Recently in Medicine Category

Yep. So says the Consumer Reports that just arrived in the mail. I'm astonished.

It seems to me I recently heard of a bevy of problems associated with surgical mesh, which can be used for hernia surgery like I had in Aug. 2001. I feel lucky I was spared the smesh.

Too bad, though, I experienced a gruesome dislocated right thumb injury a week ago climbing Mt. Percival with the two meatheads, Ruby and Beau. I think a pin may have been put in.

And no, I didn't cry, except when nurse Anna typed in my biographical info. My grandmother of the same name would have been 98 the following day. I had been thinking of her.

My manual labor job at UPS won't pay for disability since I can still (sort of) work another job, which I do as a boarding school teacher. The school gave me the day off, and I was nearly ecstatic to be putting it to some good use on such a glorious day. Except for the nose dive just coming down from the summit.

One of the hikers I encountered on the way down I thought was going to throw up. He called me a "poor bastard" three times. It looks worse on paper than the way he said it.

As time passes we get closer and closer to what has been called The Singularity. I call it getting closer to Star Trek.

The latest step towards that vision is something called biophotonic instrumentation . Now that we've named it, it's time to learn what it does.

At the moment when it's necessary to monitor a patient's heart rate, blood pressure, or blood glucose level a nurse or technician is required to attach a heart monitor, a blood pressure cuff, or to draw blood for testing. It's time consuming and requires a number of different pieces of equipment. But what if it were possible to monitor all of those parameters at the same time using nothing more than a laser beam and a camera?

Now it is.

When human skin is illuminated by a laser beam, the movement of blood under the skin manifests itself as vibrations at the skin's surface. These vibrations create a secondary optical speckle pattern that correlates to the blood flux, which depends on blood viscosity (related to glucose concentration), blood pulse pressure, and heart rate.

A few-milliwatt infrared (IR) laser at 1550 nm is used to illuminate the wrist of a patient at an oblique angle (see figure). The vertical-reflection speckle pattern is collected by an optical system that consists of a fast camera to record the reflected intensity pattern.

--snip--

Although the distance between the light source and the subject's skin was approximately 50 cm in the measurement setup, the researchers say they can also extract these biological parameters when the laser-skin distance is several-hundred meters. In addition, the parameters could be obtained not only from wrist-skin reflections, but also from chest and neck reflections.

The system could be located above the patient's bed or off to one side in one corner of a room, yet allow unobtrusive monitoring of the three medical parameters. That means less need to tether a patient to the monitoring equipment, greater comfort for the patient, and less effort for medical personnel.

There could also be certain security applications for this technology, such as monitoring passengers in an airport. A raised heart rate and blood pressure could trigger closer monitoring of some passengers as it's likely both parameters would be elevated in someone "up to no good." Of course it might also mean a passenger is a nervous flier. But it would be another covert tool for use by airport security personnel in screening passengers before boarding a flight.

The trend of physicians no longer accepting health insurance is spreading, with even more of them switching over to cash-only practices. I mentioned one Minnesota doctor who made the switch and is glad she did.

Now comes the story of Dr. Brian Forrest, his practice in North Carolina, and how he shed the frustrations and costs of dealing with health insurance companies, all to the betterment of his patients and his bottom line.

In an age of family physicians literally not being able to give away their practices, Brian Forrest has built a successful model that is similar to the age of Marcus Welby where there was a direct relationship between a patient and their doctor. Practices such as Forrest's Access Healthcare in North Carolina run unencumbered by insurance hassles.

As word of Dr. Forrest's direct pay practice has spread, he has had a constant stream of physicians visiting his practice so others could learn how he has a successful financial model, happy patients and a sane lifestyle - something increasingly less common in the hamster-wheel model of primary care that is prevalent in current fee-for-service based primary care practices. Dr. Forrest runs a cash-only practice sees 16 patients a day at a maximum, works a 40 hour week and takes home more than the average family physician a year with a highly satisfied patient base that pays less than those in fee-for-service, insurance models.

