Tel-A-Vision for the 21st Century  

 Index and Hot Links for
 Debate on Health Care Reform: an exercise in pseudo-journalism

Part One ~
An exercise in Pseudo-Journalism

The Information Gap
Failure is not an option.
National Healthcare Policy 2009:
The AMA and National Health Insurance:
A Real-World Study in Contrast:


Part Two ~ What American should
(but don’t) know about health care in the US:

The Facts ~ Quality of Care:
The US vs. Other Developed Countries:
Maternity Care for Healthy Women:
$$$ Healthcare Cost and its Consequence:
Catching-up on half a century:
Health Insurance:
Workplace Disincentives:
Bankrupting the Insured:
Double jeopardy for the Uninsured:
Corporate Medicine:
Deregulation and Privatization:
Professionalism vs. commercialism:

Part Three ~
he Marriage of Authority-based Medicine and Investor-owned Corporate Medicine

Authority-based Medicine:
Evidence-based Practice:
The difference between authority-based medicine and evidence-based practice:
Physician Preference – the decider of all things medical &
Unlimited Licensure
Stockholder conflict between doctors, hospital and health insurance companies
Where health insurance companies are king, pre-authorization is queen:

The Art of Medicine – the right place for
Political Legacy:

The Publishing Empire Power Behind the Throne:

Part Four ~

Physician preference:
The ethics of confusing art with science:
Trends in the physician workforce:
Defending professional turf
The Numbers ~ Everyday Non-urgent Health Care:
Challenging Chokepoint Medicine:
Time vs. money:
Not enough of both to go around:
Institutionalized Mismatch:
Un-choked, unhurried primary care:

Concurrent Reform in Medical Education:

Part Five -- fixing the problem

Non-physician primary care providers a threat to OM:
The AMA and its role in the Scope of Practice Partnership:
How organized medicine developed its iron grip
Politics masquerading as science:
The uncritical acceptance of an unscientific premise:

A Short Primer on the History of National Health Insurance and Organized Medicine
Historical Background of the AMA

Part Six ~ Failed national healthcare policy that have fallen off the public radar

Comparative Effectiveness ~ the lynch pin of an efficient, effective and affordable health care

A Vision for 2020: Affordable healthcare versus  ~ The 2nd federal bailout of the 21st century

Do or Die:

What Works:

Comparative effectiveness re-writes the playbook.


Five-Point Wrap Up:

The ABCs of a Political Action Plan

Additional Topics for next time:

HealthCare_2.0 ~ don’t leave for the 21st century without it: a vision for a workable, affordable system that expands on many of these topics

Excerpts from background materials:

1. MDs paid for services provided by non-physician practitioners – “income for the physician but no cost-savings to the patient” ~ Medical Board - October 5, 1993 Status Report: Health Policy and Resources Task Force

2. From a speech by Dr. W. A. Evans at the AMA’s annual convention ~ JAMA., September 16, 1911

3. Wilk vs. AMA Class Action Suit, 1987 - AMA convicted of violating Sherman Antitrust Act 

4. RELEVANT AMA POLICY ~ Scope of Practice Partnership ~ House of Delegates Resolutions H 204, 205, 303, 239, 814, 902

5. Bibliography and References ~ Set #1:

AMA Timeline; official AMA web site; AMA Scope of Practice Partnership House of Delegates Resolutions  204, 205, 303, 239, 814, 902

AMA, NMA, and the Flexner Report of 1910; Ololade Olakanmi; Writing Group-History of African Americans and the Medical Profession; [AMA archive]

Amazing Logistics of Flexner's Fieldwork; Mark D. Hiatt, MD, MBA Originally published in the Medical Sentinel 2000;5(5):167-168. Association of American Physicians and Surgeons (AAPS);

Carnegie Bulletin #4 ~ Introduction by President Henry S. Pritchett, April 16th 1910

MEDICAL EDUCATION IN THE US AND CANADA ~ 1910; (also known as the Flexner Report) 386 pages - can be downloaded from Google Books

Wilk vs. AMA Class Action Suit,

Bibliography and References ~ set #2

Bureau of Labor Statistics web site, Health Care

Fast Facts on US Hospitals - American Hospital Association; web site Jun 2009

Health Insurance Costs -- National Coalition on Health Care ( 2009

Medical News Today – Press release by CMS -- Office of the Actuary in the Centers of Medicare and Medicaid Services (CMS); Catherine Paddock, PhD Jun 2009 More Bang for the Buck? Randall Stafford, MD PhD, et al Stanford Prevention Research Center funded by Agency for Health Research and Quality; the Archive of Internal Medicine in Oct 2008

Physician characteristics and distribution in the US - 2000 edition Chicago American Medical Association 2000, pg. 352

Policy Statement on Nurse Practitioners in Primary Care; Am College of Physicians, Mar 2009

President Truman’s January 7, 1974 Call on Congress -- Healthcare Reform, reprinted NYT;

The Social Transformation of American Medicine, Paul Starr, 1982;

Strategic Management of Healthcare Organizations; Peter M. Ginter, et al; 2002, 992 pages

Time Line on Health care crisis ~ crisis/history.htm Jun 2009

White Pager – Primary Care Crisis; American College of Physicians, 2008

Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2008 July 17, 2008 | Volume 97 Authors: The Commonwealth Fund Commission on a High Performance Health System; Contact: TUcs@cmwf.orgUT

Bibliography Set #3

Achievements in Public Health, 1900-1999: Healthier Mothers and Babies - CDC

Birth Environments ~ Emerging Trends and Implications for Design; The hospital economics obstetrical departments; Alice Lerman, B.A., J.D., M. Arch; Univ Wisconsin; Sch of Architecture & Urban Planning; Am Institute of Architects & Am Hospital Assoc. Fellowship ISBN0 938744 76 3

Choice in Planning and Experiencing Childbirth AMA Journal of Ethics ~ Virtual Mentor. September 2004, Volume 6, Number 9. Policy Forum

Elective Cesarean Section: An Acceptable Alternative to Vaginal Delivery? Peter S. Bernstein, MD, MPH; Medscape Ob/Gyn & Women's Health -- Web Site 09/16/2002

Maternal Mortality Rates Are Increasing in California;

Maternal death in the 21st century: causes, prevention and relationship to cesarean delivery; Steven l. Clark, MD, et al; American Journal of Obstetrics and Gynecology July 2008

Milbank Report: Evidence-Based Maternity Care, Sakala et al 2008  ISBN 978-1-887748-70-4

Listening to Mothers Survey, 2002, 2006, 2007

Postpartum Maternal Mortality & Cesarean Delivery; C Deneux-Tharaux, MD, MPH, et al; 2006

Crisis of Abundance: Rethinking how we pay for health care; Arnold Kling; CATO Institute, Wash. DC 2006

Bibliography and References ~ Set #4

Critical: What we can do about the health-care crisis; Senator Tom Daschle; 2008

Innovator’s Prescription: A disruptive solution to health care; by Clayton M. Christensen, Jerome H. Grossman, MD and Jason Hwang, MD; 2009

International Health Care Reform: A Legal, economic and political analysis; Colleen M. Flood, Assistant Professor, Faculty of Law, University of Toronto, Canada 2000

A Second Opinion: Rescuing America’s health care – a plan for universal coverage, serving patients over profit; Arnold S. Relman, MD; 2007

SICK: The Untold Story of America’s Health Care Crisis – and the people who pay the price; Jonathan Cohn, Senior editor, the New Republic; 2007

The Truth About Health Care: Why reform is not working in American; David Mechanic, Rutgers University Press, 2006

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