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That’ll Be The Day “All I know is just what I read in the papers.” Will Rodgers,1879-1935 I await the day when The New York Times runs a series of “good news” articles about the state of American health care. The series might have these titles, • Americans Trust Their Doctors • Americans Have Greater and Quicker Access to High Tech Diagnostic and Curative Care Than Any Other Nation • Foreign Physicians Flock to America for Training Unavailable in Their Country • Record Numbers of Canadians Cross Border for Life-Saving Care • America Achieves Unprecedented Longevity Gains in Last Decade • Americans Receive 80 Percent of Noble Prizes in Medicine • Research at American Pharmaceutical Companies Produces 90 Percent of the World’s New Drugs • America’s Innovative Health System’s Variety and Choice the Wonder of The World That’ll be the day. The Times in 2005 and 2006 had a series of a dozen articles entitled “Being A Patient.” These focused largely on the perils of being a patient in America. Now The Times is embarked on a series on medicine and money, focusing on profit-mongering drug and medical device companies in league with greedy specialists to bilk the public. It all comes down to altitude and attitude. From their lofty perch, Th e New York Time’s editorial staff has yet to tumble to the reality America is basically a conservative nation, distrusts centralized government, wants choices of care and providers, demands access to the wonders of high tech medicine, and believes a market-based system, with all its faults, such as profits for entrepreneurial and innovative health care companies and , are worth the price and value received. It is almost as though The Times denies the existence of entrepreneurial capitalism in American health care. Our health system blends innovative large and small firms striving for economic growth. Such a system entails risk – workers who lose jobs and health insurance, widening of gaps between winners and losers, competition with some jobs going to skilled workers abroad who have increasing skills, occasional bankruptcies among those unable to pay health care bills. American capitalism is imperfect. It requires oversight to reduce risks without losing entrepreneurial vigor. Unremitting accusations of bad faith and constant “bad news” stories don’t strengthen health care. Read the The New York Times, and you’ll come away believing pervasive avaricious greed corrupts American health care and will break our already “broken” system. From May 9 through May 11, The Times ran 10 articles on how drug companies deceived the public and entered into unholy alliances with doctors to sell more drugs to produce more revenue for doctors, how doctors willingly entered into these alliances solely for material gain, and how lobbyist-tainted and incompetent FDA failed to monitor new drugs and harmed patient safety. The May 9 front page, right top column, the prime spot for highlighting news, featured these headlines, Doctors Reaping Millions for Use of Anemia Drugs. Payments from Industry. Concerns over Safety – Critics See Incentives for Higher Doses. The opening Section read: “T wo of the world’s largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size. Critics, including prominent cancer and kidney doctors, say the payments give physicians an incentive to prescribe the medicines at levels that might increase patients’ risks of heart attacks or strokes. Industry analysts estimate that such payments — to cancer doctors and the other big users of the drugs, kidney dialysis centers — total hundreds of millions of dollars a year and are an important source of profit for doctors and the centers. The payments have risen over the last several years, as the makers of the drugs, Amgen and Johnson & Johnson, compete for market share and try to expand the overall business.” The Times appears bent on publishing on its front pages “All the Bad News that’s Fit to Print about U.S. Health Care.” The May 9 article is part of a series of medicine and money, all decrying collusive relationships between big business and bad doctors. The Times series focus on the pharmaceutical industry and medical device industries , and how these industries reward specialists who overuse products for financial gain. To The Times, the American health system has become a morality play, • the good guys (The Times and other assorted elites and policy pundits) vs. the bad guys (profiteering health companies and doctors); • the greedy (well-healed executives and “rich” doctors) vs. the needy (poor patients in the throes of cancer or kidney dialysis); • the high brows (academics and journalists who know what’s right for the common good) vs. the low brow commercial types (who do almost everything wrong as long as it suits their own financial self-interest). I don’t wish to pick a fight with a media outlet who buys ink by the barrel. I know “bad news” sells better than “good news.” I know The Times considers itself the Watchdog and Whistle-Blower against mean-spirited, profiteering conservatives. I don’t question our capitalistic system needs oversight to reduce abuses. I’m simply seeking more balance in The Times reporting. For an example of this imbalance, in its May 9 piece, The Times dismisses America doctors’ overuse of anemia-correcting drugs for cancer and dialysis as a deliberate effort to make money. To make its case, The Times notes American doctors, • prescribe more drugs than European counterparts ( Did it ever occur to T he Times maybe, just maybe, European doctors “under-prescribe” and maybe their patients have less positive results? ) • conssciously endanger patients for profit when they know anemia drugs are unsafe (Has it occurred to The Times American physicians prescribing these drugs believe higher hemoglobin levels are “good” for improving health and alleviated distressing symptoms attributable to anemia.) • Continued to prescribe drugs even after studies indicated hemoglobin levels above 12 might endanger patients ( Did it ever occur to The Times the studies indicating “possible” risk studies were far from conclusive and only appeared in March?) Nor does The Times point out doctors themselves often criticize thenselves. For instance, on a May 11 blog, “The Doctors Weighs in on Cancer,” Dr. Dov Michaeli, an academic physician and biochemist who does cancer research takes the American Society of Clinical Oncologists (ASCO) to task for responding to the Times defensively (see epilogue to this blog for a reprint of ASCO letter to The Times). Of the ASCO letter to the times (reprinted in epilogue), Dr. Michaeli acidly comments “ASCO makes that same argument that professional people make when colleagues are caught with their hands in the cookie jar: most of us are conscientious, hardworking people. Granted, but it turns a blind eye to the corrosive influence of pharmaceutical companies on the use of drugs. This is denial of how our health system ‘works’ on a daily basis.” Michaeli concludes: “As the wheels are coming off our broken health system, more revelations of waste, abuse, greed and outright criminality are bound to surface. What are we going to do about it?” Good question. I suggest we start with a more balanced view of the system. • First, I reject the notion the system is “broken” – and constant reference by academic critics of greed by practitioners as a cause for this brokenness ( Michaeli, an academic researcher, shows some of this bias when he says, “ ASCO is led by academic clinicians and researchers, whose motivation and dedication is admirable. But many of the rank and file, community practitioners, are not beyond temptation.” I doubt medical academicians, who compete for pharmaceutical company grants and who run clinical trials, are beyond temptation. I’m unaware academic physicians wear halos and only practicing doctors are vulnerable to “temptation.” • Second, I believe critics ought to acknowledge health care is an innovate force in our economy, will soon represent 20 percent of the nation’s GNP, and is the nation’s largest employer. Professional managers, whose job is to maximize resources and revenues, run most health care enterprises - hospitals, medical practices, drug and device manufacturers. If overzealous pursuit of revenues and resources leads to excess, managers should be condemned, even fined and jailed, but it shouldn’t be assumed or taken for granted pharmaceutical and medical device companies and doctors are always seeking mutually beneficial arrangements are ipso facto evil doers. What the media in general, and The New York Times in particular, needs is a more balanced view. An occasional dollop of good news, such as more than 50 percent of cancer victims are now surviving, more than 10 million cancer victims are living with their disease, and genetically engineered cancer drugs are contributing significantly to cancer cures, would help achieve that balance. I’m pleased to report the May 12 issue of The Times contains a “good news” piece on Becton, Dickinson & Company. It’s buried on the third page of the business section. It’s titled “Medical Gear That Rarely Makes News.” It consists of an interview with Edward J. Ludwig, CEO of Becton and Dickenson, with revenues of $5.7 billion last year, on sales of syringes, diagnostic kits, lab equipment, and related gear. The unifying theme behind the company’s success is its emphasis on safety in its products to protect doctors, nurses, and patients with shields, sliding clasps, and needle retracting into the device. Its ambition is to make a significant dent in the 2 million infections each year from antibiotic resistant staphococci killing 90,000 Americans each year and costing $6 billion yearly to treat. Toward that end, B &D has acquired a diagnostic system allowing them to quickly identify the offending bacteria. Use of this system to screen every patient. entering Evanston Northwestern Hospital reduced infections by 60 percent. Ludwig contend s private innovation will help the “broken” health system to heal itself by attacking safety problems, and improving care. What the media needs is a new more flexible mindset allowing them to become more innovative in reporting the “good news” of our resourceful and responsive health system. Epilogue : In the interest of being “fair and balanced” (a term the mainstream media now considers anathema since Fox News adopted it as their slogan), I reprint six letters from the May 13, Sunday, New York Times. The Times deserves credit for publishing letters representing both points of view. Best Drug, or Best Money Maker? (6 Letters) 1) To the Editor: So two drug companies are paying hundreds of millions of dollars to doctors who prescribe anemia medicines that lack effectiveness and put a patient’s health at risk. This is not a surprise because it reflects our broken health system, a system driven by greed. Although drug companies say their intentions are not to promote the use of more medicine for profit, there will always be the risk that some doctors will prescribe higher doses to gain that extra dollar. As patients, we should work to eliminate the incentives to doctors and to raise patient awareness about them. We deserve the right to know the benefits of a medicine, both for us and for the doctors. Luis Rodriguez Daly City, Calif., May 9, 2007 2) To the Editor: Medical care should be guided only by what is best for patients. But throughout the medical system, rebates and volume discounts are common and can create the perception of improper incentives. Our organization has long advocated evidence-based guidelines, including those we produced in 2002 with the American Society of Hematology on erythropoietin use for chemotherapy-related anemia. With the appropriate use of erythropoietin, many thousands of patients have avoided potentially dangerous blood transfusions. Oncologists care deeply about their patients, and the overwhelming majority treat them based on the best available evidence. In the case of erythropoietin, recent studies prompted the Food and Drug Administration to issue a “black box” warning in March about the potential dangers of using erythropoietin to boost hemoglobin to levels higher than guidelines recommend. Early evidence suggests that doctors factored this new data into their prescribing decisions and have reduced erythropoietin use. As a whole, the medical community needs to better determine the impact financial incentives may have on prescribing patterns and patient care, to ensure that patient needs continue to be at the forefront of medical decisions. Allen S. Lichter, M.D. Exec. V.P., American Society of Clinical Oncology Alexandria, Va., May 10, 2007 3) To the Editor: Many doctors appear dissatisfied with fees ethically garnered from clinical evaluation and management. They can and will prescribe for personal profit, and will readily reshape and expand diseases to suit the available reimbursement. Without disclosure, patients are typically the last to know there might be a problem. The investigation of anemia drugs no doubt could expose the self-serving logic, unethical inducements and poor administrative surveillance that permit exploitation of the public’s soft financial underbelly. Unfortunately, there are plenty of other specialties of medicine where such professional betrayals occur. And adequate regulation is not likely to occur in the financial free-for-all of private medicine. James H. Lampman, M.D. Bismarck, N.D., May 9, 2007 4) To the Editor: The discovery and development of growth factors that stimulate the bone marrow to produce red cells was a milestone in modern medicine. In the appropriate setting, these growth factors can improve blood counts and quality of life and spare patients time-consuming, expensive, short-lasting and risky transfusions. In our practice the increasing use of these medicines is driven by the fact that they work so well. As with any new therapy, these medicines need to be used within established and developing guidelines to avoid serious side effects. Since there are two competing and equally effective drugs, the drug makers are offering incentives for preferential use — the natural outcome of a free-market economy. Deciding how regulators might control drug makers is an important undertaking, but it should not detract from the tremendous benefits of these drugs when used in the right situation. Birjis Akhund, M.D. Chief of Medical Oncology Huntington Hospital Huntington, N.Y., May 9, 2007 5) To the Editor: America has the best medical care in the world. It is the most advanced and expensive. The first two qualifications are debatable, but the third is difficult to refute. The great expense is complicated by the high cost of drugs and procedures of dubious benefit. The likelihood of being prescribed drugs of dubious benefit is obviously increased by kickbacks to doctors. The kickbacks may be legal, but should they really be allowed? The cost of medicine is increased by this practice, and the quality is sure to suffer. Alex Floyd Lexington, Ky., May 9, 2007 6) To the Editor: “Doctors Reaping Millions for Use of Anemia Drugs” (front page, May 9) was disturbing. I found it equally disturbing that the continuation of the article was in Business Day. In the past two decades, I have observed that news of important medical advances increasingly appears in, or is continued in, the business section. This practice advances the thinking that health care is primarily a business in which providers reap riches, rather than a humane social endeavor in which providers earn their living. Ira D. Feirstein, M.D. New York, May 9, 2007

