Thursday, October 29, 2009

DOCTOR GUIDELINES NOW ORDERS

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs
Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

DOCTOR GUIDELINES NOW ORDERS

It seems that new government guidelines are causing a barrier between a doctor and his patient. As the doctor listens to his patient, sees and evaluates his problem, and feels he is going to do what is necessary, the thought comes into his head: Gee, perhaps this isn’t the right thing to do, according to the Harvard government guidelines? Yet the patient in front of him is no average patient.

Every patient has some unusual or unique symptoms that must be considered in dealing and solving the patient's problems. Yet the guidelines don’t consider them.

We really should only expect average care from our doctors. Guidelines forbid medical care that is better than average. They are set to give the average patient, average medical care. If your doctor gives you better than average medical treatment, he is not following the guidelines. He will be reminded by the hovering tort lawyer waiting to pounce on his care. There is no tort reform to help him.

The guidelines suggest that if an 82-year-old patient cannot walk down the street, is short of breath, and feels lightheaded, or has broken a hip; the guidelines for his care will be minimal. Under White House health care advisers, that patient has outlived its useful years, no matter how many more years he has to live.

SPECIALISTS NOT NEEDED

Fifty years ago people went to the hospital to die. Most died by the age of 68. Medicare and Social Security was planned to pay for two or three years of your retirement. The doctors became the bad guys. They now keep you alive to 85, and this has caused Medicare to go bankrupt.

So now lets change and correct the problem. Since people are living too long, the healthcare must be changed. Lets take the doctor out of the picture and teach him how to practice non-wasteful medicine. The government has learned how to run the auto industry; it can certainly learn how to run the medical industry.

If I have a domestic or a divorce problem, I'm not told to go to a corporative lawyer. But this is what the new guidelines are telling us in medicine. The media has sportswriters, financial writers, personal journal writers, and editorial writers. Yet in medicine and healthcare, we are telling everybody go to the general practioner for everything. If he finds he can’t solve your problem after 3-4 visits, and are sick enough, you will be referred to a government secretary who will find a specialist for you.

If you're having pain in your chest and heart failure, you want to be treated by a cardiologist. He will give you the most up-to-date and accurate treatment for your problem.

Doctors are asked to deliver all your patient records, with their intimate secrets, so they can be converted into electronic medical records to increase transparency. Formerly this was called a breach of code involving his patients.

MANAGED CARE RELIVED

The health reform guidelines are duplicating everything as managed-care did for the last 15 years. It was very hard to overcome the problems with patient care being denied and withheld. We thought this would never be repeated, but our government is in the process of reduplication the same errors. “Let doctors treat the patients, and let us government czars and lawyers in congress manage the care”.

Our president reminds doctors that they “take their Hippocratic oath too seriously”. The philosophy of “doing no harm to our patients” that is held very dear to the doctor's hearts, is now violated.

Plato the philosopher, unlike Hippocrates, said things like: “If you have a poor physical condition you should be allowed to die. If you have a weak constitution, you shall perish”. It seems government programs, limiting above average medical care, which is now being proposed, somehow violates the Hippocratic oath.

If you are sitting in the examining room with your doctor you're wondering: “Why is the doctor not ordering a test for me? Is he going to get penalized by the hospital or Medicare if he does it? Since he's not ordering the test, will the malpractice lawyers have a case if I become disabled or die?

THE FINAL HOUSE HEALTH CARE PACKAGE

The Congressional House Democratic committee have just passed a reform and handed it back to Pres. Obama as a victory. Our world today is defined by nearly 100,000 iPods, and yet we are being pushed into the biggest one-size fits all legislation since 1965.

Obama, has used old Congressmen, all elected to Congress 30 years ago, to formulate his health plan. They put together a healthcare bill of over 2000 pages, big, complex, not comprehensible, and very coercive. Everything that young people hate today.

The powerful new technologies like Face book, twitter, digital and web-based technologies have decentralized virtually everything we know of. These technologies take most of our waking hours, both at work and at home.

Young people want to break things up into many discrete markets. Controlled newspapers and TV media our struggling to stay massive in the world. Our youth are slowly making them less and less influential.

The one thing that won't change is our government. Whether in Congress, California, Las Vegas, or New York---everyone else's job is measured by how he performs, or does not perform. To keep one’s job, one must be reelected. That's up to you the reader.

DECEPTION & DISAPPOINTMENT

Over the last 25 years, many entrepreneurs like those in Silicon Valley, have taken a small idea and ran with it. Our Congress has done just the opposite: They have taken something really big and made it gets bigger.

We have Medicare for our seniors, with their spending claims going to the moon. Now we are creating Medicare for everyone, young and old. Medicaid is now made even bigger yet—despite being the main thing that is financially destroying California.

We were told in the past to contribute to the common good—“Join, the Peace Corps”. Now we are told we can contribute to the common good by being willing to just fall in line behind some huge piece of legislation.

Claiming he was really on the leading edge of politics , our nation elected President Obama. If there were an iPhone for healthcare, he would have proposed it. He used the Internet masterfully, to get young voters aroused. They voted for him, thinking he would have a flexible system to calibrate their needs in the healthcare system that would suit their needs. And over time, despite errors, he would make a better system.

