"Mangled Healthcare" for All

With great fanfare the Consumer Federation of California (CFC) announced on February 27th, 2007 that "...every Californian deserves access to high quality, affordable health coverage"--a noble concept, indeed.

I certainly agree that “Our health care system is a disaster for the uninsured and insured alike. Nearly seven million Californians are uninsured. Co-payments for workers are skyrocketing, and businesses that cover their employees are being crushed under the rapid escalation in insurance premium rates."

When originally introduced to this naive country and promoted by then, and still, misguided and ill qualified Mrs. Clinton and her Jackson Hole task Force, it was defined as: " A prepaid risk-based system of integrated health care delivery, having appropriate capabilities to improve quality of care and manage utilization and cost of a given population.” (Thomas Morrow, MD., at NMHCC/IT Fall 1998, Los Angeles, CA)

Here are my postulates of "Mangled Care" vs Managed CarING:

•If someone is already paying a lot, let him or her continue
•Even if a lot of people complain about quality of managed care, it won’t contain cost
•Never provide coverage unless the treatment is unpleasant
•Quality is being in a waiting room with people who earn more money than you do

Managed care is an oxymoron by default--this system that should have been providing health carING, while managing costs--in its present form is better described as mangled health care.

The for-profit (and very profitable) “managed care” companies have embraced, and are functioning under divergent and practically mutually exclusive core values.

These companies are obligated to provide (or rather severely ration) health care services. They are also obligated to generate consistent profits for the executives and shareholders of those companies.

When the provision of proper health care and managed care companies profits come into direct conflict, it creates a “double explosion” of the system, where the availability and quality of health services goes down, while costs of services and mangled care companies' profits go up.

This abominable situation creates significant “counter-incentives” to provision of appropriate, accessible, affordable health carING to Californians, which can be gauged by the divergence coefficient.

In addition to the conflicting core values, “business disconnects” exist due to logistical, financial, physical and ethical aspects of mangled health care:

•The recipient usually does not request, does not order or pay for the service.
•The payor never requests, does not receive nor order the service.
•The orderer does not pay nor receive the service.

Governor Schwarzenegger, a traditional foe of pro-patient health care reforms, now says he wants to address the health care crisis. Unfortunately, the governor’s proposal puts too much of the burden on the uninsured, and it fails to control cost increases. Similarly, Sen. Kuehl “Zelda’s Single Payor Legend” falls far short of the target.

While it’s true that every other industrial democracy offers universal health coverage to its citizens, it does not translate into universal health carING, and in the case of Canada and England is actually counter-productive.

Surely, universal health care made some inroads in Hawaii, but only because it is a State with a super tight control of population---there are no immigrants (especially illegal) pouring over the boarder from the rest of the world. California, from the point of health care services, is a perpetual bottomless barrel, with fixed amounts of moneys paying into the system, while an ever-increasing numbers of residents generate a snowball demand for services.

Before declaring that health care (not just basic and/or catastrophic), but in fact “appropriate” (cosmetics?) health care “…is a right, not a privilege – and every Californian deserves access to high quality, affordable health coverage…” the CFC might want to clarify the definition of a “Californian” to prevent even faster emptying of the “bottomless barrel”.

CFC’s purposely trying to confuse general public and exert undue influence on Legislators by implying that just because they are uninsured resident of California, they are uncared for. Nothing can be further from the truth--the tax-paying and health insurance-paying Californians are actually paying for the care of the un/under insured.

I also disagree with CFC’s assertion on the issues of providing “…universal health insurance for all Californians at no added cost simply by taking the for-profit insurance industry waste out of the system and using those dollars for the delivery of health services”.

Health consumers can request and receive health carING from doctors, nurses, pharmacists, hospitals, labs, pharmaceutical companies, etc, without mangled care companies.

Doctors, nurses, pharmacist, hospitals, labs, pharmaceutical companies, etc, can provide health carING without mangled care companies.

Healthcare consumers (Payors) can pay for health carING without mangled care companies.

Only complete elimination of the middle man-managed care companies can generate enough money to provide universal health carING.

Its time to move from patient-driven to health consumer-administered health carING.

California Government can only guarantee universal health care when all of the recipients of such care, including the illegals, pay their fare share.

Be Well!

Zelda's Single Payor Legend

TRI-PAC Health and Wellness Advocacy vociferously opposes the reintroduction of SB 840 (Kuehl, D-Santa Monica, aka Zelda Gilroy).

In 2004, TRI-PAC leadership met with Deputies from the Office of Senator Sheila Kuehl and their “consultants” to inform and educate them, as well as to express objections and call for amendments. Unfortunately, our discussions fell on deaf ears.

