The internet is supposed to provide open access to information to people of different opinions, and algorithms for search engines such as Google were originally designed to rank entries on the basis of traffic to a site. It was democratic in the sense that people voted with their mouse clicks.
Freedom of communication is a threat to oppressors. Communist China has erected the Great Firewall (tinyurl.com/y7allgtb). Google’s secret Project Dragonfly would collect data about people’s searches that could be used for facilitating human-rights abuses, and would purge links to websites prohibited in China (https://tinyurl.com/y9ujjy3g). Because of political pressure, it has reportedly been terminated—for now (tinyurl.com/yatvngmo)—although a shareholder resolution to stop it failed (https://tinyurl.com/y5jz6j8u).
In the U.S., online service providers have broad protections from legal liability for content created by the users of their services, under the Communications Decency Act of 1996 (CDA), which added Section 230 to the Communications Act of 1934. This permits entities like Facebook, Twitter, and Google to publish others’ content without reviewing it for criminality or other potential legal issues. There are concerns that it protects pornography and sex-trafficking.
On Jun 13, 2019, the House Intelligence Committee chaired by Rep. Adam Schiff (D-Calif.) held a hearing on technology that allows the creation of “fake” videos. At the outset, Schiff challenged the CDA immunity enjoyed by interactive computer services, apparently intending to pressure services such as Google, Facebook, Amazon, and Twitter to comply with his position on access to information he deems inappropriate for public access.
In early 2019, Schiff contacted leading interactive computer services, including Google, Facebook, and Amazon, to encourage them to de-platform or discredit what Schiff asserted to be inaccurate information on vaccines. He then posted the letters and press release on the House.gov website.
Information Is Blocked; AAPS Sues
In response to Schiff’s letter, Amazon removed the popular videos Vaxxed and Shoot ’Em Up: the Truth About Vaccines from its platform for streaming videos, depriving members of the public of convenient access.
Under a policy announced in May 2019, Twitter includes a pro-government disclaimer placed above search results for an AAPS article on vaccine mandates: “Know the Facts. To make sure you get the best information on vaccination, resources are available from the US Department of Health and Human Services.” The implication is that if information is not on a government website, then it is somehow less credible. On Facebook, a search for an AAPS article on vaccines, which previously would lead directly to the AAPS article, now produces search results containing links to the World Health Organization (WHO), the National Institutes of Health, and the Centers for Disease Control and Prevention (CDC). Visits to the AAPS website have declined significantly since March 2019, both in absolute terms and relative to the decline that would result from a story’s losing its recency.
On Aug 9, 2019, Amazon suddenly announced the termination of AAPS, after 10 years’ participation, from the Amazon Associates Program, which by its own description is one of the largest affiliate networks in the world to enable website owners to earn commissions based on their traffic.
AAPS is not “anti-vaccine,” but rather supports informed consent, based on an understanding of the full range of medical, legal, and economic considerations relevant to vaccination and any other medical intervention, which inevitably involves risks as well as benefits. For two decades, AAPS has published informative articles pertaining to vaccination, which continue to draw visitors, even years later.
Schiff creates an arbitrary binary divide, simplistically labeling all speech on vaccinations as either “pro-vaccination” or “anti-vaccination,” with the latter taken to mean “anti-science” or unintelligent and uneducated and thus unworthy of public access.
WHO has declared “vaccine hesitancy” to be a major public-health concern. Thus, any information, however valid scientifically, that might influence a person to decline a vaccine, could be labeled a public-health threat and censored.
AAPS notes efforts by the AMA and others to declare that many controversial issues are public health threats—such as “gun violence,” “climate change,” or lack of convenient and affordable access to abortion or “sex-change” surgery. A precedent to censor speech on vaccine adverse events has broad implications.
AAPS and Katarina Verrelli, on behalf of herself and others who seek access to vaccine information, have filed suit in the U.S. District Court for the District of Columbia. Plaintiffs allege that Defendant Adam Schiff has abused government power and infringed on their free-speech rights (tinyurl.com/st2wdbr).
