearly-complete cessation of social and commercial interactions. Most people are now functioning under a lock-down, travel ban, and infringement on civil liberties analogous to martial law. With five months data since the virus was identified in Wuhan, and with the entire globe focused on one subject only, there are now reams of data on CoViD-19, from its genome to its behavior and clinical consequences as well as daily reports of infected cases and deaths. With volumes of evidence now available, it is time to reconsider what we are doing. A cost/benefit analysis can help advise whether we should stay the course

Injecting Reality into CoViD-19 Mass Hysteria

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At present, public awareness is focused exclusively on CoViD-19. There is a wealth of misinformation, even disinformation that must be corrected. This video provides hard facts, realistic analysis, sense of perspective, and lessons to learn. Sign up for more videos and information here:  Fixing US Healthcare

Colorado Took Healthcare Out of Washington and Implemented Medicare-for-All "Lite." Good Move or Bad?

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Supreme Court Associate Justice Louis Brandeis famously urged the states to become "laboratories of democracy" (New State Ice Co. v. Liebmann, 1932) by testing new, alternative ideas of governance. Colorado is heeding his advice. With their Governor Jared Polis' leadership, the 2019 Colorado Legislative Session passed a number of bills that increase state control of healthcare. The purpose of Governor Polis' reforms is clear from his Executive Order to establish the "Office of Saving People Money on Health Care." Will his plan, called the Colorado Affordable Health Care Option or CAHCO, save money for consumers? Will it reduce state spending? What will be the effect on access to care? CAHCO has financial controls similar to federal Medicare-for-All bill, H.R. 1384, and could be called Medicare-for-All "Lite." HB 1174 puts caps on Emergency Room charges. HB 1216 places price controls on insulin and potentially other medications. SB 5 allow