Category: Right Wing Noise Machine

A satisfying update to WSJ Editorial on US/UK liver transplantation results..

Thanks to Maggie Mahar for doing the work on this. I was willing to accept Dr. Gottlieb’s facts at face value and make my case, but Mahar went the extra mile to show that, not only is the argument bogus, so are the facts! Here’s the prime of the post:

But what Gottlieb omits is the crucial fact that, when the researchers went back and looked at “patients who survived the first post-transplant year,” they discovered that “patients who had suffered from chronic liver disease in the U.K. and Ireland had a lower overall risk-adjusted mortality” than patients in the U.S. In other words, survival rates for patients who had a chronic disease before the transplant were better in the U.K. and Ireland. As for patients suffering from acute liver disease, longer-term survival rates past one year were just as good in the U.K. and Ireland as in the U.S. Moreover, if you checked patients in the interval between 90 days and one year, outcomes were similar in the two health care systems.

So “equilibrated” wasn’t just a dodgy piece of jargon; it was inaccurate. When researchers checked on patients more than a year after they had the transplant, outcomes in the U.K/Ireland and the U.S. weren’t in perfect balance (or in equilibrium) with results in the U.S. Outcomes in the U.K./Ireland were just as good for one group and decidedly better for the second —assuming that if you go through the trauma of a liver transplant, the outcome you are hoping for is to live more than a year, rather than just 90 days.

Why is chronic care better in the U.K. in the years following surgery? Because the “primary care infrastructure” is stronger in the U.K. and Ireland, the article explains. Add in the fact that patients have “equal access” to health care and that the cost of care is “lower,” and this helps explain superior long-term results. As the researchers point out, “the 2002 Commonwealth Fund International Health Policy Survey found that sicker adults in the US are far more likely than those in the UK to forgo medical care and fail to comply with recommended follow-up and treatment because of costs. In the U.S., it seems, outcomes tend to turn on whether the patient has money.

Finally, what about outcomes after five years? What Gottlieb forgot to mention is that survival rates for patients who had originally suffered from chronic liver disease were similar in the two countries, while mortality rates for patients suffering from acute liver disease were higher in the U.K. and Ireland.

Thanks, Maggie!

Capitol Feud: A 12-Year-Old Is the Fodder – New York Times

Capitol Feud: A 12-Year-Old Is the Fodder – New York Times:

“An aide to Senator Mitch McConnell of Kentucky, the Republican leader, expressed relief that his office had not issued a press release criticizing the Frosts.

But Michelle Malkin, one of the bloggers who have strongly criticized the Frosts, insisted Republicans should hold their ground and not pull punches.

“The bottom line here is that this family has considerable assets,” Ms. Malkin wrote in an e-mail message.”

I realize this is somewhat off-topic for a single-payer blog, but here goes anyway.

Since when does Michele Malkin think that having considerable assets means one should not try to take the government for all one can, be that corporate welfare, no-bid contracts, capital gains tax cuts, killing the estate tax for the mega-wealthy, etc.?

I expect I won’t be the first one to say, without embarrasment, that it really frosts me how they are treating the Frosts. My God, if we went after every person St. Ronald of Reagan threw at us to “put a human face” on a situation, we’d still be at it 20 years later! Not to mention the Snowflake babies and their families (“any abortionists in the family, ma’am? anybody with Parkinsons?”)!

But I would like to know when someone is going to have the Edward R. Murrow moment or the Joseph Welch moment.

“Have you left no sense of decency?” When George W. Bush said after 9/11 that you were either with us or against us, I had presumed he meant with America and the liberal democracies in the world or not. No, as it turned out, he meant that you were either with the far right wing of the American Republican Party, the neocons, the fundamentalists, the constitutional “originalists,” the unitary executive-ists, the authoritarians, the xenophobes, the selfish, the unilateralists, the imperialists, and the military industrial complex. If you were not one of that “us,” you were unpatriotic, anti-american, ungodly. You deserved to be labeled with Newt Gingrich’s dirty words from his infamous GOPAC memo.

Cheers (or, Good night and good luck)

David Brooks: European system won’t fix U.S. health care woes

“Some liberals, believing that government should step in as employers withdraw,
support a European-style, single-payer health care system. That would be fine if
we were Europeans. But Americans, who are more individualistic and pluralistic,
will not likely embrace a system that forces them to defer to the central
government when it comes to making fundamental health care choices.”

