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McCamy Taylor

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Member since: Tue Nov 9, 2004, 06:05 PM
Number of posts: 19,223

About Me

Here is my fiction website: http://home.earthlink.net/~mccamytaylor/ My political cartoon site: http://www.grandtheftelectionohio.com/

Journal Archives

Simple solution to health insurance/contraception controversy.

The federal government via Health and Human Services can offer low to no cost contraception coverage for men (who want vasectomies) and women (who want anything from birth control pills to a tubal ligation) whose employers refuse to offer such services on religious grounds. There could be a token charge for this "special birth control insurance" which will be waived for anyone making less than a certain amount of money.

That way the Catholic Church can not complain that it is being forced to pay for birth control for its employees. And the employees will not lose their freedom of choice.

Employers who do not have a legitimate religious objection will be unable to participate. Since private insurance companies almost always want to cover birth control and abortion (it saves them money, since high risk pregnancy can cost them millions), you will not see many non-religious employers trying to abuse this system, because there will be no cost savings in it for them. A few may attempt to bow to consumer pressure and deny their employees coverage for contraceptive services in order to appeal to certain interest groups. If they do, the federal government will rule that the company dos not have a valid religious objection and the firm will be forced to pay for the federal contraception coverage for its employee or write a private policy that restores contraceptive coverage.

The federal government already has a system in place---or at least it did--to evaluate those who wanted to avoid the draft based upon a religious objection. And the IRS is able to judge which groups meet the definition of being Churches and therefore have tax exempt status. It should be quite simple to have a federal agency determine whether an employer has a valid religious objection. Any attempt by the Catholic Church to complain about the federal government offering its employees federal contraceptive insurance services that it does not want them to have would then be greeted by public derision as violating the separation of Church and State. If the Catholic Church seeks to fire or intimidate employees who sign up for the federal contraceptive coverage, it could then be sued/prosecuted under the Americans with Disabilities Act, with fertility being considered a "disability" that effects only some employees. This makes the Catholic Church "the bad guys".

Yes, I know that many Democrats consider this a line in the sand that Obama must cross in order to "prove himself" committed to a woman's right to choose. However, in a political battle of words between a Church and a politician, the politician will lose. Therefore, the prudent path for Obama is to ignore the Church altogether and take care of the citizens (in this case, the Church employees).

Posted by McCamy Taylor | Wed Feb 8, 2012, 06:27 PM (3 replies)

How Much More of this “Corporations are People, Too” Bullshit Do We Have To Endure?

This is a long post because it includes a rant and then a solution. If you just want the rant, read the first part.

Part I. American Airlines, Super Person

Color me angry. Color me I’d-Pull-Out-My-Hair-But-I-Can’t-Afford-a-Wig angry.

American Airlines wants the U.S. taxpayers to take over its pension obligations. AA claims that its bankruptcy filing allows it to walk away from $9 billion in pension payments that will then have to be paid by you and me, the U.S. taxpayer, since the federally controlled Pension Benefit Guaranty Corporation is already $23 billion in debt. American is not asking for help because it can’t pay those pensions.


American is the latest major domestic airline to seek court protection to reduce its costs. Over the last decade, almost all the nation’s top airlines have filed for bankruptcy protection to renegotiate their labor contracts, freeze pensions and slash debt they could no longer afford.

Airlines are generally in better shape today than they were in 2002 to 2006, when many of the nation’s top carriers filed for bankruptcy. Unlike other carriers, American filed for court protection with about $4 billion in cash, and it intended to finance its own way through the process. But that level of cash may also provide some degree of leverage to the unions, which can argue that the airline can afford to pay for the pension plan.

$4 billion in cash is far from broke. So, why should AA be allowed to dump its debt on the U.S. taxpayers? Anyone? If you said “To save the jobs of AA’s workers,” go to the back of the class. American also intends to slash jobs.

The airline, which filed for bankruptcy in November, said it wanted to get rid of 13,000 workers, or 16 percent of its work force. It plans to terminate its pension plans. It wants to cut back health benefits for current employees and retirees. Over all, it said, it seeks to cut employee costs by 20 percent.


American estimated that its proposal would reduce overall costs by $2 billion a year, $1.25 billion of which would come from employees.


It gets worse. American will not simply trim its workforce. It plans to outsource skilled, higher paying jobs to other countries.

American plans to close its Alliance Fort Worth maintenance base and outsource the work performed on wide-body aircraft such as the Boeing 767 and 777.


In other words, the U.S. taxpayer is being asked to bail out American Airlines in order to save the life of the company, not the livelihoods of its workers. We are being told that American Airlines, the corporation/person has needs, too. It deserves to live. It can not be cast out into the streets with all the homeless, unemployed, uninsured Americans to die. AA deserves gold plated health insurance from the federal government. Think of it as Super-Social Security and Medicare-Elite.

The Fort Worth Star Telegram, newspaper for the DFW area and propaganda machine for AA wants us to feel the corporate/person’s pain. Mitchell Shnurman, Star-Telegram columnist attempts to tug at our heartstrings with rhetoric like:

"’It's time for this company to start winning again," CEO Tom Horton said last week.’


“American has been fighting to just survive the past decade.”


“the gap between surviving and thriving turns out to be another billion dollars-plus”


“Horton desperately wants the carrier to be a leader again.”


Another pop quiz. What is the heart and soul of a company?

If you said “The men and women who make up its workforce”, join the other dunces at the back of the class. Yes, I know it is getting crowded back there. But you are not being a “team” player. Workers are just an unnecessary cost of doing business. The “company” is the stock price, the CEO salaries, the corporate jets. The “company” is a feudal fife, endowed by the Supreme Court with personhood. No, make that super personhood. It is enough if the nation’s disabled and elderly dine on cat food and skimp on their generic medications. America’s corporations must feed on caviar and get daily Botox injections---at the tax payer’s expense.

The Star Telegram has raised its hand. It wants to respond. Sure. Let’s hear it.

In a huge feature on the editorial page called “American’s plan offers ‘renewal and growth’” we (as in “we” the AA employees who can make or break the airline’s bankruptcy plans) are told:

Tom Horton has a remedy for the pain American Airlines employees are suffering.


Horton's antidote for all this pain is hope. As CEO, he wants the approximately 61,000 American employees who can keep their jobs to focus not on the present suffering but on what he says their airline can become.


It's a plan for "renewal and growth," Horton says. "It's not about shrinkage."


Horton offers hope.


Well put, American Airlines. You are not laying off 13,000 workers and demanding a $9 billion bailout. You are surgically removing a cancerous tumor made up of 13,000 overpaid, dead beat workers who are sucking out your life force, and you are asking for $9 billion in chemotherapy to keep that pesky old tumor from coming back. Every American (Airlines) is entitled to health care. Every American (corporation) is entitled to hope.