It's gotten to the point where the cost of accepting health insurance by primary care practices has become burdensome, both financially and in time, with doctors working long hours, seeing 40 patients a day or more, becoming detached from their patients because of time constraints, and being less well compensated for their time. Too many primary care practices have become nothing more than 'factory' medicine, much to the detriment of both health care professionals and their patients. Is it any wonder more doctors are abandoning the present model of medical practices and returning to older, more personal and satisfying models?

I can see that we have yet another "I don't take any kind of health insurance" medical practice that appears to be doing well.

A doctor in Minnesota has borrowed a page from other doctors around the US that have abandoned the endlessly more complicated (and expensive) system of health insurance covered health care. Instead all she will accept is cash, checks, and foodstuffs.

It's amazing how much costs go down when you no longer have to deal with the paperwork and regulations imposed by health insurance companies and the government if a medical practice accepts health insurance (and particularly Medicare and Medicaid).

As Minnesota Public Radio reports, Dr. Susan Rutten Wasson finds she's doing just fine without all the extra dross that comes with accepting medical insurance.

It's more a scene from the days of frontier medicine than from the modern health care system. And that's because Rutten Wasson, 42, is a throwback to a time before HMOs, electronic health records and hospitals with fountains in their lobbies. She sees patients the same day they call if she's not booked up, spends at least a half-hour per visit -- compared to the more typical 15 minutes -- and usually charges only $50 for a consultation. She takes cash or check, but no insurance -- and sometimes accepts gratuities of a dozen fresh eggs or a pie.

--snip--

In an era of high overhead, ever more byzantine regulations and payment models, cuts to Medicaid and Medicare benefits, and large medical systems swallowing independent practices, Rutten Wasson relishes her straight-forward manner of practicing. Since many federal health care reforms -- such as those requiring electronic medical records -- are tied to Medicare, they tend not to apply to her.

As she says, not having to deal with the insurance is a big time saver, allowing her more time to actually spend with patients, something that is becoming more important as even with more sophisticated medical technology at our beck and call, doctors still need to talk with patients and get to know them in order to do a better job diagnosing and treating them.

"Factory" medical clinics that so many of us go to are more like an assembly line, with doctors rushing about, seeing them for the minimum amount of time possible, before rushing out to see the next one. It isn't uncommon for some physicians to see as many as 40 patients in a day, meaning they can't possibly give the time and attention some patients need in order to be treated properly for their medical conditions. If you miss an appointment don't count on getting another one for months. I had to reschedule my annual physical due to a schedule conflict. That was three months ago and they still haven't been able to tell me when I'll be able to get another appointment. If I had to guess, it won't be until next year. And if I'm actually sick, they might be able to squeeze me in in two or three weeks.

Think I'm kidding?

After our return from a week's vacation in Florida two years ago, I came down with a bad case of bronchitis which swiftly turned into pneumonia. I called my doctor's office and they said they might be able to see me in week. It got so bad I ended up at our local hospital's ER. The physician there said I probably wouldn't have lasted long enough to see my own doctor. It took a lot of antibiotics and another week before I was well enough to return to work.

But if I had a doctor like Dr. Susan Rutten Wasson, chances are she would have come to my home, examined me, and written a prescription for what I needed, as well as make a follow up visit a couple of days later. I don't see anything like that happening under the present system or ObamaCare. Do you?

As if we need even more proof that the technology we first saw in the original Star Trek series is now becoming reality, there this: a hand-held medical scanner.

Can anyone say "medical tricorder"? Sure you can.

It looks like a cross between a flip-top phone and the medical scanner used by Dr McCoy in the TV series Star Trek.

The Vscan is not science fiction but a hand-held ultrasound machine with a scanning wand attached, which has been approved for use in Europe and North America.

It's getting closer all the time.

There's been a lot of media coverage over the past few weeks about air traffic controllers falling asleep on the job, specifically those working the so-called graveyard shift (approximately 11PM to 7AM). While the media coverage makes it seem as if this is a new problem, I have a feeling it's far more common than the FAA is willing to admit.

Working the midnight shift is tough. Not everyone can do it. It takes a certain amount of discipline to make it work. I know this from personal experience as I worked the graveyard shift for a number of years when I was employed in the defense industry.

