Friday, June 29, 2012

(Repost) Acadmics on Obamacare

A repost, but first, THIS LOVELY BIT. 
Pip Pip and Cheerio!

July 2009, MDOD
There is quite an echo-chamber in academic medicine. Witness the following...

Within the past few weeks I have been able to speak with chairs of various academic medicine departments. I have done this under the cover story of "I am working on an article" (true), or "I am working on a book and would like your input" (sorta true). The responses I have received are repetitive, infantile, and quite scary.

The number one reason that academicians WANT universal health care is to put some teeth behind RATIONING. They all believe that extraordinary care at the extremes of life will collapse the system. For instance, one particular academician I talked to wants to do away with dialysis for folks with certain criteria (having to do with her ideas about of 'quality of life'). These criteria will be decided by committees (because all the best things in life have come from committees), so no one person will be to blame.

Now this is quite amazing to me. First of all, academics have sat on their hands (and cheered) while regulations have tied private corporations' hands to the extent that their ability to perform procedures such as dialysis is severely limited. The mounds of paperwork required to open a clinic were scary enough to keep me from doing it (more power to you 'Cat).

Also, academic physicians all have a a little help with their workload and it comes with the names tenure, medical students, interns, and residents. This is a kind way of saying they have no freaking clue about private practice, they believe it is beneath them, most have never worked outside the academy (because once you do it's hard to get back in the club), and yet they want to make policy that forbids or severely limits private practice. How do you like your power Doctor? Absolutely? I thought as much. Pussies. Sell-outs. Turncoats.

I am sick of the AMA and ACEP.

ACEP
sent out a blitheringly idiotic email today asking us to 'pass it on' so that emergency physicians can be helped by the big pile of money building in Washington. Screw you ACEP. Screw you AMA. Count me out.

Also, the academics have been behind the self-flagellatory demonization of drug companies. I understand that junkets to the Caribbean for docs may be a bad idea, but now the drug companies are prohibited, in large degree, from giving out drug samples and even from giving out pens.

As it turns out I am particularly susceptible to the free pens. If I get one that says "Rocephin" on it that's all I will prescribe. Even for erectile dysfunction. Until the pen peters-out.

"Hey doc, my weenie don't work... ain't this Rocephin stuff for infection?"

"Sir, you know your medicine! But look at this cool pen I got!"


The academics want the government to be the bad guy behind letting granny die from her chronic illness which is all I need to confirm my suspicion that they are COWARDS of the worst variety.
 

49 comments:

  1. Doc, I've told you before don't believe anything you read in the Mail. It is a comic and according to them everything either causes cancer or cures it - yes even the same things. Also according to them immigration is the cause of the worlds problems and everything would be better if only Princess Diana was still alive.
    The Liverpool Pathway is designed for end of life care so of course people die on it - that's the whole point. It is to let people die peacefully, without pain and with a little bit of dignity. And yes people do occasionally get better and guess what.......? They are taken off the pathway.

    Not going to comment on Obamacare as I do not know enough about it.

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  2. so, Grumpy old chap,
    how about the telegraph? http://goo.gl/hpAHo. and you say EVERYTHING in the guardian is bullshit. how about their weather forecast? hmmmm... and it's desinged for end of life CARE? CARE? it sounds like heavy sedation and withdrawal of fluid and food which sounds a lot like poorly done euthenasia to me, but wait, EVERYTHING in the guardian is crap and this professor, IF he said it was either misquoted OR he's a crank. couldn't possibly be that since the NHS has long waits and rationed care that somone, a few, many, might bend the rules a bit and off some elderly folks who 'are going to die anyway'. but then again, you and me, we are both 'going to die anyway'. but then again, I'm a crank. oh, and the Ammerican academics i talked with (kinda the whole point of the post) told me pretty much the same thing as the professor is (mis?)quoted as saying. but the Guardian is crap. got it.

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  3. The Telegraph article you reference states "according to the the Daily Mail". So it is a rehash of another papers story. The one you originally referenced is not the Guardian but the Daily Mail which is a whole different paper. I never mentioned the Guardian and I was commenting on your first 2 sentences.