Now, can I ask a question. Hope for what? Hope for $9 billion more in federal debt? Hope for overseas employees who will get new aircraft maintenance contracts. Hope for American’s CEOs, who will be rewarded with huge bonuses in a couple of years---while 13,000 laid off workers are still pounding the pavement, trying to find jobs? Hope for the retirees who will see their pensions cut if the feds take over?

OK, I’ve had my rant. Now, the promised solution. No, it isn’t something as easy as “line them up against the wall” or “outsource all the jobs to southeast Asia”. In order to figure out a way to fix American business, we first need to diagnose the disorder. What is the problem with U.S. business? Not a lack of money. The wealthiest Americans are rolling in money. Not a lack of skilled workers. Americans are hard workers. Taxes? Don’t make me laugh. Taxes on the rich and corporations are modest in this country. Obama? Get serious here.

Part II. American Business is Not Just Sick. It Is Suicidal

When we see a person or a group of people who are fixed upon committing suicide, we step in. For the individual that means medical care to help with depression and social services to ease hunger and despair. It also means denying that person the means to kill himself. So, for instance, an acutely suicidal person gets locked up for a few days, until he no longer wants to commit suicide.

The groups of individuals known in America as “corporations” are also suicidal. They are not in their right mind. They are like a depressed person who drinks too much, smokes too much, has unprotected sex and who will eventually put a gun in his mouth and shoot a bullet through the back of his head, without ever realizing that all the pain he has endured has been self inflicted. American corporations are paranoid. They blame the workers. They blame the federal government. They blame acts of God. They study the entrails of animals (also known as the Wall Street Journal) for signs that will tell them what the future holds, without suspecting that they are living the future that they themselves have created. Lacking self awareness, they are unable to see the world around them.

If you have not read Zen and Creative Management by Albert Low, please do. If you are not already familiar with Zen, please read one of Alan Watts’ books on the subject, first, in order to acquaint yourself with the terms that Low uses in his book.

Low challenges the reader to

discover criteria by which to judge the acceptability of an organization. The popular notion is that if a company makes a profit, i.e. a return on the shareholders investment, the organization is acceptable. But this is the very point at issue; the very notion of profit itself is being challenged, as well as its acceptability as a criterion.
Albert Low, Zen and Creative Management

This remark will strike some as blasphemous. In the U.S., we were trained by our puritan forebears to believe that profit is the mark of God’s blessing upon a person or an endeavor. On the other hand, a poor person (or a business that fails) is deserving of our scorn, since loss of profit is a sign of God’s disfavor. If you want to know why we believe something so silly, read Max Weber’s The Protestant Ethic and the Spirit of Capitalism. Or, if you are pressed for time, I have a couple of old journals in which I summarize parts of the book.



Think that puritan ideals are dead? I witnessed them a few years ago, when Enron failed, and Americans suddenly realized that corporations were capable of “going bad”. Halliburton was attacked for some of its own crimes. A Republican Congressman got on CNN and angrily defended the company by telling the host (in effect) “But Halliburton is still solvent!” In other words, any company turning a profit is “good”, no matter what laws or man or God are broken to make that profit.

Back to Albert Low. Turn to page 44 of the book. See the diagram that places “employee”, “shareholder” and “market” at the three points of an equilateral triangle? This triangle is the super-person known as a company. Note that “employee” is just as important as “shareholder” and “market”. Traditionally, Americans have viewed the world as a dualism. In matters of business, the interests of the shareholders are opposed to those of the worker. This leads to the Ebenezer Scrooge model of good business, in which more poor houses mean more desperate employees mean lower wages and longer hours means more profit for me yippee! Except who the fuck will buy my product now that no one (besides me) has any money? (My apologies to the purveyors of the patent medicine/quack remedy known as “supply side.”)

Low adds another dimension to his non-dualistic corporate model by superimposing another triangle labeled “idea”, “demand” and “form.” Together, the two figures create six pointed star, with points labeled “demand”, “shareholder”, “form”, “employee”, “idea”, “market” as you go around the face of the clock from 1 to 11.

“The field is centered by an idea and this centering is producing the product. A useful analogy is that of a crystal growing out of a gel. The seed of the crystal is the idea, the gel is the organization; but the seed and the gel are made of the same ingredients.”
Albert Low

A company which understands itself recognizes that the employee is just as essential as the profits or the product or the market. A company that has been ensnared by mara---the demon that tempts us to desire so that we will then grow fearful of losing what we desire---will focus on one part of the whole---usually the profit---and declare that all else is superfluous. No, worse than superfluous. Anything besides the profit is dangerous, because it might take away our profit. And so, the bosses antagonize employees, cutting wages, breaking promises, driving away all of them that can get a job elsewhere and ending up with those who are consumed by their own form of mara---“I hate this company, but I can’t afford to quit.”

Because I am a physician, I like medical analogies. Here is another one. Under the traditional, dualistic American business model, the shareholders and CEO are the “head”. The other employees are the arms and legs. One day the head looked down and said to itself “Too much blood, oxygen and food get wasted providing nutrition to those arms and legs. What if there isn’t enough for me? I could die! Oh my! Let’s get rid of those limbs quick!” So, the head cuts off its arms and legs---and too late, realizes that it has no way to get food or water, and so it starves to death.

“People therefore seek to find a short cut to self-realization through money. However, when money is diverted from its social role to serving individuals it becomes as destructive as formerly it was liberating, because it increases the autonomy of the elements at the cost of the mutual relatedness of those elements within the system.”
Albert Low

Because a picture is worth a thousand words, compare this business model:

To this:

Which do you think is a model for lasting business success?

What does this all mean for American Airlines? If the company outsources vital aircraft maintenance work to other countries where the FAA can not set standards or supervise, it may jeopardize safety. This will have an adverse affect on the market, the employees and the profit, as people begin to 1) avoid the airline and 2) stop giving it tax breaks and other perks because it is no longer the employer of so many happy taxpayers. In order to see this complicated math, the execs at AA have to get beyond the extremely short sighted equation that says "Profit+ (Less expense)=more profit (for me!)" The public has to move beyond the old puritan notion that "proft" equals "godliness." And we have to let go of the notion that corporations are the same as people (in this country, citizens) with their right to life, liberty, happiness, and unlimited political speech.

Corporations do not have souls and God does not grant or deny them admission to Heaven, no matter how devout their CEOs claim to be, because Corporations are not human beings. (!!!!)They are not "alive". They are a "structure or process" to quote Low and as such, they do not live, they function. And I don't care how big their corporate headquarters or how shiny their corporate jets or how rich their CEOs, a company that does not function correctly is broken and needs to be fixed.

