Copy of OpEd comments to the Emergency Physicians Monthly

My Dear Medical Care Professionals,

I am pleased to have the opportunity to present my concerns to you.  Have you ever been drawn into a fight that you did not start, but once in, you realized that the fight was worth your effort?  The more you fought, the more you realized that you needed to win?  I answered a cry for help and in my research I discovered a scenario that if allowed to continue unimpeded would eventually lead to the destruction of one of Americas finest achievements.  This achievement in my estimate is our current model and practice of medicine in the U.S.

The emphasized attention by the current administration to change our model from an indemnified fee for service healthcare system to a socialized system of healthcare, if implemented, will degrade the quality of care.  In my estimation, the majority of the U.S. citizens have no interest or desire in this degradation of heath care.  At least I do not. Senator Clinton’s attempt to introduce socialized health care under her husband’s administration while done in stealth did reveal a strong objection to this proposition.

With the current system, I have built the greatest trust with my health professionals.  If I did not have this level of trust, I would freely find a professional with which I did.  This is my current prerogative and privilege.  I could do this without any delay.  I do not have any reason or evidence to believe that a socialized health care system would deliver this same comfort and quality.  All current socialized health care systems cannot match this expediency.  Their measured delays and limitations are not acceptable.

So who’s interest is it to transform our system into a socialized system of health care and why?  Who and why is important, because only then, can objective debate commence with credible ownership.  OK, Sen. Clinton and President Obama want socialized medicine.  Uninsured citizens want socialized medicine, yes/no?  I say no, they just want medical care in any form.  Undocumented non-residents want socialized medicine, yes/no?  Again, I say no, but yes to medical care in any form.  This can be qualified with documentation by our emergency room statistics.  I could go on, but you can all see the pattern that will develop.  This is the core, all want medical care.  This is a reasonable and compelling request, but the feasibility impact has consequences upon quality of care.

I will not go into theories of the economics of a limited resource.  I will only state the obvious, when all are entitled (have rights) to a limited resource, the end result is an equal portion (ration).  The type of proportion (covered services), along with the qualification for services (age limits, co-morbidities, cellular and genetic profile, etc.), reimbursement and interval are all dictated in the standard operating procedures (SOP), rules, regulations, and treatment protocol.  I beg you to pause and clearly formulate what is at stake here?  In my estimate, what is at stake is the clear attempt to rule with domination over the only true autonomous profession, you the physician practitioner.  Why?  The motivations could vary widely.  Regrettably, the need for power for the sake of power itself is also part of this equation.  I recently wrote this to a close friend of mine, “I play and live by the rules out of courtesy, but I have noticed how many do not.”

We can only estimate the success or failure of this proposed paradigm shift to socialized medicine with results from other nations and special controlled environments domestically that emulate social order.  The results do not warrant the intrusion and in certain cases cause alarm against such proposition.  Herein lays the immediate danger, with Governor Kathleen Sebelius the nominee for confirmation as the Secretary of the Department of Health and Human Services, her documented results and outcome with socialized medicine are accumulating gross evidence of being deplorable and inhuman.  Her model and executive responsibility contain all the elements, attributes, and parameters to draw correlation with which we can extract her predictability as the chief executive of the nation in all matters related to the health and welfare of the whole United States of America, as nominee for HHS Secretary.  This model presents reflecting outcomes due to its low public visibility, thus limiting coloration due to the Hawthorne effect.  Gives notice of her true concern for a vulnerable population subset versus her measured public persona.  Contains elements of the distribution of limited resource, rationing, governance, oversight protocol, 100% population coverage, treatment protocol, and quality of care that are all attributes of socialized medicine.  Her socialized medicine model of which she is the chief executive is the Kansas Department of Correction system of health care services provided to its population.  All I can say, if you are unfortunate to cause yourself entry into this system of socialized medicine under Governor Sebelius, don’t get sick.  To get sick may change your 24 month sentence into the Death Penalty.