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Xavier from About Town has written a great piece on University of Auckland (and former Victoria) Vice Chancellor Stuart McCutcheon's refusal to participate in a Multi-Employer Collective Agreement (MECA) - the piece is aptly named "Stuart McCutcheon is a Fucktard" My analysis of Stuart McCutcheon and his time at Victoria is thus (please correct any inaccuracies): McCutcheon came to Victoria when we were in dire financial circumstances. Previous Vice Chancellor Michael Irving had seriously fucked things up big time (including, but not limited to, my personal favourate: an expensive (and unsuccessful) advertising campaign involving Robert Rakete, a cactus suit, and the phrase "Victoria takes all comers"), and the university was not only loosing students, but loosing money. Irving was "asked" to leave, and was offered an undisclosed goldern handshake - rumours range from a six-figure payment, to a BBQ and a chilly-bin full of beer. So out with Irving, and in with the Knight in Shining Armour - Massey University Deputy Vice Chancellor, Stuart McCutcheon. The students stopped leaving, and the books balanced. However, McCutcheon took it a little further, building Victoria University into the corporate entity that it is. I am mixed on my feelings about this, but it did invlove expensive corporate marketing, staff salaries stagnating, and student fees going up (it also involved other factors which we are currently in legal action over). I currently have a lot of respect for the new Vice Chancellor Pat Walsh, and we enjoy a civil and prefessional working relationship. Walsh's area of expertise is industrial relations, and he has a strong record of union membership (which, admitedly is much higher at Victoria than Auckland) so AUS would also have reason to be optomistic this year. Interestingly Irving (who is now Professor of Biomedical Science at Bond University in Australia) is a bio-chemist, and McCutcheon a vetenerian, two subjects which are not especially strong at Victoria. cheap oem software buy software

