This Wasn't In the Plan

Reflecting on Dad

2009-11-29T14:19:00.001-06:00

Dad died two days ago. The funeral is tomorrow, and we are supposed to meet with the pastor later today to tell stories so he can get a feel about what to say.

Dad’s obituary told a little bit about the things Dad accomplished, but it only hinted at who he was.

Life may, at times, be complicated, but Dad didn’t see it that way. To him, life was fairly black and white. Life could be distilled down to a series of choices. And when the choices required action, then it was simple: You simply did what was right. It did not matter what anyone thought. It did not matter whether or not it was hard, convenient, or politically expedient. You just did what was right because it was right.

I often thought Dad and John Wayne were a lot alike – only Dad was real. He was generally quiet, but unafraid to speak his mind when necessary. One of my favorite quotes was when he said, “I’m not afraid of what I say, only what people say I say.”

He was a sailor in the Navy, so he knew how to curse (and sometimes did – for effect). But he taught his kids that profanity was only for people who aren’t smart enough to think of something better to say.

Like John Wayne, Dad was not someone you wanted to mess with. When he was in the Navy teaching judo, he used to begin the class by finding the biggest and toughest guy there, then throw him across the room. Bad people were correct to fear him, but we felt safe knowing he was around.

Dad had an incredibly disciplined, analytical mind. Like no one else I have known, he was able to cut to the heart of a matter without becoming emotionally involved. It was one of the traits that made him such a strong business leader. On the other hand, the emotion occasionally leaked out. I saw him cry twice – once when he got the news that his father had passed away, and again when one of the dogs died.

His love was buried deep, but no one ever doubted that it was there. He didn’t say “I love you.” Those were just words. Instead, he showed his love by providing for his family, always asking if everyone was okay, and always making sure he was doing everything he knew how to do to take care of not only his family, but his friends and coworkers, too.

Like many from Dad’s generation, he didn’t talk much about his faith. Yet he never missed church – even if the rest of us wanted to sleep in or were not in the mood to go. My brothers and I used to spend every weekend on our sailboat on Lake Meredith. Dad would sail on Saturday, drive home so he could attend church, then drive back on Sunday to pick us up.

He read the Bible and even studied it, but he didn’t talk about it much. He did not preach the Gospel. He just lived it out, helping others whenever he saw the need.

Dad could not understand liberals. He thought it was crazy for the government to take care of people. “Why,” he would ask, “do we need the government to take care of the poor? Which one of us is going to let our neighbor go naked or starve?”

Dad was the definition of loyal. He volunteered to serve his country – while we were at war! When he was at college, he dropped his parents a note – every day. When his mother had to start living in a nursing home, he went to visit her – every day. When he married my mom and promised to love only her for the rest of his life, he meant it and remained loyal to her for over 62 years.

Dad was a man of his word. His yes meant yes, and his no meant no. He wouldn’t lie to you. If you pressed him, he would just tell you to your face that you were being stupid. At our house, it was well-known that the punishment for lying would be worse than the punishment for whatever crime you were tempted to lie about. The only lie I can ever remember Dad telling me was about Santa Claus. Only later did I learn that there really was a St. Nicholas, so I guess that even that was not a total prevarication.

Dad didn’t ask for much for himself, if anything. He just wanted us to treat our mother with respect, and he wanted us to love and care for one another. I think Christmas was his favorite time of year because it was a time when all the kids would come home, laugh, eat Mom’s cookies, and enjoy being together.

Speaking of Mom’s cookies, Dad loved nothing better. If Dad had a vice, it was sweets. That is how we knew he was sick at the end. He quit eating cookies.

Dad wasn’t perfect, but it was not for lack of trying. He had his moments as we all do. But at the end of the day – at the end of his race – I feel confident the Lord smiled and said, “Well done, good and faithful servant. It is time to come home and receive your reward.”

The Seed

2009-09-26T09:26:00.003-05:00

A successful business man was growing old and knew it was time to choose a successor to take over the business.

Instead of choosing one of his Directors or his children,he decided to do something different. He called all the young executives in his company together.

He said, "It is time for me to step down and choose the next CEO. I have decided to choose one of you. "The young executives were shocked, but the boss continued. "I am going to give each one of you a SEED today - one very special SEED. I want you to plant the seed, water it, and come back here one year from today with what you have grown from the seed I have given you.

I will then judge the plants that you bring, and the one I choose will be the next CEO."

One man, named Jim, was there that day and he, like the others, received a seed. He went home and excitedly, told his wife the story. She helped him get a pot, soil and compost and he planted the seed. Everyday, he would water it and watch to see if it had grown. After about three weeks, some of the other executives began to talk about their seeds and the plants that were beginning to grow.

Jim kept checking his seed, but nothing ever grew.

Three weeks, four weeks, five weeks went by, still nothing.

By now, others were talking about their plants, but Jim didn't have a plant and he felt like a failure.

Six months went by -- still nothing in Jim's pot. He just knew he had killed his seed. Everyone else had trees and tall plants, but he had nothing. Jim didn't say anything to his colleagues, however. He just kept watering and fertilizing the soil. He so wanted the seed to grow.

A year finally went by and all the young executives of the company brought their plants to the CEO for inspection.

Jim told his wife that he wasn't going to take an empty pot, but she asked him to be honest about what happened. Jim felt sick to his stomach. It was going to be the most embarrassing moment of his life, but he knew his wife was right. He took his empty pot to the board room. When Jim arrived, he was amazed at the variety of plants grown by the other executives. They were beautiful -- in all shapes and sizes. Jim put his empty pot on the floor, and many of his colleagues laughed. A few felt sorry for him!

When the CEO arrived, he surveyed the room and greeted his young executives.

Jim just tried to hide in the back. "My, what great plants, trees, and flowers you have grown," said the CEO. "Today one of you will be appointed the next CEO!"

All of a sudden, the CEO spotted Jim at the back of the room with his empty pot. He ordered the Financial Director to bring him to the front. Jim was terrified. He thought, "The CEO knows I'm a failure! Maybe he will have me fired!"

When Jim got to the front, the CEO asked him what had happened to his seed. Jim told him the story.

The CEO asked everyone to sit down except Jim. He looked at Jim, and then announced to the young executives, "Behold your next Chief Executive Officer! His name is Jim!" Jim couldn't believe it. Jim couldn't even grow his seed.

"How could he be the new CEO?" the others said.

Then the CEO said, "One year ago today, I gave everyone in this room a seed. I told you to take the seed, plant it, water it, and bring it back to me today. But I gave you all boiled seeds. They were dead - it was not possible for them to grow.

All of you, except Jim, have brought me trees and plants and flowers. When you found that the seed would not grow, you substituted another seed for the one I gave you. Jim was the only one with the courage and honesty to bring me a pot with my seed in it. Therefore, he is the one who will be the new Chief Executive Officer!"

* If you plant honesty, you will reap trust

* If you plant goodness, you will reap friends

* If you plant humility, you will reap greatness

* If you plant perseverance, you will reap contentment

* If you plant consideration, you will reap perspective

* If you plant hard work, you will reap success

* If you plant forgiveness, you will reap reconciliation

* If you plant faith, you will reap a harvest

So, be careful what you plant now. It will determine what you will reap later.

(Hat tip: Simcha Gluck, Jerusalem)

Smelling Roses

2009-09-19T07:51:00.003-05:00

In case anyone is wondering why the blog has been slow lately:

First, things were really busy the past several months. Kids were moving around, we made some awesome dive trips, work was time-consuming.

My excuse now is that I am in an "input" or listening phase. I am mulling over some important topics in my mind and heart.

When things make sense, I am sure I will post a more detailed explanation. In the meantime, check back from time to time for tidbits.

Preface

2009-09-15T07:08:00.003-05:00

The present volume not only reflects the truism that Jesus was a Jew and wanted to remain within the Jewish faith, but it argues that, without the long preparatory work of contemporaneous Jewish faith, the teaching of Jesus would be unthinkable.

David Flusser
Professor Emeritus, Hebrew University
Professor of Judaism in the Second Temple Period
writing in
The Sage from Galilee

Book Review: Sitting At The Feet of Rabbi Jesus

2009-08-08T09:00:00.007-05:00

A few months ago I received an email from Lois Tverberg. I don't remember how she found my blog, but she noticed my interest in Judaism and the nexus between Judaism and Christianity. Lois wondered whether I would have any interest in reviewing her new book, Sitting At The Feet of Rabbi Jesus.

Circumstances were such that it took me awhile to be able to sit down and read the book carefully and thoughtfully enough to critique it. But I finished reading it, and I am now happy to share my thoughts and reactions. But first, allow me to put this into context.

I began exploring the Christian-Jewish connection over 35 years ago, long before there was a "Hebraic Roots Movement." It started when I needed a language to complete my bachelor's degree. I was somewhat new to Christianity at the time, and I had contemplated taking Greek. However, one of my teachers advised me to study intensive Hebrew instead, saying that Hebrew was the real language of the Bible. I took his advice, and it changed my life.

A careful study of church history informs us that for the first decade after Jesus' death, his followers -- who were all Jewish -- continued to meet in the synagogues and to identify themselves as members of a Jewish movement. It was only later, after Peter's experience with Cornelius (Acts 10), that some of them began to carry the message to the Gentile world, too.

As years passed, the message traveled further and further away from Jerusalem. Non-Jews assumed leadership of the movement in distant lands. Christianity developed its own traditions and doctrines, many of them intentionally divorced from its original Jewish roots, and ultimately the religion of Jesus evolved into a religion about Jesus.

For centuries, then, the religion of Jesus (Judaism) and the religion about Jesus (Christianity) had little to do with each other, and when they did, it was usually unpleasant. However, after the Holocaust and the rebirth of the state of Israel, things began to change. Archaeological finds stimulated an interest among both Jews and Christians who wanted to learn more about what life was like during the time when the Temple still stood. Jewish scholars realized that the synoptic gospels in the Christian Bible actually contained valuable historical data about first century Jewish life, and Christian scholars realized that a better knowledge of Jewish life in that time period might help them to understand some of the difficult sayings of Jesus which heretofore had not made much sense.

Thus the past couple of decades have seen a renewed appreciation for the fact that Jesus was Jewish. If he was a messiah, he would have been a Jewish messiah. If he was a rabbi, then he would have been educated in the Jewish religion and traditions, spoken to a Jewish audience, and done it all within the context of first century, Second Temple Judaism. And if Jesus revealed anything about the nature of God, it would have been consistent with the Torah, not contradictory to it.

In an attempt to recapture the environment in which Jesus lived and taught, a surprising number of Christians today have started fulfilling the words of the prophet Zechariah who said, "In those days ten men from all the nations (Gentiles) will grasp the garment of a Jew, saying, 'Let us go with you, for we have heard that God is with you.'" (Zech 8:23)

Jewish scholars, such as the late David Flusser of the Hebrew University of Jerusalem, have written much about first century Jewish life and thought, helping to recreate the milieu in which Jesus and other rabbis lived and taught. Realizing the value of putting the earliest church history back into its Hebrew context, Christian scholars, in cooperation with devout Orthodox Jewish scholars, have given us new -- or more precisely -- original explanations for what Jesus and the earliest church leaders really had to say.

Until now, much of this research has been hard to come by, and if found, challenging reading with original sources quoted in Hebrew, Greek, Latin or German. Add to this the need for non-Jews to wade through and make sense of an overwhelming volume of Jewish tradition and thought which evolved over several millennia, and one can easily appreciate why a Gentile interested in a Jewish Jesus might want to grab the garment of a Jew!

Enter authors Ann Spangler and Lois Tverberg. These two women have done a masterful job of organizing pertinent Jewish perspectives in a way that will help Christians to start appreciating the similarities in our faiths more than concentrating on the differences. Without pointing fingers they help the reader to realize that Christians have spent centuries throwing out the baby with the bathwater by rejecting and ignoring anything Jewish. To correct this error, Lois and Ann gently invite us to pick up the baby again, hold it, love it, and learn from it.

Their book is written in an easy-to-read, conversational style. They take a great deal of information which could be painfully dry in most writers' hands, and they share it in stories and analogies that cause the reader to say, "Well, of course!"

I also appreciate the authors' honesty about something.

This whole Jewish-Christian thing is confusing a lot of folks. There are Christians talking in Jewish lingo, celebrating Shabbat, wearing tsitsit, and dressing like Jews from 19th century Europe. Religious Jews aren't sure whether this copycat behavior is a compliment or just another plot to convince Jews to become Christians. Mainline Christians just think it is weird.

Ann and Lois avoid this trap by openly admitting that they are not Jews, and they make a statement with which most rabbis would agree: that Christians do not need to become Jews. The authors assume the core beliefs of Christianity, yet they explain how exposure to Judaism deepens one's relationship to the Almighty. They also do this without delving into doctrinal arguments about who is and who is not "saved", about who is going to heaven, or about the true nature of God.

The book contains a useful Glossary and an Appendix. Better, it also contains good footnotes and a resource list for further study.

If you are a Christian who wants to start learning about the Jewish roots of your faith, Sitting at the Feet of Rabbi Jesus is the best book I have seen for beginning your journey. It is a well-balanced treatment of the subject from the Christian perspective.

Would Jews find this book of any value? Perhaps. Again, the book assumes the core beliefs of Christianity, a few of which the modern Jew will strongly disagree with. However, the overall tone is not proselytizing or judgmental. The book invites Christians to be grateful to Jews for preserving the Torah, the other sacred writings, and the many traditions and sources which help Christians to better understand their own faith. Consequently, even though Jews will not agree with some of its fundamental assumptions, it might help them to better understand why many non-Jews are asking so many questions now.

You can get the book here.

Billy Graham's Prayer for Our Nation

2009-08-01T16:37:00.003-05:00

Heavenly Father, we come before you today to ask your forgiveness and to seek your direction and guidance. We know Your Word says, 'Woe to those who call evil good,' but that is exactly what we have done. We have lost our spiritual equilibrium and reversed our values.

We have exploited the poor and called it the lottery.
We have rewarded laziness and called it welfare.
We have killed our unborn and called it choice.
We have shot abortionists and called it justifiable.
We have neglected to discipline our children and called it building self esteem.
We have abused power and called it politics.
We have coveted our neighbor's possessions and called it ambition.
We have polluted the air with profanity and pornography and called it freedom of expression.
We have ridiculed the time-honored values of our forefathers and called it enlightenment.

Search us, Oh God, and know our hearts today. Cleanse us from every sin and set us free.

Amen.

Commentator Paul Harvey aired this prayer on his radio program, The Rest of the Story and received a larger response to this program than any other he has ever aired. With the Lord's help, may this prayer sweep over our nation and wholeheartedly become our desire so that we again can be called "One nation under God."

Parsing the Health Reform Arguments

2009-07-02T11:00:00.002-05:00

Corbis

by George Newman for The Wall Street Journal

The health-care debate continues. We have now heard from nearly all the politicians, experts and interested parties: doctors, drug makers, hospitals, insurance companies, even constitutional lawyers (though not, significantly, from trial lawyers, who know full well "change" is not coming to their practices). Here is how one humble economist sees some of the main arguments, which I have paraphrased below:

- "The American people overwhelmingly favor reform."

If you ask whether people would be happier if somebody else paid their medical bills, they generally say yes. But surveys on consumers' satisfaction with their quality of care show overwhelming support for the continuation of the present arrangement. The best proof of this is the belated recognition by the proponents of health-care reform that they need to promise people that they can keep what they have now.

- "The cost of health care rises two to three times as fast as inflation."

That's like comparing the price of hamburger 30 years ago with the price of filet mignon today and calling the difference inflation. Or the price of a 19-inch, black-and-white TV 30 years ago with the price of a 50-inch HDTV today. The improvements in medical care are even more dramatic, leading to longer life, less pain, fewer exploratory surgeries and miracle drugs. Of course the research, the equipment and the training that produce these improvements don't come cheap.

Corbis

- "Health care represents a rising proportion of our income."

That's not only true but perfectly natural. Quality health care is a discretionary, income-elastic expense -- i.e. the richer a society, the larger the proportion of income that is spent on it. (Poor societies have to spend income gains on food and other necessities.) Consider the alternatives. Would we feel better about ourselves if we skimped on our family's health care and spent the money on liquor, gambling, night clubs or a third television set?

- "Shifting funds from health care to education would make for a better society."

These two services have a lot in common, including steadily rising cost. What is curious is that this rise in education costs is deemed by the liberal establishment smart and farsighted while the rise in health-care costs is a curse to be stopped at any cost. What is curiouser still is that in education, where they always advocate more "investment," past increases have gone hand-in-hand with demonstrably deteriorating outcomes. The rising cost in health care has been accompanied by clearly superior results. Thus we would shift dollars from where they do a lot of good to an area where they don't.

- "Forty-five million people in the U.S. are uninsured."

Even if this were true (many dispute it) should we risk destroying a system that works for the vast majority to help 15% of our population?

- "The cost of treating the 45 million uninsured is shifted to the rest of us."

So on Monday, Wednesday and Friday we are harangued about the 45 million people lacking medical care, and on Tuesday and Thursday we are told we already pay for that care. Left-wing reformers think that if they split the two arguments we are too stupid to notice the contradiction. Furthermore, if cost shifting is bad, wait for the Mother of all Cost Shifting when suppliers have to overcharge the private plans to compensate for the depressed prices forced on them by the public plan.

- "A universal plan will reduce the cost of health care."

Think a moment. Suppose you are in an apple market with 100 buyers and 100 sellers every day and apples sell for $1 a pound. Suddenly one day 120 buyers show up. Will the price of the apples go up or down?

- "U.S. companies are at a disadvantage against foreign competitors who don't have to pay their employees' health insurance."

This would be true if the funds for health care in those countries fell from the sky. As it is, employees in those countries pay for their health care in much higher income taxes, sales or value-added taxes, gasoline taxes (think $8 a gallon at the pump) and in many other ways, effectively reducing their take-home pay and living standards. And isn't it odd that the same people who want to lift this burden from businesses that provide health benefits also (again, on alternate days) want to impose this burden on the other firms that do not offer this benefit. What about the international competitiveness of these companies?

- "If you like your current plan you can keep it."

In other words, you can keep your current plan if it (and the company offering it) is still around. This is not a trivial qualification. Proponents have clearly learned from the HillaryCare debacle in the 1990s that radical transformation does not sell. What we have instead is what came to be dubbed "salami tactics" in postwar Eastern Europe where Communist leaders took away freedoms one at a time to minimize resistance and obscure the ultimate goal. If nothing else, a century of vain attempts to break the Post Office monopoly should teach us how welcoming Congress is to competition to one of its high-cost, inefficient wards.

- "Congress will be strictly neutral between the public and private plans."

Nonsense. Congress has a hundred ways to help its creation hide costs, from squeezing suppliers to hidden subsidies (think Amtrak). And it has even more ways to bankrupt private plans. One way is to mandate ever more exotic and expensive coverage (think hair transplants or sex-change operations). Another is by limiting and averaging premiums and outlawing advertising. And if all else fails Congress can always resort to tax audits and public harassment of executives -- all in the name of "leveling the playing field." Then, in the end, the triumphal announcement: "The private system has failed."

- "Decisions will still be made by doctors and patients and the system won't be politicized."

Fat chance. Funding conflicts between mental health and gynecology will be based on which pressure group offers the richer bribe or appears more politically correct. The closing (or opening) of a hospital will be based not on need but which subcommittee chairman's district the hospital is in. Imagine the centralization of all medical research in the country in the brand new Robert Byrd Medical Center in Morgantown, W.Va. You get the idea.

- "We need a public plan to keep the private plans honest."

The 1,500 or so private plans don't produce enough competition? Making it 1,501 will do the trick? But then why stop there? Eating is even more important than health care, so shouldn't we have government-run supermarkets "to keep the private ones honest"? After all, supermarkets clearly put profits ahead of feeding people. And we can't run around naked, so we should have government-run clothing stores to keep the private ones honest. And shelter is just as important, so we should start public housing to keep private builders honest. Oops, we already have that. And that is exactly the point. Think of everything you know about public housing, the image the term conjures up in your mind. If you like public housing you will love public health care.

Mr. Newman is an economist and retired business executive.

The Speech Netanyahu Should Have Delivered

2009-06-14T18:04:00.007-05:00

Here is the speech Prime Minister Netanyahu should have delivered today (by my friend, David Wilder).

My fellow countrymen,

Yesterday, on the holy day of Shabbat, worshipping at a synagogue close to my Jerusalem home, I listened intently to the weekly Torah portion. It tells the story of 12 spies, sent by Moses, to study Eretz Yisrael and its residents, prior to the Israelites entering into the Land.

The end is quite well known; Ten of the spies opposed any attempt to conquer the land, saying that it was filled with giants and well-fortified cities and walls. Only two men, Joshua and Kalev had the courage to reject the spy's slander, and called on all the Israelites to push forward, saying that of course they could conquer Israel.

As a result of the people's rejection of the land G-d decreed that they should spend forty years in the desert. Almost all those alive at that time, died before entering the land and were not privileged to see the Promised Land. The ten spies died horribly tragic deaths. Joshua and Kalev were rewarded for their faith and were later leaders in Eretz Yisrael. And of course, the same day when the Israelites rejected Eretz Yisrael, Jews have suffered through the centuries. That day is Tisha b'Av, the date when the first and second Temples were destroyed.

I have also witnessed, in our generation, the results of forfeiting Eretz Yisrael.

Following Menachem Begin's relinquishment of Sinai and the destruction of Yamit and other communities in the south, Israel immediately faced a deadly war in the north. Begin later resigned and lived for almost a decade in isolation.

When Ariel Sharon abandoned Gush Katif to our enemies, and destroyed those communities, uprooting loyal citizens from their homes, we were forced to deal with two wars, from the north and from the south. Former Prime Minister Sharon has been in a coma for years. Most of the leaders directly involved with the Gush Katif fiasco have been disgraced, such as former army chief of staff Dan Halutz and former Prime Minister Ehud Olmert and many others.

And of course, I cannot forget to mention the fate of Yitzhak Rabin, following initiating and signing of the Oslo Accords.

Ehud Barak agreed to a Palestinian state throughout almost all of Judea and Samaria. As did Ehud Olmert. Events speak for themselves.

In truth, I myself had to deal with the same fate. Following my erroneous and fatal decision to divide Hebron, abandoning most of the city to Arafat, and my subsequent signing of the Wye accords, I was defeated at the polls by a very wide margin. I also had to deal with personal challenges, having been investigated several times by the police for crimes that never occurred.

I have come to a realization that, whatever the price, Eretz Yisrael, the land of Israel, including Judea and Samaria, is an intrinsic element of our people. Our Land is a G-d -given gift to our people, and it is not ours to give away, to anyone, at any time, for any price.

Of course, peace is a Divinely defined ideal; but only when peace is real, not phony. Since the Olso Accords were signed, almost 2,000 Jews have been killed in terror attacks, murdered in cold blood, by the very people who were supposed to be at peace with the State of Israel.

We have witnessed to formation of a new terror-entity on our southern border, which continues to fire rockets into our country. We still have no assurances that Hamas will not eventually control the Arab populations in Judea and Samaria, as they have taken over Gaza. Israel will not lend a hand to formation of another terror state on our eastern border.

I am very aware of demands to find a national home for the Palestinians.

First, it should be reiterated: the State of Jordan, which was created by the British after World War Two, has a population which is 80% Palestinian; that is 80% of the population is identical to the 'palestinians' living in Judea and Samaria. It should be recalled that Jordan ruled the west bank of the Jordan River from 1950 until 1988.

Very clearly, Jordan is a Palestinian state and can and should be recognized as such. Any Arabs living in Judea and Samaria who do desire, should be able to receive Jordanian citizenship.

As for the Arabs in Gaza: it would only be natural for Gaza to be absorbed by the State of Egypt. I believe that the issues facing us are international, and should be addressed by all nations of the world, including the Egyptians. Egypt, having received the Sinai from Israel, should be an active participate in the continuing peace process. Therefore, Israel is volunteering any and all assistance to green the Sinai desert, thereby provided both food and employment for tens and hundreds of thousands of Gazans.

Peace is not, and cannot be dependent on any one country or culture. All must play a role in bringing real peace to the world. Therefore, we expect the Arab world, the European Union, the Russians, and the United States, as well as member countries of the United Nations, to partake in funding and implementing this plan, which will allow the Palestinians to live as free citizens of their countries, without continuing to endanger the State of Israel, and without forcing Israel to divide its holy land.

Finally, concerning Jerusalem, there should not be any illusions about Israeli policy. Jerusalem has been the capital of the Jewish people for over 3,000 years, beginning with the Davidic Kingdom. After Jews were exiled from this holy city and from our holy land, Jerusalem was left desolate and abandoned.

Temple Mount is the holiest place in the world, site of the sacred Beit HaMikdash, the Temple. The Jewish people lost this holiest of sites because of our rejection of Eretz Yisrael during the days of Moses. I am sure that only when we, as a country, as a people, officially recognize our allegiance to this site, and via this, to our G-d in heaven, that eventually we will achieve an authentic, eternal peace. Israel will never, ever divide Jerusalem.

My fellow countrymen: We must be aware that there are many who will reject my proposals. In 1948 Israeli independence was rejected by the Arab world. Despite this, despite being surrounded by massive enemy forces, despite attacks on all fronts, we were victorious, because we believed in what we had to do: 100% of the Jews here in Israel believed 100% in our goals.

If we believe in ourselves, in our rights to our land, if we believe in our past and look to our future, if we believe in our G-d - given right to our land, then there is no doubt that we will be victorious again, today.

G-d bless you all.

Canada's ObamaCare Precedent

2009-06-09T16:06:00.003-05:00

picture by Martin Kozlowski

From the Wall Street Journal, (June 9, 2009)

By DAVID GRATZER

Congressional Democrats will soon put forward their legislative proposals for reforming health care. Should they succeed, tens of millions of Americans will potentially be joining a new public insurance program and the federal government will increasingly be involved in treatment decisions.

Not long ago, I would have applauded this type of government expansion. Born and raised in Canada, I once believed that government health care is compassionate and equitable. It is neither.

My views changed in medical school. Yes, everyone in Canada is covered by a "single payer" -- the government. But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system.

The problems were brought home when a relative had difficulty walking. He was in chronic pain. His doctor suggested a referral to a neurologist; an MRI would need to be done, then possibly a referral to another specialist. The wait would have stretched to roughly a year. If surgery was needed, the wait would be months more. Not wanting to stay confined to his house, he had the surgery done in the U.S., at the Mayo Clinic, and paid for it himself.

Such stories are common. For example, Sylvia de Vries, an Ontario woman, had a 40-pound fluid-filled tumor removed from her abdomen by an American surgeon in 2006. Her Michigan doctor estimated that she was within weeks of dying, but she was still on a wait list for a Canadian specialist.

Indeed, Canada's provincial governments themselves rely on American medicine. Between 2006 and 2008, Ontario sent more than 160 patients to New York and Michigan for emergency neurosurgery -- described by the Globe and Mail newspaper as "broken necks, burst aneurysms and other types of bleeding in or around the brain."

Only half of ER patients are treated in a timely manner by national and international standards, according to a government study. The physician shortage is so severe that some towns hold lotteries, with the winners gaining access to the local doc.

Overall, according to a study published in Lancet Oncology last year, five-year cancer survival rates are higher in the U.S. than those in Canada. Based on data from the Joint Canada/U.S. Survey of Health (done by Statistics Canada and the U.S. National Center for Health Statistics), Americans have greater access to preventive screening tests and have higher treatment rates for chronic illnesses. No wonder: To limit the growth in health spending, governments restrict the supply of health care by rationing it through waiting. The same survey data show, as June and Paul O'Neill note in a paper published in 2007 in the Forum for Health Economics & Policy, that the poor under socialized medicine seem to be less healthy relative to the nonpoor than their American counterparts.

Ironically, as the U.S. is on the verge of rushing toward government health care, Canada is reforming its system in the opposite direction. In 2005, Canada's supreme court struck down key laws in Quebec that established a government monopoly of health services. Claude Castonguay, who headed the Quebec government commission that recommended the creation of its public health-care system in the 1960s, also has second thoughts. Last year, after completing another review, he declared the system in "crisis" and suggested a massive expansion of private services -- even advocating that public hospitals rent facilities to physicians in off-hours.

And the medical establishment? Dr. Brian Day, an orthopedic surgeon, grew increasingly frustrated by government cutbacks that reduced his access to an operating room and increased the number of patients on his hospital waiting list. He built a private hospital in Vancouver in the 1990s. Last year, he completed a term as the president of the Canadian Medical Association and was succeeded by a Quebec radiologist who owns several private clinics.