Not much chance of that! Our old health software can't recognize trial and error. The public options that have just come out of the House is not in sync with many younger Americans. It's not the way they want to go.

COMMENTARY

People thought when they elected Obama, someone agile and smart was coming to government. The Democrats, a party of 30-year veterans in Congress, totally dependent on public sector unions, are now the Obama change makers.

Looks like there will be a health reform bill on President Obama’s desk to sign for Christmas. Or should I say " for the Holidays". (The White House announced there would be no Christmas tree lighting this year: It will now be called a “Holiday Tree.”)

Visit www.drneedles.com for more discussion of medical controversial issues.

Source www.defendyourhealthcare.us

Wednesday, October 28, 2009

REFORM EXPENSIVE FOR SENIORS

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs. Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

SENIORS, OPEN YOUR WALLETS

Medicare costs 13% of the federal budget ($391 billion). Because Medicare is an entitlement program, there is no way the government can limit to the number of people who qualify.

Once you retire, you receive a public pension to help you through old age. (We call this Medicare). The taxpayers cover the bill for everyone over 65.

CARROT STICK #1

THE COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS ACT, OR CLASS ACT

Congress is desperately trying to keep the costs of their health care reform under $900 billion. To help cover the costs of Medicare, congress now find people under 65 may kick in another $73 billion into the Medicare program.

Everyone working would be able to pay premiums for at least five years before they could qualify for benefits. The premiums would be $123 a month and would be collected while you are working. You would receive a cash benefit of at least $50 a day if you become disabled.

You could use this money to pay a home care attendant, buy some equipment, supplies, or even make home improvements as adding bathroom railings to defray the cost of nursing home care.

Retirees believe that your long-term care needs are going to be covered by Medicare. As you prepare for retirement, and pay for this disability benefit, your initial premium of $123 for the program keeps rising with time making it unattractive for healthy working age people to keep contributing to this plan.
Eventually this program would need a taxpayer bailout. It certainly keeps the long-term-care fund in the black for the first 10 years. But the true cost of expanding medical coverage are masked.

CARROT STICK #2

Ms. Pelosi and House Congress still want a government insurance plan. Going to college now are proposing a “CONSUMER OPTION” that would compete with private insurers. The government insurance plan would negotiate rates with doctors and hospitals like private insurers do. The payments would not be based on Medicare rates, since the Medicare rates so low hospitals could not survive on them--- (rural American hospitals would go out of business).

This new distorted public option if passed, would have the unintended consequence of forcing private health insurance providers out of business.
We all want reforms that would provide subsidies to the poor, and insure that everyone at least got a basic plan. Insurance companies could not deny coverage because of pre-existing conditions.

YOUR MEDICARE PREMIUMS GOING UP

Your Medicare costs are going over a hundred dollars for the first time. This is a result of the rise in medical costs. About 27% of Medicare beneficiaries will have to pay higher premiums or have someone else pay for the hike.

Many seniors will be shielded from the increase because under federal law their Medicare premiums can't go up more than their increase in Social Security benefits. Because inflation now is extremely low, you may not see an increase in premiums next year. You can also count on Medicare cutting their expenses by $100 billion by eliminating wasteful testing of seniors.

Seniors insist on their own security be protected through any current health care reform. Seniors are also concerned about paying higher insurance premiums than their children. The baby boomers that are between the ages of 50 and 65, who now buy their own insurance, typically pay a much higher premium than anyone else.

In their proposed health reform budget, Congress is using desperate shenanigans to keep the budget under $900 billion. They have shifted money into Medicaid to cover adults for the first time.

Senior Medical Advantage has now been stripped, and federal money is being placed under various other programs to finance this health reform bill under $900 billion. Congress insists there will be no added costs to the Medicare program in the first 10 years. But this overall package is masking the true costs of expanding medical coverage to everyone.

Seniors, help Uncle Sam by opening up your wallets. There is no free lunch.

Visit www.drneedles.com for more discussions of controversial medical subjects.








Monday, October 19, 2009

NASAL SNIFFING BEATS TAKING ORAL MEDS

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs
Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

NASAL SNIFFING BEATS TAKING ORAL MEDS

From painkillers to cancer therapies, the latest research shows that medication can be most effective when taken nasally.

We are losing all our effective antibiotics and we need something else. Many substances that are applied in the nose of patients in vitro work against viruses but failed to work in clinical trials in patients.

A nasal spray to shore up your own natural defense systems may be the answer to beating the cold. A white blood cell compound attacks bacteria viruses and fungi and kills them by creating a chlorine cover around microorganisms. There is no danger of growing resistance since it is based on our immune system (A spray containing an analog of CHLOROTAURINE).

ANTI-FLU SPRAYS

How can we protect the people from getting infected by the flu? Anti-flu drugs are used to treat the infection but fail to kill or resist a virus.

Usually the virus enters the nose throat and lungs by locking onto a sugar sticking out from their surface. Proteins bind to the sugar and stop the flu bug in its tracks. The virus keeps expanding until cells are killed. Targeting the sugar rather than a virus helps the drug work on bugs. The spray is given like an asthma inhaler.
Most drugs, used for the treatment of influenza, cannot work on a virus because it becomes resistant to the drugs.

These nasal sprays may stimulate your own defense system. Intranasal delivery of drugs is under investigation for more than two dozen conditions.