Note that American is just one of many companies now declaring that its right to "live" trumps the rights of the rest of us to live. Safety is being tossed out the window. Corporate super-people now demand the right to pollute the skies and water, poison their customers, sell dangerous medications and medical therapies all in the name of "survival" and "profit." The Koch Brothers lobby against mass transit, because decreased demand for petrochemical fuels will "endanger" their oil price speculation racket, the source of the wealth which is supposed to make them the most beloved of God---

While God or Buddha or the Great Mother or the Flying Spaghetti Monster or Our Collective Conscience may love the Koch Brothers individually, He, She, Other or It does not love Koch Industries or American Airlines. The deity will shed no tears if a flawed business model goes under, but It will notice and care if another person dies or goes homeless and hungry because of corporate greed.

Addendum: One more thought about American Airlines, have its CEOs considered the possibility that it has been able to delay the pension slashing/job cutting/safety trimming activities of its competitors for so long and that it approaches bankruptcy flush with cash precisely because it has (up until now) taken such good care of its employees?

Posted by McCamy Taylor | Sun Feb 5, 2012, 04:52 PM (5 replies)

The Koch Brothers are Acting Just Like Enron---Before the Bankruptcy

Remember why we got stuck with Dumbya for eight years? Enron, W.’s biggest contributor and supporter was on the verge of bankruptcy. In order to save their house of cards, they needed to persuade the federal government to look the other way while they price gouged California. As in “California,” the response of former Vice-Chairman of Enron Energy Services and later Bush Secretary of War Thomas White when asked how his company planned to pull its butt out of the fire. Al Gore was 100% unlikely to aid Enron in this endeavor. So, the Gang of the Five at the Supreme Court, under the guidance of Scalia, a man with financial ties to the oil industry selected W. to be president. Karl Rove then selected Enron’s choice, Nora Brownwell to chair the Federal Energy Regulatory Commission. Her mission? Ask no question as Enron’s energy traders manipulated the market to drive electricity prices through the roof in the summer of 2001.

Four years after California's disastrous experiment with energy deregulation, Enron energy traders can be heard – on audiotapes obtained by CBS News – gloating and praising each other as they helped bring on, and cash-in on, the Western power crisis.

"He just f---s California," says one Enron employee. "He steals money from California to the tune of about a million."

"Will you rephrase that?" asks a second employee.

"OK, he, um, he arbitrages the California market to the tune of a million bucks or two a day," replies the first.


The plan might have worked—except for two things beyond W.’s control. First, a federal judge accused Enron of price gouging. And then, the Taliban (despite wining and dining and threats of a “carpet of bombs” from the Bush administration) refused to allow Enron to build a gas pipeline across Afghanistan.

In the late summer of 2001, seeing the writing on the wall, Jeff Skilling left Enron, precipitating questions about his company’s solvency. A couple of months later, the Democratic Senate refused to go along with the bailout of Enron which the Republican House and the White House had engineered. The bailout was disguised as an “economic stimulus” package that would give the supposedly solvent company an immediate retroactive rebate of taxes it had never paid. Hmm. Wonder what the Senate Democrats thought was so fishy about that? The bailout was scrapped by the Senate, Enron went under, Ken Lay died under suspicious circumstances, no Enron employee was offered a deal for testifying against superiors (such as Thomas “Enron” White), Iraq was invaded just before the FERC was scheduled to give its report which would show that Enron did indeed price gouge California while the FERC twiddled its thumbs----

You know the rest. Thousands of Americans and millions of Iraqis died to keep all those dark, dirty Enron secrets buried. California Gov. Gray Davis was recalled and Arnold was installed as governor of that state to stop the civil suit that threatened to expose the skeletons in Enron’s and the Bush administration’s closet. Shareholders lost billions and hard working Americans lost their pensions as the world’s “biggest” company went under.

So, what does this have to do with the Koch Brothers? Ask yourself, how do you know that the Koch Brothers are rich as sin. Because they tell you so? The Kochs control the nation’s second largest privately held company. That allows them to release no information about their finances. They could be lying about how much money they have---the way that Enron lied--- and no one would ever know.

One of the “signs” that Enron was not solvent was the company's willingness to do anything, even break the law, to keep up a stream of cash in order to maintain a charade of solvency. Financially flush companies will hesitate to break the law, for fear of being caught and losing what they have. Houses of cards like Enron have nothing to lose, so they break the law at every opportunity. Have the Koch Brothers demonstrated a willingness to break the law? You bet.

Koch Industries allegedly made improper payments to win business in 6 countries over 8 years (through 2008) — a potential violation of the Foreign Corrupt Practices Act. The company described them as ”activities constitute[ing] violations of criminal law.”
Koch Industries sold millions of dollars of oil refining equipment to Iran — even after President George W. Bush described the nation as a member of the ‘Axis of Evil.’ The company maintains these sales were legal at the time, and says it has since cut ties with the rogue nation.
Koch Industries allegedly stole 1.95 million barrels of crude oil pumped from federal lands by falsifying purchasing records, a Senate investigation found. Former workers testified to the “Koch Method,” described as trying “to cheat the producer out of crude oil,” my mis-measuring the oil.
The company allegedly ignored federal regulations for pipeline safety — resulting in the deaths of at least two people in a pipeline explosion in Lively, Texas in 1996.


Does being on the verge of bankruptcy cause companies to cut back on their campaign contributions? Hell no! Enron made half of its total $5.8 million (pre- Citizens United, so every dollar really counted) contributions in the year prior to its bankruptcy, when its executives knew full well how bad the company was doing. Buying a president was supposed to be their ticket to financial solvency. They were going to price gouge California without interference from the feds (until a federal judge stepped in). They were going to make a sweet deal with Afghanistan (until federal diplomats failed to impress the Taliban.) If you had asked Ken Lay what the future held in store for his company in January, 2001, with Bush just sworn in, he would have said “Great things!” If asked whether or not his investment of $2.9 million had paid off, he would have said “You bet!”


Today, the Koch Brothers have pledged a combined $60 million (post Citizen United so the dollars mean a lot less) to get Obama out of the White House and a paid political lackey in power. Why? Ideology? Give me a break. “Ideology” to a capitalist is “what makes me money.” The Kochs expect to make money under a Republican presidency. How?

Good question. In 2000, if we had bothered to look at the ways that Enron supposedly made money, they might have scratched our heads and said “I don’t get it. What do they actually do?”

