The Perfect Storm for Physicians in America

I take the title for this blog from an article in the Journal of the American Medical Association June 18 2008 p. 2789 "The Perfect Storm of Overutilization".

Two Ph.D's in "bioethics" (one with an MD) employed by the government, paid for by your tax dollars, working for the National Institutes of Health wrote an article about what insiders in the drive for socialized health care see as "problems". This paper will hardly be noticed. Most doctors will poo-poo its implications. Many will actually gladly trumpet it as an advance, even though it calls for cutting their pay in half and submitting themselves to total government control.

First of all, as an aside, what the hell is the government doing paying my tax dollars for doctors to sit around thinking about how to limit my freedom? Why should the government be involved in this activity at all? The answer is that since the government provides welfare via medicare and medicaid, then it can decide how to provide this welfare. And you really have no moral standing if you think the government should steal from some to give unearned benefits to others and at the same time say that while the theft is just fine, what you really object to is cutting your pay.

The article notes that the US spends 2.4 times more than the average of other developed countries. The article notes that one reason is that a huge part of this is siphoned off to a massive, government subsidized and created, health insurance system. This industry (medical costs eat up 15% and more of our total GNP if you include insurance skimming) provides no useful service whatsoever other than enriching the elite owners and managers and making care more expensive through direct costs and indirect costs of bureaucracy that make your doctor charge more and have less time because of activities such as filling out forms and electronic medical records that have no use and actually harm patient care.

And by the way, isn't it amazing that these two bright authors never even pointed out that by getting government and insurers out of the way, the administrative costs could be kept by the patient and doctor? Wouldn't you like to take home an extra 800 to 1600 dollars a month that your company sends to rich executives at the insurance company so they can deny payment for your diabetes medications?

Another listed reason was that US doctors make twice what European doctors make. (And if you don't think that isn't a call to cut our pay, you deserve what's coming) They also note our drug prices our a little (10-30%) higher. Realize that these guys are trying their best to make our drugs look expensive and this is the best they could improvise. I note that there are a long list of un-subsidized drugs available for four bucks a month at many pharmacies, a price unable to be matched in any socialized paradise when you realize how much the government subsidizes medicines. Also, in other countries, you simply can't get many drugs and especially many newer drugs. For example, an expensive drug like erythropoetin to boost blood counts, would simply not be given in most of the world.

A third factor was the abundance of amenities in the US making getting health care actually comfortable and pleasant in the US. (OH, THE HORROR!) The authors note we have "more privacy, comfort and auxiliary services" in our hospitals. Damned Americans, why can't they just lie quietly in threadbare sheets on hard beds lined up like criminals like they do in Europe? The nerve of those Americans! Along these same lines the authors note that in decadent America "offices are typically more conveniently located and have parking nearby and more attractive waiting rooms". Damn those Americans again!

Another aside, my parents were Canadian immigrants and when my mother went to a hospital, there was only one wheelchair on the whole orthopedic floor and it was willed from patient to patient when they left and guarded like glittering treasure.

Then the authors get to the "most important contributor" - overutilization. The authors note that our hospitalization rate is lower than anywhere but Japan. France has more than double our rate. And we see doctors half as much as the average in other developed countries. (You might be shaking your head and wondering out loud, "Isn't that a good thing?" Not in socialized medicine world.) But we do more MRI's, heart procedures, dialysis, and use more newer drugs, and these cost money. (Implicit in this, is that if we would just quit whining and die with our heart attacks and kidney failure like a proper EU slave does, we could save a lot of money that could be spent on the survivors, especially those hard-working government workers at the NIH.)

Now a rational individual might look at this and think "so by using better drugs and tests, we get sick a lot less and survive things like heart and kidney disease a lot better than in the socialist EU", and think that that is probably a good trade-off for money. But you would be wrong. Health isn't the point of socialcare - saving money and forcing everyone to get exactly the same inconvenient, sub-standard, cheap care is the point. Damned Americans.

The authors then note "at least 7 factors" that drive overutilization. One is that American Doctors try really hard to get their patient's diagnosis right the first time. You might again be thinking unauthorized thoughts like "Why the hell would I not want my doctor to get the diagnosis right the first time for?" Idiot. Because it costs more. It's much cheaper to assume every infection is viral, give a patient a few "free" government-subsidized aspirin and send them home to die or get better. Most will get better and the odd brain-damaged meningitis patient is just the price we all have to pay for lowering costs. Idiot.