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Medical is meant to cover the cost of treatment that an individual incur after falling critically ill. Considering the uncertainties of life, it cannot be predicted when someone is going to fall ill or how much critical the illness will be. Nor anybody can foresee the cost of the treatment. So, it really makes sense to go for insurance so that you can get timely and adequate treatment in case you fall critically ill. Medical insurance are available for individuals as well as for groups. The first one provides coverage to only one individual, or family. This type of insurance plans can be obtained directly from a company who offers them. Generally, an evaluation is made by the company with whom you apply. They provide a questionnaire, to be filled up by the applicant. It contains questions about your current and past health history. What they want to asses is the risk they will have to undertake by offering you the health insurance policy. Most of the individual insurance plans come under managed health care plans. If you continue to pay your insurance premium, the coverage time continues and your insurer cannot cancel your coverage if you become sick. Individual insurance is preferable for those who want a customised plan. Like all other insurance policies, medical insurance is also available for groups. This type of policy is usually more comprehensive and less expensive than individual insurance. In this type of insurance, the provisions of the policy are negotiated between the insurer and master policy owner that may be an employer or association. It offers varied options and lower premiums. Individual or group, medical insurance is important for everybody. An unexpected illness or serious injury can render anybody unfit for work. Ultimately, you will be in an unsavoury situation and your family will be under financial stress. Hence, it is better to be in safer side and opt for insurance. buy software cheap oem software

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Auto Insurance Quote Many individuals struggle to understand what disability insurance covers. There are two basic forms of disability insurance, short-term and long-term disability. Short-term as its name implies is for a short period of time usually less than a year. Group short-term disability is more prevalent in the work place than long-term. One of the failures that individuals make is assuming that their policy covers 100% of their income. The policy usually covers up to 66 2/3%, it may be only be 50% for 13 weeks only. (Check your employee handbook) Uncle Sam allows you to get the benefit tax free, but you cannot get more in benefit than your pre-tax salary. It is very important that people read their employee benefits carefully. The two main definitions used to define if benefits under a disability insurance policy are paid include own occupation and any occupation. Own occupation disability means you are unable to perform the substantial duties of your current position in a nutshell. Any occupation includes the duties of a job that you have been trained for through education, training, or experience. Get Free Quotes Now! Individual disability policies cover a percentage of your income based on your occupation, the hazard of your responsibilities, and your income. The elimination periods for disability policies usually range from 30-365 days. If you become sick or disabled, exceed the elimination period, and become certified by a physician as unable to work, you may receive a tax free benefit except in rare cases (your employer pays for the policy). The policy is coordinated with any group disability benefits you may be receiving as well as Social Security Disability Insurance if you qualify. Things to consider when thinking about Disability Insurance: Can I get sick? Do accidents occur? Can I afford to self-fund? Can I live off my savings? Does my coverage at work cover short-term & long-term disability? buy software cheap oem software

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Health Insurance - Are You Covered? by: Jeff Lakie With the ever-increasing cost of health care, procedures and medicines, it's no wonder that the cost of health insurance has also dramatically risen over the past few years. But as that's happened, insurance companies and the government have seen the potential negative impact of families and individuals without insurance. There are some things you can do if you don't have health insurance. A federal mandate requires that all 50 states have a health insurance program for children. Each state was allowed to create a plan tailored to the needs of children in that state, but there are some things that are the same from one state to the next. The first is eligibility. Government funded health programs typically have very stringent income guidelines. These health insurance programs have income requirements, but the criteria allow higher income than most programs. Another criteria for participation is that the child isn't covered by any other health insurance. That differs from most programs in a very important way. Most programs say that if the family has access to insurance, they aren't eligible. That means that parents who have employer-based insurance don't qualify. But many of the employer-based plans are too expensive, and workers sometimes simply can't afford the premiums. This program is designed to help fill that gap. These programs don't cover families - only children. But there are some great benefits for those who qualify. Some states offer mental health benefits, transportation to and from appointments and dental/vision benefits. If your children don't qualify for this program, or if you're in the market for individual health insurance for an adult or private insurance for a family, you have some options. Even though insurance is typically very expensive, you can take some steps to control costs. You can eliminate extras such as vision and dental coverage, and increase deductibles to lower the cost of your insurance premiums. Look for policies that don't include maternity benefits and cancer plans as more affordable general health insurance plans. Basic coverage will likely be less expensive than an all-inclusive health insurance program. Finally, shop before you make a decision. Even if you're offered employer-based insurance, you might find a better deal elsewhere (depending on the amount of employer participation). Look to professional groups for discounts and advice. buy software cheap oem software