Nasal gels and fluids are used to prevent bacterial and viral infections as varied as MRSA, Flu, Sars, Ebola, cancer alleviation of cancer symptoms, and many new forms of vaccines.

ADVANTAGES OF NASAL DOSING

In order to ensure the therapeutic amount gets to the right place, larger doses of drugs must be given orally and the risk of side effects increases.

Research on antihistamines and hay fever shows that while an oral dose can lead to drowsiness, no such side effect occurs when it is given intranasally. Since the required dose is much smaller, stomach upsets associated with some oral drugs are also less likely.

Another big advantage of nasal sniffing is, that it is a direct route into the circulation. The noses inner surfaces, all 150 square centimeters, are rich in tiny veins that help the drugs get into the circulation directly.
Once in the circulation, the drug has a direct and rapid way to work more quickly.

Nasal sprays can deliver molecules called neuropeptides directly to the brain. These molecules include insulin and other hormones--- that communicate with the brain. Nasal sprays quickly cross the blood-barrier and prevent the accumulation of the drug. Nasal delivery is also useful in treating brain diseases, such as Alzheimer's disease and obesity.

DIABETES

Diabetic patients soon will be able to use a small inhaler containing a cartridge of insulin powder, which is inhaled into the lungs, dissolve there, and then travels through the bloodstream.

The insulin doses will be prepackaged in cartridges. A mouthpiece is used to release the insulin. No electricity or compress gas will be used. The patient's own breathing will do the job. The airflow through the cartridge allows the powder to be inhaled. This small sized inhaler, called dreamboat, soon may enter the market with FDA approval.

WEIGHT LOSS

Insulin plays a pivotal role in regulation of central nervous system functions, as memory processing and energy metabolism, for weight loss.

ALZHEIMER’S

Since part of the malfunction of the nervous systems signaling is involved, nasal spray insulin may help in the treatment of cognitive and metabolic disorders, such as obesity and Alzheimer's.

Gender seems to be a critical factor in brain insulin signaling affecting both food intake and cognitive functions. Insulin given intranasally, decreases food intake in men but surprisingly not in women. The compound improves memory function in women but not in men.

IMPROVING MEMORY


A molecule from the body's immune system (interleukin-6) when administered through the nose helps the brain retain emotional and procedural memories during REM sleep. A nasal spray can improve memory,

Interleukin-6 ,plays a beneficial role in sleep-dependent formation of long-term memory in humans. (University of Lubeck, Germany).

COLD DISORDERS

We are losing all of our effective antibiotics, and we simply need something else. A nasal spray that mimics our own natural defense system may be the answer to beating the common cold, It works like bleach, creating a chlorine cover around bacteria, viruses and fungi, which kills them. The spray has already proved effective against MRSA.

FLU PREVENTIONS


A nasal spray can protect you from getting infected by the flu bug (researchers at St Andrews University).

Usually, a flu virus enters the cells through nose, throat and lungs by locking on to a sugar that is sticking out from the cell’s surface. Once inside the human body, the virus keeps on expanding itself, killing the cells.

Instead of attacking the flu bug directly, ranges of proteins are used to bind the sugar and stop the flu bug in its tracks. Targeting the sugar rather than the virus itself helps the drug to work on bug. The spray is given like an asthma inhaler and gets quickly into the respiratory track.

PAIN RELIEF


Acute pain is a key target for new nasal drugs, largely because of the speed of their action. Morphine is being used to combat cancer pain, while other drugs are nasal sprays tackle cluster headache, post-operative pain, and dental pain.

AUTISM

Autism is a developmental disorder with symptoms that include poor social functioning and repetitive behaviors. Low levels of oxytocin, a brain chemical involved in emotion, may be involved in the development of autism.
A daily nasal spray, based on the hormone oxytocin, has been used to treat autism symptoms in adults. (Mount Sinai School of Medicine, New York). Other studies found that oxytocin plays a role in social bonding, memory, anxiety reduction, and repetitive behaviors.

MEMORY AND FORGETFULNESS

Insulin plays a role in normal memory processes. Insulin abnormalities may contribute to brain changes associated with Alzheimer's.

Nasal insulin can boost memory in both healthy older people and those with Alzheimer's. Both the healthy and the Alzheimer's patients performed significantly better on memory tests after getting insulin than getting a placebo

FEMALE VIAGRA

Nasal delivery may boost libido in women. A nose spray based on testosterone, currently in development, increases libido in women over 40, and improves sexual arousal. Women who had the nasal testosterone, when shown sexual test pictures had a greater emotional response.

OTHER NASAL USES

Health regulators approved a generic nasal spray to treat osteoporosis, making bones stronger. This calcitonin nasal spray is the copycat version of Micalcin, which is marketed by Novartis. The nasal spray is indicated in females who have low bone mass, after five years or more of menopause.

PROSTATE


Buserelin, a class of medicines (called LHRH analogues works by decreasing the production of sex hormones. Suprefact, a nasal spray, is used to treat cancer of the prostate by reducing levels of testosterone.

COMMENTARY

From painkillers to cancer therapies, the latest research shows that medication can be most effective when taken nasally. Nasal sprays can stimulate your own immune system, and prevent bacterial and viral infections.