You might think I'm exaggerating. "Medical school education and postgraduate training emphasize thoroughness." Damn those American medical schools!

Secondly, we get paid for working - in the lingo of medicine "fee-for-service". That means that you pay me each time you see me. That means I even like to see patients. That means I treat them well because I want them to come back. According to the authors, this "misaligns incentives." If I got paid the same low salary whether I saw you and sucked up to you or not, I would rip the carpet out my waiting room, work reduced hours, make you wait for hours in metal chairs, and treat you like crap, which is good because this would keep you away from the doctor and save money. We also get paid more if we take your bad appendix out than if we send you home with aspirin. This "reduces physician's inclinations to watch, wait, and communicate". You might again selfishly think, "But I don't want to wait to have my appendectomy until after it gets worse and bursts. That will really hurt, and might kill me". Selfish bastards. Damned Americans, go home and writhe in pain like the rest of the world!

Reason three was that our system is making so many advances that I might occasionally talk to a drug rep who is trained in what the new drug or device can do to save time. I might even take a bright purple pen with writing on it! And that would make me - I don't know what that would make me, but it would be very, very bad. It would be much better if we closed down most of the research so we would stop making drugs to manage diseases like diabetes. Then we wouldn't need a drug rep. And that 10,000 dollars that the pharmaceutical companies spend on educating doctors on new advances wouldn't be spent because there would be less advances. And while that new drug might have saved your life or made you feel better, quit being a selfish pig!

So how to fix these horrendous things like caring, "thorough", doctors with nice waiting rooms, convenient parking, and pleasant manners, who stay open late and take out our appendixes before they burst? The authors despaired at getting us to act like jerks. "Calls for changing physician training and culture are usually ignored." Damn those independent doctors who want to provide the best possible medical care for their patients. Scumbags.

"Realistically, the most effective change would be to alter how insurance pays." Wait, you mean like let patients keep their own money rather than letting insurance companies take a big cut before denying you care? You mean like negotiating price with the doctor? Things like allowing the doctor not to make me pay the co-pay? (Amazingly, this is strictly illegal under current US law and punishable by fine and imprisonment as a racketeering violation. Look it up if you don't believe me.) Wow, that sounds too good to be true.

And you would be right. Rather than the obvious solution of allowing free men to make free choices and contracts without government regulation and government-sponsored skimming by corrupt insurance companies, the authors suggest that we have a lower co-pay if we agree to accept lower quality irradiation of our prostate cancer that will leave us sterile and incontinent. Don't be so selfish! You could pay a lower co-pay!

Now you may think that I'm exaggerating this last part. "For instance, men with early stage prostate cancer who choose radiation therapy might have no co-payment for 3-d conformal radiation but might have to cover the marginal cost if they want more expensive (and safer and better) intensity-modulated radiation". Come on, diapers are cheap and Viagra is expensive anyway! Egomaniac.

Well, since most of us are too lazy to care or shoot our politicians like they deserve, welcome to the future of American Medicine. I note that we are being assaulted on every side. Medicare pay cuts of over 10% go in effect in 10 days. The US medical graduate average debt of over 150k can no longer be put off until after residency. Etc., etc., etc.

All I can say is you were warned, and you deserve exactly what you are going to get. Bend over and quit complaining. The doctor will see you now.

Firing of Top 2 Air Force Officials and Confirmation from Unnamed Source that Nuclear Triggers Were Not "Mistakenly" Sent to Taiwan

Regarding my blog of last week where I wrote that I was worried about the firing of the top General and the Air Force Secretary over a couple of old "accidents" involving nuclear weapons, I have received confirmation of one of my concerns: that it was no mistake that nuclear triggers were sent to Taiwan. My source said "You know the real story about those nuclear fuses being sent by mistake when they should have been helicopter batteries?" Since all internet traffic is monitored, I will not specify who the source is and what their credibility is. Believe me or not; your choice.



They then told me that someone in Taiwan who was out of the loop kept calling up and saying we sent the wrong thing. Our side kept saying no, we didn't, wink, wink. It became public eventually. Now these top brass could have been fired because it became public, but it wasn't our side that messed up this secret deal, so it wouldn't make sense to fire our guys. Which brings me back to why did they fire these guys and blame it on this lame excuse? The only reason that makes sense to this old cynical veteran is that these guys opposed some major pet project - and only attacking Iran seems to be a big enough project to fire your own guys.