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Welcome to another edition of Blawg Review -- where bloggers come for their legal news every Monday. It's good to be hosting another edition of Blawg Review at the Health Care Law Blog. However, it's even better to be done. First off, thanks to all who submitted posts to this edition. There was wonderful material to work from. Much of the information that I regularly consume online is related to my practice as a health lawyer and I enjoy the opportunity to step outside of that specialty and be a part of a larger legal discussion going on in the blogosphere. As an active participant in the blogosphere and Live Web I am constantly amazed by the knowledge, skills and imagination of those who create electronic content (written, audio and video) for public consumption. Not just lawyers -- but every profession imaginable. The volume of information conveyed online today through electronic social networking is mind boggling. How much you say? Technorati is now tracking approximately 69.4 million blogs with 175,000 new blogs created per day. The world live web is being updated with 1.6 million new posts per day, for an average of 18 per second. Could Johannes Guttenberg have ever imagined this phenomenal transformation in communication. Lately I've been thinking and posting more about the impact that blogging and web 2.0 is having on the health care industry. It is a time of change for the health care industry. Likewise, I think many of you will agree that fundamental changes are occurring in the delivery of legal services as a result of the rise of the new social networking technology movement. For more of what this may mean for health care check out some of my materials from a presentation I did to introduce health lawyers to the basics of Health Care Blogging and Web Health 2.0. [Note: I'd also suggest watching (if you haven't already) "Web 2.0 . . . The Machine is Us/ing Us," created by Michael Wesch , Assistant Professor of Anthropology Kansas State University. The video visually explaining Web 2.0 and how today's digital technology influences human interaction.] To begin with let's highlight a few of the submissions that reflect some of these fundamental technology changes which we are all experiencing as a result of the social networking phenomenon, the availability of new technology tools and the shift toward living our lives out on the web. Bruce MacEwen gives us a tour of the The Law Library of the Future? at Adam Smith, Esq showing us all the differences that exist within today's firms. From the traditionalists/silent generation to the Boomers to theGenXers to the Millennials. Online political social networking hits full speed at My.BarackObama.com covered by Susan Cartier Liebel at Marketing Genius - the "Obama Principle" and suggests that lawyers have something to learn from observing the process as it unfolds. Mike Madison and Denise Howell will be hosting a public conference call today, February 26 at 1:00 p.m. PST to gain insight on ownership considerations and issues of governance and liability that are critical to the creation, maintenance and long term health of business communities (corporate use of Web 2.0 technologies). The call is being held to help them prepare for the upcoming Community 2.0 Conference. Overlawyered looks at the liability of curb cuts and wheelchairs vs. jaywalkers in Jury blames hit-run death on wheelchair curb cut (fascinating to me is the comment discussion and the use of Yahoo Maps to support user comments on whether the jury made the right decision). Brent Trout at Blawg IT touts the ideas of Seth Godin and the application of his concepts to the practice of law in his post Law Firms - Small is the New Big. Scott Felsenthal at The Legal Scoop, a new law student collaborative blog by three students from Tennessee law schools, provides a look at the what's happening across campuses as a result of students living their lives out online in Facebook and MySpace- Quickly Becoming Breeding Grounds For Disciplinary Actions and Arrests. If you or your kids are on the edge of becoming the next one hit wonder, don't miss reading So you want to be a Recording Artist . . . by another of The Legal Scoop team members, Tim Bishop. David Lat examines a recent survey at UVA Law School and my question is -- what about Tennessee law schools? Watch and read the post on Prosecutorial Indiscretion (or the lack thereof) at Sui Generis--a New York law blog. She looks at a Virginia "rage road" incident that resulted in an ice throwing felony conviction. The video clip also includes a discussion of a series of posts on the newly promulgated lawyer advertising rules in New York which forbid the use of a nickname, moniker, motto or trade name that implies an ability to obtain results in a matter." The post series uses actual video clips of lawyer advertising clips from various jurisdictions to demonstrate application of the new rules. Dmitriy Kruglyak founder of Trusted.MD reports on two articles appearing in the East Bay Business Times. One about Kaiser's ongoing encounters with blogging and social media and the other examining how hospital administrators and executives should use blogs. On February 8, 2007, Wendy Seltzer in In My First YouTube: Super Bowl Highlights or Lowlights conducted an experiment to determine whether copyright overreach would trump her fair use rights when exercised to teach about copyright overreach. Five days later she received the DMCA Takedown Complaint courtesy of the NFL and YouTube. If you're an RSS fan don't miss Justia Federal Court Filings which allows you to see new filings by state, court or subject matter. Reported at Robert Ambrogi's Lawsites and The IllinoisTrial Practice Weblog. And now on with the rest of the submissions for this week's Blawg Review. The most highly talked about topic this past week was the Supreme Court's ruling on punitive damage awards in Philip Morris USA v. Williams. SCOTUSBLOG reports that the 5-4 decision found that it is "unconstitutional for a jury to award punitive damages out of a desire to punish a company for harming individuals other than those directly involved in the lawsuit -- that is 'strangers to the litigation'". The Court held that punishing a defendant for harming persons who are not before the court amounted to a taking of property from the defendant without due process of law. EricTurkewitz of New York Personal Injury Law Blog covers the decision in Court Tosses Philip Morris Verdict, And Further Confuses Punitive Damages Issue and Philip Morris Punitive Damage Decision - Why It Was Good For Plaintiffs indicating that the decision requires judges to now tell the jury in a punitive damage case that they can consider the reprehensibility of the defendant's conduct toward others, but not the harm to them. The South Carolina Appellate Law Blog says the decision creates an unworkable standard in After Philip Morris: What can a jury consider for punitive damages purposes? SCOTUS sets an unworkable standard and sets out some options that trial judges have when considering evidence of harms to non-parties. More on the decision from Law Prof on the Loose with Tobacco Verdict Goes Up In Smoke. Bill Watkins at South Carolina Appellate Law Blog looks at a the interplay of the Controlled Substance Act and a recent South Carolina senate bill proposing that Marijuana be considered a prescription drug in South Carolina lawmakers review bill to legalize marijuana for medical use. Ilya Somin at The Volokh Conspiracy disagrees with a recent Slate column that contended that split decisions make bad law and, in the specific context of the current Supreme Court, undermine the Chief Justice's admirable goal to promote unanimity amongst the justices. The HR Lawyer's Blog looks at the continuing trends on alternative billing arrangements in Alternative Billing - Clients Want It - Big Law Firms Hate It.The post highlights that a recent survey of corporate counsel indicate that 90% of outside counsel still resist the suggestion to consider alternative fee arrangements. Kevin Jon Heller at Opinio Juris covers a running battle between Glenn Reynolds and Paul Campos, law professor at University of Colorado, over one of Instapundit's posts arguing that selective assassination of Iranian nuclear scientists is both legal and advisable. Eugene Volokh also weighs-in with some worthwhile comments. Charles Green questions the "legal tip" included in Business Week's SmallBiz magazine which suggests that retail sales slips should include a written statement to protect the interests of your business in his post From Our Legal Experts... posted at Trust Matters. David Maister gives interesting insight into his experience as a juror in a 5 day trial involving a pastor, a parishioner and $80,000 in Jury Duty posted at Passion, People and Principles. He offers some simple lessons for litigators to remember. Charlie Weis, Notre Dame's football coach, appears headed back for seconds in his trial over an allegedly botched gastric bypass surgery. Quizlaw has an entertaining post about the events that lead to the mistrial. Only one can speculate what would have happened if the physicians chose not to respond. Are you an avid T.J. Maxx or Marshalls shopper? If so, check out Law Practice Management's post Identity Theft Begins with Access to Your Information discussing on of the latest electronic data breaches. The post offers practical advice on how to better protect your personal information in this growing age where everything is electronic. Overlawyered writes about Dr. Vatura who saved the life of a 400 pound man thrown from a motorcycle in a high speed accident in Treating the morbidly obese (redux). Due to his obesity it was impossible to stabilize the man with typical cervical spinal precautions and as a result he ended up a quadriplegic. One of my favorite medical bloggers, Kevin, M.D., covers this same topic and what he believes the impact these events have everyday on doctors. For another perspective on the impact of medical malpractice on physicians, consider hospital CEO and blogger Paul Levy's recent post The Shame of Malpractice Lawsuits at Running a Hospital. Also, Kevin, M.D. mentions an interesting issue coming before the Virginia Supreme Court of Appeals in his post Should academic physicians be protected against malpractice suits? Don't miss Quizlaw's Wacko gets Jacko'd providing evidence that you can be sued for almost anything -- the family of a 73 year old woman is suing Michael Jackson and Marian Medical Center claiming that the hospital's VIP treatment of Jackson resulted in the death of the woman. PointofLaw Forum links to David Rossmiller's Insurance Coverage Law Blog which covered Mississippi Attorney General Hood's press conference call where State Farm was called "a cult,""decadent" and "robber barons".Rossmiller questions much of what was said during the call and makes a good point -- if you think that that much of the company why would you want them to stay and provide insurance to citizens of Mississippi. If you regularly draft contract language you shouldn't miss That" and "Which" by Ken Adams at AdamsDrafting who looks at the confusion over the distinction between that and which and a New York case, AIU Insurance Co. V. Robert Plan Corp. that considered the differences. Ben D. Manevitz who writes IP Notions looks at Mike Carroll's "Fixing Fair Use" made at the Some Modest Proposals 03 Conference in Fair Use and Fee Shifting and adds a suggestion that the proposal needs to be given teeth by tying the payment of attorneys feed to the process. A reason to let your associates get sleep from Davit Lat at Above the Law. Mike Madison at madisonian.net reports in IP and Insurance on a breakthrough partnership among insurers, the Standford Fair Use Project and a network of practitioners willing to discount their rates to documentary filmmakers to lower the cost of insurance for documentary filmmakers who rely on fair use doctrine for portions of their content. Lessig Blog has additional details of the announcement. This week Eugene Volokh notes that Ohioans are presumptively protected from being fired for off employer property (and presumably off duty and lawful) possession of guns. The decision in Plona v. UPS involved the termination of a UPS employee who was found to have a handgun in his vehicle wile at work. The gun was disassembled, unloaded and locked in his care in a public access parking lot used by UPS employees and customers of UPS. The court held that the public policy permitting Ohio citizens the right to bear arms under the Ohio constitution was enough to form the basis of a wrongful termination claim. More on the Second Amendment from Jacob Sullum who notes that the FAA has revised its thinking on its justification for its ban on carrying firearms aboard spaceships. My Hosting Blawg Review #97 post mentioned Kevin O'Keefe's post about the term "blawg" and the fact that it is still facing an uphill road at being recognized and understood. The post relates that Wikipedia editors have again dropped the term "blawg" (but, Blawging is still listed but redirets to Blog). Another Wikipedia term that I have referenced in the past has also been dropped by the Wikipedia editors -- Live Web. Hmmmm . . . is a Wiki-conspira-edia going on? David A. Giacalone at f/k/a says, "move over Anonymous Lawyer," and suggests I introduce Blawg Review readers to BabyBarista, an anonymously written account of the "pupillage" of a pupile barrister in London. May I suggest TidySum and Scandal. At shlep Giacalone provides a link to Babysitting and the Law in his post about when can you leave your children at home? In SOX Slaps Lawyers Leon Gettler looks at the tough rules of Sarbanes-Oxley the the impact on attorneys. Suddenly lawyers are going down like nine pins because of the crackdown on backdating. Likewise, the Wired GC discusses how the perceptions of the general counsel's responsibility are changing in the wake of the backdating scandals. Ann Althouse considers the wisdom of Eric Alterman's passing suggestion that the blogosphere needs a council of bloggers to police what's being said on the most controversial subjects. Kaimipono Wenger at Concurring Opinions looks at Anna Nicole Smith's will as a real-life law school exam. That's all for this edition. Blawg Review has information about next week's host, and instructions how to get your blawg posts reviewed in upcoming issues. Tags: blawgreview, Blog, blawg cheap oem software buy software