    Further down the Telegraph report is this, "The LCP was developed as a template for health workers to make the last days of terminally ill patients comfortable.
    The guidance recommends patients' on the pathway are regularly assessed, and they can be taken off the LCP if they are no longer close to death. A Department of Health spokesman said: "The Liverpool Care Pathway is not euthanasia and we do not recognise these figures. The pathway is recommended by NICE and has overwhelming support from clinicians - at home and abroad - including the Royal College of Physicians.
    "A patient's condition is monitored at least every four hours and if a patient improves, they are taken off the Liverpool Care Pathway and given whatever treatments best suit their new needs."

    Almost every American medical and nursing blog I read complains about putting patients at the end of life through more and more invasive treatment instead of allowing them to die peacefully and with dignity. The Liverpool Pathway is always used with the knowledge of family.

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  4. recommended by "NICE". seriously? "NICE". hello George Orwell. Wasn't he a POME? and you speak as if we do not allow people to die who express the wish to do so or whose family are in agreement that further care is futile. that's why we have hospice care. withdrawal of fluids and food is killing. explain to me how it isn't. i mean I'm glad you are a big fan of the reassurances of people in government jobs who can not be fired, but I'm not in your camp.

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  5. Wait.

    Grumpy, does the LCP pathway allow the patient or patient's designated power of attorney for healthcare make the decision with the consult of the medical group? Or is just left to the medical group to decide no matter what the patient or patient's designated power of attorney for healthcare want?

    Here in the US you can preplan what type of care you want before you get sick. Only sometimes weak MDs tend to allow an override by a selfish family member or selfish specialist. I'm all for chasing those docs down and making an example of them. I also keep a list.

    Most medical professionals would never willingly leave the decisions on care up to another random medical professional. Decisions are only made by us or our trusted friends (who may be medical) when it comes to ourselves or those we love.

    911, you are just STILL just pissed-off because you did not get a Levitra pen. All this other stuff is just smoke.

    -SCRN

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  6. DEAR SCRN,
    but i did get a viagra pencil, but it's very small and ran out of lead. now it just sits there dreaming of the glory days.

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  7. SCRN, if you go here it will give you a briefing paper of the LCP from 2011.

    http://www.mcpcil.org.uk/media/livacuk/mcpcil/documents/March-2011-LCP-Briefing-Paper.pdf

    As you can see section 3 specifically states;

    "We believe that recognition of dying is a complex decision making process which should be undertaken by the multidisciplinary team - in conjunction with the patient where possible and deemed appropriate, and always with the relative/carer".

    Section 4 states;

    "Recognition of dying is not in itself a decision that automatically leads to withdrawal or withholding of care, treatment or interventions. It does however require a review of the current situation and current
    care, treatment and interventions – healthcare professionals need to stop, think, assess and change care according to the patient’s individual needs and communicate this change in the focus of care effectivelyto all concerned. The views of the patient, relative/carer should always be listened to and taken into account as part of any decision making process".

    This is the way it is supposed to be, but as I am sure you are well aware, what is supposed to happen and what actually happens can vary enormously. In my own unit I can honestly say it does happen this way. Does it happen in the hospital in the next city? I don't know.

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  8. Grumpy..
    We still kicked your ass in 2 wars, saved it in 2 more, and did I ever tell you you look suspiciously like my Uncle Lucious, who coincidentally spent 3 years in Eng-a-land during the WW2...
    Those Paki's in the flat below still playing that loud music? Tell me bout it, you put up a "Lost Dog" flyer in my neighborhood, damn (redacted) look at it like its a friggin Menu...
    That bein said, didn't you ever hear "Brevity is the soul of wit"?
    Even a rapist's wit like yours..
    "Dying is a complex decision making process which should be undertaken by the multidisciplinary team"????
    That's not how we Amuricans do thangs, we go out with a bang, like Hemingway, JFK, JFK Jr, even my Uncle Pettigrew...
    OK, Uncle P got stung by an angry nest of Yellow Jackets while retrieving a horse shoe that somehow got under his trailer, and died cause the Epi-Pen required a $5 co-pay...and damned if he was gonna shell out any of HIS shekels after paying into Medicare for 50 years...

