[PRCo] Re: Gas Prices

[Richard Allman]

thanks, John-you can get Relman's schtick if you Google his name Arnold S. 
Relman and look for the citation "The Health of Nations". This is a great 
summary article-around 14 readable pages- that appeared in New Republic 
around 3 years ago. A while back, I arranged for him to speak on this 
subject at my church's Community Forum, an endowed lectureship we provide 
roughly 3 times annually. The article is passionate yet well documented. 
Tell me if you have any problem accessing it and I'll find a way to get it 
to you. BTW, List-just back from movie The Reader w/ Ray Feinnes and Kate 
Winslet. Besides being a compelling story, there are fabulous scenes of old 
German trams. RICH
----- Original Message ----- 
From: "John Swindler" <j_swindler at hotmail.com>
To: <pittsburgh-railways at dementia.org>
Sent: Wednesday, December 31, 2008 8:58 PM
Subject: [PRCo] Re: Gas Prices


>
>
> This emails a 'keeper'.  Thank you, Rich
>
> John
>> Date: Wed, 31 Dec 2008 17:08:02 -0500> From: allmanr at verizon.net> 
>> Subject: [PRCo] Re: Gas Prices> To: pittsburgh-railways at dementia.org> > 
>> ok, John- I'll get it to you. What I suggest is a highly readable book on 
>>  > the subject by Arnold S. Relman, MD, former chairman of the Department 
>> of > Medicine at the University of Pennsylvania School of Medicine and 
>> former > editor-in-chief of the prestigious New England Journal of 
>> Medicine. I'll get > the exact title for you. Happy New Year! RICH> -----  
>> Original Message ----- > From: "John Swindler" <j_swindler at hotmail.com>> 
>> To: <pittsburgh-railways at dementia.org>> Sent: Wednesday, December 31, 
>> 2008 8:50 AM> Subject: [PRCo] Re: Gas Prices> > > >> >> > Thank you, 
>> Rich. Very much enjoyed your "insiders" viewpoint. If you > > care to lay 
>> out a solution for our health care mess, may I request being > > put on 
>> the distribution list??> >> > Cheers> > John> >> >> >> >> >> Date: Tue, 
>> 30 Dec 2008 18:00:22 -0500> From: allmanr at verizon.net> > >> !
> Subject: [PRCo] Re: Gas Prices> To: pittsburgh-railways at dementia.org> > > 
>  >> anyone who wants to know what I think is needed to fix our health care 
>  > >> mess, > contact me off this site and I'll lay it out. You might be > 
>  >> surprised re: my > view and if you are a Red State mentality you 
> probably > >> won't like it. > Suffice it to say, that a "system" which 
> consumes more > >> than 15% of GNP, > leaves 47 million people without any 
> coverage and > >> another almost 50 million > underinsured has problems. 
> Add to that the > >> impact on American industrial > competiveness because 
> of health care > >> expenditures(GM's biggest supplier is > no long USX or 
> it's successors, > >> it is Blue Cross of SE Michigan.) Then look > at the 
> disparities in > >> care-back operations per captia much higher in New > 
> Haven than Boston w/ > >> similar populations and severity adjusted 
> disease > incidence. Then look > >> at some outcomes-third world type 
> incidence of infant > mortality and!> > th!
> oroughly undrwhelming life expectacny vs. other > industrialized > > n
> ations. Other nations have found a way to cover all of their > citizens, > 
>  > with better outcomes, for far less cost. Then the fragmentation of > > > 
> care-ping ponging from one specialist to another with a shortage of > > 
> primary > care physicians due to pathetic reimbursement and a system that 
>  > > rewards > technical procedures, but nothing for those who follow 
> patients > > and at the > right time decide that the procedure is timely. 
> The situation > > is like this-a > woman who is the wife of a retured 
> dentist living on the > > Main Line > approached me after church a few 
> months ago and told me she > > was unable to > find a primary care 
> physician who is accepting new > > patients. Similar stories > are 
> reported in Metropolitan Boston, home of > > some of the world's best > 
> hospitals. Medical students graduate with like > > $200,000 in student 
> loan debt > and are pushed into high paying > > specialties, irrespective 
> of societal needs. > And believe me,!> > society is invest!
> ed: the huge tuitions cover only a fraction > of med> > ical education and 
> the rest is subsidized; students get to learn on > > > patients doing 
> examinations well before they are fully qualifed. > > Therefore, > medical 
> knowledge and skills are in no way the property of > > physicians-they > 
> are a public trust. It's eay to beat on the VA system, > > and it has had 
> a too > long history of problems, but by any pbjective > > measure, the 
> quality of care > there in the past decade has probably > > improved more 
> than in any other > system. It's easy to rail against > > Medicare, but 
> look back to before there > was that program, and firther, > > Medicare 
> has the lowest percentage of > expenditure for overhead of any > > system 
> in the US. Sorry to rant for so long. > You got me started, > > Fred!Happy 
> New Year , all!> > RICH> Richard L. Allman, MD> President, > > Medical 
> Staff, Albert Einstein Medical Center> Medical Ethicist> Medical > > 
> Revolutionary -in-Waiting> PTM Member> > -!
> ---- Original Message ----- > > > From: "Schneider Fred" <fwschneider@
> comcast.net>> To: > > <pittsburgh-railways@!> > dementia.org>> Sent: 
> Tuesday, December 30, 2008 9:14 AM> Subject: [PRCo] > > Re: Gas Prices> > 
