Rest in Peace, Harvey Korman (and thanks for the laughs)

Georgia O'Keefe

Here's a Georgia O'Keefe painting called "Jack in the Pulpit no. I V." Nice.


On a completely different subject, what is it about physicians that makes us pussies? Somehow the previous generation of physicians rolled over and ate a huge shit-sandwich from the government called EMTALA. Our national organizations, the AMA, ACEP and the like, have acted like a bunch of perpetually-stoned good-time rock and roll maggot-infested hippies and have embraced the fucksticks at JCAHO too.

I know that the premed route is not exactly peppered with economics, logic, or business classes but please, you freaking douchebags, how in the name of all that is holy did you swallow the EMTALA and JCAHO pills? How, exactly, can you provide CABGs for all regardless of their ability to pay? The answer is, you can't, but while trying to accomplish this ass-hattery you will do it by having everybody else pay for it. In other places this is called stealing.

Could you not see, if only from a rudimentary common sense perspective, that EMTALA was going to crush you? Did you not know that when unfunded mandates have been tried previously, or their ugly father called communism, that they have failed miserably and made the situation worse?

Where were you, docs? Out on the golf course? Why were you not on the steps of Capitol Hill marching and carrying signs and threatening to strike? Why? Are you all a bunch of pussies or did you figure that by the time EMTALA ruined medicine that you would be comfortably retired? Damn your eyes for being clueless pussies because not only did you screw the next generation of doctors, you screwed the next generation of patients too.

That IS what happened, OR, in your feel-good liberalism you knew, you knew deep-down, that EMTALA would end fee-for-service and force a "solution" from above because you love government and its power and revere it with religious zeal. Better that all be in a similar state of misery than some have it better than others. OR, you were too busy working, and didn't think your colleagues and national organizations could be that stupid. WRONG!

Well good for you sunshine. Why don't you just move to some socialist heaven with closed borders and frozen social classes and live there. In the meantime you have made being an ER doc, or a doc that gets consults from me, an endless parade of entitled asswipe misery, and you have sucked the soul right from my body. You have wrecked specialty care for everyone outside of a big city. You have also wrecked the best care for the most system which we had and replaced it with mediocre care for all.

Happy now? I thought not, because there are still some in America who have more than others. Still, some rich folks get better care than that guy who ran his stolen car into a bridge abutment, drunk, while running from the police. How will you fix that? Why not go all the way and join the American Communist Party. Fucksticks. Have fun driving your Prius and drinking soy and wheat-grass shakes. Guess what? You are going to die too. Double fuckstick Deborah Peel in your face asswipe douchebags.

*** and thanks to my friend medblogaddict, for this post

U.S.S. of A

Well I'm back. Had some major computer issues with a damaged hard drive, not to mention meetings, family, school ending, etc. But now I am on a mission. Tomorrow I leave for Washington D.C.. Part vacation, part mission. I am going to petition for a change in the name of our great nation to the United Socialist States of America. With recent comments from Maxine Einstein-Waters "this liberal wants ... socialization, we'll take over the oil industry", to Barack's recent commencement speech at Wesleyan " individual salvation is directly related to the collective salvation.." and " we all can't drive, and eat as much as we would like, or keep our homes at 72 degrees...we need to give a little more".. (look at his tax records to see how much he gave over the years) to the ever-present take-over-healthcare,it has become obvious where we are headed. While there I will do my part to stamp out any last reference in textbooks to the rugged individualism that this nation was founded on, and replace them with glowing references to "achieved" 5 year plans, collective farms, and meeting target steel production, all for the glory of the state. It has become obvious to me that the market economy is an abject failure, and this nation does not care about the rest of the world, statistics on individual giving and U.N. contributions to any and every cause be damned. I envision a cross between France/Cuba/China, taking the best that each of these bastions of collective/socialist thought can offer this once great nation that has lost it's way down the road of individual freedom, market economy, and innovation. It's time for the workers of the world to unite, and take back from those who toiled/ invented/ designed etc. to make this nation great, what is rightfully ours. This is my dream. Change, change, change.



Good day.

Ah, the VA.

Just a quick note typed while on the phone with the VA. I get all my prescriptions from the VA as I have a service-connected disability. I got through to their automated phone service then waited five minutes to get the phone to ring to speak with a human. I am now at 340 rings with no answer... 360. I have dispositioned three patients and written orders for two others while waiting to talk with someone... 449 rings. Government health care. Free. 540 rings. Energizer bunny shit (and no this is not a wrong number... I already got the 'next available operator' message) 670 rings ago.