    Frank "Multi-discipline THIS" Drackman

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  9. And there we go, a discussion ruined by the moronic comments of Frank. Grumpy's law has now taken effect.

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  10. "Grumpy's law"?
    Is that anything like the Tatoo/Teeth(oops, sorry, Tatoo/TOOTH)ratio???
    Seriously, have you ever seen the Queen smile? Looks like a friggin Jack-o-lantern...
    And because I live in the Best-us Country, IN THE UNIVERSE, I was able to tear my Rotator Cuff on a Saturday, get an MRI on Monday, get it repaired the NEXT Saturday(wanted to be sure no Muslims were workin)and back to jerkin it, the...
    OK, it was a while, maybe reading "Rotator Cuff Rehab for Dummies" instead of payin for some PT wasn't the best idea...
    And thats right, I didn't use any Insurance, wrote the check myself(OK Mrs. Drackman wrote it) and instead of some lame-ass-vicodin, I rode out my post-op pain with some fentanyl patches and Oxy chasers...
    And I got to fade out to LaLa land listeinin to "Free Bird" instead of some CRNA tellin me to take deep breaths..
    So it cost 10 grand, in America Doctors make REAL money(umm REAL doctors I mean, not Shrinks or Fleas), in a Currency that's still legal tender even in the sleaziest Bellorussiona brothels...
    Just TRY and spend your Pound Sterlings anywhere outside your fruity kingdom...
    What do they do for torn Rotator Cuff's in Gay old Eng-a-land? Some hot tea and a spot of Paracetomol?

    Frank "I know you are but what am I" Drackman

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  11. Fair Distribution of Life-Years

    Yuri N. Maltsev - 06/22/12  [edited]

    Ezekiel Emanuel is director of the Clinical Bioethics Department at the US National Institutes of Health and an architect of ObamaCare. His brother is Rahm Emanuel, Obama's former Chief of staff.

    Ezekiel Emanuel wrote in The Lancet medical journal Jan 2009  [edited]:
    === ===
    Allocation of healthcare by age is fair, unlike allocation by sex or race. Even if people aged 25 receive priority over those aged 65, everyone who is now 65 was previously 25.

    It would be ageist to treat 65-year-olds differently because of stereotypes or falsehoods. It is fair to treat them differently because they have already received more life-years.
    === ===

    Rationing healthcare is tough. Choices must be made because resources are limited. The diabolical part of Emanuel's vision is that he wants to restrict the availability of care even to those people who can pay for it, under the god-like vision of leveling the distribution of resources to the worker bees.

    Any 16th century king would recognize the utility of feeding the young and healthy workers, and starving the old. The old have already lived, and the young have much tax to contribute to the treasury of the king.

    EasyOpinions.blogspot.com

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  12. Charge: Britain is Allowing Thousands of Seniors to Die Prematurely
    06/22/12 - NCPA by John Goodman [edited]
    === ===
    Professor Patrick Pullicino said doctors had turned the use of a controversial “death pathway” into the equivalent of euthanasia of the elderly. The Liverpool Care Pathway [LCP] is a method of looking after terminally ill patients, used in hospitals across the country.

    It can include withdrawal of treatment, including withdrawal of water and nourishment by tube. On average, it brings a patient to death in 33 hours. There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 130,000 (29%) are patients who were on the LCP.

    Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP, and it had now become an “assisted death pathway rather than a care pathway.”
    === ===

    EasyOpinions.blogspot.com

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  13. zzz.

    Grumpy and Frank, you two need to sync posting, 'cause the delays are just a snooze fest.

    Let's talk about something important. My hair. Should I keep growing it out so it will be long? Or, should I cut it short again. You know how it is, I've got my cell on my desk and am feeling no willpower to keep me from making that call...