Last legislative session, on request and recommendation of TRI-PAC, the Governor responded favorably and vetoed the bill (SB 840).

The education and teaching community have done a great disservice to their students, parents, to their profession, and should be ashamed of themselves for supporting and advocating passage of such misinformed and misguided policy and legislation which is not in the best interest of children, families, current and future generations of Californians.

Single payer health care is a system where government pays for all health care costs usually from taxes. Private hospitals and physician practices may remain private. Single payor is distinct from socialized medicine; hospitals are run by the government and medical professionals are employed by the government.

In 1975 my mother and I went to visit relatives in Winnipeg, Manitoba, Canada. My Dad (now deceased) was an ophthalmologist who stayed behind to tend to his patients. I went swimming in Lake Winnipeg. I got stung in the eye by a mosquito. I could not be seen nor could I get a prescription. There was a fee dispute between the physicians and the Manitoba Provincial Government. The system came to a grinding halt. There was a physician classmate of my Dad on site. He stood firm with his colleagues in "solidarity" and would not see me. I returned from our visit to Winnipeg with the stinger in my eye as a Canadian "souvenir".

In the ensuing 30 years, there have been no material improvements to the Canadian system—people still have to wait for elective surgery, CAT Scan, MRI, and other ancillary service that we take for granted.

Now, that the health care proposals by the Senate President Pro-Tempore, the Assembly Speaker, the Governor, and Senator Kuehl (which was heard separately) begin their way through the legislative process.

I have been informed that all these bills will be negotiated and combined into a single bill for passage by both the Assembly and the Senate and forwarded to the Governor for signature.

SB 840 is a "legend" in the minds of misguided politicians.

Its intent is not doable.

It will not cover the uninsured.

Robert Donin,
President, TRI-PAC Health and Wellness Advocacy
11693 San Vicente Boulevard, #346
Los Angeles, CA. 90049
robertdonin@yahoo.com

Epiphany from hospice professionals.

The American Academy of Hospice and Palliative Medicine (AAHPM), composed of physicians and medical personnel (an industry association) who are expert in end-of-life care, has removed its opposition to terminal patients’ right to request aid in dying from their doctor. The hospice physicians said use of the term “suicide” to describe the terminally ill patients’ aid in dying is “emotionally charged” and is not “accurate.”

Indeed, for the past 10 years, I've been referring to subject process as "dignified passage".

The medical personnel who provide care to patients at the end of life examined the use of the word “suicide” to describe physician-assisted death and found that “the term PAD captures the essence of the process in a more accurately descriptive fashion than the more emotionally charged designation Physician-assisted Suicide.” California hospice care physicians working to pass the California Compassionate Choices Act (AB 374) applauded the national medical experts’ change of position. "

No matter which definition one subscribes to, the only issue is person's right to self determination and resulting informed choice of pain-free dignified passage.

In the meantime, be well!

Additional information about AB 374 and end-of-life choices and language can be found at: http://www.caforaidindying.org/

More on Hippocratic Oath

In his comment this morning Mr.Roland Halpern said: "Dr. Steve Miles researched the Oath in its historical context and is of the opinion that the reference to not giving a deadly drug had nothing to do with physician aid in dying, but rather was an admonition to doctors not to use their position of trust to gain access to those in power for the purposes of assassinating them. It appears that during the time the Oath was apparently “written” (the first copies weren’t found until hundreds of years latter) there was a lot of political upheaval in Greece and it was not uncommon for politicians to eliminate their competition. Miles points out that many physicians were servants of the state, very much like soldiers, and could be given orders to poison the enemy"

I do not profess to be a scholar of Hippocratic Oath, and am thankful to Mr. Roland Halpern for his valuable comment. Dr. Miles' interpretation of the classical version further supports my contention that there is no prohibition against physicians’ participation in assisted suicide and/or lethal injection.
Furthermore, it is my strong belief that physicians have moral, professional and legal obligation not to abandon their dying patients, especially when they are most vulnerable and dependent. To abandon a dying patient would be hypocritical and nihilistic.

Keep reading. Keep writing. Be Well!

Hippocrates: Do's & Dont's

During my media appearances and in response to the postings on this blog, I am frequently asked how physicians can reconcile their role as healers with participation in physician-assisted suicide and/or lethal injection. Frequently, the Oath of Hippocrates is cited as “the governing” document.

The oath is, and always was, ceremonial only--just like traffic signs in the city of New York, that functions only as general guideline.