Resuscitation docs..

This is kind of for only the docs here and those who stumble upon us. Just an observation. As you all know I started in medicine, oh, before Penicillin or so.

Yesterday, old lady, 89, arrests in ED, and I unfortunately bring here back. Call ICU doc to come admit. He comes down, writes orders and before he leaves, she codes again. He turns to me to run the code again and doesn't want to have anything to do with it. This, it seems has become the norm. No one else in medicine can run a cardiac or trauma code anymore but US!

I mean, you can have 3 cardiologist's standing around with their heads up their butt's if an EM doc is present at a code situation. Everyone just assumes we are the only docs who are qualified to run the situation. Kind of a compliment, but also a major PIA.

Is this what you folks out there are seeing, too? Is it because they have no balls or have we become the only docs willing to take care of the situation? If so, why? Malpractice concerns, scared, or what? Thoughts?

Memorial Day

Semper Fi, Marine Corps. Thank you, and you my best friend in the Army, and you my best friend in the Navy, and you my buddies deployed now with the Air Force. Thank you too, Coast Guard. Thank you all.

Interlude

I feel more rants bubbling up from my bezoar-distended stomach, so, as an amuse-bouche, I serve to you today the following. First, from Monkey-Girl's blog, a good question. Second, from my favorite sports blog, comedy based on the question. And third, a music-video, which, I think, encompasses our whole god-dammed raison d'etre (movie quote) here at MDOD. Enjoy!

Is That a Bezoar in Your Pocket...?

Insane people are cool. Who else would systematically pull out their hair, eat it, and end up with that thing (pictured above) lodged in their stomach? And all for MY entertainment.

That thing is called a trichobezoar. Tricho = hair. Bezoar = nasty mass of indigestible stuff. We get these with reasonable frequency in the pathology lab. The one you see above, you may have noted, is cast in the shape of a stomach. Those who eat their hair are said to suffer the from the so-called “Rapunzel syndrome”. I’m trying to figure out a catchy name for those who eat their own pubic hair.

Hair is not the only material we get. I have seen phytobezoars (plants), plasticbagobezoars, paperclipobezoars and CornNut®obezoars (OK, I made that last one up – shockingly, the other ones I did not).

This came up recently on a scalp biopsy from a young woman with patchy baldness. “Well, of course”, you are probably thinking, “could be telogen effluvium, alopecia areata, like ya know, wha-eva’”. Well, I diagnosed trichotrillomania, or, for the non-medical types, freakshow-who-pulls-out-her-own-hair. Maybe I’m being too critical. Maybe Head-and-Shoulders tastes like fucking maple syrup. So I apologize for the offense I have caused. Go ahead and eat that plastic shopping bag from Wal-Mart. Who am I to judge.

The Little Boy We All Know and Hate

Enuff bashing the lawyers, insurance and shit..Something fun.

OK, I've wanted to post this for a long time. Some of you are going to hate me(BFD!)and the docs, nurses and EMT's are going to LOVE IT..

I (and each and every one of you) have wished for this opportunity all of my career.

Grandma brings in Jr, about 10 yrs old, by 911!! for a PSYCHIATRIC EVALUATION because he's threatening her and she's scared of him. We all know this story..
The difference is Grandma(mom's a crack ho') seems like a very nice woman who just is at wits end with this little POS and Jr is well groomed, no tats, no ear ring, belt on his pants, no crooked ball cap. And he's clearly just being a BRAT. We have a little conversation and Jr decides to try and bite me..
Grandma says she can go get his Uncle(where's Dad?) who he, Jr, relates too..I say by all means please go get Uncle to help me with this complex medical case.

Granda leaves and I grab both of Jr's arms and put them over his head, put my hand over his mouth so my eardrums stay intact and tactifully tell him if he doesn't shut up I will turn him over my knee and BUST HIS ASS ALL UP! And if he tries to bite me or anyone else I will FHU! I have his address and know where he lives and if Grandma ever calls 911 again because he's being a brat, I will return and he will never live to repeat the 5th grade..

God, it felt good. Jr quiets down very quickly, Grandma and Uncle "Joe" come back in and I tell them Jr and I have reached an understanding. If he ever causes Grandma trouble again, I give her my card and tell her to call me. And Jr is right there, and, of course sees this.
I leave.