    Frank?
    911?
    Grumpy?

    -SCRN

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  14. hard to say without pics. summer = short, but short sometimes = lesbian, which is not necessarily a bad thing. can't say without pics, but maybe a multidisciplinary committee should decide, it is clearly not something YOU are qualified to decide. that much seems clear.

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  15. That is why I requested a consult, duh!

    If I went short I'd highlight it and make it wispy short not Rachel Maddow short - but it would be very short. I don't think lesbians do the highlighting and wispy kind of thing. But after seeing a clip of The Real Housewives of "you name it city", long hair can really be sad, don't you think?

    Maybe Andrew has some input here too?

    -SCRN

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  16. Andrew, clinically speaking here, the withdrawal of food and water might be a hospice thing. What motivates it needs to be defined.

    Dependent on the terminal disease process for example many cancers or in Alzheimers/dementia there can often be a natural refusal to eat or drink (a sign of a natural dying process)this is normal. Force-feeding is cruel to me. Witholding food from a person who would and could eat/swallow is also cruel. Spend some time in an ICU and see the long term lifeless on permanent ventilation, tube feedings, urinary catheters who spend months going from long term acute care nursing homes to the ICU and then back again, just lab rats unable to speak, move, or tell you or show you if they are in pain - or tell you "Please stop and let me die now". That is torture.

    I really don't think you actually personally believe that somebody is going to legislate refusal of care to those that want treatment. Nobody is going to legislate anything that says just stop feeding them to decrease the surplus expenditures...

    What everybody needs is to be educated on what really goes on during serious illness. Hide nothing. Currently, you will see some people get some great education on what is what from doctors and nurses, in order to make decisions themselves, and you will see some told lies (eg. "You can fight this thing, lets do some more tests") to get a few more specialty procedures $$ in when the patient is really just beginning to actively die - no saving them.

    -SCRN

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  17. oh you are right that it won't be legislated. but it might be, and i can't remember where i heard this, 'decided on by a multi-disciplinary panel of experts'... that way, no ONE is to blame.

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  18. Now that is not fair 911, I asked you for advice about my hair because I value you input (and thought you had the balls to tell it to me straight).

    BTW, If such ever came to be legislated, I and tens of thousands of practitioners would refuse. Simple that = Legislation fail. In the end I decide. So do you. No legislation can make me harm someone.

    -SCRN :)

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  19. you would quit, right? but i agree, there won't be euthenasia, there will be wait lists. and people will die on wait lists just like they do at the VA now.

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  20. Same applies. If things went that far, we'd all realze that we are stlll going to take care of people. It's still up to us.

    Hey, Frank's packin. I could take lessons :)

    -SCRN

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  21. but it's really not. I'm out of the game. so are the other er docs on this blog. surgeons are fleeing to the large centers. only option? promote the PAs and NPs.

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  22. Andrew M Garland 2:43pm, you are using the same sensationalist report that I have already rubbished.

    SCRN 3:35 pm, yes, I broadly agree with you.

    911 3:49pm, "decided on by a multi-disciplinary panel of experts" I did not say this and the LCP does not say this. It says "the multidisciplinary team" which has a specific meaning. It is the team who are involved in the patients care, not some random strangers. It includes the doctors, nurses and even social workers if they are involved with the patient.
    "no ONE is to blame", there is no blame, it is a consensus decision.

    SCRN - I prefer shoulder length/long hair over short but having worked with women for a long time I would be very hesitant to give any opinion.

    Frank, Grumpy's law, as I have told you before is similar to Godwin's law. It basically states, 'in any internet discussion when Frank Drackman makes his usual inane, uninformed, racist, remarks then the discussion is effectively over'.

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  23. @ SCRN, LONG, LONG, LONG,
    except the ones on your(the collective "you" not YOU) upper lip/legs.
    And I like a little armpit hair, and in that other place, lets just say I came of age in the 70's Nome Sane? Not sayin I want an Amazon Jungle down there, just evidence that you've (collective again) passed Menarche...
    And short hair just makes you look like one of the Manson Chicks, whoa, I'm dating myself, like Sinead Oconnor, umm like Natalie Portman, and it deletes that sexy "hair flip" move from your playbook.

