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A Voice for Private Physicians Since 1943

AAPS News November 2018: Revolutionaries

Volume 74, no. 11  November 2018

There is no secret conspiracy to bring about a socialist revolution in the U.S. Barack Obama announced openly that we were going to see a “fundamental transformation” starting the day of his inauguration. (Arguably, it had started decades earlier.) He told small business owners that “You didn’t build that.” His connections with unrepentant domestic terrorists of the Weather Underground were known, but not widely publicized.

Hillary Clinton, in the debates prior to the 2016 election, wanted Donald Trump to agree to accept her win, and not pursue charges of a rigged outcome—how ironic in retrospect!

The Democrat “Resistance” from the outset has been single-mindedly attempting to overturn the 2016 election, with talk of impeachment and the 25th Amendment. Meanwhile, the function of the White House is impeded by unprecedented obstructionism: lawsuits, refusal to hold confirmation hearings on nearly 200 appointees, slow-walking in the bureaucracy, constant negative press.

Democrat Party leaders have long-standing deep connections with radical groups. All Democrats on the Senate Judiciary Committee “would struggle to pass any form of basic background check to get even the lowest form of security clearance” due to connections they have to communist or Islamist front groups, writes Trevor Loudon. All are “in some way affiliated with countries, organizations, or philosophies opposed to the U.S. Constitution” (https://tinyurl.com/ychk6yq9).

Hillary Clinton, who recently relinquished her security clearance, said, “You cannot be civil with a political party that wants to destroy what you stand for.” Former Attorney General Eric Holder told a crowd that “we kick them.” (https://tinyurl.com/y7325d6n). Many condone or even incite harassment or assault of Trump officials or supporters. Rand Paul noted that the shooter at the congressional baseball game shouted “This is for health care!”  (https://tinyurl.com/ybabouar).

Leftist institutions and social media not only kick, but censor. In the lead-up to the midterm elections, Facebook announced it was purging more than 800 political pages and accounts for what it called “inauthentic content.” While Facebook refused to release a full list, The Western Journal has identified more than 185 pages, with more than 60 million followers, that have been unpublished (https://tinyurl.com/yak3gkmw). 

Power vs. Force

In discussing China’s pervasive “social credit system,” Charles Hugh Smith observes that in the Song Dynasty (860-1279 AD), social control required very little force. The populace generally managed itself via an internalized secular religion that placed the father, civil authorities, and the Imperial state at the top of a natural order that enabled the harmony of Heaven and Earth. To disobey would be to threaten the harmony that served everyone.

In the early days of the communist revolution (1949 to 1965), the majority of China’s people embraced the values and authority of the communist regime. But the Cultural Revolution, launched with Mao’s blessing in 1966, was only embraced by the youthful Red Guards. The rest of society had to be forced to comply with the mercurial injustices and arbitrary decrees.

“Power is people choosing of their own accord to comply, for reasons they find sound and that serve their self-interest,” writes Smith. “Power is highly leveraged; a relatively small police/military and judiciary is all that’s needed. Force, in contrast, doesn’t scale: it’s enormously costly in capital and labor to monitor an entire populace and impose control and obedience.”

China’s new social contract—obey the party and the state and you’ll become prosperous—is apparently not considered powerful enough to harmonize Heaven and Earth. Hence the vast surveillance system being developed for fine-grained control of the populace (tinyurl.com/ybyejw3b).

What the American Cultural Revolution Stands for

Mallory Millett describes the origin of the revolution as she experienced it when staying with her older sister Kate. At a 1969 “consciousness-raising” gathering—“a typical communist exercise, something practiced in Maoist China,” the women opened the meeting with a recitation resembling a Catholic litany. “Why are we here today?” began a series of questions eliciting the answers: to make a cultural revolution, by destroying the American family, by destroying the American Patriarch—by promoting promiscuity, eroticism, prostitution, and homosexuality. There’s a war on men.

Millett was shocked, having just returned from Asia, where she had seen factory workers and sex slaves chained to walls. But  Kate Millett’s thesis was that the family is a den of slavery, with men as the Bourgeoisie. She became known as “the Karl Marx of the Women’s Movement.” Mallory writes that Mao and the Soviets won the Cold War by taking over our women, our young, and the minds of intellectuals (https://tinyurl.com/ycvya6zd).