“The First Amendment protects the rights of free speech and association. Included within the right of free speech is a right to receive information from willing speakers. Under the First Amendment, Americans have the right to hear all sides of every issue and to make their own judgments about those issues without government interference or limitations,” Plaintiffs argue. “Content-based restrictions on speech are presumptively unconstitutional, and courts analyze such restrictions under strict scrutiny.”
Vaccine News
Tattooing Vaccine Records: To guard against missed injections or counterfeited records, a technology now in early stages of development could inject nanoparticles into the skin at the same time a vaccine is given. Forming a pattern like a QR code, they might be read with a smartphone. Some suggest introducing them first in low- and middle-income countries. However, there are privacy and ethical concerns. “The idea of administering tattoos en masse may not be well-received” (tinyurl.com/rwugtjl).
Safety: At the WHO Global Vaccine Safety Summit, Dr. Soumya Swaminathan openly admits, “We really don’t have very good safety monitoring systems” (tinyurl.com/r9bk6s9, at 57 sec).
High-dose Flu Vaccine: Since approval of the high-dose influenza vaccine for persons over age 65, its use has increased slowly. The death rate from influenza in the elderly has also increased from 1.6 per million in 2006–2012 to 7.0 in 2013–2017, a 329% increase, compared to a 132% increase in ages 35-64, and 0% under age 25. Various reasons are suggested (tinyurl.com/sb4drj8).
Non-specific Effects: Various vaccines have been shown to have NSEs, both beneficial and harmful, on diseases completely different from the ones they target—an “unresolved story in many ways” (https://tinyurl.com/whmdk33).
Mandates’ Effectiveness Questioned: While strongly supporting vaccination, a GSK-funded “Outlook” noted that penalizing persons who refuse mandated vaccines or suppressing discussion on public forums might be less effective than listening to the concerns of the “hesitant” (Nature 11/28/19).
The True Measure of Quality
After enduring 7 years of agony in dealing with rapid behavioral deterioration in their son with Down syndrome—and consultations with seven specialists, parents Melissa Khorana, R.N., and Alok Khorana, M.D., found a primary-care physician who made a life-changing diagnosis in 15 minutes. They write that they did not check for board certification, rankings by national organizations, or any of the 2,500 performance metrics; they asked parents of other disabled children. The physician suspected celiac disease, ordered a confirmatory blood test, and prescribed a gluten-free diet. The patient is doing well off the psychotropic drugs that had caused a 75-pound weight gain (JAMA 12/3/19).
Punishing Patients for Sake of Ideology
As Alberta considers a plan to reduce wait times by increasing the use of private facilities for publicly funded surgeries, opposition mounts, arguing that “greedy doctors and rich patients” would benefit, and resources would be sucked out of the public system. But “offering government funding for everyone doesn’t have to entail barring anyone from opting to pay for themselves,” writes Marni Soupcoff. It’s “unconscionable to insist that a patient…be legally compelled to suffer for the sake of an ideal of a purely public health-care system.” She adds that pouring more and more money into the system hasn’t worked (https://tinyurl.com/wbpzyt2).
“We have no censorship, only control to prevent misuse of the freedom of the press.” — TASS (Soviet news agency), 1959
Flashback: Aug 15, 1971
A 2011 article in Forbes called it “a date which has lived in infamy.” On that day, President Nixon announced that the U.S. would no longer officially trade dollars for gold, beginning a 40-year period (now almost 50) in which for the first time in 4,000 years of history humanity has not based its currency on a metal. The price of gold went from $35/oz to $800 by 1980 (https://tinyurl.com/ure5eb9). It is $1,552 on Jan 10, 2020.
In August 1971, The People’s Daily in China wrote: “These unpopular measures reflect the seriousness of the US economic crisis and the decay and decline of the entire capitalist system…. [and] “mark the collapse of capitalist monetary system with the US dollar as its prop…. Nixon’s new economic policy cannot extricate the US from financial and economic crisis.” Further, “the policy is meant to fleece the American working people and to shift the worsening of the US financial and monetary economic crisis onto other countries” (quoted at https://tinyurl.com/stka4pq).