This method of delivery is now being used for delivering vaccines, cancer symptoms, Alzheimer's disease, obesity, prostate cancer, memory loss, and loss of female libido.

The required doses are much less and side effects are few. It offers a direct route into the circulation. Insulin and other hormones can be directly delivered to the brain, crossing the blood brain barrier and drug accumulation can be prevented.

It has been found useful in the treatment of Alzheimer’s disease obesity. Interleukin-6, administered nasally, helps the brain retain emotional and procedural memories during sleep.

Having lost all our effective antibiotics, the drug companies are turning to nasal sprays for the treatment of many diseases.

Visit www.drneedles.com for more discussion of controversial medical subjects.

Sunday, October 18, 2009

BENEFIT CUTS WILL BE MADE FROM SENIOR CARE

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs
Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

BENEFIT CUTS WILL BE MADE FROM SENIOR CARE

Seniors are very concerned that Medicare will be cut as Congress expands the ranks of the insured. Obama calls of the savings, to reward quality care rather than quantity of services, more efficiency and less waste.


Seniors will be the big losers if this plan is accepted as submitted. Since Medicare was formed 54 years ago, older Americans have been able to avoid disability, live by themselves, and travel. The new health plan will reduce this access to care for seniors, and pressure them to end their lives prematurely, and doomed them to painful years in nursing homes.


It seems that typically Congress sets up a budget formulae and if the formula turns out to give people money it passes. If people are denied money, Congress changes the formula.


CUT TO DOCTORS FEES


Congress passed a sustainable growth rate, SGR, for Medicare to cut federal deficits. Many physicians quit accepting Medicare patients this made Congress coming up with funds to fix the cuts every year since 2003. Now the Democratic Senate wants to end the SGR, to again cut doctor payments.


WHERE IS THE MONEY?


Why on earth is Medicare running out of money? The ratio of seniors compared to fewer workers paying Social Security into the system, has resulted in a deficit in the Medicare budget. Because of this, it has been suggested to push the Medicare eligibility rates to age 70.


Should you pay higher insurance premiums than their children? If you are between the ages of 50 and 65 and buy your own insurance, you typically pay a much higher premium than your children would pay. Once you turn 65, however, Medicare takes over your insurance coverage, and your premium difference is no longer an issue.


If you buy your own insurance you will pay 6-7 times more than the younger generation. If however, your employer buys your insurance, you don’t face a premium. Obama wants to reduce this premium price difference.


HOW INSURANCE COMPANIES THINK!


Seniors need more health care. If there is no premium price difference, to make up for the loss of insurance company revenue, younger people will have to pay higher premiums. If the cost between older and younger workers is no more than two to one, premium prices will go up for younger people by as much as 60%.


If you are in a lower or middle income person, you would need some tax credits or subsidies to keep your premium costs around 12 1/2% of your income. If all policies provided dependent coverage to the age of 26, as proposed, you and your children luck out.


CUTS THAT WILL BE MADE FROM SENIOR CARE


Seniors had no idea they would have to foot the bill for this massive experiment in government health care through cuts to their Medicare. The Medicare advantage will be cut $130 billion, $120 billion will be cut from hospital care for seniors, another $40 billion will be cut from home health agencies, $15 billion cut from nursing homes, and $8 billion cut from hospice care.


Sen. Harkin of Iowa said that if seniors want to have these little added features, it should not be done through Medicare. “They can buy supplemental insurance.”


RIFT OVER MAILINGS BY INSURERS


Insurance company mailings to seniors recently, from Humana, warned seniors of the disastrous Medicare cuts to their health care if present proposed health legislation is approved.


The president. Irate, issued an order to Medicare, to stop all the plans from communicating with their beneficiaries.


Since 25% of all Medicare beneficiaries are signed up in private plans, lawmakers became apprehensive of a potential backlash, and last month, Obama backed away from his Medicare ban on mailings. He rephrased the order, saying insurance companies may lobby seniors, provided they get permission from their beneficiaries first, and that no federal funds or data are used. Medicare official said the directive was only clarifying a long stand policy protecting seniors from nuisance mailings and abusive marketing.


COMMENTARY


Considerable funding has been made for comparative effectiveness research. This is the codename for limiting care based on the patient's age. This formula is used currently in Britain to deny treatment for older patients who have few years to benefit from the care. Treatment for the elderly will be denied on the basis of age. This will result in denying seniors lifesaving care, keeping them disabled, but saving tons of Medicare money.


Because specialty care costs a lot of money, this care will be shifted to the primary care doctor, and there will be less access to medical care. Reducing access to medical treatment ,as hip replacements, knee replacements, and bypass surgery, will make our senior’s lives shorter. Counseling on end of life options should also produce huge cost savings to Medicare.


Do you think these are reasonable solutions to the health care problems of our seniors?


Visit www.drneedles.com for more discussion of controversial medical problems. We strive to have our viewers “read between the lines”.

Saturday, October 17, 2009

TORT REFORM ESSENTIAL FOR GOOD BILL

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs
Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

TORT REFORM MUST BE ADDED TO THE BILL


Finally, the founder of the Democratic leadership Council, Al From,in a Wall Street editorial, asks for measures to limit abuses in malpractice suits, (which Republicans have long called for). This should garner the 60 votes necessary to pass the Senate, and achieve most of what liberals have long fought for. Open-minded Republicans might even find this hard to resist.