Furthermore, try to fight her inhumanity and you may find that she has close allies in the federal courts that see no need to recuse.  Judges name look similar to the governors? https://ecf.ksd.uscourts.gov/cgi-bin/show_public_doc?2003cv3451-111 .  Conflict of interest rules does not extend to the Sebelius family, they appear above the law.  A quick web search of the many instances of medically documented court proceedings for instances of torture, pain, and suffering under her socialized medicine system demonstrate the poor quality of care (Google: CORRECT CARE SOLUTIONS complaints).  It also demonstrates her ability to not be subject to oversight on the grounds of technicalities.  As I write, I am beginning to understand the motivation and reasoning by Gov. Sebelius to transfer certain inmates to certain correctional facilities within certain Federal Jurisdiction, clever.  A statistical study may prove a high correlation with the transfer of inmates who have filled suite for medical care claims into particular Federal Jurisdiction Districts due to the high probability for dismissal by certain judges.  This if demonstrated, does offer direct evidence of intent and collaboration.  For more detail see:  www.iscientiausa.com  She does not deserve the honor of HHS, it is a mockery and dangerous.

My friends, I may not be the first to bear you bad news, but I do believe you must take a stand.  You have earned you place in society by talent, hard work, and dedication.  This along with a love to serve mankind has enabled you the ability to practice you profession in an autonomous fashion.  I want to thank you for your service.  I also want to pledge, you have my support and I will join the fight, but this fight must be led by you.  I have confidence that your dedication and intellect will enable you to win the battle.  But let us be clear, the opposition is motivated and with one party controlling the majority in both houses and the Office of the President on there side, they are a clear and present danger to our freedom and our medical system.  Remember, it is better to fight; win or die on your feet in the name of freedom, than it is to die on your knees in tyranny.  Resolve to fight!

Sincerely,

The Shape of Things to Come in our New System of Socialized Medicine?

The Economics of Medical Care

We have all heard about the alleged poor treatment and torture of detainees at Guantanamo Bay under the Bush administration.  As a civil society we deplore such atrocities committed by a government against a population that is subject and vulnerable to abuse by its captors.  This is a national shame, we as a nation should never stoop to such low levels of tyranny.  It is easy for a government in power to abuse its prison population and reflect any criticism because after all, these are criminals and deserve what they get.  Eyes turn blind; ears go deaf when cries of torture sound from enemy criminals of the State.

Yet as a society we reward the perpetuators of these atrocities as heroic and demonstrating the finest quality of leadership.  Why is that?  Why do we allow leaders to continue perpetual policy that is filled with continuing instances of abuse of the lesser voice?  Could it be that this is our way of rationing goods and services that are limited?  Think about it?

As we all know by experience, health care can be costly and the debate now; is health care a right or, is it a privilege for those who have attained coverage.  With the current emphasis on social medicine by the Obama administration, the quality of care will become an issue directly tied to the distribution of a limited resource.  Let us say, our current one party controlled Congress does intact socialized medicine, it will still come down to who get what and who does not and for what reason if any.

What will the government approved treatment list treat and what will it not and what level of accountability will the government apply to itself?  Can you image the horrendous conditions and treatment the detainees receive for medical treatment at GITMO under George Bush?  After all, they are enemies of the state and the state must control cost.  So, why not build and approve treatment protocols that maximize cost reduction by a system that dictates high rates of denial.  Who are the criminals going to tell, the warden?

Unfortunately, this is exactly what is occurring at these facilities.  Save money for the state by having a system that denies costly treatment for any reason.  These criminal deserve what they get.  Get a heart attack, take an aspirin.  Get cancer, take an aspirin.  Get Hepatitis C, take an aspirin.  Saves money for the state and it is in the protocol, so it is justified.

The newly sentence detainees will think twice about committing a crime.  Steal something and you are sentenced to 18 months time, but if you get sick, the system can then change your sentence to the death penalty.  They can, will, and have done this all under the cover of “it was part of the approved written protocol”, next.

