Manchin, Sinema Doing The Right Thing For The Country Instead Of Being Partisan, Hero’s Without Knowing It

Even though the MSM, the democrats and those against protecting US citizens are claiming that 2 Senators stopped a power grab, it was really 52. Half of the Senate plus Kyrsten Sinema and Joe Manchin saved us by voting not to kill the filibuster.

Harry Reid threw the nuclear switch on voting in Justices. Not long afterwards in 2016, republicans took control of the Senate where they are approved, and the left is still (bitching) licking it’s wounds that the Supreme Court is (supposedly) 6-3 conservative. Recent verdicts show that Roberts has sided with the liberal judges on important issues like Obamacare by calling it a tax. We still suffer with that albatross. I just went through the process of getting insurance and Healthcare.gov is just another unnecessary layer of red tape that doesn’t really help anyone other than politicians.

Most politicians care most about getting power and staying in power. The two “rebel” democrats risked being outcasts in the next election by doing what was right for the people of the USA. They protected citizens from the government so we don’t have to do it. (see my 2nd amendment post a few down from here)

They should be hailed as hero’s for keeping us a Republic (no Pelosi and Shumer, we didn’t hurt the democracy because we are a Republic) rather than a monarchy.

[OC] Remember: Republicans and Democrats are both liberal ...

The House and maybe the senate should flip this November and it also protected the democrats from being run over by a Republican majority, even if it is not 60 members.

Most of all, the ability to stop power grabbing legislature, like the voting act keeps the country protected by those who want to rule us instead of govern us. That was the intent of the current voter protection act, which only protects those in power to keep them there.

How to Improve the American Voting System

So, we escaped that one, but the spawn of Satan who are in charge won’t stop. There will be another power grab soon. I hope that the election cycle, which causes all candidates to lie about being moderate will stop the idiocy. If not, more like Manchin and Sinema will have to grow a spine.

I think that by being true to the people, that Manchin gets re-elected. Sinema faces a state of people less educated on history and what is right vs wrong, but I would vote for her for doing her job.

BIG PHARMA and Government, The Real Reason People Are Dying From Covid?

There is an unbelievable push to get people vaxxed. There is an equal effort to stop the cure and prevent people from being healed. Why is this?

HURTING THE CURE

This week, the HHS restricted mono-clonal doses to “Red States like Florida and Texas”.

The governor said he was surprised at the HHS “abrupt and sudden” announcement that it would be taking control of distribution. He said this took him by surprise because a week prior, on Sept. 9, the Biden administration said they were increasing monoclonal antibody distribution by 50 percent.

Now the HHS, as of Monday, “seized control” of the treatments, the governor said, adding that earlier in the week he received “official word” that Florida’s shipments of the monoclonals would be reduced by 50 percent.

Before, providers and infusion centers, as well as the state of Florida, would simply call Amerisource, a third-party affiliate of Regeneron that makes the monoclonal antibodies treatment, and request whatever amount was needed. Now, DeSantis said this new method will make it “doubly difficult” for hospitals and other providers because they will now have to go through the state to get their treatments.

“They sprung this on us,” DeSantis said at the press conference on Thursday. “They pulled the rug out from under us.”

It is surprising when the hospital Covid cases have been reduced by 50 percent because of this.

He said the results of the monoclonal antibodies are positive and that there have been 24 consecutive days in the decline of the COVID hospital census statewide.

The governor said he is pleased with the trends that are occurring and credits the vaccine and the monoclonals for the reduction in hospitalization rates. Florida hospital admission rates have decreased by 50 percent.

And this: States are having big success with monoclonal treatments, so the Biden administration is rationing it.

Ivermectin Works

There is of course Ivermectin, which in medical studies has been proven to work, but they won’t approve that either, rather they trash it as a cure as well as people being healed.

Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance. Furthermore, results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin. Finally, the many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.

Yet Celebtards like Jimmy Kimmel trash Ivermectin users and it’s treatment. Fortunately, a Dr has responded with facts about it rebuking him from carrying the water for Big Pharma.

During your show on 8 September 2021, you commented on the shortage of ICU beds, saying “Vaccinated person having a heart attack? Yes, come right on in, we’ll take care of you. Unvaccinated guy who gobbled horse goo? Rest in peace, wheezy.” I take issue with your commentary for three primary reasons: 1) the comments appear to be racially discriminatory, 2) the comments are not founded in science and serve to further divide a country that, unfortunately, is taking medical advice from too many non-physicians, and 3) the suggestion that doctors should selectively treat patients is unethical.