According to economist Egon von Greyerz, writing in King World News, Dec 15, 2019 (ibid.), “there are rumors in the market that China is planning to announce a gold backed yuan supported by gold holdings in excess of 20,000 tonnes.” The U.S. supposedly has 8,000 tonnes of gold, but there has been no physical audit since the 1950s, and a major part has been leased to bullion banks and is said to be located in China.
Muammar Gaddafi, dictator of Libya, killed in 2011, had reportedly planned to release a pan-African currency backed by his gold and silver reserves. This threat to the French franc may have been a key motive for deposing him (tinyurl.com/y2ervg69).
“Re-Education” Camps Suggested
Putting Americans in “re-education” camps has been suggested from purportedly opposite sides of the political spectrum.
Rick Wilson, a Never Trumper who claims to be conservative, was responding to an NBC News story about how people who question the safety of vaccines are now taking their fight “offline” due to mass censorship by the likes of Facebook and are allegedly “harassing doctors and private citizens.” He tweeted: “Anti-vaxxers are a scourge and a strong argument for re-education camps, the immediate seizure of their property, and putting their children into protective custody.” His tweet drew 8,000 “likes” (https://tinyurl.com/vmpfe2y).
Bernie Sanders organizer Kyle Jurek told a Project Veritas journalist that Trump supporters might have to be reeducated in camps: “free education for everybody.” The best way to break billionaires of their privilege is to have them break rocks. Stalin’s gulags weren’t so bad, he said (https://tinyurl.com/wglq6gp).
AAPS Calendar
Mar 20-21. Workshop, Board Meeting, St. Louis, MO
Sep 30-Oct 3. 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/.
HHS Fails to File Vaccine Safety Reports
The “Mandate for Safer Childhood Vaccines,” 42 U.S.C. §300aa-27, requires the Secretary of Health and Human Services to file with Congress a report describing its work to improve vaccine safety, including reports of adverse reactions, within 2 years of Dec 22, 1987, and periodically thereafter. The Informed Consent Action Network (ICAN) filed a Freedom of Information Act request for these reports on Aug 23, 2017. After being stonewalled for 8 months, ICAN filed suit, which was dismissed after HHS responded that “the [Department]’s search for records did not locate any records responsive to your request.”
“HHS had to finally and shockingly admit that it never, not even once, submitted a single biennial report to Congress detailing the improvements in vaccine safety.” This “heightens the concern that HHS doesn’t have a clue as to the actual safety profile of the now 29 doses, and growing, of vaccines given by one year of age,” ICAN wrote (https://tinyurl.com/vfdzfc6).
Doctor Wins $6 Million for Defamation
Dr. Miguel Gomez of Houston, Texas, a cardiothoracic surgeon known for robotic cardiac surgery, won a $6 million dollar jury award as a remedy against Memorial Hermann Hospital system. The award was upheld by the Court of Appeals for the First District of Texas (No. 01-17-00632-CV) on Aug 15, 2019.
After Dr. Gomez told the hospital’s CEO he was concerned about the declining quality of patient care and threatened to move his practice to another hospital, he was subjected to a program to analyze patient outcomes in 2009. The hospital initiated a whisper campaign alleging that he had a high patient mortality rate, without making the proper adjustment for patient risk.
The “huge scarlet letter” has affected his practice volume and his mental well-being for years. The hospital might still appeal.
Successful outcomes are rare. “Doctors need to find competent counsel, have a legal war chest, and be prepared for a long fight. While fighting, they may become unemployable,” writes Jeffrey Segal, M.D., J.D., of Medical Justice (tinyurl.com/rhya8ye).
Kentucky Ultrasound Requirement Stands
The U.S. Supreme Court declined, without comment, to hear an appeal from the Sixth Circuit Court of Appeals decision in the American Civil Liberties Union’s challenge to Kentucky’s Ultrasound Informed Consent Law (EMW Women’s Surgical Center v. Beshear). The law, which passed overwhelmingly, thus goes into effect. It requires that women be shown the monitor during their pre-abortion ultrasound, be told what it depicts, and be allowed to listen to the fetal heartbeat if audible. Women are not required to look at the monitor or listen to the description, and physicians may inform them of that. They may also turn down the volume on the heartbeat recording. The ACLU argued that the law impermissibly interfered with the physician’s First Amendment right by requiring him to deliver an “ideological message.” The State of Kentucky responded that the message contained “pure scientific facts” relevant to the abortion decision. The bill includes a fine of $100,000 for a first offense and $250,000 for subsequent offenses if doctors fail to offer women the opportunity to view the ultrasound (https://tinyurl.com/reaorc4).