The modern version of Hippocratic Oath, written in 1964 by Louis Lasagna, then Academic Dean of the School of Medicine at Tufts University states that a physician “…will apply for the benefit of the sick, all measures (that) are required, avoiding those twin traps of overt treatment and therapeutic nihilism…” Clearly, in cases of chronic debilitating, and frequently fatal diseases, usually associated with intractable pain, one should not over treat and concentrate only on proper pain control and patients comfort.

The modern version of the Oath also states that “…it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play God…” The recently reintroduced Compassionate Choices Act of 2007 (California AB374) specifically addresses physicians’ responsibility and respect for patients’ right to self-determination and the right-to-die with dignity. More importantly, the modern Hippocratic Oath recognizes the concept of medical futility.

Similar safeguards should be in place when taking person’s life by lethal injection. A recent article published in the Lancet (Volume 365, Page 1412, April 16, 2005) is a study of post-mortem blood tests that in 43% of reviewed cases, thiopental levels (a drug used to put people to sleep) in the subjects were too low to prevent awareness, pain and suffering.

Double trained in Anesthesiology and Pain Management, I bring over 30 years of academic and clinical experience Attending Anesthesiologist to the argument.

A Diplomate of the American Academy of Pain Management, Associate in Medicine of the American College of Legal Medicine, and a Diplomate and Distinguished Fellow of the American College of Ethical Physicians, I am more than qualified to represent an alternative viewpoint that an Anesthesiologists participation in the preparation and administration of the legal injection is needed to protect the condemned from undue pain and suffering, and their right-to-die with dignity.

An earlier, “classical”, version of the Oath was translated from Greek and interpreted by Ludwig Edelstein in 1943. It is by far more conservative and discriminatory against women than the current one. It starts with a “mini-oath and covenant” of allegiance to:”...Apollo Physician and Asclepius and Hygiea and Panacea and all of the gods and goddesses…”; and promises to teach the art of healing free, but to men only: “…and to regard his offsprings as equal to my brothers in male lineage and to teach them this art-if they desire to learn it without fee or covenant…”

The “classical” version weighs in on some other “hot” health/ethical/legal issues of our society: “…I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give a woman an abortive remedy. In purity and holiness I will guard my life and my art…”

Obviously, the questions of how physicians can reconcile their role as healers with participation in physician-assisted suicide and/or lethal injection, are probably asked by the conservatives who obviously prefer the “classical” version of the Oath.

And if physicians were even close to practicing their art in “purity and holiness” why are there so many lawsuits and investigations by the Medical Boards?

“…May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.”

Be Well!

Privacy of execution methods!?

An opinionated federal judge yesterday (February 23, 2007) refused to guarantee California state officials privacy in their discussions over revising the state's method of executing prisoners by lethal injection.

U.S.District Judge Jeremy Fogel instead promised to bar attorneys for the convicted criminals from seeking information about the state's deliberations until they are concluded and a proposed new protocol for lethal injection is unveiled by May 15th.

I believe that the entire discussion of proper methodology of lethal injection should be left to medical experts. I first contacted Judge Fogel, Gov. of California, and numerous state officials in October , 2005 regarding Anesthesiologist participation in the proper administration of lethal injection. Despite numerous written communications and mass media exposure over the ensuing 15 months, no acknowledgement or response was received from the bench or state officials.

The "new" protocol is long overdue. This should not be a subject for discussion between the State of California and over-zealous attorneys for condemned super-felons who are only interested in dragging out the already ridiculously complex and slow process.

Gov. Arnold Schwarzenegger had asked the judge to shield the deliberations from public view so participants would feel comfortable discussing options without fear of reprisals, intimidation, or subpoenas by the attorney for the condemned criminals.

In addition to lawyers for condemned inmate Michael Morales, the omni-present ACLU and the media had argued against protecting the deliberations from public view, and will probably seek information about the talks by filing requests through the California Public Records Act.

Fogel ruled in December, 2006 that California's method of executing prisoners by lethal injection violated the U.S. Constitution's prohibition against cruel and unusual punishment. He called the system "broken" but added it could be "fixed." The state agreed to revise lethal injection methods and make public its proposal by May 15th. Fogel ruling was triggered by a challenge from Morales, who was sentenced to death more than 20 years ago for murdering Terri Winchell, a Lodi teenager.

The existence of death penalty in California is a prerogative of the People of California. As long as death penalty is legal punishment, it should be carried out without unreasonable delays. As long as lethal injection is a legal way of execution of a condemned felon, it should be administered in an ethical medically-proper way to avoid undue pain and suffering, but without including the condemned and the ACLU in the discussion of medical methodology. Allowing the condemned and ACLU to render a legal medical opinion, amounts to practice of medicine without a license--a felony in and by itself in the State of California!