THE VAXX IS A DEATH SHOT

THE “VACCINE” KILLS 70 PEOPLE A DAY NOW

The Vaccine Adverse Events Reporting System (VAERS) is exploding with vaccine injuries, at a rate never seen before. The number of injuries and deaths from these vaccines is so immense, all prior vaccine injury data over the past two decades pales in comparison to the carnage observed in 2021.

The government’s passive vaccine injury surveillance system has logged over 675,000 adverse reactions from the vaccines in just eight short months. If these medical issues were divvied up among the roughly 17,000 hospitals in the United States, there have been roughly 40 COVID vaccine injuries for every hospital in the nation.

Over the past forty-seven days of reporting, there have also been 3,296 deaths reported to VAERS. This is equivalent to SEVENTY deaths per day — a sacrificial routine of medical malpractice and wrongful death that must be stopped.

THE VACCINATED CAUSE THE BREAKTHROUGH AND HIGHEST COVID CASES

Singapore has just reached a level of vaccination penetration that many other developed economies would envy: 80% of its adult population has been vaccinated. And yet, it continues to struggle with one of the worst outbreaks yet. On Sunday, the nation of 5.7 million people reported 555 new local COVID-19 cases, the most since August 2020. One day prior, Singapore recorded its 58th COVID death, a partially vaccinated 80-year-old man with a history of diabetes, hypertension and heart problems.

A curious thing has happened since Singapore hit 80%, Cook reminds us: “The community cases have actually gone up since reaching 80 per cent coverage, in part because we’re allowing more social events for those who are vaccinated and, I dare say, more fatigue at the control measures,” Cook told the ABC.

And the outlook isn’t exactly positive: Gan Kim Yong, co-chair of the multi-ministry task force, said the “worrying” spike in infections would “probably get to 2,000 new cases a day,” describing the next two to four weeks as “crucial.”

It’s a lesson that’s not unique to Singapore; “One main lesson from across South-East Asia is that it is incredibly hard to prevent Delta’s spread and, as Singapore shows, even high vaccination rates will not help that much,” Cook added.

Of course there are the other 2 countries, Israel and the UK that have the same high level of break through Covid cases.

An inconvenient fact is being suppressed. In countries like the United Kingdom or Israel where the double- and triple-vaxxed are dominant, they are seeing spikes in hospitalizations. This directly and unambiguously debunks claims that the vaccines are working, yet cognitive dissonance and confirmation bias have the pro-vaxxers performing mental gymnastics to explain it all away.

Another series of inconvenient facts exist in VAERS data. People are definitely dying from the vaccines. There are far too many reports to conclude that they’re all just lies or misunderstandings. Moreover, it has been demonstrated that only 1%-10% of actual adverse reactions to the vaccines are reported to VAERS, which means the total dead is almost certainly much higher than what anyone is saying.

Gibraltar has a 99% Vaxx rate:

MONEY

Well, isn’t that always the reason? Isn’t that the lesson from Watergate, follow the money?

Big Pharma gets paid for every “free” vaccination by Government. Government gets lobbying money from Big Pharma to have them push their products. One hand washes the other. In real life, it’s called laundering and crime.

The Government is pushing everyone to get vaxxed, knowing that it is causing the variants and killing people. The long term effects are not known, but it is not good.

But the failure of the mRNA vaccine is far more serious than the failure to protect. The vaccine itself (1) causes illnesses and deaths identical to Covid illnesses and deaths as the massive number of deaths and health injuries in the adverse vaccine reaction databases indicate, (2) the “vaccine” creates variants capable of escaping immune response, and (3) the vaccinated are contagious and dangerous to the unvaccinated.

Did the FDA largely shrug-off its regulatory duties and abandon its normal standards and protocols because

a– It wanted to rush the Covid vaccines into service as rapidly as possible?
b– It knew the Covid-19 vaccine would never meet long-term safety standards?

We don’t know yet, but the adverse events report strongly suggests that the Covid-19 vaccine is hands-down the most dangerous vaccine in history.

VERDICT

The Government is guilty of getting money from Big Pharma in the form of lobbying. They want control over people and are willing to kill them. They have no idea what the long term effects will be because they rushed it to market without proper testing.

Big Pharma is raking in the profits while having a track record of producing vaccines that don’t work. They paid off the Government to get emergency authorization and didn’t do proper testing to know what the effects will be.

Both are guilty of murder, but neither will be held accountable. Money talks and there is a lot of it going around. The People’s best interest is not a concern for them, power and control are.