Yeah, the elderly are practically rioting in the streets to get rid of Medicare, aren’t they? What a self-serving load of hogwash. It’s easy enough to just say you are ideologically against any kind of reform involving a single payer type solution. It’s another thing to blame it on the “American Character”, as if this is some unchanging monolith, or ever was.

“We shouldn’t disrupt the lives of those who are happy with the insurance they
have.”

Mr. Brooks apparently doesn’t realize what a vanishingly small number of people this is these days.In the end, Brooks advocates yet another half-baked idea that tinkers aroun the edges and fails to provide real healthcare security for all Americans.

read more digg story

Response to: Commentary: What’s Wacko about Sicko

Commentary: What’s Wacko about Sicko
From Dr. Donald P. Condit, orthopaedic surgeon specializing in hand surgery in Grand Rapids, Mich. He also holds an MBA degree from the Seidman School of Business at Grand Valley State University. [My comments are in italics.]

Michael Moore wants socialized medicine in the United States.

Actually, he wants single payer or a Medicare for all system, not a socialized system such as Britain’s.

It would, as his film Sicko suggests, give us a system that better delivers health care to those who need it. Although Moore effectively documents some deficiencies in American health care, his message is undermined by misinformation, inconsistent rhetoric, and a disingenuous agenda.

I argue that it is not his job to do a 12 hour mini-series. He had two hours to make his case, and he did. See this post for more details: http://cmhmd.blogspot.com/2007/07/sicko-heavily-doctored-by-kurt-loder.html

Moore’s plan would result in worse, not better, health outcomes for Americans — including the poor and underserved.

Please supply some evidence of this. Here is a bit showing you are wrong:
http://cmhmd.blogspot.com/search/label/US%2FWorld%20Health%20Care%20Comparisons
http://cmhmd.blogspot.com/search/label/Canada

As a hand surgeon who treats many traumatic injuries, Moore’s portrayal of a patient who amputated his middle fingertip captured my interest. He depicted this uninsured man as required to pay $23,000 to have his finger “saved.” Moore lost considerable credibility here. Most hand surgeons would never consider micro-surgically replanting this table saw injury at the finger nail base. Rather, this unfortunate injury would have been comfortably and safely treated — without reattachment of the severed bit of finger — in an office procedure room for $1,000 or less.

Doing a Dr. Frist, here, aren’t we? Diagnosing and managing via a film clip? I am encoursged that you think this kind of thing wouldn’t happen where you are.

In Sicko, Moore consistently equated lack of insurance with inability to obtain care.

See here: http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html
and here: http://www.newyorker.com/printables/fact/050829fa_fact
and here: http://cmhmd.blogspot.com/search/label/Rationing%20Health%20Care

I’d say the problem is grossly inadequate ability to obtain care.

In Grand Rapids, Mich., where I practice, a sign on the front door of Blodgett hospital, in English and Spanish, indicates patients will not be turned away for lack of ability to pay. This is policy across the United States.

As John McEnroe might say, “You cannot be serious!” Does anybody really believe that having to show up in an emergency room, knowing that if you can’t pay you’ll be hounded for years to pay whatever you can, is equivalent to open access to primary care as is done essentially everywhere else in the industrialized world? No disincentive to comply with treatment there, is there?

We hear a lot about the nearly 50 million Americans without health insurance. However, approximately half of them are insured six months later with new jobs, suggesting more of a problem with our employer based health care system than with affordability.

And another 50 take their place. This happened to my brother, an engineer, while between jobs. His wife took ill and he nearly filed for bankruptcy. He had a last minute generous help from his employer. Most are not so “lucky.”

Moore harshly criticizes the U.S. government. Yet he is arguing for a centrally controlled allocation of health care resources. Who does he want to run health care in this country?

Easy answer, here: NOT private health insurers! Not even “not for profit” ones!

Medical resources are not unlimited. The combination of aging demographics, technological advances and unconstrained consumption within our third party payment system has led to an unsustainable trajectory of ever increasing spending.

Unconstrained consumption? Really? How about delayed appropriate consumption resulting in later excessive costs due to inadequate treatment of manageble acute and chronic illnesses? How about the burden imposed on providers by private insurers? How about administrative costs? The lack of a national medical informatics infrastructure? The only place where I really do worry about consumption is in the last months of life. We do a lousy job of dealing with end-of-life care and our patients pay dearly for it with their suffering and angst, and society suffers under the burden of using resources inappropriately.