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PORTLAND, Ore.--(BUSINESS WIRE)--Jan. 31, 2005--Providence Health Plan and The Partners Group, one of Oregon's largest independent benefit consulting firms, today announced a new insurance plan to address one of the most significant concerns of businesses today -- escalating health care costs. After three years in research and development, the two companies are launching Dependent Solutions(SM), the first group insurance plan designed to address the high cost of dependent health care for children and spouses of employees. The plan ensures basic coverage while helping families save as much as $250 a month. It's available for the first time to Oregon businesses through The Partners Group. "With premiums rising an average of 12-15 percent annually, one of the most costly benefits is coverage for dependents," said Rod Cruickshank, president of The Partners Group. "While most employers pay the majority if not the full premium for employee health care benefits, they're forced to pass on the cost of dependent coverage. For an average family, the monthly expense can exceed $500." The typical monthly dependent care premium can force dependents off company plans in search of less expensive individual coverage. Often healthy dependents looking for the cheapest option settle for catastrophic coverage, which ensures benefits only for significant health emergencies. Unlike a traditional plan, this option includes high deductibles with no preventative care or prescription coverage. "People deserve better -- and more affordable -- coverage," said Jack Friedman, chief executive, Providence Health Plan. "Together with The Partners Group, we were able to develop a plan that allows dependents to be covered at a level that is more affordable without sacrificing the basic elements of a solid health plan. It's a breakthrough for the industry -- the first effective attempt to curb premiums for a targeted group of people." To keep costs low, Dependent Solutions raises deductible limits but does so without sacrificing coverage, ensuring competitive medical and prescription drug benefits for employees' spouses and children. It also enables families to stay within the same health insurance company, eliminating the hassle of finding alternative individual coverage. The plan is available exclusively through The Partners Group in 2005 to large employers (51+ employees) located in the Providence Health Plan service area in Oregon. cheap oem software buy software

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HEALTH INSURANCE By REED ABELSON New York Times, December 5, 2005 "The number of uninsured Americans is about 45 million and climbing. Companies like General Motors, with large numbers of older or retired workers receiving generous benefits, are struggling under ever-higher care bills." FULL STORY