In Canada, private-sector health care is growing. Dr. Day estimates that 50,000 people are seen at private clinics every year in British Columbia. According to the New York Times, a private clinic opens at a rate of about one a week across the country. Public-private partnerships, once a taboo topic, are embraced by provincial governments.

In the United Kingdom, where socialized medicine was established after World War II through the National Health Service, the present Labour government has introduced a choice in surgeries by allowing patients to choose among facilities, often including private ones. Even in Sweden, the government has turned over services to the private sector.

Americans need to ask a basic question: Why are they rushing into a system of government-dominated health care when the very countries that have experienced it for so long are backing away?

Dr. Gratzer, a physician, is a senior fellow at the Manhattan Institute.

Perseverance

2009-06-05T15:04:00.006-05:00

Rabbi Daniel Lapin has written:

John Quincy Adams said, "Courage and perseverance have a magical talisman, before which difficulties disappear and obstacles vanish into thin air." Samuel Johnson once said, "Great works are performed not by strength, but by perseverance." Repeated studies consistently indicate that in sales, as well as in other fields, few attributes correlate more directly with success than perseverance. It is also one of the toughest characteristics to inculcate in ourselves. Shrugging off failure and redoubling efforts takes perseverance. Picking oneself up off the ground to where one has been knocked and taking another shot at the goal takes perseverance. Resisting pain, sometimes humiliation too, and remaining stubbornly focused on the task takes enormous reserves of perseverance.

How do we enhance our ability to persevere? Perseverance means that we have the ability to follow our heads rather than our hearts or our bodies. Using our heads, we have determined that our lives would be improved if we adhered to a diet or an exercise program. Perhaps you have decided to make 10 cold calls each day at work to increase your sales. It might be something else, like completing a difficult night-school credential course for career advancement. There will be many evenings when your heart will urge you rather to spend the evening with a friend. There will be evenings when your body will urge you to climb into bed and go to sleep. Each and every time you overcome one of those urgings and adhere to your plan, you not only come closer to your goal, but even more importantly, you have strengthened your perseverance muscle for future occasions.

Perseverance's twin is patience. The very concept of perseverance implies that instant results are not to be expected. Patience and Perseverance peer into the future. They fix their eyes upon the ultimate goal, and they keep going until it is theirs.

These are keys to long-term success in most facets of life, including personal relationships, business, and issues of health, to name a few.

Peace With Whom?

2009-05-18T17:11:00.004-05:00

Everyone is putting all this pressure on Israel to "make peace."

With whom?

Which Muslim group wants to make peace with Israel? And if you can find one, what about all the others?

Paying Taxes

2009-05-06T07:33:00.000-05:00

Actual 'Letter to the Editor' from the February 5^th edition of the Wichita Falls, Texas Times Record News...

Dear IRS:

I am sorry to inform you that I will not be able to pay taxes owed April 15, but all is not lost. I have paid these taxes: accounts receivable tax, building permit tax, CDL tax, cigarette tax, corporate income tax, dog license tax, federal income tax, unemployment tax, gasoline tax, hunting license tax, fishing license tax, waterfowl stamp tax, inheritance tax, inventory tax, liquor tax, luxury tax, Medicare tax, city, school and county property tax (up 33 percent last 4 years), real estate tax, social security tax, road usage tax, toll road tax, state and city sales tax, recreational vehicle tax, state franchise tax, state unemployment tax, telephone federal excise tax, telephone federal state and local surcharge tax, telephone minimum usage surcharge tax, telephone state and local tax, utility tax, vehicle license registration tax, capitol gains tax, lease severance tax, oil and gas assessment tax, Colorado property tax, Texas, Colorado, Wyoming, Oklahoma and New Mexico sales tax, and many more that I can't recall but I have run out of space and money.

When you do not receive my check April 15, just know that it is an honest mistake. Please treat me the same way you treated Congressmen Charles Rangel, Chris Dodd, Barney Frank and ex-Congressman Tom Daschle and, of course, your boss Timothy Geithner. No penalties and no interest.

Sincerely,
Ed Barnett
Wichita Falls

P.S. I will make at least a partial payment as soon as I get my stimulus check.

Who Is Carrying the Bricks?

2009-04-16T07:01:00.003-05:00

Del Tackett just posted the following over on his blog:

Think of all the American households as being represented by 100 people and the entire federal tax burden represented by 100 bricks.

60 of the people are each carrying ½ of a brick;
19 of the people are each carrying 2 bricks;

20 people aren’t carrying anything;

1 person is carrying 39 bricks.

Most people think that the one person with the 39 bricks should be carrying more. Most people think he isn’t carrying his “fair share”.

In 2006, the top 20% of American households paid 86% of individual taxes. But, somehow, that isn’t seen as a “fair” enough share.

If there is no limit to this “fairness”, then the 80% can continue to vote to take more and more money from the 20%. Eventually, they could take it all. When that happens and more money is wanted, then I suppose it would have to be the 60% voting to take it all from the 40%. After that…who knows? Maybe it becomes a free-for-all.

Interesting times.

Margaret Thatcher once stated: “Socialism works until you run out of other people’s money.”

When do you just call it theft?

This is why there were tea parties yesterday...

Scientists vs God: Man-Making Contest

2009-04-04T19:50:00.001-05:00

There was a convention to discuss all of the achievements in science for the past decade. After their meetings, a group of scientists were talking and came to the conclusion that man no longer needs God. So they picked one from the group to go tell Him.

The scientist approached God and said, "Listen, we've decided we no longer need you. Nowadays, we can extract stem cells, clone people, transplant hearts, and all kinds of things that were once considered miraculous."

God patiently heard him out, and then said, "All right. To see whether or not you still need me, why don't we have a little man-making contest!"

"Okay, great!" the scientist said.

"Now, we're going to do this just like I did back in the old days with Adam," God said.

"That's fine," replied the scientist and he bent down to scoop up a handful of dirt.

"Whoa!" God said, shaking his head in disapproval. "Not so fast, pal. You get your own dirt."

Why Can't People Figure This Out?

2009-03-25T21:24:00.002-05:00

An economics professor at Texas Tech said he had never failed a single student before-- but had once, failed an entire class. The class had insisted that Socialism worked and that no one would be poor and no one would be rich, a great equalizer. The professor then said OK, we will have an experiment in this class on Socialism.

All grades would be averaged and everyone would receive the same grade--no one would fail, and no one would receive an A.

After the first test the grades were averaged and everyone got a B. The students who studied hard were upset... and the students who studied little were happy. But, as the second test rolled around, the students who studied little had studied even less and the ones who studied hard decided they wanted a free ride so they studied very little. The second test average was a D. Nobody was happy. When the 3rd testwas given, the average was an F.

The scores never increased... while bickering, blame and name calling resulted in hard feelings; shortly no studying was being done. All failed, to their great surprise, and the professor told them that Socialism would ultimately always fail, because the harder it is to succeed, the greater the reward. But when government takes the reward away, no one tries and neither the individual nor the group succeeds.
________

The problem with Socialism is that you eventually run out of other people's money.

--Margaret Thatcher

What Have We Learned?

2009-03-20T18:26:00.001-05:00

So what have we learned in 2 millennia???

The budget should be balanced, the Treasury should be refilled, public debt should be reduced, the arrogance of officialdom should be tempered and controlled, and the assistance to foreign lands should be curtailed lest Rome become bankrupt. People must again learn to work, instead of living on public assistance."
Cicero - 55 BC

Evidently, nothing.

Medical Ethics: Scenario 1

2009-03-14T15:49:00.001-05:00

What would you do?

The patient is a 75 year old woman with an unusual bone marrow condition that failed to get better with the standard treatments. She might have been starting to get better with a non-standard medication, but she could not tolerate the side effects. The patient and family have asked to stop chemotherapy.

Before starting treatment, the patient's bone marrow seemed to be making excessive numbers of white blood cells at the expense of red blood cells and platelets. A few weeks ago the white cell count became very elevated, and the patient suffered a stroke which left her with a mild speech problem. Before treatment, she required transfusions of red cells and platelets every few days. After starting chemotherapy, the transfusion requirement did not disappear, but it decreased.

Now that the patient has stopped chemotherapy, it is expected that the white cell count will skyrocket, and the need for transfusions will become more frequent. You have explained to the family that you have done all there is to do, and you recommend hospice care so that the patient can at least die in comfort.

The family refuses hospice care and asks you to keep transfusing the patient indefinitely. On the one hand, if you do not transfuse the patient, she will die within a few days or weeks. If you transfuse the patient, she may live longer, but she will probably have another stroke. If she has a stroke, you worry that it may NOT kill her, but only leave her paralyzed or with an inability to communicate at all.

Question: You have explained it to the family every way you know how, yet they continue to demand futile measures that also use up precious resources (blood products) that could be used to save someone else's life. What do you say, and what do you do now?

Lessons from Ethan

2009-03-08T12:59:00.003-05:00

This is something that was certainly not in our plan.

Many of you know that our first grandson, Ethan Andrew, had Trisomy 13. Like most children with this syndrome, he died in utero last week. Nevertheless, he was otherwise born normally, and we got to hold him in our arms for a few minutes. Although he had serious problems inside his little body, on the outside he was a perfect, cute little boy.

I cannot describe what it is like to hold your first grandson, knowing that this is the only time you will ever hold him. His eyes were closed, and he appeared to be sleeping peacefully. And indeed he was.

There are no coincidences, and we realize that our children did not bear this child in vain. While we can only wonder about what God was doing with Ethan, we know that there were lessons for us in all of this.

The first lesson was to realize who Ethan was.

He was a human being, a child. He was desperately wanted. He was greatly loved. He was a precious gift from God, formed in the womb by Him and, apparently, for Him. Ethan was a son, a first son. He was a grandchild. He was a nephew and a cousin. He was one of God's creations. He was alive.

Another lesson was, possibly, a tiny insight into God's heart.

We now know how it feels to love someone, to want someone, and to have that someone come so close to sharing life with us, but not quite making it. Is this what God feels when a person is awakened spiritually, shows interest, begins to ask questions, finds answers, but then decides that he or she doesn't need God?

We also learned how important family and friends are. Sometimes it is the people we love whom we take the most for granted. Events such as this remind us that we need each other.

We learned how fragile life can be, and how your thoughts and dreams can evaporate in an instant. Thus, it is important to make the most of every day, every moment. We have no guarantee there will be another.

We learned that there is always hope. Even when there is something bad going on in your life, there is always something good going on, too. The trick is to balance one's self between them, letting the good counterbalance, if not outweigh the bad.

Finally (though not last), we were reminded that God is there. We are never alone. I do not know how people live without God. I do not know why they try.

The Originality of Jesus

2009-02-26T22:06:00.006-06:00

One of the complaints that some have against Jesus is that he didn't say anything original. They argue that everything that Jesus said can be found in Jewish literature. Some point out that Jesus' "Golden Rule" actually derives from the great rabbi Hillel who preceded him. Others observe that it is actually possible to find everything he ever said in the Talmud, and to then construct a parallel to the sermons he gave in the gospels.

What these critics fail to recognize is that the only reason that it is possible to do this is because Jesus already did it! In other words, Jesus selected stories and principles from the Jewish traditions of that day and put them together in order to communicate his own message. As Brad Young wrote in Meet the Rabbis:

The powerful originality of Jesus is discovered in the incredible combination of teachings he puts together, to demonstrate what it looks like for people to love God with all their hearts and to love their neighbors as themselves ... The originality of Jesus must be seen not only in the combination of ethical teachings and their synthesis into a whole way of life, but also in his emphasis on the kingdom of heaven, which takes on a greater dynamic force in his teaching. More than keeping commandments, the kingdom is the power of God in the individual's life to bring healing and salvation."

Home builders all use cement, wood, wire and bricks to make a house. But the design of those homes may vary widely. Similarly, rabbis can draw from the rich and vast array of Jewish teachings in order to describe many different paths to the same conclusion.

Jesus should not be criticized for using the same building blocks that every other rabbi in his day used. If we admire the building materials, how much more should we appreciate the unique and novel way in which he blended different streams of Jewish thought to communicate a bold, new concept of malchut hashamayim (the Kingdom of Heaven)?

More on that later.

What Is Fair?

2009-02-08T09:37:00.003-06:00

"It isn't fair," said one young friend as we talked about my son, his lovely wife, and the bad news we had all received recently.

Trouble with their pregnancy had been hinted at, but specialists in Dallas confirmed that their first-to-be-born son, Ethan, has serious congenital heart defects which are destined to end his life, perhaps even before he is born. And this bad news came upon the heels of MUCH prayer from innumerable friends, including precious believers in Israel who carried our prayers to the Wall.

It isn't fair.

I mean, why this couple? Why should a syndrome -- which only occurs in 1 out of 16,000 births -- happen to these two? They have always loved God. They have served Him faithfully and devotedly. Surely a God who is fair would not choose to inflict such suffering on such a righteous couple.

It isn't fair.

I will be the first to admit that I do not understand God's economy. I cannot fathom His ways. But consider this.

God forms babies in their mothers' wombs. And sometimes He seems to make babies that either fail to make it to term, or else they die in infancy. I have no idea why He does this, but let's just assume that He has His reasons.

So if God needs to make a baby with life-threatening defects, and if He needs someone to carry the child for awhile, then ... well, then WHY NOT ask a young, devoted, loving couple to do it? After all, God knows that they will not abort the baby simply because it has problems. God knows that they will love and take care of this baby every day that it is alive in the womb and for everyday thereafter. God knows that they, in turn, will have the support of their families and friends. So why not?

When you look at it from God's point of view, it isn't fair.

It's a privilege.

Letter to Gaza Citizen: I Am the Soldier Who Slept in Your Home

2009-01-30T08:52:00.003-06:00

I recently received an email from one of our friends in Israel. It included this letter which was originally published in the Hebrew newspaper, Ma'ariv, then translated and republished on Israel National News website. It turns out that the letter was written by a friend of our friend. You may find it interesting.

Hello,

While the world watches the ruins in Gaza, you return to your home which remains standing. However, I am sure that it is clear to you that someone was in your home while you were away.

I am that someone.

I spent long hours imagining how you would react when you walked into your home. How you would feel when you understood that IDF soldiers had slept on your mattresses and used your blankets to keep warm.

I knew that it would make you angry and sad and that you would feel this violation of the most intimate areas of your life by those defined as your enemies, with stinging humiliation. I am convinced that you hate me with unbridled hatred, and you do not have even the tiniest desire to hear what I have to say. At the same time, it is important for me to say the following in the hope that there is even the minutest chance that you will hear me.

I spent many days in your home. You and your family's presence was felt in every corner. I saw your family portraits on the wall, and I thought of my family. I saw your wife's perfume bottles on the bureau, and I thought of my wife. I saw your children's toys and their English language schoolbooks. I saw your personal computer and how you set up the modem and wireless phone next to the screen, just as I do.

I wanted you to know that despite the immense disorder you found in your house that was created during a search for explosives and tunnels (which were indeed found in other homes), we did our best to treat your possessions with respect. When I moved the computer table, I disconnected the cables and lay them down neatly on the floor, as I would do with my own computer. I even covered the computer from dust with a piece of cloth. I tried to put back the clothes that fell when we moved the closet although not the same as
you would have done, but at least in such a way that nothing would get lost.

I know that the devastation, the bullet holes in your walls and the destruction of those homes near you place my descriptions in a ridiculous light. Still, I need you to understand me, us, and hope that you will channel your anger and criticism to the right places.

I decided to write you this letter specifically because I stayed in your home.

I can surmise that you are intelligent and educated and there are those in your household that are university students. Your children learn English, and you are connected to the Internet. You are not ignorant; you know what is going on around you.

Therefore, I am sure you know that Kassam rockets were launched from your neighborhood into Israeli towns and cities.

How could you see these weekly launches and not think that one day we would say "enough"?! Did you ever consider that it is perhaps wrong to launch rockets at innocent civilians trying to lead a normal life, much like you? How long did you think we would sit back without reacting?

I can hear you saying "it's not me, it's Hamas". My intuition tells me you are not their most avid supporter. If you look closely at the sad reality in which your people live, and you do not try to deceive yourself or make excuses about "occupation", you must certainly reach the conclusion that the Hamas is your real enemy.

The reality is so simple, even a seven-year-old can understand: Israel withdrew from the Gaza Strip, removing military bases and its citizens from Gush Katif. Nonetheless, we continued to provide you with electricity, water, and goods (and this I know very well as during my reserve duty I guarded the border crossings more than once, and witnessed hundreds of trucks full of goods entering a blockade-free Gaza every day).

Despite all this, for reasons that cannot be understood and with a lack of any rational logic, Hamas launched missiles on Israeli towns. For three years we clenched our teeth and restrained ourselves. In the end, we could not take it anymore and entered the Gaza Strip, into your neighborhood, in order to remove those who want to kill us. A reality that is painful but very easy to explain.

As soon as you agree with me that Hamas is your enemy and because of them, your people are miserable, you will also understand that the change must come from within. I am acutely aware of the fact that what I say is easier to write than to do, but I do not see any other way. You, who are connected to the world and concerned about your children's education, must lead, together with your friends, a civil uprising against Hamas.

I swear to you, that if the citizens of Gaza were busy paving roads, building schools, opening factories and cultural institutions instead of dwelling in self-pity, arms smuggling and nurturing a hatred to your Israeli neighbors, your homes would not be in ruins right now. If your leaders were not corrupt and motivated by hatred, your home would not have been harmed. If someone would have stood up and shouted that there is no point in launching missiles on innocent civilians, I would not have to stand in your kitchen as a soldier.

You don't have money, you tell me? You have more than you can imagine.

Even before Hamas took control of Gaza, during the time of Yasser Arafat, millions if not billions of dollars donated by the world community to the Palestinians was used for purchasing arms or taken directly to your leaders' bank accounts. Gulf States, the Emirates - your brothers, your flesh and blood, are some of the richest nations in the world. If there was even a small feeling of solidarity between Arab nations, if these nations had but the smallest interest in reconstructing the Palestinian people – your situation would be very different.

You must be familiar with Singapore. The land mass there is not much larger than the Gaza Strip and it is considered to be the second most populated country in the world. Yet, Singapore is a successful, prospering, and well-managed country. Why not the same for you?

My friend, I would like to call you by name, but I will not do so publicly. I want you to know that I am 100% at peace with what my country did, what my army did, and what I did. However, I feel your pain. I am sorry for the destruction you are finding in your neighborhood at this moment. On a personal level, I did what I could to minimize the damage to your home as much as possible.

In my opinion, we have a lot more in common than you might imagine. I am a civilian, not a soldier, and in my private life I have nothing to do with the military. However, I have an obligation to leave my home, put on a uniform, and protect my family every time we are attacked. I have no desire to be in your home wearing a uniform again and I would be more than happy to sit with you as a guest on your beautiful balcony, drinking sweet tea seasoned with the sage growing in your garden.

The only person who could make that dream a reality is you. Take responsibility for yourself, your family, your people, and start to take control of your destiny. How? I do not know. Maybe there is something to be learned from the Jewish people who rose up from the most destructive human tragedy of the 20th century, and instead of sinking into self-pity, built a flourishing and prospering country. It is possible, and it is in your hands. I am ready to be there to provide a shoulder of support and help to you.

But only you can move the wheels of history.

Regards,
Yishai, (Reserve Soldier)

Utila Dive Trip

2009-01-20T20:39:00.008-06:00

Below are the photos from our recent dive trip to Utila, Honduras. This was one of our best trips yet. The Utila Lodge was great. Our group were the only guests, so we had the Lodge and the boat to ourselves. The diving was very good, and we got to see Whale Sharks -- the largest fish known. Some in our group had been diving all over the world for 20 years and had never seen one before.

Click the play button to view. You can control the slideshow by moving your cursor over the pictures to bring up the control buttons. You can click on the quote box in the lower left-hand corner to turn the captions on and off.

Correction

2009-01-20T12:55:00.003-06:00

Contrary to what is being reported, Barack Obama is not the first black President. He is the first biracial President.

The first black President was David Palmer.

I would have voted for him.

Light for the World

2008-12-25T07:35:00.005-06:00

"At that time the Feast of the Dedication took place at Jerusalem. It was winter, and Jesus was walking in the temple in the portico of Solomon." (John 10:22-23)

Which Jewish festival occurs in winter? Answer: Hanukkah, also known as the Festival of Lights or the Feast of Dedication, as it was called in Jesus' day. The holiday was and is to commemorate the rededication of the Temple in Jerusalem at the time of the Maccabbean Revolt in the 2nd century before Jesus.

The emphasis on Light is because of the miracle which occurred when the Temple was rededicated. The leader of the Greeks, Antiochus IV, had defiled the Temple by sacrificing a pig on the altar. When the Jews regained control, they made things holy again. According to the Talmud, at the re-dedication following the victory of the Maccabees over the Seleucid Empire, there was only enough consecrated olive oil to fuel the eternal flame in the Temple for one day. Miraculously, the oil burned for eight days, which was the length of time it took to press, prepare and consecrate fresh olive oil.

Jesus would have been very familiar with this story, and I'm sure he enjoyed the celebration like everyone else. Perhaps it was this holiday he had in mind when he said, "I am the light of the world. He who follows me shall not walk in the darkness, but shall have the light of life." (John 8:12). Jesus also said, "We must work the works of HaShem who sent me, as long as it is day. Night is coming, when no man can work. While I am in the world, I am the light of the world." (John 9:4-5)

I love it when Hanukkah and Christmas fall together, as they do this year, because it reminds me how much this world needs Light. We are to be that Light as we do the works of Him who made us and who gives us Life.

Tonight will be the 5th night of Hanukkah. If you'd like to see the lighting of the candle on the first night in the Jewish community of Hebron, Israel, check out this link.

So Merry Christmas everyone, and Happy Hanukkah! Let us thank God for the Light, and may He help us to be Light in this world.

"Tuesday Night Live" to Resume Dec 30

2008-12-17T12:47:00.002-06:00

Below is a story about Ari and Jeremy's TV show, Tuesday Night Live, which is scheduled to resume with its second season at the end of the month. Ari, Jeremy, and Rachel (mentioned in the story) are our friends with whom we toured Israel in August.

(IsraelNN.com) Tuesday Night Live in Jerusalem (TNL), a live, bi-weekly pro-Torah English TV broadcast, is gearing up for its second six-month season on Israel National News TV, beginning Dec. 30.

Co-hosts Ari Abramowitz and Jeremy Gimpel, together with special guests and Jewish music bands, celebrate the beauty of Torah and Judaism in the State of Israel in Holy Land. Ari and Jeremy are an IDF soldier in the reserves and his former commander, respectively, who made Aliyah (immigranted to Israel) from the United States.

Special features, such as "Meet the Street" - video clips of questions posed to people on the Jerusalem street - as well as the active participation of the varied studio audience, give the show its unique flavor and vibrant atmosphere.

In its first season, which ended this past June, TNL packed the downtown-Jerusalem Heichal Shlomo hall with over 500 audience members for each bi-weekly show. “With Israel painted by the international media as a place of terror and fear,” Abramowitz says, “we come to set the record straight by introducing thinkers, educators, activists, and regular people on the street who share a tangible excitement and optimism about life in Israel.”

"The modern State of Israel is the culmination of 2,000 years of dreams, hopes and prayers,” Gimpel adds. “The majesty and greatness of our Jewish destiny will unfold in Israel. Our national soul was restored when we reentered the Land of Israel and it's exactly that Jewish spirit we want to share with the world.”

Time Warner Signs On

Gimpel and Abramowitz are expecting a major increase in their viewing audience, having recently signed an international syndication agreement with Jewish Life TV on Time Warner Cable.

"When we first embarked on this adventure, it was me, Jeremy, a couple of cameras, and one really out-of-the-box idea,” Ari says. “Going into this season with the knowledge that a voice of Jewish pride and clarity will be aired on televisions across the world via a major television network makes this season all the more powerful and exciting."

Free refreshments and booths offering Jewish art, handmade jewelry, information on various Israel-based organizations, and more greet the audience members as they arrive. "We wanted every show to be an event,” Ari explains. “We wanted people to come together to celebrate our lives in Israel, meet other immigrants from around the world, and enjoy the positivity and optimism that Israel is all about."

The "Three" Keys

Asked how they are able to pull off such a production, Jeremy answers, "There are three keys to our success. One is Hashem (G-d), two is Rachel Gluck, and three is Hashem." Gluck, the producer of TNL, manages a staff of over 20 volunteers during the show. "Without our team of volunteers it would be impossible,” she says. “There are a thousand things happening all of the time and you need a real support staff. It just shows that Tuesday Night Live in Jerusalem isn't just a TV show; it's a movement. People volunteer because they believe in the cause and because they love Ari and Jeremy."

The season debut, titled "A Tribute to Hebron", is scheduled for Tuesday night, December 30th. Sinai Tor will be the musical guest and will perform a short concert at the end of the filming. Doors open at 6:45 p.m., and the show starts at 8.

The two young dynamic Jewish leaders also host a radio show on IsraelNationalRadio.com, and frequently visit the U.S. on speaking tours.

Government To The 'Rescue' - Been There, Done That

2008-12-12T08:54:00.005-06:00

by Larry Elder

"Say something nice about Obama."

This challenge came at a party from a good-natured self-described "rabid Obama supporter." Normally, when off the clock, I avoid this kind of stuff. How different is it to, say, approach a physician in a social setting and say: "Doc, my knee hurts in the morning. What do you think it is?" But the guy seemed nice enough.

"OK," I said. "Obama is likable. He means well. He appears to be a good father and a faithful and loving husband."

"That's it?"

"You asked me to say something good. I just did."

"Aren't you leaving something out?"

"I'll bite," I said. "What?"

"Well, you left out something that's pretty obvious. The man is extremely intelligent, don't you think?"

"I make a distinction," I said, "between intelligence and wisdom, intelligence and judgment, and intelligence and common sense. Obama attended elite schools and did well enough at Harvard to become president of the law review and graduate magna cum laude. But..."

"But?"

"But my 93-year-old Republican father, who only finished the eighth grade until going back to get his GED in his late 30s, has more judgment, wisdom and common sense. My father never spent one minute in the auto industry and does not think he could run it. Obama thinks government can. My father thinks if you lend or borrow money irresponsibly, you shouldn't be 'saved' by taxpayers. Obama -- and a whole bunch of Republicans -- think they should."

"It's about helping people," my "rabid" friend said.

"My friend, economist Thomas Sowell, told me that whenever government wants to 'do something,' ask yourself three questions. 1) Who pays for it? 2) How much will it cost? 3) Will it work? With this brief analysis, Sowell said, one almost always finds 'something' is not worth it, is wrongheaded, or makes things worse.

"Who pays?" I continued. "Taxpayers do -- either through higher taxes, borrowed money to be repaid with higher taxes, or printing money that creates inflation and higher interest rates."

"The cost?" he asked.

"Well, last Sunday morning, Obama appeared on Meet the Press," I said. "He offered a massive 'infrastructure' program, a New Deal II. The cost? Obama said his economic team is working on that. So far, the amount of government money spent or expects to spend -- on FDIC insurance and to rescue banks, borrowers, insurance companies and investment firms, as well as the auto industry -- exceeds $7 trillion or $8 trillion.

"Treasury Secretary Henry Paulson initially proposed $700 billion under TARP, the Troubled Assets Relief Program," I continued. "But wait, Paulson then said no, it's not a good idea to spend the money on troubled assets -- better to spend the money on buying stock in financial institutions. So within weeks, the central premise of the bailout -- the need to purchase 'toxic' assets held by financial institutions -- was thrown out the window."

My friend and I were now drawing a crowd.

"Paulson told us," I said, "that lenders needed money in order to unlock the 'credit freeze.' But banks instead used the money to clean up their own balance sheets or to purchase other banks -- completely contrary to the stated purpose of providing them cash infusions. And now Obama wants to 'put people to work' on government infrastructure projects. He wants to 'modernize' school and federal buildings. He wants to invest in technologies to create 'green' jobs."

"How do you know it won't work?" he asked.

"Well, years into the Great Depression, FDR's secretary of the treasury, Henry Morgenthau, declared (quoted here verbatim): 'We have tried spending money. We are spending more than we have ever spent before and it does not work....We have never made good on our promises....I say after eight years of this Administration we have just as much unemployment as when we started...and an enormous debt to boot!'

"So this has been tried, and many economists believe that the spending, along with other dumb government actions, prolonged and possibly deepened the problems and certainly did not solve them."

"So what's the answer?" he asked.

"Well, back to my dad. Mind you, he does not read The Wall Street Journal or Investor's Business Daily or Forbes magazine. I recently asked him the same question.