It is already clear that price controls have created strong disincentives to debt-burdened students considering careers in primary care.

That, and the ridiculously skewed compensation to procedure related specialties. Compared to the rest of the world, our PCP’s income is comparable. It’s in the procedure-intensive specialties where the big diference lies. Spread that money out more evenly and those price controls don’t hurt PCP’s so much.

Yet Sicko gives market oriented solutions no consideration.

What about the last fifty years makes you even a teensy optimistic?

Three individuals with ailments after admirably serving in New York rescue and recovery efforts after September 11, 2001, were transparently used in Sicko to promote Moore’s agenda. This manipulation was as revolting as the stories of individuals egregiously denied care by insurance companies. Transported to Cuba, the three 9-11 patients were shown to Cuban doctors who (while cameras were rolling) appeared more than happy to provide care and subsidized prescriptions.

I think they were willing participants and understood what they were doing. I think it funny that people get exorcised that he “held up Cuba” as a fine example. I think his point was that EVEN Cuba, a communist dictatorship, pretended it had some universal healthcare. And still managed to only come in a couple slots lower than us in the infamous 37/39 slide.

This contrasted with a California hospital denying care to a child with a severe infection and a sick, elderly woman dropped off by a taxi in front of a rescue mission while still in her hospital gown. The latter two tragic situations were portrayed as illustrative examples of our domestic medical system.

You’re a surgeon. I bet given 15 minutes you can come up with a half dozen anecdotes about the stupidity and callousness of our ‘system,’ can’t you?

There is no question we need major improvement in U.S. health care. To use a few outrageous anecdotes to argue for a socialized solution, however, is a non-sequitur.

Agreed. And besides, in a contest of anecdotes, we’d lose. Badly.

Despite ostensibly compassionate intentions on the part of its backers, greater harm would result from centrally planned and controlled health care. Canada and the United Kingdom provide contemporary models: rationing occurs by decree and delay.

Rationing comes by under funding the system. That will be a serious danger here, too, when we move to Medicare-for-All. It is up to us to make sure it doesn’t.

And of course, our rationing is economic. I find this indefensible and reprehensible.

Even the Canadian Supreme Court, when ruling against Canada’s single-payer law prohibiting private payment for health care in 2006, stated, “access to a waiting list is not access to health care … in some cases patients die as a result of waiting lists for public health care … and many patients on non-urgent waiting lists are in pain and cannot fully enjoy any real quality of life.”

The Supreme Court decision was bad for a number of reasons, and since has been near universally derided in the Canadian press. Follow this link:http://www.pnhp.org/single_payer_resources/Canadian%20Supreme%20Court%20Ruling.pdf (Thanks to Nick Skal, of PNHP for this bit.)

Please click on the topic Waiting Lists on the right side of my blog for more info.

Pope Benedict XVI wrote in his recent encyclical Deus Caritas Est, “We do not need a State which regulates and controls everything, but a State which, in accordance with the principles of subsidiarity, generously acknowledges and supports initiatives arising from the different social forces and combines spontaneity with closeness to those in need.”

I do not know the context of these remarks, but considering very other industrialized nation in the world has some form of universal healthcare, I expect he was specifically not talking about helathcare. But that’s just a guess based upon my Catholic upbringing. And this, from Cardinal Bernadine, “Health care is an essential safeguard of human life and dignity and there is an obligation for society to ensure that every person be able to realize this right.”

Moore and his allies would do well to take this exhortation to heart. We now have unsustainable consumption of medical resources, with third party responsibility for health care expenses. A socialized system would increase state dependency and diminish motivation for charity. Greater government bureaucracy would increase inefficiency and waste compared to doctor-patient “two-party” interaction. Socialized medicine violates the social justice principle of subsidiarity by interfering with the family, churches, charitable clinics, and other intermediate organizations

Violates social justice? You’ve got to be kidding, or, more likely, just defending a weary ideology not suited for this issue and rationalizing.

