- Del Meyer, MD - https://delmeyer.net -

Law, Lawyers & Politics

Congratulations to our own UCD School of Law with 94% of its graduates passing the state bar the first time, the highest in the state, out performing both Boalt Hall (UCB) and Hastings (UCSF).

Chicago, known for its organized crime and its politicians becoming felons, may be reversing the process with five felons running for City Council. They took their cue from Marion Barry who was re-elected as Mayor of Washington, D.C. after his narcotic conviction and jail term. Although the felons stated that armed robbery, burglary, murder for hire done in youth shouldn’t hurt them when they grow up, many Chicagoans and the Feds are concerned.

After hearing that medicare and medicaid are so over funded that we could sneak our $trillion health care system into the federal budget with the hundreds of billions we’d save, we are now hearing that medicare is so under funded that the medicare eligibility age may have to be advanced along with the social security eligibility to perhaps age 70. What a difference a day makes, especially if elections are held that day.

Univ Press Synd: In New York City recently, Bartolome Moya, 37, charged with kidnaping, drug dealing, and six murders, skipped town after being released on bail. In 1993, Moya was jailed pending trial on the same charges but was in such poor health from heart disease that a judge thought his death was imminent and dismissed the charges so Moya could go home to die. He later obtained a Medicare financed heart transplant. Prosecutors learned of the transplant, re-indicted Moya and jailed him. Then a judge released him on bail on the condition that Moya wear a beeper. Moya has not been heard from since.

Joycelyn Elders, MD, made some statements that offended a lot of people. The Lancet editorialized that Elders’ dismissal was an “example of the triumph of politics and prejudice over common sense.” Knowing that physicians are frequently quoted out of context, which changes the meaning of what we said, can we give our colleague credit for trying to state that autoeroticism should be placed in the courses variously labeled as sex education? Then we can proceed with the more relevant discussion of whether what the Surgeon General of the US Public Health Service is promoting is a matter of Public Health.

Edmund Faltermayer reporting in Fortune under the title, “Will the cost cutting in health care kill you?” quotes Harvard’s Dr. Lucian Leape, a contributor to a new book, Human Error in Medicine, who estimates that iatrogenic hospital deaths…may total 100,000 a year nationwide. That’s more than twice the number who die in automobile accidents… Should we now warn our patients that hospitalizing them may be twice as hazardous as driving a car before an attorney wins a case against us because his client was not sufficiently informed of the hazards of hospitalization?

Attorney General Dan Lungren stated that Californians donated $192 million through 161 registered professional fund raisers but only 33% of the money actually went to charities. The rest went to solicitation expenses and profits. He also said that 516 commercial fund-raising campaigns turned less than half of their donations over to charities. He noted that some medical charities only got 10% of the donations. He suggests that we ask a solicitor if he or she is being paid to solicit, the name of the fund-raiser, proof of registration, and what percentage of your donation actually will go to the charity.

Psychiatrist Judith Cohen lost a $272,000 malpractice suit for failing to investigate allegations of sexual abuse by her 19 year old patient Nicole Althaus. When did investigation of our patient’s medical history become the practice of medicine? Let’s see, physicians are playing attorney, judge, jury, and now criminal investigator? Will somebody get us organized? Or are we “gazelles grazing on the plain unconcerned about the intense struggles going on about us?”

AMT, American Medical Television, which has been giving us “Second Opinion” and “House Call” every Saturday went off the air with a repeat performance of one of their most noteworthy out-of-control session on December 31. The JAMA Editor, George Lundberg, MD, had been having increasing problems keeping his panel under control. Frequently there were three of panelists composed of physicians and lawyers speaking at the same time and he was left with calling for a commercial break. The replacements, so far, appear to be less interesting.

Another 1359 laws were passed by the Legislature again last year, about the same as the previous year. Of those, 294 took effect last year and 1065 took effect January 1, 1995. Of note, is that fund raisers must give at least 50% to the charity; lawyers now have a truth in advertising law; sexual harassment has been extended from the work place to anyone with whom anybody has a professional relationship; women can select an OB/GYN as their primary care physician (Why was that ever restricted?); and a law that prohibits job discrimination against women who wear pants (Why was a law required to prevent discrimination?)

Steven A. Schroeder, MD, President of the Robert Wood Johnson Foundation, and a frequent participant on AMT, was in Sacramento recently for the Health Forum. He deplored the fragmentation of American medicine. He found it hard to understand why it’s so hard to write health care legislation. He defined “Demosclerosis” as the inability of post war democrats to adapt, to eliminate programs that no longer serve a useful purpose. Only two countries have been able to do that–Japan & Germany. Americans are so confused about government medicine that he hears statements such as “Get the government out of Medicare.” He concludes that market forces rather than government will serve as the catalyst for health care reform, and asks “What happens to medical care when the doctor/patient relationship is reduced to a business relationship?” He didn’t seem to have an answer. Perhaps physicians (organized medicine) should be the catalyst and focus on the doctor/patient relationship. The window of opportunity seems to be closing.