The confirmation that these nuclear supplies really were intended for Taiwan brings up some interesting points. First of all, let me get the Chicoms attention. (I'll explain why later) Communist China deserves to be nuked by atomic weapons! That ought to do it. China has been monitoring web traffic for years, just like we do through our massive ECHELON program. (Look it up, if you don't believe me.) There are certain key words that trigger a more in depth look at the message being recorded and I just used some that the chicoms look for. They will read this humble blog and I would rather not see the chicoms take over Taiwan in a nuclear exchange, so I will contribute in my small way by one more confirmation that attacking Taiwan after the Olympics would lead to unacceptable damage to themselves. By the way, if you don't believe that China also monitors, get a firewall program that will trace attempts to access your computer. Type in my sentence about nuking China. Come back in a few days. Bet you've been probed by Chinese military bases or para-military companies like COSCO or Hutchison-Whampoa (google these names and see what you get). Try it and see.

This info means we are taking Chicoms rumblings seriously to the point of arming our friends with nuclear weapons. Since the Chinese also have missiles (technology stolen mostly during the Clinton admin - which was the original reason the John Birch Society and others called for the impeachment of Clinton - it was never about Lewinsky, but the elite turned it into a circus about sex- and this theft continues to this day under Bush with many companies blatantly sending this technology to China) aimed at the US and their generals frequently remind us of this threat, it may well come to a limited nuclear exchange with communist china. Oh, and remember who supplies Iran with its weapons like the silkworm missiles that could devastate our at least 2 carrier groups in the middle east? (I say at least 2 because that is public knowledge, meaning that there may well be more) You guessed it - Communist China. There are so many possible convolutions and peripheral machinations involved that it makes your head spin. Perhaps firing these guys and using the phony reason of nuclear accidents was meant to reassure China that we don't really care about Taiwan and just leave us alone in the attack of their ally Iran. Or, knowing that the Chinese already know we are sending nuclear stuff to Taiwan, we are rubbing it in their faces and firing 2 guys who don't want to bomb Iran - signalling our intentions and warning them simultaneously. Etc. etc. It's dangerous to assume too much intelligence in international relations because of the egos involved.

Anyway, if all that doesn't scare you, you must not have much feeling left.

Let your legislators know that they need to 1)Oppose bombing Iran and 2)Support Taiwan. Our country and its citizens may depend on this.

Or I'm a total idiot who knows nothing. Keep right on smoking that "medicinal" marijuana and voting for Barrack Hussein Obama and John why-do-all-my-fellow-POW's-hate-me McCain. (Did you know I have a source close to McCain's old war buddies who has incredible stories and allegations?) Check it out and make up your own mind.

Vincet Veritas, MEB

The following is a guest editorial pending in the Ogden Standard Examiner. It is in response to a guest editorial in favor of making our alcohol laws easier under the guise of saying that we will get richer if we attract more convention business and everyone knows conventioneers want smoking, booze and hookers. I notice that no one wants to bring back cigarette vending machines, etc. Alcohol is simply dangerous. It kills and destroys. It costs all of us, especially drinkers and their families. Like tobacco, anything that lessens its use is good.