Cheers,

An unhealthy health care plan

I only link to mock…An unhealthy health care plan — The Washington Times, America’s Newspaper By Robert Goldberg (vice president of the Center for Medicine in the Public Interest)
Pablo Picasso observed, “To copy others is necessary, but to copy oneself is pathetic.” Is anyone more pathetic than Arnold Relman, the former editor of the New England Journal of Medicine, who continually writes about why America should adopt the Canadian health care system? There is. It’s Arnold Relman himself, writing in Canada about why Canadians shouldn’t abandon the Canadian health care system. In this case, it’s Mr. Relman in the Toronto Globe and Mail opposing the Canadian Medical Association (CMA) proposal to “allow physicians to bill patients (or private insurance plans) for services that are covered by Medicare, and allowing Medicare to purchase covered services from for-profit private facilities.” The goal of the CMA plan is to allow people a chance to get medical care when they need, not when the government sees fit to provide it. Canada has pumped billions of dollars into its system to reduce waiting times for specialty services, cancer care, first-time health visits and emergency rooms.

Here’s the link to the article by Relman. Dr. Relman’s piece speaks for itself.

But according to Health Canada and the independent Frasier Institute the waiting times and shortages have gotten worse.

Please see this previous post to read why you should discount anything from Fraser, and yet recognize that Fraser is a pernicious force to be watched and refuted at every opportunity.

In a recent incident, a child with a brain tumor headed to the states to get a MRI because he would have had to wait four months in Canada. His family paid cash because Health Canada refused to cover the cost. Mr. Relman’s response? He urges Canadians to “avoid exploitation by those who would like to make profits from publicly funded health care. Canadians should not follow Americans down the path to greater privatization.” The kid should die for the greater glory of socialized medicine rather than pay cash and line the pockets of profit hungry docs in America. Groucho Marx once observed, “Who do you believe? Me or your eyes?” Our eyes tell us that here and abroad government run and financed health care stinks.

Welcome to another episode of “Anecdote-Off”, the great justifier of all things wrong in the US sytem if you believe people like this. As I’ve said many times before, if you want to debate this by anecdote, the US loses. Badly.
For waiting times, go here.

Price controls cause shortages of doctors in the UK that in turn are filled by waiving immigration regulations that allow neurologists with bomb-making skills into the National Health Service (NHS).

Good thing we don’t allow ferners to practice medicine here.

In the United States, restrictive formularies and cookbook approaches to care have undermined mental health treatment for soldiers returning from Iraq.

Got that backwards.

Medicaid reimbursement levels have increased waiting times and caused millions of children to seek care in emergency rooms.

Because we underfund Medicaid and the economics of reimbursement of course cause providors to scurry for the hills. How is this an argument against single-payer?

Meanwhile SCHIP — 10 years after its enactment — has failed to enroll 3-out-of-5 Medicaid eligible children in private health care plans and access to care has barely increased.

Again, how does this support an argument against universal healthcare? It’s an argument against the stupid patch-work non-system we have here in the US, I agree.

Incredibly, Mr. Relman claims that’s just a sign free market health care does not work and does not care about people. Enlighten us Arnie, how are the two connected?

Because the patch-work “free market” mess we have here does not work. Clearly Mr. Goldberg has never actually seen patients or been responsible for providing healthcare in this disaster we work in. When funded properly and overseen appropriately and by giving doctors the ability to provide care as they see fit (as opposed to insurers or underfunded goverment programs), a single payer system can not possibly be worse that what we have now. Unless someone puts the Republicans in charge of it. Then, watch out, Brownie will be in charge!

“Physicians in our commercialized, profit-driven system tend to gravitate toward the highly paid specialties, so we now face a major shortage of primary-care doctors.” Well, we know how flush the NHS is with well-trained terrorists — I mean family doctors. What about Canada? It turns out the College of Family Physicians of Canada found that 17 percent of Canadians didn’t have a family doctor because of a primary care physician shortage. Two million of the Canadians that Mr. Relman wishes to deny free choice of care to have attempted to find a family physician in the past year, but have failed. In the U.S., we have a market-based response to the problem.

OMG! 17% don’t have a PCP. I’ve got an idea, let’s take insurance away from 1/6 of Candians and underinsure another 1/6 so they can’t afford a PCP visit, and see what happens to that shortage. The free-market will get rid of those whiners!

A rapid expansion of retail health clinics in the United States is taking place in what the Department of Health and Human Services has designated as medically underserved areas. Take MinuteClinics, a division of the drugstore chain CVS, which offers walk-in health care centers for common medical problems such as strep throat, sunburn, mono, flu, ear infections and sinus infections, and offer vaccinations, checkups, etc. People can pay cash or use their regular insurance.