Tip of the Month: Cyber Risk from Medical Devices. When connected to the Internet of Things, medical devices can potentially expose patient information, or hackers could cause dangerous malfunctions. FDA has warned of “URGENT/11” vulnerabilities in widely used software. This warning may create a legal duty to act (https://tinyurl.com/yyxmtbw6).
Is Misdiagnosis Fraud?
The conviction of rheumatologist Jorge Zamora-Quezada, M.D., age 63, for healthcare fraud should alarm specialists who accept Medicare or Medicaid funding for treating chronic conditions with expensive therapies. Doctors may dread a malpractice lawsuit for overdiagnosis, misdiagnosis, or bad outcomes from treatment. These are civil actions, with defense costs and judgments usually covered by insurance. But prosecution as fraud—for allegedly false diagnosis with “unnecessary” treatment—is highly likely to mean impoverishment and decades in prison. If the treatments were costly, the alleged loss to the government adds years to the sentence, and the doctor could well die in prison.
In a 25-day trial, Dr. Zamora was convicted of one count of conspiracy to commit health care fraud, seven counts of health care fraud, and one count of conspiracy to obstruct justice. His billing supervisor, money manager, and his wife were all acquitted.
“As evidenced by the length of trial, this was a massive investigation into one of the worst medical fraudsters,” said U.S. Attorney Ryan Patrick of the Southern District of Texas. “Unnecessary medical tests to create millions of dollars of false billing is as bad as it gets. Patients were put through unneeded anxiety and pain so the doctor could make millions. He won’t need it where he’s headed.” Dr. Zamora diagnosed a large number of patients with rheumatoid arthritis, and treated them with “toxic, medically unnecessary medications like chemotherapy drugs.” [Methotrexate, also used for cancer chemotherapy, is a standard treatment, and early use for disease modification is recommended.]
Dr. Zamora operated medical practices throughout South Texas and San Antonio. The prosecutor emphasized that he commuted by private jet or Maserati (tinyurl.com/yx3tonff).
Bruce Freundlich, M.D., a rheumatologist and professor at the University of Pennsylvania, reviewed the records of all 29 patients listed in the indictment, from visits with Dr. Zamora as well with other doctors. He testified that he believed Dr. Zamora’s diagnosis and treatment was appropriate and, in some cases, conservative (https://tinyurl.com/vsafdhs).
A physician who attended the trial writes that the jury was influenced by a year of constant advertising against Dr. Zamora, requesting patients to come forward to sue the doctor for malpractice and to speak to the FBI. This was in newspapers, billboards, and radio and television announcements in both English and Spanish. Nonetheless, of 10,000 possible patients, only nine spoke against Dr. Zamora at the trial for his “misdiagnoses”—according to the second opinion of a competing rheumatologist. No patient injuries or complications were presented, she said.
Sentencing is expected in March. The doctor has already been jailed for a year, as a purported flight risk.
Since its inception in March 2007, the Medicare Fraud Strike Force has charged more than 4,200 defendants who have collectively billed the Medicare program nearly $19 billion, and is working to decrease the presence of fraudulent providers (DOJ, op. cit.).
Correspondence
Data Mining to Avoid Clinical Trials. On the heels of the revelation of Google’s secretive deal, “Project Nightingale,” with Ascension (2600 hospitals, physician offices, related facilities) to share and mine personal health information in electronic health records of non-consenting patients, comes another major revelation. Google already had access to millions of patient records through its relationship with many “health care partners,” including Mayo Clinic, University of Chicago, and the Cleveland Clinic. Patients are “rarely informed” that their data is being shared and “mined.” A law passed in 2016 “required the FDA to explore greater use of real-world data” (tinyurl.com/rvsqd3e).