"'It seems to me the government's just too d--- big,' said my Depression-era/World War II-veteran father. 'I'd let people keep their own money. They'll figure it out. They always do.'"

"But," I repeated, "Obama certainly is likable."

CREATORS SYNDICATE COPYRIGHT 2008 LAURENCE A. ELDER

Told Ya to Get Ready For This

2008-12-02T07:51:00.002-06:00

Found the following article over at The Physicians Foundation web site. Everything they say here is also true about Oncology, Hematology and probably most non-procedure oriented specialties.

National Survey Finds Numerous Problems Facing Primary Care Doctors, Predicts Escalating Shortage Ahead

November 18, 2008

BOSTON–A survey released today by The Physicians’ Foundation depicts widespread frustration and concern among primary care physicians nationwide, which could lead to a dramatic decrease in practicing doctors in the near future. The survey examined the causes behind the doctors’ dissatisfaction, the state of their practices and the future of care. The resulting findings show the possibility of significantly decreased access for Americans in the years ahead, as many doctors are forced to reduce the number of patients they see or quit the practice of medicine outright.

An overwhelming majority – 78 percent – of physicians believe that there is an existing shortage of primary care doctors in the United States today. Additionally, nearly half of them – 49 percent, or more than 150,000 practicing doctors– say that over the next three years they plan to reduce the number of patients they see or stop practicing entirely.

“Going into this project we generally knew about the shortage of physicians; what we didn’t know is how much worse it could get over the next few years,” said Lou Goodman, PhD, President, The Physicians’ Foundation. “The bottom line is that the person you’ve known as your family doctor could be getting ready to disappear – and there might not be a replacement.”

The Physicians’ Foundation believes the future of primary care could have a significant impact on the American healthcare debate.

“At a time when the new Administration and new Congress are talking about ways to expand access to healthcare, the harsh reality is that there might not be enough doctors to handle the increased number of people who might want to see them if they get health insurance,” said Walker Ray, MD, Vice President, The Physicians’ Foundation. “It’s as if we’re talking about expanding access to higher education without having enough professors to handle the influx of students. It’s basic supply and demand.”

The reported reasons for the widespread frustration among physicians include increased time dealing with non-clinical paperwork, difficulty receiving reimbursement and burdensome government regulations. Physicians say these issues keep them from the most satisfying aspect of their job: patient relationships.

“Tens of thousands of primary care doctors face the same problems as millions of ordinary citizens: frustrations in dealing with HMOs and government red tape,” said Sandra Johnson, Board Member, The Physicians’ Foundation. “The thing we heard over and over again from the physicians was that they’re unhappy they can’t spend more time with their patients, which is why they went into primary care in the first place.”

The Right To Win

2008-11-25T08:55:00.000-06:00

by Thomas Sowell

Among the many new "rights" being conjured out of thin air, a new one seems to be a "right" to win.

Americans have long had the right to put their candidates and their ideas to a vote. Now there seems to be a sense that your rights have been trampled on if you don't win.

Hillary Clinton's supporters were not merely disappointed, but outraged, when she lost the Democrats' nomination to Barack Obama. Some took it as a sign that, while racial barriers had come down, the "glass ceiling" holding down women was still in place.

Apparently, if you don't win, somebody has put up a barrier or a ceiling. The more obvious explanation of the nomination outcome was that Obama ran a better campaign than Hillary. There is not the slightest reason to doubt that she would have been the nominee if the votes in the primaries had come out her way.

As the election approached, pundits warned that, if Obama lost, there would be riots in the ghetto. We will never know. But since when does any candidate have a right to win any office, much less the White House?

The worst of all the reactions from people who act as if they have a right to win have come from gay activists in the wake of voter rejection of so-called "gay marriage," which is to say, redefining what marriage has meant for centuries.

Blacks and Mormons have been the main targets of the gay activists' anger. Seventy percent of blacks voted against gay marriage in California, so racial epithets were hurled at blacks in Los Angeles -- not in black neighborhoods, by the way.

Blacks who just happened to be driving through Westwood, near UCLA, were accosted in their cars and, in addition to being denounced, were warned, "You better watch your back."

Even blacks who were carrying signs in favor of gay marriage were denounced with racial epithets.

In Michigan, an evangelical church service was invaded and disrupted by gay activists, who also set off a fire alarm, because evangelicals had dared to exercise their right to express their opinions at the polls.

In Oakland, California, a mob gathered outside a Mormon temple in such numbers that officials shut down a nearby freeway exit for more than three hours.

In their midst was a San Francisco supervisor who said "The Mormon church has had to rely on our tolerance in the past, to be able to express their beliefs." He added, "This is a huge mistake for them. It looks like they've forgotten some lessons."

Apparently Mormons don't have the same rights as other Americans, at least not if they don't vote the way gay activists want them to vote.

There was another gay activist mob gathered outside a Mormon temple in Orange County, California.

In the past, gay activists have disrupted Catholic services and their "gay pride" parades in San Francisco have crudely mocked nuns.

While demanding tolerance from others, gay activists apparently feel no need to show any themselves.

How did we get to this kind of situation?

With all the various groups who act as if they have a right to win, we got to the present situation over the years, going back to the 1960s, where the idea started gaining acceptance that people who felt aggrieved don't have to follow the rules or even the law.

"No justice, no peace!" was a slogan that found resonance.

Like so many slogans, it sounds good if you don't stop and think -- and awful if you do.

Almost by definition, everybody thinks their cause is just. Does that mean that nobody has to obey the rules? That is called anarchy.

Nobody is in favor of anarchy. But some people want everybody else to obey the rules, while they don't have to.

What they want is not decisive, however. It is what other people are willing to tolerate that determines how far any group can go.

When the majority of the people become like sheep, who will tolerate intolerance rather than make a fuss, then there is no limit to how far any group will go.

COPYRIGHT 2008 CREATORS SYNDICATE, INC.

Why Obama voters won't repeat their mistake

2008-11-17T09:02:00.000-06:00

Posted on WorldNetDaily on November 13, 2008

By Brad O'Leary
© 2008

While it's true that the Republican Party must do some soul-searching and needs to restore its commitment to limited government and traditional values that made it so successful in the past, the truth is, the future is not as bleak as advertised. The party is more in a state of recession than depression. A full analysis of the 2008 election bears this out.

America still center-right

In addition, a majority of Americans still support traditional American values. Initiatives to uphold traditional marriage were on the ballots in two states carried by President-elect Obama, California and Florida. In both states, voters passed measures to ban gay marriage.

In California, where Obama beat McCain 61 percent to 37 percent, "values voters" beat special interest voters 52.5 percent to 47.5 percent on the issue of same-sex marriage.

In Florida, another state won by Obama, the margin of victory for values voters was even more substantial – 62 percent of Floridians voted against gay marriage, while only 38 percent voted in favor. Many of these values voters who voted for Obama and against gay marriage will certainly be disappointed in Obama's presidency.

Likewise, when Obama and the Democratic Congress institute the "Freedom of Choice Act" and lift all state restrictions on abortion, how will the 49 percent of Catholics who attend church on a weekly basis feel about their vote for Obama?

Read stunning blueprint for upcoming White House agenda. Get Brad O'Leary's blockbuster, "The Audacity of Deceit," for just $4.95 today – a $21 savings!

How will the roughly 9.1 million evangelical Christians who voted for Obama vote in the next election? Will Obama's actions compel the 31.2 million evangelicals who didn't vote in the 2008 election to vote next time?

President-elect Obama deceived gun owners as well. In rural district after rural district, he aired commercials, dropped fliers and dispatched surrogates to dupe voters into believing he strongly supports the Second Amendment. Polls show that National Rifle Association members weren't fooled, but gun owners who didn't have access to the NRA's massive political communications system were duped. A full 37 percent of voters in gun-owning households pulled the lever for Obama, despite his long history of hostility toward gun owners. Another 80 million eligible voters in gun-owning households didn't vote at all, nor did 3 million union gun owners. Money buys deception, as Obama and his supporters easily outspent the NRA's political victory fund 20 to 1. And this doesn't count the money spent by union bosses to convince the 6.43 million gun owners within their ranks to vote for Obama. How will they vote next time, after witnessing President Obama's disdain for their right to hunt and their right to use a firearm for self-defense?

McCain was the candidate of special interests – or was he?

The notion that Obama's fundraising advantage was the result of a groundswell of donations from average Americans is a myth. Obama raised substantially more money from special interests than McCain during the campaign, according to Federal Election Commission data.

For example:

Obama had 66 percent more individual wealthy special-interest donors (donors who gave the maximum allowable contribution of $4,600) than McCain.
Lawyers and lobbyists gave 245 percent more to Obama than they gave to McCain.
The investment industry gave 59 percent more to Obama than McCain.
The banking and finance industries gave 19 percent more to Obama than McCain.
Labor unions gave 1,880 percent more to Obama than McCain.
The education industry gave 1,075 percent more to Obama than McCain.
The film and music industries gave 615 percent more to Obama than McCain.
The hedge fund industry gave 69 percent more to Obama than McCain.
The pharmaceutical industry gave 187 percent more to Obama than McCain.
The health care industry gave 98 percent more to Obama than McCain.

So much for Obama's campaign being fueled by "the little guy." In reality, he is more beholden than ever to special interests, as you can see from the groups listed above, which gave him a total of $148,932,012.

95 percent who are getting tax relief from Obama

Obama was also able to gain substantial support for his candidacy by running on an issue that Republicans used to own: tax cuts. The president-elect constantly repeated in the debates, and told anyone who would listen, that his economic plan would cut taxes for 95 percent of Americans.

This would equate to 274 million Americans receiving a tax cut. However, a true analysis of his tax plan shows that only 40 percent of Americans will actually get a tax cut. This means that 173 million Americans Obama told would get a tax cut won't get one. How do you think they will vote in the next election?

Additionally, when the 13 million wealthiest American taxpayers discover that $1 trillion of their hard-earned money will go to a U.N. welfare program and another trillion will go to tax credits for people with no income tax liability, how many of them will vote differently next time? How many of the 6 million wealthiest Americans who didn't vote will be motivated to do so in the next election?

The final numbers in perspective

In the end, McCain received 6.7 million more votes than George W. Bush received in 2000, 13.3 million more votes than Ronald Reagan received in 1980, and 2.7 million more than Reagan received in 1984.

Many Democrats projected they would gain 10 seats or more in the Senate. However, they managed only six and fell short of achieving a filibuster-proof 60-seat majority. (Three Senate seats are still technically undecided, however. Republicans lead in all three.) In the U.S. House of Representatives, Democrat projections of a 30-seat gain fell way short. As of this writing, they gained 20 seats (four elections are still too close to call, and Republicans are leading in three of them.)

For its part, the media breathlessly warned of nationwide voter problems due to unprecedented turnout. However, the percentage of eligible voters who turned out in 2008 was roughly the same as it was in 2004, and there was no substantial turnout of young voters. This is hardly the groundswell for which the Democrats had hoped.

Though the Democrats may call Obama's victory a landslide, the true margin of victory was about 1 million votes spread out over seven battleground states. Not quite as large as the Electoral College indicates. And, there were roughly 35 million eligible conservative voters who did not cast a ballot in this election. If just 1 million of these conservatives had turned out to vote in Ohio, Florida, Indiana, Colorado, Nevada, Virginia and North Carolina, McCain would have received 274 electoral votes and won the election.

So, yes, it is true that the Republican Party has some serious work ahead of it. Yet proper perspective indicates that it's a stock worth buying and all is not lost.

Brad O'Leary is the author of "The Audacity of Deceit: Barack Obama's War on American Values," which details President-elect Obama's plans for the next four years.

Thomas Sowell on Intellectuals

2008-11-16T13:45:00.000-06:00

Among the many wonders to be expected from an Obama administration, if Nicholas D. Kristof of the New York Times is to be believed, is ending "the anti-intellectualism that has long been a strain in American life."

He cited Adlai Stevenson, the suave and debonair governor of Illinois, who twice ran for president against Eisenhower in the 1950s, as an example of an intellectual in politics.

Intellectuals, according to Mr. Kristof, are people who are "interested in ideas and comfortable with complexity," people who "read the classics."

It is hard to know whether to laugh or cry.

Adlai Stevenson was certainly regarded as an intellectual by intellectuals in the 1950s. But, half a century later, facts paint a very different picture.

Historian Michael Beschloss, among others, has noted that Stevenson "could go quite happily for months or years without picking up a book." But Stevenson had the airs of an intellectual -- the form, rather than the substance.

What is more telling, form was enough to impress the intellectuals, not only then but even now, years after the facts have been revealed, though apparently not to Mr. Kristof.

That is one of many reasons why intellectuals are not taken as seriously by others as they take themselves.

As for reading the classics, President Harry Truman, whom no one thought of as an intellectual, was a voracious reader of heavyweight stuff like Thucydides and read Cicero in the original Latin. When Chief Justice Carl Vinson quoted in Latin, Truman was able to correct him.

Yet intellectuals tended to think of the unpretentious and plain-spoken Truman as little more than a country bumpkin.

Similarly, no one ever thought of President Calvin Coolidge as an intellectual. Yet Coolidge also read the classics in the White House. He read both Latin and Greek, and read Dante in the original Italian, since he spoke several languages. It was said that the taciturn Coolidge could be silent in five different languages.

The intellectual levels of politicians are just one of the many things that intellectuals have grossly misjudged for years on end.

During the 1930s, some of the leading intellectuals in America condemned our economic system and pointed to the centrally planned Soviet economy as a model -- all this at a time when literally millions of people were starving to death in the Soviet Union, from a famine in a country with some of the richest farmland in Europe and historically a large exporter of food.

New York Times Moscow correspondent Walter Duranty won a Pulitzer Prize for telling the intelligentsia what they wanted to hear -- that claims of starvation in the Ukraine were false.

After British journalist Malcolm Muggeridge reported from the Ukraine on the massive deaths from starvation there, he was ostracized after returning to England and unable to find a job.

More than half a century later, when the archives of the Soviet Union were finally opened up under Mikhail Gorbachev, it turned out that about six million people had died in that famine -- about the same number as the people killed in Hitler's Holocaust.

In the 1930s, it was the intellectuals who pooh-poohed the dangers from the rise of Hitler and urged Western disarmament.

It would be no feat to fill a big book with all the things on which intellectuals were grossly mistaken, just in the 20th century -- far more so than ordinary people.

History fully vindicates the late William F. Buckley's view that he would rather be ruled by people represented by the first 100 names in the Boston phone book than by the faculty of Harvard.

How have intellectuals managed to be so wrong, so often? By thinking that because they are knowledgeable -- or even expert -- within some narrow band out of the vast spectrum of human concerns, that makes them wise guides to the masses and to the rulers of the nation.

But the ignorance of Ph.D.s is still ignorance and high-IQ groupthink is still groupthink, which is the antithesis of real thinking.

The Baucus Health Care Proposal

2008-11-14T09:21:00.001-06:00

Here is a serious proposal to reform the heath care system in this country. This is the text from an Executive Summary released by Senator Max Baucus.

EXECUTIVE SUMMARY

The link between health care costs and the economy is undeniable. Reforming the health care system is essential to restoring America’s overall economy and the financial security
of our working families.

The case for reform is strong. The U.S. is the only developed country that does not guarantee health coverage for all its citizens, with 46 million uninsured and another 25 million underinsured. As a result, families are struggling to keep up with out-of-pocket costs for medical care. American businesses are straining to absorb rising health care
costs while staying competitive at home and around the world. Despite high levels of spending on health care, research documents poor quality of care received by patients in the U.S. Studies show, for example, that adults receive recommended care for many illnesses only 55 percent of the time. Children fare even worse.

Americans are acutely aware of problems in the country’s health care system, and they are ready for change. They are not alone. The nation’s health care stakeholders — consumers, businesses, labor, providers, plans, manufacturers, and state and local governments — are signaling that they are ready and willing to engage in serious and comprehensive reform of a health system in crisis. They recognize that the status quo of high costs, unacceptable numbers of the uninsured and underinsured Americans, and far less than optimal quality and value is unsustainable and intolerable. And, notably, the nation’s economists concur that system reform is not only necessary to rationalize our health care system, but to sustain our economy, our ability to compete internationally and, over the long haul, to deal with our long-term fiscal challenges.

A high-performing health care system would guarantee all Americans affordable, quality coverage no matter their age, health status, or medical history. Today, the costs of care for the uninsured are largely borne by those with insurance; providers charge higher prices to patients with private coverage to make up for uncompensated care, and these costs are passed on to consumers in the form of increased premiums. Requiring all Americans to have health insurance will help end the shifting of costs from the uninsured to the insured.

Covering all Americans would also ensure that the insurance market functions effectively. Insurance works because policyholders pay into their plans when healthy, and have their medical bills paid when they are sick. If a significant portion of Americans does not purchase coverage until sick, then premiums for all enrollees will increase to cover insurer outlays, and the problem of unaffordable coverage will persist.

Finally, covering all Americans is essential to effective prevention and wellness efforts and managing chronic illnesses. Efforts to guard against and better manage illness are an
effective tool to improve health and contain costs but, without every American in the
system, those efforts will fall short of their full potential.

In a high-performing health care system, employers, individuals, health providers and plans, as well as government would all bear responsibility and contribute to fulfilling the goal of covering all Americans. Wellness and prevention would be prioritized. And increased quality would result in lower costs so that employers could afford to continue to offer health coverage and still compete in a global marketplace. Our public health programs would be on a more fiscally sustainable path. Ensuring that every American has coverage would make health care truly portable, so that Americans are no longer locked into a job based on a need to retain their health coverage. This Call to Action outlines a vision for creating that high-performing health care system.

Like a sturdy stool, the Call to Action has three equally important legs: (1) a policy that ensures meaningful coverage and care to all Americans; (2) an insistence that any such expansion be coupled with an emphasis on higher quality, greater value, and — over time — less costly care; and (3) an absolute commitment to weed out waste, eliminate overpayments, and design a sustainable financing system that works for taxpayers as well as for the nation’s recipients and providers of health care.

Ensuring Health Coverage for All Americans. The Baucus plan would ensure that every individual can access affordable coverage by creating a nationwide insurance pool called the Health Insurance Exchange. Those who already have health coverage could keep what they have. But for those who need affordable, guaranteed coverage, the Exchange would be a marketplace where Americans could easily compare and purchase the plans of their choice. Private insurers offering coverage through the Exchange would be precluded from discrimination based on pre-existing conditions. Premium subsidies would be available to qualifying families and small businesses. By making health care more affordable and universally available to all Americans, the Baucus plan would take a major step toward eliminating racial and ethnic health disparities.

While the Exchange is being created, the Baucus plan would make health care coverage immediately available to Americans aged 55 to 64 through a Medicare buy-in, and it would begin to phase-out the current two-year waiting period for Medicare coverage for individuals with disabilities. The plan would provide every American living below the poverty level with access to Medicaid. This policy is consistent with the original intent of Medicaid, and it is the quickest and most cost-effective way to cover every American living in poverty. The Baucus plan would also ensure that all states use the State Children’s Health Insurance Program (CHIP) to cover children at or below 250 percent of the Federal poverty level, putting help within reach for more needy children. Finally, recognizing that America cannot keep its promise to provide care to Native Americans and Alaska Natives with the current level of Indian Health Service (IHS) funding, the Baucus plan calls for additional funding for IHS.

Once affordable, high-quality, and meaningful health insurance options are available to all Americans through their employers or through the Exchange, individuals would have a responsibility to have health coverage. This step is necessary for insurance market reforms to function properly and to end the cost shifting that occurs within the system. It is expected that the vast majority of American employers would continue to provide coverage as a competitive benefit to attract employees. Except for small firms, employers that choose otherwise must contribute to a fund that would help cover those who remain uninsured.

The Baucus plan would immediately refocus our health care system toward prevention and wellness, rather than on illness and treatment. Those who are uninsured -- and therefore less likely to receive preventive care and treatment for major conditions -- would be given a “RightChoices” card that guarantees access to recommended preventive care, including services like a health risk assessment, physical exam, immunizations, and age and gender-appropriate cancer screenings recommended by the U.S. Preventive Services Task Force. Individuals without private coverage and not eligible or enrolled in a public health coverage program, but whose RightChoices screening detected and diagnosed one or more of the most common, costly chronic conditions, would qualify to receive treatment on a temporary basis until viable coverage options are available under the Health Insurance Exchange. Current Medicare, Medicaid, and CHIP beneficiaries would receive recommended preventive services with little or no co-payment. Preventive services would be covered by all insurance options offered through the Health Insurance Exchange.

Improving Health Care Quality and Value. Recognizing that any attempt to cover the uninsured and reduce health care spending must address the perverse incentives fostered by current payment systems, the Baucus plan includes delivery system reforms that would improve quality and, over time, lower costs. The plan strengthens the role of primary care and chronic care management. Primary care is the keystone of a high-performing health care system. Increasing the supply and availability of primary care practitioners by improving the value placed on their work is a necessary step toward meaningful reform.

The plan would refocus payment incentives toward quality and value. Today’s payment systems reward providers for delivering more care rather than better care. A redefined health system would realign payment incentives toward improving the quality of care delivered to patients. Fixing the unstable and unsustainable Medicare physician payment formula is a necessary step in this process. The plan would promote accountability and coordination among providers by encouraging providers in different settings — physician offices, inpatient hospitals, post-acute care settings, and others — to collaborate and provide patient-centered care in a way that would improve quality and save money.

To facilitate the proposed delivery system reforms, the Baucus plan would improve the health care infrastructure by investing in new comparative effectiveness research and health information technology (IT). Health IT is needed for quality reporting and improvement and to give providers ready access to better evidence and other clinical decision-support tools. Reinvesting in the training of a twenty-first century health care workforce is necessary for many delivery system reform goals to be realized.

Achieving Greater Efficiency and Sustainable Financing. The U.S. spends $2.3 trillion per year on health care, and economists warn that rising health care costs represent a serious threat to our long-term fiscal security. According to the Congressional Budget Office, up to one-third of that spending — more than $700 billion — does not improve Americans’ health outcomes. Excess spending must be eliminated and dollars put to better use, not only to correct the imbalances of the current health care system, but to offset the high costs of much-needed comprehensive reform.

Beyond measures to refocus the system on primary care, reward quality care, and invest in critical research and technology, the Baucus plan would endorse direct steps in five additional areas to curb excess health care spending. The plan would invest more to detect and eliminate fraud, waste, and abuse in public programs. The plan would address overpayments to private insurers in the Medicare Advantage program. The plan would increase transparency of cost and quality information and would require disclosure of payments and incentives to providers by drug or device makers that may lead to biased decision-making. The plan also considers careful reforms of medical malpractice laws that could lower administrative costs and health spending throughout the system, while ensuring that injured patients are compensated fairly for their losses.

Long-term care services and supports are both a significant share of national health expenditures and a driver of cost. Considering policies to shift the focus from institutional care to services provided in the home and community could improve the quality of care delivered and reduce costs. Finally, the plan would explore targeted reforms of the tax code to make incentives more efficient, distribute benefits more fairly, and promote smarter spending of health care dollars by consumers themselves.

Conclusion. I believe it is the duty of the next Congress to reform America’s health care system. In 2009, Congress must take up and act on meaningful health reform legislation that achieves coverage for all Americans while also addressing the underlying problems in our health system. The urgency of this task has become undeniable.

In the short term, health care reform would cost taxpayers more than the government can achieve in savings from all reforms and financing changes. Congressional leaders and the public must be realistic about the timeframe in which the fiscal success of reform is measured. If we fail to act, however, we will double our current national expenditure on health care from $2 trillion to $4 trillion, continue to witness the plight of tens of millions of our citizens without health insurance cost shifting to those who do, continue to tolerate poor quality that leads to nearly 100,000 deaths a year, and watch our businesses become less competitive and our nation go further into debt. In short, we all must realize that the costs of inaction, both in human and financial terms, will eventually be far greater than any initial outlays. We must choose to invest now in a health care system that will richly repay the nation with greater health and economic stability in the long term.

The 'Noah Covenant' With Mankind

2008-11-13T09:42:00.004-06:00

by Rabbi Dr. Shlomo Riskin

Posted on Israel National News
Cheshvan 2, 5769 (31 October 08 03:22)

Everyone Doesn't Have to be Jewish

Is Judaism a universal religion, with a message for all of humanity, or a national religion, with a message specifically for Jews?

Unlike surviving records of the ancient world, our Bible opens with a universal sweep, introducing G-d as the Creator of the universe, not just of a local area, and the Torah insists that every human being - not just Jew or Israelite - is created in His Divine image: "In the beginning G-d created the heavens and the earth" (Genesis 1:1); "and G-d created the human being (Adam) in His image, in the image of G-d created He him, male and female created He them." (Genesis 1:27)

Adam, the first human being, was then placed in the Garden of Eden and given one commandment - not to eat of the fruit of the tree of knowledge of good and evil, leaving the judgment of what is good and what is evil to G-d's objective decision, rather than to the subjective desire of the individual. Had Adam and Eve obeyed the Divine command, this world would have merged with the eternal world, and Eden would have remained the human universe. Alas, Adam failed and humanity was banished from the perfectly harmonious haven called Eden.

Exiled from an eternal life in close proximity to G-d, the ten generations that follow Adam descend into an even deeper depravity. The final result is that G-d recants having created humanity and decides to destroy the world with a flood.

Our Biblical portion opens with the one righteous individual who, together with his family and representative creatures of the Earth, was deemed worthy of rescue from the deluge: Noah, effectively a second Adam. Through Noah, G-d gives humanity a second chance to redeem itself. He blesses Noah with the same blessing He initially bestowed upon Adam, "Be fruitful, multiply and fill the earth...." (Genesis 1:28; Gen 9:1), granting Noah the same dominion over the animal world He had granted Adam. The Almighty goes even one step further: unlike Adam and Eve who were required to eat a vegetarian diet exclusively, G-d permits Noah to express his mastery by being permitted to eat all living creatures.

But G-d gives Noah two additional commandments, very different from the command given to Adam in the Garden: He forbids Noah to eat the flesh or the blood of a living animal, and He forbids Noah to carry out self-murder (suicide), or the taking of any human life, "since G-d created the human being in His Divine image." (Genesis 9:4-6)

The sages of the Talmud add five more Noahide laws: prohibitions against stealing, against adultery (including sexual transgressions such as rape and incest), against blaspheming G-d, and against idolatry, as well as the positive directive to establish Courts of Law to see to it that these six commandments are adhered to (Babylonian Talmud, Sanhedrin 56).

At this point in the Biblical text, G-d establishes His first covenant with all of humanity. G-d pledges that "never again will all flesh be destroyed by a flood," and the sign of this Divine Covenant is indelibly embedded within nature by the formation of the rainbow in the heavens, often appearing in the sky after a rainfall (Genesis 9:11-16).

The 12th-century Biblical commentary by Ramban (Nahmanides) has a striking explanation for the symbol of the rainbow: ancient cultures fought their wars with the bow and arrow, and the side which surrendered, pursuing peace instead of war, would express their will to do so by raising an inverted bow that the enemy could see. Similarly, G-d places an inverted bow in the heavens as a sign that He is no longer warring against humanity.

In the 19th century, Rabbi Samson Raphael Hirsch suggested an even deeper meaning to the rainbow's symbolism. When we look upon the glorious colors of the rainbow, we are dazzled by the red, orange, yellow, green, blue indigo and violet. In truth, however, these colors only appear to be different hues and shades; they are all light refractions of white, the one true base of all of them. So, too, with the cosmos of humanity; so many peoples of different colors and diverse ethnic backgrounds, all emanating from the "womb" of the one G-d who created them, who all are united by the spark of the Divine which gives them life.

Whatever the symbolism, it's clear that the rainbow is a half-picture, lacking a second half to complete the circle of wholeness. G-d can pledge not to destroy humanity, but since He created humanity with freedom of choice, He cannot guarantee that humanity will not destroy itself, especially in our global village when a mad Ahmadinejad publicly and unashamedly threatens the stability of the world by seeking the destruction of the Jewish nation. Much of the world looks on quietly, acquiescently, even investing in Iranian oil, thereby speeding up the process of Iran mastering nuclear power; a nightmarish prospect as we watch Ahmadinejad's trigger finger inch its way toward The Button.

That is why G-d's half-circle bow must be predicated upon humanity's acceptance of the seven Noahide laws of morality which precede it, even, at least, the prohibition against murdering innocent people. For the world to endure, everyone need not be Jewish, but everyone must be moral. Human life must be seen as sacred and inviolable.