“People can pay cash or use their regular insurance.” Hahahahahahah!

And will Mr. Goldman and his family use this service? Of course not, because they have good insurance.

Most visits are 15 minutes or less with no appointment needed. In many cases, MinuteClinics are often affiliated with local hospital or physician practices, and will refer customers to a primary care doctor if they don’t have one. Additionally, the center generates an electronic medical record that customers and doctors can access through the phone, fax or Internet. There are 200 MinuteClinics across America. Most are in federally designed medically underserved areas providing immediate care, referrals and electronic medical records for about $50 per person. Other private companies are involved in this trend as well and have been joined by the American Academy of Family Physicians in an effort to improve access to health care for millions Americans.

Well, let’s take it a step further and have us (by us, I mean the U.S., our government) fund such a system. And that way, when the patient is referred to a PCP, the patient will be able to actually go to the PCP without choosing between healthcare and something else.

Meanwhile, as the marketplace makes medical care more accessible in America …

…still can’t get that idea that it should be universal rather than just “more accesible”…

Mr. Relman is telling Canadians, “One thing is certain. If medical care and health insurance are allowed to become private businesses… patients with little or no resources do not get the care they need.”

And Mr. Goldberg doesn’t care about those people. Why not just come out and say it?

What did Santayana say about fanaticism? It consists of redoubling your efforts when you have forgotten your aim.

Pot, meet kettle… And as John Kenneth Galbraith said, “The modern conservative is engaged in one of man’s oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness.”

Fighting against medical choices that are available elsewhere in the world is a sure sign that ideological zeal has transcended compassion or the Hippocratic oath.

Uh, he’s fighting for medical choice, not against it. He’s advocating for compassion, not against it. And if Mr. Goldberg thinks physicians anywhere in the world compromise the spirit of Hippocrates (put the well-being of the patient above all else) more than we do in America, he is as out of touch as the rest of his piece confirms.

Mr. Relman, once a great scholar, should be pitied, not scorned.

It’s Dr. Relman, and he doesn’t need Goldberg’s pity.
read more digg story

Costly ‘affordable’ health care — The Washington Times, America’s Newspaper

Costly ‘affordable’ health care — The Washington Times, America’s Newspaper:

“John Stossel is right.”

When an editorial starts out like this, and it’s from the Rev. Moon’s Times, you know it’s going to be dead on true, don’t you?

Healthcare policy by anecdote- isn’t that what Michael Moore is accused of all of the time?

UPDATE: I contacted an ICU director in Brussels regarding this article. His response:

This is simply wrong – and worrisome if published in the Washington Times
(hopefully not the Washington Post)!

As stated, we have here one of the best health care systems in the world.
Much better than socialistic systems like in the UK or in Scandinavia or even
the Netherlands.

Maybe his grandfather became deaf because of an aminoside administration, but
the antibiotic choice was not restricted by costs !

Maybe it is a case of malpractice – I do not know, these can happen anywhere
– but it is not related to a limitation in health care costs.

The False Promise of Single-Payer Health Care

The False Promise of Single-Payer Health Care: “Speech October 9, 2002
Sally C. Pipes
President and Chief Executive Officer
Pacific Research Institute
Presented at St. Vincent’s College”
—————-
How many straw men can you count?

I think we need to put a dozen experts from each side in a house for a month. They can have internet access, whatever materials they need. Heck, they can even phone a friend or poll the country, but they need to rebut each other in a factually based manner until they come to some understanding. Pretty good reality show, huh?

I frankly think it will all boil down to Lakoff’s model of conservative/liberal:authoritarian/nurturant world views. If you think the rich deserve to be rich and the poor deserve to be poor, you will never “accept the premise” of single payer healthcare.

Cheers.

