The Next Tibet

The death throes of Tibet are pitiful to watch. As are the death throes of Kosovo. And the next Tibet could well be the Southwestern United States of America.

Tibet has been controlled by Communist China for a generation now. It's predominent cultural institution, its brand of Buddhism led by the Dalai Lama, has been completely destroyed. The Dalai Lama is in India and the few remaining pro-tibetan priests are being killed, imprisoned, or exiled. The priests that are left are creatures of the Communist Chinese government. But the main reason that Tibet has no hope is that the Communist Chinese have used the only way to really take over conquered territory permanently - immigration. Tens of millions of Chinese now call Tibet home and they are not leaving, so supporting a free Tibet is a waste of time. It's a shame, but reality bites.

Northern Ireland is still part of Great Britain because English immigrated and became a majority. The Serbs lost their homeland because Albanians immigrated and became a majority. I could go on and on from pre-history to today. Tibetans will protest and complain, but how do you kick out millions of people who now call Tibet home?

And so we come to the US. How will we kick out tens of millions of Mexicans who will call the US home? We still have sovereignty and the wealth and military to do it if we wish. But the window is closing. Eisenhower did it in the 1950's with Operation Wetback. But I fear we lack the political will to do this. When this current generation becomes established and their children become citizens (as they are becoming by the millions), we will no longer be able to kick "them" out because "them" will be us. And then, like Tibet, we will watch as a foreign culture that does not value Rule of Law and rugged individualism and beliefs against socialism imposes their will on the rest of us. There was never much hope anyway as even the Americans now have a majority who accept bread and circuses, socialized medicine, and ever higher taxation of the productive few. But it would have taken longer for us to fall without the Mexican conquest by criminal aliens.

I no longer expect anything to happen. We have lost control of our government. Even though nearly all of us want a border fence and deportation, and even though we elect politicians that agree with us, and even though they pass laws, there is a critical mass of bureacrats led by the President of the US who wish the US to fail. And there is not a damn thing you can do about it. When this government falls, and it must if there is a just God who punishes evildoers who kill 50 million babies and practice every immorality ever known, perhaps those of us who are left can build a better world again. Long Live the Republic! MEB

Electronic Medical Records (EMR) and Pay for Performance (P4P) were never about quality

An article in this weeks American Medical News (March 2008) caught my attention, and thus this commentary is offered. It was entitled "Bush eyes EMRs, P4P to slow Medicare spending". All along, various shills supported by money from their school, the Institute of Medicine (IOM), the Ford Foundation, the Robert Wood Johnston foundation, and members of disreputable medical establishments on both coasts have pushed the lie that EMRs and P4P would somehow help quality. Anyone that looked into this could easily tell that this was nonsense.

First of all, studies on whether this kind of stuff helped quality are mostly negative. There are only a few studies that showed any benefit, a few equivocal studies, and the majority that found these things hurt quality. I argued long and hard about this with many of my well-meaning colleagues. Even when the last AMA president pointed out the harm from EMRs and P4P, they didn't believe me. Well who's laughing now. Bush mentions that EMRs and P4P will slow medicare spending. How will spending large amounts of money on EMRs lower costs? Only by allowing government access to data that they can then use to lower pay. That's it. And the same with P4P. This article treats us like retarded animals and says a portion of current medicare funding (that means money taken out of our payments or a payment cut) will be returned to those who meet unspecified quality indicators.

This means that all of our pay will be cut and a few may get some of the money back - but there is no known standard by which this will occur. What idiots we doctors have become in just a few short years. I blame mostly the ivory-towered pseudo-intellectuals and the doctors who like to feel important by telling the rest of us working stiffs what to do and schmoozing with lying sacks of politicians who run our organizations like the AMA and AAFP. Most of us are too busy to spend time on this stuff, and our trade organizations that were suppposed to help us, have long been taken over by political junkies who thrive on telling others what to do since they have lots of extra time because patients won't see them.

I note that President Bush was "required" by Medicare Modernization Act of 2003 to offer a proposal to cut costs if costs got too high. Where in the US Constitution does it give legislators the power to make the Executive Branch take over a function that is solely that of the legislative branch - bills on revenue and spending? Why haven't the 9 black-robed minions of hell ruled this un-constitutional?

Once again the only way EMR's and P4P could lower costs would be by cutting our pay. And we are being forced to buy the instuments (EMRs) that will allow the government to cut our pay. Shame on us physicians for allowing this! And for the rest of the population, you deserve the contempt of your elected officials for voting for these idiots in the first place, and you deserve the sub-standard medical care and death that awaits you when the best doctors limit or leave their practices. Try and find your mother a good internist in a year when we get more medicare cuts and health care is nationalized. Serves you right.

It was never about quality; it was always about control and paying us less.