A good explanation. This was passed on to my wife by her doctor.


Immoral Medicine
By Dr. Lee Hieb
11/09/2009

The magician distracts the audience by doing meaningless but fascinating things with his right
hand, while his left hand is doing the really meaningful activity unnoticed by the crowd. The
bigger the trick, the bigger the distraction required.

Democrats and President Obama should make David Copperfield proud. With one hand they are
distracting the American people with a nonstop barrage of bills and discussion: What will
happen to the budget? How many are really uninsured? Is the Congressional Budget Office to be
believed?

And for the ultimate distraction, Mr. Obama paraded a group of “doctors” in borrowed white
coats for a great visual effect wholly devoid of substance. For all we knew, these guys could
have been a group of actuaries at a DC convention bussed in as props for the day. (More likely
they were doctors of the government paid variety, like Rahm Emanuels’s physician brother
Ezekiel, sheltered in research institutions and teaching hospitals where they don’t have to run
their own small businesses.)

While this diversion is going on, the real issues are hidden from the public -- the consequences of
government funding of medical care on individual liberty and our moral compass.
Government pay medicine -- under any name you give it -- is immoral for patients/citizens, and
for physicians. No citizen would consider it moral to put a gun to his neighbor’s head and
demand that he pay for his mother’s medical care -- no matter how much she may need it. It is
no more moral when people use the government as intermediary. For the physician, it is
impossible to practice moral medicine in a government system, because ultimately at some level
a physician will have to choose between doing the best for his patient or acquiescing to the
requirements of the state.

The worst moral examples of course were the German doctors who were forced to cooperate in
death camp selections. At the other end of the spectrum the moral tightrope has already started
here with Medicare. Federal practice guidelines have slowly become mandates. If you do not do
what the government has deemed the optimum pathway for care, the hospital will not get
paid. In my case, for the most part, the guidelines can be followed, but the day is coming when I
will have to choose.

There is no question that the risk of DVT -- deep venous thrombosis, and PE (pulmonary
embolism) goes up after some hip fractures. So, usually, Orthopaedic Surgeons prescribe a form
of blood thinner to prevent this complication. But thinning someone’s blood comes with its own
risks of death and morbidity, and there are certainly people for whom the risk of anticoagulation
is greater than the risk of thrombosis after the fracture. Without federal “guidelines” physicians
used clinical judgment to cull out those people who would do well without the risk of
anticoagulation, e.g. those who have a non-displaced fracture, who undergo minimally invasive
pinning, and who are mobilized within hours of the fracture. This is not uncommon in small
hospitals where these patients can be treated promptly.

But the government is telling us we must anticoagulate all patients -- as if all patients and all
circumstances were the same. Although there are recognized exceptions to the blood thinning
protocol, judgment of relative risk by the surgeon is not one the government accepts. So
surgeons are in the position of doing what is best for their patient, or what is prescribed by the
state wielding a financial mallet.

In between these two extremes is the Canadian physician who must prioritize patients in a
system with too little resources. Dr. Leo Kurisko is a radiologist who left Canada to practice in
the US (as have 11% of practicing Canadian doctors). At a recent medical meeting, he related
the moral problem of practicing radiology in Canada. Because the system is chronically short of
functioning CT scanners, at his regional hospital there was a three month waiting list for a
CT. Dr. Kurisko would review the requests for testing, and would then triage which patients
went to the front and which to the back of the queue. After the scans were finally completed, he
reviewed the studies and began to recognize patients with life threatening tumors whom he had
prioritized to the back of the line. Faced with this Canadian version of “death camp selection” he
quit. He has documented the evils of government medicine in a new book, Health Reform: The
End of the American Revolution?

Consider the Netherlands, where the number one reason for the death of children under the age
of ten is murder by their doctor. Oh, of course they do not call it that, but it is what it
is. Because the Netherlands pays for medical care, they choose whom to support. And severely
disabled children and the infirm elderly are not high on their priorities.

The Dutch doctors practicing thus are the children and grandchildren of physicians who went to
the death camps themselves rather than participate in the Nazi killing machine. So how did this
happen? It happened through the moral incrementalism of becoming state doctors--of putting the
good of the state above the good of the individual patient.