If you examined the Koch Brothers business today, you would probably ask yourself the same thing. Study their business model, and you will discover that Koch “wealth”, like that of Blanche Dubois, depends upon the “kindness of strangers”, in this case, “strangers” being the government they pretend to despise. The Kochs make money from Georgia-Pacific---with the help of corporate welfare from the government which gives them trees from government owned land and builds the roads that allow them to get at the trees.

As Yasha Levine has reported, Koch exploits a number of government programs for profit. For instance, Georgia Pacific, a timber company subsidiary of Koch Industries, uses taxpayer money provided by the U.S. Forestry Service to provide their loggers with taxpayer-funded roads and access to virgin growth forests. “Logging companies such as Georgia-Pacific strip lands bare, destroy vast acreages and pay only a small fee to the federal government in proportion to what they take from the public,” according to the Institute for Public Accuracy. Levine also notes that Koch’s cattle ranching company, Matador Cattle Company, uses a New Deal program to profit off federal land for free.


The Kochs made a bundle when W. hired them to fill up the nation’s strategic oil reserve---a resource he then refused to use, even when high oil prices were destroying the economy.

Koch Industries won massive government contracts using their close relationship with the Bush administration. The Bush administration, in a deal even conservatives alleged was a quid pro quo because of Koch’s campaign donations, handed Koch Industries a lucrative contract to supply the nation’s Strategic Petroleum Reserve with 8 million barrels of crude oil. The SPR deal, done initially in 2002, was renewed in 2004 by Bush administration officials. During the occupation of Iraq, Koch won significant contracts to buy Iraqi crude oil.


Bushs’ refusal to use the strategic oil reserve facilitated the Koch Brothers other big Enron style profit making venture, its oil price speculation racket. Think Progress has a piece about the Koch Brothers lead the way in creating the “industry” of oil speculation, Here is a highlight.

2008: Rampant oil speculation spikes prices to unprecedented levels. As academics from the Peterson Institute, the James Baker Institute at Rice University, and others conclude, non-commercial speculators begin to dominate the market, forcing up prices. Although the evidence was abundant that speculators caused the massive price spikes during the summer of 2008, regulators were toothless to act. A bipartisan majority in the House overwhelmingly passed legislation to award powers to the CFTC to oversee rampant oil speculation, but Republican in the Senate — acting with help from Koch lobbyists — killed the bill, called the Energy Markets Emergency Act.


Be sure to read the whole article. I will wait.

Finished the Think Progress piece on the Kochs’ oil speculation racket? Now, ask yourself two things. One, do you think they have continued to make the same kind of money under the Obama administration, which actually dared to release oil from the strategic reserve, bring down oil prices unexpectedly? Yes, I know that the Kochs have attempted to portray themselves as big “winners”, boasting that they have stored up all that cheap government crude in supertankers and that they are just waiting to unload it when oil prices have been driven artificially high again (presumably as a result of another war of choice for oil, this time with Iran)---

Argus Media reports that Koch Industries has already shown interest in leasing super tankers for storage of crude in the Gulf of Mexico. The Economist points out that the small rebound in oil prices have already provided an incentive for oil traders to store, rather than refine, the oil: “If a trader was able to purchase West Texas Intermediate—the oil held in America’s Strategic Petroleum Reserve (SPR)—at the spot price on June 24th, they would already be sitting on a tidy profit.”


But how long can the Kochs sit on those tankers? Shell predicts that oil prices are going to go lower this year.

Oil prices could fall to $70 a barrel during 2012, from current levels above $110, as high volatility in the economy and energy markets becomes "a fact of life", Royal Dutch Shell executives said.


What do the Kochs have to fall back upon if their oil speculation racket goes belly up? Dixie-Cups? The herd of cattle they graze on federal government land? Maybe they could move back to Russia and drill some of that country’s oil. Recall that their scion could not make it big in the U.S., so he went to Communist Russia under Stalin, and the state paid him to drill for oil.

The Kochs’ business model is quite simple. The government shall provide---as long as the Kochs control the government. That was Ken Lay’s philosophy back in 2000, too.

Oh, and remember that gas pipeline across Afghanistan which was supposed to bring Enron back from the financial grave? Ther Kochs have their hopes pinned on another pipeline, one that almost certainly will not get built if Obama continues to be president.

Koch officials have denied having any financial stake in the pipeline, but Waxman has argued that Koch connections to the project merit further investigation. A Koch Industries subsidiary had filed official documents with the Canadian National Energy Board claiming "a direct and substantial interest" in the Keystone XL pipeline.


There you have it. Two shady companies that spend extraordinary amounts of money "buying" politicians, two companies that are serial lawbreakers, two companies whose finances are shrouded in secrecy, two companies that make money the "new fashioned way"---by manipulating markets. Two companies dependent upon the government for their profits----

Pardon me if I question the wisdom of financial analysts who swear that the Kochs are solvent. I remember another time, back in the late summer of 2001, when Wall Street said that Enron was doing just fine, but I could not help but wonder why Jeff Skilling was walking away from such a "prosperous" company.
Posted by McCamy Taylor | Fri Feb 3, 2012, 07:55 PM (25 replies)

Right to Life Hates Women

I have suspected it for years. When Right to Life’s rank and file are interviewed, they do two things. First, they tell us how sweet and innocent the fetus is. Then, they tell us how selfish, lazy and just plain evil the woman seeking the abortion is and how she must be forced to carry the fruits of her sin in order to teach her a lesson. They do not always use those words, but this is the message they send. Women who have sex are sinful. Pregnancy is God’s Way of punishing that sin. If you love God, you must make sure the women are punished—

I can think of a number of reasons why some folks would like to see mothers-to-be punished. Those who felt abandoned or unloved as children have a grudge against the female sex---even if they happen to be women themselves. Since they can not go back in time and force their own mothers to love them---or rather, make them feel loved, for I suspect that most of the women really did love their children, the kids simply did not realize it----since they can not go back in time to change the past, they do the next best thing. They seek to control other women now, by denying them reproductive freedom. They also deny them an equal wage for equal labor, even though lower wages for women are a major cause of childhood poverty in this country. They deride those who are attempting to raise their children in single parent families with public assistance, calling them “welfare queens.” When women are the victims of the hate crime known as “rape”, they insist that the woman “lead him on”---because they know in their hearts that Eve is still chomping on that apple and still leading Adam into sin. And if a woman becomes pregnant as a result of an act of rape, she had damn well better give birth to that baby that was part of “God’s plan”---making God an accessory to rape.