Utah's alcohol laws are sensible and save lives

The Utah Department of Alcoholic Beverage Control (UDABC) is currently being pressured to make the consumption of larger amounts of alcohol quicker and easier. A recent guest commentary (Mathur, May 30,2008) was filled with distortions and inaccuracies. As a former medical director of the Northern Utah Alcohol Foundation and long-time community Family Physician who has seen the ravages of alcohol destroy individuals and families, I thought I would correct some misinformation before we make the mistake of changing our sensible and evidence-proven laws.
Let's start with the fact that 75,000 deaths a year come from alcohol consumption. Then realize that alcohol is responsible for 200 billion dollars a year in economic costs. And then there are the non-economic costs - things like drunks murdering and maiming innocent motorists, violent crime, family violence, family breakdown, mental illness, and various other health problems too numerous to list. From this week's Journal of the American Medical Association you may read, "Four health behaviors (smoking, diet, physical inactivity, and alcohol use) account for 38% of all US deaths." I'm tired of people trivializing this huge problem that affects us all or saying opposition to alcohol comes from intolerant Puritans. It is a real societal and health issue, regardless of your religion.
Utah's alcohol laws are sensible and have worked well. Research available from the very source cited by Professor Mathur shows evidence supporting Utah's current laws. (This source was incorrectly cited in the article - it is actually the Pacific Institute for Research and Evaluation) "Most American adults either abstain or drink very little." "A relatively small percentage of drinkers drink most of the alcohol." "This small percentage often consumes several drinks at a time, increasing the risk of serious health and safety problems." "Binge drinkers are 23% of the population, but drink 76 % of the alcohol." These problem drinkers both cause most of the damage associated with alcohol and they are pushing to make their binge drinking easier.
The simple facts are that 75% of Americans don't drink or drink very little. Of the remaining 25%, over half do not drink large enough amounts for the Utah laws to even have much effect. Those affected by the Utah laws are a minority of a minority who disproportionately cause the problems associated with alcohol that we all pay for through increased taxes, increased costs of goods, increased auto insurance premiums, and in death and disability.
Again quoting from Professor Mathur's source and the US Department of Justice on proven methods for limiting the damage done by alcohol, "Manydifferent studies have found that higher alcohol prices lead to lower consumption and fewer alcohol-related problems. Higher prices tend to have a particularly strong effect on young people." As a citizen of Utah, yes I want higher prices and taxes on alcohol. This not only benefits society, but the drinkers themselves who are less likely to drink as much. Just as taxes and pricing of tobacco lead to proven health and other societal benefits, so does increasing the price of alcohol.
"Restricting the density of alcohol outlets and their location is one way of decreasing consumption and related problems. Several studies have demonstrated the connection between the density of alcohol outlets in a community and the rates of violence, particularly among youth." Yes, as a citizen I want to decrease violence, particularly among youth, by limiting alcohol outlets.
Many studies show Utah's sensible alcohol laws were ahead of their time and continue to provide a measure of safety to the community and to the drinkers themselves. Much support for making it easier to drink more alcohol more quickly comes from a few business people affiliated with large out-of-state hotels and large companies who own properties like ski resorts and restaurants who would see their profits rise even as our quality of life would drop. Don't let the designs which do and always will exist in the hearts of conspiring men, including unfortunately our own Governor, interfere with our rights as citizens. Call up the Governor and your representatives and share both your support for current laws and the fact that Utah's alcohol laws have stood the test of time and have scientific research to back them up. Do your own research; think for yourselves. And you will find, as I have found, that Utah's alcohol laws make good sense. And that is the simple truth.

Air Force Fires Top 2 Leaders - Will We Needlessly Attack Iran?

I'm scared about this firing for ostensibly being careless with nuclear stuff in 2 instances. One would be the last year flying of nuclear bombs (unarmed) across country to Barksdale AFB Louisiana. The other was the sending of nuclear fuses instead of helicopter batteries to Taiwan in 2006. This firing stinks to high heaven. Let me explain why from my perspective as a non-combat, non-flying veteran of the Air Force.



There are all kinds of things wrong with this firing. There is the way it was done. Out of nowhere without warning. Normally, there would be bickering back and forth and adequate time for excuses, transfers, etc.



Then there is the fact that the supposed infractions are old ones. That is, the plane that flew loaded with Nukes to Barksdale AFB in Louisiana did this some time ago. There was actually quite a bit of fuss, and to all outward appearances, things were tightened up. Any mistakes would be by a computer clerk or a crew chief. No commander would be at fault and that would be that. This story had legs and kept popping up, making me think at the time that it maybe wasn't that it happened, but that they got caught or it went public. No way to tell, but these kinds of things happen quite often and usually don't make the evening news. Rumors were even found that moving these atomic weapons was part of a plan to be prepared for a nuclear response to Syria or Iran, entirely plausible possibilities. Again, I have no way of knowing the truth; I only note that this didn't play out as usual.

