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Should We Panic over the Measles Outbreaks?

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by: Jane M. Orient, M.D.

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In general, it is not a good idea to panic about anything. The panic itself often causes more harm than the original threat.

Crisis situations, real or contrived, lead to new intrusive laws that the public would never accept otherwise. We supposedly cherish freedom, but if we believe that the world will end if we don’t act NOW, then we may clamor for the government to save us. Cynical politicians bent on increasing their power never let a crisis go to waste.

Something like the Green New Deal—the end of our comfortable, prosperous lifestyle—takes a truly apocalyptic threat. But to eliminate our freedom to decline a medical treatment, the threat that “millions will die” of measles is evidently enough. Or if not millions (most older people had measles and recovered fully), a few especially vulnerable children, who can’t be vaccinated themselves, might catch measles and die.

There are several hundred cases of measles nationwide, more than in 2014, and bills are being pushed through state legislatures to eliminate all but very narrow exemptions to the 60 shots now mandated for school attendance.

In New York City, people are receiving summonses based on Mayor Bill de Blasio’s emergency order. Everybody, adult or child, who lives in four ZIP code areas must get an MMR shot or prove immunity, or face the prospect of a $1,000 fine ($2,000 if you don’t appear as ordered). Your religious exemption is overridden. The threat of 6 months in prison and the prospect of forcible vaccination were removed before a hearing on a lawsuit brought by five mothers. The judge dismissed the case.

Health Commissioner Oxiris Barbot said that the purpose of the fines is not to punish but to encourage more people to proclaim the message that vaccines are safe and effective. Get it? If you say something to avoid a fine, that makes it true. More

Who Is Your Doctor?

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April 2nd, 2019

Who Is Your Doctor?

by: Jane M. Orient, M.D.

People used to know who their doctor was. His name and phone number were on the wall or the refrigerator next to the telephone. He was there for you and could manage most of your problems.

When I was about 13, my mom took me to our pediatrician for belly pain. He was on his way out the door, but he stopped to take care of me. He diagnosed appendicitis based on history and physical examination. He called his favorite surgeon (“Billy,” a Tucson legend), who came from the golf course to meet me in the emergency room. Within hours, my red-hot appendix was in a jar. My parents paid the hospital bill ($150—10 days’ pay for a construction laborer) as I was discharged a few days later.

Today, the patient with abdominal pain could wait for hours to see the ER provider—possibly a nurse practitioner or physician assistant who had never seen a case of acute appendicitis. She’ll probably get a CT scan, after another wait. Eventually, Dr. On-call may take her to the operating room, hopefully before the appendix ruptures. And the bill will be beyond the means of ordinary people.

I used to be able to direct-admit patients from my office and send them with a set of orders to the hospital admitting office. For years, this has been impossible. The hospital is decidedly unfriendly to independent doctors. There’s now a gatekeeper in the emergency room, and most patients are under the control of a hospitalist. More

What to Do about a Caravan of Rag-tag Migrants

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October 30th, 2018

by: Jane M. Orient, M.D.

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Where is the supply caravan? People are not carrying heavy back packs full of provisions. It is said that an army marches on its stomach. What about these people?

No sanitary facilities are visible. What does the trail look like after the crowd has passed?

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The narrative appears to be that thousands of oppressed peoples spontaneously decided, all at once, to flee a murderous, corrupt government in Central America, and walk to the U.S., in time for election day, to plead for asylum and begin to work hard for a better life in the U.S. (Take note: it is a “caravan” not an “army.”)

We see photos of a mass of walking people, including women, some carrying babies. There are photos of a resting crowd, some tending to infants.

Some are waving flags of the purportedly evil regimes they are fleeing—such as Honduras. Some are receiving cash from men in white T-shirts. Some are reportedly receiving gifts of sandals or food from charitable Mexicans.

But there are some questions that surely have occurred to the Trump Administration, and even to the mainstream media. More

What The Election Means To Your Medical Care

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October 16th, 2018              For Immediate Release!

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

Interview – Contact Dr. Orient directly at (520) 323-3110

Preview: People are marching with “Health Care Voter” signs, and this is generally believed to be one of the most important issues in the 2018 midterm elections. Republicans who got elected on the promise to repeal ObamaCare, and reneged, may now get unelected. Voters who supported them are dissatisfied, and Democrats demand still more government involvement in medicine.

On Twitter, #HealthCareVoter posts warned that the confirmation of Brett Kavanaugh to the U.S. Supreme Court would “rip health care away from people with pre-existing conditions.” This illustrates several profound misunderstandings.

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by: Jane M. Orient, M.D.

People are marching with “Health Care Voter” signs, and this is generally believed to be one of the most important issues in the 2018 midterm elections. Republicans who got elected on the promise to repeal ObamaCare, and reneged, may now get unelected. Voters who supported them are dissatisfied, and Democrats demand still more government involvement in medicine.

On Twitter, #HealthCareVoter posts warned that the confirmation of Brett Kavanaugh to the U.S. Supreme Court would “rip health care away from people with pre-existing conditions.” This illustrates several profound misunderstandings.

