Volume 75, no. 12 December 2019
Most have probably heard the definition of insanity often attributed to Albert Einstein: “Doing the same thing over and over again while expecting a different result.” But we still do it.
This admonition does not seem to apply to socialism, despite repeated experience from the Soviet Union to Venezuela. In his book Socialism: the Failed Idea That Never Dies, Kristian Niemietz addresses the standard response that the failed experiments were not real socialism. Believers called them socialist during the honeymoon period; later their accolades went down the memory hole.
Moreover, the horrendous atrocities in states self-identifying as socialist have been air-brushed out of history. Vladimir Bukovsy notes that while we are still hunting down the last 90-year-old Nazi war criminal in a Latin American jungle, there was never a Nuremberg-style accounting for Soviet crimes. When the archives were finally revealed, the Western response was, “So what” Who Cares?” Bukovsky’s 1996 book Judgment in Moscow: Soviet Crimes and Western Complicity was not published in English until 2019. For evidence of real collusion, look there.
Sen. Bernie Sanders et al. say they are “democratic” socialists. So did the other “not real socialists.” The Washington Post calls “socialism” a “smear,” and states that not one of the candidates “is a Latin American socialist” (Wash Post 12/2/19).
The Definition of “Unfit”
Bandy Lee, M.D., M.Div., and the self-appointed Independent Expert Panel for Presidential Fitness have resurfaced, angling to participate in the impeachment inquiry on President Trump, declaring his mental health to be a “national and global emergency.” Worse, Dr. Lee claims that Trump’s “madness is catching” and that his followers (nearly half of the U.S. population) have “cult-like characteristics.”
“Trump infects his followers with a violence-inducing ‘sickness’,” shouts a headline in Salon, associating Trump’s policies with mass shootings in Dayton and El Paso. “As long as we tolerate an impaired president and take his pathologies to be mere personal quirks, a malignant normality will prevail,” Dr. Lee told Raw Story. “We predicted that the longer he stays in office, the more his supporters will be drawn into sickness and be further detached from reality.”
The “not a diagnosis” that has “nothing to do with politics” is based partly on the 448-page Mueller special counsel’s report concerning alleged collusion with Russia.
A confidential five-person working group headed by Dr. Lee has been devising a sort of tribunal that would require “regular fitness-for-duty exams” on U.S. Presidents, Vice-Presidents, and candidates running for those offices.
For about 20 years, Dr. Lee has been an assistant clinical professor at Yale. She consults with prisons on violence prevention and with the UN on the 2030 Agenda for “Sustainable Development” (“the Progressive’s Stone,” see https://www.jpands.org/vol20no1/battig.pdf ).
With Red Flag laws, psychological fitness becomes a prerequisite for exercising Second Amendment rights. Freedom of speech and thought is also threatened through censorship by “private” but government-favored entities. Disagreement with orthodox dogma, which disqualifies a person from many positions in academia or the media, may now be framed in psychological terms, such as “denialism” of “climate disaster.”
“This collective denial hinders individual as well as political action,” according to Psychologists/Psychotherapists for Future. “Psychological mechanisms that prevent behavioural change and political action must be identified, communicated and overcome.”
Being called “disruptive”—or perhaps “burned out”—may cause physicians to be coercively referred to a Physician Health Program for a costly “fitness-for-duty” evaluation. Neither legal due-process requirements nor medical ethics governing a patient-physician relationship may apply. “Society” or the state, not an individual, is the patient.
Can we hope for a different outcome if we again try the experiment of making psychiatry a political tool?
“Undoubtedly, the misuse of psychiatry as an instrument in political repressions was the most outstanding crime against humanity in the postwar epoch,” writes Bukovsky, who experienced 12 years of imprisonment in Soviet prisons, labor camps, and psychiatric hospitals. “It shall be remembered by our descendants for centuries to come, just as we remember the guillotine of the French Revolution, Stalin’s gulags, and Hitler’s gas chambers.”