A few days ago, we saw proof that Right to Life hates women. All women, not just mothers-to-be. Because Planned Parenthood offers low cost birth control and elective abortions, the Susan G. Komen charity decided that over one hundred thousand poor women should be denied breast cancer screening. Yes, I know that decision makes no sense. But if you hate women, then you see nothing wrong with punishing the entire sex for the “crimes” of a few. If you are a member of Right to Life, the deaths of a few poor women from breast cancer are an "acceptable loss" in the war to control women.

I am waiting for the day when a group like Right to Life gives Planed Parenthood a huge donation, with the money earmarked for contraception only. Prevent those unwanted pregnancies and the U.S. will have the low, low, low abortion rate of Denmark, where contraception is readily available to women of all ages and everyone is encouraged to use it. I think I will be waiting a long time. Because Right to Life’s real goal is not ending abortion. Its members want to punish women. And so they quibble about which birth control method is slightly “like” an abortion. They fume if poor women have access to birth control (and nine months later, they fume when poor women ask for help raising the child they were forced to carry). They call women on the left “whores” and “witches”---

A little part of me feels very sorry for them. Their childhoods must have been hell. But we all suffer in some way. We become compassionate adults when we stop seeing the world through the eyes of a needy child and realize that everyone suffers and everyone is needy.

Posted by McCamy Taylor | Fri Feb 3, 2012, 12:39 PM (5 replies)

Psych Assoc.(Once Labeled Being Gay as a Disease) Says Your Sleep Apnea is All in Your Head

When science intersects with money, science gets tossed out the window. We see this with global warming deniers. The same is true of medical science. There is no medical textbook as politically---and economically---controversial as the DSM---short for Diagnostic and Statistical Manual of Mental Disorders. In its earlier incarnations, the DSM labeled homosexuality a mental illness. In 1986, seventeen years after Stonewall, the “disease” of being gay was removed from the list of psychiatric disorders. In DSM IV, homophobia is now a disease.

Volume five of the DSM is currently in the works. The disorders described in the book will have a massive impact on health care for years to come, since your doctor (family physician as well as psychiatrist) can bill your insurance for treating you for one of these problems. They will also allow Big Pharm to make (even bigger) profits, by selling drugs to treat these disorders. But at what cost to you, the patient/health care consumer?

In case you have missed my previous journals on OSA (Obstructive Sleep Apnea), sleep apnea is the most common unrecognized disease in the US. The incidence has risen from about 4% of Americans over 40 to an estimated 15% of all adult Americans in recent years. Though the disease is becoming increasingly common, thanks to our obesity epidemic and the aging of the population, diagnosis of the condition is still a huge problem. Less than 1 in 5 people with OSA know that they have it.


Untreated OSA leads to 1) increase in car wrecks 2) lost work productivity 3) increased utilization of health care resources 4) heart disease 5) high blood pressure 6) stroke 7) depression 8) migraine headaches and other pain disorders. It causes bright children to perform poorly in school. It makes people crabby (due to chronic lack of sleep) so that they are more likely to anger easily. It causes erectile dysfunction in men and a loss of libido in women. Who wants to have sex when they have not had enough sleep in years? Show a victim of untreated OSA a bed, and all he/she wants to do is sleep.

Right now, there are a bunch of people in this country being treated for a variant of bipolar disorder (one in which there is no actual mania), because no one has thought to check them for sleep apnea. They are given psychiatric medications that help their emotional symptoms but which do nothing about the damage to their hearts, lungs and brains. These medications generally cause weight gain, which makes the OSA worse. And they do nothing to improve road safety. Remember, untreated sleep apnea sufferers drive like a drunk driver even when sober. Treat the sleep disorder, and their driving returns to normal. Treat their emotional symptoms without addressing the sleep disorder, and they continue to be a menace to themselves and to everyone else on the highway.

The economic costs of untreated OSA are staggering.

Hundreds of billions of dollars a year are spent on direct medical costs associated with doctor visits, hospital services, prescriptions, and over-the-counter drugs. Compared to healthy individuals, individuals suffering from sleep loss, sleep disorders, or both are less productive, have an increased health care utilization, and an increased likelihood of accidents.


Hundreds of billions of dollars. Note that these are hundreds of billions of dollars that flow into the hands of health care providers for treating the symptoms of OSA rather than the disease itself. Hmm. Maybe there is a sound economic reason that no one bothers to improve the rate of sleep apnea diagnosis and treatment in the U.S.. If we had a single payer cradle to grave system that rewards disease prevention, we might be more interested in treating the disease and cutting the costs associated with it. But since “the best health care system in the world” is driven by the money that can be made from fee for service, there is little economic incentive for health care researchers to come up with ways to prevent disease and a lot of economic incentive to come up with ways to treat the complications of disease. For instance, if undiagnosed OSA is a huge cause of erectile dysfunction and you make Viagra, do you really want all those customers to get their sleep disorder under control?

Now, the American Psychiatric Association appears poised to treat even more of the symptoms of OSA with Band-Aid medicine. Among the changes being considered for the new DSM


I. Adult Type ADHD Loosening the diagnostic criteria for adult type ADHD. Right now, you have to have shown symptoms before the age of 7 to qualify for (very expensive) medical treatment with stimulants and other drugs. The new DSM will eliminate that criterion, meaning that if the OSA you developed as a middle aged adult has you feeling out of it---can’t concentrate, can’t remember, can’t do your work, all signs of sleep disorder---you can now skip the sleep study you so desperately need and go straight on to speed.

And ADHD treatment is huge business in this country.

Using a prevalence rate of 5%, the annual societal ‘‘cost of illness’’ for ADHD is estimated to be between $36 and $52 billion, in 2005 dollars. It is estimated to be between $12,005 and $17,458 annually per individual.


Don’t look now, but ADHD is about to become even more “prevalent.”

On the plus side, all those stimulants may offset the weight gain from the bipolar medication. They may even make the underlying OSA better, if enough weight is lost. However, diet pills and a weight loss diet would be much cheaper.

II. Frigid 2.0 The DSM will create a new mental health diagnosis for women that isn’t really new at all. Remember when women who would not put out were labeled frigid? Those days are back. If you are a woman who is not interested in sex, you will now be referred to a psychiatrist. The psychiatrist almost certainly will not perform a sleep screen on you and he or she will not order a sleep study to see if your decreased libido is a natural response to your lack of sleep. Instead, you will receive counseling and medication. What medication? I am sure that Big Pharm can come up with something, so that you can have more sex before your (premature) stroke puts an end to your sex life completely. Or maybe you will see an ad on television that promises that “Viagra for Women” can make you feel like a real woman again. Go to your FP, and he or she will write you a prescription---which will be much simpler and quicker than trying to do a sleep history and ordering a sleep test. And cheaper, too, for those tens of millions of Americans without health insurance.