And as they are walking out, Grandma says thank you. She asks Jr what he has to say and the little dude comes over and gives me a HUG! It may have been better than a thoracotomy surviving!

Go ahead and call CPS, you liberal MF's, I don't care. Maybe there's one less gang banger in the making and I sure saved a hell of a lot of $$$$..

New Medical Condition - GRINCHISM

You may recognize this face if you watched the most recent Survivor series from Micronesia. This unfortunate young woman, who somehow managed to make it to the final four, has Grinchism. This disease was first describe by Dr. Seuss in 1972. The criteria for diagnosis are quite simple, but must be met completely to be considered 'true' Grinchism...

1. You must look exactly like the Grinch.

2. You must be an absolute raving, crazy, BITCH.

Sadly, this disease is incurable. Wish her luck.

M.D.O.D. Scavenger Hunt

Dear Readers,

You have heard many of us say that medicine is not a business and that patients are not customers. Let's try a little exercise here. I really am interested in what you have to tell me. Just for fun, call up your local hospital and ask the following...

1. How much is an EKG in the ER?

2. How much is a set of cardiac markers in the ER?

3. How much is a chest XRAY in the ER?

Make a couple of calls on different days. One time say you are uninsured and are concerned about your bill and the tests above are what you have been told you will need and you want to be able to pay. Another time, tell them you have medicaid, another time tell them you have kick-ass private insurance with gold-plated benefits through the railroad or IBM or some shit like that. Let me know what you find out.

I suspect you will not be able to get this information at all. If you are able to get the information I bet you get different answers based on your level of insuredness (if that's a word), which will prove my point. In a business you know the price before you buy. In a cost-shifting game the price is hidden because some pay none and others pay a lot. Have fun!

Не волнуйтесь по поводу мужчина скрывался за занавесом. он с правительством и находится здесь, чтобы помочь вам.


EDITOR'S NOTE: THE HAPPY HOSPITALIST IS DOING SIMILAR WORK HERE SO LET'S GET THIS INFO TOGETHER. 911DOC

Resubscribe Please! (sticky post)

Dear readers, we changed our email feed program to feedblitz a few weeks ago. If you want updates please do sign up again in the box to the right. And just so I can make money off of charlatans... "JCAHO, JCAHO, Complimentary and Alternative Medicine, Fibromyalgia Cure, Chronic Fatigue Syndrome Cure, remedies doctor's don't want you to know about, HIPAA compliance software, homeopathic cure". Do me a favor and click on these ads as they robotically show up on the site. These folks are fantastic and we stand behind their rite to advertise idiocy and snake oil! Mo-money bizzle.

Incomprehensible Grief

As a parent, can you imagine anything that could remotely come close to the grief of losing a child? This photo shows parents saying 'goodbye' to their child killed Monday in the earthquake centered in Sichuan Province, China.

There is no time to prepare...no chance to say goodbye.

Lofty's family has been particularly saddened by this disaster because we adopted a little girl from Sichuan Province a few years ago. Her hometown of Deyang has been decimated. We pray for her birthparents and the wonderful people we met who care for the children in the orphanage in Deyang.

Our little girl is six years old...smart, funny, beautiful, and so full of life. We are blessed to have, apparently, been lucky enough to have saved her life twice.

Consider helping here at Network for Good.

Lofty

All Your Medical News Right Here

Hate to blow our own horn but we've been saying this stuff for a couple of years now and the Wall Street Journal is late to the party.

Check Here too, and here, and here, and here, and here, and here, and here, and here, and here, and here, and other places, and, finally, here, oh, and here too.

M.D.O.D., we're cynical about medicine and the politicians and entitled teat-suckers that have destroyed it, and you should be too.

Consults Circa EMTALA

PHYSICIAN TO PHYSICIAN CONSULT PRIOR TO EMTALA

Dr. A: Hey Bill, I've got a patient down here that has a lung mass. She has no insurance and no job and is quite distressed. She needs a biopsy and maybe surgery and chemo. Can you help?

Dr. B: Well jeez doc, my schedule is full for the next few days, but maybe I can work her in between appointments on Friday. Tell her not to worry, I'll see her in my office. I'm sure we can get her plugged in.

Dr. A: Thanks Bill, she really feels badly about not being able to pay you much and her husband says they can pay some over time... They are really nice folks and will try their best.

Dr. B: Yeah, okay, probably won't see a dime but let's get her in. I'll ask the oncology folks to get involved too. Jim will jump on this. Maybe we can fix her.