Because Western psychiatrists strongly condemned Soviet abuses at the Sixth World Congress of Psychiatry in Honolulu in 1977, the goal of establishing a psychiatric gulag was thwarted.
But is the world now safe from a repeat occurrence? Bukovsky points out: “Nobody has repealed our diagnoses, nobody has thought of apologizing for all the slander that was hurled at us for decades…. None of these “academics” ever stood before courts to answer for crimes against humanity, and none were stripped of academic titles for violating the Hippocratic Oath.”
Do American academics truly believe that opponents of their “progressive” programs are mentally deranged? Soviets might have believed that only mentally ill persons could be hostile to the “most perfect sociopolitical system in the history of mankind.”
Once the U.S. Constitution and the Oath of Hippocrates are gone, what is to stop the abuse of power?
Flashback: Soviet Psychiatry
“You keep talking about the Constitution and the laws, but what normal man takes Soviet laws seriously? You are living in an unreal world of your own invention, you react inadequately to the world around you.
“Do you put the blame for your conflict with society on society? What do you mean, the whole of society is wrong? A typical madman’s logic….
“This procedure worked very well with the Marxists—they had an obvious reforming mania, an overvalued idea of saving mankind….
“Under socialism, there is no contradiction between society’s goals and man’s conscience….
“And, of course, complaints about persecution by the KGB, being searched and followed, telephone tapping, the opening of letters, and dismissal from work were pure persecution manias.”
Vladimir Bukovsky, To Build a Castle: My Life as a Dissenter, 1977
Could the managed-care cartel be feeling the heat of competition, and thus be seeking government help to keep patients inside?
10-day Waiting Period: In implementing a law supposedly intended to permit patients to seek nonemergency out-of-network care at the market price, the Texas Medical Board proposes a mandatory “cooling off” period between signing a balance-billing agreement and scheduling a procedure.
Red Tape for Out-of-State Referrals: The New Jersey legislature is fast-tracking the “Patient Protection Act,” which would require physicians to provide extensive information to patients and to the state medical board for every out-of-state referral they make.
Ultimate Cost Containment: The Urban Institute estimates that the Sanders or Warren plan to eliminate cost-sharing would increase spending by $1 trillion per year. “Ridiculous,” said the People’s Policy Project, because “there is still a hard limit to just how much health care can be performed because there are only so many doctors and only so many facilities.” No worries: the socialist magazine Jacobin stated that “utilization is ultimately dependent on the capacity to provide services, meaning utilization could hit a hard limit.” https://thefederalist.com/2019/11/25/if-you-think-health-care-is-expensive-now-just-wait-until-its-free/
Hidden Costs: The cost of reduced innovation, rationing, waste, and deadweight losses would add some $33 trillion to the estimated $52 trillion 10-year cost of the Warren Medicare-for-All plan, writes Chris Conover. [Follow http://www.liberato.us/single-payer-news.html.]
Death in ICU: In a study of 22 European intensive care units, a significantly higher proportion of patients who died had had limitations placed on treatment in 2015-2016 compared with 1999-2000 (90% vs. 68%), suggesting a shift in end-of-life practices. This was described by editorialists as an “optimistic trend” in the evolution of ICU-based palliative care (JAMA 11/5/19).
“Mit der Dummheit kämpfen Götter selbst vergebens” [Against stupidity the gods themselves war in vain].
Friedrich von Schiller, Die Jungfrau von Orleans, 1801
Punitive Political Psychiatry Coming to Germany?
In a recent article in the leading journal Das Psychotherapeutenjournal, Fabian Chmielewski states that being in a panic about the imminent “climate apocalypse” is normal, while remaining calm and having doubts about it is abnormal and might endanger society. In a critical essay, Air Türkis warns that this could be grounds for compulsory hospitalization and medication. “People are contemplating declaring political dissenters to be mentally ill—for having the wrong opinion.”