If this interpretation is correct, then it means that, at the very least, the Noahide laws must be disseminated throughout the world. Tragically, Noah failed; at the end of his life he falls prey to alcoholism, and the ten generations which follow were again filled with debauchery and depravity. G-d is true to His world; He destroys the especially wicked cities of Sodom and Gomorrah, but preserves the world intact.

Finally, there is a third attempt to bring about redemption, this time through Abraham, the first Hebrew-Israelite Jew, establishing a covenant with him and his descendants; eventually charging those descendants with 613 commandments in order to forge them into a "holy nation and a kingdom of priest-teachers (to the world)." G-d guarantees that Abraham's progeny will never be destroyed and that - from the backdrop of their land of Israel and Jerusalem - the world will learn to accept a G-d of love, morality and peace.

G-d's initial charge to Abraham includes this Jewish mission to the world: "I will make you a great nation.... I will bless those who bless you and those who curse you, I shall curse; and all the families of the Earth shall be blessed through you." (Genesis 12: 2,3)

Maimonides, the greatest Jewish legalist-philosopher in history, codifies the Jewish mission to the world: "Moses is to bequeath the 613 commandments only to the Israelites, as it is written, 'a heritage for the congregation of Jacob' (Deuteronomy 33:4), but similarly (and of equal importance) did the Almighty command Moses (to teach and if necessary to enforce) all of the Noahide commandments to all of humanity...." ("Laws of Kings", 8,10)

Yes, humanity doesn't have to be Jewish, but it must be moral for a free world to endure.

© Copyright IsraelNationalNews.com www.IsraelNationalNews.com

Can We Question God?

2008-11-12T07:55:00.004-06:00

From Albert Mohler's blog:

A recent caller to my radio program raised an issue of obvious personal urgency. He explained that he and his wife had recently experienced the death of a young child. He spoke of his faith in Christ and of his desire to be obedient. "But, can we question God?," he asked.

Of all possible tragedies, the death of a child is singularly horrific. The caller did not relate details of this tragedy, but we all heard enough to feel the unspeakable grief experienced by this young Christian couple. Do they have a right to question God?

It seems to me that the answer is both yes and no. Beginning with the biblical affirmation that God is omnipotent and omniscient, sovereign and ever-reigning, we start with the understanding that whatever comes to pass does so by the express command, ordination, or permission of the Father. Thus, the Creator is at all times responsible for his creation -- and for his creatures.

So, is it legitimate to question God?

Perhaps we should consider how God has revealed himself to us as Father. Considering a human father for a moment, we can recognize two different ways of questioning his ways. The first way would be to rest secure in his love and fatherly care, but to express confusion over his ways. Even the most faithful and trusting children wonder about their parents at times. What are they up to? Why did they make that decision rather than the other? What was the purpose of that action? As close as childrne are to parents, parents often perplex children by acting like adults. In this mode of questioning, the child never questions the father's love and faithful disposition, but does admit confusion -- and perhaps even disappointment.

The other way of questioning a human father is to question his character, his faithfulness, or the authenticity of his love. This is an altogether different mode of questioning. In this second pattern of questioning, the child questions the father's heart, not merely his actions and ways.

Now, move from considering these two different modes of questioning a human father to a parallel set of approaches to questioning our heavenly Father. It is not unfaithful to admit and to articulate a sense of perplexity and pain in observing the ways of God. There are times when we cannot offer an explanation of God's ways. At times, we cannot even detect any possibility of a purpose. We can admit this to ourselves, to our brothers and sisters in Christ, and to our heavenly Father.

The other mode of questioning God, on the other hand, constitutes sin and implies unbelief. We cannot remain faithful and question God's own faithfulness. His love for those who are in Christ is beyond question. His character is a constant and his love never fails. He is not loving and gracious toward believers at one moment, only to turn into a malevolent deity the next. He never changes.

In this light, it would be sin to question God in this second sense -- the sense in which we might question whether God really loves us, or if He is really faithful to his promises. This is not the questioning worthy of a believer, but of an unbeliever.

In Numbers 23:19 we read: "God is not a man, that He should lie, or a son of man, that He should change his mind. Has he said, and will he not do it? Or has He spoken, and will he not fulfill it?" To question God's faithfulness is to assault his character. Finite human beings are incapable of understanding the wisdom of God, except when that wisdom is mediated to us through the miracle of revelation. We are not promised that all of our questions will be answered on earth.

We are promised, however, that on the Day of the Lord every believer's eyes will be dry, and every tear will be wiped away. We will understand all things in a transformed light. We will know in a fully revealed sense what it means when we are promised that nothing can separate us from the love of God. On that day will not be God's interrogators or questioners, but worshipers who will see him face to face.

Is it legitimate for a believer to question God? Yes and no. Even the Apostle Paul admitted to being perplexed [2 Corinthians 4:8], but by his own affirmation he was not crushed. We have no right to question the steadfast love of God for us, however, because this insinuates that God is either unable or unwilling to keep his word. As the Bible reveals, He is neither unable or unwilling. He is ever faithful, even as his ways are "past finding out" [Romans 11:33].

One day, we will be beyond asking any questions about God's ways. Until then, it may help to remember that even the Apostle Paul was sometimes perplexed. Perplexed, that is, but not unfaithful.

Letter From Chuck Norris to Obama

2008-11-10T07:56:00.003-06:00

Saw the following letter today on WorldNetDaily:

Dear President-elect Obama:

First, congratulations on your victory. The historical magnitude of your presidential win is nothing short of stupendous and a colossal fulfillment of the American dream (an achievement embedded long ago in the equality clauses of the Declaration of Independence). Your life has served and will serve as an example to countless millions, and I pray that you will live up to that honorable position and responsibility.

Now that Democrats have a virtual monopoly over our land, with control of the White House, both houses of Congress, a majority of gubernatorial positions, state legislatures, the courts, the news media, the unions and the entertainment and educational fields, it would be relatively easy for you to rule as king, casting liberal edicts in any direction. But now will come your biggest test: Will you be able to lead the other half of the country that doesn't agree with your vision, views and policies?

It's no big surprise that I don't see politically eye-to-eye with you. Actually, I stand in stark opposition to most of your politics. Still, even in our differences, I realize that we must learn to work together if we are to see our country get back on track. After Election Day, I asked myself, despite the outcome, how can I work for our new president to help better America? Then the thought occurred to me, the first question that should be answered is: How will you work for me? After all, it is "We, the People" of the Constitution for whom you are employed, correct?

So I outlined a few ways you might begin to gain the respect of those who oppose you and show that your campaign pledges to bridge the divides were not empty promises to get you into office. And these requests I make are based upon the inaugural oath you will make on Jan. 20, "I do solemnly swear that I will faithfully execute the office of president of the United States, and will to the best of my ability, preserve, protect and defend the Constitution of the United States." No doubt these won't be my only suggestions through the years, but they serve as a good beginning:

1. Use and cite the Constitution. If that constitutional oath ("preserve, protect and defend") is the central duty of your job description, then I would assume we will be hearing often from you about exactly how you are doing just that. There is no replacement for strict adherence, application and defense of the Constitution. And it's high time that presidents quit tritely reciting the presidential oath only to abandon its tenets when they enter the Oval Office. You should be publicly quoting from the Constitution as often as a preacher quotes the Bible to his congregation – at least weekly. If you take this oath and challenge seriously, you will limit the powers of federal government, reduce taxes (for everyone), encourage the freedom of religion and expression (even in the public square) and stand up for such things as our right to bear arms. The American public and the government has lost its grip on the content and role of the Constitution, and, if you daily choose, you can help to reeducate and model its usage for them.

2. Protect American life. Thomas Jefferson wrote in 1809, "The care of human life and happiness, and not their destruction, is the first and only legitimate object of good government." Those are powerful and enlightening words – "first and only legitimate object of good government." Of course, such a role was created and secured in the very fabric of our nation – in the Declaration of Independence. The commitment to protect life should serve as a basis to all you do, even as a foundation for your national defense strategy or to protect human life from the womb to the grave. I'm sure the first of your secret briefings this last week on our global security threats have opened your eyes some to the extensive onslaught of our enemies. Don't allow your pride, partisanship, personal bias or political abilities to ever jeopardize the safety of Americans lives. As commander in chief, you are called to preserve American life. Quite frankly, that is why I'm surprised that a man like you, who professes to fight for minorities, would not recognize the clear value of a human life in the womb. Federal law should not edict the sacrifice of one human life for the preference of another. Both lives should be protected. Otherwise what do Jefferson's 1809 words mean? As president, you are called to protect (not destroy) human life – it is the "first and only legitimate object of good government.

3. Learn from the mistakes of your Democratic predecessors. I'm referring specifically to presidents Carter and Clinton. Despite how many trumpet their accomplishments today, they learned big lessons at our expense about international diplomacy and economic recovery, Carter's diplomatic naïveté, combined with his overly altruistic belief that America's enemies can be won by a smile and handshake, ultimately gave rise to Ahmadinejad's Iranian regime. Furthermore, Carter's handling of our economic affairs also led to the highest interest, inflation and unemployment rates in history. You were only a young man, I realize, but I respectfully wonder if you know of those lessons, or might be doomed to repeat them? You can increase the taxes of individuals who make more than $200,000. You can impose the same on companies and corporations. But don't believe for a minute that they aren't even now making plans and moving their monies into overseas accounts. Any businessman knows that such tax increases will trickle down to employees, shareholders, consumers or further tempt them to take their productivity abroad where costs are lower. And what will be the effect on our economy? Isn't it obvious? And don't forget this: Bush is only partially to blame for our economic woes. Remember, it was the Clinton administration in 1999 that was the primary contributor to our Freddie Mac and Fannie Mae subprime fiasco (and subsequent Wall Street bailout need), by extending billions of mortgage loans to those who wouldn't or couldn't ever pay them back. Though gloating over his end-term budget surplus, Clinton paved the path through his government backing of millions of toxic mortgages to low income households – all of which would turn into gargantuan balloon payments years down the road that would bankrupt corporations and lead to our economic recession.

4. Lead more from the center. It's been pointed out by countless pundits. Your track record is clear. You have one of the most liberal records in the Senate. You've had the liberty of voting and fighting for an agenda "from the left," as you've tried to persuade state and congressional constituents to do the same. But if you continue to lead our country down a more liberal road, you will follow the peril of Clinton as well. He stepped into office and initially tried to lift the ban on gays in the military and extend abortion rights, only to prompt the creation of a more-balanced and strong Republican Congress in the 1990s. Don't underestimate the resurrecting power of the conservative voice. You observed in Tuesday's election how three states across this union voted to protect marriage in their constitutions (the 28th, 29th and 30th states to do so – California, Arizona and Florida). We will be watching how you lead Pelosi and Reid. We will be observing those you select as candidates for Supreme Court justices. The election is over. No more promises. No more words. You might work well in a team, but this time you don't have congressional members to hide behind. You're on your own – leading the pack – and the whole country is watching. Especially me. So make sure you lead more from the center.

There is one thing I will be specifically doing for you, as you carry the weight to lead our nation. I will be praying for you. As the scripture says, "I urge, then, first of all, that requests, prayers, intercession and thanksgiving be made for everyone – for kings and all those in authority, that we may live peaceful and quiet lives in all godliness and holiness." You have my word – I'll be praying.

One of your 300 million bosses,

Chuck Norris

Can We Trust the Polls?

2008-10-30T11:18:00.005-05:00

Just wondering:

Are the pollsters also talking to representative samples of all the dead, fictitious and disqualified people who have already voted or who are planning to vote in this election?

Corollary:

Will the dead voters still be eligible for the incipient government health care plan?

Obama's Gun History

2008-10-25T09:07:00.003-05:00

Illinois State Rifle Association Executive Director Richard Pearson Issues Open Letter to Nation's Sportsmen Regarding Obama's History in the Illinois Senate

    CHICAGO, Oct. 15 /PRNewswire-USNewswire/ -- The following is the text
of an open letter to the nation's hunters and sportsmen issued today by
Illinois State Rifle Association Executive Director Richard Pearson:

 Fellow Sportsman,

 Hello, my name is Rich Pearson and I have been active in the firearm
rights movement for over 40 years. For the past 15 years, I have served in
the Illinois state capitol as the chief lobbyist for the Illinois State
Rifle Association.

 I lobbied Barack Obama extensively while he was an Illinois State
Senator. As a result of that experience, I know Obama's attitudes toward
guns and gun owners better than anyone. The truth be told, in all my years
in the Capitol I have never met a legislator who harbors more contempt for
the law-abiding firearm owner than does Barack Obama.

 Although Obama claims to be an advocate for the 2nd Amendment, his
voting record in the Illinois Senate paints a very different picture. While
a state senator, Obama voted for a bill that would ban nearly every hunting
rifle, shotgun and target rifle owned by Illinois citizens. That same bill
would authorize the state police to raid homes of gun owners to forcibly
confiscate banned guns. Obama supported a bill that would shut down
law-abiding firearm manufacturers including Springfield Armory, Armalite,
Rock River Arms and Les Baer. Obama also voted for a bill that would
prohibit law-abiding citizens from purchasing more than one gun per month.

 Without a doubt, Barack Obama has proven himself to be an enemy of the
law abiding firearm owner. At the same time, Obama has proven himself to be
a friend to the hardened criminal. While a state senator, Obama voted 4
times against legislation that would allow a homeowner to use a firearm in
defense of home and family.

 Does Barack Obama still sound to you like a "friend" of the law-abiding
gun owner?

 And speaking of friends, you can always tell a person by the company
they keep. Obama counts among his friends the Rev. Michael Pfleger - a
renegade Chicago priest who has openly called for the murder of gun shop
owners and pro-gun legislators. Then there is his buddy Richard Daley, the
mayor of Chicago who has declared that if it were up to him, nobody would
be allowed to own a gun. And let's not forget Obama's pal George Soros -
the guy who has pumped millions of dollars into the UN's international
effort to disarm law-abiding citizens.

 Obama has shown that he is more than willing to use other people's
money to fund his campaign to take your guns away from you. While a board
member of the leftist Joyce Foundation, Barack Obama wrote checks for tens
of millions of dollars to extremist gun control organizations such as the
Illinois Council Against Handgun Violence and the Violence Policy Center.

 Does Barack Obama still sound to you like a "friend" of the law-abiding
gun owner?

 By now, I'm sure that many of you have received mailings from an
organization called "American Hunters and Shooters Association(AHSA)"
talking about what a swell fellow Obama is and how he honors the 2nd
Amendment and how you will never have to worry about Obama coming to take
your guns. Let me make it perfectly clear - everything the AHSA says about
Obama is pure hogwash. The AHSA is headed by a group of left-wing elitists
who subscribe to the British view of hunting and shooting. That is, a state
of affairs where hunting and shooting are reserved for the wealthy
upper-crust who can afford guided hunts on exclusive private reserves. The
AHSA is not your friend, never will be.

 In closing, I'd like to remind you that I'm a guy who has actually gone
nose to nose with Obama on gun rights issues. The Obama I know cannot even
begin to identify with this nation's outdoor traditions. The Obama I know
sees you, the law abiding gun owner, as nothing but a low-class lummox who
is easily swayed by the flash of a smile and a ration of rosy rhetoric. The
Obama I know is a stony-faced liar who has honed his skill at getting what
he wants - so long as people are willing to give it to him.

 That's the Barack Obama I know.

 The ISRA is the state's leading advocate of safe, lawful and
responsible firearms ownership. Founded in 1903, the ISRA has represented
the interests of millions of law-abiding Illinois firearm owners.

 WEB SITE: http://www.isra.org

SOURCE Illinois State Rifle Association

Aspirin and Decompression Sickness

2008-10-15T17:48:00.004-05:00

Sorry, been busy lately.

Some of you divers in the family may be interested in this response that I posted on ScubaBoard today. It is in answer to a question about aspirin and diving and the various responses that followed in the Diving Medicine Forum.

Where is Eichmann Now?

2008-10-05T08:00:00.005-05:00

We were in Israel, standing beside the Dead Sea, waiting for the wives to meet us for a swim. Ari Abramowitz (pictured here), had many questions about Christianity. This one was particularly provocative.

I'm sure my readers know Adolph Eichmann as the Nazi who is sometimes called "the orchestrator of the Holocaust." After World War II, he managed to escape from the Allies and eventually made his way to Argentina where he changed his name and went to work as a manager in a Mercedes Benz factory.

The Israeli special force, Mossad, eventually tracked him down, kidnapped him, and transported him back to Israel to stand trial for his crimes. This event has been depicted in a movie, The House on Geribaldi Street. Eichmann was tried in Jerusalem, found guilty, and hanged on May 31, 1962. He was the only war criminal to be tried in the land of Israel, and the only person executed by the state.

That part of the story is common knowledge. But Ari wondered about the following.

According to Ari, after his conviction and prior to his execution, Eichmann asked to see a priest. The priest visited Eichmann in his cell. When he came out, reporters asked the priest what had happened. The priest answered that Eichmann had confessed his sins, asked for forgiveness, and would now be ready to meet God in Heaven.

Shocked, the reporters asked, "And what happened to the millions of Jews that he had murdered? Did they go to Hell because they did not believe in Jesus?" Reportedly, the Priest replied, "Yes."

Ari asked if the priest was right, and do Christians agree with this?

I thought for a moment and said to Ari, "You will find many Christians who will agree with the priest."

Do you?

(By the way, see the necklace around Ari's neck? It now hangs around mine.)

Shrinking Oncologists

2008-09-27T08:00:00.001-05:00

Although earlier diagnosis of certain malignancies, new treatments and improved survival rates are good news for those with cancer today, tomorrow's patients may be left to flounder. The interface between new discoveries and what it costs to provide them may be taking us one step forward and two steps backwards.

According to a recent report by the American Society for Clinical Oncology (ASCO), by 2020 the United States could face a shortage of as many as 4,080 cancer doctors.

Explanations for the shortfall include the growing number of Americans 65 or older, a population which is expected to double between 2000 and 2030. Cancer is more common among seniors, so as their number increases, the number of cancer cases will, too.

Not only are the patients getting older, but so are their doctors. The average age of oncologists in many communities is in the mid-50's or early 60's. These are doctors who will be retiring soon, especially if third parties insist on hassling these physicians with more duties, more paperwork, more malpractice risk, more certification requirements, and less reward.

Increasing patient demand in the face of decreasing doctor supply is not a healthy combination.

Another interesting (and politically incorrect) factor contributing to the looming oncologist shortage is the growing number of female oncologists. Although the medical profession applauds the improved gender balance among oncologists, studies have found that women oncologists tend to see fewer patients than do their male counterparts. The reason is not clear. Some women may work fewer hours because of family obligations, or they may spend more time with their patients than men do. Patients may like having a doctor spend more time with them, but they won't like it if it means it will be harder to get the appointment in the first place.

In anticipation of the expected shortage, some are now wondering whether cancer patients really need to be cared for solely and continuously by cancer specialists. While I have argued that a good primary care physician can screen for recurrence as well as an oncologist, the fact is that many primary care doctors do not seem interested in or comfortable with that idea. Could that be because they fear being sued for "failure to diagnose" the recurrence? Even though there is insufficient evidence to prove that earlier detection of recurrent, metastatic cancer makes any difference in survival, try explaining that to a patient. Consequently, "failure to diagnose" is the most common reason that primary doctors get sued. It probably doesn't matter, though, because the supply of primary care doctors is shrinking rapidly, too!

Like it or not, physician extenders may have to be the answer. In a growing number of clinics, nurse practitioners are being called upon to take over the less complicated aspects of cancer care. So far, patients seem a little slow to accept this. They want to see their doctor, not a substitute.

For people my age, this is not good news. I mean, when I retire, who will take care of me?

I'm not optimistic that the government can fix this problem, either. You can force doctors to work for less, but you cannot force smart, young people to become doctors. And it is even harder to convince young doctors to go into a field that focuses on death, pain and anxiety. Why do that when they can find happier lines of work such as delivering babies, removing wrinkles, or helping people to see without glasses or contacts?

As I said the other day, it is going to be a rough ride.

.

Problem Solving

2008-09-23T08:00:00.001-05:00

It is easy to think that problem solving is something that comes naturally. After all, everyone solves problems on one level or another all the time.

And yet, it is this universal confrontation with problems which deludes us into thinking we can solve most problems without effort. No need to apply any rules; no need to work through it in an orderly fashion. Just go with one's intuition or instinct. Fortunately, such "shooting from the hip" often works, but this only reinforces our belief that we are so adept at this that we always instinctively know what to do.

Someone has said that the definition of insanity is to keep trying the same thing over and over again while expecting different results. Such as flipping a two-headed coin again and again, hoping it will come up tails! Or repeatedly falling in love with alcoholics, hoping that this time, this one will not become abusive, leading to another divorce. Or continuing to take increasingly toxic chemotherapy when the first two regimens did nothing, hoping that the miracle will come through the less effective agents.

Trying to solve problems "by feel" can be dangerous when overwhelmed by conflicting and distracting emotions. Therefore, when confronted with a problem that proves to be a little more complicated or resistant to "gut feel" solutions, it may help to apply the following steps:

Determine the precise problem. Not always easy to do. Sometimes the things that we perceive as problems are really only symptoms of a more basic problem. If there appears to be more than one problem at a time, ask whether there could be a single, underlying problem which is causing those which are more obvious?
Inventory your resources. Once you have identified the problem, think about what talents you have, what skills, and what tools or other resources lie at your disposal.
Make a list of available options. Think about all the different things you could try. While brainstorming, it is helpful to "think outside the box," but it is also wise to consider the tried-and-true options as well.
Choose the best one and implement it.
Assess and adjust. After enough time has passed to fairly evaluate the response to your choice of action, you need to decide whether you have done enough, whether you need to keep doing more of the same, or whether you need to try something different.

What I see too often is that people skip steps 1 and 2, saying, "Well, let's just try this and see what happens." They compose a short list of options in their heads, pick one, then hope it works out. If they are lucky, their choice may work. But if they are like most people, this approach will lead to lots of wasted time going in circles. What circles? Steps 3 through 5: They say, "Well, that didn't work," but then skip back to step 3 again, hoping they will get it right this time around.

Another common mistake is to rush step 5. That is, deciding too quickly that the solution you tried has not worked. We want instant results, but sometimes even the right answer will take time to come to fruition.

So if you find yourself frustrated by an inability to deal with the same problems over and over again, make sure you are addressing the correct problem. Make sure you have considered every option based upon your list of talents and circumstances. Be certain you have fully applied your efforts towards implementing a solution. Finally, give it time to work.

Government Medicine

2008-09-22T09:26:00.004-05:00

The newspaper had an article this week about how the hospitals lose money whenever they have to take care of Medicare patients.

This is news?

I have been saying this for years now, as have most other health care providers. Not only is this true for the hospitals, but it is true for physicians who see Medicare patients in their offices.

If this is the way the government-controlled health care works, what can we expect when everyone is on Medicare?

People claim we have a problem with access to health care in this country. The government's answer is to squeeze the hospitals and doctors even harder, forcing them to become "more efficient."

The problem is that many providers cannot become any more efficient. They will simply go out of business. How does that help solve the access problem?

This is going to be a very rough ride, folks.

Israel Photos

2008-09-12T15:56:00.002-05:00

Israel photos are online here.

I hope someday to get time to tell the stories behind them.

Ari and Jeremy in the Jerusalem Post

2008-09-02T11:47:00.004-05:00

There is a nice article in today's Jerusalem Post about Ari and Jeremy and their TV show, Tuesday Night Live.

These are the two young men, along with their family and friends, who showed us around Israel. I can personally vouch for their sincerity, passion and love for the G-d and the Land of Israel.

You can read more by clicking here.

Israel

2008-08-31T16:36:00.005-05:00

The trip to Israel was life-changing. Traveling with Israeli's who were on vacation, we enjoyed many adventures that are not included on most tours.

Such as heading way beyond the Green Line into Samaria and Shechem, and visiting settlers in Hebron where Arab snipers have shot Jewish babies in the head while they rested in their father's arms.

We toured the Temple Mount as Jews, and we experienced the discrimination and harassment that religious Jews must endure.

If time allows, I will share pictures and stories. But in the meantime, let me tell you that you may as well not even pay any attention to the news reports in this country. We visited the communities that Secretary Rice wants to destroy. We visited with the people who are putting their lives on the line every day for their faith.

You cannot see such things and still be the same person. So, God willing, more will follow later on.

Gun Quote

2008-08-15T07:35:00.002-05:00

The only thing that stops a bad guy with a gun is a good guy with a gun.

Wisdom

2008-08-03T16:03:00.002-05:00

The most concise definition of wisdom that I have seen comes from the Talmud:

Who is wise? The man who can foresee the consequences of his actions.

Universal Health Care: The Cost

2008-08-01T13:56:00.006-05:00

Everyone wants the best medical care available.

Not everyone cannot afford the best medical care available.

If those who cannot afford the best medical care available tax all the money from those who can afford the best medical care available, then no one will be able to afford the best medical care available.

Everyone will have equal care, but no one will have the best care.

Unless you are a politician who does not live by the rules that apply to everyone else.

Universal Health Care: First Taste

2008-07-23T08:15:00.006-05:00

I don't hear many Medicare recipients clamoring for universal health care. They are already on it. Most of those begging the government to step in are younger folks who have no real experience with government-run systems.

People should be careful what they ask for; they may get it. And Medicare patients are already getting a good taste of the future for everyone else.

The Center for Medicare and Medicaid Services (CMS), in its wisdom, has decided to severely restrict coverage for erythropoiesis stimulating agents (ESA's). This includes Epogen, Procrit, and Aranesp.

These drugs clearly work. Despite concerns about the possibility of causing blood clots and making cancers grow more, thousands of recipients have not experienced such problems, and their quality of life has been dramatically improved while taking chemotherapy that used to be disabling.

Patients on chemotherapy are not the only ones who have benefited from ESA's. Patients with myelodysplasia and other bone marrow disorders have been spared repeated transfusions and have enjoyed improved quality of life.

But CMS has decided that such therapy is too expensive, and they have put on the brakes.

They issued their decree a few months ago (see previous posts). There was an uproar from the scientific medical community, enough so that CMS hesitated. They left the decree in place, but allowed a period of comment. During the comment period, leading international hematology and oncology organizations weighed in alongside patients, individual physicians, and physician groups. Witnesses told stories about how ESA's had given them life-changing benefits, and researchers pointed out the weaknesses of the data CMS was using to sort of justify their decision to stop paying for these drugs.

No one denies that there were abuses of the drugs. However, such abuses were not usually motivated by profit, but were more often a reflection of ignorance about how and when to use these drugs. Accordingly, physicians suggested guidelines for the proper use of these agents.

It didn't make any difference. The government would not and still will not budge.

So now, when a doctor files a claim to be reimbursed for having given one of these drugs to a patient, he must now draw a CBC so that hemoglobin and hematocrit levels can be reported to Medicare. (How does requiring another lab draw save money?) And if Medicare sees that the hemoglobin is 10 gm/dL or higher, or if Medicare sees that the hematocrit is 30% or more, then they reject the claim.

Oh, sure, patients can agree to pay for the drugs out-of-pocket if they want, but at a couple of thousand bucks a pop, most cannot afford it. Neither can the doctors.

So, in effect, Medicare has removed these drugs from our cache of weapons against cancer and blood diseases. Sadly, the private insurance companies will be right on their heels.

I got annoyed when the makers of these drugs put ads on TV promoting them directly to patients. But now I think the companies should run TV ads telling everyone that the government has decided to deny patients access to them even though the agents have generally been found to be safe and effective for the majority of patients.

Government Rationing has begun. So much for them giving everyone better access to the best health care.

If you want to comment yourself, you are supposed to be able to do so at CMS's contact web site. However, as of yesterday, the link to comments was not working. Ironic, isn't it?

You can also call the Medicare hot line toll-free at 800-633-4227.

Our Israel Trip

2008-07-20T16:26:00.004-05:00

When we go to Israel, we will be staying and vacationing with Ari and Jeremy, the hosts of this show.

Below is the full 50 minute season finale. The first few minutes will give you a pretty good idea, though, of what these folks are about.

For more information, you can also visit their web site here.

Roatan Dive Photos

2008-07-06T08:20:00.003-05:00

Here are some photos from our trip to Roatan Island, Honduras.

We spent seven days at the Fantasy Island Dive Resort. In 6 days we got in 19 dives, including a night dive, 3 wreck dives (one at night), and lots of wall diving.

Most of the dives were from the dive boat. On a typical dive, we would drop into the water and descend to the bottom, usually between 20 and 35 feet. We'd gather, then swim off the edge of the reef, descending to around 60 feet along the wall. Sometimes we went deeper, but most of the good stuff to see was between 40 and 60 feet. When someone hit half a tank (1500 psi), we would turn the dive and come back along the wall towards the boat, then back up on top of the reef where we were allowed to play around until we used our air. Most of the dives ended up being about 50-60 minutes.