Medicare has been an assault on freedom since its inception. Americans who turn 65 may think
they are still free but they are not. You are not free to opt out unless you are willing to forgo
your social security payment. Even people who see Social Security as part of the problem are
not willing to give up an entitlement they have paid into all their lives. And once enrolled in
Medicare, you cannot pay for services outside the system unless these services are not offered at
all by Medicare, or unless you find that rare physician who runs a cash practice totally off the
grid.

Physicians who see any Medicare patients at all are not free to bill outside the Medicare system
for services which they cannot afford to offer at Medicare rates. For example, if an active 65
year old patient wants to have a special high tech knee implant that was designed for the more
active younger patient, he cannot pay the difference between the regular implant and the latest
development. If Medicare offers “the service” at any level you cannot buy the service on the free
market.

In this way, rationing by diminishing the supply of specialists has already started by diminishing
the options open to Medicare recipients. Physicians are not that different from Starbucks -- they
are not going to pay you for the privilege of serving you.

Although, for a while, Oncologists did just that. In the last few years, as Medicare cut the
reimbursement for some newer types of chemotherapy, Oncologists would suck up the cost
because they wanted to do the best for their patients. But now, as Medicare has ratcheted back
payment even more, they have reverted to older drugs. And because there is no free market, the
patient cannot simply pay the difference to get the latest scientific breakthrough.

So ignoring the smoke and magic mirror tricks, government payment for medicine must be
rejected, not on practical financial grounds, but by people who value their freedom and their
moral lives. As recognized by our founders, but ignored by the current crop of politicos, the most
unhealthy immoral force in human history has been overly powerful central
governments. Charley Reese put it best when he said, “It is an eternal shame to give up one’s
freedom for a filled bowl of oatmeal and the promise of security from liars”.

Lee Hieb is an Orthopaedic Surgeon, in solo private practice. Her first-hand experience in
medicine began in the 1950s, when she accompanied her father on his housecalls in Iowa

On 18/04/2011 12:30 PM, John H wrote:
A good explanation. This was passed on to my wife by her doctor.


Immoral Medicine
By Dr. Lee Hieb
11/09/2009

The magician distracts the audience by doing meaningless but fascinating things with his right
hand, while his left hand is doing the really meaningful activity unnoticed by the crowd. The
bigger the trick, the bigger the distraction required.

Democrats and President Obama should make David Copperfield proud. With one hand they are
distracting the American people with a nonstop barrage of bills and discussion: What will
happen to the budget? How many are really uninsured? Is the Congressional Budget Office to be
believed?

And for the ultimate distraction, Mr. Obama paraded a group of “doctors” in borrowed white
coats for a great visual effect wholly devoid of substance. For all we knew, these guys could
have been a group of actuaries at a DC convention bussed in as props for the day. (More likely
they were doctors of the government paid variety, like Rahm Emanuels’s physician brother
Ezekiel, sheltered in research institutions and teaching hospitals where they don’t have to run
their own small businesses.)

While this diversion is going on, the real issues are hidden from the public -- the consequences of
government funding of medical care on individual liberty and our moral compass.
Government pay medicine -- under any name you give it -- is immoral for patients/citizens, and
for physicians. No citizen would consider it moral to put a gun to his neighbor’s head and
demand that he pay for his mother’s medical care -- no matter how much she may need it. It is
no more moral when people use the government as intermediary. For the physician, it is
impossible to practice moral medicine in a government system, because ultimately at some level
a physician will have to choose between doing the best for his patient or acquiescing to the
requirements of the state.

The worst moral examples of course were the German doctors who were forced to cooperate in
death camp selections. At the other end of the spectrum the moral tightrope has already started
here with Medicare. Federal practice guidelines have slowly become mandates. If you do not do
what the government has deemed the optimum pathway for care, the hospital will not get
paid. In my case, for the most part, the guidelines can be followed, but the day is coming when I
will have to choose.

There is no question that the risk of DVT -- deep venous thrombosis, and PE (pulmonary
embolism) goes up after some hip fractures. So, usually, Orthopaedic Surgeons prescribe a form
of blood thinner to prevent this complication. But thinning someone’s blood comes with its own
risks of death and morbidity, and there are certainly people for whom the risk of anticoagulation
is greater than the risk of thrombosis after the fracture. Without federal “guidelines” physicians
used clinical judgment to cull out those people who would do well without the risk of
anticoagulation, e.g. those who have a non-displaced fracture, who undergo minimally invasive
pinning, and who are mobilized within hours of the fracture. This is not uncommon in small
hospitals where these patients can be treated promptly.