    @ Grumpy: Attack the Messenger much?
    Its not my fault your Country, Oh, I'm sorry, KINGDOM, has an Ugly Queen, bad food, unreliable cars, dental hygiene that even Russians joke about, and The Clash/Beatles/Who/Oasis couldn't carry Def Lepard's massive jockstraps.

    Frank

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  24. Grumpy - Yeah, we're all going to die eventually, but I have a problem with your saying that if someone who is on the LCP shows signs of recovery, the protocol will be discontinued. How does someone who is weak hope to recover if he is denied food and water? How does he communicate and how do you notice improvement in someone who is heavily sedated?

    When my time comes, I will go ... but allowing someone to dehydrate is just plain cruel, IMO, even if you ease your conscience by drugging the shit out of him.

    Not speaking as a medical expert - just as a human being with a conscience.

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  25. Like it or not, there ARE people who would hasten the demise of other people who they don't believe meet their "quality of life" standard.

    My cousin, who is mentally retarded but sufficiently functional to hold a landscape maintenance job, had a health crisis and required a ventilator. Some of his caregivers pressed my aunt and uncle to remove him and "let him go" peacefully. Instead they followed the advice of a pulmonologist, who felt he would recover given sufficient time. He did, and was transferred to a nursing home eventually to continue his recuperation. He is home now, and they are hoping he will be back to work in a couple more weeks.

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  26. To GrumpyRN 4:37 AM, July 02

    Should I know who you are? You have already rubbished the sensational account which I referred to. Sorry, I missed your commentary, or surely I would not have referred to that report.

    Unfortunately, this leaves me in the dark which you think I live in. What is wrong with that report? Possibly you have an argument and a link. Otherwise, I'll just rely on your reputation.

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  27. @ Peggy U
    You have a Cousin in the Landscape Business too???

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  28. Andrew M Garland, "Should I know who you are?" That's very rude of you.

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  29. To GrumpyRN,

    I'm rude to you? I suggest some introspection on your part.

    Your reply to me was in its entirety, "You are using the same sensationalist report that I have already rubbished."

    That is an appeal to your status, so I wondered just what gives you the status to pronounce on matters without link or explanation.

    If you want to describe why the report is bad, then that is a discussion. When you speak from on high, then it is you who is condescending and rude.

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  30. Dear Andrew,
    Very nicely framed logical riposte. But remember sir, we are arguing with a relativist... one who, if asked to say if he agreed more with the philosophy of the Marquis de Sade or that of Pol Pot would find a comfortable place between the two and defend it with all rigor. He's the one who thinks decisions on life and death are properly ruled on by committee. That's when I stopped talking to him directly, because he is the nurse who saves that extra 10mg of morphine to push to 'hasten the inevitable' and then pats himself on the back for preventing suffering. IOW, he's a useful idiot.

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  31. OK, OK, time to break up this Circle Jerk with a little humour(British Spelling for Grumpy)

    My youngest daughter was "studying"* for the SATs recently, and asked me what "Dualism" was...
    "Its when you do a #1 and a #2 at the same time" I answered

    HAHAHAHAHAHAHA

    *studying as in reviewing old tests, key words, trivial facts, none of that gay "Concepts" Crap

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  32. Sheesh. Thank God for Frank.

    FYI, I decided not to cut my hair - like anybody cares about what's really important these days.

    And, gotta side with Grumpy re: Andrew.
    Andrew you can be sooooooo irritating because you clearly haven't spent the time educating yourself. Your points are always lost in bluster and crazy-ass links to the freak network.

    Now PeggyU has some concerns and she speaks from experiences that give her the ability to see how fluid things are in healthcare - getting second opinions, etc. but always having the choice to do that, and then retaining the ability to make the ultimate decisions regarding care.