III. Bitch We all get crabby when we are deprived of sleep, right? People with untreated OSA are a bundle of nerves. They used to shrug off stress like water from the back of a duck, but now every little thing gets them down. And mad. Well, guess what? Having three “bitchy” episodes a week will now qualify you for psychiatric care. And once again, no one will notice that you are slowly killing your heart---until you show up one day in the emergency room with full blown congestive heart failure.

These three “mental health disorders” also happen to be some of the most annoying symptoms of OSA. People who do not know that they snore or stop breathing at night will notice if they lose interest in sex, have diminished work performance or can’t get along with their family. They will see ads on television telling them that a pill can make their lives oh so much better. They will go to the doctor demanding medication. The doctor will prescribe said medication. If the first pill does not work, they will try another. If the second does not work, they will be sent to a psychiatrist who will prescribes experimental drugs. Their eventual sleep apnea diagnosis will be delayed for years, giving them plenty of time to develop more medical complications—or die on the road, maybe taking a few innocent passengers in another car with them.

I can see why the APA has considered making three new mental health diagnoses. They probably see millions of people who suffer from these three symptoms, and they think Ah ha! It must be an epidemic. Let’s treat it. But there is no epidemic of 1) bitchiness 2) frigidity 3) poor mental concentration. There is an epidemic of one condition that causes these three symptoms. And the APA is about to make it that much harder for the people suffering from OSA to get the care they need, by slapping them with the label of “mental health disorder”, ignoring the fact that our minds and bodies are intimately linked.

The APA will be guilty of medical malpractice if they do not attach a diagnostic criteria to each of these new three mental health disorders. Under each heading, in big bold letters it should say Must exclude sleep disorder such as OSA before this diagnosis can be made.

Will they? They don’t include this in DSM IV (the current version).

Inexplicably, the most widely used criteria for ADD/ADHD diagnosis, (the American Psychiatric Association’s ‘DSM IV’), does not include sleep disorders as part of the symptomatology. However, research does suggest that (out of 1822 cases) 48% of those diagnosed with ADD/ADHD had been or still were bed wetters.


Posted by McCamy Taylor | Sun Jan 29, 2012, 05:38 PM (7 replies)

In America, Dogs Get Dental Implants, Man Can’t Get Infected Tooth Pulled

I just saw something in the newspaper that blew my mind. You can now get dental implants for your pooch, when his teeth get broken or fall out. No, this is not an early April Fool’s prank. I did a Google to make sure. For around $2500-3000, your veterinary dentist will fix your dog up with a brand new tooth so that he does not have to feel embarrassed when he bares his fangs at the mailman.

This ad struck a nerve, because I see folks all the time in my family medical practice who can not afford to visit a dentist, even for the simplest, cheapest tooth extraction. Occasionally, I will treat the same dental abscess two or even three times with antibiotics, before my patients can get the decayed stump pulled. Forget about a crown or a root canal. These are folks like the man who recently died of a dental infection, because he could not afford the antibiotic that a doctor prescribed.

"'The (doctors) gave him antibiotic and pain medication. But he couldn't afford to pay for the antibiotic, so he chose the pain meds, which was not what he needed,' Collins said. Doctors told Willis' family that while the pain had stopped, the infection kept spreading -- eventually attacking his brain and causing it to swell."


This young man’s death was shocking---but not surprising. It has happened before. In 2007, 12 year old Deamonte Driver died from complications of an abscessed tooth, after his mother was unable to get dental care for him.


Medicaid is supposed to help the poor get necessary health care in this country, but Medicaid offers little or no help for most dental problems, especially for adults.


"My granddaughter, who is a single mom and lives in Louisiana, recently got a medicaid card saying dental was provided. However, when she called for an appointment they told her all they provided for a 20 year old is dentures. How ridiculous is that? She needs dental care. Where can she get free dental care in Louisiana?"

Yes, I have seen that. Young adults who are having all their teeth extracted and dentures fitted, because that is all that their “insurance” will cover. This is not at all uncommon in the public clinic where I work.

"Don't come to Texas if you are on medicaid and over 21 years old. You don't get dental on medicaid, or any help with your dental care, broken teeth or toothaches. Missing teeth, nothing. Dental colleges are 50.00 or 200.00 fee. Who in the world who gets ssi and s.s can afford that? You have to live in a certain area to get help from clinic.

"My daughter's teeth are all broken off because of the meds she takes, but there's no help in Dallas, Texas. She is on medicaid and has to go to the hospital for toothaches, and medicaid does not pay for a hospital visit for a tooth pain, so they turn it over to the credit bureau. What a joke it is."

Hmm. No wonder so many of my patients end a visit by saying “Oh, by the way, I have this infected tooth, and I can’t afford to see a dentist. Can you give me something for it?” Why is an infection a medical problem if it happens on your arm but a “cosmetic” problem if it happens in your mouth? "Bad" teeth are not the same as "bad" hair. Folks with missing teeth can not get proper nutrition. Chronic dental infections have been linked to heart and other problems. They cause lost time from work and can make it impossible to get some jobs. And, in the worst situations, "bad" teeth can kill you. That's why the Department of Veteran's Affairs has a special Homeless Veterans Dental Program.

"The dental needs of homeless Veterans are well documented. In surveys listing and ranking the 10 highest unmet needs for homeless Veterans, dental care was consistently ranked by homeless Veterans as one of their top 3 unmet needs, along with long-term permanent housing and childcare. Dental problems, such as pain and/or missing teeth can be tremendous barriers in seeking and obtaining employment. Studies have shown that after dental care, Veterans report significant improvement in perceived oral health, general health and overall self-esteem, thus, supporting the notion that dental care is an important aspect of the overall concept of homeless rehabilitation."


We love our veterans, and so we make sure they have dental care. We love our dogs, and so we have vet dentists. If we really loved the poor and the chronically disabled and the unemployed, wouldn't we do something about their teeth, too?
Posted by McCamy Taylor | Sun Jan 15, 2012, 07:48 PM (35 replies)

Carlyle Group: $16 Billion in Debt in 2008, Now Flush in Cash.

In September, 2008, the Carlyle Group went on CNBC and urged “fast approval” for W.’s multi-trillion dollar bank bailout. Their reason? So they could help taxpayers.


Excuse me for a second while I pick myself up off the floor where I have been laughing my ass off. The world’s biggest, baddest vulture group helping U.S. taxpayers? I think not. The only thing that Poppy Bush’s employers know how to help is themselves.

Last year, the Carlyle executives paid themselves huge bonuses. They paid their stock holders huge dividends.