But the government is telling us we must anticoagulate all patients -- as if all patients and all
circumstances were the same. Although there are recognized exceptions to the blood thinning
protocol, judgment of relative risk by the surgeon is not one the government accepts. So
surgeons are in the position of doing what is best for their patient, or what is prescribed by the
state wielding a financial mallet.

In between these two extremes is the Canadian physician who must prioritize patients in a
system with too little resources. Dr. Leo Kurisko is a radiologist who left Canada to practice in
the US (as have 11% of practicing Canadian doctors). At a recent medical meeting, he related
the moral problem of practicing radiology in Canada. Because the system is chronically short of
functioning CT scanners, at his regional hospital there was a three month waiting list for a
CT. Dr. Kurisko would review the requests for testing, and would then triage which patients
went to the front and which to the back of the queue. After the scans were finally completed, he
reviewed the studies and began to recognize patients with life threatening tumors whom he had
prioritized to the back of the line. Faced with this Canadian version of “death camp selection” he
quit. He has documented the evils of government medicine in a new book, Health Reform: The
End of the American Revolution?

Consider the Netherlands, where the number one reason for the death of children under the age
of ten is murder by their doctor. Oh, of course they do not call it that, but it is what it
is. Because the Netherlands pays for medical care, they choose whom to support. And severely
disabled children and the infirm elderly are not high on their priorities.

The Dutch doctors practicing thus are the children and grandchildren of physicians who went to
the death camps themselves rather than participate in the Nazi killing machine. So how did this
happen? It happened through the moral incrementalism of becoming state doctors--of putting the
good of the state above the good of the individual patient.

Medicare has been an assault on freedom since its inception. Americans who turn 65 may think
they are still free but they are not. You are not free to opt out unless you are willing to forgo
your social security payment. Even people who see Social Security as part of the problem are
not willing to give up an entitlement they have paid into all their lives. And once enrolled in
Medicare, you cannot pay for services outside the system unless these services are not offered at
all by Medicare, or unless you find that rare physician who runs a cash practice totally off the
grid.

Physicians who see any Medicare patients at all are not free to bill outside the Medicare system
for services which they cannot afford to offer at Medicare rates. For example, if an active 65
year old patient wants to have a special high tech knee implant that was designed for the more
active younger patient, he cannot pay the difference between the regular implant and the latest
development. If Medicare offers “the service” at any level you cannot buy the service on the free
market.

In this way, rationing by diminishing the supply of specialists has already started by diminishing
the options open to Medicare recipients. Physicians are not that different from Starbucks -- they
are not going to pay you for the privilege of serving you.

Although, for a while, Oncologists did just that. In the last few years, as Medicare cut the
reimbursement for some newer types of chemotherapy, Oncologists would suck up the cost
because they wanted to do the best for their patients. But now, as Medicare has ratcheted back
payment even more, they have reverted to older drugs. And because there is no free market, the
patient cannot simply pay the difference to get the latest scientific breakthrough.

So ignoring the smoke and magic mirror tricks, government payment for medicine must be
rejected, not on practical financial grounds, but by people who value their freedom and their
moral lives. As recognized by our founders, but ignored by the current crop of politicos, the most
unhealthy immoral force in human history has been overly powerful central
governments. Charley Reese put it best when he said, “It is an eternal shame to give up one’s
freedom for a filled bowl of oatmeal and the promise of security from liars”.

Lee Hieb is an Orthopaedic Surgeon, in solo private practice. Her first-hand experience in
medicine began in the 1950s, when she accompanied her father on his housecalls in Iowa

Big problem the fleabaggers don't realize is what do you do when the
no-competition government service sucks, and government has your money
what to do? Pay twice? Pay for extra care on top of government taxes?

--
I can assure you that the road to prosperity is not paved with
fleabagger debt.

On Mon, 18 Apr 2011 17:24:42 -0400, Gene wrote:

On Mon, 18 Apr 2011 14:30:42 -0400, John H
wrote:

A good explanation. This was passed on to my wife by her doctor.