“Hard-working helpers from the humanities and social sciences are paving the way to totalitarianism,” Türkis writes. “These are not amusing thought experiments for discussion, but totalitarian ideology in pure culture. In the German Democratic Republic (East Germany), dissenters were treated in closed psychiatric wards on false pretexts” (trans. by Ed.)
Free Speech Bullied in Germany
Organizers of the 13th annual conference of the European Institute for Climate an Energy (EIKE) had to find an alternate, secret location. The hotel cancelled its contract because of threats by leftist green extremists.
German Chancellor Angela Merkel justifies recent bans on government-defined “hate speech.”
The last Saturday in November is dedicated to the remembrance of the 10 million human beings deliberately murdered by starvation in Ukraine in 1932-1933: the eggs that were broken to make the omelet—forced collectivization of agriculture. The silence in the West was broken in 1933 by British journalist Gareth Jones. Walter Duranty wrote in the New York Times that Jones’s report was a fabrication. Duranty’s reporting and Holodomor denial won a Pulitzer Prize. Jones was discredited by the mainstream media, then shot in the back and the head at age 29 in China, an attack possibly orchestrated by Russian secret police. The Times refused to relinquish the Pulitzer.
Pay AMA—or Lose Your Seat
Members of the Heart Rhythm Society received a mass mailing urging them to join AMA—because the HRS would lose its seat at table where fees for electrophysiology CPT codes were being set. Kevin Campbell, M.D., wonders whether AMA is holding other societies hostage. He recommends reminding Congress that only 12% of American doctors belong.
Mar 20-21. Workshop, Board Meeting. St. Louis, MO – https://aapsonline.org/thrive2020
Sep 30-Oct 3, 2020. 77th Annual Meeting, San Antonio, TX
ACTION OF THE MONTH
Nominate a student for a scholarship to attend our March workshop, or contribute to the AAPS Educational Foundation: https://aaps.wufoo.com/forms/z7w7q5/ .
AARP Sued over Kickbacks
Now crusading for Speaker Nancy Pelosi’s bill that allegedly combats “unfair pricing,” AARP faces serious legal allegations that it is unlawfully raising the medical costs of its own members. In Krukas v. AARP, plaintiff Helen Krukas alleges: “AARP received ‘a 4.95% commission from every policy sold or renewed,’ id., which ‘constitutes an illegal kickback.’ AARP collects an illegal commission, acts as an unlicensed insurance agent, and materially misrepresents information about the 4.95% charge, all of which constitute violations of the CPPA [Consumer Protection Procedures Act] and common law.”
“AARP has become little more than a marketing scam for its big corporate financial sponsors—UnitedHealth and its wholly-owned OptumRx pharmacy business,” write Jon Decker and Phil Kerpen. In 2017, AARP reportedly received $627 million from UnitedHealth. When seniors were urging opposition to Obama Care by a 14-to-1 margin, AARP instead supported it and received a special carve-out to keep the UnitedHealth gravy train running. Since the law’s passage and implementation, AARP has received more than $4 billion in “royalties” from UnitedHealth.
AARP is now one of the most vocal supporters of Pelosi’s radical prescription drug plan, which threatens manufacturers with a shocking 95% gross-receipts tax if they don’t accept government-set prices. While opponents say this would obliterate funding for research and development, insurers would see a short-term profit.
The U.S. District Court for the District of Columbia denied the defendants’ Motion to Dismiss.
Hospitals Sue over Transparency Rules
The American Hospital Association, the Association of American Medical Colleges, and major hospital groups are suing the Trump administration over the proposed rule that would require hospitals to disclose their prices (AHA v. Azar). This would include: “gross charges,” “payer-specific negotiated charges,” “discounted cash price,” and “de-identified” minimum and maximum negotiated charges. Plaintiffs complain that this would require posting confidential pricing information reflecting individually negotiated contract terms with third-party payers. They say they cannot “reverse engineer” these rates to accurately reflect what a patient’s actual out-of-pocket costs would be. Also, the Rule would “blunt incentives” to participate in “alternative payment arrangements.”