Dr. A: Thanks so much. See you at dinner on Saturday, got a few days off coming up.

Dr. B: See you then.


PHYSICIAN TO PHYSICIAN CONSULT POST-EMTALA


Dr. A: Hey Bill, I've got a patient down here that has a lung mass. She has no insurance and no job and is quite angry. Had to wait three hours to be seen and all. She needs a biopsy and maybe surgery and chemo. Can you help?

Dr. B: What, am I on call for the ER?

Dr. A: That's what it says on the schedule.

Dr. B: You guys are killing me. That's four patients over the weekend that will cancel my clinics on Tuesday. You guys just cost me over five grand from paying patients.

Dr. A: Yeah, us too. Thirty people waiting to be seen. Twenty walk-outs today. Eighteen ambulances and four of them reasonable calls. This woman was actually diagnosed with a lung mass last year but never followed up. Still smokes. Came in tonight because she's been coughing up blood. Says she 'can't afford to see a doctor so she came here.

Dr. B: Fucking incredible! What does she think that the ER is free?

Dr. A: It is free to her. She will never pay for any of this, says she's disabled. Drove herself in, has a cell phone that she's been talking on half the time I've been in the room. Seems quite unconcerned except for the wait. Says her lawyer said to come here and that we have to treat her.

Dr. B: Do we?

Dr. A: Yes.

Dr. B: Lawyer?

Dr. A: Yeah, she's suing the poor sap who took her chest film a year ago. Says he didn't explain the consequences of the XRAY findings to her adequately... says she didn't understand this was dangerous. Went to the lawyer before coming here.

Dr. B: Holy shit, now I really don't want to take care of her! Hey can't you transfer her to the General?

Dr. A: No, EMTALA prohibits it.

Dr. B: But she can't sue the city hospital but she can sue the hell out of me! Can't you get Dr. C to take this one?

Dr. A: No, his privileges are suspended for not signing his charts on time.

Dr. B: Suspended for not signing charts?

Dr. A: Yes.

Dr. B: Well, come to think of it, I haven't signed my charts in a while. Maybe I can get suspended too?

Dr. A: Worked for him.

Dr. B: Can we get oncology to consult?

Dr. A: They aren't on call tonight?

Dr. B: Well will they help out after the biopsy?

Dr. A: Don't know, you will have to ask them, we only heave oncology ten days out of the month.

Dr. B: Fuck this! I knew I should have gone to business school. I can't wait till I retire. Just so you know, I'm seriously considering dropping my privileges and doing all outpatient stuff, surgery center, the whole bit.

Dr. A: Join the club. Sorry.

The Heroes and the Vultures

Helicopter transport is dangerous. Read about these fallen heroes, and then read about the vultures.

Drackman Goes to Free Agency

As often happens in the world of big-money blogging, lawyers and agents have interrupted the smooth-running snark-machine known as MDOD. As a result Dr. Frank Drackman has started up his own blog here. We will miss Frank and his well travelled wit, but are sure that Frankie's Hideout will soon be well known amongst the cognoscenti as a place where one may go for a fine cocktail and some eclectic conversation. Best to you Frank, or, as they say in the Navy, "fair winds and following seas".

Ciao, Baby

Its been real, but I'm blowin' this Pop Stand for a little outta the way place called Frankie's Hideout. Bring your Broads, Tired and Weary, check your Heater at the door, and enjoy some of the driest Martinis on the strip, just don't touch the dancers unless your lookin' for a free knuckle sandwich. Not sure about this Ringo Cat who's takin' my place, sure he beats some mean skins, but don't know about that whole English Music thing catchin' on. Gotta run baby, hitchin' up with Sammy, Dino, joey, and Pete, for a little pre-party party. Later.

I Vant to Bite your Neck

Must have been a Vampire in a former life cause I

love necks. Met my wife based on her cute Sternocleidomastoid (she thinks it was the implants). Hey Reverend Wright, you want to talk about discrimination, just try putting an internal jugular line in left handed. You can't do it because in training they make you use your right hand just like English boarding schools did with lefties in the 1800s. Same thing with intubations, even if you could find a left handed Laryngoscope, no one would let you use it. True, you will give the patient a few nasty elbows to the nose doing a line left handed, but since when did patient comfort become an issue? One of my favorite operations to do anesthesia for was Carotid Endarterectomies under local. Basically you just inject a shitload of local anesthetic in the neck and ask to patient to be still for an hour or so. He even gets a bicycle horn he has to honk every so often to assure everyone his grapes getting enough circulation. You walk into the OR during one of those cases and you wonder where Groucho is hiding. The kids nowadays have fancy schmanzy Ultrasound machines to help them find the Jugular, but I prefer Drackies old school method. I don't trust any device that has a Probe and requires Lube.