And yet, just a couple of years ago, Carlyle took a huge hit during the mortgage meltdown crisis. A huge hit that the mainstream media attempted to downplay as just a “egg” dropped on the kitchen floor. A $16.6 billion dropped egg.


That was one huge default. Lucky for Poppy Bush that his son created a massive media distraction in the form of the sacrifice of Bear Sterns at exactly the same time. For those who do not remember the Bush 1 administration, one of Poppy’s favorite ways to deal with bad news was to create a fire somewhere else and hope that the smoke kept the public from noticing his own raging inferno.

So, where did the Carlyle Group get the $16 billion that it needed to pay off its creditors? Where did they get the money to pay huge bonuses to their founders last year, when, just three years ago, they were circling the bottom of the toilet?

No one wants to say.

But plenty of people are speculating. Some think that the bailout of American International Group was an under the table bailout of the Carlyle Group.


Where did the AIG bailout money go?

[div]”There are also undoubtedly non-bank beneficiaries to this bailout - and we’ll find out who they are eventually when they get named to the Forbes’ wealthiest people list (if the magazine is still in print) and their fortunes shadow Bill Gates and Warren Buffet combined but for the sake of maintaining this chaotic but survivable world we live in I would be indifferent to their success.”


Yeah, that’s what I think, too.

Note that under intense pressure from the public and Congress, AIG released a partial list of where some of its bailout money went.


Would love to have the complete list. Because I have a sneaking suspicion that Bush Jr. was not just setting up the world’s biggest political slush fund for the 2010 elections. He was also trying to save his Poppy’s company from shame and ruin.

Oh, and if you missed it, here is an old journal of mine from DU 2 called “The Carlyle Group is Run By Zombies That Want to Eat Your Brains”

Posted by McCamy Taylor | Wed Jan 11, 2012, 07:45 PM (2 replies)

Better Than Drive-In! Six Zombie Republican Candidates In A Circular Firing Squad Armed W/ Shotguns!

Q: How is a Republican presidential candidate different from a zombie?

A: Trick question. He isn’t!

I have to admit, that I have had more than a few chuckles over this year’s Republican presidential primary. The circular firing squad is a delight to watch. The candidates have killed each other so many times now, that every one of them is a dead man walking, propped up only by the seemingly unlimited amounts of good money that Super Pac donors are willing to throw after bad to some really bad candidates.

Recall that in 2008, the corporate media under the direction of the RNC borrowed from the dirty political tactics of CREEP, the infamous committee to re-elect Dick Nixon. The CREEP playbook was written by a then not-yet-senile Pat Buchanan.

Karl Rove and others cut their political teeth in the 1972 campaign, when false press releases were sent out from one Democratic primary candidate sliming another candidate and the front runner, Ed Muskie was slipped a tab of acid, if Hunter S. Thompson is to be believed.

In 2008, we saw right wing webmaster, Matt Drudge, publish a photo of Obama in a dress---and claim that he got it from Hillary. We had mainstream media correspondents claiming that Clinton called Obama a Muslim when she said the exact opposite. We saw Edwards called a loser and a racist for running for president. We saw Rush Limbaugh praying for a repeat of Chicago, 1968----

And instead, we saw Democratic unity, as Clinton hopped aboard the Obama campaign train and later join his cabinet as Secretary of State.

There is some very satisfying karmic justice being handed out this year. All thanks to the Supreme Court of the United states which ruled that anyone in the world has a Constitutionally guaranteed right to pump as much money as he wants into any election in the name of freedom of speech.

All that cash works exactly the way that brains do for a zombie. Say, one candidate manages to get ahead in Iowa by airing a bunch of really nasty attack ads on his opponent. Does his opponent lie down and die from his mortal wounds? Hell, no! He gets handed a few million dollars and he is back on his feet again, launching his own attack---

I haven’t read what the corporate media pundits have had to say about tonight’s New Hampshire campaign. Because their opinions don’t mean shit. Yes, Romney shot himself in the head with a loaded double barrel shot gun.

“I like firing people.”

Political death, like Muskie’s tears? I don’t think so. Just stuff a few million in cash in that big hole in the back of his skull, and he is ready to hit the campaign trail again. Same for “I don’t want to improve the lives of Black people” Santorum and “I agree with what Rick said” Newt. These guys have tripped over their own tongues so many times that it is a wonder their handlers even let them out to speak. And why do they bother? Why get on national television and make fools of themselves for not knowing the names of the cabinet positions they want to axe? All they really need to do is hold out their hands as they shuffle through the crowds and mutter

“More brains. More money. More votes. Arrrr!”

Posted by McCamy Taylor | Wed Jan 11, 2012, 03:32 AM (0 replies)

JAMA Watch Jan.11,2012: Moderate Marijauana Use is NOT Bad for Your Lungs

This weeks most interesting article is one in the research section about the effect---correction, the lack of effect that moderate marijuana smoking has on the lungs.

Before I get to the study results, a few words about how to evaluate research papers. If the study is a medical one, the most important thing is how was it conducted. The best studies are prospective, meaning that you take a group of people---the larger the better---and you follow them for a time----the longer the better---to see what happens to them. Along the way, you measure lots of things of interest. So, for example, you can measure cholesterol on day one and see if this seems to predict heart disease development over the course of the study. Much of what we know about chronic disease prevention comes from these types of research projects, of which the Framingham Heart Study is probably the best known.

A quicker, dirtier way to do the same type of research is a retrospective study. In this, a bunch of people who have a disease are questioned. A bunch of people who do not have the disease are also questioned. If a lot more of the people with the disease answer "yes" to the question, then you have an association. Remember, association is not causality. People with heart disease are also more likely to have had a stroke than folks without heart disease. That does not mean the stroke caused the heart disease. Retrospective studies are often flawed, because sick folks are more likely to remember things---like, say, the summer they worked with asbestos---than healthy folks are.

In the article "Association Between Marijuana Use and Pulmonary Function Over 20 Years" the researchers followed over 5000 men and women for two decades as part of the Coronary Artery Risk Development in Young Adults (CARDIA) project. Along the way, many pieces of information were collected, including how much tobacco was smoked and how much marijuana was smoked. The authors then compared this data to measures of lung function. Since many of those studied used both, the authors used statistical software that is able to take multiple possible factors and see how each is associated----or not associated---with different potential outcomes.

The results: tobacco cigarette smoking use was associated with reduced lung function. No surprise there. The more interesting finding: marijuana use was not associated with decreased lung function. Low level use (2 times a month or less) was actually associated with better lung function, while even heavy (i.e daily ) use did not significantly affect the lungs. However, heavy use was rare in the study, meaning that the findings here may not be valid.