Tip of the Month: Has an insurer denied a prescription you wrote for a patient? The denial might be a blessing in disguise, especially if the medication is available as a generic. A physician recently contacted us about a Medicare Part D plan’s denial of a drug she prescribed her patient. We suggested that the patient might check GoodRx.com for a cash price for the drug. She found that the medication was available for a cash price of $30 for a month’s supply. Ironically, if the plan had approved the prescription, the patient could have paid more. The median Part D price was twice as much, the average 4 times more, and the highest Part D price was nearly 30 times more than the cash price. Always check the cash price at GoodRx instead of assuming that coverage will be a better deal for the patient.
Medical Records Subpoenaed: The San Diego Unified School District sent subpoenas to 32 physicians of children with medical exemptions. A motion to quash was filed by Advocates for Physicians Rights (physiciansrights.org).
China Plans to Allow Lawsuits: After a major rabies vaccine scandal, draft legislation would allow people to sue drugmakers for cases involving death or serious illness. “This is the first time punitive damages have been introduced in civil cases relating to health,” said Zhu Yonggen, a Beijing-based medical lawyer. The new law identifies as “serious breaches of the law” violations such as fabricating production inspection logs, changing batch numbers, filing fake data for lot releases, and failing to recall substandard vaccine .
HPV Vaccine in Japan: Since the Ministry of Health, Labour and Welfare suspended its “proactive recommendation for routine use of the HPV vaccine in the national immunization program” in 2013, the HPV (human papilloma virus) vaccination rate among younger women dropped sharply from its peak of about 70% in 2013 to a current rate of 1% or less for those born in after 2002. MHLW is being urged to reverse this decision, which was made after public hearings on adverse reactions. A Japanese court has ruled against a journalist accused of defaming a neuroscientist who claims to have demonstrated a link between the vaccine and brain damage in mice. Class action lawsuits brought by vaccinees against two vaccine producers and the health ministry, seeking damages for alleged side effects, are expected to drag on for years.
Drug Companies Settle Opioid Case
Drug companies settled with Ohio counties for $260 million on the eve of a trial in which counties sought $8 billion for the companies’ alleged role in opioid overdose deaths. Large distribution companies AmerisourceBergen, McKesson, and the Ohio-based Cardinal Health, which together distribute 90% of U.S. pharmaceuticals, and Israel-based drugmaker Teva Pharmaceuticals reached an agreement without admitting responsibility. Walgreens, Walmart, CVS, and Rite Aid face a trial later.
The counties’ trial was set to be a test case to see how future trials may play out. More than 2,300 federal lawsuits have been filed over the opioid epidemic, mostly by city and county governments across the country.
OxyContin maker Purdue Pharma reached a deal for all the lawsuits it faces nationwide that could be worth up to $12 billion.
The lawsuits largely accuse drugmakers of downplaying the addiction risks of opioids, and distributors of not flagging suspiciously large pill orders.
Defendants note that the Drug Enforcement Administration authorized a 400% increase in oxycodone manufacture between 2002 and 2013. A government watchdog report also said the DEA didn’t issue enough immediate suspension orders for product delivery when diversion was suspected.
Though illegal rather than prescription opioids largely account for the spike in opioid deaths, as John Lilly, D.O., demonstrates, transnational drug cartels can’t be sued. https://www.jpands.org/vol23no1/lilly.pdf
Medicare Does Not Treat People Equally. Medicare adopts the slogan of the former Soviet Union, “From each according to his ability and to each according to his need.” Thus, since 2007, Medicare has been means-tested. The more you make, the more you pay. Part D services are also means-tested. You are being punished for your success. It is the Bernie Sanders/Elizabeth Warren way. An article from 2012 (Tucson Citizen 2/14/12)explains that beneficiaries at the $85,000-and-above income level for an individual, and $170,000 and above for a couple, were paying premiums ranging from $139.90 to $319.70 per month, compared with the standard premium of $99.90. The number of beneficiaries subject to this means-tested premium was expected to increase from 2.4 million in 2011 to 7.8 million in 2019, an increase from 5% to 14% of Part B enrollees. In 2020, the Part B premiums are said to be $144.60–$491.60. [Part B premiums cover only 26% of the program’s costs.]