The FAA had controllers working swing shifts, meaning their work schedules rotated so they worked all three shifts over a period of weeks or months. That's a formula for chronic fatigue, higher absenteeism, and higher accident rates. Put another way, it's a formula for disaster, particularly for such a critical job like air traffic control.

Instead, controllers should be working the same shift all the time. It makes it easier to adapt to the off hours.

When I worked graveyard shift you could always tell when someone new to the shift would make it or not. All you had to do was ask them when they slept. If the answer was anything other than "I go to sleep at the same time every day" you knew they wouldn't last long. That was the secret to surviving the graveyard shift: going to sleep at exactly the same time every day, followed only by making sure you got enough sleep. For me it was going to bed around 8:30 in the morning and waking up sometime between 3 and 4 in the afternoon. Some of my co-workers would bed down some time after noon and wake sometime during the early evening. It was different for all of us.

What the FAA has done is make it almost impossible to set a schedule that would allow their controllers to get enough sleep. Constantly changing shifts makes it impossible. Physiologists claim it takes approximately one day for every hour of time 'shift' in our wake/sleep cycles. That means if you go from a day shift to graveyard shift, it will take a little over a week to adjust to the new sleep time (assuming bed time is now sometime around 8 in the morning rather than midnight). If the shift changes every week, then you will never adjust to the changed hours and you will be tired all the time.

Even if the shift change is on a monthly basis, there will still be at least one week where everyone will be 'off' until they adjust. It plain doesn't work that well.

Maybe it's time for the FAA to change how they do things.

First it was McMansions. Now it's McVictims.

This crap is getting old. Call these folks what they are: self-indulgent fatties not willing to admit the reason they're fat is because they eat too damn much, eat the wrong things, and don't exercise. It's easier to blame someone/something else rather than take responsibility for their own actions.

But then that's been the way over the past 40 years or so - it's always somebody else's fault.

One of the many claims made in favor of ObamaCare is that it would mean a decrease in the workload at hospital emergency rooms as people seeking treatment would go to a regular doctor once they had health insurance. But if the situation in Massachusetts is any indication, that claim cannot be justified.

Just as Massachusetts' health care system has been the prototype for ObamaCare, it has also shown that many of the features included in ObamaCare won't work. The ER claim is but one of them.

A year ago at a town hall meeting on health care reform, he said, "We know that when somebody doesn't have health insurance, they're forced to get treatment at the ER, and all of us end up paying for it. ... You'd be better off subsidizing to make sure they were getting regular checkups." In late May, House Speaker Nancy Pelosi wrote in Roll Call that "the uninsured will get coverage, no longer left to the emergency room for medical care."

Now we know better.

It's not terribly surprising that real data from Massachusetts, which has had universal health coverage since 2006, show otherwise. From 2004 to 2008, ER visits in the Bay State rose by 9%, with no discernable improvement after 2006. Why? At least part of the reason has been the inability of patients to find primary care physicians for last-minute visits. Let's face it: The ER won't turn you away, but individual and overburdened doctors can and will. The Massachusetts Medical Society has reported that new patients wait for a primary care doctor visit up to two months.

Under ObamaCare we can expect exactly the same results nationwide because exactly the same problems exist in the rest of the nation as well. ObamaCare doesn't increase the number of hospitals, physicians, nurses, and other medical care staff. All it does is place an even greater burden upon them than doing nothing. That is no way to 'reform' health care.

What is occurring in California, where a quarter of the children HAVE NEVER BEEN TO THE DENTIST, notwithstanding the availability of free or subsidized health care indicates that the Russian proverb is true.


The racial differences are noteworthy. Whites and Asian parents seem to realize that going to the dentist is something that shouldn't be avoided. Hispanics and esp. blacks? Not so much.

Offering a panoply of health services at public expense to parents of below-normal intelligence means you need an army of social workers guiding them through the process, which can be cumbersome and confusing even to an MIT-trained engineer. All very expense and Rube Goldbergesque, too. I want to say un-American.

