The continuing saga of the “biomedical rape” of women at UCI’s fertility clinic continues to get more complicated. Some of these eggs have been implanted without donors or recipients consent and have produced children with biologic parentage in doubt. A second doctor is out of the country developing a huge practice in Chile. However, the three doctors on “suspension” continue to get their salaries (about $100K each) deposited to their bank accounts because they are tenured, and they can still access these funds. UCI is a California tax-supported institution with research funded by federal grants. It appears that both sides of this fiasco are paid for by state or federal taxpayers.

Doctors’ incomes continue to fall. The current estimate is that after paying over $180,000 in expenses, we make about $150,000 for our 3000 hour year which is about $50 an hour. About the same as the “handy man” that fixed the skylight and ceiling in my office. Except we had to have an extra 12 years of higher, professional, and post doctoral education to allow us to make this humongous hourly wage.

Sixth-grader to his father who just finished explaining to his mother that with all the new contract reductions and with increasing overhead, he thought he was losing about $2.50 a patient: “Daddy, if you saw ten less patients every day, you’d save $25, and you could buy me a CD ROM every day, come home when I get out of school, and we could play it on the computer. Wouldn’t that me more fun than losing money at the office?”

Just as we were convinced that all government projections missed their mark by only 200-400%, we came across the failed health plan. The 12 member President’s Task Force on Health Care Reform, which Hillary Rodham Clinton oversaw, had an original charter in March 1993 stating that the planning cost was “expected to be below $100,000.” In testimony before Congress in 1994, White House aide Patsy Thomasson revised that estimate, placing the planning cost closer to $211,000. (A 111% error, not bad.) The associated press found advisers with political connections who were getting as much as $100,000 each. The General Accounting Office then did an audit and found that the White House spent over $662,000 of its funds and over $13 million in funds from other federal agencies. Included was $433,966 to unsuccessfully fight a law suit against a doctors’ group wanting to make the task force documents public. A sixty five fold increase on top of the second projection is another 6500% error in a government projection for a total of 13,000% error over initial cost projections. That was just for planning the health plan which was discarded by congress in a few months. What if it would have passed and the half trillion dollars were a few hundred percent off? Can we try NOT to top that?

The government recently ran out of funds. Actually this happened decades ago but there is a renegade crowd in D.C. that is calling a spade a shovel. When the government shut down by calling off 800,000 nonessential workers, David Lettermen commented that maybe we have found the cause of our national problem… Jackie Mason, on CNN, stated that it was obvious that the 40% put on furlough should not be rehired. Since the other 60% didn’t seem to be exerting themselves to get additional work done, he suggested that another 10% or half of the 2 million federal workers should be furloughed …Debra Saunders in the SFChronicle, commenting on this showdown, stated that the $66 per year Medicare premium increase is reasonable since retirees are getting $126,700 more in lifetime benefits than they paid into the system… The national debt monitor near Times Square froze at $4.9 trillion… Did we balance the budget for a few days? Can we just balance it forever now that we know how: Just freeze spending until it equals income. Like the rest of us have to do… Six days later, all the nonessential workers were rehired and given back pay for not working. Rewarded with an extra week of vacation with pay. The government then announced that it actually cost more money to stop spending than was saved.

Jon Carroll reports in the SFChronicle that “Some of the for-profit HMOs in California make the Mafia look like a model of…compassion.”

Piraro in a cartoon suggests a Miranda type statement to be read to all patients when admitted to a hospital: “..Everything here is grossly overpriced…not every doctor is fully qualified…some of our nurses couldn’t care less about you…this is an excellent place to catch a weird disease…we’re not above ripping your insurance company off..we’re only in it for the money…

The SF based Pew Health Professions Commission, a private foundation of 21 experts from universities, the health care and health insurance industries, and other private and public organizations, predicts that in 2005 there will be a surplus of at least 100,000 doctors, 200,000 nurses and 40,000 pharmacists. They recommend closing one-fifth of the medical schools and dramatically reducing the FMG’s in US residencies. They attribute the surplus in medical professionals to the government subsidies in the 1960s and 1970s, which encouraged the excessive construction of medical schools, and to managed care… But without the government push to increase medical school enrollment and residency programs, neither the mass importing of FMGs or managed care would have occurred. Nearly all our current ills are caused by government planning. Unfortunately much of government planning is done by physicians in the bureaucracy. The challenge is how can we keep from hurting ourselves?

Von Gordon Sauter, CEO of KVIE Channel 6 spoke at a recent meeting of the Comstock Club. As you know some people inside of public radio and TV are bemoaning shrinking government money. Sauter replied, “Once the government gives you money, you accept the government concept on how you will proceed. Government money does not help…”

And with that, we wish everyone a professionally satisfying 1996.