The Critical Factors Driving Up American Healthcare Costs vs. Other Countries

Why can’t the US get it right vs. other countries?  It is explained below.  Most of all, our politicians have gotten in the way of actual healthcare.  We need to get rid of them first, although that is not the nature of this article, but the crux of how we got where we are.

Check out the one where other countries deal with their population that smokes way more than the US does….need I say more?

By Samuel Metz

The Bipartisan Policy Report titled “What is Driving US Health Care Spending? America’s Unsustainable Health Care Cost Growth” issued in September lists seven factors increasing American health care costs. The “fiscal cliff” debates include many of these arguments.

While these factors do indeed play roles in American health care, almost all are at work in other industrialized countries, all of whom provide better care to more people for half what we spend. Good intentions aside, the report overlooks critical (and dysfunctional) characteristics of American health care and instead distracts itself with factors never mastered by any country (including ours).

The report was prepared under the direction of former Senate majority leaders Tom Daschle (D-S.D.) and Bill Frist (R-Tenn.), former Senator Pete Domenici (R-N.M.) and former Congressional Budget Office Director Dr. Alice Rivlin. With such participants, the report certainly qualifies as bipartisan, but unfortunately the final product does not qualify as accurate.

Here are the seven factors. They are largely irrelevant in our quest for better care at less cost.

1. Many industrialized countries pay providers on a fee-for-service basis, seemingly rewarding more care rather than better care. Yet their costs are lower and their citizens are healthier.

2. Other countries face aging populations with higher smoking rates and more chronic illnesses than we have. Yet their costs are lower and their citizens are healthier.

3. Other countries face patient demands for the latest therapies. Yet their costs are lower and their citizens are healthier.

4. Other countries do not financially penalize patients seeking care. Yet their costs are lower and their citizens are healthier.

5. Other countries provide patients with no more information about complex health decisions than we do. Yet their costs are lower and their health results are better.

6. Many hospital systems in other countries dominate their markets. Yet their costs are lower and their citizens are healthier.

7. The one exception making us unique is our malpractice costs. Yet defensive medicine costs $55 billion annually, just 0.2% of our $2.6 trillion health care spending.

Thus we face the same challenges every country faces. But American costs are increasing faster and are already twice as high. What are these other countries doing differently? They apply three characteristics missing from American health care:

  • Everyone is included without discrimination against the sick. Unlike other countries, Americans encourage private insurance companies to insure only healthy patients, leaving sicker patients to government programs, charities, or no care at all.
  • Patients can seek care without financial penalty. We are unique in using high deductibles and co-pays to discourage patients from primary care. Although patients in other countries see their physicians more frequently and spend more days in the hospital than we do, their costs are less and their citizens are healthier.
  • Financing is provided exclusively by publicly accountable, transparent, not-for-profit agencies. Although providers make a profit in many countries, we are the only nation in which financing agencies make a profit.

No country, including ours, has ever resolved the Bipartisan Policy Report factors. Yet our health care costs are the world’s highest. Although the report is bipartisan, it misses the critical factors driving up American health care costs. And unfortunately so does the Affordable Care Act, another valiant but futile effort at addressing our health care crisis. If the US wants a health care system that provides better care to more people for less money, we should take our lessons from countries already doing so, not from think tanks speculating on economic theories never applied successfully anywhere.

Successful systems around the world can teach us proven methods of containing costs while providing better care, but if only we choose to learn from them. These policy makers chose to ignore these lessons. The rest of us should not.

France Rejects 75% Tax on Millionaires (Socialism fails again)

Once again, the rich like their money.  Once again, Socialism doesn’t work because growing an economy is the way out of a deficit rather than taxing your way out.  So Hollande’s premise during his campaign, like in the US is a facade.

As Frank Zappa said: Communism doesn’t work because people like to own stuff.

Margaret Thatcher noted that socialism doesn’t work because sooner or later you run out of other people’s money.

Read the whole article here:

France’s Constitutional Council on Saturday rejected a 75 percent upper income tax rate to be introduced in 2013 in a setback to Socialist President Francois Hollande’s push to make the rich contribute more to cutting the public deficit.

The Council ruled that the planned 75 percent tax on annual income above 1 million euros ($1.32 million) – a flagship measure of Hollande’s election campaign – was unfair in the way it would be applied to different households.

Prime Minister Jean-Marc Ayrault said the government would redraft the upper tax rate proposal to answer the Council’s concerns and resubmit it in a new budget law, meaning Saturday’s decision could only amount to a temporary political blow.

While the tax plan was largely symbolic and would only have affected a few thousand people, it has infuriated high earners in France, prompting some such as actor Gerard Depardieu to flee abroad. The message it sent also shocked entrepreneurs and foreign investors, who accuse Hollande of being anti-business.