As cultural Marxism destroys the power of the existing, mainly Christian morality and culture, the disoriented masses are driven to Communism as their new creed, writes Antony P. Mueller. A socialist system cannot function without dictatorship. Political control is coming in disguise, as the dictatorship of political correctness. “The moral destruction of the individual is a necessary step to accomplish the final victory” (tinyurl.com/y7vyahpw).

The new “healthcare” is an essential tool for surveillance and application of force.


On the Council of Europe’s Istanbul Convention

The Istanbul Convention is a binding comprehensive legal framework purportedly intended to eliminate domestic violence and all forms of gender-based discrimination against women. As of December 2016, it had been signed by 43 nations and ratified by 22 (https://tinyurl.com/y79vuapb). It was declared unconstitutional in Bulgaria on Jul 27, 2018 (tinyurl.com/yasdw4me).

On Sep 28, the Day of Czech Statehoood and the anniversary of the murder of Good King Wenceslaus, our national patron, Mons. Petr Piťha delivered an explosive sermon in St. Vitus Cathedral, writes Luboš Motl. Some cultural Marxists attacked him in the media, and a far left group (ČŽL, Czech Women’s Lobby) has sued him for “fearmongering” (tinyurl.com/ycd94hw4).

“Our Parliament talks about the ratification of the Istanbul Convention….  I already see a threat in the insidious way in which [it] is formulated. In the text of the convention itself [on “preventing and combating violence against women and domestic violence”], there is nothing that a reasonable person couldn’t subscribe to. All the dangerous and unacceptable things may only be found in an explanatory note that is so extensive that an ordinary person, and maybe many lawmakers, will never read it….

“[In] a certain convention’s extension of…rights and freedoms, [we are] overlooking the fact that freedom isn’t a sum of partial freedoms, freedomlets, and little freedoms. Instead, freedom is a unique, compact whole, and it is indivisible. It has the character of the sea that is not the sum of droplets like the rain. Freedom is either present—and then all the smaller things naturally follow…—or it doesn’t exist, and there’s non-freedom….

“[L]aws that…have already been adopted by several other countries are directed against the traditional family. The proposed laws and their protagonists have embraced the ideology of Marxism and Nazism…. They are…dictatorial. Dictatorships have always needed to get rid of the family, [which is] the source of democracy and the basis of the true bonds in the society….

“Your families will be torn apart and dispersed. What will be enough for that will be your saying that the man and the woman aren’t the same. They will take your children away from you and they will keep as secret from you the place where they hid them, where they sold them, where they imprisoned them. A sufficient condition will be a false accusation. The sex of newborns by a look into their groin will be abolished. The baby itself will decide about its sex and that’s why you will be obliged to educate it asexually, and…you will sometimes not be able to even name it….

“The experience from ages has taught us that the defense of endangered free people is easier and more effective than the uprisings of slaves and inmates.” [translated by Luboš Motl]

According to the UN Regional information Centre for Western Europe, the Convention will “put equality back on the agenda.”


“Those who seek absolute power, even though they seek it to do what they regard as good, are simply demanding the right to enforce their own version of heaven on earth. And…they are the very ones who always create the most hellish tyrannies…. Their mistaken course stems from false notions of equality….  Equality, rightly understood, as our Founding Fathers understood it, leads to liberty and to the emancipation of creative differences. Wrongly understood, as it has been so tragically in our time, it leads first to conformity and then to despotism.”

Barry Goldwater, https://tinyurl.com/y9tqj2eo


Diamond Anniversary Meeting

At our 75th annual meeting in Indianapolis, Marilyn M. Singleton, M.D., J.D., of Redondo Beach, CA, was installed as president, and the following were elected:

President-elect: Kristin S. Held, M.D.,  San Antonio, TX

Secretary: Charles McDowell, Jr., M.D., of Johns Creek, GA

Treasurer: W. Daniel Jordan, M.D., of Atlanta, GA

Board of Directors: Janis G. Chester, M.D., Dover, DE; Erika LeBaron, D.O., of Manassas, VA; Michael J. A. Robb, M.D., of Phoenix, AZ; and George Smith, M.D., of Covington, GA.