At least it came from a disinterested third party! Or not........

Either way, it makes good sense.

On Mon, 18 Apr 2011 18:01:45 -0400, Gene wrote:

On Mon, 18 Apr 2011 17:39:41 -0400, John H
wrote:

On Mon, 18 Apr 2011 17:24:42 -0400, Gene wrote:

On Mon, 18 Apr 2011 14:30:42 -0400, John H
wrote:

A good explanation. This was passed on to my wife by her doctor.


At least it came from a disinterested third party! Or not........

Either way, it makes good sense.

NO... IT DOESN'T!

When you have to write a persuasive article using the following, you
are full of ****:

*The magician distracts the audience.....

*Democrats and President Obama should make David Copperfield
proud.....

*Is the Congressional Budget Office to be believed?

*And for the ultimate distraction, Mr. Obama paraded a group of
“doctors”.....

*Government pay medicine -- under any name you give it -- is immoral
for patients/citizens, and for physicians.

*No citizen would consider it moral to put a gun to his neighbor’s
head......

*The worst moral examples of course were the German doctors who were
forced to cooperate in death camp selections.

Lee Hieb is an Orthopaedic Surgeon, in solo private practice. Her
first-hand experience in medicine began in the 1950s, when she
accompanied her father on his housecalls in Iowa....

And I wonder what her father would think of her obscenely high fees
and a practice that is so focused on maximizing income, that
housecalls are not EVEN on the radar....?

You've found fault with the way she presented herself, not the facts of the article. And, you have
to admit there was a hell of a lot of deception going on.

On Mon, 18 Apr 2011 19:51:44 -0400, Gene
wrote:

On Mon, 18 Apr 2011 19:03:55 -0400, John H
wrote:

On Mon, 18 Apr 2011 18:01:45 -0400, Gene wrote:

On Mon, 18 Apr 2011 17:39:41 -0400, John H
wrote:

On Mon, 18 Apr 2011 17:24:42 -0400, Gene wrote:

On Mon, 18 Apr 2011 14:30:42 -0400, John H
wrote:

A good explanation. This was passed on to my wife by her doctor.


At least it came from a disinterested third party! Or not........

Either way, it makes good sense.

NO... IT DOESN'T!

When you have to write a persuasive article using the following, you
are full of ****:

*The magician distracts the audience.....

*Democrats and President Obama should make David Copperfield
proud.....

*Is the Congressional Budget Office to be believed?

*And for the ultimate distraction, Mr. Obama paraded a group of
“doctors”.....

*Government pay medicine -- under any name you give it -- is immoral
for patients/citizens, and for physicians.

*No citizen would consider it moral to put a gun to his neighbor’s
head......

*The worst moral examples of course were the German doctors who were
forced to cooperate in death camp selections.

Lee Hieb is an Orthopaedic Surgeon, in solo private practice. Her
first-hand experience in medicine began in the 1950s, when she
accompanied her father on his housecalls in Iowa....

And I wonder what her father would think of her obscenely high fees
and a practice that is so focused on maximizing income, that
housecalls are not EVEN on the radar....?

You've found fault with the way she presented herself, not the facts of the article. And, you have
to admit there was a hell of a lot of deception going on.

We agree, there was deception... and it was all hers.... she didn't
cite one factual, quantifiable, supported statement... she played on
people's fears. If she had any proof... any real argument, she never
stated it... it was all about fear, uncertainty, and doubt.

In fact, she even made the point that it wasn't about facts, it was
about fearing some nebulous thing she characterizes as "government pay
medicine," whatever you call it.

John, really, there is a meaningful dialog to be had about this
subject, but this article is a textbook example of lies, deceptions,
and misinformation... our parents would (rightfully) have called this
Yellow Journalism.... would you have accepted this paper from one of
you students? No citations? No facts? No thesis? No logical
development? No conclusion? I think not..... this isn't even a proper
4th grade paper.... this is plain and outright deception .... nothing
but fear mongering.... Certainly not worthy of posting....

Fear is the touchstone for the right wing. You're shocked by this?