HOW DOCTORS THINK

Doctors would be ordering fewer unneeded tests, and save taxpayers billions of dollars, if a limit on medical malpractice suits would be placed. Over $41 billion over 10 years would be saved if limits on awards for pain and suffering were enacted.

If doctors are forced to limit medical tests and treatments, our trial of trial lawyers will have a feast. A failure to test for a medical problem is tantamount to malpractice. We will find patients being bounced around from doctor to doctor to dilute any medical liability. In conclusion, the solution is for arbitration boards to pay patients who have suffered from malpractice, and eliminate trial lawyers from gobbling 60% of any settlement. It's too bad, the press and media are silent on this important issue.

NO DISCUSSION ABOUT MEDICAL LAWSUITS

If defensive medicine could be eliminated we could save over $200 billion each year.

Since the trial lawyers are the largest contributors to the Democratic Party, and thrive on this unreliable justice system, our congressional lawyers until now have refused to even consider this issue.

CONGRESS BLACKMAILED BY TRIAL LAWYERS

Very simply stated, a few thousand trial lawyers are blocking reform that would benefit all of us 300 million Americans.

Trial lawyers see firsthand the effects medical errors have on patients and their families. These injured people must be protected.

All of America wants its legal overhaul. Congress now realizes it can't completely ignore legal reform. Big pronouncements and token proposals have been issued, but all specific ideas are avoided.

Rep. Gordon (Dem.) proposed an amendment to fund pilot projects for liability reform, including possible voluntary alternative dispute resolution. What happened to this proposed amendment? They were all crossed out due to the agreement with the trial lawyers.

Howard Dean quoted the recent tort reform is not in the bill is because the people who wrote it did not want to take on the trial lawyers -- is the plain and simple truth.

THE SAVINGS ARE ENORMOUS

These savings are 10 times greater than the CBO estimated last year. In a reversal, CBO Dir. Elmendorf, explained the agencies shift. He acknowledged what doctors have been saying for years. Fear of being sued, leads doctors to practice defensive medicine. A doctor will order a $1500 MRI for a patient with back pain instead of a simple $250 X-ray, just to cover himself against the chance, he will be accused later of having missed a cancerous tumor. There has been no mention of tort control by the lawyers in either the house or senate committee bill, until Al From's editorial in the WSJ Oct. 16.

DOCTORS AND TORT REFORM

Tort reform is essential for any solution to our health plan stalemate. If doctors are forced to limit medical tests and treatments, our trial of trial lawyers will have a feast. A failure to test for a medical problem is tantamount to malpractice. We will find patients being bounced around from doctor to doctor to dilute any medical liability.

Medical testing reduces their chances of medical liability in case of a legal problem. The prosecuting attorney notes that any failure in obtaining a test that might have saved a patient from a medical problem is malpractice.

WHERE ARE THE VOTES?

A health bill can be pushed through the Senate without Republicans. but 60 votes are needed. The Senate might use a seldom-used rule called re-conciliation where it can pass anything with 50 votes. The Senate would need 60 votes to break a potential Republican filibuster. In theory they have the 60 votes to stop a filibuster.

COMMENTARY


With an election year coming up, a decision has to be made whether Democrats want to build or really want an issue to fight the Republicans. With an election coming up in 14 months, this may not be the time to call for a vote.

Both sides want issues to take back to their constituents. The Democrats must quell the present anger over health reform, if they want to avoid the risk of losing seats and their majority.

Some Democrats, as Al From, (founder of the Democratic leadership Council,) in a WSJ editorial, 10.16.09) want to push the reset button and look at this malpractice reform with fresh sets of eyes.

It seems the elderly see what is going on in an attempt to limit their access to health care. They know it will cost them more, and they oppose this bill.

This bill ignores tort reform by both the media and the White House. Everyone seems to refuse to challenge the trial lawyers, and consequently there has been no discussion of tort reform in this bill.

The present health care plan is not clear, and has a secret language that no one understands. For a bill to be passed, it must be simple and clear. When you hear it, you must understand it, and should be able to explain it to others. Retired workers receive a public pension to help them through old age. It is called Medicare. We the taxpayers fund this bill for people over 65. People who have no money and can’t support themselves deserve help until they get them back on their feet.

Since we don't understands this stuff, and don't know what the words mean, we say to ourselves: “I may not understand this but my honest government sure does, and I know they're going to treat me with kindness and respect. But since I can't understand what they're talking about, they must be trying to confuse me, and so I will not support such a plan”.

It has been a grave mistake to not discuss tort reform legislation in this bill. It has allowed Republicans to divert attention away from the reforms most American want and instead focus on what Americans disagree on. Giving malpractice reform will refocus the attention on enormous financial savings

The American people will hold Democrats accountable for the outcome of this health debate. The president's approval ratings, with a double-digit lead in the past, on the recent generic ballot poll showed that Democrats are essentially in a dead heat with Republicans on the on the ballot. There is a nearly 20% drop in Democratic support since the last elections among independents. The lack of tort reform could cost many blue dogs in the house and red state moderates in the Senate to lose their seats in the 2010 elections.