Kenneth S. Jago, M.D., of Canton, GA, was appointed to fill the two-year term of Kenneth Christman.

Winners of the student essay contest were: Ben Emery, a resident in the Harvard T.H. Chan School of Public Health, on the question of “Is ‘healthcare’ a right?”, and Kelly Yuan, a student at Sidney Kimmel Medical College, on comparing the Oath of Hippocrates with modern oaths or principles. See https://aapsonline.org/aaps-2018-essay-contest-winners-announced/ for the winning essays.


On Affirming Transgenderism

The American Academy of Pediatrics (AAP) issued a statement directly approved by 36 committee members entitled “Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents,” which asserts that transition-affirming therapy for “transgender youth” is the best medical practice. Members who disagree re afraid to say so publicly. In 2016, AAP guidelines stated “there is evidence that both reparative therapy and delayed transition can have serious negative consequences for children,” a claim denied by many experts (tinyurl.com/y8jnbbd6): the American College of Pediatricians   (ACPeds) explains “How Gender Ideology Harms Children” (tinyurl.com/hu28oq8). AAP has been compared (favorably) to the Weather Underground. It had to rescind a 2010 policy favorable to female genital mutilation (ibid.).


Updates on the Revolution

  • Acceptance: An online survey of 1,006 millennials found that nearly half of millennial Democrats identify as democratic socialists or socialists (https://tinyurl.com/ycrugzqq).
  • Violence: The Breitbart Rap Sheet now lists 603 acts of harassment or violence against Trump supporters that have been covered up, ignored, downplayed, or approved by the media. (https://tinyurl.com/yd2zw998).

    AAPS Calendar

Feb 22-23, 2019. Thrive, Not Just Survive; Board meeting, Dallas.

Sep 18-21, 2019. 76th Annual Meeting, Redondo Beach, CA.


Jury Awards $780,000 over Sex-Change Surgery

The state of Wisconsin must pay two transgender women $780,000 because the state did not cover sex reassignment surgery for its employees. Last month, U.S. District Judge William Conley ruled that a ban on transgender medical procedures was discriminatory and that the state must add coverage for sex reassignment medical care. Insurance companies will have to figure in up to $150,000 in medical costs for every person who wants to change sexes.  The coverage could cost as much as $1,400 dollars a year. While a doctor has to certify that the operation is medically necessary, those doctors who make the determination are the same ones who profit from the procedure (tinyurl.com/y9353jkx).

The ACLU claims that denial of insurance coverage was a “violation of civil rights.” Larry Dupuis, legal director for the Wisconsin ACLU, said, “Discrimination comes with a cost.”


The Presumption of Innocence

The Babylonian Code of Hammurabi put the burden of proof on the accuser, and provided that: “§3. If a man has borne false witness in a trial, or has not established the statement that he has made, if that case be a capital trial, that man shall be put to death.  §4. If he has borne false witness in a civil law case, he shall pay the damages in that suit” (https://tinyurl.com/y8h9odg4).

The ancient Greek statesman Demosthenes wrote about the importance of not calling people criminals before they were convicted, and a key third-century Roman legal document set forward rules about the evidence an accuser must supply (https://tinyurl.com/y8rxy6ls).

Today, the 5th and 14th Amendment Due Process clauses, by Supreme Court interpretation [Coffin v. United States, 156 U.S. 432 (1895)], protect the presumption of innocence.

The absence of the presumption of innocence is associated with some of the worst events in human history (Liberato.US,  10.6/18, https://tinyurl.com/y88wf86e): the Spanish Inquisition, the French Revolution, the show trials of Stalin’s Great Terror.  In the English Star Chamber, used to control the king’s political enemies, a finding of guilt could be based on the silence of the accused. Che Guevara said, “I don’t need proof to execute a man, I only need proof that it’s necessary to execute him.” He also said, “To send men to the firing squad, judicial proof is unnecessary….  These procedures are an archaic bourgeois detail. This is a revolution!”  [Guevara was a physician!]