Future American Physician

http://youtube.com/watch?v=lj3iNxZ8Dww

More and more bright young Americans are figuring out that there are much easier, faster, less painful and time-consuming ways to make money than being a physician. Hence, you may soon learn that your major surgical procedure, for example, is going to be performed by a gal like the one shown above. I imagine that being a physician will still be important enough, and will remain held in such high esteem by families like that of our little debutante above, that you may someday meet Miss Teen South Carolina just before you head into surgery to remove the meningioma from your cranium. Keep in mind that her valedictorian classmates are all working on Wall Street and at Microsoft.

Have you guys ever heard of 'word salad'? Word salad is a string of words that vaguely resembles language, and may or may not be grammatically correct, but is utterly meaningless. You will never see better videotape evidence of word salad than what I have shown you above.

Imagine the conversation you could have when Miss Teen South Carolina becomes Dr. Teen South Carolina M.D., neurosurgeon.

You: Good morning, Doctor. I have to say that I am a bit afraid of anesthesia and having the tumor removed this morning. Can you answer a few questions for me before we go to the operating room?

Dr. Teen S.C.: Oysters sucking giraffes have not...don't be afraid...alfalfa.

You: What?

Dr. Teen S.C.: Tramway flogging into my question, are you why is it thirty letters down under peanut butter, what is it?

You: Doctor, are you OK?

Dr. Teen S.C.: Hold the patient's nose squarely, waiter, or friendly milk will countermand my trousers. Opossum.

You: What the fuck?!?

Dr. Teen S.C.: I personally believe...that colorless green ideas sleep furiously.

You: Wow. That shit was gramatically correct. NURSE!!!!!!

Israel Vacation Week 2

F-15 Eagle that shot down 4 POS Syrian Migs back in the 80's. The F-15 was originally intended only to shoot down other aircraft, later models had air to ground capability added. The only F-15 aces in the world fly in the Israeli Air Force.

Arranged an interview with an Israeli Army physician so I could deduct the trip as a business expense. (Just Kidding!! I've had quite enough of Federal Correctional Facilities thank you very much) She wasn't too impressed with my whole 4 days of combat experience from the first Gulf war.

Ahh, the Brachial Plexus. Too bad your cadaver doesn't have yellow nerves with neat labels on them. These 2 soldiers are pre med students at the University of Tel Aviv. Organic Chemistry probably doesn't seem so bad after 18 months of carrying an M-16.

In the Mecca of kosher delis and my wife has to go to Burger King. I don't even go to BK in the U.S. A guy could open a branch of the Varsity in Jerusalem and make a pretty Shekel. Would help with the peace process too. Enjoy a chili dog and a frosted Orange and you're too content to blow up any thing. How many terrorist bombings in Atlanta? Oh yeah, that whole 96' Olympics thing, oh well its an idea, surprised Jimmy Carter hasn't thought of it.

"DOH!!" is funny in any language. Homer has just offended 1 billion Muslims by eating with his left hand, and Maggie is not wearing proper Shari'a attire.

Jet on the right is an A-4 "Ayit" or Vulture, same type that John McCain flew. Takes some pretty big Motza balls to bring one of those in to a rolling carrier deck on a dark and stormy night.
Wanted to take in some Israeli Baseball League games but the season doesn't start until June. Just like in America, alot of the players are caribbean, but theres a smattering of Horowitzes and Steins on the rosters. The flight back is always a bitch. I think its that whole going against the earth's rotation thing. Despite my southern upbringing I still get a warm and fuzzy catching a glimpse of the big apple on final to JFK. Never understood U.S. Customs. I get hassled more trying to sneak into a better seat at Turner Field. Maybe thats the strategy, act so incompetent Bin Laden himself won't bother to wear a disguise when he visits. Upon arriving home was greeted by a distinctly uncut lawn. The Americans who cut my grass must have moved on to greener pastures, thats it, its the dark side for me, from now on Pedro gets all my yard work.

Interview advice

There are few professions where, upon reviewing job applicants, one must ask oneself: ‘Is this the type of person who wants to have sex with dead people?’.