And the thing is self-defeating. As taxes go up while crime rates and educational performance deteriorate, middle class flight is accelerated as community organizers call for the whole thing to be ratcheted up.

It reminds me that infant mortality is not so much a function of income level but of the mother's intelligence, which helps guide her behavior. I think I learned from the great Thomas Sowell (or Walter Williams) that blacks have a higher infant mortality in California than recent Mexican immigrants, who are lower on the economic ladder.

It's largely behavior-based. And in a republic the gubmit isn't supposed to be paternalistic like Cass Sunstein, an Obama friend and official advisor, wants it. We're supposed to take care of ourselves.  But people are running away from freedom into security, which is a false fire.

At least when one looks at the results.

Last Monday going to a well check-up for my nine-year-old son I encountered a lengthy checklist since he hadn't been in for several years.

Most were what one would expect.

But the last question--this is not the first time I've encountered it before--drove me nuts. It asked Yes or No. Do you have a gun-free home? The implication was clear: Having firearms in the home is an unnecessary and dangerous condition for the health and well being of the children. "It's for the children!"

Since many more children die by drowning, and no question was asked whether I've taught or had the child taught how to swim, I simply crossed off the offending question and inserted one about this.

According the Centers for Disease Control twenty children were killed in 2004 while playing with guns of family or friends while 900 were killed by that dangerous element, water.

Bathtubs kill more children than accidental discharge of firearms!

I almost had my oldest in fact drown when someone irresponsibly used our private beach to launch a large boat and the keel created a nearly three-foot furrow in the sand. Hard to see under the water.

I was geared to have push back, but I received none. These forms are created by others, and it seemed as if the medical staff was relieved or understanding of my concern.

But when the herd and unprincipled soccer moms who are far more concerned about safety than liberty see this, you can kiss the Second Amendment good bye.

That's an inalienable right, the last time I read the Bill of Rights in the light of the Declaration of Independence. Please excuse me for being an alarmist, since the so-called right to health care would have been laughed at as recently as the early 1980s.

I didn't for my three sons, even though I am. I felt as though I didn't have the right to genitally mutilate them, severing up to fifty percent of their nerve endings.

Except for Jews and Muslims, the practice seems to be diminishing in the United States. Thank goodness for that. Even if I were a Jew, I'd still be against the practice even though it occupies a central tenet of that faith.

But with some Muslim groups female circumcision, which rightly makes normal people aghast, is sometimes practiced, esp. in northern Africa. But for both sexes the procedure is remarkably analogous...and should be considered equally repugnant. This was first explained to me by a medical doctor and doesn't, of course, include the especially disgusting removal of the clitoris. That's in a league by itself for cruelty.

Here's a recent Huffington Post entry on the subject.

I know Nancy Pelosi doesn't think much of the Constitution, seeing it as an obstruction to creating a truly socialist state much like that of the old Soviet Union, but even she must realize that certain portions of the ObamaCare/PelosiCare bill she rammed down the throats of the House are unconstitutional. Not that she'll let that stop her. After all "the people" must be coerced into doing things she and her fellow socialists have decided is for the good of all, even if it will have just the opposite effect.

Democrats' health bills depend on forcing individuals to buy insurance or face severe fines or imprisonment. In 1994, the Congressional Budget Office said forcing individuals to buy insurance would be "an unprecedented form of federal action," adding: "The government has never required people to buy any good or service as a condition of lawful residence in the United States."

This year, the Congressional Research Service delicately said "it is a novel issue whether Congress may use the (Commerce) Clause to require an individual to purchase a good or service." Congress has the constitutional power to "regulate commerce ... among the several states." But a Federalist Society study by Peter Urbanowicz and Dennis Smith judges it perverse to exercise coercion under the Commerce Clause "on an individual who chooses not to undertake a commercial transaction." As Sen. Orrin Hatch, R-Utah, says, there is "a fundamental difference between regulating activities in which individuals choose to engage" -- e.g, drivers can be required to buy auto insurance -- "and requiring such activities" just because an individual exists.