Economy Signs in the USA and EU that WE ARE IN DECLINE, PROTECT YOURSELVES

Two disturbing articles came my way.  I watch the economy and look for trends.  I found two that are similar because of political policies, yet would be so easy to fix if the respective governments would stop spending, handing out money to those who don’t deserve it, stop handing to themselves and stop the regulations.

We are headed into a depression and it appears that is what the governments want.  History shows they can control a distressed population more easily than a productive, self-reliant successful one…so the preponderance of evidence shows it is intentional.

You’ve been warned, get out of debt, get a strong cash position, stock up on supplies (they are much cheaper now before inflation) and do everything you can to be self reliant rather than convenient.  This is against all the pundits who want you to buy into this is just a phase, just like right about 1926.

Here they are.

THE USA

Link to the full article here:

#1 According to the World Bank, U.S. GDP accounted for 31.8 percent of all global economic activity in 2001.  That number dropped to 21.6 percent in 2011.  That is not just a decline – that is a freefall.  Just check out the chart in this article.

#2 According to The Economist, the United States was the best place in the world to be born into back in 1988.  Today, the United States is only tied for 16th place.

#3 The United States has fallen in the global economic competitiveness rankings compiled by the World Economic Forum for four years in a row.

#4 According to the Wall Street Journal, of the 40 biggest publicly traded corporate spenders, half of them plan to reduce capital expenditures in coming months.

#5 More than three times as many new homes were sold in the United States in 2005 as will be sold in 2012.

#6 America once had the greatest manufacturing cities on the face of the earth.  Now many of our formerly great manufacturing cities have degenerated into festering hellholes.  For example, the city of Detroit is on the verge of financial collapse, and one state lawmaker is now saying that “dissolving Detroit” should be looked at as an option.

#7 In 2007, the unemployment rate for the 20 to 29 age bracket was about 6.5 percent.  Today, the unemployment rate for that same age group is about 13 percent.

#8 Back in 1950, more than 80 percent of all men in the United States had jobs.  Today, less than 65 percent of all men in the United States have jobs.

#9 If you can believe it, approximately one out of every four American workers makes 10 dollars an hour or less.

#10 Sadly, 60 percent of the jobs lost during the last recession were mid-wage jobs, but 58 percent of the jobs created since then have been low wage jobs.

#11 Median household income in America has fallen for four consecutive years.  Overall, it has declined by over $4000 during that time span.

#12 The U.S. trade deficit with China during 2011 was 28 times larger than it was back in 1990.

#13 Incredibly, more than 56,000 manufacturing facilities in the United States have been shut down since 2001.  During 2010, manufacturing facilities were shutting down at the rate of 23 per day.  How can anyone say that “things are getting better” when our economic infrastructure is being absolutely gutted?

#14 Back in early 2005, the average price of a gallon of gasoline was less than 2 dollars a gallon.  During 2012, the average price of a gallon of gasoline has been $3.63.

#15 In 1999, 64.1 percent of all Americans were covered by employment-based health insurance.  Today, only 55.1 percent are covered by employment-based health insurance.

#16 As I have written about previously, 61 percent of all Americans were “middle income” back in 1971 according to the Pew Research Center.  Today, only 51 percent of all Americans are “middle income”.

#17 There are now 20.2 million Americans that spend more than half of their incomes on housing.  That represents a 46 percent increase from 2001.

#18 According to the U.S. Census Bureau, the poverty rate for children living in the United States is about 22 percent.

#19 Back in 1983, the bottom 95 percent of all income earners in the United States had 62 cents of debt for every dollar that they earned.  By 2007, that figure had soared to $1.48.

#20 Total home mortgage debt in the United States is now about 5 times larger than it was just 20 years ago.

#21 Total credit card debt in the United States is now more than 8 times larger than it was just 30 years ago.

#22 The value of the U.S. dollar has declined by more than 96 percent since the Federal Reserve was first created.

#23 According to one survey, 29 percent of all Americans in the 25 to 34 year old age bracket are still living with their parents.

#24 Back in 1950, 78 percent of all households in the United States contained a married couple.  Today, that number has declined to 48 percent.

#25 According to the U.S. Census Bureau, 49 percent of all Americans live in a home that receives direct monetary benefits from the federal government.  Back in 1983, less than a third of all Americans lived in a home that received direct monetary benefits from the federal government.

#26 In 1980, government transfer payments accounted for just 11.7 percent of all income.  Today, government transfer payments account for more than 18 percent of all income.