    If you want choice, you have to seek information/education -- when it's serious, it's going to be hearing very scary stuff, stuff nobody wants to talk about.

    -SCRN

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  33. Grumpy RN (walking the wrong pathway) - "no ONE is to blame", there is no blame, it is a consensus decision."

    Ah.... ever hear of a nice lady named Margaret Thatcher? She believed "Consensus is the absence of leadership."

    And said "To me, consensus seems to be the process of abandoning all beliefs, principles, values and policies. So it is something in which no one believes and to which no one objects."

    Now I understand why you're so grumpy...judging by your picture you're not far from that ole pathway yourself huh? Not to worry I'm sure the consensus will be in your favor.

    Happy 4th of July to everyone in the U.S.

    Barb

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  34. Anonymous 10:43 AM, July 04,

    Is that the best you've got? You find my link irritating, and your explanation is that I am uneducated. I understand why you want to remain anonymous.

    The article I linked is by a doctor in a British hospital, talking about the breezy way a man with pnumonia was put on a treatment track to death by denial of food and water. He took that man off the Liverpool protocol and he recovered.

    But, if you say so, that is all crazy-talk bluster. If you know of some more information useful to understand that incident, then please present it. I have an open mind.

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  35. Eww! Eww! Eww!
    Mr Kot-Tair!!!!!
    Barb punked Grumpy with the O-Word!...
    good call though, I attributed his stupid Hat/Sour demeaner to his NHS-treated Prostrate Cancer, if cutting someone's balls off really counts as "Treatment"...
    Or maybe it's those old school Mercurrial Diuretics, none of that fancy HCTZ for the Queen's subjects...
    and @ Andrew M. Garland, (if that really is your name)
    did anyone ever tell you you're a C-Blocker?
    We've got 2 Chicks just beggin to talk about their sex lives, and you wanta talk End of Life Issues?
    End your own life, for cryin out loud...

    Frank

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  36. Andrew,
    You often attempt naive sensationalism instead of educated, or just honest personal opinion.

    -SCRN

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  37. Andrew M Garland, OK, I have introspected. Now what? You were still rude in your reply to me. Nothing changes that. I made no appeals and I had already explained why the report was bad as part of this thread - you can see it, it is the first comment here.
    Re your comment at 2:05 to SCRN. A patient was taken off the pathway and recovered - wow - the whole point is that patients can recover and they can be taken off the pathway and they can recover. They are assessed to allow this, they are not just ignored and left to die. Oh and before you ask what my reference for this is, I have used the pathway and watched patients improve and get transferred out of our department. I have also seen other patients die peacefully, pain free and with their families around them.

    911, as usual you resort to abuse - I am again a communist, yes I got the allusion and yes I do know what it refers to. A relativist? Why not say I am an athiest and therefore have no fear for my soul. It would be more accurate.
    Death by committee? Never said that, I used the word team, different meaning. Pushing 10mgs Morphine would be called murder in the UK, not sure what you call it in US.

    Barb, Margaret Thatcher is one of the most hated politicians in this country and is the reason that Conservatives - her party - are unelectable in Scotland. The picture I use is of an actor called Richard Wilson in the character of Victor Meldrew a well known grumpy pensioner from a UK sit com.

    Frank, I think I love you man. Will you have my children?

    Happy 4th July.

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  38. @ Grumpy
    You're an XX???
    I knew British women tended to the homely side, but Great Ceasar's Ghost man!
    Anyways, my Vas Deferens went DB Cooper in the 90's, and I'm still shootin blanks some 14 years later..
    Pretty good considerin it was the "Surgeons" 4th procedure, you know, See One, Do One, Teach One, Fuck up One..
    I know, a Scrotal Hematoma's a well known complication, and it was sort of fun walkin around like a mutant hybrid of John Holmes/Chester for a week...

    Frank

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  39. Andrew,
    you need to 'feel' more and think less.

    SCRN,
    I have no idea what to make of you.