Now, remember how I said that association does not equal causality. It is possible that low level use of marijuana strengthens the lungs in some way. But it is just as likely that other health or lifestyle differences associated with low level marijuana use (say, for instance, a healthy, more organic diet or living in a less polluted part of the country) could explain the lung findings.

So, don't walk away from this study thinking that two joints a month will give you the lungs of a marathon runner. On the other hand, if you need to use marijuana occasionally to control pain or glaucoma or nausea, you probably are not damaging your lungs.

Love the authors final paragraph, in which they admit that medical marijuana is beneficial for pain, appetite and other uses. The medical establishment is more than ready to start prescribing the drug. Now, if we could only convince government officials that the health and comfort of Americans is more important than the Prison Industrial Complex's ability to make money incarcerating low risk "offenders" whose only crime is smoking weed.
Posted by McCamy Taylor | Tue Jan 10, 2012, 06:40 PM (0 replies)

JAMA Watch Jan. 4, 2012: I read what the AMA is writing so you won't have to.

In the interest of the public health, I am going to start posting summaries of significant articles from JAMA the Journal of the American Medical Association, because it is widely read by U.S. physicians, and it has lots of influence on physicians in the U.S.--and sometimes the lay public. Recall that the editor of JAMA was given the boot during the Lewinsky Hearings for publishing a study done at a southern college which revealed that the majority of bright, educated southerners really do think that oral sex is not sex. Overnight, the Internet went from "Only a moron would try to claim that oral sex isn't sex" to "Of course, in some parts of the country 'sex' does not mean 'oral sex'. That is a scientifically proven fact."

Most of the stuff in JAMA isn't that much fun. A lot of it goes something like "Rhesus monkey pancreatic RNA useful in decreasing human aveolar diffusion in vitro tests" and crap like that.

Here are this weeks offerings of stuff you might want to know. There is a four article special on controlling health care costs.

1. "Reversal of Established Medical Practices: Evidence to Abandon Ship" In a nutshell, lots of things that doctors have been doing for a long time are not doing their patients any good, but people keep having them done because they are "The standard of medical care." The authors site the example stenting diseased coronary arteries that are not causing any symptoms. 84% of the stents performed in this country are of this type--and studies show that they do not do the patient any lasting good and probably isn't any better than placebo procedures at reducing angina (non fatal chest pain). The near universal use of hormone replacement therapy in any woman who had insurance is another example cited. So is verterbroplasty. These are treatments doctors have used for years because they ought to work, if you think about the physiology. However, health often does not make sense. There are too many factors at play. Sounding good does not take the place of clinical studies--and I am not talking the kind of sham circus performances that the company with the patent often stages with the help of a highly paid physician investigator.

Moral. We waste an awful lot of money on snake oil.

2. "What are the Health Care Cost Savings?" Did you know that if our health care spending continues at its present rate, one of every two dollars in the U.S. will be sucked up by the Medical Industrial Complex in 2080? Did you know that U.S. health care spending is the world's fifth largest economy?

Yeah, I agree. It is time to trim the fat. But where do we start? Malpractice caps, limiting insurance company profits, increasing use of generic drugs, letting preemies die (eeks!) will not do the trick.How do we start? The authors suggest tertiary prevention. Tertiary prevention means going after the cow when it is out of the barn and attempting to lasso it before it can run across the road and get run over by an eighteen wheeler. It makes good money for the cowboy doctors riding the horses in chaps and spurs carrying the lassos, but it would still be a lot cheaper to hire one pimple faced teenager to keep the barn door closed. That is what is known in the public health profession as primary prevention. The problem is primary prevention does not do anything for the years of medical neglect that our nation's middle aged and elderly have already suffered. The implication of tertiary prevention is you pay the family doctors to keep the patients from needing the much more expensive care of the specialty doctors. However, family doctors will have little control over whether or not the new patients 50 pack/year smoking history has given him a bad heart, emphysema and lung cancer. Meaning that the only way to give the appearance that you are "saving" money is to make sure that you do not accept any sick patients. See article 4 below.

3. "How will the affects of the Affordable Care Act be monitored?" Good question. The author suggests measuring how much preventable mortality drops----not the easiest thing to do, since sudden access to health insurance will not reverse a lifetime of health neglect. The drop in preventable hospitalizations should occur more rapidly as more of us get our diabetes controlled in an office rather than an emergency room when we finally go into diabetic coma. Third, how many people will actually get health care that they can afford to use out of their new health insurance? I'm betting that there will still be a huge number of people who will not be able to get the care they need, thanks to high deductibles, co-payments and limited provider directories. Fourth does the cost of health care per person go down to Western European levels? As with one above, expect a lag.

4."Withholds to slow Medicare spending: A Better Deal Than Cuts" A better deal if you belong to a huge multispecialty medical practice that cherry picks healthy, rich elderly patients, maybe. Remember HMO withholds? I do. They were a crock of shit. Doctors were told "We will reduce your fees by (anywhere from 5-50%) and if you are very frugal, you will get that money back. " Doctors are no fools. Indeed, they are some of the brightest folks you will meet. Tell them something like this and they immediately go full Titanic mode, jettisoning the sick folks from their practice and hanging onto the healthy. Yes, they do. My practice absorbed a lot of these orphan cancer and heart patients in the mid-nineties when their regular family doctors suddenly discovered that they did not have the skills necessary to treat these kinds of people. Or, they suddenly had the skills necessary to take the place of the oncologist and cardiologists. Remember, referral denials are not intended to make patients do without necessary care. That would lead to malpractice suits. Docs who refuse to refer knows that their patients will get on the phone to their insurer and find a doctor who will.

OK, I will get down from my soapbox. What do the authors suggest? One, base payments on the cost savings (or excessive spending) of care providers in a specific geographic region. Which is bullshit. Who is going to set up practice in an area with a lot of poor folks, knowing that poor folks are also sick folks, and therefore the doctors who spend long agonizing hours trying to improve the lives of America's least fortunate---like the minorities that live in the petrochemical industry's pollution---will be penalized for doing so? This is nothing but regional discrimination. Boundaries would be drawn to keep the poor and minorities in areas that would remain woefully under served. Second option? You guessed it. Let savvy doctors join huge multi-specialty groups that will vow to keep down costs by eliminating waste but which will actually cherry pick their way to riches.

Moral: watch out for financial arrangements suggested by doctors (Yeah, I am one. Want to make something of it?) They are not ready to give up on their six and seven figure salaries yet, and if they can find a way to get rich quick and then quit practice, many of them will do it.
Posted by McCamy Taylor | Mon Jan 9, 2012, 11:25 PM (7 replies)
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