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The Horror of Chemical Weapons

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Contributor & author: Jane M. Orient, M.D., Executive Director of Association of American Physicians and Surgeons (AAPS)

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  • One may ask how to draw a red line between chemical agents that poison and burn and chemical agents that explode? The latter, called “conventional” weapons, kill by tearing people apart or setting fires. Is this a more humane death?
  • Then there are the methods used by Assad’s enemies: burning children alive, running over them with a truck, crucifying them, or beheading them. And there are the true weapons of mass destruction: biological agents (which have a doubling time instead of a half life) and nuclear weapons.
  • Chemical Weaponry is not the Demon that must be slain at any cost. It is one of a legion of horrors called War.

April 18th, 2017

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Syrian President Bashar al Assad is being read out of the human race, and the Trump Administration seems to have done a 180-degree turn on the necessity for “regime change” in Syria because Assad used horrible, horrible! weapons against civilians, including helpless little babies.

A journalist might ordinarily assert the word “allegedly” before the charges—if for no other reason that while no one thinks Assad is good, some might think he is not that stupid. But he has already been tried and convicted, by the media and the government. That’s the infallible tribunal that sequentially declared that Iraq had chemical weapons, then didn’t (might they have shipped them to Syria?), and that the Syrian regime had disposed of theirs, but now had used them to kill their own babies.

Chemical weapons seem to be in a class by themselves: the ultimately gruesome way to die. Their use crosses the final Red Line to a heinous crime against humanity, and is a violation of international law. Of course, we don’t always do much about it. More

Danger: Interstate Compact Could “Fundamentally Transform” Medicine

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Jane M. Orient, M.D.

While Americans are preoccupied with the political theater of the Presidential race, special interest groups toil to pass legislation that could radically transform your medical care. One example is the Interstate Medical Licensure Compact, which has passed in 11 states. Pennsylvania has joined a number of others in proposing it.

The proposal promises to provide “remote communities with access to high-quality care through telemedicine” and “address a shortage of medical personnel in underserved rural and urban regions,” according to an article in the Pennsylvania Business Daily.

Americans need to remember three things about proposed legislation:

  • Its real purpose is likely to be very different from the stated one, and the result may be the opposite of the one that is promised.
  • Especially when the same law is surfacing simultaneously in a number of states, some vested interest wants to make money from it. A lot of money—getting laws passed can be very expensive.
  • There may be no way back, as the law empowers and funds interest groups that will oppose repeal.

So what does the Compact do to bring telemedicine to underserved areas? By itself, nothing. It’s about a bypass to state control of licensure, not about providing care. If telemedicine were the real object, the way to expedite it would be to define the location of medical care as the location of the doctor, not the patient. The doctor would need a license in only one state. Compact proponents oppose a telemedicine bill in Congress that would do just that.

Some physicians already hold a license in several states—they just apply to each state. Under the Compact, they would apply to a private interstate commission, which would have its own rules, possibly overriding rules of the states, and which would have no public accountability. This would add costs, not eliminate them. It could also allow doctors to evade state laws meant to protect patients. For example, a carpetbagger abortionist could fly in to do late-term abortions forbidden by the state, under his Compact license. More

Will Republicans Keep the Court from Blowing Obama’s Cover?

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by Jane M. Orient, M.D.

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The Big Lie of ObamaCare is in the title: the Affordable Care Act. Administration officials invoke “affordable” over and over again.

The U.S. Supreme Court could well blow the Democrats’ cover in King v. Burwell if it rules that people in the 37 states that did not establish an Exchange cannot legally get taxpayer subsidies for health insurance.

The subsidies hide the reality. People generally look only at what they themselves have to pay. They do not care what faceless taxpayers are paying to insurance companies for their policies.

Of the 11.7 million Americans who now have private health insurance through federal and state marketplaces, 86 percent of them are receiving financial assistance from federal taxpayers to help pay premiums—or, more accurately, their insurance company is.

“More than seven million people could lose subsidies, making insurance unaffordable,” said White House officials, according to the New York Times.

These subsidies (“tax credits”) averaged $263 a month and reduced the premium by 72 percent, on average. Taxpayers who manage to earn more than a certain threshold thus have to pay 100 percent of their own premiums plus their “fair share” of 72 percent of premiums for those who earn less.