On Mon, 18 Apr 2011 21:33:46 -0400, Gene
wrote:

On Mon, 18 Apr 2011 17:55:47 -0700, wrote:

On Mon, 18 Apr 2011 19:51:44 -0400, Gene
wrote:

On Mon, 18 Apr 2011 19:03:55 -0400, John H
wrote:

On Mon, 18 Apr 2011 18:01:45 -0400, Gene wrote:

On Mon, 18 Apr 2011 17:39:41 -0400, John H
wrote:

On Mon, 18 Apr 2011 17:24:42 -0400, Gene wrote:

On Mon, 18 Apr 2011 14:30:42 -0400, John H
wrote:

A good explanation. This was passed on to my wife by her doctor.


At least it came from a disinterested third party! Or not........

Either way, it makes good sense.

NO... IT DOESN'T!

When you have to write a persuasive article using the following, you
are full of ****:

*The magician distracts the audience.....

*Democrats and President Obama should make David Copperfield
proud.....

*Is the Congressional Budget Office to be believed?

*And for the ultimate distraction, Mr. Obama paraded a group of
“doctors”.....

*Government pay medicine -- under any name you give it -- is immoral
for patients/citizens, and for physicians.

*No citizen would consider it moral to put a gun to his neighbor’s
head......

*The worst moral examples of course were the German doctors who were
forced to cooperate in death camp selections.

Lee Hieb is an Orthopaedic Surgeon, in solo private practice. Her
first-hand experience in medicine began in the 1950s, when she
accompanied her father on his housecalls in Iowa....

And I wonder what her father would think of her obscenely high fees
and a practice that is so focused on maximizing income, that
housecalls are not EVEN on the radar....?

You've found fault with the way she presented herself, not the facts of the article. And, you have
to admit there was a hell of a lot of deception going on.

We agree, there was deception... and it was all hers.... she didn't
cite one factual, quantifiable, supported statement... she played on
people's fears. If she had any proof... any real argument, she never
stated it... it was all about fear, uncertainty, and doubt.

In fact, she even made the point that it wasn't about facts, it was
about fearing some nebulous thing she characterizes as "government pay
medicine," whatever you call it.

John, really, there is a meaningful dialog to be had about this
subject, but this article is a textbook example of lies, deceptions,
and misinformation... our parents would (rightfully) have called this
Yellow Journalism.... would you have accepted this paper from one of
you students? No citations? No facts? No thesis? No logical
development? No conclusion? I think not..... this isn't even a proper
4th grade paper.... this is plain and outright deception .... nothing
but fear mongering.... Certainly not worthy of posting....

Fear is the touchstone for the right wing. You're shocked by this?

I'm shocked by how the dumbing of America has made this so possible
and accepted.

Logical Argument?
Fact Checking?
Citations?
Belief in Scientific Method (data)?

Not necessary, if we have an emotional story..........

It's pretty sad when "all we have to fear is fear itself" becomes the
reality.

On Mon, 18 Apr 2011 19:51:44 -0400, Gene wrote:

On Mon, 18 Apr 2011 19:03:55 -0400, John H
wrote:

On Mon, 18 Apr 2011 18:01:45 -0400, Gene wrote:

On Mon, 18 Apr 2011 17:39:41 -0400, John H
wrote:

On Mon, 18 Apr 2011 17:24:42 -0400, Gene wrote:

On Mon, 18 Apr 2011 14:30:42 -0400, John H
wrote:

A good explanation. This was passed on to my wife by her doctor.


At least it came from a disinterested third party! Or not........

Either way, it makes good sense.

NO... IT DOESN'T!

When you have to write a persuasive article using the following, you
are full of ****:

*The magician distracts the audience.....

*Democrats and President Obama should make David Copperfield
proud.....

*Is the Congressional Budget Office to be believed?

*And for the ultimate distraction, Mr. Obama paraded a group of
“doctors”.....

*Government pay medicine -- under any name you give it -- is immoral
for patients/citizens, and for physicians.

*No citizen would consider it moral to put a gun to his neighbor’s
head......

*The worst moral examples of course were the German doctors who were
forced to cooperate in death camp selections.

Lee Hieb is an Orthopaedic Surgeon, in solo private practice. Her
first-hand experience in medicine began in the 1950s, when she
accompanied her father on his housecalls in Iowa....