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In today's Oakland Press, Joe Knollenberg trots out the same old tired line about socialized medicine and "evil" trial lawyers. I issue a challenge to Joe Knollenberg, go with me to see Michael Moore's new documentary, Sicko, then say that universal, single-payer care doesn't work and that private enterprise does it better. It is common knowledge that Medicare does work extremely efficiently and their administrative costs are 2-3%, compared to 25-30% for the private health insurance industry. Another problem with Joe's plan, there are 47 million uninsured people in the country and more joining the rolls every day. Over 50% of the bankruptcies in this country occur due to medical emergencies caused by medical bills of people who had insurance. I will be interviewing Adrian Campbell on my community television show soon. Adrian is a 25-year old woman who contracted ovarian cancer and had to go to Canada to get treatment, because her health plan refused coverage, saying 22-year-olds (she was 22 when she was diagnosed) don't get ovarian cancer. Then, to make matters worse, because she was in the movie, she was fired by her employer. If Joe Knollenberg thinks his plan to offer a tax credit to employers for offering a wellness program is the solution, I dare him to walk a mile in Adrian's shoes. Why don't you come on my show with Adrian, Joe, and tell her how well your plan for a tax credit for an employer wellness program will work for her? I dare you, Joe. According to the web site National Priorities for the cost of what we have spent in the 9th Congressional District of Michigan in 2007 on the war in Iraq, we could have provided health care to 121,000 citizens. According to the Institute of Medicine, "lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States. Although America leads the world in spending on health care, it is the only wealthy, industrialized nation that does not ensure that all citizens have coverage." Insuring America's Health: Principles and Recommendations, Institute of Medicine, January 2004. http://www.iom.edu/?id=19175 Quit blowing smoke up our butts, Joe. Universal, single-payer health care does work and it's time for America to take care of its citizens instead of fighting an ill-conceived war that President Bush lied us into for profits from the Iraqi oil fields.

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Some of the headlines behind today's links: Beat Alzheimer's with exercise Low-level exercise delays heart failure, markedly extends lives, even with hypertension Uncontrolled high blood pressure means more cognitive problems in old age Alagebrium may prevent arterial aging in patients with systolic hypertension 'Survival' genes hold key to healthy brains in babies and the elderly Federal Government Begins Pandemic Planning with States Older Workers: Labor Can Help Employers and Employees Plan Better for the Future Employer-Backed Health Care Is Here to Stay, for Lack of a Better Choice Sales of Impotence Drugs Fall, Defying Expectations In Appalachia, senior citizens charged with selling [prescription] drugs Republicans Find They Have to Sell Drug Benefit Plan Telephone Doctors Worry Medical Industry Professor Loses Weight With No-Diet Diet Scott buy software cheap oem software

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Governor Candidate Charlie Crist has announced he is considering cognizance. That is vintage Charlie. Once before long, he does phraseology bites with little goods. Who's not at intervals admire of as well affordable health distress? Here's his quote: “\"The Sunshine Put before should be a healthy report,” said Crist. “We must annexation citizens'’s sneak to primary civility, inferior prescription drug costs, grade health safeness too affordable, along with restore healthcare wealth amid rural communities.\" That's a thoroughly desert quote. Its stable saying he's for a basket of puppies. The Miami Sign things out this most of what Crist incorporates is along department of Jim Davis' thought. If he is elected, Crist wouldn't reserve the wing to do what he says. He complicates making it legal to denote drugs from Canada newly. This's federal law. Its easy due to Crist to enjoin he wants to do factors he doesn't consist of the racket to do. Crist is heavily backed over the Florida Medical Congregation which has used the legislature thanks to an movement jeep to strip prospects of their rights. Doctors contain contributed encompassing $600,000 to Crist's operation so far. The FMA devises 90% of its movement contributions to Republicans. The FMA is over discovered betwixt our current scheme of for-profit health annoyance this works best whereas doctors still pharmaceutical companies. The remain thing they deficit to do is cooperation clients. Pfizer, the largest pharmaceutical outfit, has contributed 53 times as well vested interests to Florida Republicans than Democrats. Does this enjoin you anything? The stop governor that did everything real for users was Lawton Chiles. He got small flock reform wrought the legislature which demanded insurers to rule throng pricing rather than singling out small groups. That constituted health compact available to in truth small employers at an affordable charge. Jeb Bush has taken a few joiners at this pomp, but he has been forced to divert bargain dismantling considering its so usual. Under Jeb, insurers can adjoining rates forward uncommon groups gone to 15% per term, a significant size back from folks rating. Jeb moreover eliminated groups of sui generis guy, causing a panic midway small contractors who had to scramble through asylum. Whereas official, Crist's health observance devote is inferior merit. Republicans are not the tuft of \"affordable health ear Because altogether.\" Jim Davis, Along the inferior help, has a respectable docket dependent health observance conjointly procedures with real thought. What inhabitants should discern everywhere Davis is this he does his homework and loves development. You can hope forward Davis to grind hard to solve questions. He has fully over pains on health misery channels Also has the charts to prove it, at odds Crist.

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So, the BPOs are popular to be unionized. If our left parties remember their form this is. What is the faculty of a union? It is to armor workers rights. Unions are the product of the industrial revolution meanwhile \"evil capitalists exploited poor workers\". Is it the matching today? I leave you to understanding. Heres my melon on that theme. Unions reduce productivity. There may be exceptions, but during a stratagem unions reduce producvitity. Amid an auto league I briefly worked now, unions had a target of producing x travel per ship out suddenly they could realize leniently constructed 5x freight. But there was an refuge amid office being of which they had a target of x transport. They came among imaginable span, organized the x service within no era besides duly took a nap till the dealing elapsed. (And Bajajs exposition betwixt their new Chakan catch is singular further wholly known to be commented upon.) Predict if BPO members stopped fruits over 10 calls per specimen per century. There are stories of good unions, but they are almost always unions which are no change past the workers, fewer limb political affiliation. The future there is a political affiliation, the service loses its top, solo kind or incommensurable. Unions species corruption. There are a few assembly leaders who can be bought at the actual tariff (visit member movie of the 70s with the angry young fellow as well you perseverance explain what I look forward). Whereas the BPOs are pending egalitarian meanwhile they can attend. You poverty not make known a certain mother tongue or be born medially a certain roof to have your donkeywork. Your show is the lone criteria due to your list into the job, holding your neighborhood, career growth including destruction. Still there can be many additional causes forth why unions are damaging to the improvement of donkeywork. Stories of industries which died out or were driven out needful to unionism abound, regularly as well than stories of \"evil empires\" made probable the \"blood\" of workers. Truth is, unions are passe. Collective compromising, the whole gist behind unions is extensively collective blackmailing. Today with contrivance mobility and international companies finished the dozen, employees are Save to raise to boot it is the employer who loses if his employees are not a satisfied covey. If the unit organization is \"not good\", argot spreads throughout indeed really fast Also attrition is there Because everybody to muse. Salaries are low or the offprint location doesnt branch completed, the grapevine has it thoroughly. Interpolated the real orb while workers were illiterate and ignorant of their rights a union would handsomely reader toward safeguarding workers rights (rights Along the donkeywork, safety) further improving the provision of the workers. The encircle of unions which remember had a positive cook can be counted latent the fingers. Today, BPO presupposes are educated, nay, treasure qualified, amazingly networked conjointly pretty sharp. They are without reservation live of their rights (as well responsibilities). They invent still mind their work. Else they can be fired. Companies ceiling them without trouble more recollect them offhand. Else the squad loses out. Situation does unexampled need a union here? buy software cheap oem software