Electronic health records are often filled with inaccuracies. This is to be expected since a priority of EHRs is creating a billing record so as to maximize payment by third-party payers. This is the type of data drugmakers want to use to obtain FDA approval of new drugs. The drugmakers’ goal is to make more people “eligible” to be treated with their medications. The “guidelines,” developed by committees whose members take huge amounts of money from drugmakers, often become quasi-standards of care, such that if the doctor does not prescribe the medications, he will be deemed to be practicing beneath the “standard of care.”
Lawrence R. Huntoon, M.D., Ph.D., Lake View, NY
The Truth about HIPAA. The disturbing news about Ascension sharing data with Google—and Google partnering with the Mayo Clinic—exemplifies the dangerous truth about HIPAA (Health Insurance Portability and Accountability Act). Its “Privacy Rule” allows more than 702,000 covered entities, such as hospitals, health plans, clinics, laboratories and radiology facilities, plus 1.5 million “business associates,” and a variety of government agencies to access and use patient medical records without patient consent. It eliminates the pre-HIPAA consent rights patients had regarding the use and sharing of their private medical records. Congress must repeal this Rule.
Twila Brase, R.N., P.H.N., CCHFreedom.org
Freedom of the Press. The USSR Constitution guaranteed “freedom of the press.” This meant freedom to publish articles that Party officials, such as Nikita Khrushchev, deemed “truthful and objective.” It was mandatory for all regional (oblast) newspapers in the Soviet Union to publish the exactly worded propaganda that appeared in Pravda. It was like today’s Democrat party giving its marching orders to anchors on various leftist channels, who repeat the script religiously. Meanwhile, conservative Americans have restricted access to social media platforms. Invisible computer censors tell us that we “violate community standards” if we try to post something that they find objectionable. We are not sure exactly what these community standards are.
What good is a Constitutional guarantee if it is not enforced? Does freedom exist when leftist elites own all venues of the mainstream media and social media?
Ileana Johnson, Ed.D., https://tinyurl.com/u957mra
“A Hard Rain’s A ’Gonna Fall.” I keep thinking about Governor Cuomo’s State of the State speech. He had already cut Medicaid payments 1%, and we now learned that he plans to propose legislation to boost Office of Professional Medical Conduct (OPMC) and physician discipline. We often we hear that physician burnout, physician suicide, and physician wellness are on the Department of Health agenda. How ironic, when the state is cutting payments and talking about streamlining physician discipline. Medicine has become a profession of Rodney Dangerfields. I can hear him now: “When I see patients, I get no respect. After Press Ganey gets me, the Insurers, Trial Lawyers and Government get their licks in, too.” Remember Bob Dylan’s song.
Arthur Fougner, M.D, excerpted from MSSNY eNews 1/8/20
“Volume-to-Value” Transition. Although value-based incentive payments were only 6.2% of total cash compensation (TCC) across all specialties studied in one broad survey, one source “anticipates more physician compensation to be tied to performance metrics, such as clinical quality, patient experience, and access, as new models of care focusing on population health support the transition from volume to value.” In other words, more doctors’ paychecks will be tied to things over which they have no control. Why aren’t AMA, AAFP, et al. pushing back against Big Insurance and Big Government and their “Value Based!” propaganda posters, to reverse this stupidity? They know (or ought to) that the purpose of value-based compensation, with all its nebulous, pointless, and unenforceable metrics, is NOT population health. The entire point of this scam is to pay physicians less.
Pat Conrad, M.D., https://tinyurl.com/tml5lft
Same Day “Service.” Physician Health Programs (PHPs) brag that they are not constrained by due process: “Because they are not constrained by legal requirements (such as prolonged investigations, hearings and due process) in the same way as medical boards, PHPs often act quickly at the first report of credible symptoms to recommend discontinuation of practice and entry into evaluation and, when needed, treatment (even same day, in some cases)” (https://tinyurl.com/vjdr6ew).
Albert Fisher, M.D., Oshkosh, WI