We used Nitrox 32% for all of our dives. That was the standard mix at the resort. We did not request anything different.

Sorry if the pictures sort of fall outside the usual boundaries, but you can get a better view this way.

I left the captions off, but you can turn them on if you want to see what something was.

545 People

2008-07-04T09:00:00.000-05:00

A friend sent this clipping from an editorial by Charlie Reese in the Orlando Sentinel Newspaper.

Politicians are the only people in the world who create problems and then campaign against them.

Have you ever wondered why, if both the Democrats and the Republicans are against deficits, WHY do we have deficits?

Have you ever wondered why, if all the politicians are against inflation and high taxes, WHY do we have inflation and high taxes?

You and I don't propose a federal budget. The president does.

You and I don't have the Constitutional authority to vote on appropriations. The House of Representatives does.

You and I don't write the tax code, Congress does.

You and I don't set fiscal policy, Congress does.

You and I don't control monetary policy, the Federal Reserve Bank does.

One hundred senators, 435 congressmen, one president, and nine Supreme Court justices -- 545 human beings out of the 300 million in the United States -- are directly, legally, morally, and individually responsible for the domestic problems that plague this country.

I excluded the members of the Federal Reserve Board because that problem was created by the Congress. In 1913, Congress delegated its Constitutional duty to provide a sound currency to a federally chartered, but private, central bank.

I excluded all the special interests and lobbyists for a sound reason. They have no legal authority. They have no ability to coerce a senator, a congressman, or a president to do one cotton-picking thing. I don't care if they offer a politician $1 million dollars in cash. The politician has the power to accept or reject it. No matter what the lobbyist promises, it is the legislator's responsibility to determine how he votes.

Those 545 human beings spend much of their energy convincing you that what they did is not their fault. They cooperate in this common con game irrespective of party affiliation.

What separates a politician from a normal human being is an excessive amount of gall. No normal human being would have the gall of a Speaker, who stood up and criticized the President for creating deficits. The president can only propose a budget. He cannot force the Congress to accept it.

The Constitution, which is the supreme law of the land, gives sole responsibility to the House of Representatives for originating and approving appropriations and taxes. Who is the speaker of the House? She is the leader of the majority party. She and fellow House members, not the president, can approve any budget they want. If the president vetoes it, they can pass it over his veto if they agree to.

It seems inconceivable to me that a nation of 300 million cannot replace 545 people who stand convicted -- by present facts -- of incompetence and irresponsibility. I can't think of a single domestic problem that is not traceable directly to those 545 people. When you fully grasp the plain truth that 545 people exercise the power of the federal government, then it must follow that what exists is what they want to exist.

If the tax code is unfair, it's because they want it to be unfair.

If the budget is in the red, it's because they want it to be in the red.

If the Army & Marines are in IRAQ, it's because they want them in Iraq.

If they do not receive social security but are on an elite retirement plan not available to the common people, it's because they want it that way.

There are no insoluble government problems.

Do not let these 545 people shift the blame to bureaucrats, whom they hire and whose jobs they can abolish; to lobbyists, whose gifts and advice they can reject; to regulators, to whom they give the power to regulate and from whom they can take this power.

Above all, do not let them con you into the belief that there exists disembodied mystical forces like "the economy," "inflation," or "politics" that prevent them from doing what they take an oath to do.

Those 545 people, and they alone, are responsible.

They, and they alone, have the power.

They, and they alone, should be held accountable by the people who are their bosses -- provided the voters have the gumption to manage their own employees.

We should vote all of them out of office and clean up their mess!

Roatan

2008-07-03T08:34:00.004-05:00

We are back from our dive trip to Roatan, Honduras. It was a lot of fun, with great company and spectacular diving.

Pictured here is the Fantasy Island Resort where we stayed.

I'm working on photos now, and as soon as they are ready, I'll post them for viewing.

Obama on Guns

2008-06-29T15:56:00.000-05:00

The presidential primary season is finally over, and it is now time for gun owners to take a careful look at just where apparent nominee Barack Obama stands on issues related to the Second Amendment. During the primaries, Obama tried to hide behind vague statements of support for “sportsmen” or unfounded claims of general support for the right to keep and bear arms.

Print PDF version

But his real record, based on votes taken, political associations, and long standing positions, shows that Barack Obama is a serious threat to Second Amendment liberties. Don’t listen to his campaign rhetoric! Look instead to what he has said and done during his entire political career.

FACT: Barack Obama voted to allow reckless lawsuits designed to bankrupt the firearms industry.¹

FACT: Barack Obama wants to re-impose the failed and discredited Clinton Gun Ban.²

FACT: Barack Obama voted to ban almost all rifle ammunition commonly used for hunting and sport shooting.³

FACT: Barack Obama has endorsed a complete ban on handgun ownership.²

FACT: Barack Obama supports local gun bans in Chicago, Washington, D.C., and other cities.⁴

FACT: Barack Obama voted to uphold local gun bans and the criminal prosecution of people who use firearms in self-defense.⁵

FACT: Barack Obama supports gun owner licensing and gun registration.⁶

FACT: Barack Obama refused to sign a friend-of-the-court Brief in support of individual Second Amendment rights in the Heller case.

FACT: Barack Obama opposes Right to Carry laws.⁷

FACT: Barack Obama was a member of the Board of Directors of the Joyce Foundation, the leading source of funds for anti-gun organizations and “research.”⁸

FACT: Barack Obama supported a proposal to ban gun stores within 5 miles of a school or park, which would eliminate almost every gun store in America.⁹

FACT: Barack Obama voted not to notify gun owners when the state of Illinois did records searches on them.¹⁰

FACT: Barack Obama voted against a measure to lower the Firearms Owners Identification card age minimum from 21 to 18, a measure designed to assist young people in the military.¹¹

FACT: Barack Obama favors a ban on standard capacity magazines.¹²

FACT: Barack Obama supports mandatory micro-stamping.¹³

FACT: Barack Obama supports mandatory waiting periods.²

FACT: Barack Obama supports repeal of the Tiahrt Amendment, which prohibits information on gun traces collected by the BATFE from being used in reckless lawsuits against firearm dealers and manufacturers.¹⁴

FACT: Barack Obama supports one-gun-a-month sales restrictions.⁹

FACT: Barack Obama supports a ban on inexpensive handguns.⁹

FACT: Barack Obama supports a ban on the resale of police issued firearms, even if the money is going to police departments for replacement equipment.⁹

FACT: Barack Obama supports mandatory firearm training requirements for all gun owners and a ban on gun ownership for persons under the age of 21.⁹

1. United States Senate, S. 397, vote number 219, July 2, 2005. (http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=109&session=1&vote=00219)

2. Independent Voters of Illinois/Independent Precinct Organization general candidate questionnaire, Sept. 9, 1996. The responses on this survey were described in “Obama had greater role on liberal survey,” Politico, March 31, 20087. (http://www.politico.com/news/stories/0308/9269.html)

3. United States Senate, S. 397, vote number 217, Kennedy amendment July 2, 2005. (http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=109&session=1&vote=00217)

4. David Wright, Ursula Fahy and Sunlen Miller, "Obama: 'Common Sense Regulation' On Gun Owners' Rights," ABC News' "Political Radar" Blog, http://blogs.abcnews.com, 2/15/08. (http://blogs.abcnews.com/politicalradar/2008/02/obama-common-se.html)

5. Illinois Senate, March 25, 2004 SB 2165, vote 20.

6. “Fact Check: No News In Obama's Consistent Record.” Obama ’08, December 11, 2007. (http://www.barackobama.com/factcheck/2007/12/11/fact_check_no_news_in_obamas_c.php)

7. “Candidates' gun control positions may figure in Pa. vote,” Pittsburgh Tribune-Review, Wednesday, April 2, 2008, and "Keyes, Obama Are Far Apart On Guns," Chicago Tribune, 9/15/04. (http://www.pittsburghlive.com/x/pittsburghtrib/news/s_560181.html)

8. 1998 Joyce Foundation Annual Report, p. 7. (http://www.joycefdn.org/pdf/98_AnnualReport.pdf)

9. “Obama and Gun Control,” The Volokh Conspiracy, taken from the Chicago Defender, Dec. 13, 1999. (http://www.volokh.com/posts/1203389334.shtml)

10. Illinois Senate, May 5, 2002, SB 1936 Con., vote 26.

11. Illinois Senate, March 25, 2003, SB 2163, vote 18.

12. “Clinton, Edwards, Obama on gun control,” Radio Iowa, Sunday, April 22, 2007. (http://learfield.typepad.com/radioiowa/2007/04/clinton_edwards.html)

13. Chicago Tribune blogs, “Barack Obama: NIU Shootings call for action,” February 15, 2008, (http://blogs.trb.com/news/politics/blog/2008/02/barack_obama_comments_on_shoot.html)

14. Barack Obama campaign website: “As president, Barack Obama would repeal the Tiahrt Amendment . . .” (http://www.barackobama.com/issues/urbanpolicy/#crime-and-law-enforcement.)

Copyright 2008, National Rifle Association of America, Institute for Legislative Action.
This may be reproduced. It may not be reproduced for commercial purposes.

How Did We Survive?

2008-06-22T13:58:00.002-05:00

If you recognize this bottle of "Monkey Blood," then you must have grown up before 1970.

This stuff and a band aid cured anything. We used a lot of it at my house.

A friend forwarded an email recently that evoked a lot of other memories. Here is what that email said about those who were blessed to grow up when kids were still kids:

First, we survived being born to mothers who smoked and/or drank while they were pregnant.

They took aspirin, ate blue cheese dressing, tuna from a can, and didn't get tested for diabetes.

Then after that trauma, we were put to sleep on our tummies in baby cribs covered with bright colored lead-based paints.

We had no childproof lids on medicine bottles, doors or cabinets and when we rode our bikes, we had no helmets, not to mention, the risks we took hitchhiking.

As infants and children, we would ride in cars with no car seats, booster seats, seat belts or air bags.

Riding in the back of a pickup on a warm day was always a special treat.

We drank water from the garden hose and NOT from a bottle.

We shared one soft drink with four friends, from one bottle and NO ONE actually died from this.

We ate cupcakes, white bread and real butter and drank Kool-aid made with sugar, but we weren't overweight because...

WE WERE ALWAYS OUTSIDE PLAYING!

We would leave home in the morning and play all day, as long as we were back when the streetlights came on.

No one was able to reach us all day. And we were O.K.

We would spend hours building our go-carts out of scraps and then ride down the hill, only to find out we forgot the brakes. After running into the bushes a few times, we learned to solve the problem.

We did not have Play Stations, Nintendo's, X-boxes, no video games at all, no 150 channels on cable, no video movies or DVD's, no surround-sound or CD's, no cell phones, no personal computers, no Internet or chat rooms...

WE HAD FRIENDS and we went outside and found them!

We fell out of trees, got cut, broke bones and teeth and there were no lawsuits from these accidents.

We ate worms and mud pies made from dirt, and the worms did not live in us forever.

We were given BB guns for our 10th birthdays, made up games with sticks and tennis balls and, although we were told it would happen, we did not poke out very many eyes.

We rode bikes or walked to a friend's house and knocked on the door or rang the bell, or just walked in and talked to them!

Little League had tryouts and not everyone made the team. Those who didn't had to learn to deal with disappointment. Imagine that!!

The idea of a parent bailing us out if we broke the law was unheard of. They actually sided with the law!

These generations have produced some of the best risk-takers, problem solvers and inventors ever!

The past 50 years have been an explosion of innovation and new ideas.

We had freedom, failure, success and responsibility, and we learned HOW TO DEAL WITH IT ALL!

If YOU are one of them, CONGRATULATIONS!

You might want to share this with others who have had the luck to grow up as kids, before the lawyers and the government regulated so much of our lives for our own good.

While you are at it, forward it to your kids so they will know how brave (and lucky) their parents were.

Kind of makes you want to run through the house with scissors, doesn't it?!

The email also contained a "quote of the month" from Jay Leno:

With hurricanes, tornadoes, fires out of control, mud slides, flooding, severe thunderstorms tearing up the country from one end to another, and with the threat of bird flu and terrorist attacks, are we sure this is a good time to take God out of the Pledge of Allegiance?

Oregon Denies Cancer Medicine But Pays For Suicide

2008-06-21T09:53:00.005-05:00

On Thursday World Net Daily carried this story about Oregon's State Health Plan will not pay for chemotherapy for a woman's lung cancer, but it will pay for her assisted suicide.

The patient, Barbara Wagner, told the Eugene Register-Guard, "To say to someone, we'll pay for you to die, but not pay for you to live, it's cruel. I get angry. Who do they think they are?"

Indeed!

Is this what we can expect when the federal government starts rationing health care, too? Seems pretty scary to me.

I have turned the Comments on for this post because I really would like to hear what others have to say about this report.

Although the comments will be on, they may not appear for several days because I will be away from the computer. When I get back, I'll post any good ones, but due to time constraints, I may not be able to respond to them.

Ted's Brain Cancer and You

2008-06-17T08:00:00.002-05:00

I have an idea of what Senator Ted Kennedy is up against. I have a number of patients who are in the same boat. I feel for him and his family. No matter what type of positive spin anyone wants to put on his situation, it is still bad. Very bad. He and his family have my sympathies.

That said, the handling of his case ironically emphasizes the differences between how people in this country are treated now compared to how we are likely to be treated under the very health care system that Senator Kennedy wants us to live under.

The senator suffered a seizure, and within a day he had had an MRI which demonstrated the presence of a malignant glioma. Within 14 days he was undergoing surgery. After a short recovery period, he will almost certainly undergo radiation therapy using the latest technology. This will be supplemented by chemotherapy according to the latest recommendations of neuro-oncology experts. When the radiation is finished, he may receive additional treatment using biologic agents such as bevacizumab or anti-cancer vaccines.

He will not receive such treatment simply because he is rich and powerful. Almost any American can be treated similarly right now. However, once universal health care is enacted, it may become true that only the rich, like he, will have access to the latest therapies. Under their plan for you, it is likely you will not get the same care that Ted is receiving.

As we have written about before, our government cannot afford to give everything to everyone. It will be forced to ration. Value judgments will be made. Everyone will have access to care, but not necessarily the highest quality care.

In an article in the New York Post, Robert Goldberg tells the story of Jennifer Bell of Norwich, England. In 2006, the 22-year-old complained of headaches for months - but Britain's National Health Service made her wait a year to see a neurologist. Then she had to wait more than three months before should could get what the NHS decided was only a "relatively urgent" MRI scan. Three days before the MRI appointment, she died.

Goldberg also informs us that Temodar, an oral chemotherapy agent which Kennedy and several of my patients are taking, has been widely used in this country since the FDA approved it in 2000. But a British health-care rationing agency, the National Institute for Comparative Effectiveness (NICE), ruled that even though the drug helps people live longer, it wasn't worth the money - and they denied coverage for it.

This does not mean that Brits cannot get the drug. If they have the money, they can pay for it out of their pockets. However, the catch is that if a person decides to pay for part of his treatment out of his pocket, then he must assume the cost of all of the other treatment as well. This can mount up to tens of thousands of dollars a month!

Right now, I am treating a young man who developed a seizure much like Kennedy did. A brain scan was done within 24 hours. He was found to have the same cancer that Kennedy has. He got surgery more quickly than Kennedy did, and he is now receiving radiation and chemotherapy like Kennedy will. Guess what? He has no insurance! He lost it when he lost his job as a truck driver (because those who deliver gasoline cannot drive if they have had seizures). So he is one of those "uninsured" that everyone worries about, and yet he is getting the same treatment that Kennedy will.

How? Well, it is not because the government has come to his rescue. It is because private industry and compassionate physicians worked together to help him.

What about Canada? Are things any better there? Apparently not.

Goldberg reports that the wait for an MRI is now 10 weeks. He writes, "For Canadians relying on their government health care, the average wait time from diagnosis of cancer to surgery is beyond the guideline set by both the US and European societies for surgical oncology."

Goldberg goes on to tell us about Chad Curley, a 37 year-old auto worker from Windsor, Ontario. He had a brain tumor like Kennedy's, but it was too large to do surgery. Temodar did not work. The same doctors who are now treating Senator Kennedy told Chad that bevacizumab might help. If he were an American, he could have been treated with it, but HealthCanada would not pay for it, and Chad died.

Here is my point:

You do not have to tell me that the system is broken. I know first-hand that there are problems. But is government-run health care the best answer?

Here in the middle of the Great American Desert, in the heart of red-neck fly-over country -- I treat uninsured people with the latest drugs. Next week we will continue treating an uninsured, young Hispanic woman who has metastatic rectal cancer. She has already had chemoradiation therapy to stop her hemorrhage, and now she will receive bevacizumab and irinotecan, two powerful, new agents which are remarkably prolonging lives in people with this disease.

Keep in mind that I work for (gasp) a for-profit physician group that is affiliated with (oh no!) another for-profit entity which works closely with the (dare I say it?) evil drug companies to make these treatments available to everyone.

Again, my patient is not getting help from the government. In fact, the government turned her down flat. She could not qualify for Medicaid because her husband makes too much money doing manual labor -- about $400 a week. Can you believe that? So we turned to private resources and got the funding to pay for her care.

If this woman had been a Medicare patient, this could not have happened. And if we extend Medicare to everyone (as I fear we will), this kind of charity will become a thing of the past. Ironically, it will become illegal to help people like her the way that we do now.

I have not had the opportunity to study McCain's plan yet. I don't have high hopes, though, because it sounds like something the insurance industry may have "helped" him to draw up -- sorta like letting the fox guard the hen house. The dim ray of hope is that if we as individuals can retain some control -- any control -- then we may still have access to the higher quality care that Americans have come to expect.

On the other hand, once Washington has assumed control, you can kiss your options goodbye.

The Ted Kennedy's and Barack Obama's of the world will be able to afford to go around the system. But will you and I?

Wal-Mart's Gun Buyer Database

2008-06-10T09:00:00.001-05:00

Did you know that if you buy a gun from Wal-Mart, your purchase will be recorded on video and kept on file forever?

Me neither.

Most who keep up with the anti-gun movement are aware that New York City's Mayor, the billionaire Michael Bloomberg, has been using his money to try to get rid of guns even outside his own state. Recently Wal-Mart joined Mayor Bloomberg at a gathering of his anti-gun group, Mayors Against Illegal Guns, to announce a series of changes to the way in which Wal-Mart handles firearm transactions.

At the press event, J.P. Suarez, chief compliance officer for Wal-Mart Stores Inc., said: “The costs are, we think, part of what it takes to be responsible.” Suarez also added, "This is not a signal that we're getting out of firearms."

With these changes up and running, firearm purchases at Wal-Mart will involve a video record of the sale, which the store will keep on file -- effectively creating a video database of gun purchasers.

In addition, Wal-Mart announced that its employees will be given discretion to deny firearms purchases to anyone who has had a firearm traced by BATFE for any reason -- including completely innocent citizens who have had a firearm stolen and later used in criminal activity.

In Wal-Mart's defense, I certainly do not mind giving an employee the discretion to refuse to sell a gun to a questionable buyer -- as long as that employee is acting in good faith. Businesses should have the right to sell or not to sell anything to anyone or no one.

We also know that if you buy anything from someone online or using any method besides cash, your name and what you bought probably go into some sort of database. It is conceivable that such a video database could help clear someone whose identity was stolen and used to purchase a weapon that was subsequently used to commit a crime.On the other hand, that's an unlikely scenario. Most criminals just steal their guns outright or buy them on the black market.

Recording gun purchase transactions on video is also unlikely to have any preventive effect. Sociopaths who take weapons into gun-free zones to commit mass murder actually seem to like the attention. In fact, they post their threats on YouTube and leave videos laying around for everyone to watch after their killing spree and (usual) suicide. They'll just smile into the camera, but no one will be any safer for having taken pictures of the transaction.

I am not sure whether this policy is already in effect at your local Wal-Mart. If you’d like to find out or simply to let Wal-Mart know what you think, please contact them by phone, at (800) 925-6278 or electronically by clicking here.

Whatever the case, it sounds like something hunters may want to check out before heading off to Wal-Mart this coming fall for hunting and sporting supplies, even if it means paying a few cents more to shop somewhere else.

10 Reasons to Love Universal Health Care

2008-06-06T13:00:00.003-05:00

Okay. I'm figuring that universal health care -- that euphemism for government-run health care -- is inevitable. The system is just way too broken, and people have become so conditioned to expect that the government should bail them out of any and all troubles.

As I have said repeatedly, doctors won't mind this as much as patients will. And now I will explain why.

Here are 10 reasons why your doctor will like government health care more than you will:

The doctor will no longer have to be a patient advocate. Right now, doctors and their staff spend hours -- no exaggeration -- arguing with insurance case managers, trying to convince them to let their patients have the treatment that is best for them. But we don't have to do this with Medicare. Medicare doesn't have case managers. Why? Because there is no negotiation. They cover what they cover, and there is no convincing them to make an exception.
The doctor will no longer have to obtain pre-certification. Right now, this is a huge time waster. It is simply one of many hassle hoops we must jump through on the patient's behalf. We want to be sure the patient doesn't get stuck with a huge bill, so we call the insurance company to be sure they know we want to give a certain treatment or order a certain test. We wait days for an answer, then usually have to call again or fill out multiple forms so they can get around to saying, "Oh, all right. We'll allow you to give it, but it doesn't mean we're going to pay for it." (What?) Again, we don't have to do this with Medicare. The rules are already defined with them, and there is no bending.
The doctor's overhead will be less. Since we won't have to argue with insurance companies on the front end, we won't need so many employees to get permissions and to track denials. We also won't have to argue so much on the back end because, again, you don't argue with Medicare. It's really very simple: You play by their rules, or else you don't get paid.
The doctor will get more time off. As doctor pay is continually reduced, there will be less and less incentive to continue working so much. Most of my colleagues agree that when it no longer becomes "worth it" to put in 12-14 hour days plus take more calls after they go home, they'll simply stop doing it. This has already happened in Canada. And why not? This is human nature.
Doctors won't have to spend as much time reading and studying. "Treatment guidelines" will cease being only guidelines. The algorithms will become the standard modus operandi. So instead of having to spend hours researching the latest thoughts on the best way to treat a specific condition, doctors will simply check the government-approved recipe book and do what it says (that is, if they want to be paid for their efforts).
Doctors won't have to spend so much time discussing treatment options with patients. That's because there won't be as many. See #5. You might also check out this post over on Terry Hamblin's blog about the UK's National Health Service.
Doctors won't have to worry about competition as much. With the institution of universal guidelines and enforcement of drug-label usage, practices will become increasingly similar. The remaining differences will be the doctor's personality and style.
Doctors won't have to wait so long to get paid. Ironically, right now Medicare is the fastest payor. It's pretty clean. You submit your claim, and either they pay or they do not. This is to be contrasted with private payors who deliberately find all kinds of excuses to hold on to the check. They know they have to pay eventually, but the longer they can hang onto the doctor's money, the more interest they can earn.
Doctors won't have to work so hard trying to keep sick patients alive. First of all, increased waiting times will weed many of them out. Second, when it becomes financially unfeasible for doctors to put in a full day at the office AND then attend to their really sick folks in the hospitals, they will turn the care of the sick ones over to hospitalists and others who work in shifts. If the patient survives the hospital stay, care will be turned back over to the outpatient physicians who may or may not know what went on during the hospital admission.
Doctors won't have to take care of unfunded patients anymore. Instead of donating their time and services as they do now, doctors will get paid something because everyone will have insurance.

And that's just a quick list off the top of my head. If I really thought about it, I bet I could come up with more reasons why government health care will be good for doctors, but won't be so good for you, the patient.

Yes, I know that in other countries, things seem to work fine. But most of those countries are already socialized, and the people are used to it.

Americans are not.

Especially in these times of increasing patient empowerment, patients want and demand to have more say in what tests are done, what treatments are given, and how the whole plan plays out. In short, Americans want to be the boss of their own lives. And I don't blame them. I'm that way, too.

But in a socialized American system, this simply will not happen. Patients who become more dependent upon the government system will lose much, if not most, of the empowerment they have come to enjoy. Remember: whoever pays gets to call the shots.

I know this sounds cynical and somewhat depressing, but the truth hurts.

Just realize, though, that even though I can think of reasons why I will like government-run health care as a physician, I'm very concerned about what it will mean when I am the patient -- which may not be so very far away in the future. Worse, I am sad for my children who will likely never experience the empowerment patients and families enjoy today.

Crossroads

2008-06-03T08:22:00.005-05:00

I don't watch this regularly, but whenever I do, I am intrigued.

For those who don't know, Crossroads is a Country Music Television (CMT) production where artists are paired to perform together and to sing each other's songs. It usually matches popular rock and current country artists. Thus the name Crossroads which finds the intersections of the two musical genres.

The first one I ever saw was with Keith Urban and John Fogarty (of Credence Clearwater Revival or CCR fame). Another favorite was when Pat Benatar and Martina McBride got together. Not only did the two girls sound alike when they sang each other's songs, but they also look like they could be sisters!

Last night there were two shows, each with an interesting pairing that made me think, "Now how in the world is this going to work?" But it did!

The first show paired Lindsay Buckingham with Little Big Town. Once upon a time, Lindsay Buckingham was romantically involved with Stevie Nicks. They were high school friends who struck out on their own but eventually came to form half of the mega-group known as Fleetwood Mac. Little Big Town is a much younger group that found fame with their hit Boondocks.

At first I wondered how this was going to sound, but as soon as they started playing, I realized that there are many similarities. When Lindsay Buckingham started playing a Little Big Town song on his acoustic guitar with his unique picking style, the similarities jumped out of the TV set. And when the quartet sang back-up vocals on some of Buckingham's hits, you could close your eyes and swear you were listening to Fleetwood Mac again live.

The second show was an even stranger pairing. How about Sara Evans and Maroon 5? Yep, that's right. Twangy Sara singing with Adam Levine? Yet, it worked -- perhaps because Levine sings with that falsetto voice that allows him to cover her songs, and which allows her to convincingly sing ones he has written. The only disappointment with this pairing was that the songs they chose to perform were more mellow, and I missed the Maroon 5 songs that have a little more beat. (I suspect a couple of my favorites were un-singable on TV due to the fact that they contain profanity. I wish Levine could express himself with cleaner language because the songs are otherwise captivating.)

I don't know who picks the artists for this show, and I'm not sure what criteria they use, but they do a good job. Although all internet radio stations are at risk of going off-air if the music industry gets its way, Pandora.com also does a good job of finding artists with similarities that are not immediately apparent.

Bring On Global Warming

2008-05-20T09:21:00.005-05:00

It is now the middle of May, and here is a picture of my driveway!

Okay, I'm kidding.

That's not my car.

Seriously, over the weekend I told Janie that after much contemplation, and after way too much cold weather lately, I have decided that global warming is a good thing!

Really. I'm tired of being cold.

And, as many suspected, Al Gore was inconveniently incorrect. (But what did we expect from the guy who invented the internet, inspired Love Story, and never met a tree he didn't want to hug?)

I live in Texas -- but at an altitude of 3600 feet. It gets hot, but after you pay the heating bills for the swimming pool for awhile, you learn that it is colder more than it is hotter in this part of the state. Global warming would save me a lot of money!

Unfortunately, as much as I like warmer weather and warmer water, global warming simply isn't happening. Which is really too bad for a lot of folks because they spent the last decade trying to convince us all that the earth is in danger of melting. And, unfortunately, the two most likely contenders for U.S. Presidente have bought into it.

Oh, well.

Don't get me wrong. I'm a scuba diver. I am huge on protecting the environment and wild life. I don't want to swim in pollution and murky water. I want to be able to see cool corals and healthy animals. I swim responsibly. I don't touch coral. I don't drown turtles by trying to hitch a ride on them. I leave the animals alone. I don't feed the fish or the dolphins. I don't use sunscreen that hurts the marine life. I take only memories (well, a few pictures) and leave only bubbles.

So with respect to scuba diving and global warming, I figure it this way. If the polar ice caps melt, that means there will be more water to dive in! And it will be warm water, too! No more struggling to get into 7 mm wetsuits! No more hoods and gloves! Hooray!

I only wish.

The truth is, over the last decade or so 31,000 scientists have quietly signed a petition rejecting the claim that there is global warming. You can read the document yourself at the link provided, but here is a sample:

There is no convincing scientific evidence that human release of carbon, methane, or other greenhouse gases is causing or will, in the foreseeable future, cause catastrophic heating of the Earth's atmosphere and disruption of the Earth's climate ... Moreover, there is substantial scientific evidence that increases in atmospheric carbon dioxide produce many beneficial effects upon the natural plant and animal environments of the Earth.