The second infraction was again a years' old problem about sending nuclear fuses rather than helicopter batteries to Free China (Taiwan). This one is also odd. Helicopter batteries and nuclear fuses are not even in the same division. Nuclear stuff has all kinds of security that batteries don't. They are different commands. And China continues to threaten to nuke Taiwan if they ever declare Independence as well as nuke LA for whatever reason. It might be entirely possible that we were sending nuclear fuses to Taiwan. It would make perfect sense in some ways. I would hope that Taiwan would bear the brunt of its own defense in a post-Olympic blitzkrieg that many think is inevitable. This would be done semi-secretly for a variety of reasons. One is, China can break us anytime it wants by selling off our dollars and debts that it holds. That's the reason we hardly uttered a peep when they shot down our spy plane, imprisoned its crew and stole all our advance secret electronics a few years ago. So we wouldn't do it openly so they wouldn't feel publicly insulted and have to show a response like destroying our economy. (This would also destroy their economy shortly thereafter since our exports would stop.) Another is to not provoke the international sissies like the UN. And not to anger the real power in the US - Big Business with their billions of investments in Commie China.

There is always the problem that giving the Taiwanese weapons would be just like giving the commies weapons when they take over China - just like Vietnam etc. where our aid was quickly turned against us by a new regime. But that kind of thinking would be too advanced for the average political general who could always cry "Who could have known?" As badly as our military and political structure is infiltrated by the Chicoms, such a general would probably get an extra star, making it all the more likely that it wasn't a mistake, but just that they got caught again.

So if both "mistakes" weren't mistakes, or even if they were mistakes like happen all the time without fanfare, then why were the 2 top Air Force people fired?

And this is where it gets scary. The press got these releases about these guys instantly and everywhere. Rather than the usual announcement about age, fine service, time to move on, etc., we get this nasty notice of incompetence of these two political appointees. Every single general has to pass approval by Congress and expecially an upper general. And the Secretary of the Air Force is a direct political appointee. Criticizing these 2 guys would be like the Bush regime accepting the blame themselves, which is not something that will ever happen. So there must be another reason.

And that reason (sorry to take so long to get here) is that these guys may well have opposed some new plan of the neo-cons like bombing Iran, and these guys may have had the guts to oppose it. And that would get them fired. Can't have the top 2 guys in charge of the service that would bear the brunt of the initial attack along with the Navy (which is why there are not one but 2 carrier groups in the area even as the casualty rate falls in Iraq) dragging their feet.

Now, some might ask, why wouldn't these guys go public then? First, because they seem to be intelligent. Intelligent enough to get fired by the Bush regime, when so many run-of-the mill idiots don't get fired. They would recognize that all kinds of things from demotion and loss of pension to even imprisonment and random suicide (like the DC madam) could happen. Remember poor Secretary Forrestal who, when he found out the government was run by neo-con one-world thugs was thrown out a hospital window?

Second, if we are going to attack, loyalty would demand you not say anything because it would harm the mission, the men of the military, and the country. Much like those who knew Roosevelt withheld information from the Pearl Harbor commanders Short and Kimmel that would have avoided Pearl Harbor. What would be gained? We were already at war.

And third, what would it matter? If we're going to attack (like so many source seem to say we are), then what good would it do? They would get the blame for the fiasco because someone could always say, "If those last 2 traitorous idiots would have done their job, this disaster might not have occurred."

Again, I have no special knowledge, no contacts, no reason to think this. But it worries me. I don't think these kinds of high-level things happen without a good reason, and a few "accidents" are not enough, in my opinion.

So my advice? Watch out for war with Iran before Bush leaves office. Hope I'm wrong, but I wouldn't bet on it.

Blue Planet in Green Shackles

Vaclav Klaus Speech at National Press Club May 27, 2008

Here is the speech that has the enviro-liars and believers in "starvation theology" (my term for nut cases like Al Gore, Ted Turner, and Eric Pianka who hope for the starvation and miserable death of billions of souls) quaking in their boots. I heard some excerpts on Limbaugh but the rest of the media, including even supposedly conservative outlets, have been strangely silent. So here it is in all its glory. Choke on it.

"It is a great pleasure to be here. Let me thank all those who helped to make the English translation and publication of my book "Blue Planet in Green Shackles" possible, especially Fred Smith and his Competitive Enterprise Institute, and those who co-organized the presentation of it in this very prestigious place. I am really excited to finally hold in my hands - after the Czech, German and Dutch editions - the English version of my book.
The authors often claim that their books speak for themselves. I cautiously agree and will, therefore, speak not about the book itself but about my motivations to write it.
To make my position and my message clear, I should probably revoke my personal experience. My today's thinking is substantially influenced by the fact that I spent most of my life under the communist regime which ignored and brutally violated human freedom and wanted to command not only the people but also the nature. To command "wind and rain" is one of the famous slogans I remember since my childhood. This experience taught me that freedom and rational dealing with the environment are indivisible. It formed my relatively very sharp views on the fragility and vulnerability of free society and gave me a special sensitivity to all kinds of factors which may endanger it.