#27 In November 2008, 30.8 million Americans were on food stamps.  Today, 47.1 million Americans are on food stamps.

#28 Right now, one out of every four American children is on food stamps.

#29 As I wrote about the other day, according to one calculation the number of Americans on food stamps now exceeds the combined populations of “Alaska, Arkansas, Connecticut, Delaware, District of Columbia, Hawaii, Idaho, Iowa, Kansas, Maine, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, Rhode Island, South Dakota, Utah, Vermont, West Virginia, and Wyoming.”

#30 Back in 1965, only one out of every 50 Americans was on Medicaid.  Today, one out of every 6 Americans is on Medicaid, and things are about to get a whole lot worse.  It is being projected that Obamacare will add 16 million more Americans to the Medicaid rolls.

#31 In 2001, the U.S. national debt was less than 6 trillion dollars.  Today, it is over 16 trillion dollars and it is increasing by more than 100 million dollars every single hour.

#32 The U.S. national debt is now more than 23 times larger than it was when Jimmy Carter became president.

#33 According to a PBS report from earlier this year, U.S. households that make $13,000 or less per year spend 9 percent of their incomes on lottery tickets.  Could that possibly be accurate?  Are people really that foolish?

#34 As the U.S. economy has declined, the American people have been downing more antidepressants and other prescription drugs than ever before.  In fact, the American people spent 60 billion dollars more on prescription drugs in 2010 than they did in 2005.

THE EUROPEAN UNION

Link to the full article here:

The following are 11 facts that show that Europe is heading into an economic depression…

1. The economies of 17 out of the 27 countries in the EU have contracted for at least two consecutive quarters.

2. Unemployment in the eurozone has hit a brand new all-time record high of 11.7 percent.

3. The unemployment rate in Portugal is now up to 16.3 percent.  A year ago it was just 13.7 percent.

4. The unemployment rate in Greece is now up to 25.4 percent.  A year ago it was just 18.4 percent.

5. The unemployment rate in Spain has hit a brand new all-time record high of 26.2 percent.  How much higher can it possibly go?  This is already higher than the unemployment rate in the United States ever reached during the Great Depression of the 1930s.

6. Youth unemployment levels in both Greece and Spain are rapidly approaching the 60 percent level.

7. Earlier this month, Moody’s stripped France of its AAA credit rating, and wealthy individuals are leaving France in droves as the socialists implement plans to raise taxes to very high levels on the rich.

8. Industrial production is collapsing all over Europe.  Just check out these numbers…

You don’t have to be an economic genius to understand that the perpetual uncertainty over the Eurozone’s future has led to a widespread freeze on industrial investment and development. Industrial production is collapsing at an accelerating rate, falling 7% year-on-year in Spain and Greece, 4.8% in Italy, and 2.1% in France.

9. There are even trouble signs in the “stable” economies in Europe.  In Germany, factory orders in September were down 3.3 percent from the month before, and retail sales in October declined 2.8 percent from the previous month.

10. The debt of the Greek government is now projected to hit 189 percent of GDP by the end of this year.

11. The Greek economy has shrunk by more than 7 percent this year, and it is being projected that the Greek economy will contract by another 4.5 percent in 2013.

But sometimes you can’t really get a feel for how bad things really are over there just from the raw economic numbers.

Many people that are living through these depression-like conditions are totally giving in to despair.  Just check out the following example from an RT article from earlier this year…

A 61-year-old Greek pensioner has hung himself from a tree in a public park after succumbing to the pressure of crushing debt. A note in his pocket indicates he is merely the latest in a rash of economic crisis-induced suicides.

The pensioner’s lifeless body was found dangling by an attendant in a public park not far from his home in the suburb of Nikaia, Athens. The attendant also found a suicide note in the man’s pocket, The Athens news reports.

The man, identifying himself as Alexandros, said he was a man of few vices who “worked all day.”  However, he blamed himself from committing one “horrendous crime”: becoming a professional at the age of 40 and plunging himself into debt. He referred to himself as a 61-year-old idiot who had to pay, hoping his grandchildren would not be born in Greece, as the country’s prospects were so bleak.

The State of Healthcare Firsthand, From the Doctor

I went to a hospital today to have a procedure done.  When the nurse apologized for the quantity of paperwork, I casually mentioned that things might become more complicated with Obamacare.
I was not ready for the answer.  Actually, being in a very socially liberal city and healthcare system, I thought I was going to hear support for the program.  I instead was told how government has corrupted the system, made it worse for both Doctors and patients and other horror stories.  I replied that the government has not helped healthcare in a long time to which the nurse responded that the decline of morals in our culture was the beginning of the problem.  How correct this nurse was.