When asked whether any compulsory insurance purchases are constitutional, Speaker Nancy Pelosi was genuinely astonished: "Are you serious? Are you serious?" In 1803, in Marbury v. Madison, Chief Justice John Marshall wrote, "The powers of the legislature are defined and limited; and that those limits may not be mistaken, or forgotten, the Constitution is written." He was serious.

Nancy's reaction to the question illustrates either her ignorance of what the Constitution actually says or her willful choice to ignore it in favor of her own agenda and the American people's rights be damned.

Should the awful and onerous ObamaCare/PelosiCare bill become law I hope it will be challenged on constitutional grounds and struck down for being overreaching and in violation of the Constitution. But we can't count on such a thing happening. Therefore we must strive to let our Senators know how displeased we are with this legislation because we know its a disingenuous attempt to do an end run around the people's wishes, a flagrant attempt to violate the Constitution, and a blueprint for medical and financial disaster.

Here's yet another story about how great ObamaCare/PelosiCare will be for the average American:


Some may say that this example and the one I posted yesterday are atypical of what occurs under Canada's socialized medical care system. But I know far too many friends north of the border that tell me it is all too typical. I've heard the same thing from friends in the UK about the NHS as well.

(H/T Instapundit)

If you want a preview of what ObamaCare/PelosiCare is going to be like, take a look at this:


The only problem we'll have is that we'll have no place to go to get the care we want, unlike our Canadian brethren do now. Hmm, maybe some of the more enterprising physicians in the US will move their practices offshore to one of the Caribbean islands in order to give the care we Americans will soon be deprived of by the oh-so-caring US Government.

(H/T Instapundit)

They are going the way of the Walkman. So what are the feds going to do after they expand coverage and stiff doctors on pay even more broadly than they have with Medicare?

The shortage is likely to only get worse as pay goes down and paperwork is stacked higher. I have no confidence in Washington. I wish the Ninth and Tenth Amendments to the Bill of Rights still had some force.  As this commentator over at Lucianne's writes:

Under what Constitutional authority do these people act? Where is it written that some bureaucrat can tell you when and where you may obtain medical care, and refuse to allow you to purchase what you wish, even WITH your own money?

When asked (rarely), they just stare like a deer in the headlights.

I hope we don't mind waiting in long lines--and that even if we have an unscheduled emergency. I feel as though the FedEx medical delivery system we have--warts and all--is going to be ruined, turned into the medical equivalent of the DMV/Postal Service. Greater costs with less service. Fewer innovations. What a shame.

I find it interesting that with all the noise I've been hearing from the Democrats and the rest of the Left about health care reform, not once have I heard any of them mention that we should see about raising the level and quality of medical care, not pulling it down to the lowest common denominator. They like to point to Europe as an example of how it should be done, but all I ever see (and read in a number of publications and medical journals), is how the quality and quantity of care has gone down. But shouldn't we be seeing them trying to catch up to us rather than we trying to pull ourselves down to their level?

The next time you see one of these oh, so morally concerned politicians, academics or book-hustling authors preaching on TV that we really ought to catch up with the rest of the advanced world on health care, talk back to the to the set, shout out that it's mostly lies, and make the opposite case.

The rest of the world ought to catch up with us.

Despite what almost seems a conscious effort to keep the facts properly subdued and tucked out of sight, the truth has been worming its way to the sunshine. Now it's clear, as one example, that longevity is only partially connected to health care in the first place and that when you subtract homicides and accidents, we in America live longer than anyone, despite President Obama's constant reiteration of the reform-encouraging and utterly deceptive thesis that we do not.

We know that our treatments of serious disease produce better outcomes than elsewhere in the world, that everyone can get treatment at least in emergency rooms, that most Americans are satisfied with their care, that insurance net profits are a relatively low 3.3 percent and that the actual number of citizens without access to insurance is closer to 10 million than the 46 million number so often heard. We also know that Medicare and Medicaid have accumulated trillions of dollars in obligations to future recipients that we have no way of paying.