I do not, however, live in the past and do not see the future threats to free society coming from the old and old-fashioned communist ideology. The name of the new danger will undoubtedly be different, but its substance will be very similar. There will be the same attractive, to a great extent pathetic and at first sight quasi-noble idea that transcends the individual in the name of something above him, (of something greater than his poor self), supplemented by enormous self-confidence on the side of those who stand behind it. Like their predecessors, they will be certain that they have the right to sacrifice man and his freedom to make their idea reality. In the past it was in the name of the masses (or of the Proletariat), this time in the name of the Planet. Structurally, it is very similar.
I see the current danger in environmentalism and especially in its strongest version, climate alarmism. Feeling very strongly about it and trying to oppose it was the main reason for putting my book together, originally in Czech language, in the spring of 2007. It has also been the driving force behind my active involvement in the current Climate Change Debate and behind my being the only head of state who in September 2007 at the UN Climate Change Conference in New York City openly and explicitly challenged the undergoing global warming hysteria.
My central concern is - in a condensed form - captured in the subtitle of this book. I ask: "What is Endangered: Climate or Freedom?" My answer is: "it is our freedom." I may also add "and our prosperity".
The book was written by an economist who happens to be in a high political position. I don't deny my basic paradigm, which is the "economic way of thinking", because I consider it an advantage, not a disadvantage. By stressing that, I want to say that the Climate Change Debate in a wider and the only relevant sense should be neither about several tenths of a degree of Fahrenheit or Celsius, about the up or down movements of sea level, about the depths of ice at North and Southern Pole, nor about the variations of carbon dioxide in the atmosphere.
The real debate should be about costs and benefits of alternative human actions, about how to rationally deal with the unknown future, about what kind and size of solidarity with much wealthier future generations is justified, about the size of externalities and their eventual appropriate "internalization", about how much to trust the impersonal functioning of the markets in solving any human problem, including global warming and how much to distrust the very visible hand of very human politicians and their bureaucrats. Some of these questions are touched upon in my book.
My deep frustration has been exponentially growing in recent years by witnessing the fact that almost everything has already been said, that all rational arguments have been used and that global warming alarmism is still marching on. It could be even true that "We are now at the stage where mere facts, reason, and truth are powerless in the face of the global warming propaganda" (R. McKittrick, private correspondence).
We are regretfully behind it. The whole process is already in the hands of those who are not interested in rational ideas and arguments. It is in the hands of climatologists and other related scientists who are highly motivated to look in one direction only because a large number of academic careers has evolved around the idea of man-made global warming. It is, further, in the hands of politicians who maximize the number of votes they seek to get from the electorate. It is also - as a consequence of political decisions - in the hands of bureaucrats of national and more often of international institutions who try to maximize their budgets and years of careers as well regardless the costs, truth and rationality. It is in the hands of rent-seeking businesspeople who are - given the existing policies - interested in the amount of subsidies they are receiving and look for all possible ways to escape the for them often merciless, but for the rest of us very positive, general welfare enhancing functioning of free markets. An entire industry has developed around the funds the firms are getting from the government.
The basic questions of the current climate change debate are sufficiently known and well-structured:
1) Do we live in an era of a statistically significant, non-accidental and noncyclical climate change?
2) If so, is it dominantly man-made?
3) If so, should such a moderate temperature increase bother us more than many other pressing problems we face and should it receive our extraordinary attention?
4) If we want to change the climate, can it be done? Are current attempts to do so the best allocation of our scarce resources?
My answer to all these questions is NO, but with a difference in emphasis. I don't aspire to measure the global temperature, nor to estimate the importance of factors which make it. This is not the area of my comparative advantages. But to argue, as it's done by many contemporary environmentalists, that these questions have already been answered with a consensual "yes" and that there is an unchallenged scientific consensus about this is unjustified. It is also morally and intellectually deceptive.
Václav Klaus is President of the Czech Republic.