Assuming that they will be blamed for the surge in the number of uninsured, although they did not write the law, congressional Republicans are scurrying for ways to “fix” the problem of a purported “mistake” in drafting the law.

The only problem they apparently see is that people would lose coverage—not that ObamaCare drove premiums to unaffordable levels. And the only remedy they can think of is to force others to pay the unaffordable cost, at least for a time. Not having learned from vast experience, they assume that an extension of subsidies will be temporary.

One would like to see Republicans explain to the people why the whole structure of ObamaCare is a mistake, which worsens and solidifies the problems that make American medical care so costly in the first place. These are the simple, incontrovertible facts:
• Guaranteed issue/community rating always drives up premiums and leads to a “death spiral.” Unless premiums are based on risk, people have no incentive to buy insurance when they are well.
• Mandates to pay for expensive services people do not need or want help purveyors of such services but drive up premiums.
• Third-party payment itself always and everywhere drives costs far higher than people would pay if spending their own money.
• Administrative micromanagement drives up costs and limits access.
• Insurance is not the only way to buy medical care—just the most expensive way.

ObamaCare needs to be repealed. Tweaking one of the interlocking parts just makes the interconnected rest even more unworkable. If the Supreme Court exposes the true cost by removing the veil of subsidies, Republicans should not try to cover it up.

If people lose coverage, another shocking truth might be revealed, to the horror of the insurance cartel: they might be better off. The unsubsidized share of premiums—instead of being sucked into the insurer’s bank account—would be available to buy actual care, which people might now avoid because of high ObamaCare deductibles. A market might develop for true catastrophic-only insurance, with appropriately low premiums. Note that if ObamaCare insurance becomes unaffordable because of lack of subsidies, the individual mandate penalty/tax does not apply.

Of the money paid to insurers, at least 15 percent goes to administration and much more to activities like “quality assurance” that provide nothing recognizable to patients as a medical service or product. And if the insurer does pay for something, it decides exactly what, when, and how much a beneficiary might receive.

There are many alternatives to dependence on the government/insurer monolith, which the cartel would love to crush, such as health sharing ministries, direct-pay practices, and indemnity insurance. More resources are becoming available to patients (for example, medicalselfsufficiency.com and selfpaypatient.com).

Republicans should not help to suppress alternatives by propping up the ObamaCare monster and leaving the façade of subsidies intact.

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Federal Officials Want to Spend $20 Billion on AIDS Drugs, Based on 45 Cases

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new logoJane M. Orient, M.D.

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About $6 billion per year is now spent on a cocktail of drugs to treat “HIV disease”—a positive blood test for antibody for human immunodeficiency virus, the accepted cause for AIDS. Treatment generally starts when the patient’s CD4 white blood cell count drops below 350-500. (Normal is 500 to 1,200 per cubic millimeter.) But if we didn’t wait for this, we could spend $20 billion.

A front-page story in New York Times trumpets a call to start treatment immediately, based on the cleverly named START trial (Strategic Timing for Anti-retroviral Treatment), which was designed to test whether patients who got immediate treatment did better than those for whom treatment was delayed. Some 4,685 HIV-positive persons in 35 countries, of median age 36, were involved.

The AIDS industry and its government allies were just waiting for evidence to justify a change in policy. Dr. Anthony S. Fauci, director of the National Institute for Allergy and Infectious Disease, which sponsored the trial, said he had had “no doubt how it was going to turn out.” The trial was stopped early, when a (statistically) significant difference of 53 percent favoring the treatment group was announced .

Many patients have been reluctant to start early treatment because of drug side effects. Newer regimens are more tolerable. The 53 percent difference is likely to persuade many to opt for immediate treatment.

But the “53 percent” represents just 45 individuals. At the time the study was stopped, 86 of those in the deferred-treatment group had died, developed AIDS, or suffered a serious non-AIDS event like heart, liver or kidney disease or cancer, vs. only 41 of those in the immediate treatment group.

As in many other studies of this type, enthusiastic researchers cite the relative risk reduction (53 percent), which looks much more impressive than the absolute risk reduction from about 3.67 percent to about 1.75 percent—a difference of less than 2 percent.