    Grumpy,
    you have completely lost me. I made no allusions except to things you said yourself.

    Margaret Thatcher saves the UK from spiraling into oblivion and she's hated. yup, that's about right.

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  40. A hot enigma?

    -SCRN :)

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  41. @ SCRN
    ummm better watch usin any word with "nig" in it in todays polarized Political Environment...
    I mean the current President/Attorney General aren't exactly Ronald Reagan/Ed Meese, "Nome Sane"???
    And my late Grandfather, Nathan Bedford Jesse Helms George Wallace Drackman III said if we ever had an N-word(his epithet, not mine)President, he'd let Homos in the SEALS, run up the largest Debt in US History(thats what they do), destroy the finest Healthcare system in the Universe, and do a horrible rendition of Al Greens "We Should Stay Together"
    Oh, and He'd show up at his Second I-n-word-urationd drinkin a Fawty, wearing a "Huggy Bear" hat...

    He's been pretty accurate so far...

    Frank

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  42. But Frank,
    Us girls have always had our suspicions about "clubs" that are male exclusive being a disguise for that other thing...

    Football,SEALs,Boy Scouts,Priests, etc. Any guy thing that involves some kind of secret meeting place and a secret handshake.

    -SCRN

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  43. @ SCRN
    thats why I quit Boy Scouts as a "Tenderfoot", Football in 9th grade, Baseball in 10th(OK, I got cut in 11th)and I'm so anti-social I make the Una-bomber look like Stuart Smalley...
    and I'd like to apologize for the agregious in-sensitive error in my previous post...
    it was Al Green's "LET's stay together"

    Frank

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  44. Recently, I was provided rumors via a business professional and a nurse about what can be treated and what can't be treated in the future. One of the statements was "if you have a stroke at 50 years old or older, you will not receive treatment." My mother is 65 years old, owns her own business and works 80 hours plus a week. To say to if you are older than 50, we should axe you, is unnecessary. Luckily for me, I have contacts in a 3rd country that has little government regulation. They are missionaries with a ton of doctors from America, and a crew that can build a hospital. I suspect I will live in Haiti, Congo or somewhere else.

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  45. I have no doubt there will be rationing. There will HAVE to be. There will be rationing of doctors (most folks will be seen by PAs and NPs, and there will be rationing of intensive care. But to say that strokes will not be treated makes no sense. The treatment for survived stokes is cheap... Rehab and aspirin is usually all there is to it.

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  46. @9-11
    Aspirin?
    ENTERIC Coated Aspirin?
    Stuff ain't cheap, OK it is, but projected over the 10 years required by the CBO, we're talkin bout some real money...
    OK, probably less than Michelle Obama pays in a week for her Afro-Sheen, but still...
    And thats the problem, once people get free Aspirin, they'll want free Tylenol, and Free Benadryl, and next thing there's a 15 Trillion Dollar deficit.
    and do we really need high paid therapists to teach Grandpa how to drool out on the corner of his mouth?
    OK, that was cruel, even by my lower than a Snake's belly in a Wagun Rut (HT Dan Rather)"standards.

    Frank "I'm bein Ironic, like Alanis" Drackman

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  47. In fact, the irony of the Alanis song is that it is not, properly speaking, about "irony", rather, it is about a series of unfortunate events.... "it's like rain on your wedding day" for instance... Unfortunate, but not ironic... Which makes the song rather comically ironic.

    And Frank, you are right about the aspirin, if the govt. manufactures it, one tablet will cost ten dollars.

    ReplyDelete
  48. Disturbing Anecdote:
    When Alanis hit the charts in 95' I was at the Pensacola O-club(yes, the one from "Top Gun")enjoying a few Brew-ski's with America's best, when Alanis popped up on the 32 inch Big Screen...
    "Hey!" I exclaimed,
    "Thats the chick from Nickelodeon's "You can't do that on Television!"
    And everyone moved away from me at the bar........
    Um, you see, cause Alanis had been on that show in 1987, when she was 12...
    Blow me, it was a funny show.

    Frank

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