But let us not confuse the issue with anything as mundane as facts. Instead, let us cast all caution into the wind and base the destruction of the American health care system on feelings, something which the Left is very good at doing. They feel it's unfair that not everyone can get the same level of health care, therefore something must be done to ensure egalitarian treatment, even if it means tearing down an effective, though flawed system, and replacing it with something that will come to resemble those like the UK's National Health System, which provides poor care at best. Let us make sure that the incentives to treat ill health will be destroyed and replaced with an "I don't give a s**t, where's my paycheck?" attitude. Let's make sure that all the truly dedicated and effective physicians, nurses, and other health care professionals are driven out of their careers by an ineffective, heartless, compassionless bureaucracy, and let them be replaced with people we wouldn't care to have take care of our pets, let alone our loved ones. (You think it won't happen? Then take a look in countries where many of the truly gifted health care professions went after their governments 'saved' health care. Or better yet, look at how many medical practices no longer take Medicare or Medicaid because of the exorbitant costs of providing care versus what they are paid for said care. It's a losing proposition.)

Health care 'reform' is something that must be handled carefully, with logic, reason, and in the end, an eye on the economics of reform. It must not be based on emotion or some fantasy egalitarian 'ideal' that can never be achieved unless countless millions are made to suffer because the government says they must, all in the name of equality.

While there is agreement amongst most parties that health care reform is something needed, it is the difference in approach that divides the nation (and more specifically, Congress).

Being the frugal Yankee that I am, I am all for making sure any reforms are sustainable, actually save money, and require no use of tax dollars to support. Is such a thing possible? I believe so, and I'm not the only one. Unfortunately far too many members of Congress and their 'supporters' believe the only answer is government control (and funding) of any and all reform. The only problem with that viewpoint is that it entirely overlooks the economics of such a system, to the peril of us all (and our wallets).

Peter Angerhofer in the September 6th Sunday Citizen (Laconia, NH) reminds us, again, that health care reform can't defy economics. (Sorry, no link available)

[I]f the current governmental health care reforms attempt to subvert basic economic laws, they are, at best, bound for failure; at worst, they could destroy the quality of care that most Americans enjoy.

While the problems of rising costs should be obvious for all to see, the president and his allies have proposed solutions that ignore the fundamental economic laws of supply and demand. I f we are to provide better access to health care, we need to recognize these basic laws and reduce prices by either reducing demand, increasing supply, or both.

The President and the leftists in Congress are basing their health care reform on the mistaken premise that the supply of health care is finite, that it is static and that it won't change. And because of that false premise, they'll try to force a drop in demand for health care as the means of reducing the costs. The only means of reducing demand is to ration care, to deny care, to decide who will and who won't be treated, who will live and who will die.

But the supply is not finite except at the present moment. Tomorrow there could be more. The day after there could be less. It is fluid. But should the government 'take over' health care, the finite supply will not expand. It will not be static. Instead, it will shrink.

How do I know that? History.

All one needs to do is look at every country that has instituted government provided/controlled health care. In every single case the quantity and quality of health care declined. In a few there were minor changes, mostly because the quality of health care wasn't all that great to begin with. In most others the decline was dramatic. Is that what we, the American people, really want to do here?

Of course not. But the Obama Administration and the leftists in Congress do. That desire has nothing to do with actually providing health care. Instead it's about control. They truly believe they know what's good for you better than you do. They believe they are the only ones that can possibly make the right decisions for you because you are incapable of making them for yourselves, that you're not smart enough. Only the government is wise enough to make those decisions. Of course we've seen the dystopian results of that before and we know we don't want to go down that path.

Should Congressional leftists ignore the economics of their health care reform bills, reform won't work. The burden placed upon the economy and the taxpayers will be too great. It will require the infusion of billions, if not trillions to ensure mediocre health care, increased morbidity, and increased suffering. A once great, though imperfect, health care system will have been reduced to a shadow of its former self. And the leftists will congratulate themselves for succeeding in pulling of the greatest swindle since Bernie Madoff.

One thing far too many people promoting national health care reform have overlooked has been the actual economics of the main proposal (HR3200). In their minds the numbers will come into alignment if we all just wish hard enough and keep our fingers crossed. But taking a look at the economics with a (hopefully) dispassionate eye reveals some disturbing issues that have been ignored, either by design or through ignorance. (I, being the kind of guy I am, am willing to give the proponents the benefit of doubt and assume it's from ignorance.)