By “health care,” most seem to mean health “insurance”—usually a prepaid health plan, which is not at all the same as medical care. The Supreme Court already decided that it is unconstitutional under the Commerce Clause to force people to buy a commercial product. Remember stare decisis? Would it be ok to overturn the ACA decision, just not Roe v. Wade? More

Universal Coverage Means Less Care

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

Interview – Contact Dr. Orient directly at (520) 323-3110 or by email at janeorientmd@gmail.com

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When the money is gone, treatment is canceled. There will be fewer beds, fewer CT scanners, fewer drugs, and fewer doctors. But all will be fair. No rationing by price, just by waiting lines, political pull—and death. There will be no medical bills to pay after a service, if you get any service. Only taxes in advance, service or no service.

That’s why the universal care advocates count enrollees, not the number of services, and constantly harp on “excessive” treatment, even while planning to make patients wait months for an appointment.”

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May 16th, 2017

The reported success of the Affordable Care Act (ACA or ObamaCare) is based on enrollment numbers. Millions more have “coverage.” Similarly, the predicted disasters from repeal have to do with loss of coverage. Tens of thousands of deaths will allegedly follow. Activists urge shipping repeal victims’ ashes to Congress—possibly illegal and certainly disrespectful of the loved one’s remains, which will end up in a trash dump.

Where are the statistics about the number of heart operations done on babies born with birth defects, the latest poster children? How about the number of babies saved by this surgery, and the number allowed to die without an attempt at surgery—before and after ACA? I haven’t seen them. Note that an insurance plan doesn’t do the operation. A doctor does. The insurer can, however, try to block it

Also missing are figures on the number of courses of cancer chemotherapy given, or not given, or the time from diagnosis to death in cancer patients before and after ACA. Five-year survival of cancer patients in the U.S. is generally better than in countries that have universal coverage, or the type of plan progressives want to import. Again, the insurance plan isn’t medicine. You can get medicine without insurance, and if you have insurance it might refuse to pay.

There are selected comparisons of change in mortality rates in states that did or did not expand Medicaid (such as New York vs. Pennsylvania). On the other hand, mortality did not decrease in one state (Oregon). These estimates—guesstimates really, are based on the weakest type of data, and the differences may have nothing to do with Medicaid. Maybe it was better AIDS treatments. We hope that the FDA does not use evidence this poor to evaluate drugs.

But what effect did ObamaCare have on overall U.S. mortality?

Between 2014 and 2015, U.S. mortality rates increased for the first time in decades. This primarily affected less-educated whites. Is ObamaCare the cause? There are many factors involved, drug abuse probably being the most important. But I suspect that if repeal had happened in 2012 or 2013, it would have been blamed.

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ObamaCare Can Cancel Your Insurance, Warns Association of American Physicians and Surgeons (AAPS)

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Association of American Physicians and Surgeons

1601 N. Tucson Blvd. Suite 9

Tucson, AZ 85716

 

March 10, 2015

Tucson, AZ. One of the biggest selling points for the Affordable Care Act (ACA or ObamaCare) was the promise that insurers couldn’t cancel your plan if you get sick. But if the U.S. Supreme Court, in King v. Burwell, holds premium subsidies to be illegal in Exchanges not established by States, the Administration will allow insurers to abrogate their contracts, says the Association of American Physicians and Surgeons.

“It’s déjà vu all over again,” states AAPS executive director Jane M. Orient, M.D. “When Medicare passed, seniors who had private insurance lost it. The insurers told President Johnson that they couldn’t unilaterally cancel subscribers’ contracts. But LBJ said they could cancel all the contracts, and they did. Private insurance for seniors was ended with a stroke.”

“While the Administration assures HealthCare.gov policyholders that ‘nothing has changed,’ it has been conveying a contradictory message to health insurance companies,” writes Senator Orrin Hatch (R-Utah) in a letter to former CMS head Marilyn Tavenner. “Late last year, CMS altered the agreements to participate in the federal exchange, guaranteeing insurance companies the right to pull out of their contracts should federal subsidies such as the APTC come to an end—in other words, if the Administration loses before the Supreme Court.”

The Administration apparently has a contingency plan to protect insurers, Orient notes, but what about patients? “Millions lost their existing plans, which they liked, when ACA forced them to be pulled from the market. People had to buy an ACA-compliant replacement plan, usually much more expensive, and they could now lose that too.”

“What will be left?” AAPS asks. “Will Congress repeal ObamaCare and all its impossible mandates on insurers and the medical system? Or will Americans be forced into Obama’s preferred system of total dependence on government—and its completely untrustworthy promises?”

Sen. Hatch has demanded documents from CMS so that the Senate Finance Committee can conduct oversight.

Sen. Ben Sasse (R-Neb.) and other Republicans are proposing transition plans such as the Winding Down Obamacare Act, which are intended to protect patients from loss of insurance, and to prevent the Administration from exerting coercive pressure on States to establish Exchanges that would further cement ObamaCare in place.

The Association of American Physicians and Surgeons (AAPS) is a national organization representing physicians in all specialties, founded in 1943 to preserve private medicine and the patient-physician relationship. More

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