Next, I met with the Doctor to go over what the procedure was going to entail.  I again mentioned whether the healthcare system was affecting his job.  Again I received a surprise answer.

The doctor told me of his passion for his practice all of his life.  He then told me that what is being done to us by Washington has him considering getting out.  He was honorable enough to not practice if he couldn’t do his best.  It was a John Galt conversation.  There are others like this doctor.  I’ve found that if you are contemplating your retirement in your mind, you are already in the process of retiring.

To a person, the hospital staff admitted that Washington and the damage they have done and are doing to our healthcare system makes it worse for patients and providers.  This is not a partisan statement for the record.

Let me point out that this was a highly successful practice with state of the art equipment and professional personnel making these perspicacious comments to me.

It was  clear that they wanted to help people and do their job, but our own government is in the way.  It seems obvious that they have overstepped their role in making sure that medicine is safe and lawful.

If I hadn’t heard it from the horse’s mouth, I wouldn’t have known.  I did go in looking for a cure, but I left with a dose of information.  It is easy to conclude that we need to fix or excise Washington from the healthcare system and put it back in the hands of the doctors.

Here is another story by a Doctor in a completely different area of the country from me that I read by chance on the same day as my procedure.

After 18 years in private practice, many good, some not, I am making a very big change.  I am leaving my practice.

No, this isn’t my ironic way of saying that I am going to change the way I see my practice; I am really quitting my job.  The stresses and pressures of our current health care system become heavier, and heavier, making it increasingly difficult to practice medicine in a way that I feel my patients deserve.  The rebellious innovator (who adopted EMR 16 years ago) in me looked for “outside the box” solutions to my problem, and found one that I think is worth the risk.  I will be starting a solo practice that does not file insurance, instead taking a monthly “subscription” fee, which gives patients access to me.

I must confess that there are still a lot of details I need to work out, and plan on sharing the process of working these details with colleagues, consultants, and most importantly, my future patients.

Here are my main frustrations with the health care system that drove me to this big change:

  1. I don’t feel like I can offer the level of care I want for my patients.  I am far too busy during the day to slow down and give people the time they deserve.  I have over 3000 patients in my practice, and most of them only come to me when there are problems, which bothers me because I’d rather work with them to prevent the problems in the first place.
  2. There’s a disconnect between my business and my mission.  I want to be a good doctor, but I also want to pay for my kids’ college tuition (and maybe get the windshield on the car fixed).  But the only way to make enough money is to see more patients in my office, making it hard to spend time with people in the office, or to handle problems on the phone.  I have done my best to walk the line between good care and good business, but I’ve grown weary under the burden of having to make this choice patient after patient.  Why is it that I would make more money if I was a bad doctor?  Why am I penalized for caring?
  3. The increased burden of non-patient issues added to the already difficult situation.  I have to comply with E/M coding for all of my notes.  I have to comply with “Meaningful Use” criteria for my EMR.  I have to practice defensive medicine to avoid lawsuits.  I have more and more paperwork, more drug formulary problems, more patients frustrated with consultants, and less time to do it all.  My previous post about burnout was a prelude to this one; it was time to do something about my burn out: to drop out.

Here are some things that are not reasons for my big change:

  1. I am not angry with my partners.  I have been frustrated that they didn’t see things as I did, but I realize that they are not restless for change like I am.  They do believe in me (and are doing their best to help me on this new venture), but they don’t want to ride shotgun while I drive to a location yet undisclosed.
  2. I am not upset about the ACA (Obamacare).  In truth, the changes primary care has seen have been more positive than negative.  The ACA also favors the type of practice I am planning on building, allowing businesses to contract directly with direct care practices along with a high-deductible insurance to meet the requirement to provide insurance.  Now, if I did think the government could fix healthcare I would probably not be making the changes I am.  But it’s the overall dysfunctional nature of Washington that quenches my hope for significant change, not the ACA.

What will my practice look like?  Here are the cornerstones on which I hope to build a new kind of practice.