Whenever government gets involved, and particularly the federal government, costs go up. It is inevitable. Our own history has shown again and again that is the case. Why does anyone doubt that it will happen again if government takes a broader role in health care? All anyone needs to do is look at what's been happening in Massachusetts, where their preview of nationwide health care reform has done nothing but increased costs and wait times. Can anyone say that won't happen across the board if Obama gets his way?

So before there's any progress on such reform, proponents cannot defy the economics of that reform and what it really means. Too many parts of the most well known health care reform bill - the aforementioned HR3200 - ignore the economic impacts, which in turn will lead to the failure of the reform measure while at the same time damaging or destroying the existing medical care infrastructure. That's no way to 'fix' the problem.

A few 'lowlights' of what we can look forward to if HR3200 should pass:

Massachusetts reduced its uninsured population by two-thirds -- yet the cost would be considered staggering, had state officials not done such a good job of hiding it. Finally, Massachusetts shows where "ObamaCare" would ultimately lead: Officials are already laying the groundwork for government rationing.

The most sweeping provision in the Massachusetts reforms -- and the legislation before Congress -- is an "individual mandate" that makes health insurance compulsory. Massachusetts shows that such a mandate would oust millions from their low-cost health plans and force them to pay higher premiums.

The necessity of specifying what satisfies the mandate gives politicians enormous power to dictate the content of every American's health plan -- a power that health care providers inevitably capture and use to increase the required level of insurance.

--snip--

Those requirements can increase premiums by 14 percent or more. Officials further increased premiums by imposing new limits on cost-sharing.

Over time, as mandates eliminate low-cost options and price controls eliminate comprehensive options, both the Massachusetts and Obama reforms will march consumers into a narrow range of health plans.

As goes choice, so goes quality. Statistics on waiting times for specialist care in Massachusetts read like a dispatch from Canada. In 2004, Boston already had the longest waits among metropolitan areas. By 2009, waits had generally shortened in other metro areas (average wait: less than three weeks) but lengthened in Boston (average wait: seven weeks), according to the Merritt Hawkins survey.

Some may argue that the national version of this program won't suffer from the problems seen in Massachusetts, but anyone with even a little knowledge of history will understand that the problems with a national program will be far worse. In the end it will benefit no one but the government. Disincentives for health care workers will make sure the quality and quantity of health care available will fall, particularly after the more gifted and dedicated workers are finally driven out by frustration and stress. It's already started in Massachusetts and has been an ongoing problem in the UK.

One does not promote better health care by penalizing those giving exceptional care. But that's exactly what this latest version of socialized medicine will do.

I always thought the way to ensure more 'equality' when it came to any issue, be it economic, political, or medical, was to raise everyone up to a higher level, not pull everyone down to the lowest common denominator. That's what health care reform as proposed will do, making sure no one but the most wealthy (and members of the ruling elite) will receive exceptional care. The rest of us will be left with an ever declining quality and quantity of health care because reform made it inevitable that it would be so.

If nothing else such a move should be considered criminal because it looks like just what it is: racketeering. And we must remember racketeering has a long, fruitful history in Chicago.

Another problem with health care reform is that viable, workable plans are being ignored. It could be because the plans are being proposed by people other than those belonging to the 'right' party. Never mind that they might actually work as compared to ObamaCare.

One would thing the Democrats would pay attention to some of those plans, particularly those put forth by knowledgeable health care professionals, like Dr. Arthur M. Feldman:

As a cardiologist and the administrator of a large practice that includes general internists and specialists, I spend much of my time trying to figure out how to provide care for a growing number of uninsured or underinsured patients. I also have to battle billion-dollar private insurance companies that don't adequately cover patients with preexisting illnesses and often deny coverage for necessary treatments.

On a basic level, I'm with the president: Our health-care system needs to be changed so that all of my patients, and all citizens, have access to the care they need. But I don't agree with how he wants to fix things. Most of my colleagues and I strongly oppose the health-care reform bills that Congress will take up again this week. The proposals leave enormous gaps unfilled.