Lawrence R. Huntoon, M.D., Ph.D., Lake View, NY
My Medicare Part B First Bill. For my 65th birthday, after I had paid hundreds of thousands of dollars into Medicare, I got a bill for my monthly Part B premium ($1,300.20), plus $141.80 for Part D. There is a warning that if not paid in full by a certain date, I may lose my coverage and not be able to get it back right away.
Paul Martin Kempen, M.D., Ph.D., Weirton, WV
A Dollar Spent, a Dollar Wasted. Current electronic health records are unworkable and in need of replacement in the next year, according to 45% of physicians surveyed. However, in 2021, proposed Medicare billing changes will render essentially all current EHR systems obsolete for billing substantiation. All are now structured based on numeric-included items in the history and physical exam. The medical-decision-making component, now non-numerically defined and subject to interpretation of actual complexity, is to become the new way to determine visit payment, along with time—a radical shift. Why invest in what will be obsolete technology in 2021? Be warned about what is coming.
Stephen Replogle, D.O., Yuma, AZ
“Provider” Data: Management and Sharing: Humana, MultiPlan, Optum, Quest Diagnostics, and UnitedHealthcare have formed an alliance to apply blockchain technology to manage “provider data” (tinyurl.com/y6ayku5d). They may soon be trading us like baseball cards. See how to fight back: https://hpec.io/.
Leah Houston, M.D., Humanitarian Physicians Empowerment Community
“Classless” = Two-Tiered. The supposed “classless society” in Communist Romania had two classes, the proletariat, who called each other “comrades in chains,” and the ruling elites. The controlling elites shared all the wealth, which they confiscated from the “bourgeoise.” Only the elite could have private property.
Dictator Ceausescu made 40,000 people homeless in a 3-year span while building his palace in a hill. While people lived on near-starvation rations, his daughter had freezers full of steaks for her dogs.
The anticommunist resistance fought bravely through the 1980s despite brutal repression. But there were traitors who sold their families out for extra food, and by the time communism “fell” in 1980, few dissidents were still alive.
Communism never died; it has rebranded itself across the world. It is making a comeback in the U.S. thanks to many groups, including the Democrat Party, the Occupy Wall Street movement, Antifa, and UN Agenda 21/2030, which is the design of global communism. Norman Thomas said, “I no longer need to run as a presidential candidate for the Socialist Party. The Democrat Party has adopted our platform.”
If socialism and communism are great, why are there 100 million victims and so many freedom fighters? Americans today never learn of the mass graves from the media or the academy.
Ileana Johnson, Ed.D.
Monopoly Pricing. My patients are insisting that I not refer them to Ballad Health because of its high prices. As I wrote in The Tennessean, Jul 31, Ballad does post its prices, as the federal government requires, but not on its main website and not in a form that the general public can understand. An MRI of the knee lists for $7,000 at Ballad, but costs only $422 at Tennova in Newport through MDSave. Competition forces Americans to provide quality goods and services at fair prices or risk going out of business. Monopolies can get away with charging high prices while providing shoddy service. The only recourse my patients now have is to travel outside of the area for their medical care. Single payer would be Ballad Health on steroids.
Robert Berry, M.D., Greeneville, TN
Slashing Medical Spending by More than 75%. Only two changes are needed: Put a price tag on everything, and fund the health insurance deductible with a health savings account. For evidence of the effect, see Singapore, and Indiana’s deductible-security plan for state employees. Honest prices potentially eliminate the middleman and reduce administrative costs. People who get to keep their HSA balance spend more prudently.