America, hold your head in shame for allowing this type of leadership to be rewarded.  How can you allow this and why are you rewarding Governor Kathleen Sebelius to lead the nation in all matters related to the health and welfare of the whole United States of America?  Under her leadership she has allowed these atrocities against the incarcerated inmates of the Kansas Department of Corrections.  Is this the shape of the socialized medicine President Obama promised us?  Maybe it was, we heard the message, but we did not listen.

Prove me wrong and I will accept the responsibility of my error.  It is better that I am wrong in my assessment, than to be right and allow the perpetuation of terror at the hands of the Governor of Kansas against the most venerable, and who are also human.

Iudicium Scientia

http://www.defenselink.mil/news/newsarticle.aspx?id=25852

Note: see related letter directly below

 April 5, 2009

Deputy Secretary Haden

Programs, Research and Support Services

Topeka, KS 66612-1590

Dear Deputy Secretary Haden,

Thank you for the information dated April 2, 2009, subject Mr. Troy Green, Inmate #86994, State of Kansas, Department of Corrections.  I have waited for your response as a courtesy before engaging any further.  I am now in the process of disseminating the information received.  Please send me a current copy of the State of Kansas Standard Operating Procedures (SOP), rules, regulations, and treatment protocol for the treatment and care of inmates with Hepatitis C (Freedom of Information Act) as administered by your Medical Contract Consultant (CORRECT CARE SOLUTIONS LLC, Nashville, TN and Topeka, KS).  I am also requesting a copy of the same SOP and Treatment Protocol as on record April 05, 2008.  The purpose of this request is for a comparative study with the National Institute of Health (NIH) Chronic Hepatitis C: Current Disease Management available for the public domain at: http://digestive.niddk.nih.gov/ddiseases/pubs/chronichepc/index.htm#g and that of the

Department of Health and Human Services, Centers for Disease Control and Prevention available for the public domain at: http://www.cdc.gov/hepatitis/HCV.htm In addition, I have made a similar request for SOP and Treatment Protocol from the United States Department of Homeland Security, Guantánamo Bay Detention Camp, for the treatment and care of detainees with Hepatitis C (Freedom of Information Act) held as "enemy combatants" as classified by the United States Government, President George Bush Administration.

These documents will provide me the data necessary to do a comparative analysis and describe the parameters of care as indicated by algorithmic flow charting of treatment protocol.  This document will then serve as a parameter baseline upon which the administered medical treatment of Mr. Troy Green as indicated through his actual medical records can be overlay in specific chronological order.  The results will enable qualified subject matter experts to determine which policy and administration correlates toward the best practice and also, which policy and administration indicates methodologies, procedures, and practice outside acceptable indications if any.  If so determined that Standard Operating Procedures (SOP), rules, regulations, and treatment protocol for the treatment and care of inmates with Hepatitis C as administered by your Medical Contract Consultant CORRECT CARE SOLUTIONS LLC, Nashville, TN and Topeka, KS is an outlier of normal practice, then this gives rise and concern to all citizens of Kansas.  If the facts prove in support of medical practice and procedures outside the norm, then we must immediately uncover why, the motivational factors, and give ownership to the responsible person or parties.  Further, if upon research, a pattern indicates a strong correlation to support systemic practice of substandard medical treatment, we should move to alleviate this inhumanity.  A quick, unscientific query of complaints and legal proceedings in the World Wide Web retrieves circumstantial documentation that if qualified may prove binding.  While the outcome within a majority of the proceedings reveal disqualification on the grounds of technical merit; a Meta analysis may reveal highly correlated medical practice patterns that prove detrimental and punitive to one of our most venerable segments of our society. Thus further creating a cause for all who have been injured or whose injuries exacerbated suffering, pain, and or death could then join together in their claims to seek relief.