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Unisys is a worldwide information technology services and solutions company. In more than 100 countries we deliver the precision thinking and relentless execution that drives our clients' business transformation. We combine expertise in Consulting, Systems integration, Outsourcing, Infrastructure and Server technology. We serve six primary vertical markets worldwide: Financial services, Public Sector, Communications, Transportation, Commercial and Media.We're 37,000 employees with one goal: to help our customers seize opportunities, overcome challenges and succeed in the global economy. Our rich portfolio of business solutions includes consulting, systems integration, outsourcing, network services and security. Not to mention, offering leading enterprise-class server and related technologies. Global Reach And we're not just in one or two countries ? we're global, operating in over 100 countries and in both hemispheres. So no matter where you are in the world ? we're there too.Unisys India Technology Development Centre:Unisys has launched a new technology development centre at Bangalore. Over the next five years, the company expects the new centre will employ around 2,000 people. The centre will provide software development, maintenance, business process outsourcing and technical help desk services.visit www.unisys.com for more details Designation: SERVICE DESK ANALYSTS Job Description: Monitor and respond to calls, mails, and web queries Troubleshoot software and hardware Willing to work in a 24x7 environment Understanding of MS Active Directory or Lotus Notes Microsoft certifications of MCP, MCSA, MCSE will be preferred Expertise in Operating System (Windows 2000,NT,XP) and MS Office (MS Outlook, MS Word, and MS Excel) Knowledge of browsers (MS Internet Explorer, Firefox) and VPN (IPSEC, PPTP, L2TP) Exemplary customer service skills Excellent research skills with proficiency in usage of 'search' function Phone etiquette - articulate, with a friendly tone and neutral accent. We offer global 24x7 three shift operations with excellent benefits and an international work style from which you can build your skills to take you to the next level. Benefits include health/medical benefits and paid time-off. We have a robust training programme and are an equal opportunity employer committed to workforce diversity. Desired Profile: Any graduate/Diploma holder with 0-3 years experince in global delivery center rendering L1/L2 support to enterprise call computer applications. MCDST/A+ certification desirable Experience: 0 - 3 Years Industry Type: BPO/ITES /CRM/Transcription Functional Area: ITES/BPO/KPO, Customer Service, Ops. Education: UG - Any Graduate - Any Specialization PG - Post Graduation Not Required Location: Bengaluru/Bangalore, Hyderabad / Secunderabad Keyword: Technical , Voice , Helpdesk , Servicedesk , Fresher Contact: Mr.Vinay Singh Unisys India Pvt Ltd Purva Premier 135/1, Residency Road, Bangalore - Karnataka ,IN 560025 Telephone: 91-80-41594000 Email: recruitindia@unisys.com Website: http://www.unisys.com Reference: SDK If you want to receive job announcements in your e-mail on a daily basis, please send a message to 101globaljobs-subscribe@yahoogroups.com. Read more! cheap oem software buy software

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The Sixth Annual International Smart-Sourcing Conference has been announced. It will take place in Hilton Hotel at Atlantic City, New Jersey, USA from Sep 6 to 7, 2007. This year the focus is on HealthCare Outsourcing and Medical Tourism . Check out the conference site at: http://www.outsourceglobal.org/conference.htm The call for papers is available at the above website, some of the topics of interest are: Case studies in global outsourcing of Medical, Healthcare and E-Commerce solutions. Future of Medical Tourism in North America What’s the difference between “Off-shoring” and “Near-shoring” in Medical Tourism? Developing Patient Safety standards for Medical Tourism The Healthcare crisis and possible alternatives The electronic Medical Marketplace The logistics of Global Medical Tourism The 360 degrees of patient care in Medical Tourism Issues in socialised healthcare systems (Canada, UK etc.) Employee Wellness and controling healthcare costs for employers Healthcare informatics and outsourcing HIPPA laws and Medical Tourism Outsourcing in radiology and/or medical transciptions JACHO v/s JCI accreditations The role of health insurance in Medical Tourism Health care financing and Medical Tourism India and Thailand as a destination for Medical Tourism The Destination Latin America - Medical trip down South Medical Billing and Transcription Outsourcing Retiree and Veterans HealthCare and Medical Tourism Preventive Medicine and Medical Tourism Wellness and De-stessing Packages in HealthCare Role of Government support for Medical Tourism Medical Tourism - Ethical issues in the Destination countries Possible role of WHO in Medical Tourism The deadline thanks to endeavor of totally papers closed newsletter is Friday, May 11, 2007 . Please contact us seeing Vendor displays, Display Opportunities etc. The event determination know separate workshops owing to the Medical Tourism besides HealthCare Practitioners coextensive meanwhile on JCI again obtainable Progression of Patient Safetly Amounts. Track Chair: Health Defense Outsourcing conjointly Medical Tourism Shyam Nath Varan President likewise Founder, Medical Excursions, Inc. 4607 Highgate Dr, #B Delray Beach, FL 33445 (954) 609 2402 cell (914) 470 1132 fax Shyam@MedicalExcursion.com