As Canada’s Slow-Motion Public Health System Falters, Private Medical Care Is Surging – New York Times

As Canada’s Slow-Motion Public Health System Falters, Private Medical Care Is Surging – New York Times
By CLIFFORD KRAUSS
Published: February 26, 2006

Article about waiting times in Canada: below are responses from Physicians for a National Health Plan’s Nicholas Skala:

1. This writer is well known for peddling fake data, and this story is no exception. For his outrageous waiting time estimates, he uses data supplied by the Fraser Institute, an ultraconservative PR firm that masquerades as a legitimate research institution. Dr. Robert McMurtry, the Canadian orthopedic surgeon who is a former dean of a Canadian medical school and served on the national waiting times commission tells me that not even the right wing Canadians take them seriously. Their “scientific” method of determining wait times consists of bulk-mailing a list of pro-privatization physicians and asking them how long they think their patients will have to wait to see them. If they return the mailing they are entered in a drawing to win a $2,000 cash prize. It’s pathetic. Unsurprisingly, Fraser comes up with outrageous waiting time estimates (17.8 weeks last year, as I recall), and is quite adept at publicizing them in the American media. Wait times are scientifically measured every year by Statistics Canada (the counterpart to the U.S. Census Bureau). I’m sure most Americans would be surprised at the results of scientific measurement: In 2005, median wait times were 4 weeks for elective surgery, 4 weeks for specialist care, and 3 weeks for diagnostic tests.

http://www.statcan.ca/Daily/English/060131/d060131b.htm

Also, the Canadian Health Services Research Foundation has done a short, scholarly critique of Fraser’s methods and compared them with real studies. (In fact, I think they’re far too kind to Fraser).

http://www.chsrf.ca/other_documents/newsletter/qnv1n4p4_e.php

2. The Supreme Court decision was bad for a number of reasons, and since has been near universally derided in the Canadian press. Follow this link:
http://www.pnhp.org/single_payer_resources/Canadian%20Supreme%20Court%20Ruling.pdf

3. As far as proposals to create a parallel private system, compelling evidence shows that more private participation leads to longer waiting times and lower quality care because 1) private insurers “cherry pick” healthy and profitable patients and leave the sick and poor to the public system and 2) physicians have a perverse incentive to move to the private sector (where they make more money), draining the public system of capacity and resulting in lower-quality care (and eventually creating a self-fulfilling prophecy for the right wing, because they then say the public sector can’t do anything right).

The Canadian Health Services Research Foundation has a couple of great fact sheets on this too.
http://www.chsrf.ca/mythbusters/pdf/myth17_e.pdf
http://www.chsrf.ca/mythbusters/pdf/myth13_e.pdf
http://www.chsrf.ca/mythbusters/

Finally (and kind of philosophically), there is a reason that rationing in Canada gets so much attention in the media. Its because the Canadian health system is held publicly accountable. Grievances aired in public are likely to be addressed by policymakers (and in many cases have, as waiting times for many procedures have dropped dramatically). This is a foreign idea to us in the U.S., where the operation is exactly reverse: no one is ultimately accountable, and the forces that profit from the system have every reason to keep problems quiet. And so, although rationing (based on the ability to pay) in the United States kills at least 18,000 Americans every year (according to the Institute of Medicine’s most conservative data…Himmelstein and Woolhandler estimate it may be 10 times that many), our media acts as though Canada’s the place with the problems.

Hope this helps.

nick

Nicholas Skala
PNHP Staff

JAMA — Lives at Risk: Single-Payer National Health Insurance Around the World, January 19, 2005, Orient 293 (3): 369

JAMA — Lives at Risk: Single-Payer National Health Insurance Around the World, January 19, 2005, Orient 293 (3): 369: “by John C. Goodman, Gerald L. Musgrave, and Devon M. Herrick (National Center for Policy Analysis), 263 pp, with illus, $70, ISBN 0-7425-4151-7, paper, $22.95, ISBN 0-7425-4152-5, Lanham, Md, Rowman & Littlefield Publishers, 2004.”
The link is to the review of the book in the Journal of the American Medical Association by Jane Orient.
[Jane M. Orient, MD, Reviewer Association of American Physicians and Surgeons University of Arizona College of Medicine Tucson jorient@mindspring.com ]

and a reply…
JAMA — Single-Payer Health Systems and Statistics, July 6, 2005, Starfield and Morris 294 (1): 43

and a response…
JAMA — Single-Payer Health Systems and Statistics–Reply, July 6, 2005, Orient 294 (1): 44

And who is Jane Orient? http://en.wikipedia.org/wiki/Jane_Orient
and the AAPS : http://en.wikipedia.org/wiki/Association_of_American_Physicians_and_Surgeons
“The motto of the AAPS is omnia pro aegroto which means “all for the patient.”

Your moment of Zen.