The list includes 9,021 PhDs, 6,961 scientists with master's degrees, 2,240 medical doctors, and 12,850 carrying a bachelor of science or equivalent academic degree. Even if you disagree with their conclusion, you still have to admit that this is a lot of smart people. And they are all real. Yep. Signers Perry Mason and Michael Fox are real people who coincidentally have the names of fictitious characters.

And now more climatologists are beginning to speak up, too. Turns out global warming isn't causing all the hurricanes, either.

Now, I realize that it is very "in" to go green and to be Chicken Little and to worry about the planet and all. And, again, don't misunderstand: I'm all in favor of taking care of dear Mother Earth. But I refuse to freak out over it.

Especially since I can breathe underwater...

Guns Don't Kill People -- Doctors Do!

2008-05-16T09:42:00.004-05:00

I got this note from Will:

According to the U.S. Department of Health and Human Services, there are 700,000 physicians in the United States. There are 120,000 accidental deaths caused by physicians each year. This means the accidental death rate at the hands of physicians in 0.171.

Now, according to the FBI, there are 80 million gun owners in the U.S. The number of accidental gun deaths per year (all age groups) is 1,500. That yields an accidental death rate per gun owner of 0.000188.

So, statistically, doctors are approximately 9000 times more dangerous than gun owners.

FACT: NOT EVERYONE HAS A GUN, BUT ALMOST EVERYONE HAS AT LEAST ONE DOCTOR.

Please alert your friends to this alarming threat. Clearly, we must ban doctors before this gets completely out of hand!

(Out of concern for the public at large, I withheld the statistics on Lawyers for fear the shock would cause people to panic and seek medical attention!)

No-Smoking Ban

2008-05-10T16:18:00.005-05:00

For those who care, I voted in favor of the no-smoking ordinance that is being proposed for our city today.

The non-smokers framed the issue as one of public health. They said that they want to protect workers and customers from second-hand smoke. They argue that although customers may be able to walk out and take their business elsewhere, employees (such as waiters and cooks) do not always have that option.

Those opposing the ordinance said the public health angle was a sham, based upon junk science. They said that this was really an issue of freedom -- particularly the right of business owners to choose whether or not to allow smoking in their establishment.

Each side has good points, but here is how I decided the issue.

While I lean towards a libertarian point of view -- meaning I prefer NOT to pass laws which restrict personal freedoms, I realize that all laws restrict somebody's freedom.

If everyone could do whatever he or she wanted, then we would have anarchy. Individuals each have their own notions about what is right and what is wrong, what is good and what is evil. So what happens when people disagree?

We pass laws -- rules which dictate whose freedom will be restricted and whose will not. We set parameters that, hopefully, will help us to maintain some civility in everyday life.

If I were a pure libertarian, then I wouldn't like laws which put limits on abortion. But I do think there should be limits since lives are at stake.

If I were a pure libertarian, then I wouldn't vote for a ban on smoking. But frankly, I'm tired of having my meals ruined by one person clear across the room chain-smoking and poisoning the air for everybody else in the restaurant.

So, sorry.

It will be interesting to see which side wins. It won't break my heart either way, but I will probably spend less time in establishments which don't provide most of us with clean air to breathe.

----------------------
Update (5/11/08): The smokers won. Once again, the tail wags the dog.

Peggy Noonan on Bush and Us

2008-04-25T08:51:00.002-05:00

Another excellent article by Peggy Noonan. This time a comment on Bush and America.

Boy. I like the way she writes. Even if one disagrees, you have to like the way she paints word pictures and the way she describes what she observes.

Read it here.

Thomas Sydenham

2008-04-19T14:00:00.006-05:00

Thomas Sydenham (1642-1689) was an English physician who is considered to be one of the most important revivers of Hippocrates' methods, placing primary importance upon observation of the clinical picture.

With so much emphasis on today's technology, it is easy to be confused by contradictory test results. Viewing radiology reports and lab results prematurely can lead to erroneous conclusions about a patient's condition. Therefore, as one of my mentors put it, "When all else fails, look at the patient."

Sydenham was the first to write extensively about the relationship of fever to disease. He also developed the theory of an epidemic constitution, that is. the idea that conditions in the environment can cause the occurrence of acute diseases. His treatise on gout (from which he personally suffered) is considered his masterpiece.

Sydenham was a bit of a maverick because he did not always follow the fads of the day, such as bleeding patients who were ill. He was an independent thinker who benefited by remaining detached from the speculative theories of his time. Characterized as an investigator who was free of prejudices, his reputation grew from the fact that he concentrated on relieving the suffering of the sick and made them well.

There are a number of interesting quotes which have survived the years, but my favorite is one which should form the foundation of any physician's career:

It becomes every man who purposes to give himself to the care of others, seriously to consider the four following things: First, that he must one day give an account to the Supreme Judge of all lives entrusted to his care. Secondly, that all his skill, knowledge and energy as they have been given to him by God, so they should be exercised for His glory, and the good of mankind, and not for mere gain or ambition. Thirdly, let him reflect that he has undertaken the care of no mean creature, for in order that he may estimate the value and greatness of the human race, the only begotten Son of God became himself a man and thus ennobled it with His divine dignity, and that far more than this died to redeem it; and fourthly, that the doctor himself being a mortal man, should be diligent and tender in relieving his suffering patient, in as much as he himself must one day be a like sufferer.

My thanks to Dr. John Logsdon, a cardiologist who embodies this advice, for leading me to this valuable bit of medical history.

Cancer Patients Needing More Transfusions

2008-04-15T08:15:00.008-05:00

I hope my internet buddies who are clamoring for government health care are following this story, because it is the future of medical care in this country.

No, wait. This is happening now!

Since the Centers for Medicare and Medicaid Services (CMS) decided it would severely restrict payment for the use of erythropoiesis-stimulating agents (ESA), there has been a striking increase in adverse events among Medicare cancer patients.

To refresh everyone's memory, one of chemotherapy's undesirable side effects is that it interferes with normal blood cell production by the bone marrow. Thus patients develop low white blood counts (which makes people susceptible to infections), low red blood counts (which makes people feel fatigued and breathless), and low platelet counts (which can lead to abnormal bleeding or bruising). Different drugs may affect one cell line more than another.

Before the advent of ESA's, patients had to learn to tolerate anemia. That is, they simply had to put up with feeling miserably fatigued while they were taking chemotherapy. However, that all changed when Procrit, Epogen and Aranesp became available. Doctors and patients alike found that by using these drugs -- which stimulate red blood cell production -- they experienced less fatigue and less breathlessness. Patients' overall sense of well-being was improved, and many were able to continue working even while undergoing cancer treatment.

Two problems cropped up, though.

First, some doctors (we were among them), expressed some worry about the downside effects that these drugs might have. Researchers had noticed that there are erythropoietin receptors on certain cancer cells. Might these drugs, which are analogues of erythropoietin, actually cause cancers to grow? In addition, clinicians also began to notice that some patients developed a higher risk for blood clots while on these agents. So there was concern in the medical community, though not yet enough to outweigh the obvious benefits patients were enjoying. To us, it simply meant we needed to continue our research and learn where the land mines lay, then figure out how to better select which patients to treat and how to tweak the dosing so as to minimize risk.

But the second problem was out of our hands: They cost too much.

Since cancer is primarily a disease of the elderly, it was Medicare who bore the brunt of the bill for these agents. Looking for a way to cut spending, they jumped upon the negative reports as an excuse to quit paying for them altogether. Ignoring the protests of those who actually care for cancer patients, CMS seemed to decide that if the drugs were bad for a few, then perhaps no one should have access to them. But by refusing to pay for these admittedly expensive agents, they effectively removed them from the list of options doctors have to help their patients feel better.

Based upon scientific evidence presented to it, the Food and Drug Administration had approved the use of ESAs to maintain the hemoglobin between 10 and 12 g/dL. But CMS decreed that it would only pay for ESA use when the hemoglobin falls below 10 g/dL.

So whereas I used to see the hemoglobin falling, and whereas I could intervene before it hit the floor, I must now wait until it actually bangs on the bottom and the patient is starving for air. And if I check a blood count to find that the drug worked, and the hemoglobin is now 10.1, may I give another dose to keep it in the 10-12 range, or must I wait until it falls below 10 again? Well, no one is sure. Including CMS.

Consequently, 3 months after the decision went into effect, 91% of oncologists reported adverse events among their patients which were attributable to the bureaucratic decision which had been implemented over the cries of cancer organizations.

Predictably, the number of blood transfusions went up -- along with the adverse reactions which accompany them. This was no surprise as 98% of ESA experts had said that the Medicare coverage decision would result in the rise of avoidable transfusion.

But for those who decline or are unable to receive transfusion, quality of life has deteriorated as more patients remain anemic.

73% of physicians surveyed felt that the current Medicare coverage decision has negatively impacted their ability to deliver quality care. Almost half said that they have had to reduce or modify chemotherapy regimens for almost a third of their patients. Having to reduce drug doses or lengthen treatment intervals may have more of a negative impact than any concern about erythropoietin receptors on cancer cell surfaces. We don't know -- but worse -- we don't get to find out because the options and the research have been taken out of our hands.

In short, the decision is now controlled by government edict, not by the physician who is there at the patient's side. Consequently, as government workers sitting at a desk somewhere have usurped the authority of the physicians who are trying their best to help patients feel better, they are creating a two-tiered system in which Medicare patients receive lower-quality care than privately-insured patients.

On the other hand, private insurance companies tend to follow Medicare, so eventually everyone's quality of care should drop to the same lower level. Even now private payers are changing their policies to match Medicare's. They are forcing doctors to order more labs in order to prove that the ESAs are necessary, and they are requiring pre-authorization before their use. (Ie, they have increased the "hassle factor.") This increases the burden on both the patient and the doctor's office.

Some wonder how this is going to save money in the end. When patients feel worse, they come to the office more. More visits to the office with more complaints usually means more testing to find out what is wrong. And if the complaints are indeed due to chemotherapy-induced anemia, then trips to the hospital for transfusions will increase, too. They already have.

When government attempts to balance the costs and benefits of healthcare, it sometimes forgets to think about the unintended consequences. With respect to the ESA controversy, evidence is mounting that this attempt to ration payments is having a negative impact on cancer patients.

Leaders of the hematology and oncology community were cut out of the decision when it was made. They need to be brought back into the process.

As a practicing physician, I am helpless against this type of government fiat. My hands are tied. I used to be able to help, but now all I can do is feel sympathy and say, "Sorry. This is your government, here to help you once again."

Who Will Defend You?

2008-04-07T10:30:00.001-05:00

Most readers probably know that the U.S. Supreme Court is deciding on whether or not citizens of Washington D.C. have a constitutional right to own guns in order to defend themselves.

Ever wonder how this all got started in the first place?

In 1975 three women shared a townhouse in Washington, D.C. Two of the roommates slept upstairs, and one occupied the downstairs bedroom. On the night of March 16, they were suddenly awakened by the sound of their door being kicked in.

The two women upstairs heard the screams of their friend downstairs as she was being beaten, raped and sodomized by two men. Carolyn Warren called the police and was told help was on the way. She and her other upstairs roommate watched in horror as a police car passed by their home, merely slowing down. They called the police again, but this time there was no response at all.

The downstairs became silent. After an hour of waiting, they called down to their friend. However, the two rapists were still in the home. Suddenly alerted to the presence of more victims, the rapists forced the other two women downstairs and meted out 14 more hours of sexual torture.

The women felt betrayed by the police and the system that they thought should protect them. They sued the District of Columbia in the case that became known as Warren v. District of Columbia. After two years of wondering and waiting, they lost. The D.C. Superior Court ruled:

... a government and its agents are under no general duty to provide public services, such as police protection, to any particular individual citizen.

Well, while the women were busy losing their right to police protection, they -- along with every other citizen of Washington D.C. -- were also losing their ability to protect themselves.

In July 1976 the D.C. City Council enacted the Firearms Control Regulations Act, a draconian gun ban that made it illegal for most D.C. citizens to possess a firearm which was actually operable and ready to use. The law said that even within one's home, a gun must be disassembled or disabled -- which is the same as having no gun at all in a crisis.

If it was bad enough that the court ruled that D.C. police had no duty to protect citizens, and that the City Council had removed the best means by which citizens could protect themselves, matters only got worse when, in 1981, the D.C. Court of Appeals ruled further on the case:

The duty to provide public services is owed to the public at large, and, absent a special relationship between the police and an individual, no specific legal duty exists.

After 25 years of feeling defenseless, in 2003, six residents of Washington, D.C. filed a lawsuit in the United States District Court for the District of Columbia, challenging the constitutionality of provisions of the Firearms Control Regulations Act. The suit was called Parker versus District of Columbia, named after Shelly Parker, the first-named of the litigants. The others were Tom Palmer, Gillian St. Lawrence, Tracey Ambeau, George Lyon and Dick Heller. The District Court dismissed the lawsuit.

On appeal, the U.S. Court of Appeals for the D.C. Circuit ruled, for technical reasons, that five of the six who had sued had no right to do so. However, Heller, who had applied for a handgun license and been denied, did have standing. The Court went on to rule that:

“[T]he phrase ‘the right of the people,’ when read intratextually and in light of Supreme Court precedent, leads us to conclude that the right in question is individual.”

The D.C. Circuit also rejected the city's claim that the Second Amendment does not apply to the District of Columbia because D.C. is not a state.

The District of Columbia appealed, but the District Court refused to rehear the case. So both sides petitioned the Supreme Court, and in so doing, the case was renamed Heller versus the District of Columbia.

The District of Columbia's petition stated that the question presented was, "Whether the Second Amendment forbids the District of Columbia from banning private possession of handguns while allowing possession of rifles and shotguns."

Heller replied that the question was broader, namely, "Whether the Second Amendment guarantees law-abiding, adult individuals a right to keep ordinary, functional firearms, including handguns, in their homes."

The Supreme Court adopted neither question, but came closer to the question posed by Heller in framing the issue to include review of the District's prohibitions against possession of all types of firearms, and not just handguns. The Court heard oral arguments last month, and a decision is anticipated this summer.

Both anti-gun and pro-gun rights forces anxiously await the outcome of the Supreme Court's ruling. As I understand it, this ruling will only apply to Washington D.C. However, gun-rights advocates are watching to see whether the U.S. Supreme Court will interpret the 2nd Amendment to hold that the Constitution does grant to individuals the right to own a gun.

Fortunately, some of us in the red states currently still have the right to own firearms in order to defend our homes and families. Of course, we hope the U.S. Supreme Court will read the Constitution the way that we do so that we can continue to protect ourselves and those we love.

But for those who think the whole country should enact guns bans like the one in D.C., the amazing state of affairs in Washington D.C. begs the question:

If the police have no duty to protect individuals in their homes, who does?

And if the answer is YOU, then HOW?

Managed Care - 8

2008-04-03T08:08:00.004-05:00

For those of you who are new to the party, you can check out my earlier examples of Managed Care nonsense from July 2007. I thought I was done, but you gotta love this one.

It is now standard in many centers for lymphoma staging to include a PET scan, preferably a PET/CT.

Enter managed care manager.

The company's published guidelines include PET/CT scanning for lymphoma staging, but then when my partner tried to order one just now, they told him No.

So he called them to ask why. Answer: "Because you haven't done any other tests."

"What?" he replied.

"Well, you haven't done a CT scan or something like that first."

My partner: "But I don't need one. I want to do a PET/CT all at the same time. Our machine will do them both simultaneously and provide superior information."

Insurance company rep: "I know, but those are our rules. If you had ordered the CT first, then you could order the PET because you could say that the CT was 'inconclusive'."

My partner again: "What?"

Managed care manager: "That's right. Look, here is what you should do. Order a chest x-ray or something else first, then tell us that the results were 'inconclusive' and that you need a PET scan. Then we'll approve the PET/CT scan."

My partner: "Really?"

Manager person: "Yes. Really."

So my partner tells me about this conversation. We conclude: Okay, so now as part of our "routine" tests to work up a lymphoma, we need to order a chest x-ray so that we can get the study that we really need.

And I'm left wondering: How does this save any money? How does this help the patient?

Answer: It doesn't. Yet at the end of the day, it will be the doctor's fault that he spent too much money evaluating this patient.

And this is one more reason why we will have nationalized health care.

Doctors Favor Universal Health Care

2008-04-01T08:10:00.007-05:00

Well, there you have it.

According to a letter published in the April 1 issue of the Annals of Internal Medicine, nearly two out of three doctors support universal health care.

Or, at least, that is probably all you will be told.

This not an April Fool's joke. Here is the rest of the story.

Two doctors sent out questionnaires to 5000 physicians who were listed in the American Medical Association Master File. They received responses from 2193 (51%). The respondents were asked two questions:

1. Do you support or oppose government legislation to establish national health insurance?

2. Do you support achieving universal coverage through more incremental reform?

To the first question, 59% of physicians supported legislation to establish universal coverage, 9% were neutral, and 32% opposed it. Compared to the same survey which was taken in 2002, the percentage of physicians supporting question number 1 increased by 10%.

To the second question, 55% supported incremental reform, 21% were neutral, and 25% opposed it.

My comments:

On the surface, the claim is correct.

I have said it before: doctors are not going to mind this nearly as much as patients will.

This morning, on Bill Bennett's Morning in America, a nurse called in and explained this very well. She said:

I am a dialysis nurse. We know that when we treat Medicare patients, we get paid $10 less than what it costs us to perform the service. We have to make up the costs by charging the private insurance patients more.

But here is the difference. If we need to increase a patient's blood pressure medicine by one pill a day, we have to fight with the insurance company for hours and sometimes days. That is time that we don't have. Meanwhile, the patient goes with uncontrolled blood pressure because she cannot afford the extra pill out of her own pocket.

The host asked, "Well, but what about the government? Don't you fight with them, too?"

"No," she replied. "There is no point. We know that they will just say No."

Do you see what is really happening here? It isn't so much that doctors are in favor of government-controlled health care. We lose money on those patients! No, the reality is that we are simply growing weary of fighting with everyone else.

I'm serious.

As a physician, it will be nice to only have to work with the government. I have been working with Medicare for 30 years. I can tell you that there is no fighting because there is no negotiation. The government's attitude is "take it or leave it." So we physicians will take the cut in pay, take more time off, and probably be a whole lot happier.

But as one who is at the age where I may become a health care consumer, I'm not so sure I will like it -- for the same reason: There is no negotiation.

So the 59% support for universal health care legislation is not some kind of situation where doctors have "seen the light" and become more altruistic.

It is surrender.

Rough Week

2008-03-29T08:36:00.004-05:00

This was a rough week.

It started while I was on call Sunday, having to admit a colleague who was two years younger than I. He had been fighting a metastatic sarcoma for almost a year and a half, but was now exhausted from the struggle. He went to hospice the next day, and he died two days later, leaving behind a wife and their kids. The whole community will miss him, especially young athletes whom he treated and their parents.

On Tuesday one of my favorite patients came in sick. He had metastatic rectal cancer. The cancer grew into his bladder, creating a hole (fistula) that connected the rectum and the bladder. Fecal contents constantly infected the bladder, and urine drained out where it shouldn't have. He had been miserable for a long time, yet he never complained. He was, simply, one of the most pleasant guys I have ever known. But this day he came in looking horrible. He was hurting badly. I examined his abdomen, and the growth of his liver metastases had exploded so that his liver now filled almost the whole belly. No wonder he couldn't eat or sit up. He had already had every drug on the market, so he went to hospice, too. And now he is gone.

Wednesday seemed to hold more promise, but then I was asked to see an 80+ year-old woman with acute leukemia. But that was not actually what got her into the hospital. She also had emphysema, heart disease, and kidney failure. I had to explain to the family that while we nowadays offer induction chemotherapy to octogenarians with leukemia, she would not be a candidate unless her general health improved to the point of having a reasonable chance of withstanding it. Which will not happen.

On Thursday I was asked to see a wonderful woman. She is a strong, Texas pioneer-type who still runs a ranch and a family. She was doing great until a few weeks ago when she developed abdominal pain and turned yellow. It did not take but one test to confirm everyone's worst fear: advanced, metastatic pancreatic cancer. At first she said she wanted to "be aggressive." So we talked about a phase 2 clinical trial we are opening comparing gemcitabine plus amplimexone with gemcitabine plus placebo. However, after giving it a day's more thought and talking with family, she decided she'd rather be home feeling good, not traveling back and forth to town while also suffering the side effects of chemotherapy. So another nice person headed to hospice. She may have a few weeks of life left.

Finally, Friday came. I looked forward to having a day to back down from the stress and the death. But at the last minute, I was asked to see an older gentleman who came into the hospital with chest pain. He was found to have pneumonia, and maybe a lung mass. Fortunately, the CT did not show a mass. But further testing showed a significant, macrocytic anemia. An astute pulmonologist noticed that the man's protein level was high normal, yet his albumin was low. He wondered whether he might have multiple myeloma. Indeed, when I looked at his blood under the microscope, he had rouleaux and circulating plasma cells. He appears to have a really bad, incurable disease -- yet he might actually live for a few months.

So now it is Saturday. It is still cold, but the daffodils are up, and buds are beginning to appear on the trees. It will be nice to see more sun, warmer days, and more signs of life.

Noonan on Obama

2008-03-21T14:43:00.003-05:00

One of my favorite writers is Peggy Noonan, the lady who actually wrote some of Ronald Reagan's best speeches.

She noticed the same things in Obama's talk that I did, only she is much more eloquent.

Here is what she had to say.

Obama

2008-03-18T12:43:00.006-05:00

I just read Obama's speech on Drudge.

The guy is amazing. This was a great speech. Inspiring. It is difficult to read it -- or, I bet -- to have heard it and not agree with much of what he says.

I, too, grew up in the 60's. I remember segregation. I remember the riots in LA and Chicago. I remember busing. I remember when black (that's what they were in those days) kids came to my high school from across town.

Guess what? We didn't mind. They were nice, and so were most of us. We got along. There were more fights between white kids than there were between kids of different colors.

One particularly friendly guy, Greg, is now pastor of a church in town. On weekends he preaches. During the week, he works at one of the hospitals here, ferrying patients from one place to another. We see each other and visit about his church, our kids, other high school friends we have bumped into -- you know, life. Everyone knows Greg, and to my knowledge, he has no enemies.

When I was elementary school age, one of my playmates was black. I never noticed. I just thought he was fun to be around. I live in the South, so I have always had African-American friends and co-workers. Same for Hispanic and Asian. Of course I am aware of the stereotypes, but those doors swing two ways. I have, at times, understood why they exist, and I have also felt the discomfort of being unfairly judged simply because I am white.

Nevertheless, I consider myself to be pretty colorblind. I think today's kids are even more so. Race just doesn't seem to matter to them as much as it does to their parents. Maybe this is because there is increasingly more interracial marriage today.

One friend is Hispanic. She is married to an African-American policeman. I asked her one day, "When your kids have to indicate which race they belong to, what do they say?" Her answer: "Whichever one helps the most." See, society doesn't care, but government racial monitors do, and they keep forcing the issue. Oh, well.

So Obama, who is both white and black, has tapped into a vein that nourishes our desire to live together in peace, to support one another, to love one another. He calls it Hope. And if he is elected, I do hope that such a spiritual goal can actually be realized.

I can say Amen to some of the dreams he talks about in his religion/race oratory. The problem is, I don't agree with the way he plans to get there. Obama is great until you start looking at the specifics (at the end of the speech).

It would be nice if we could elect someone else who can actually make some changes, although Heaven knows who that would be. The President can't really do much besides make suggestions about our economy, the law, etc. But even if someone else is elected, we should still make Obama deliver all the speeches. There is no question that he excels at that.

Cozumel Dive Trip -- Photos

2008-03-09T20:46:00.002-05:00

My intention was to use several posts to share photos from our dive trip last month. However, I just don't have the time. Below is my "diary" from the travel day. Needless to say, it is the only day that I wrote about -- and it was a non-diving day. But if you want to see the dive photos, just CLICK HERE and then click on the Slideshow button on that page.

The flight to Cozumel wasn't bad at all -- except for having to get up at 3:00 in the morning to make the 5:00 A.M. departure. The flight to Houston was smooth, and the transfer also went without a hitch. It was fun to leave Amarillo where it was 30-something degrees, and arrive around noon in Cozumel where it was in the high 70's.

Going through customs took longer than expected. Unbeknownst to us, the authorities in Cozumel had decided to convert the airport hours to 24/7. But they had not yet hired enough people to staff the various stations. Consequently, the line through customs was quite long, and we happened to be at the end, another flight having arrived right before ours. Nevertheless, we got our visas stamped and all found our luggage intact.

They have an interesting system with respect to the baggage. They have a big traffic signal. As you go through customs, the head of each family pushes a button. If it stays green, then you throw your bags onto a conveyor for them to be x-rayed. If it turns red, then you have to unpack everything for them to inspect by hand. It is random.

The FunJet folks were there to meet us and transport John, Beverly, Amy, Janie and I to the Iberostar resort. It was about a 20 minute ride through down, then down along the coast to the southern end of the island.

We got checked in without difficulty. Our rooms were great, and we were able to get them close together. This certainly made it easier to dive and dine together.

The Iberostar has a dive shop which is run by Dressel Divers, an international outfit that is headquarted in Spain. However, we had already made arrangements to go with Dive Palancar which was located at the next resort down, the Occidental. John and Beverly had managed to secure Ismael as our dive master. They had been with him before, and we were so glad that he was able to take us on.

We walked up the beach to the Palancar Dive Center, filled out all the necessary documents, and purchased dive packages. We also arranged for them to pick us up at the Iberostar dock each day, and also to clean and store our gear for us.

Making all these arrangements took longer than expected, and we also learned that Dressel would not allow us to make a shore dive in front of the Iberostar. We were unable to take a check-out dive, so we went snorkeling instead.

Our first dinner was great. Iberostar is an all-inclusive resort, so we just showed up at the dining room, got a table, ordered drinks, then helped ourselves to the buffet which had some great food. By nightfall, we were tired. It had been a long day, so sleep was welcome. Yet the excitement and anticipation of the next day kept us from sleeping as soundly as we might have otherwise.

Keep An Eye on Massachusetts

2008-03-06T15:16:00.004-06:00

Last August I reported on Massachusetts' state universal health insurance plan. The state mandated that all citizens must acquire health care insurance. This plan was much like the one that Hillary has proposed. Basically, if the state deems that you can afford insurance, you must buy it. If you cannot afford it, then the state will pony up for you. If you can afford the insurance but chose not to buy any, then you can be fined. Interestingly, some clever individuals calculated that the fine was less than the cost of the insurance, so they chose to ignore the law and pay the fine.

Well, here is an update.

Last year, the first year the program was in force, the fines amounted to $219. But now the fines are going up. The fines accrue each month that an individual goes bare, and then it is assessed when tax time rolls around. It may be as much as $912 for the year. Yet that is still about half the cost of the cheapest state-approved insurance plan.

Arnold King of the Cato Institute thinks that the hefty fines are an indication of the failure of the program to provide the affordable health insurance that was promised.

Devon Herrick, a senior fellow at the National Center for Policy Analysis said,

The Massachusetts universal coverage plan is overregulated and largely unworkable. The least expensive plan would cost a 37-year-old male resident of Massachusetts $196 a month, and a fine for not having insurance could run half of that, or $98 a month. The same 37-year-old living in Dallas could buy coverage for $98 per month.

Herrick said deregulation of the insurance market in Massachusetts would bring the costs way down. Probably so. Can anyone think of an instance in which government intervention resulted in costs going down?

So how is the program doing financially? The 2-year-old program is already $147 million in the red, and the four carriers that provide the subsidized insurance estimate costs rising by 14 percent in the next year.

And what does the state plan to do about it? According to the Boston Globe, state officials have ordered carriers to "cut payments to doctors and hospitals, reduce choices for patients, and possibly increase how much patients will have to pay."

Let's see. The government takes over. Costs go up. Providers get paid less. Patients have fewer choices. For this everyone pays more.

Is this what we can expect if the same thing is done on a national level?

Why We Will Have Nationalized Health Insurance

2008-02-28T08:27:00.004-06:00

Actually there are a number of reasons why we seem destined to have nationalized health insurance (aka socialized medicine, single-payer system, et al). But this one is a prime example that even makes me want to throw in the towel.

Don't get me wrong. As a potential patient some day, I dread it. There is only so much money, and I won't like having my treatment options curtailed by bean-counters in Washington. I won't like NOT being able to get the treatment that I need because some government fiat has rendered the procedure or pharmaceutical or medical device financially unfeasible for the provider to provide.