The Senate Finance Committee showed a public option is unnecessary to expand coverage. Dropping public option from the plan would win support of most centrist Democrats, and adding tort reform will add moderate Republican votes for the plan.

Health reform needs broad support. It's too controversial and too important for Congress to ignore tort reform. In the past civil rights legislation and Medicare in the 60s always passed with bipartisan majorities. Health care reform should be no exception. Tort reform is essential to make this bill succeed.

What do you think? Visit www.drneedles.com for more dicussion of pertinent controversial medical issues. Everyone must learn how to read between the lines.
Source Wall Street Journal October 16, 2009

GARDISIL VACCINATIONS FOR BOYS APPROVED

As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read betwwen the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs
Visit http://www.americanacupuncture.com/ for more detailed information on mind, body, and spirit healing.

GARDISIL VACCINATIONS FOR BOYS APPROVED


Are you willing to have your son vaccinated to prevent his girlfriend from getting cervical cancer? The vaccine will prevent him from getting genital warts, and we are told it is safe and effective.

The FDA recently approved GARDISIL vaccinations safe in males as well as females. If the CDC, Center for Disease Control, recommends its routine use in boys, many states will see that as a mandate to force vaccinations of boys from age of 10-25 (and also prompt health insurers to pay for it). A panel of experts at the agency will soon debate the matter.

Boys don't receive any direct benefit from being inoculated. Only 1% of sexually active males actually do develop genital warts. Warts are not life threatening but merely irritating. Since the HPV virus that causes warts can lead to cervical cancer, vaccinations in boys could help prevent cervical cancer in his girl friend.

VACCINE DESCRIPTION


The vaccine contains HPV16 and HPV18 virus, combined with HPV6 and HPV 11 virus. (HPV6 and HPV11 were added because these viruses are present in genital warts).

Human papilloma virus type 16 (HPV=16) and type 18(HPV18) cause 70% of cervical cancers throughout the world. The vaccine is effective in high-grade lesions, but most lesions found were low grade. Since most HPV infections are transient, these lesions are reversible.

A MANDATE?

Because the CDC recommended girls get vaccinated against HPV, several states have required them to do so. Overall, only 37% of teenagers have gotten at least one dose. Many never get the full three doses recommended.

Public health authorities already require everyone be vaccinated for other diseases such as rubella or German measles. The fact that there is no evidence of direct benefits to the boy makes a mandate unlikely.

AVAILABILITY


The vaccine has been available since 2006 for teenage girls. Its high price of $390 for the three-dose regime has resulted in very slow sales of the drug.

The FDA also has just approved a rival vaccine, called Cervarix. Like Gardisil, it protects against two HPV strains that are linked to 70% of cervical cancers, but it does not protect against the strain that causes genital warts.

NO RISK TO OTHER CHILDREN


HPV can only be obtained by sexual contact. It doesn't endanger any other child in a school setting or put any of our population at risk. Yet, the CDC has made it a statutory requirement.

Many older sexually active girls have already been exposed to HPV, and the vaccine is then not recommended.

COMMENTARY

There are 13 vaccinations that your child must get, all to fight infectious diseases transmitted by the respiratory route that are considered highly contagious. This Gardasil vaccination is now #14 and is the sole exception.

Giving girls four viruses to prevent cervical cancers could lead to other disease entities. Why expand that risk to boys? A risk of seizures exists from the vaccinations.

Adding the vaccination for boys, to prevent a 1% chance of getting irritating genital warts, seems like a hard sell.

What do you think?
Visit www.drneedles.com for more discussions of controversial medical subjects.

Tuesday, October 6, 2009

MEDICAL DEVICE SAFETY QUESTIONED

As a medical physician for over 50 years, I strive to give you the best medical information on controversial medical subjects and let you, the reader, come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary that results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Let me know how we are doing. Your constructive comments are always appreciated. Click the RSS post button on the upper right hand corner if you would like to receive by email our future medical blogs.
Visit http://www.americanacupuncture.com/ for more detailed information on healing.

WHO CHECKS MEDICAL DEVICE SAFETY?

Medical devices have a $200 billion year market, yet there is a risk with each medical advance, especially in medical devices. Billions of dollars are spent researching and developing new surgical procedures, rehabilitation, technology, and medications. Defective medical devices can cause great harm to patients, and make the conditions worse than the problem they already suffer.

Patients are asking their doctors for newest technologies from genetic testing to specific radiation treatments, and doctors have trouble finding the latest evidence-based information. The only information they get this from the manufacturer.

FDA ROLE

The FDA oversees many products to make sure they're safe for you the patient. The FDA gathers reports of medical device problems and alerts you the public about them. They may require the manufacturer to issue a warning statement, and maybe even a recall of that particular product.

If there is a new indication for an already marketed device, the device must be subject to new investigation.

The FDA regulates more than 100,000 different medical devices from more than 15,000 manufacturers—in addition to receiving several thousand new and supplemental applications each year—and are expected to evaluate and approve these devices without delay. How can they monitor the safety of every device they approve?

Thousands of medical technology applications are submitted each year to the FDA, and less than 100 of them undergo scrutiny required for new drugs. They rely and manufacturers and clinical investigators to initiate recall and failure reports. The FDA is limited in oversight of these new medical technologies. There is a need for an independent review organization to provide transparent objective evaluations.