  1. I want the cost to be reasonable.  Direct Care practices generally charge between $50 and $100 per patient per month for full access.  I don’t want to limit my care to the wealthy.  I want my practice to be part of a solution that will be able to expand around the country (as it has been doing).
  2. I want to keep my patient volume manageable.  I will limit the number of patients I have (1000 being the maximum, at the present time).  I want to go home each day feeling that I’ve done what I can to help all of my patients to be healthy.
  3. I want to keep people away from health care.  As strange as this may sound, the goal of most people is to spend less time dealing with their health, not more. I don’t want to make people wait in my office, I don’t want them to go to the ER when they don’t need to.  I also don’t want them going to specialists who don’t know why they were sent, getting duplicate tests they don’t need, being put on medications that don’t help, or getting sick from illnesses they were afraid to address.  I will use phones, online forms, text messages, house calls, or whatever other means I can use to keep people as people, not health care consumers.
  4. People need access to me.  I want them to be able to call me, text me, or send an email when they have questions, not afraid that I will withhold an answer and force them to come in to see me.  If someone is thinking about going to the ER, they should be able to see what I think.  Preventing a single ER visit will save thousands of dollars, and many unnecessary tests.
  5. Patients should own their medical records.  It is ridiculous (and horrible) how we treat patient records as the property of doctors and hospitals.  It’s like a bank saying they own your money, and will give you access to it for a fee.  I should be asking my patients for access to their records, not the reverse!  This means that patients will be maintaining these records, and I am working on a way to give incentive to do so.  Why should I always have to ask for people information to update my records, when I could just look at theirs?
  6. I want this to be a project built as a cooperative between me and my patients.  Do they have better ideas on how to do things?  They should tell me what works and what does not.  Perhaps I can meet my diabetics at a grocery store and have a dietician talk about buying food.  Perhaps I can bring a child psychologist in to talk about parenting.  I don’t know, and I don’t want to answer those questions until I hear from my patients.

This is the first of a whole bunch of posts on this subject.  My hope is that the dialog started by my big change (and those of other doctors) will have bigger effects on the whole health care scene.  Even if it doesn’t, however, I plan on having a practice where I can take better care of my patients while not getting burned out in the process.

Is this scary?  Heck yeah, it’s terrifying in many ways.  But the relief to be changing from being a nail, constantly pounded by an unreasonable system, to a hammer is enormous.

The Guarantee of Hyperinflation

Economist John Williams of Watchdog.com describes why we will suffer from hyperinflation that will begin no later than 2014 and why.

Open ended QE will cause treasury debt which leads to long range insolvancy of the US Government.  If they had to report income under GAAP (Generally Accepted Accounting Principles)  rules, we are losing $5 trillion annually.   Taking 100% of peoples income would still not pay for this debt.

We are broke.

Government has been kicking the bucket down the road and the result will be inflation.

The global loss of confidence in the dollar happened with the raising of the debt ceiling last year.

The Fed’s primary goal is to keep the banking system solvent.  They haven’t done anything to stimulate the economy.

More evidence that inflation is just around the corner from the Federal Reserve Bank of Dallas.

Self Help Healthcare

I checked in with KevinMD for this piece of helpful information.  The free market will produce a better product than the government will ever be able to handle.  Capitalism always provides competition which drives DOWN prices and drives UP services.

f you cannot measure it, you cannot improve it.
-Lord Kelvin

Asking science to explain life and vital matters is equivalent to asking a grammarian to explain poetry.
-Nassim Nicholas Taleb

Of course the quantified self movement with its self-tracking, body hacking, and data-driven life started in San Francisco when Gary Wolf started the Quantified Self blog in 2007. By 2012, there were regular meetings in 50 cities and a European and American conference. Most of us do not keep track of our moods, our blood pressure, how many drinks we have, or our sleep patterns every day. Most of us probably prefer the Taleb to the Lord Kelvin quotation when it comes to living our daily lives. And yet there are an increasing number of early adopters who are dedicated members of the quantified self movement.

 

They are an eclectic mix of early adopters, fitness freaks, technology evangelists, personal-development junkies, hackers, and patients suffering from a wide variety of health problems. What they share is a belief that gathering and analysing data about their everyday activities can help them improve their lives.

According to Wolf four technologic advances made the quantified self movement possible:

First, electronic sensors got smaller and better. Second, people started carrying powerful computing devices, typically disguised as mobile phones. Third, social media made it seem normal to share everything. And fourth, we began to get an inkling of the rise of a global superintelligence known as the cloud.

An investment banker who had trouble falling asleep worried that his concentration level at work was suffering. Using a headband manufactured by Zeo, he monitored his sleep quantity and quality, and he also recorded data about his diet, supplements, exercise, and alcohol consumption. By adjusting his alcohol intake and taking magnesium supplements, he has increased his sleeping by an hour and a half from the start of the experiment.