On the other hand, as a current health care provider, it really burns me up to learn about scams like this one that I heard about yesterday.

Senior citizens on Medicare are now being sold "Medicare replacement" policies. According to the marketing information that I have seen, the elderly are being told that these policies are less expensive than Medicare, and that they are better because patients will no longer need a supplemental policy.

Well, if something sounds too good to be true, then it usually is. And such is the case here.

Yeah, these replacement policies are cheaper, but as in most of life, one gets what one pays for. What the seniors are NOT told is that these private insurance replacements work just like most other managed care plans.

With Medicare, a patient can choose to see any doctor who participates in the Medicare program. Since that is virtually every doctor in America right now, that means patients have a lot of freedom of provider choice. But with these private plans, there is a restricted panel of participants. Patients are suddenly finding their provider options severely narrowed. Our group, the largest private oncology group in the world, has so far refused to join these provider panels because it seems worse than Medicare.

Patients are told these plans cost less than Medicare. Well, how can anything be cheaper than Medicare which is mostly taxpayer supported? I suppose if you are healthy, then the monthly premium could be lower than Medicare's monthly cost. But since the risk of illness increases as people age, the odds are you will use this insurance. And what they do NOT tell you is that there are higher co-pays and higher deductibles than there are with Medicare. So the out-of-pocket expense is actually MORE than if you had just stayed with the government program (ie, Medicare).

If that is not bad enough, these companies have greatly increased the burden for the provider, demanding copies of patient records and letters of necessity and all kinds of (insert bad word here) before they will agree to think about approving a treatment or procedure that they might agree to reimburse us for afterwards.

Our experience so far has been this: The patients tell us they are still on Medicare -- because they think they are. But when we call to verify, we find out they are no longer covered by the program. The expensive chemotherapy treatments that used to be covered now are not. Whereas the patient had NO out-of-pocket expense for their chemotherapy, now they are having to cough up co-pays and deductibles.

Only they aren't. Because they didn't know they weren't on Medicare any more, and they didn't tell us. So we couldn't precertify the treatments. So they aren't approved. So we eat it. Big time -- because we already paid for the drugs that we gave. So then we have to stop giving them because we can't keep absorbing losses which run in the thousands of dollars per treatment!

So then we spend hours explaining to the patients what REALLY happened when they bought this policy, and they are mortified and angry that they were sold a bill of goods. But you can be sure that they are not mad at us. They want back on Medicare, but now it is too late. They are stuck with coverage that is worse than Medicare for the rest of the year, at least.

How stupid can people be? At a time when the country seems to be itching for the government to take over the health care system, why on earth do these insurance companies design products that only further demonstrate why they cannot be trusted? It must be for the same reason that criminals keep committing robberies, rapes and murders until someone else forces them to stop.

I was talking to another physician yesterday about a local health entity which constantly crosses the line with respect to the law and ethics, yet still seems to get away with it. The comment I made to him applies here, too.

I am a capitalist, but somewhere along the way there have to be some rules about what is fair and ethical. When people ignore those rules and seem to have no sense and no shame, then we can only expect the hammer to fall hard when people finally get fed up with the bad behavior.

As I have said here before on numerous occasions: I am not a huge fan of Medicare, but it has been better for patients than most of the private plans we see.

So to those of you who are on it, please listen. Don't fall for one of these "replacement" scams. You will get what you pay for, but that will be much much less than what you think you are buying.

Aging Parents

2008-02-26T08:58:00.006-06:00

It is hard watching the parents grow older.

As I have written about before, Dad has Alzheimer's, a disease that is worse than cancer in many ways. Mom has deforming osteoporosis and arthritis. Her mind is deteriorating, too.

I found myself wondering this morning how I am going to feel when they are gone. Will I be sad, or will I feel relieved for their sakes?

As a cancer physician, I watch people suffer all the time. We do what we can to relieve pain and other symptoms of the actual diseases, but we cannot take away or undo the very facts that they have terminal diseases which have utterly and completely changed most of their lives.

It is a sad fact that most of our patients die. Obstetrics brings babies into the world. Pediatrics and most medical specialties help people to grow and stay healthy. But in oncology, we find ourselves doing the best we can to usher folks out of this life as peacefully and with as little suffering as we can. Consequently, I am all too acquainted with death and dying -- how it affects patients, and how it affects their families.

When it comes to my parents, though, I am not an outsider. This is MY dad and MY mother. The family members are MY brothers and all OUR wives.

Sometimes I can't figure out what I am SUPPOSED to feel. When Mom or Dad complain about some ache or symptom, I instinctively go into "doctor mode." The feelings switch off, and the analyzer switches on. I know this is what they expect -- even what they want. But afterwards, it bothers me that I don't feel more. Have all these years of having to remain objective while watching people die caused my feelings to be so suppressed that they no longer exist?

Yet I know I have feelings. I cry sometimes for reasons that I do not understand. Cheesy commercials can even trigger it. It's like I can only hold the feelings at bay for so long, then they simply MUST come out -- often at the most inexplicable times.

So this past weekend I went to see Dad with my son, David. There was Dad, lying in bed in a fetal position. I woke him up. He seemed a little confused, but then I think he recognized us. I asked him if he was okay, and he said, "I have a headache." Well, Dad never got headaches. Again, I went into "doctor mode" long enough to determine that it wasn't serious. We got the nurse to give him something, and that helped. But who was going to help me? I mean, seeing my Dad lying there helpless, confused, hurting...

It still haunts me, and that recurring memory is what got this started again this morning. I'm already sad about Mom and Dad. So when they finally do pass into the next life, will I be more sad, or will I feel relieved that they are no longer suffering, no longer crippled? Will I be happy that Dad will once again have that brilliant mind to pester the Lord with questions and that Mom will be able to dance the way she always loved to do?

In a number of ways, Dad is already gone. It has been a few years since he was the Dad that I always knew. Mom is close behind. Am I mourning now? Will I mourn more later?

I'm not sure.

Lawmakers, CMS and Patient Groups Wrangle Over ESA Policy

2008-02-20T09:28:00.003-06:00

I'm back.

I'm trying to put together some photos from our recent dive trip to Cozumel, but I simply have had too many other things to do, not the least of which is getting back to taking care of sick folks.

Speaking of sick patients, the drama continues surrounding the government's decision to deny access to agents which are very important in the excellent care of cancer and hematology patients.

InsideHealthPolicy’s Rolf Rosenkranz reports:

CMS’ decision to stand up to powerful Capitol Hill lawmakers who demanded the agency put off its anemia-of-chemotherapy policy for Epogen sort of got lost in the controversy over which patient groups do, and don’t, support the controversial coverage decision.

Appropriators last year told CMS it was inappropriately limiting reimbursement for Epogen and other ESAs when prescribed to certain chemotherapy-induced anemia or bone marrow failure disease patients. CMS shot back in 2009 budget documents that it was sticking with its decision, citing support from patient groups. That’s where things got muddled. Key patient groups insist they haven’t backed the controversial policy, which CMS recently instructed carriers to implement.

CMS told lawmakers that “many members of the patient advocate community, including the National Breast Cancer Coalition” (NBCC) support the coverage decision. CMS’ budget justification document goes on to mention a Dec. 21 letter from the American Cancer Society (ACS), and other patient advocates, that the agency said “expressed ongoing concern” about “additional safety signals seen in trials of ESAs in cancer patients.”

The letter, it turns out, went to Amgen, Johnson & Johnson (who markets Procrit under an agreement with Amgen) and the FDA. While it was copied to CMS, it didn’t even mention the NCD, reports Inside CMS’ Brett Coughlin.

ACS has concerns about safety but does not support the NCD, an ACS representative told Coughlin after a Feb. 11 story – based on the budget documents – stated otherwise. The ACS rep said the society has taken a neutral position on the NCD. The other groups that signed the Dec. 21 letter—C3: the Colorectal Cancer Coalition, the Lung Cancer Alliance, and the Ovarian Cancer National Alliance – also have not taken a position on the NCD.

Groups like ACS and C3 are in a tight spot. Their members, some of whom take anemia-fighters like Epogen or Procrit, say the drugs give them the needed energy and strength to fight cancer and survive the chemotherapy regimen. These advocacy groups must find themselves in a precarious position when they look at mounting data that suggest the meds can be dangerous for some patients, while at the same time many cancer/anemia patients –their members – clamor for the drugs, citing quality of life improvements.

CMS is also in a bit of a jam. While the NBCC, which represents over 600 patient organizations, backs the NCD, ACS – probably the leading consumer/patient advocacy group – doesn’t. Pressed by Inside CMS to issue the list of provider groups that support the NCD, agency officials either couldn’t, or wouldn’t, produce the list.

Meanwhile, CMS – or its budget masters at the White House Office of Management and Budget – are sitting on a report that likely recommends Epogen should be bundled into the composite rate for end-stage renal disease. Acting CMS chief Kerry Weems told House Ways & Means health subcommittee Chair Pete Stark (D-CA) last week that a demonstration project won’t be necessary before the agency implements a bundling policy for ESAs, labs and other services in 2011.

Comment:

For those of you who can't wait for nationalized health care, I hope you'll follow this story. It has important implications for all of us -- providers and patients.

Atheism and Violence

2008-01-29T13:01:00.001-06:00

All right, all right. I don't have time to compose, but I have had a moment here and there to read a good article between patients.

If you want something a little deeper (and more difficult), try this one on for size from First Things.

Religion and the Death Penalty

2008-01-29T08:31:00.000-06:00

I don't have time to blog, but had to mention an interesting article by this title from The Weekly Standard.

If you have a minute, check it out here.

(Acknowledgment: Albert Mohler)

Sorry

2008-01-28T18:35:00.000-06:00

For anyone who may be wondering, I am still alive.

Work is simply NUTS right now. No time to blog. No time to do anything else.

Lord willing, I'll be back in a couple of weeks.

Brain Surgery in Ontario

2008-01-17T18:46:00.000-06:00

.

I'm pretty sure that this is not what we want...

By the way, in the United States, it is also illegal for Medicare doctors (which is virtually every one) to accept anything but what the government allows.

.

Oncology and The Family

2008-01-16T14:15:00.000-06:00

I received the following from a reader of this blog:

Vance;

I wanted to ask you a few questions. My name is Dan, I was just admitted to medical school, and I will begin courses in the fall. I previously spent time shadowing an oncologist, have great interest in the field, and feel inspired by its work. Indeed, I can say at this point in my life that "I want to be a medical oncologist when I grow up."

I appreciate your candidness and insights. Tonight I read your post from last March regarding the potential solutions to the predicted shortage of oncologists. It has again stirred up thoughts in my mind regarding many issues that my wife and I frequently discuss. These thoughts are about my hopes of becoming an oncologist yet still maintaining the hopes and dreams my wife and I have for the future.

Our hopes and dreams are centered around our family life. It is our highest priority that we raise our children with their parents home each evening, reading and studying with them, attending their sporting events, and having family dinner together every night. Though I feel passionate about my future career in medicine, my greatest passion will always be my family. I will never let my career stand in the way of my most precious goals and relationships.

Consequently, we have wondered if it is feasible for an oncologist to operate his own solo practice and limit his work hours to between 30 and 40 hours each week. I am aware that certain oncologists operate solo practices and others work part-time. Is it complete foolishness to ever dream of combining the two (part-time and individual practice)? Could an oncologist succeed with such a career approach?

I'd love to hear your honest thoughts and opinions. Thanks.

Reply:

Dear Dan,

Congratulations on your acceptance to medical school. We all know that acceptance to medical school is a very competitive process, so the very fact that you got admitted tells us that you are a smart guy who knows how to persevere and remain on-task. It also tells us that you have already made certain sacrifices to attain this first goal.

I also want to congratulate you for having such admirable priorities. It shows that you are at least cognizant of the difficulty there is in determining how your duties as a physician should mesh with your obligations as a husband and father.

Your questions are good ones, yet not as simple to answer as one might think. The biggest problem is that the future of medicine in this country is quite uncertain. Things are changing rapidly. Whether those changes will all be for the better remains to be seen.

It is important to realize that you are roughly 10 years away from becoming an oncologist (4 years of medical school, 3 years of Internal Medicine residency, and 3 years of fellowship). A LOT can happen in that time frame. I cannot tell you with certainty what the medical world will look like a decade from now, but I can tell you about some trends that I (and others) are observing.

Decreasing Physician Supply

The bad news for patients is that the supply of physicians is decreasing in relation to the rising number of patients who will need doctors soon. The overall physician supply is flat or slightly decreased. That is, physicians are entering the work force at or slightly below the rate that physicians are leaving practice. However, the first wave of baby boomers has reached the age where they need doctors, so the demand for physician services is outstripping the supply. This is particularly true of certain sub-specialties such as Oncology where there is a net loss of 125-150 oncologists per year.

While increased demand for their services would ordinarily be good news for doctors, you must know that medicine does not operate in a free market with the usual rules of supply and demand. Medicine is highly price-controlled. At a time when physician income should be rising -- due to increased demand -- physician income is actually falling due to government mandate and commercial insurance pressure.

I say this not to complain, but to point out the natural pressures that will affect you. While it appears you will never have to worry about running out of patients or of being out of work, it remains to be seen whether that job will pay what you need it to pay in order for you to pay off any debt incurred during your 14 years of training and to provide a decent level of support for your family.

So, without going further, you can see that you could be pressed to see more patients each day -- both because of the high demand and because the only way a physician can earn more income is to see more patients.

People Don't Get Sick on Schedule

How will these pressures play against your desire to spend time with your family? You might think that it would not be so difficult to work it out. You simply establish office hours, and you adjust your home budget to match a conservative, reasonable lifestyle. Right?

Maybe. You will quickly learn that people do not always get sick during office hours. Patients have an annoying habit of calling about 4:45 pm on Friday afternoon to tell you about the "emergency" that they have been fiddling with or ignoring all week long. You think you are ready to go home after a hard week's work, but no! Of course, most people respect your time, but it only takes one bonehead to screw up the Friday evening dinner you had planned with your wife.

Even if you are lucky enough for the patients to call you before the problem turns into an after-hours emergency, you still find yourself having to work them into an already-full schedule. This can "bust your schedule" and significantly lengthen your day by the time you finish filling out all the paperwork that the government bureaucrats, insurance companies, and lawyers all require.

And just when you think you have your office under control, you'll get a phone call from another physician wanting your advice on one of his hospitalized patients. So you also get to figure out where to fit in another unexpected hour's worth of work.

In short, Oncology means taking care of sick people, and there is simply no way to control when people get sick and need you.

Experience Helps

As you can now see, medicine is a demanding mistress. She will take all of you that you are willing to give. Some of my friends and colleagues have given more than they should have, and their personal lives have suffered greatly.

On the other hand, I know plenty of physicians -- busy ones -- who have learned the art of time management. They have learned how to juggle the needs of their patients and their families.

If you ask my wife or kids, they will almost certainly tell you that they think I work too much. When I am not at the office, the emergency room, or doing a hospital consult, I may be at home reading up on the problems I will encounter the next day, preparing a presentation, or studying for a recertification exam. I often wish I could have spent more time with my kids, but when I look back, I realize that I actually spent more time with them than my non-physician father did with me. Somehow, in the midst of long hours and nights on call, I still managed to coach my two younger sons' basketball teams, go to karate with my oldest, and take some pretty cool vacations with them over the years. We have many good memories.

Things to Watch

You may be drawn to Oncology now, but as you go through training, your interests may change. Be open to that. You may find some other specialty more conducive to your goals than oncology. (Dermatology comes to mind.)

You also need to keep your eye on the political landscape. Although doctors still catch all the blame for the high costs of medical care (they are an easy target), the fact is that they have very little control. Should the system become federalized, they will have even less control. While that might seem bad on the surface, the actual effect will probably be that doctors' lives will become easier. They won't make as much money, but they will have more time on their hands.

Go For It!

So, Dan, is it possible to be a cancer specialist and have a nice family life? Absolutely Yes! But I hope that you can see from my reply that it is not something that will happen naturally. The inherent pressures are geared towards you sacrificing time with your family in order to help more patients or to make more money.

You are the only one who can determine what is right and to what lengths you are willing to go to achieve your goals. You will have to work to achieve the balance between being there for patients versus being there for your kids; making more money to help the kids with college versus coaching them to qualify for scholarships; seeking the approval of your colleagues versus being the apple of your wife's and kids' eyes.

It is not easy, but it is definitely a realistic goal.

Political Notice

2008-01-12T12:30:00.000-06:00

Once again the season is upon us. Actually, it was forced upon us way too early, but here we go nevertheless.

One of my blogging buddies has issued his appeal for voters to consider John Edwards for President. I have not yet made up my mind whom I will support. I'm not really enamored with any of the candidates.

It might be easier if I were a died-in-the-wool supporter of one of the parties, but alas, I am not. I vote issues, not parties. Consequently, at one time or another, I have been registered as a Democrat and as a Republican. (For purely pragmatic reasons, I shy away from third parties.) It is rare that I ever vote a straight ticket. In the last election, I voted for Republicans AND Democrats.

But only because I have to.

I don't like politicians. I have a hard time respecting people who make a living by compromising their principles. On the other hand, this is the way the world works, and compromise is what allows us to live together in a free society.

If I decide to punish myself by jumping into the political blogosphere, I am more likely to talk about issues than party lines or personalities.

Just so you know before yielding to the temptation to label.

The Cost of Lung Cancer

2008-01-06T14:47:00.000-06:00

A Harvard researcher recently reported her results of a study about the cost of treating lung cancer. The results are interesting.

She found that over the past two decades, life expectancy for patients treated for non-small cell lung cancer has improved by 18 days. That's the good news.

She also found that the cost of those extra two weeks of life has risen from $20,157 per patient to as much as $143,614 per patient life-year for localized cancer, $145,861 for regionally advanced lung cancer, and $1,190,322 for metastatic lung cancer!

The most surprising result from the study, though, was that it costs less to have lung cancer than it does to NOT have lung cancer and die from something else.

How's that? The answer may be that the end-of-life costs for the general population have risen even higher than for those who have lung cancer.

I have made the point repeatedly on this blog that he who pays for medical care controls medical care.

So, if you are boss of government-sponsored health care, what will you do with this information?

Santa Rosa's Blue Hole in Winter

2007-12-31T13:00:00.000-06:00

Believe it or not, the busiest season for diving in the Blue Hole is winter. Maybe that is why they call it the BLUE Hole.

Perhaps that is because it is the best, if not only, place to make deep dives, test gear, and practice diving skills within a couple hundred miles of cities such as Denver, Albuquerque, and Amarillo.

We ended 2007 with another trip to the Blue Hole this weekend. The water, which is normally a "refreshing" 61 degrees, was 58 at the surface. The air temperature was 28 in the morning when we started, finally warming up to 34 by the end of our day.

We went with John and Beverly, and their son, Jeff. They are hard core divers -- which is what makes it bearable. John, our friend/instructor, built a really nice dive trailer with built in propane heaters, electricity (for hot water for coffee or hot chocolate), tank racks, and everything else you might need. John and Jeff cheated -- they used dry suits. The rest of us toughed it out with 7mm wetsuits, hoods, boots, and gloves.

The air was cold, made worse by the frosty wind. Fortunately, this had the effect of making frigid water seem warm. Getting that first wave of water filling your suit was a little uncomfortable, but after that, the most we felt was a slight chill. While moving under water, we felt just fine.

Diving at 4600 ft altitude increases the risk of decompression sickness, and our first few dives were at or near the bottom, between 70 - 80 feet. John was playing with his new high definition underwater video camera, and I was trying out the underwater housing the kids gave me for my little camera. Messing with the gear was sometimes distracting, and we tended to mess up a little with our buoyancy. Nevertheless, I am happy to report that no one "got bent" or showed evidence of nitrogen narcosis. Well, except maybe John who seemed to spend lots of time hovering upside down, standing on his head -- presumably to get some interesting camera angles on the other divers. (Ain't weightlessness cool?)

The dives all went well except for the night dive. After our last outing, we had told Janie and Bev that the night dives in the Blue Hole were so much fun because of the critters that came out from the rocks at night. However, this time the night dive was not so much fun. Instead, it was unnerving.

The water that fills the Blue Hole comes in from the bottom. There is a huge underground cavern system. People used to dive in it, but after some deaths, a large metal grate was placed over the entrance to keep people contained within the Blue Hole itself. Occasionally things happen within the deeper underwater caves. Ground shifts, walls collapse -- that sort of event. Anyway, for the past month or so the water in the Hole -- which is normally crystal clear -- has been somewhat murky. Folks speculate that something big must have collapsed, sending silt out into the Blue Hole.

Such was the case with our attempt to make a night dive. Our plan started out just fine. We descended and floated down to the first dive platform at 22 ft. From there the plan was to simply swim around, circling the walls at about 40 ft, looking at all the critters, crawdads, fish and stuff which people had put there over the years.

The problem was, even though we had on tank beacons and all had lights with backups, we couldn't see a darned thing. Our lights simply reflected off all the silt. It was like trying to drive in fog with your bright headlights on. We had trouble seeing the wall. We had trouble seeing each other, and it went downhill pretty quickly from there.

Because we had no visual references, it was next to impossible to tell whether one was staying level, dropping in the water, or ascending. You simply could not feel the difference, except for the occasional change in pressure on your ears.

Janie wanted to stay close to me. This was a nice thought, but before I knew it, she had me pinned against a wall at about 45 ft depth. I maneuvered to regain position so that we could move on, but as I did, she started to fall.

"Oh, No!" I thought. "She's falling!"

I turned head down to grab her, feeling she might get scared! But I couldn't get to her in time. She continued to drop, faster and faster. It didn't take but a few seconds before I could see that I wasn't going to get to her in time. But she had already been to the bottom before, and she knew that once there, she could breathe. Besides, John was right beside her, so she would be okay, I thought. Assured of that, I turned heads up again to re-orient myself -- only to hit my head against a ledge that hangs out from the wall nearer the top.

What?

I checked my depth gauge. 18 ft. Again, "What? How did I get here?"

Have you ever been on a bus or a train which is parked next to another bus or train, and when one starts to move, you aren't sure whether it is you or the other bus which is moving? That is what had happened.

Janie wasn't falling at all. It was I who was messed up. Somehow, I had started ascending, but I couldn't feel it at all, and my eyes perceived that Janie was the one moving. Since the worst dive injuries can occur with uncontrolled ascents, I was suddenly very thankful that nothing hurt, and that I could still function. I gathered my nerves, dumped air, and dropped back down to rejoin the group. I finally found Janie, and John found us. John had finally located the platform and pointed the way with his light. We swam over to it, happily made our safety stop, and ascended to end our dive.

At the surface, Janie remarked, "Wow. That was ... interesting! We need to talk about that dive."

It all happened so fast. We laughed about what a comical sight it must have been -- everyone going in different directions, some going up while others were going down. Yet it was also very, very instructive. We were proud that no one had panicked and that everyone was safe.

Once home, I downloaded the dive information from both our computers to try to reconstruct what had happened. In retrospect, Janie had actually dropped about 8 feet, but I had really ascended almost 30 ft in a matter of 20 seconds or less. Had I not been trying to swim downwards, I might have ascended faster and gotten hurt.

The next day, our dives were much more routine. The daylight improved visibility to a manageable level, and we were able to work on skills, test our gear, and to RELAX.Jeff observed later, "The bad dives help you learn. The good dives help you stay confident." He was correct.

Who Were the Wise Men?

2007-12-21T08:00:00.000-06:00

The Archbishop of Canterbury says that the story of the three wise men is only a legend. You can read his remarks here.

He is partially correct.

I agree with him that Jesus was probably born in the spring, not in December. I agree that the celebration of Christmas was timed to replace the pagan celebration of the winter solstice. I agree that Matthew's gospel account does not specify that they were kings, nor does it even say how many "wise men" there were.

However, I think it is highly likely that the story is based upon historical fact.

We must remember that Jesus, or Yeshua as he would have been called, was a Jewish boy born to Jewish parents living in a Jewish world. The various legends and popular misunderstandings arose in a Gentile culture which has been largely unfamiliar with Jewish history.

The best scholars agree that Matthew was probably originally written in Hebrew. It was later translated into Greek. The original Hebrew accounts have not survived, so the oldest texts we have are the Greek ones.

In Greek, the word used for "wise men" is magi. The singular is magos. The word is regarded by many to be of Babylonian origin (which should have been a clue right there). Magos can have many meanings, including wise man, teacher, priest, physician, astrologer, seer, interpreter of dreams, augur, soothsayer, or sorcerer. The common interpretation which has come to us has been that the wise men were astrologers because they said they "saw his star in the East."

The story becomes more clear when we read the story in Hebrew. Although no Hebrew originals survive, scholars have successfully translated the gospels from Greek back into Hebrew using various Greek/Hebrew translations (such as the Septuagint) as guides.

In the Hebrew translations of Matthew, the word for wise men is chachamim, or chacham in the singular. In Hebrew, chacham refers to a wise man or a scholar -- more commonly known now as a rabbi. Okay. We all know what a rabbi is.

So why would rabbis be coming to Bethlehem from "the East"?

First, check a map. What great ancient city is east of Jerusalem? Well, Babylon is straight East very near modern-day Baghdad in Iraq (formerly called Persia).

Remember that in 586 BCE, the Babylonian king Nebuchadnezzar destroyed Jerusalem and carried the people back to Babylon where they remained captive for 70 years. When the Medo-Persians conquered the Babylonians in 539 BCE, the Persian king, Cyrus, presented himself as a great liberator and benefactor. When he was shown a 200 year-old scroll of Isaiah bearing a prophecy which mentioned him by name, he was notably impressed and agreed to let a small remnant of Jews go back to Jerusalem to rebuild the city, the walls, and the Temple.

Most people know this much. But what they do not know is that while the Jews were held captive in Babylon, the Hebrew religion evolved remarkably. The time of Jewish captivity in Babylon became a refining fire which purified the gold of Yahweh worship. It was during this time that major religious developments took place which survive even to this day.

With Jerusalem in ruins, Babylon had evolved into the major center of Jewish religious and scholarly activity, and it remained the hub of Jewish scholarship for centuries, even during Jesus' day. (Jerusalem did not resume its place as the center of Jewish learning and scholarship until May 15, 1948.) In fact, the more extensive and popular version of the Talmud is the Babylonian Talmud, not the Jerusalem Talmud.

So who were the wise men? Simple. They were Jewish scholars, rabbis who had read the Messianic prophecies and knew that "a star will come from Jacob, and a scepter will come up from Israel." (Numbers 24:17) They, like most other Jews at the time, were eagerly awaiting the Messiah. They knew he would be born in Bethlehem, and they had a rough idea about when he would be born. It is not difficult to imagine that when they heard reports of miraculous events surrounding the birth of a Jewish baby in Judea, they may have wanted to check it out.

We do not know how many chachamim came to see Jesus, and we do not know exactly when they arrived. The traditional number three most likely comes from the fact that three gifts were recorded as having been given to Jesus -- gold, frankincense, and myrrh.

As to timing, while most nativity scenes depict three wise men as being present at his birth, it is more likely that they arrived up to 24 months after the fact. We say this because when asked where they might find "he who has been born king of the Jews," Herod began asking questions himself, wondering exactly when and where the child would have been born. Being very paranoid, he subsequently ordered the massacre of all infants two years and under.

When we think about this, it makes much more sense. Why would Eastern, polytheist astrologers be interested in traveling hundreds of miles to visit a baby who would become king of a tiny Roman province? They wouldn't. But would Jewish rabbis have been willing to trek through the deserts to find the boy who would become Messiah? Without a doubt.

So there it is. The rest of the story.

Things Worse Than Cancer

2007-12-16T07:30:00.000-06:00

There are things worse than cancer.

Last week Dad was finally transferred to the Alzheimer's unit. We had known this was coming. Once upon a time, Dad even knew it, though he had no clue when the time actually arrived.

My Dad has to be one of the smartest men I have ever known. He was never eloquent; he didn't really talk that much. (Now I wish that he had.) He was one of those World War II kids who enlisted in the Navy while still in high school. He was subjected to testing, and right off the bat, along with 4 other guys, was sent to the University of Texas to study Electrical Engineering. But as part of a special, secret Navy program, they were also working with new weapons technology that ultimately led to what we now know as microwave.

Dad had wanted to study Law, but he was told to be an Electrical Engineer. So that's what he did. He did his undergraduate and Master's level work in the span of 4 years. He never got his Master's Degree because a woman in the department died unexpectedly, and his thesis was lost with her.