“These examples from history all involved political or ideological opponents,” writes Liberato.  “The presumption of innocence is one of the first casualties of a totalitarian mindset when political orthodoxy is threatened.”


Judge Orders Return of Forfeited Assets

Dr. Joseph Edwin Oesterling, previously chief of urology at the University of Michigan Hospital, was charged with running a “pill mill” in 2016.  He was acquitted of  all charges in 2017. Finally, on Sep 25, 2 years after his property was seized during the investigation, a Michigan judge has ordered the return of $6.2 million in assets, including five vehicles, four properties, and two dozen bank accounts. Even after acquittal, the prosecution continued to call him a drug pusher (https://tinyurl.com/y8wyzmcu).


Tip of the Month:  Beware of a “gotcha” in settlement offers. Declining a settlement offer in litigation can be costly, particularly in California. California has a “Section 998” procedure that shifts costs, including expert witness fees and sometimes even attorneys’ fees, against a party that declines a settlement offer but then does not win more at trial. One California physician prevailed at trial in a whistleblower case, but the judgment was less than what had been offered in settlement by the other side. As a result, California Section 998 made her liable for nearly $1.3 million in attorneys’ fees and costs expended by the other side during the litigation. In Texas there is Rule 167 which can shift costs (including attorneys’ fees) against a party that rejected a settlement offer, and in federal court there is Rule 68 that can shift costs (not including attorneys’ fees) against a party that prevails by less than the settlement offer.


“No Cause” Terminations

While “no cause” termination clauses are ubiquitous in physician-hospital contracts, we were surprised to hear of a Texas physician who was expelled from the network of his WellMed Medicare Advantage plan, without cause.

WellMed is a  subsidiary of Optum, which is part of UnitedHealthCare. United has a history of cutting physicians from its Medicare Advantage networks without cause, calling it a “network realignment initiative.” In 2013 affected states included Rhode Island, Connecticut, Florida, New Jersey, New York, and Indiana (tinyurl.com/ybhmhv2n). United is apparently now aggressively trimming its networks in Texas (tinyurl.com/yc9ux6ao).

No-cause terminations should not be reportable to the National Practitioner Data Bank. If, however, the health insurance plan has a formal peer review process and the termination was allegedly due to a professional competence or conduct issue, then the action should be reported to the NPDB.


Aetna/CVS Merger Approved

The Department of  Justice approved the CVS Health Corp.’s acquisition of Aetna for $69 billion, requiring only that CVS divest Aetna’s Medicare Part D drug plan. The deal “could potentially transform the health-care industry and change how millions of Americans receive basic medical services” (Wash Post 10/10/18).

“Mergers can decrease competition and such mergers are not in the interest of our patient,” writes AAPS president Marilyn Singleton, M.D, J.D., in a letter to Attorney General Jeff Sessions (aapsonline.org/cvs-aetna/). This merger combines the third-largest health insurer and the largest national pharmacy chain, which has the dominant pharmacy benefits manager (PBM), CVS Caremark. Experience has shown that mergers steer patients to insurance plans and site of care, and away from their trusted physicians, Dr. Singleton explains. CVS and its PBM gain considerable profits from such steerage. Mergers make it nearly impossible for independent pharmacies and stand-alone PBMs to compete.

CVS has already demonstrated a pattern of anticompetitive behavior. For example, the price of a generic prescription jumped from $45 to $241 after CVS took over a Target pharmacy. CVS Caremark drastically cut payment rates to independent pharmacies, sometimes below cost, while inflating payments to its own CVS pharmacies.


ACTION OF THE MONTH

Midterm elections: Questions to ask candidates on key issues, such as pre-existing conditions and Medicare for All, are posted at: https://aapsonline.org/category/midterms/.