Before President Obama addresses a joint session of Congress on Wednesday, I hope he will consider these 10 major reasons why I -- and doctors like me -- worry that the legislation on the table will leave us worse off.

1.Private insurance companies escape real regulation.
2.We urgently need tort reform, but it's nowhere to be seen.
3."Prevention" won't magically make costs go down.
4.Reform efforts don't address our critical shortage of health-care workers.
5.We need more primary-care physicians -- but we also need specialists.
6.We have to streamline drug development and shake up the Food and Drug Administration.
7.We can't fund health-care reform by cutting payments to doctors.
8.We can't forget about research.
9.Cutting reimbursements could shut some hospitals down.
10.We need to improve the quality of care.

Each of Dr. Feldman's points bear looking into. (In his article linked above, each of his ten points are explained in detail.) Failure to address these issues will cause health care reform to be a dismal failure, creating both medical and economic chaos. Of course, I always thought health care reform was supposed to make things better, not worse. But if Congress does not abandon its ill-advised course of action in this regard, we will all be worse off for no other reason than they made it be that way.

More to follow in Part II.....

As if we need yet another example of a failed "public option" plan, there comes this one from Maine.

Want a preview of ObamaCare in action? Sneak a look at what has happened in Maine. In 2003, the state to great fanfare enacted its own version of universal health care. Democratic Governor John Baldacci signed the plan into law with a bevy of familiar promises. By 2009, it would cover all of Maine's approximately 128,000 uninsured citizens. System-wide controls on hospital and physician costs would hold down insurance premiums. There would be no tax increases. The program was going to provide insurance for everyone and save businesses and patients money at the same time.

After five years, fiscal realities as brutal as the waves that crash along Maine's famous coastline have hit the insurance plan. The system that was supposed to save money has cost taxpayers $155 million and is still rising.

It only took five years to show taxpayers the public option doesn't work, costs far more than governor and the Democrat majority legislature promised, and is in deep trouble, requiring an increasing amount of scarce tax dollars to support.

Many of the same arguments used to promote Maine's DirigoCare are being used to promote ObamaCare. As far as I can tell the differences in the economics of the programs are small other than the size of the programs, which means the shortfalls experienced by ObamaCare will likely be proportionately larger than the deficit being experienced by Maine. The Congressional Budget Office has already come right out and said Congress and President have seriously underestimated the cost of implementing and running ObamaCare. That members of Congress haven't learned the lessons of TennCare, MassCare, and DirigoCare is disturbing. What's insane is that these same members of Congress want to do the same thing on a national scale, ignoring that they are likely to end up with exactly the same result as the other programs - less care, higher costs, scarce medical resources, and an ever increasing amount of taxpayer dollars to fix the problem of their own making.

One thing I hear again and again during the health care reform debate is how Obamacare will ration health care. Proponents of Obamacare counter that opinion with a claim health care is already rationed by the insurance companies. I think it's time to clear up that canard.

First, government-provided and controlled health care is always rationed. That's how they save money on health care costs.

Second, insurance companies do not provide health care, they merely pay for their policy holder's medical claims. Coverage depends upon the health insurance policy. They are not obligated to pay for treatments or procedures not covered by the policy. But the patient still has the option to undergo the treatment or procedure on their own dime. They are not denied care by the insurance company.

Another misdirection used by the Obamacare proponents is that the free market has failed in regards to health care costs. The only problem with that claim is that the free market has little to do with health care costs because for the most part it hasn't been a free market for over 40 years. Both the states and the federal government skew free market signals with regulations and mandates, which makes them totally useless for setting the market value of various medical services. The prices are, in effect, set by the government, state and/or federal and not by the medical practices or the insurance companies.

The only exceptions to this are those medical practices that do not take insurance. They are the only free market health care practices operating in the US, be they small single physician family practices or certain medical specialties (like plastic surgery and LASIK). Their costs are known, under their control, and their costs are far smaller than the health care industry in general.

That ought to tell us something.