>  > > And, whether we wish to recognize it or not, with > > the welfare 
> medical> > cards for those of insufficient means to afford > > medical 
> care> > otherwise, we are somewhere in the middle. We simply have > > 
> refused> > to acknowledge it. There are several of us on this list who > > 
> have> > relatives who participate by choice. Will someone explain to me> > 
>  > > what the difference is? Yes, the difference lies in the middle> > 
> between > > those who have employer paid benefits or abundant cash and> > 
> those who > > have nothing or choose to have nothing ... those who> > 
> struggle and get > > no where may have nothing. However, the doctors> > 
> can still not turn them > > down.> >> > It is the doctor who gets screwed. 
> One of the many I have > > collected> > as I aged told me several years 
> ago, "I have not raised my > > rates in> > five year!
> s because it won't do any good. The insurance > > companies> > and 
> medicare tell me what they are g!> > oing to pay me anyway." What he> > 
> left unsaid was that he didn't have> > the heart to charge those with no> 
>  > money. Unfortunately, what happens is > > that the minutes the doctor> > 
> can allocate to each patient becomes > > reduced each year and the> > 
> patient is forced, in some ways, to control > > his own medicine and to> > 
> make sure he asks the right questions. There is > > a medical> > 
> practitioner on this list who I personally know wrote off a> > > > 
> substantial amount of money when he went from private practice to> > > > 
> hospital practice some years ago. My father-in-law wrote of> > hundreds of 
>  > > thousands of dollars in his life time as a surgeon.> > Sadly the image 
> is > > a man driving around in a big car; they are not> > all like that.> 
>  >> > On > > Dec 30, 2008, at 8:54 AM, Edward H. Lybarger wrote:> >> >> If 
> you remove > > the profit motive, you remove the inc!
> entive for any> >> kind of> >> > > quality or service. But you also ge
> t in trouble when there is> >> > > unlimited> >> profit motive, because in 
> the hubris, the recognized need > > for those> >> qualities gets lost.> 
>  >>> >> As wit!> > h everything else, the best position is somewhere in the 
> middle.> >>> >> > > Ed> >>> >> -----Original Message-----> >> From: > > 
> pittsburgh-railways-bounce at lists.dementia.org> >> > > 
> [mailto:pittsburgh-railways-bounce at lists.dementia.org] On Behalf Of> >> > 
>  > John> >> Swindler> >> Sent: Tuesday, December 30, 2008 8:37 AM> >> To: > 
>  > pittsburgh-railways at dementia.org> >> Subject: [PRCo] Re: Gas Prices> >>> 
>  > > >>> >>> >> We already have an example of socialized medicine in this > 
>  > country.> >> It's> >> called the Veteran's Administration.> >>> >> I've 
>  > > heard some good stories about the VA, particularly the one in> >> > > 
> Lebanon,> >> but also too many horror stories. Also, there were three > > 
> incidents> >> over> >> past 12-15 months of patients being ignored in > > 
> emergency rooms to> >> die. All> >> three happ!
> ened in government run > > facilities. I'd rather be able to> >> schedule> 
>  >> an appointment at > > Lancaster General instead of being put on a VA> 
>  >> waiting> >> list.> >>> > > >> John> >>> >>> >>> >>> Date: Mon, 29 Dec!> 
>  > 2008 14:50:18 -0800> From: pcc_sr at yahoo.com>> >>> Subject:> >> [PRCo]> > 
> Re: Gas Prices> To: pittsburgh-railways at dementia.org> > > -----> >> > > 
> Original Message ----> > > From: John Swindler> >> > > 
> <j_swindler at hotmail.com>> > >> >>>>> My wife went on a mission trip to > > 
> Novosibirsk several> > years ago,> >> and at a get-together showed a > > 
> picture of our > > house. The> >> 'locals' wanted> >> to know on which > > 
> floor was> > our apartment located. She felt> >> embarrassed> >> telling > 
>  > them> > that we lived in the entire house. And our > > square> >> 
> footage > > is smaller then the average.> > When living in San> >> 
> Francisco in the> > > >> 1980s I attended a> church which had a big 
> missionary project to> >> > > Russia> as> >> well as Russian i!
> mmigrants here. Mention a trip> to the > > super> >> market and> >> th
> ey begged to go along. They> were constantly > > astonished at the> >> 
> variety we> >> have here.> > The battle cry of > > protesters coming out 
> of the hippy> >> era> was> >> 'food for people not > > for profit.' Remove 
> the profit> incentive and> >> there> >> goes our > > variety does!> > n!> 
>  >> 't it. That's why> I give pause to 'socialized' medicine. As I> >> > > 
> mentioned> >> before> we seem to have much better health care in some > > 
> respects> than> >> Britain. But 'if' we go socialized method I shall> > > 
> probably be> >> pushing up> >> the daisies by then.> > > Phil> > > > > >> 
>  > > >> _________________________________________________________________> 
>  >> > > Life on your PC is safer, easier, and more enjoyable with Windows> 
>  >> > > VistaR.> >> http://clk.atdmt.com/MRT/go/127032870/direct/01/> >>> 
>  >>> >>> > > >>> >> >> > > >> > 
> _________________________________________________________________> > It's 
> the same Hotmail®. If by "same" you mean up to 70% faster.> > 
> http://windo!
> wslive.com/online/hotmail?ocid=TXT_TAGLM_WL_hotmail_acq_broad1_122008> >> 
>  > > >
> _________________________________________________________________
> Send e-mail faster without improving your typing skills.
> http://windowslive.com/online/hotmail?ocid=TXT_TAGLM_WL_hotmail_acq_speed_122008
>
>