Gravedigger, Mortician, Pathologist, Hillary Clinton’s potential boy-toy… the list is short. And in the field of medicine, if you hire someone who would check the ‘yes’ box when asked if they liked violating Sylvia Plath while her head was in the gas oven, you have made a big mistake.

It looks really bad when the family comes in to identify grandma’s body and the pathology assistant is humping her on the autopsy table. It is considered very bad taste when her organs have already been removed.

This brings me to a related issue. Is it wrong to have sex with the dead when the dead have pre-approved the process? This is a rare and unusual fetish that some (I think it was Socrates originally) like to refer to as reverse necrophilia. This brings up quite a few moral dilemmas involving the rights of consensual adults and the sanctity of the dead. I’m quite upset the ‘The Ethicist’ column of the New York Times Sunday Magazine has not returned my calls.

The real problem for you sickos considering a career that brings you close to the non-living is that dead people are not pretty. Gisele Bundchen on the slab would give the Marquis de Sade pause before jumping aboard. Although, I must admit, Kate Moss would probably look about the same.

So next time you are interviewing for one of these jobs, just remember to hide your boner when touring the morgue. This will leave you in a better position when bargaining for vacation time.

Frankie goes to Holywood (Or how I spent my Economic Stimulus Check) Week 1

Theres something about Bugs Bunny in Hebrew thats just funny. I know I should be offended that a cartoon rabbit is out smarting a sacred Islamic figure, but I'm sorry. I bet even Bin Laden laughs when nobodys watching. What a trip, surly Arab cab drivers, fascist security guards, and that was just in Atlanta. El-Al is great. 100% American built jets (not the commie-Euro Airbus crap that most American airlines use) armed undercover agents on every flight, never had any jets end up in the side of tall buildings. The security helps keep out the riff-raff, it didn't feel quite as much like a Greyhound bus as your typical Delta flight.

Thats supposed to be Jesus's tomb. Not quite the tourist trap I thought it'd be. Did pass on the "Jesus Slept Here" T- shirt though. Its not everywhere you can bump into 2 young ladies carrying M-16s in the hotel lobby. My kind of breakfast, Marlboro lights, and a Diet Coke.

Wife was busy getting emergency manicure. Koreans have even taken over the Nail Salon business in Israel. Don't let their cuteness fool you, each one of these young ladies will rip your heart out if you try any terrorist stuff. Thats the Wailing Wall on the right. On my list of favorite walls, I'd rate it in between the Berlin Wall and Fenways Green Monster. During Gross Anatomy the faculty used to post the test answers on a wall outside the lab, along with a sheet to challenge any disputed questions. We all called it the "Wailing Wall" . The pic on the upper right is "Minerva", a lesbian Jazz club, my wifes idea to go, honest.

Observations from Week 1..Larry King style...I was the only male wearing a tie on the Atlanta-JFK flight, whatever happened to dressing up? Gas is really expensive here, but I'm surprised the Arabs sell them any at all. Trying to teach the wife to drive a stick shift on the rental car, with the inevitable stalls at busy intersections we're getting cursed out in 3 languages. I don't know whats stranger, an old orthodox jewish man wearing a Red Sox cap, or the Soccer Moms toting Uzis...You can't beat Sals in the Bronx for a great corned beef sandwich...

Bar Stool Economics

In thinking about the recent posts regarding taxes, the 'right' to universal healthcare in the U.S., and - most importantly - our good friend Shrodinger's Cat's decision to become DOWNWARDLY MOBILE - I thought I would revisit this fun, old tale.

Suppose that every day, ten men go out for beer and the bill for all ten comes to $100. If they paid their bill the way we pay our taxes, it would go something like this:

The first four men (the poorest) would pay nothing.

The fifth would pay $1.

The sixth would pay $3.

The seventh would pay $7.

The eighth would pay $12.

The ninth would pay $18.

The tenth man (the richest) would pay $59.

So, that's what they decided to do. The ten men drank in the bar every day and seemed quite happy with the arrangement, until one day, the owner threw them a curve. "Since you are all such good customers," he said, "I'm going to reduce the cost of your daily beer by $20." Drinks for the ten now cost just $80. The group still wanted to pay their bill the way we pay our taxes so the first four men were unaffected. They would still drink for free. But what about the other six men - the paying customers? How could they divide the $20 windfall so that everyone would get his 'fair share?' They realized that $20 divided by six is $3.33. But, if they subtracted that from everybody's share, then the fifth man and the sixth man would each end up being paid to drink his beer. So, the bar owner suggested that it would be fair to reduce each man's bill by roughly the same amount, and he proceeded to work out the amounts each should pay. And so:

The fifth man, like the first four, now paid nothing (100% savings).