As example;

STEVEN RAY THOMAS,  Plaintiff - Appellant, v. LOUIS E. BRUCE, Warden, Hutchinson Correctional Facility; ROGER WERHOLTZ, Secretary of Corrections; DENNIS GOFF, Nurse Practitioner; JANET MYERS, Registered Nurse; DEBRA LUNDRY, Nurse; NEAL R. BROCKBANK, Contracting Physician; CORRECT CARE SOLUTIONS; KANSAS DEPARTMENT OF CORRECTIONS; STATE OF KANSAS; HUTCHINSON CORRECTIONAL FACILITY, Defendants - Appellees.  http://www.ca10.uscourts.gov/opinions/04/04-3368.pdf 

The Deputy Secretary, Roger Haden has recommended in this communication with me that no further administrative action is necessary at this time.  This letter was sent to me with copies also sent to Kathleen Sebelius, Governor of the State of Kansas, Owen Donahue, Representative, State of Kansas, Roger Werholtz, Secretary of Corrections, and Paul Feliciano, Chairmen, Kansas Parole Board.  I will assume that if this recommendation is accepted it will be in full knowledge and acceptance by the State of Kansas’s top elected official Governor Kathleen Sebelius.  I acknowledge your recommendation and the ultimate responsibility of your recommendation concurrence by the Governor unless specifically rebutted with a retraction of Governor Sebelius specific knowledge on this specific matter.

At balance, and in light of the evidence offered by the State, I have a preliminary fear that the treatment given to Mr. Troy Green is substandard and a direct result of action or inaction by the State of Kansas and it’s contractor CORRECT CARE SOLUTIONS LLC.  This action puts at risk the well being and life expectancy of Mr. Troy Green, Inmate #86994, State of Kansas, and Department of Corrections.  With this letter, let it be know that I and all citizens of the State of Kansas do hold responsible for injury, pain, life expectancy, and God fear death of Mr. Troy Green;  Kathleen Sebelius, Governor of the State of Kansas, Roger Werholtz, Secretary of Corrections, and Roger Haden, Deputy Secretary, Programs, Research and Support Services.

At balance is a human being who is paying back through the serving of his sentences his debt to society.  To knowingly add injury and suffering to his debt is punitive and outside the jurisdiction of his caretaker the State of Kansas.  Unique to this real time tragedy is the fact that Governor Kathleen Sebelius is currently in consideration to lead the nation in all matters related to the health and welfare of the whole United States of America, as nominee for confirmation as the Secretary of the Department of Health and Human Services her actions and policy are a matter of our concern and scrutiny.  My conscience leads me to bring fully to the surface the revelation of my objection in the matters of health administration and treatment of our most venerable segment of our society under Governor Sebelius administration.  I will make my objections to her confirmation immediately to President Barack Obama and the confirmation hearing members in both the House and Senate along with publication of my concern at the web sight www.iscientiausa.com , the Associated Press, and other outlets.  I may be in error and it may be that Governor Sebelius does in fact agree with me that the possibility of malaise does indeed exist and she opposes this punitive sentencing.  In that case, as I have agreed to error on the human side, so should she.  To not do so otherwise, is without question cruel and unusual punishment of Mr. Troy Green and possibly many other patient inmates.  The nation called for a halt in the torture of the detainees at Guantánamo Bay Detention Camp, I now call upon the leadership of Governor Kathleen Sebelius to stop the torment of inmates within the Kansas Department of Corrections.

GIVE Act (HR 1388/S 277) - Eagles Concert  -  Homeless

May I share an experience with you?  Yesterday my wife and I attended the Eagles concert at the Sprint Center.  The tickets were given to us by a friend of ours and they were above average seats.  At $179.00 apiece along with a covered parking pass, you would expect them to be good seats.  I was not planning on going to the concert.  In fact, I was not even aware that the Eagles were even playing in Kansas City until Thursday evening when she told me about the gift.  It has been awhile since I have attended a concert with performers of this caliber and genre.  I wasn’t excited about going to a concert, but neither was I dampened by the prospect.  I would describe it as neutral but yet obligated in light of the fact that our friend had endowed this substantial package to us.