Correspondence

Behind the “Guidelines.” Early this year, the Trump Administration announced that “it was starting a Medicare payment model very similar to the ones it canceled and curtailed last year” (https://tinyurl.com/ydd4toqq). The Obama Administration created the earlier bundled payment models using authority under ACA. Under the new program, “Medicare will make a single ‘bundled payment’ for nearly all the services provided in a 90-day period to certain Medicare patients who are admitted to a hospital or have certain outpatient medical procedures,” and providers can receive a bonus “if they hold Medicare spending for these patients below a target set by the government.” In theory, “lump sum payments encourage health care providers to work together and coordinate care.” In this context, “coordinate”  means that the government will put out a fixed-sized pie, and everyone who provides care will fight to get a slice of the pie. Independent physicians will be at a severe disadvantage. As will sicker patients who require more frequent care.

Think what would happen if you applied this concept to auto repair. Auto repair shops would likely increase the price of an oil change dramatically, and they would act to schedule as few extensive repairs as possible, with accompanying lengthy delays. Why would anyone think that this idea would work in medical care?

Lawrence R. Huntoon, M.D., Ph.D., Lake View, NY 

Stealth Euthanasia. In just one hospital in the UK, 450 patients were “hastened to death” between 1989 and 2000. All such imposed deaths are undeclared. In the U.S., we hear of increasingly hostile-to-life conditions in hospitals, nursing homes, and even home care. Family members have to fight to get supplies and procedures that were once routinely provided. Nurses and physicians report a hugely increased push to get patients into “palliative care” even when they are not terminal.

Ron Panzer, Hospice Patients Alliance

The Healthcare Algorithm Cartel. We have too many folks today choosing “virtual” values and getting lost in the real world,  not realizing what goes on behind the scenes—things you can’t see rising from corporate America to gain control of us lesser-valued serfs. Every direction you turn, somebody is mining some behavior data and scoring you today. We have so many scores,  many of them secret, and who knows what value some big corporation or government is putting on our head today?  Like Obama, Trump is embracing virtual values, keeping consumers in the dark about the ugly real world: Operation Perception Deception.

Barbara Duck, https://tinyurl.com/yb5vmg24

Physicians as Cash Cows. For licensure and credentialing, physicians are required to obtain varying amounts of AMA PRA Category 1 Credit™  approved by the Accreditation Council for Continuing Medical Education (ACCME). This monopoly collected $2.5 billion in fees in 2012, according to its annual report.

Paul Martin Kempen, M.D., Ph.D.,  Weirton, WV

Rule of Party of One. Our country now is negatively transformed and divided by one party, the Democrats, who are busy inciting mob violence among their followers, even paying them to  create violent situations. Democrats, who are masters at demonizing the opposition,  are following in the footsteps of Soviet communists and Nikita Khrushchev’s “conquest without war” to fundamentally transform life around the globe. In the insane world of Bolshevism and communism, it was patriotic to kill the opposition. After Sergei M. Kirov, a Politburo member, was killed by a young Party member, the annihilation of “class enemies” exploded.  Show trials for made-up, unfounded, and unproven accusations sent millions of useful idiot Russian communists and non-communists in front of the firing squad or to the Gulag.

The Kavanaugh hearings were eerily reminiscent of Stalinist show trials, complete with screaming paid communist Democrats in the gallery. The guilty “accused,” who had to prove his innocence, was already sentenced in the blaring court of public opinion. The precedent has been set. Are we really free, or are we living under the rule of the party of one and its paid violent mobs?

Ileana Johnson, https://tinyurl.com/ydho8t5r

Adaptation. Since the passage of ACA in 2010, insurance companies have (predictably) adapted. Follow the money. We’ve seen rampant industry consolidation and blurring/co-mingling the  functions of corporate insurers, “providers,” and care managers. Insurers are profitably managing Medicaid HMOs through restricting “provider” networks and passing on insurance risk (costs) to taxpayers. Democrats now advocate changing laws to encourage many more middle-class citizens to enroll in public programs, and they’re betting that voters will agree.

Lee Beecher, M.D., Maple Grove, MN

Insane Policies. Guaranteed issue/community rating in ACA is   driving the toxic prices for insurance with toxic levels of deductibles, which can only be corrected by its repeal. Or do we prefer funding giant HMO-ACO cartels? Every such CMS rationing “experiment” has failed to control costs, as did HMO rationing for 37 years before ACA’s creation of a cartel version.

Robert  W. Geist, M.D., North Oaks, MN

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