No matter. Dad left Austin and went to work. He was recruited by Southwestern Public Service Co., and he started with the company "at the bottom." Soon he was promoted into management, and over the rest of his career he rose steadily to the top. He retired as President and Chairman of the Board of a company that spanned 5 states and was named by Forbes as "The Best Run Utility Company in America."

One of my brothers and I had business relationships with SPS, so we got to see Dad at work as well as at home. He was pretty much the same in both environments: demanding, but fair. He expected a lot from people, but no more than they should have expected from themselves. He loved the company, and he loved the more than 2,000 employees who worked for him. He wasn't the friendliest man; he showed his love through his actions, not his emotions or his words.

We also got to see just how smart Dad really was. Here he was handling millions of dollars, yet he was an engineer, not a businessman. My brother, who does have a Masters in Finance, marveled at how Dad always seemed to come up with the right answers, if not always with the same reasoning that a financial person would have used.

After retirement, Dad got interested in computers. He wanted to learn to use such programs as Quicken and TurboTax. At first he caught on in a flash, but after a couple of years and upgrades, it seemed that I was spending more and more time on the phone with him. One of the problems with buying your dad a newer computer is that you also take on the tech support.

At the most inopportune times, Dad would call to tell me, "I have things messed up, and I can't fix it." This was from the man who never had to call a repair man or a technician because he could fix anything, and did. But not now. I would ask, "Dad, have you read the manual?" He would reply, "Yes, I tried, but I don't understand their words."

I used to get so aggravated. I mean, we were going over the same problems, the same questions over and over and over. It was so much easier for me to just fix it, but he insisted that I show him how to do it. He so wanted to understand it. But it took me a long time -- a couple of years -- to realize that he just couldn't.

This was our first clue that something was wrong. And when he started repeating himself, we realized what we were probably dealing with. Even then it was hard to be sure for two reasons. First, the disease is so insidious and so unpredictable that you tend to just write the lapses off to simple aging. Second, Dad was so smart that he could cover up extremely well. Dad in the early stages of Alzheimer's was like most people on an average day.

One of the problems with dementia is that the person with the problem doesn't know he has a problem. It took awhile, but when Dad came due for his annual physical, we asked the doctor to check out his mental status. He did, and he told Dad what was going on.

Whereas most people might have been devastated with such news, Dad, true to form, took the bull by the horns. He asked lots of questions of me and his friends who had relatives with Alzheimer's. Then he turned to his lawyer and financial advisers to make sure that Mom would be well taken care of when he was no longer able to look after her.

The next few years went by painfully slowly, but in the past year the slippage became much more obvious. Thankfully, when the doctor told Dad he couldn't drive anymore, Dad agreed without a fight. (Until the doctor had spoken, Dad still claimed that his judgment and reflexes were as good as they had ever been -- which was so not true!)

The last few months got harder and harder on Mom. Dad's insistence on being with her became suffocating. He started falling a lot, and it is a wonder he never broke anything. Still, it was unnerving. Mom had had a stroke herself. Early one morning I went by their house to pick her up to take her to the hospital to have carotid artery surgery. When I walked in, I found Dad lying in the kitchen floor, blood everywhere. Dad had fallen again and cut himself. Fortunately, another family member arrived, and we were able to get Mom to the hospital and Dad cleaned up.

Episodes such as this increased in frequency. Eventually Mom could bear it no more, so we packed them up and moved them to assisted living -- Dad complaining the whole time that we had stolen all his stuff and left him at his house with no furniture, no food, and no money. He had to sit there alone for a few hours before he would finally consent to go be with "that woman."

Over the next few weeks, we saw some improvement in Mom's health as the load of cooking and housekeeping was lifted. Dad could no longer remember our names, but he recognized us as family. Sometimes he would forget who Mom was, and more than once he asked her to marry him. "Bill," she said, "we have been married for over 60 years!"

He smiled and replied, "Good."

Dad was not the only one falling. This time Mom fell and broke fingers on both hands. Both had to be splinted in such a way that she could no longer do even the simplest of routines by herself. So Mom and Dad were moved from assisted living to the nursing home portion of the facility. This worked out okay until Dad developed a kidney stone and had to be hospitalized.

The hospital stay was a week long trial for everyone. Dad did not understand why he was there, didn't know where "there" was, and wasn't very cooperative. Like many older patients with dementia, he would sleep all day, then be awake all night, trying to get out of bed, pulling out his IV, and tugging on his Foley catheter. We kept waiting for the stone to pass, but it finally took a surgical procedure to get it out.

This episode took the last little bit of wind from Dad's sails. We had also observed that while Dad was away, Mom's disposition and strength dramatically improved. As soon as Dad returned to the nursing home, she started getting dragged down again both physically and mentally. It became clear that they needed to be separated. It was now time. Time for Dad to go to the Alzheimer's unit.

Last week, the night before the move, the care center put on a Christmas dinner for all the residents and their families. We attended -- not only to take part in the dinner, but also to say goodbye to Dad. We had been told that once people go to the unit, they get comfortable there and tend to forget for good who people are. So now we are in the stage of letting Dad get adjusted, and we are not supposed to visit him right now lest he have to go through the grief of separation all over again.

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As my blog heading implies, I am a people watcher. I watch families and patients with cancer. I hate seeing, over and over again, the sadness that ensues when hope turns to disappointment, laughter turns to tears, and love turns to grief.

Dementia is also a slow dying process. But unlike cancer, in which the physical deterioration precedes the mental, with dementia the mental death comes first.

The thing that I hate about dementia is not just that it robs the person of his mind, his memory, his personality, his coordination, and his dignity -- but that it also robs the families of many good memories as well. As much as I try to remember what Dad was like when he could still perform complicated math equations without a pencil, the most recent visions of a man who can hardly form a sentence get in the way. My recollections of him being so physically strong that he could man-handle a stuck whisker pole while racing in a 30 knot wind during a regatta -- a feat that my brother and I together could not accomplish -- those memories are crowded by the current images of a frail, bent man who can hardly walk.

On the other hand, we are seeing a side of Dad that we never saw during most of our lives. Dad was not affectionate. He hardly ever said, "I love you." And he never said, "I'm sorry."

The other night Janie and I nearly lost it when he sat there at the dinner table. I had to cut up his meat for him, and I had to help him get it to his mouth. He accidentally knocked over a glass of tea. He had to be moved by a wheelchair. He sat quietly, then said softly, "I'm sorry. I'm sorry I ruined everything."

He wasn't talking about the meal, though. In reality, I think that it is so ingrained in his soul to take care of others that he felt our lives were ruined because he realized that now we are having to help him the way that he helped us for all of our lives.

No, Dad. You haven't ruined anything. This isn't a burden. It is a privilege.

Science and Miracles (Part 6)

2007-12-11T06:00:00.002-06:00

The Limits of Materialism

This series of posts is about the relationship between science and miracles. If you are just now joining, you should start at Part 1.

Here is what we have said so far:

Miracles are singular events that, by definition, happen only once. Science is generally based on observation and repeatability. However, science can offer explanations for singular, unrepeatable events by comparing them to similar repeatable events.

One unrepeatable event was the origin of life. Life is made possible by the information contained in the genetic code. We repeatedly observe that information comes from intelligence. Therefore, it is within scientific boundaries to hypothesize that an intelligent being was involved in the origin of life.

Although someone someday may demonstrate how life may have originated, no one will ever prove how it actually occurred. No one was there to see it. The best we can hope to do is reach agreement about what is the most likely explanation. It is beyond the scope of these posts to delve into the various claims made by the numerous contributors to this debate. All I want to stress is that it is reasonable and scientific to postulate the influence of intangible, unmeasurable forces by making inferences from evidence which is evaluable -- namely, the key role of information. (Feel free to disagree. A lot of people do.)

Even the simplest organisms contain enough information in their DNA to fill a book. Everywhere we look, information is seen to derive from intelligent sources. Everywhere we look, life produces life. Therefore, when we see intelligent life, it is reasonable to postulate that intelligent life was at the source, tangible or not, now living or not. This is a scientific inference, not a religious conclusion. The conclusion may lead to religious implications, but as we said before, the implication of a hypothesis is not the same thing as the hypothesis itself.

Now, we started this series talking about miracles. So why are we now talking about the origin of life? Well, here is why:

If we can scientifically conclude that the origin of life could have been the result of intelligent action, and if such activity was a singular unrepeatable event, then by definition it was a miracle. Most important, we reached this conclusion through scientific inquiry and explanation, not religion.

Science can easily postulate the influence of an intelligent agent without knowing anything else about the agent (or agents). Science can observe the effect, the result. It is here where science and religion interface, and it is the role of religion to subsequently attempt to describe the nature of the intelligent agent.

Conclusion

To recap, the materialist position is that scientific understanding is always based on repetition of events. Miracles, by definition, are not repetitive events. Therefore, there can be no scientific way to understand miracles. This is where the materialist stops.

But it is important to note what that line of reasoning does not say. It does not say that miracles do not occur. It also does not say that singular events cannot be analyzed. It only says that science is based upon repeatability, and that singular events must be understood on the basis of observable repeatable events.

Thus we could restate the naturalist's argument this way: Scientific understanding is based upon observable repetitive events. Miracles are singular events. There are scientific theories about singular events which scientists accept as valid because they can compare them to observable repeatable events. So if scientists have methods for understanding and examining singular events, then miracles need not be eliminated from the realm of science.

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And there you have it: my explanation of how science and miracles can co-exist. If it helps you, great. If it offends you, I'm sorry. There are millions of other blogs that you may enjoy more. In either case, thanks for dropping by mine.

Jan 2, 2008 update: I found the link to the article which I borrowed heavily from. It is by Norman Geisler and can be found here.

Science and Miracles (Part 5)

2007-12-10T05:00:00.000-06:00

If you are just joining this series now, please go back to Part 1 so that you can follow the line of reasoning up to this point.

In Parts 1-2 we discussed the singular nature of miracles compared with the repeatability requirement of science. In Part 3 we described how the principle of uniformity allows scientists to draw conclusions about events which are not repeatable. In Part 4 we looked at examples of unrepeatable events which are accepted by science. We also noticed that it is instinctive and scientifically valid to associate information and complex systems with intelligent causes.

We ended Part 4 by noting: If science recognizes that in most (if not all) presently observable cases, information points to intelligent causes, then it is reasonable to postulate that intelligence may have been behind a singular event such as the origin of life.

Now before we we go further, let me make clear what I am not saying. The implication of a theory is not the same thing as the theory itself. When the Big Bang theory was first proposed, many scientists resisted it because it seemed to have religious implications that pointed to a first cause, a creator. (Religious people also resisted it because they thought it was a natural explanation that excluded God.) Over time, however, as everyone calmed down and looked at the evidence, it became clear that the theory stood on its own scientifically because the evidence supported it. The implications had nothing to do with its acceptance, and in fact, people still argue over the implications. So with respect to the idea that there must be intelligence behind the language of DNA, I am not saying that science should conclude that God created life as we know it. I am also not saying that the action of an intelligent agent necessarily excludes a process of evolution.

What I am saying is that if we want to insist on adherence to the principle of uniformity, then perhaps we should not so easily accept the notion that non-living matter simply gave rise to life all by itself until we can observe similar events happening on a repeated basis in the present.

Here is what we know from everyday observation.

We know that life produces life, and intelligence produces intelligence. Intelligent people can create non-intelligent machines that perform life-like functions, and they can create devices that mimic intelligence ("artificial intelligence"). We have tinkered with the natural method of procreation so that we now have "test tube babies" and clones, but we have not yet seen life arise out of nothing.

Scientists claim to have created conditions in which some of life's building blocks, such as amino acids, formed on their own. Others believe they have demonstrated how chemicals can rearrange themselves in a manner that might lead to more complicated chemical structures. But they have not yet created life, nor have they provided adequate scientific evidence that non-living matter can give rise to either life or intelligence.

But what if they did? Even if scientists did create an environment in which life seemed to arise on its own, and even if that life could be shown to be intelligent, could we accurately conclude that this was completely natural and that it could have happened without their intelligent rigging and tinkering in the first place?

The more we learn about cellular biology, the more apparent it is that life is produced and sustained by the preservation and transmittal of the information contained in nucleic acids and proteins. Very recent data even indicate that much of what used to be considered "junk DNA" is not really junk. The transmission of information is important, and if you go back and read my posts about oncogenes and transcription factors, you can see what happens when that information gets corrupted.

So our observation still stands. If we repeatedly observe that life is produced and sustained by the information contained in the genome, and if we repeatedly observe that information is a product of intelligence, then it is not unscientific to postulate that DNA-driven life might be the product of an intelligent cause.

If, at this point, you want to object and claim that I must be a creationist, then you are jumping ahead and erroneously conflating an implication of the postulate with the postulate itself. A lot of people on both sides of the issue seem to have trouble prying the two apart, but some dispassionate reflection can get it done.

Again, all I have said up to this point is that the DNA code is a language which conveys the information necessary for life. Everywhere we look, information is associated with intelligence. Therefore, it is reasonable and scientifically valid to propose that intelligence lies behind the mechanisms of life.

(Next: The Limits of Materialism)

Science and Miracles (Part 4)

2007-12-09T04:00:00.000-06:00

Pattern Recognition

If you are just joining us now, you should go start at Part 1 to catch up. Otherwise the rest of this may not make much sense.

In Part 3 we discussed how the principle of uniformity allows scientists to understand extraordinary, unrepeatable events that occurred in the past by comparing them to observable, repeatable events in the present.

Let us continue by asking: If we are able to scientifically understand singular events that occurred in the past by observing repeated events in the present, then can we not also scientifically understand a singular event that occurs right now? Can we not compare it to similar current experiences? Can we not see whether the singular event fits into some sort of pattern? Of course, we can.

This, too, is something we do intuitively. We are always observing things, people, effects, results, etc. Our minds categorize and store information in "patterns" that we subconsciously use to interact with our world and other people.

This can be a very powerful tool. For example, what if someone in New Mexico monitoring the Very Large Array (pictured above) received the message from space, "We'd like to visit your planet." Would the recognition of a pattern of intelligible communication be sufficient scientific evidence to conclude that there is intelligent life beyond earth?

Carl Sagan said it would be. In his book, Broca's Brain, Sagan said that one intelligible message would allow us to know that there is intelligent life out there somewhere. Why? Because we know from daily experience that language and information are products of intelligent, rational beings. Therefore, the discovery of a message from space would be all the evidence we need to conclude that some kind of intelligence was the source of the message.

As Sagan points out, the information does not have to be verbal. Look at Mt. Rushmore (pictured). Does anyone seriously conclude that it was the result of erosion? Of course not. While the random forces of erosion do sometimes form shapes that we can interpret as recognizable patterns, the exactness, complexity and attention to detail of Mt. Rushmore lead us to instantly realize the difference between erosion and intelligent action upon the mountainside.

So if respected scientists like Carl Sagan can be convinced by a single message that intelligent life exists elsewhere, and if anyone can instantly recognize the difference between natural effects and intelligent intervention, then when we observe the complexity of life and study the language contained in the DNA that makes life work, it is entirely reasonable to hypothesize that intelligence may have been behind the origin of that information.

Richard Dawkins, the prominent atheist, would disagree. He maintains that things only appear to be designed. If he and others want to think that, fine. I can picture them looking at Mt. Rushmore, telling themselves, "It's just erosion. It's just erosion. It's just erosion..."

Now, be careful at this point. I have not said that the DNA code and complex cellular machinery of life is proof that there is a god. I have not said anything about what mechanism an outside intelligence may have chosen to bring about life as we know it. If the intelligent being (or beings) chose to work through a process of evolution, it does not matter to me.

All I have said so far is that it is not difficult, and it is not unscientific to recognize a product of intelligence when we see it.

(Next: More on Information)

Science and Miracles (Part 3)

2007-12-08T03:00:00.000-06:00

In Part 1 of this series we defined miracles as singular, extraordinary events which defy explanation by the usual methods of investigating causes. We also said that science depends upon observation and repeatability.

In Part 2 we elaborated on the repeatability requirement and how it seems to put miracles, which are not repeatable, outside the realm of science.

Now we will look at how scientists explain events that happened in the past.

We said earlier that science does not validate events or experiments which cannot be repeated. But actually, this is not quite true. There are singular, extraordinary, unrepeatable events whose explanations scientists commonly accept. For example:

The Big Bang is widely accepted as a valid scientific explanation for the origin of the universe. Yet it only happened once, was not observed, and is not a repeatable event.

Spontaneous Generation is a hypothesis, sometimes called the "chemical origin of life," which some scientists use to explain how life emerged from non-living matter. At the moment that life emerged from non-life, it was an event that could only occur once, was not observed, and was not repeatable. (There can be only one "first time.")

Most biologists accept evolution with common descent as the best scientific explanation for the origin of our species. Yet when the first homo sapiens emerged from some other species, it was an event which was not observable by modern scientists and is not repeatable.

Do you see the inconsistency? No one observed the Big Bang. No one saw life spontaneously appear. No one witnessed the evolution of lower animals into humans. Furthermore, none of these events are repeatable. If science demands observation and repeatability, then our explanations for these seminal events should be labeled as "not science." And yet they are not. Why?

The Principle of Uniformity

Scientists realize that there are events which only occurred once, could not be observed, and cannot be repeated. Nevertheless, we can still form testable hypotheses about what may have occurred. How?

In such cases scientists make use of the principle of uniformity which is based upon the assumption that the laws of nature have not changed substantially; things happen the way they have always happened. The idea is that if the laws of nature have remained constant, then we may understand singular, unobservable, unrepeatable events from the past by comparing them to similar observable, repeatable events events which occur in the present.

Using this idea, astronomers feed measurements of light and distances into mathematical computer models which allow them to "recreate" the Big Bang over and over.

Imagining what the primordial world must have been like, biochemists mix chemicals and gases together in the presence of energy to see whether life will emerge. If it does, then they can make an educated guess that this is how it may have happened in the past.

By observing small genetic changes which lead to different phenotypic expressions in animals living in the present, evolutionary biologists can hypothesize that enough of these small changes over a long, long period of time may explain the larger changes which we recognize as different species today.

So the principle of uniformity allows one to conclude that even though there were singular events in the past which we did not and could not observe, they can still be understood scientifically by observable, repeated events which occur in the present.

Next: Pattern Recognition

Science and Miracles (Part 2)

2007-12-07T02:00:00.000-06:00

More on The Repeatability Requirement

In Part 1 we defined miracles as extraordinary, singular events or effects which surpass human or natural causes. We also established that science is based upon observation and repeatability.

In fact, science is so firmly rooted in repeatability that odd events are thrown out as chance or as fluke events. They are not considered as part of scientific explanation. Even a statistically robust experiment, if it cannot be repeated, is not fully accepted.

Since miracles cannot be repeated, then it would seem that they lie outside science. Indeed, scientists who adhere to a strict materialistic worldview say that it is impossible to use science to explain singular extraordinary events, and they assign miracles to the realm of the supernatural, religion, or fantasy.

Because miracles are so often ascribed to a supernatural being or deity, there is misunderstanding on both sides. The religious recognize the singularity of some event and quickly jump to give credit to god. The materialists don't mind as long as the religious don't try to mix it with the materialist's view of science. But if the religious even talk about trying to use science to explore the boundaries of the natural world with the scientific method, then critics play the repeatability trump card, claiming that science cannot be used to attribute extraordinary events or effects to anything, much less a rational agent. "You are mixing religion with science!" they exclaim.

Even to non-scientists, this requirement for repeatability seems intuitive. For example, let's say that Mary picks up a set of darts and hits the bulls eye on her first throw. Everyone's instinctive reaction is, "Let's see you do that again."

Naturally everyone wants to know: Did Mary really cause the dart to hit the bulls eye? Did she get lucky (i.e., was it random chance)? Did some unseen force guide the dart to the center of the target? If we stop at only one throw, there is no scientific way of being sure. But if Mary keeps throwing darts and keeps hitting the bulls eye every time, then we could reasonably conclude that she is causing the darts to go there.

We intuitively place the same requirement upon non-intelligent forces. Let's say that we put the letters of a Scrabble game into a cup, shake them up, then toss them onto a table. If the letters fall so that the message "stop doing that" appears, what are we to think? Few would be inclined to think that the letters arranged themselves that way, but without additional attempts, there would be no scientific way of demonstrating that it was just a random happenstance.

So whether we are dealing with unintelligent or intelligent (rational) causes, the requirement for repeatability once again seems to place miracles -- which by definition are not and cannot be repeated -- outside the realm of science.

But is that so?

(Next: The Principle of Uniformity)

Science and Miracles (Part 1)

2007-12-06T01:00:00.000-06:00

A few months ago I was raked over the coals for making a comment about Darwinism on this blog. One of the claims that the critics kept making was that "intelligent design is not science." I took a lot of heat, naively walking into a hornet's nest of materialistic anti-theism. One antagonist piled on by linking to an earlier post, Miracles Really Do Happen, implying that I am nuts for talking about miracles. Maybe, but I'm a happy nut!

Check out this photo of the famous Spiral Staircase in the Sisters of Loretto Chapel in Santa Fe, New Mexico. It is built without nails, dowels, or any visible means of support. Some claim it is a miracle that it does not crash. I have been there a few times, and I have examined this staircase. I admit that I do not know exactly how it remains standing, but do I think it is a miracle? Not necessarily. There are many things and processes which I do not understand, but that does not mean I consider them miraculous or supernatural.

So is it mind-bending to live and work in the world of science, yet at the same time declare that I have witnessed miracles? Only a little. With so many scientists claiming that science disproves the possibility of miracles, how do I reconcile the apparent contradiction?

I am going to try to answer this over the next several posts. We will reserve comments for the end. Let me stipulate that I am not sharing anything original here. Others have written on this subject in more depth. A quick Google search will reveal thousands of articles on both sides of this issue. I have borrowed heavily from one or two that I found most helpful. Unfortunately, the link to the main one, which I had been storing with intent to include, died, and I cannot find it again. Accordingly, I cannot give the author proper credit. If I rediscover the link, I'll post it. Meanwhile, here are my thoughts, such as they are, at this time. I am constantly upgrading my thinking, so if you are smarter than I (which is likely), I'll be delighted to learn from you at the end. Please note that this is not an attempt to persuade. I'm just sharing this stuff with my family and friends. They know me, and they understand me. Anyone else, read at your own risk of being offended or whatever.

The Nature of Miracles

Let's define terms. First, what is a miracle? The definition found at dictionary.com seems like a reasonable starting point:

An effect or extraordinary event in the physical world that surpasses all known human or natural powers and is ascribed to a supernatural cause.

How often do people exclaim, "It's a miracle!" This is a phrase that gets tossed around a lot in everyday conversation. Yet upon close scrutiny, we see that there are many things we call miracles which do not meet this definition.

For example, we talk about "the miracle of birth." When we speak this way, we really mean that there are aspects of birth which are mysterious and poorly understood. Our statement also displays an assumption that there is an intelligence outside the natural realm which does understand and which guides the processes of reproduction. However, technically speaking, reproduction is something that happens every day. Therefore, it is not extraordinary, and it does not really fall under the definition of a miracle. Even though there are aspects of it that we do not understand, childbirth is still better classified as a natural event.

The Nature of Science

While mankind has probably always been curious about his surroundings, approaches to and explanations for the what's and why's of our world have varied over the centuries. Only relatively recently has Science emerged as the method or set of procedures by which we now attempt to understand the natural, physical world.

Science is based upon two fundamentals.

The first is observation. No hypothesis, theory, or law ever arose -- and never can arise -- unless someone first notices something. The thing observed can be something that is happening right now, or it could be something that happened in the past. Either way, there is physical evidence that can be analyzed.

The second fundamental is repeatability. Science depends upon predictable rules of nature. If we drop something, we expect it to fall -- every time. If we leave an iron tool out in the rain, we expect it to rust eventually -- every time.

When dealing with complex living organisms, such as humans, unseen and unanticipated factors can confound our observations, making it more difficult to be sure that we are observing the same phenomenon over and over. Nevertheless, we still demand a certain level of repeatability before we consider experiments to be valid. We use such terms as p values (probability values), confidence levels, and power. So, for example, when we talk about a result being true with a p value of 0.05, we mean that if we repeated our experiment one hundred times, we think that we would get different results less than 5% of the time. Put another way, we think there is a 5% chance (or less) that the results we obtained in our experiment were due to chance or some unknown force or factor.

A strong statistical probability is helpful, but it is not enough. Even with statistical odds that weigh heavily in favor of an experiment being valid, we still want to see the results repeated by someone else in another institution or another laboratory before we will fully accept them. We want to see the results repeated by others to be sure that we are not witnessing the 5% fluke.

One of the problems with cancer research is that results which initially appear promising are often not repeatable. The results are not confirmed by others performing the same or similar experiments. When desirable results cannot be replicated by others, then questions remain unanswered. Most scientists are not willing to anchor their ideas upon the results of a single study. So repeatability is key to good science.

Well, by definition, miracles are isolated, extraordinary events. They are not repeatable. Therefore, they seem to lie outside science -- which is where materialists insist on leaving them.

But is this really the right place to stop?

(Next: More On the Repeatability Requirement)

Conversation with a Canadian Physician

2007-11-29T08:02:00.000-06:00

This morning I bumped into one of my friends in the doctor's lounge where we were both grabbing a bite of breakfast. He is a cardiologist from Canada and worked there until a few years ago when he moved here.

I asked him, "Since you lived under a nationalized health care system, tell me whether what I have been saying is accurate.

"I maintain that if the US moves to a single-payer system, and that payer is the federal government, the doctors won't mind, but the patients will."

He replied, "Correct. In Canada, the doctors have a very nice lifestyle. Many work only 4 days a week. They regularly take from one to three months of vacation a year, and they take lots of time to go to meetings."

He went on to explain, "Our overhead was very low, about 24%. Since there was only one payer -- the government -- filing insurance claims was easy. For seven physicians we only needed one person."

But here was the catch -- and the explanation for all this time off.

"The government capped physician income. They would pay your claims (like Medicare does) up to a certain point. But once your income hit the limit, then they would reduce physician reimbursement to 1/3. Well, no one wants to work for 1/3, so doctors would simply take the time off instead."

"Well, of course, " I remarked. "That's just human nature."

Then I asked, "What about patients? My argument is that once the government takes control, our job will be easier because the government will limit therapeutic options to the one or two that they deem most cost-effective. We won't have to wrestle trying to decide which is the best choice among many, but simply which is the best of a few."

"Right," he said. "That happened. And then there is a lot of waiting to take advantage of those options."

He elaborated, "It started out with everyone being equal, but then inequities arose. For example, when the heart surgeons all started taking off, there was no one around to do the operations. The government couldn't have that, so they stopped capping their incomes in order to encourage them back to work. But then the anesthesiologists went on strike because they did not think it was fair for the heart surgeons to receive full pay while they were having to work for 1/3 pay. After all, both specialities are necessary for the operation. Well, while the doctors are on strike or taking vacation, there is no one left to see patients. So in the end, they suffer most."

"I had a nice lifestyle there," he sighed. "I cannot take all that time off here and now. I have to be more available for my patients. Fortunately, the financial incentives make it worthwhile to be available and to do a good job."

At that point my cardiologist friend had to finish making rounds, and so did I.

But the conversation left me thinking. Over the past 30 years, thousands of physicians have left Canada to move to the United States. In fact, Canada is second only to India as a supplier of physicians to this country. Curiously, Canada now suffers a severe deficit of physicians to the point that it is having to recruit physicians from yet other countries. It is so bad that South Africa has formally protested to Canada for stealing its physicians to replete Canada's losses to the US.

So what will happen when we do away with the very incentives that have enticed physicians from other countries to come here? When it is no longer financially feasible to be a physician here and doctors decide to remain where they are, what effect will it have on our own physician work force? Even with all these Indians and Canadians moving to the US, we are still facing severe physician shortages ourselves within the next several years. Are these trends going to make patient access to care more or less available?

Everyone's knee jerk reaction is, "Let's get national health insurance so that everyone will be covered." Fine. But what good is insurance coverage if there is no one left to take care of you?

Robert Phillips, M.D., M.P.H., director of the American Academy of Family Physicians' Robert Graham Center has said the United States has an "ethical responsibility not to devastate the health care systems of other countries." It also is imperative for state and federal governments in the United States to develop policies that "facilitate physicians choosing to work in places where they are needed," he said.

The data "point out the failings in the US when it comes to developing a physician workforce and distributing physicians where they are most needed," Phillips has said.

It seems that everyone wants a simple answer. So far, I haven't seen one.

Heroes Question

2007-11-27T18:01:00.000-06:00

How did they give Noah Bennett a transfusion of Claire's blood if he was dead and his heart was not pumping?

Just wonderin'