I was OK with just staying at home and watching the NCAA basketball games while working on the computer and avoiding travel in the mixture of rain, ice, and snow that hit the Midwest this weekend.  I just don’t like the cold and it was cold outside.  I didn’t care too much with the fact that the weather was not playing by the official Kansas City rules.  According to local tradition and culture, winter unofficially starts on Halloween and unofficially ends on St. Patrick’s Day.  Your body and mind go into a mini strike when these weather events occur outside the traditional parameters.  Late winter eruptions are analogous to a technical foul in basketball.  Luckily, the venue presented enough intrigue to overcome my objections.

So we are off to the Eagle Concert for Assisted Living, allowing ourselves plenty of time to travel downtown the Interstate 15 miles away at 15 miles an hour if need be.  We found our parking garage which was only 3 block away from the Sprint Center and proceeded down the elevator to the street level.  We along with others got off the elevator and proceeded to the sidewalk.  As we exited I also noticed an unassuming shadow.  A person, I assumed a homeless person was sitting in the corner of the stairwell hunched over with a thin felt cover over him.  He was trying his best to stay warm and rest on this frigid night.  We started our trek through the slushy snow.  We got within one block of the Sprint Center and I could go no further.  I apologized to my wife and informed her that I could go no further and had to go back to the homeless person.  She asked what person?  I told her I saw a homeless person with only a thin cover and I needed to give him my coat.  She asked me if I had another coat in the car.  I told her no, just the coat I was wearing, but I didn’t need it.  I could always wear another coat or buy another coat.  This person needed a coat tonight in order to survive the cold. She did not object and we turned back.

Approaching the person I removed my coat and gently announced my presence and asked the person if they would please accept my coat?  To my surprise a women’s voice came out of the opening in the thin cover and refused my offer.  I insisted that she accept my offer, but again she refused.  Not sure if she was just too proud to accept my coat, I tried to explain to her that I didn’t need the coat and would be grateful if she would accept it.  With authority and an intonation in her voice, she replied to me that she would not accept it and she would be fine.  At that, I respected her wishes and walked away.  I was perplexed that she would choose to reject my offer of a warm coat that would have offered additional shelter from the cold.  I didn’t fully understand her reason to refuse.  It saddened me to know that she would choose to be cold and I had failed in my attempt to comfort her.  We found our seats in the arena and they were very good seats.  Comically, the members of the Eagles did indeed look very old.  Pleasantly, they could still sing with sweet voices and play their instruments with precision and cadence.  It took me awhile to loosen my thoughts and feelings about that homeless person.  The encounter with the homeless person caused me to challenge the opulence of such an expensive venue.  The tickets were a gift, but at $179.00 per ticket, even if I was a billionaire that would still strike me as excessive.  The performance was pleasant and offered some consolation to my feelings.  The meaning and lesson from the experience was not as clear, but I remained faithful that it was significant.

The next day, toward the evening, my wife shared her concern with me about legislation passed by the U.S. House and Senate called the "The GIVE Act" (HR 1388/S 277).  This legislation would make it mandatory for all children to be conscripted into compulsory community service.  Mandatory community service for children sounded bizarre to me.  The legislation rang with undertones of Hitler’s mandatory participation of children in the Nazi Youth Groups.  I said to myself, timeout and begged that we remind ourselves about that word and concept we call freedom.  Someone, some person, some government is going to force my children into community service or whatever to teach them what and do what and for whom?  Did I miss something, did my 8 and 10 year old commit a crime and were ordered into community service as part of their sentence?  Not so fast.  Did they put LSD in the Washington D.C. municipal water system?