Note that many of the adverse outcomes in study patients can be caused by antiretroviral drugs, especially with prolonged use. These include heart disease, liver damage, and cancer—and also premature aging and cognitive impairment. Had the study been continued another year or so until completion—or better still for 5 more years, the outcome might have been different.

Early treatment advocates also say it prevents disease transmission to a sexual partner. For this, the relative risk reduction, 96 percent, looks even more impressive. “Overwhelming,” said Fauci. That trial was also terminated early.

It involved 1,763 couples, 90 percent of whom were heterosexual, in 13 cities on four continents. One member of each couple was HIV-positive; the other was not. In half the couples, the HIV-positive partner was put on antiretroviral drugs immediately after a positive test was obtained. In the other half, treatment was started only when the CD4 count dropped below 250.

In 28 of the couples, the HIV-negative person became positive for the partner’s strain of the virus; in 27, anti-retroviral treatment had not been started. This means that sero-conversion did NOT occur in about 880 of 881 couples getting treatment (99.8 percent) or in 854 of 881 of untreated couples (96.9 percent), for an absolute difference of less than 3 percent.

Based on these limited results, some advocate treating 40 million people worldwide, both to improve the health and longevity of HIV-positive people and to stop the spread of AIDS. Additionally, universal screening is called for to identify candidates for therapy—forgetting that in low-risk individuals, a positive result is most likely a false positive.

This type of reasoning is not limited to AIDS. For example, an influential trial of statin drugs for preventing cardiovascular disease was stopped after about 2 years. That was far too soon to detect premature aging, cognitive impairment, or many other long-term drug effects. Again, the relative risk reduction of some 36 percent is touted, and the absolute risk reduction of less than 2 percent is not mentioned.

Only one result of policy based on such research is certain: a vast expansion of the market for expensive drugs to treat lab test results and “risk factors,” rather than apparent disease. The effect on patients is unknown, but likely not good.

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Will U.S. Keep Ebola in Check Here at Home?

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new-logo25Contributor & author: Jane M. Orient, M.D.,

Media Pundit & Internal Medicine Physician

              President, Doctors For Disaster Preparedness

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Some 3,000 American soldiers are arriving in Africa to fight an Ebola epidemic that is doubling about every 3 weeks, with the number of infections projected to reach 1.4 million by January. President Obama said: “It will require an ‘air bridge’ to get health workers and medical supplies to areas that are affected.”

Meanwhile, the virus has used the air bridge of a commercial flight to reach Dallas. So far, only the index patient is ill, but 100 contacts are being observed.

Although a large number of experts agree that the likelihood of a widespread outbreak is “vanishingly small,” owing to our “highly sophisticated public health system,” a number of breaches in our invulnerability are already manifest.

The hospital where the patient initially presented failed to follow federal guidelines. He told a nurse that he had been in Liberia and should have been placed in isolation and tested for Ebola immediately. Instead, he was sent home on antibiotics, which are useless for viral infections.
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Will Medicare Become Like the VA?

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new-logo25By Jane M. Orient, M.D. 

Executive Director of Association of American Physicians and Surgeons,

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“No VA employee, however incompetent, could ever be fired,” stated one physician.  Another said, “Incompetence is accepted…, and keeping quiet about it is the accepted norm.”

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Most veterans get most of their medical care from private doctors through Medicare or private insurance. Just think what those secret waiting lists would be like if they didn’t!

Still, a VA-like system for all has been proposed as a replacement for our unsustainable current system—at least until the recent scandals broke.

One enormous difference between the VA and Medicare is that veterans are free to go elsewhere—if they pay privately. Some veterans use their VA doctor only to get free medications.

Medicare patients, on the other hand, are trapped. There is virtually no private coverage available to persons over 65 to replace Medicare—President Lyndon Johnson wiped it out to prevent competition with “his” beloved system. There are only policies to “supplement” Medicare. And Medicare patients can’t just pay out of pocket for a “covered” service they can’t get otherwise, say because the Medicare-allowed price is too low—unless they see a doctor who is opted out of Medicare or disenrolled. For doctors, Medicare is all or nothing, so most doctors are still enrolled.

Most people don’t care about that—not yet. Who would want to pay for something that is free?

So it’s a good idea to look at those “free” (taxpayer-paid) VA services. More

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