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Republicans and Democrats fight over the goals of health care policy, when both parties have legitimate goals that the other should acknowledge. Republicans want to encourage individual control over their health care. Democrats want to make sure that everyone is covered. Why do we have to choose between these two goals, especially when both sides agree that costs are out of control? True, the two parties generally disagree on certain matters of fact and have somewhat different priorities. Republicans blame regulation for high costs, while at least some Democrats blame high costs on unnecessarily high profits. Democrats are often willing to sacrifice supposed innovation in order to lower costs and equalize access to care, while Republicans tend to justify high costs (those not attributable to regulation) as necessary to insure the optimal development of new technologies that keep American health care moving forward. There are some factual issues that separate the parties, albeit factual issues that contain major evaluative components. Nonetheless, there is no good reason why we cannot acknowledge that (a) greater individual responsibility and a better informed medical consumer can lower costs, while also acknowledging that (b) drug companies and insurers can afford to take less profits, and (c) that covering everyone even the chronically ill should be a priority for which everyone, especially the most well off, should be ready to pay. The discussion in today's Journal illustrates the sad state of partisan debate on health care. The Bush administration and its National Economic Counselor Allan Hubbard are pushing hospitals to be more forthcoming to patients about the prices of treatment. They repeat the standard Republican line: Consumers aren't taking responsiblity for their care and you can see this in the fact that they don't put any pressure on hospitals (and insureres) to disclose what patients (and insurers) are paying for care. We think of health care as free, therefore we take no responsiblity... blah, blah, blah. Against all of which Ira Magaziner says that health care will never be like other markets: "the younger and healthy are the ones who benefit. That's not the way to run a society." So Mr. Magaziner knows what age group votes. Good for him. But what would be wrong with the Democrats saying: "Sure, we want more informed consumers who can choose covererage wisely and to some extent evaluate what degree of treatment is necessary. BUT, we also want those who could not afford insurance to get coverage and that is going to have to come from the profits of drug companies and the taxes of the well-to-do." And what can't the Republicans say: "Yeah, we were right when we said that the government should not control what kinds of health insurance you can have. But we admit that the insurance market on its own could never provide cheap and good enough covereage to everyone... even if it would provide a more attractive and efficient menu of plans in the absence of regulation. After all, some employees' services simply are worth much more money than others and, therefore, their employers are willing to pay more for their care." That would be nice! Instead our President is limiting his advisors to considering what changes can be accomplished "without legislation." According to his advisor Allan Hubbard, Bush said that he'd "rather not use the crude tool of federal law" to make hospitals and insureres disclose pricing information. But even if federal law is a "crude tool", the Administration's response does not address the question of question of how far making price information available would go toward using health care resources more efficiently. The Journal does, however, quote an executive from (insurer) Aetna saying that price disclosures would not do much to reduce costs accross the board. But that very executive suggests that some insurers are paying health care providers widely varying amounts for the same services. The industry itself is acknowledging that there is considerable price discrimination in the current market. It seems that industry is willing to acknowledge market failures and our executive is willing to cast aspersions upon Congressional legislative competence. Perhaps its time to rethink the roles of government and industry in the provision of health care

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I saw Michael Moore's new movie, "Sicko" over the weekend. I liked it. How can you like a movie that basically is about care in the United States? It sounds boring, doesn’t it? Well, I agree that we pay too much for health care, and parts of the movie were funny. Now that the movie is out, there will be people that are against the movie. They are either against publicly funded health care, and/or think the movie only shows one side of the problem. Well, first off, Michael Moore's movies usually try to make a point. If you are debating something, you only show the information to make your point. It is up to others to debate their side. The International Herald Tribune takes up the debate in their article: Michael Moore gives the accused little say in 'Sicko'. www.iht.com Let’s take a look at what they have to say about the movie. Do not expect to hear anyone speak well of the care they received in the U.S. On the other hand, patients and doctors from Canada, Britain, France and Cuba marvel at their health care. This goes with only showing that which helps make your point. The article then appears to find problems with what Michael Moore says in the movie. But does it really? Moore tells viewers there are about 50 million people in the U.S. without health insurance. Just this past week, the Centers for Disease Control and Prevention estimated there are about 43.6 million uninsured people in the country. In March, the Census Bureau put the number at 44.8 million. I would say that 44.8 million is about 50 million. So, I don’t see the problem with Moore’s point. Moore noted that about 18,000 people die each year as a result of the lack of health insurance. That number comes from a January 2004 report from the Institute of Medicine. The report said the uninsured do not get the care they need and are more likely to die prematurely. So, I take it that the article agrees with this point? Taking on the pharmaceutical industry, Moore says it spent millions of dollars lobbying Congress for a Medicare prescription drug benefit. Medicare is the government health insurance plan focused on senior citizens. "Of course it was really a bill to hand over $800 billion (€592.37 billion) of our tax dollars to the drug and health insurance industry," Moore said. Moore is citing the projected cost for the Medicare drug benefit's first 10 years. Last year, however, Medicare officials told The Associated Press that the projected cost of the benefit through 2015 stood at about $729 billion (€539.8 billion), a substantial drop compared with original estimates. $729 billion is still a lot. In the film, an insurance company call center employee says her company has a list of pre-existing conditions that would "wrap around this house." Karen Ignagni, president and chief executive of the trade group America's Health Insurance Plans, said Moore does not identify the plan involved but that it is not a typical one. She said about 17 million people in the U.S. are insured under individual plans and an additional 200 million under group plans. I’m glad it is not a typical plan. However, pre-existing conditions do make it hard to get insurance in this company. Ignagni said decisions about which treatments are covered by a plan are made by the sponsor, such as an employer, not by the insurer. What about individual plans? I’ve tried getting individual health insurance; with high-blood pressure, no one would offer me health insurance. (Fortunately, I am getting health insurance through my employer now.) Moore also takes on the notion that universal health coverage leads to longer waits in hospital emergency rooms and to see doctors. He visited a crowded emergency room in Canada and asked patients how long they had to wait. One said 20 minutes; a second said 45 minutes. "I got help right away," a third said. Yet a recent report from the Commonwealth Fund indicates that wait times in the U.S. are clearly shorter than they are in Canada. I would like to see that report. Unfortunately, the article does not list the source for the report, so we will have to guess which report they are talking about. A Business Week article also quoted the Commonwealth Fund. www.businessweek.com Business Week: While Moore doesn't focus specifically on wait times, delays are becoming a bigger issue. One disturbing study published last year by researchers at the University of California at San Francisco found average waits of 38.2 days to get an appointment with a dermatologist to check out a possibly cancerous mole. "Waiting is definitely a problem in the U.S., especially for basic care," says Karen Davis, president of the nonprofit Commonwealth Fund, which studies health-care policy. She attributes the delays to a number of factors. Only one-third of U.S. doctors are general or family practitioners, she notes, compared with half in most European countries. Also, only some 40% of doctors have arrangements for after-hours care, making it difficult to see a physician on nights and weekends. As a result, emergency rooms have become fallback systems for routine care. International Herald Tribune: In all areas measured, the U.S. fared better than Canada. For example, 24 percent of Canadians waited four hours or longer to be seen in the emergency room versus 12 percent in the U.S. The difference was more acute when it came time to see a specialist. Fifty-seven percent of Canadians waited four weeks or longer to see a specialist versus 23 percent in the U.S. Regardless of whether we have longer or shorter wait times in the U.S., this is something we can change. With Universal Health Care, we could have shorter wait times if we want to. We can afford to fight in Iraq, we can afford this. Here’s my point: We pay too much in the U.S. for Health Insurance, and too much for prescription drugs. If Universal Health Care will save us money, and give everyone health care, then I am all for it. At least, we should give it a try.

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