A California teacher used CureTogether, an online health website, to study her insomnia and found that tryptophan improved both her sleep and concentration. As an experiment, she stopped the tryptophan and continued to sleep well, but her ability to concentrate suffered. The teacher discovered a way to increase her concentration while curing her insomnia. Her experience illustrates a phenomenon that Wolf has noticed: “For many self-trackers, the goal is unknown … they believe their numbers hold secrets that they can’t afford to ignore, including answers to questions they have not yet thought to ask.”

Employers are becoming interested in this approach in connection with their company sponsored wellness programs. Suggested experiments include using the Jawbone UP wristband to see if different amounts of sleep affect work performance such as sales or using the HeartMath emWave2 to monitor pulse rates for determining what parts of the workday are most stressful.

Stephen Wolfram recently wrote a blog illustrating just how extensive these personal analytics experiments in self-awareness could become when coupled with sophisticated technologies. Wolfram shares graphs of his “third of a million emails I’ve sent since 1989” and his more than 100 million keystrokes he has typed.

Anyone interested in understanding just how far reaching this approach may become in the future should examine the 23 pages of projects being conducted by the MIT Media Center. My favorites from this fascinating list include automatic stress recognition in real-life settings where call center employees were monitored for one week of their regular work; an emotional-social intelligence toolkit to help autism patients learn about nonverbal communication in a natural, social context by wearing affective technologies; and mobile health interventions for drug addiction and PTSD where wearable, wireless biosensors detect specific physiological states and then perform automatic interventions in the form of text/images plus sound files and social networking elements.

It is easy to get caught up in the excitement of all this new technology and to start crafting sentences about how the quantified self movement will “transform” and “revolutionize” health care and spawn wildly successful new technology companies.

Jackie Fenn’s “hype cycle” concept has identified the common pattern of enthusiasm for a new technology that leads to the Peak of Inflated Expectations, disappointment that results in the Trough of Disillusionment and gradual success over time that concludes in the Slope of Enlightenment and the Plateau of Productivity. Fenn’s book, Mastering the Hype Cycle: How to Choose the Right Innovation at the Right Time can help all of us realize that not all new technologies becomes killer applications.

Jay Parkinson, MD has also written a blog that made me pause before rushing out to invest in quantified self companies or predict the widespread adoption of this approach by all patients. Parkinson divides patients into three groups. The first group is the young, active person who defines health as “not having to think about it until they get sick or hurt themselves.” The second group is the newly diagnosed patient with a chronic illness that will affect the rest of their lives. After a six month period of time coming to terms with their illness, Parkinson believes this group moves closer and closer to group one who do not have to think about their disease. The third group are the chronically ill who have to think about their disability every day. Parkinson concludes that “it’s almost impossible to build a viable social media business that focuses on health. It’s the wrong tool for the problem at hand.”

The quantified self movement should be closely monitored by all interested in the future of the American health care delivery system. The potential to improve the life of patients with chronic diseases is clearly apparent; whether most people will use the increasingly sophisticated tools being developed is open to debate.

Court Weighs Heavy on Health Costs

From the Raleigh WRAL sometimes news.

WASHINGTON — Death, taxes and now health insurance? Having a medical plan or else paying a fine is about to become another certainty of American life, unless the Supreme Court says no.

People are split over the wisdom of President Barack Obama’s health care overhaul, but they are nearly united against its requirement that everybody have insurance. The mandate is intensely unpopular even though more than 8 in 10 people in the United States already are covered by workplace plans or government programs such as Medicare. When the insurance obligation kicks in, not even two years from now, most people won’t need to worry or buy anything new.

Nonetheless, Americans don’t like being told how to spend their money, not even if it would help solve the problem of the nation’s more than 50 million uninsured.

Can the government really tell us what to buy?

Federal judges have come down on both sides of the question, leaving it to the Supreme Court to sort out. The justices are allotting an unusually long period, six hours over three days, in sessions that started Monday, to hear arguments challenging the law’s constitutionality.

Their ruling, expected in June, is shaping up as a historic moment in the century-long quest by reformers to provide affordable health care for all.

Many critics and supporters alike see the insurance requirement as the linchpin of Obama’s health care law: Take away the mandate and the wheels fall off.

Politically it was a wobbly construction from the start. It seems half of Washington has flip-flopped over mandating insurance.

One critic dismissed the idea this way: “If things were that easy, I could mandate everybody to buy a house and that would solve the problem of homelessness.” That was Obama as a presidential candidate, who was against health insurance mandates before he was for them.

Once elected, Obama decided a mandate could work as part of a plan that helps keep premiums down and assists those who can’t afford them.

To hear Republicans rail against this attack on personal freedom, you’d never know the idea came from them.

Its model was a Massachusetts law signed