Now, I am begging to understand the meaning and lesson from the experience with the homeless person from yesterday.  Its significance now makes sense.  Why in the world would someone choose to remain cold and in sub-freezing temperature when they could have easily accepted the opportunity to avoid this circumstance?  Was this homeless person mentally ill, maybe, but sub-freezing cold is still lethal and attempted suicide by freezing to death is not very plausible to me?  Who was this homeless person and why did she choose to be cold?  All I know is this, it was her freedom to say no and I did not have any further right or authority to impose my will on her no matter how noble I thought my cause was.

Now onto the subject of the GIVE ACT, these are our children and my wife and I are their legal guardians.  Being a free person and citizen of the United States of America, I am here to inform any and all people, whether elected to Congress, the Senate, and or the President of the United States, under no uncertain terms, will you force my children into your service for what ever cause no matter how noble or mundane your stated purpose is.  The lesson prescribed from the homeless angel was this; it is your free will to refuse the tyranny of the GIVE Act.  So to all authors of the GIVE Act let me please inform you with the most charitable of response required by me as a Christian.  If you think you are going to force my children into a required concentration of service, you are mistaken and you can kiss my ass if you think otherwise.

Partial List the bailout must have, else let the market correct itself.

Note: this list was originally composed on Sept 23, 2008.  This list was sent to all of my elected representatives in the US House and
Senate, Minority and Majority Leaders, Finance Committee Chairman, and both then Presidential candidates Barack Obama and John McCain.  This list made sense then and even more sense today.  Our elected leaders just don’t get it.  They seem to want to follow an ideologue over solutions that address the root cause.  A sickness onto death. 

Participants of bailout forfeit all related Credit Default Swap CDS claims

Sellers of underfunded CDS will refund premiums or face criminal fraud.

Participants of bailout will only receive open market auction proceeds to be no less than 50% book value.  Upon surrender of real-estate, participant will receive 40% book value and remainder at closing.

Distressed Home buyer of record will have the right of first refusal to match auction rate plus 5% to be re-financed by Federal Bailout holding company at a rate proportional to accurate Standardized means test.  If distressed Home buyer of record does not qualify for assets based on Standardized means test, then they will not qualify.

Upon closing, participants will redeem all Collateralized Debt Obligation (CDO) at a rate proportional to the recovered value ratio (market sale proceeds to book value).

Upon fulfilling CDO obligations at bailout participating rate, all CDO are closed and become extinct instruments.

Mandate Standardized default risk into higher capital requirement

Mandate Standardized specific capital requirement for different structured tranches (example, B or NR tranche required 1250% risk weight, BB tranche requires 200% risk weight)

Ban ARMs with artificially low teaser rates and accelerated rate change.

Ban prepayment penalty

Mandate balance guidelines between affordable housing objective and financial stability

Participants of bailout will have a Standardized cap on Executive Officers compensation for 5 years.

Phase out any government ownership and guarantees from Fannie Mae and Freddie Mac within 5 years.

Any profit produced by bailout must be rebated directly back to taxpayers.

Refund damages caused toward the Hedge fund (short contracts) due to the market interference by the government into the free capital market.

Extensive evaluation of the current proceedings of the TARP actions to date, along with the evaluation of the directive of their efforts as stated in public reports leads me to believe that the TARP will not result in the stated objective.

You should instead contemplate a scenario going forward that will most likely reveal a long DEFLATIONARY period.  By long I mean a deflationary period of 3 to 7 years.  I will give more detail later.

Contributing Factors:  high unemployment, negative growth rate, lower profit margins due to regulatory compliance, and compromised risk management.

“Compromised risk management: this is at the core of the current financial meltdown.  All elements of the breakdown have their root in this core defect.  Specifically, Pandora’s Box was opened when un-validated, no documentation income mortgage applications were allowed to be processed, accepted, and bundled into (CDO) Collateralized Debt Obligation by the GSOs Fannie Mae, Freddie Mac, the 12 Federal Home Loan Banks (FHLBanks).  If you can identify the person and /or government department/agency that authorized the acceptance of un-validated, no documentation income mortgage applications, you have found the Osama Ben Laden of this disaster.”

IScientiaUSA.com