The sixth now paid $2 instead of $3 (33% savings).

The seventh now pay $5 instead of $7 (28% savings).

The eighth now paid $9 instead of $12 (25% savings).

The ninth now paid $14 instead of $18 (22% savings).

The tenth now paid $49 instead of $59 (16% savings).

Each of the six was better off than before. And, the first four continued to drink for free. But, once outside the restaurant, the men began to compare their savings.

"I only got a dollar out of the $20," declared the sixth man. He pointed to the tenth man," but he got $10!" "Yeah, that's right," exclaimed the fifth man. "I only saved a dollar, too. It's unfair that he got ten times more than I!" "That's true!" shouted the seventh man. "Why should he get $10 back when I got only two? The wealthy get all the breaks!" "Wait a minute," yelled the first four men in unison. "We didn't get anything at all. The system exploits the poor!" The nine men surrounded the tenth and beat him up. The next night the tenth man didn't show up for drinks, so the nine sat down and had beers without him. But when it came time to pay the bill, they discovered something important. They didn't have enough money between all of them for even half of the bill!

And that, boys and girls, journalists and college professors, is how our tax system works. The people who pay the highest taxes get the most benefit from a tax reduction. Tax them too much, attack them for being wealthy and motivated, and they just may not show up anymore (in the ER, that is).

How many docs feel like the tenth guy????

The Bill of Rights

All this talk about a right to free health care got me kind of mad because I didn't believe it existed under our constitution. I also thought that patients should bear at least some of the burden for maintaining their own health and paying a reasonable fee either for insurance, or to physicians who treat them. Boy was I wrong! Witness the genius of America!


The Bill of Rights


Amendment I Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances. And all humans within the border of the United States have a right to free health care.


Amendment II A well regulated militia, being necessary to the security of a free state, the right of the people to keep and bear arms, shall not be infringed. Health care for free is a right for any organism with 23 chromosomes found within the borders of the United States.


Amendment III No soldier shall, in time of peace be quartered in any house, without the consent of the owner, nor in time of war, but in a manner to be prescribed by law. Doctors are required by federal law to see and treat all patients regardless of their citizenship, state of intoxication, assaultive behavior, or ability to pay for said care.


Amendment IV The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized. Doctors are to accept 30 cents on the dollar for their services. Dentists, Complimentary and Alternative Medicine practitioners, chiropractors, and life-coaches are to be reimbursed at 100 cents on the dollar.


Amendment V No person shall be held to answer for a capital, or otherwise infamous crime, unless on a presentment or indictment of a grand jury, except in cases arising in the land or naval forces, or in the militia, when in actual service in time of war or public danger; nor shall any person be subject for the same offense to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation. The right to free health care is universal while in any state, territory, or possession of the United States. The right to payment for goods or services delivered is universal except for physicians who are greedy, rich bastards and should be held in the lowest esteem especially by the uninsured, addicted, politicians, liberals, and attorneys.


Amendment VI In all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial, by an impartial jury of the state and district wherein the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation; to be confronted with the witnesses against him; to have compulsory process for obtaining witnesses in his favor, and to have the assistance of counsel for his defense. The right to sue physicians for negligence occurring in the delivery of free health care shall not be abridged unless the physician guilty of negligence is employed by the United States Government, in which case the plaintiff is shit outta luck dude!


Amendment VII In suits at common law, where the value in controversy shall exceed twenty dollars, the right of trial by jury shall be preserved, and no fact tried by a jury, shall be otherwise reexamined in any court of the United States, than according to the rules of the common law (except for physicians, who may be forced to settle lawsuits by their insurers or surrender their privileges, or insurance and therefore their ability to practice). Also, it is hereby mandated that physicians have no right to sleep, or to the pursuit of happiness.


Amendment VIII Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted. An exception shall be made for physicians, especially physicians in training, who may be imprisoned by their hospitals and kept awake for up to 72 hours at a time while performing surgery or fetching stool samples.


Amendment IX The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people. Did we mention that primo allopathic health care for all is a right?


Amendment X The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people (physicians excepted, of course).