FDA REVIEW PROCESS

Assessments should require that the information be published or accepted by a peer-reviewed journal. This allows companies to make their trial results available to you the public.

Many medical devices that have proven defective, as: Stryker hip implants, Medtronic defibrillators, and cool mesh hernia patches, have injured countless people. These medical devices have not been subject to the rigorous review process as drug companies have.

A report by the Government accountability office for the five years of 2003 2007, showed 228 medical devices were approved without full review. Scientists were pressured to approve medical devices against their professional judgments.

Nine FDA scientists complained a corrupt review process was putting public health at great risk. These scientists provided a detailed list of laws that the FDA officials have violated. They asked for immediate intervention. They complained that some class 3 devices should be classified as class 2 devices and others should be tested more. Manufactures claim that the FDA is already overly restrictive.

Problems arise when exceptions are made for improvement to devices already on the market. They convince the FDA devices are substantially equivalent to the ones on the market. The FDA acknowledged the problem and said they either have to carry out full reviews on all products, or reclassified some devices at lower risk.

Over two dozen distinct devices escaped close scrutiny: metal hip joints, external defibrillators, and electrodes for pacemakers, all put patients at risk.

FAST TRACK APPROVAL

Medical device companies ask for a fast-track approval, claming their device is similar to other products already on the market. The FDA reviewers however felt, this was a new product that needed more extensive clinical trials to prove its safety and efficacy.

There is a heated internal battle in the FDA agency device division, charging that FDA officials routinely approve for sale high-risk medical devices even though the manufacturers never prove their products are safe or effective.

The FDA normally divides devices into three classes. Class I, are exempt from agency reviews (as reading glasses, tongue depressors). Class 2; get quick reviews (as mercury thermometers). Class 3 devices must be proven through extensive testing that they are safe and effective (as pacemakers, and replacement heart valves).

Annually there are tens of thousands of reports alleging harm from devices. The device industry avoida the FDA,s rigorous oversight of thousands of medical devices every year. Millions of Americans benefit from these devices.

CONGRESS ACTION

Congress is demanding more scientific device evaluations from the FDA. New FDA commissioner, Margaret Hamburg, vowed she would examine the approval process with a comprehensive analysis. Some lawmakers felt that with competent management, enforcement, and more funding to the FDA safety would be improved. The FDA claims they have a lack of resources and increasing technical complex city of these medical devices are to blame for their inability to maintain safety standards.

Congress is trying to change its original intent to allow injured patients to recover for injuries caused by manufacturers of defective medical devices.

The new bill S540 Medical Device Safety Act of 2009 “is being proposed to amend the liability under state and local requirements. A recent 2008 Supreme Court decision in Riegel vs Medtronic, created this uproar. It would reverse the court decision that gave legal immunity to manufacturers of defective medical devices that were approved by the FDA under the premarket approval process.

The Supreme Court ruled that the medical device amendments of 1976 of the Federal Food, Drug, and Cosmetic Act, overrides state law for wrongdoing for which action in damages may be brought.

Congress says they never intended that the FDA approval would give blanket immunity to device manufacturers from liability for injuries caused by their faulty devices. It has resulted in a green light for shoddy practices by manufacturers. Manufactures would not have total immunity from any claims because the FDA approved their device.

FDA ACCUSED

We all know medical devices must have adequate quality and safety and not harm us. The GOA, (Government accountability office), claims the FDA is efficient in protecting us from safety risks

Accusations are made that: the approval process for medical devices need a major overhaul. The GAA has over-reported inadequate post-market surveillance and are not regularly inspecting medical device manufacturing facilities. Preapproval reviews and postapproval monitoring have been inadequate They claim, the FDA is incapable of guaranteeing safe medical devices, and manufactures must be wholly accountable for their products and effectiveness.

Rigorous review processes were not required for all of the most potentially harmful devices, and the agency has a difficult time analyzing that tens of thousands of reports received annually claiming injury from devices.

Recent recalls of defibrillator wires and other devices raised doubts as to the FDA's ability to identify safety problems. The FDA has recalled over 20% of automated external defibrillators.

Formerly, the process-streamlined clearance for products that were deemed, substantially equivalent, if two devices were already on the market. It accelerates innovation and bills on the expanding knowledge.

Now the FDA is tightening the fast track process, (known as 510 K), under new Obama appointed FDA head, Peggy Hamburg, who is reviewing the entire process. Clearance for new devices will now require more indications that in the past. By requiring more evidence for approvals, development costs will increase, making it more difficult for device developers to enter the market with their products.

The FDA is now scrutinizing certain applications more severely. Device makers will now have an increased tax on their device devices to the tune of $40 billion over 10 years.

The 510 process did not require lengthy clinical trials, and allowed device makers to get their products to market quickly. Many companies have been using the process too often for complex products that required more testing for safety and efficacy. These multiple reviews now will certainly result in fewer medical devices entering the marketplace.

Zimmer holdings, the largest maker of hip and knee replacements, had recently some product issues with replacement hip cups. Surgeons reported the cups were loosening and repeated surgery was necessary. Zimmer now has included two new hip parts to help the company improve its market but they too will have to be approved with new intense scrutiny.