And I wonder what her father would think of her obscenely high fees
and a practice that is so focused on maximizing income, that
housecalls are not EVEN on the radar....?

You've found fault with the way she presented herself, not the facts of the article. And, you have
to admit there was a hell of a lot of deception going on.

We agree, there was deception... and it was all hers.... she didn't
cite one factual, quantifiable, supported statement... she played on
people's fears. If she had any proof... any real argument, she never
stated it... it was all about fear, uncertainty, and doubt.

In fact, she even made the point that it wasn't about facts, it was
about fearing some nebulous thing she characterizes as "government pay
medicine," whatever you call it.

John, really, there is a meaningful dialog to be had about this
subject, but this article is a textbook example of lies, deceptions,
and misinformation... our parents would (rightfully) have called this
Yellow Journalism.... would you have accepted this paper from one of
you students? No citations? No facts? No thesis? No logical
development? No conclusion? I think not..... this isn't even a proper
4th grade paper.... this is plain and outright deception .... nothing
but fear mongering.... Certainly not worthy of posting....

For this group it's totally appropriate.

John H wrote:
On Mon, 18 Apr 2011 19:51:44 -0400, wrote:

On Mon, 18 Apr 2011 19:03:55 -0400, John
wrote:

On Mon, 18 Apr 2011 18:01:45 -0400, wrote:

On Mon, 18 Apr 2011 17:39:41 -0400, John
wrote:

On Mon, 18 Apr 2011 17:24:42 -0400, wrote:

On Mon, 18 Apr 2011 14:30:42 -0400, John
wrote:

A good explanation. This was passed on to my wife by her doctor.

At least it came from a disinterested third party! Or not........
Either way, it makes good sense.
NO... IT DOESN'T!

When you have to write a persuasive article using the following, you
are full of ****:

*The magician distracts the audience.....

*Democrats and President Obama should make David Copperfield
proud.....

*Is the Congressional Budget Office to be believed?

*And for the ultimate distraction, Mr. Obama paraded a group of
“doctors”.....

*Government pay medicine -- under any name you give it -- is immoral
for patients/citizens, and for physicians.

*No citizen would consider it moral to put a gun to his neighbor’s
head......

*The worst moral examples of course were the German doctors who were
forced to cooperate in death camp selections.

Lee Hieb is an Orthopaedic Surgeon, in solo private practice. Her
first-hand experience in medicine began in the 1950s, when she
accompanied her father on his housecalls in Iowa....

And I wonder what her father would think of her obscenely high fees
and a practice that is so focused on maximizing income, that
housecalls are not EVEN on the radar....?
You've found fault with the way she presented herself, not the facts of the article. And, you have
to admit there was a hell of a lot of deception going on.
We agree, there was deception... and it was all hers.... she didn't
cite one factual, quantifiable, supported statement... she played on
people's fears. If she had any proof... any real argument, she never
stated it... it was all about fear, uncertainty, and doubt.

In fact, she even made the point that it wasn't about facts, it was
about fearing some nebulous thing she characterizes as "government pay
medicine," whatever you call it.

John, really, there is a meaningful dialog to be had about this
subject, but this article is a textbook example of lies, deceptions,
and misinformation... our parents would (rightfully) have called this
Yellow Journalism.... would you have accepted this paper from one of
you students? No citations? No facts? No thesis? No logical
development? No conclusion? I think not..... this isn't even a proper
4th grade paper.... this is plain and outright deception .... nothing
but fear mongering.... Certainly not worthy of posting....

For this group it's totally appropriate.

You really ought to stop whining about others in here, Herirng. Your
behavior is no better than those about whom you complain.

On Tue, 19 Apr 2011 17:36:03 -0400, Gene wrote:

On Tue, 19 Apr 2011 07:52:58 -0400, John H
wrote:

For this group it's totally appropriate.

Actually, I think you've got me, there.....

LOL!!

In article ,
says...

On Mon, 18 Apr 2011 14:30:42 -0400, John H
wrote:

A good explanation. This was passed on to my wife by her doctor.


At least it came from a disinterested third party! Or not........

This is crazy stuff.
A doctor taking Tri-Care and probably Medicare patients passing out
an anti-government health care screed.
"Socialists against Socialism Unite!"