HAZARDS OF OTHER DEVICES USED TODAY

The Emergency Care Research Institute (now called the ECRI Institute), an international non-profit organization dedicated to improving patient safety and care listed the top 10 hazards currently related to medical devices. The list is based on the experience of its expert technicians, who investigate and consult on device-related incidents

ALARM HAZARDS

Devices must limit false or excessive alarms, the volume must be loud enough to be heard, and visible indicators must be seen. The staff must know why it's appropriate and meaningful. Problems tend to occur in pulse oximetry monitors and ventilators.

ACCIDENTAL NEEDLE STICK INJURIES

There must be good disposable techniques that are effective, and disposals must offer good protection.

CONTRAST MEDIA INJECTORS

Contrast media is injected into the vessels with power contrast media injectors. There is a risk of injecting error resulting in fatal air embolisms. There should be standard protocols defining who does tube checks rather than assuming someone else will do them. Those who prepared the injectors must be trained and disposable items must be labeled. A second clinician must verify that the injection tubing is tightly free and that there is no contrast media outside of the tubing that could interfere with error detection. Before injection clinicians should inspect the tubing and injector for possible air bubbles

FOREIGN BODIES LEFT IN PATIENTS

During surgery, sponges may end clamps may be left hidden by body tissues. Catheter tips or foresaw jobs breakaway and fragments are left because the doctor fails to notice them missing. Often the decision is made to leave it because it is too risky for retrieval. Such retention can lead to serious infection or damage to the surrounding tissue. If the patient has a future MRI, the retained metal can heat or migrate resulting in Burns.

Devices should be visually inspected as soon as they are removed from the patient and it should be systems to locate retained surgical sponges before a procedure is completed. Devices should be visually inspected before they are used to see if they were damaged, and should be looked at immediately after they are removed.

SURGICAL ELEMENTS

Electrical devices and lasers can stay hot for some time after they are used and must be discarded safely. Accidents are more likely if there is supplemental oxygen being used. Drinks must be arranged to prevent the pooling of oxygen. The amount of oxygen use must be kept to a minimum. Towels and electrical must be kept as far away as possible from the ignition source. Alcohol-based preparations must be decorated before electoral surgeries started. And sponges must be moistened to reduce their flammability. Electrical cables and oxygen hoses should be inspected regularly be forced surgery.

ANESTHESIA EQUIPMENT PROBLEMS

Breathing circuits are mis-connected, ventilators are leaking, and empty gas cylinders are used. All devices and accessories used in anesthesia, as manual resuscitators and scavenging equipment, must be inspected. A checklist should be used prior to every anesthetic being given.

MEDICAL DEVICE DISPLAY SYSTEMS

Some displays are ambiguous or counter intuitive and may result in false readings resulting in treatment decisions being made on this false information. Device displays that may pose a real risk report of confusion should be assessed and pre purchased trials should be done.

CT RADIATION OVERDOSES

CT radiation doses CT scans may be responsible for about 6000 additional cancers a year. The patient should not be unnecessarily exposed to high dose levels. The benefits of a CT scan must outweigh the radiation risk. Guidelines should be regularly reviewed especially for children CT scans. Protocols should minimize doses, and monitoring should be part of quality control and equipment maintenance. Referring doctors should have access to this information.

MRI BURNS

MRI burns are a common hazard. Cables crossing each other, conductive cables that are looped, exposed symmetry sensors are placed too close to the radiofrequency coils, blankets and sheets are used rather than manufacture supplied padding, all can cause poor magnetic contacting. Sensors, tables, and MRI accessories (as RF coils and cables), should be checked for breaks in insulation. Headphones and video goggles used, must be checked for signs of damage. Heating can still occur during MRI's high scan, and the patient should be told to shout if they feel heat during the scan.

Fiber optic light sources, retractors, and headlamps, can all cause burns at the end of the cable or if the scope is placed on a patient without shutting off the light source. Cable connections can be heated if the cable is too large for the light post on the connecting device. Light sources must be turned off, or placed in a standby mode, before removing the cables from the light source. Minimum output should be used when performing procedures. All light sources must have safety features, such as power up and standby modes, or any variable output settings.

COMMENTARY

Because the FDA approves a medical device does not guarantee its safety. In 2006, 650 recall actions were initiated involving 1550 products.

Under today’s rules, a negligent device manufacturer is not accountable for the costs incurred when a patient as a faulty medical device removed or replaced. The patient or Medicare is responsible for all the costs. A provision in the device amendments of 1976 authorized the FDA to make a manufacturer pay the replacement of a faulty device.

If this safety act passes, medical devices will be more costly and less accessible and there will be less innovation. Experts and scientists of the FDA now decide the safety and effectiveness of medical devices. A jury of laypersons is not qualified to decide the effectiveness of these devices.

If state courts effectively review and regulate medical devices, it would allow the states to set their own standards for safety and effectiveness. Chaos would result. This bill will result in needless delays in patient access to essential medical technologies, ultimate higher health care costs, and again provide more income for the poor trial lawyers.

Visit www.drneedles.com for more commentaries on controversial medical issues. Your comments are always appreciated.

Related Posts:

ARE HEARING AIDS FOR YOU?

DANGERS OF MRI

LET YOUR IPOD HEAL YOU

Labels