Be Well!

Tobacco first, than...

In a letter of February 21, 2007 to US Representative Henry Waxman, http://www.house.gov/waxman/ Robert A. Donin, MPA, President of TRi-PAC writes:

"...On behalf of TRI-PAC Health and Wellness Advocacy, our Industry Advisory Board, as a longtime tobacco control advocate, and as your longtime constituent:

It is a personal privilege to congratulate, commend, and to express our SUPPORT and ENDORSEMENT of HR 1108.

Given your leadership and the new leadership in Congress, the time has come for the FDA to be granted authority to regulate the sale, production, and marketing of tobacco products.

Tobacco companies have long been able to play under their own rules and deceive the public.

As this legislation wades its way through the legislative process’, may the change in tobacco companies rules and operating process’ and the benefits to our citizens commence..."

As a Physician and a former smoker, I am wholeheartedly against smoking, and support any all efforts to educate the entire population as to to the dangers of all forms of tobacco use.

However, as a private citizen and longtime advocate of individual freedoms and health consumers rights, I am extremely concerned with governments, from local to Federal, getting into the business of controlling private lives of its citizens, and, in the process, infringing on the individual freedoms of citizens.

It started a while back with bars, than restaurants, than parks, than beaches, that public areas (City of Santa Monica-http://link.brightcove.com/services/player/bcpid252586736?bclid=254756163&bctid=254756161) and all the way to no smoking in the city (Calabasas and Belmont, both in California).

When enough is enough? How and when our health concerns balanced with the citizens rights!? Ms. Esther Schiller runs an organization dedicated to availability of smoke-free housing, especially affordable housing and is working with the City of Santa Monica to enact the appropriate ordinances (http://www.smokefreeapartments.org/).

I believe a person has a right to be dumb, uninformed, ignorant and/or outright self destructive (A.N.S.-RIP) with regard to tobacco uses, whether sniffing, chewing, or smoking, especially inside person's home.

Once citizens who used to use tobacco are under "control" the politicians will decide to "control" global warming. According to Al Gore, the best way to reduce his personal carbon foot print is to buy indulgence (carbon credits) for his own energy-wasting life style. What if, in the interest of reduction of carbon foot print the government decides to control flatulence? Are we going to see flatulence-free bars, parks, beaches, public buildings, and entire cities (like Santa Monica)?

How do you balance occasionally involuntary physiologic occurrence (of cultural significance in some European countries) with other peoples right not to be exposed to noxious and potentially harmful methane? Should the "flatulant", or "flatulator" be fined and/or forced to buy carbon credits like Al Gore does?

I for one, think the government should start "no flatulating" enforcement in enclosed/crowded spaces like bathrooms, elevators, Costco check-out lines, movie theaters, prisons, museums and Jet Blue planes! But than again, according to Al Gore, there are legitimate energy uses of bio-gases!?

A person has the right to smoke & be flatulent by the same reasons that a person enjoys its foundation right to self-determination, which allows a person to refuse medical treatment for any reason, or without one, and soon will allow a person to exercise its right to die painlessly, with dignity, and without attached stigma.

Don't use tobacco & be well!

TRI-PAC Health and Wellness Advocacy can be contacted at: 11693 San Vicente Boulevard, #346, Los Angeles, CA. 90049, robertdonin@yahoo.com; 310-319-9305, 310-420-2169 ©

NEW™ Prescription for Pharma Marketing.

Since the beginning of my healthcarING© career in 1993, in addition to my full time clinical practice (since 1975), I have served as the Managing Editor of Managed Care Medicine, Editorial Board Member of the US Pharmacist, Advisory Board Member, Center for Consumer Healthcare Information, Board Member of The Formulary & Managed Care Information Exchange (M.C.I.X.), Editorial Board Member, The Medical Reporter, Editorial Board Member, Managed Healthcare Journal, Information Security Magazine, Editorial Board Member, ADVANCE for Health Information Executives, to name a few.

In addition, I’ve served on numerous Advisory-Industry-Executive Boards: National Managed Health Care Congress, (NMHCC/IT), American College of Managed Care Medicine, American Board of Managed Care Medicine, Pharmacy Partnership/CMA Foundation, State of California Task Force on Health Plans and Managed Care, The IPA Association of America (TIPAA), US Congress, Ministry of Health of Russian Federation, Association of Medical Directors of Information Systems (AMDIS), American Society of Consulting Pharmacists, the Institute for Alternative Futures, and the National Pharmaceutical Council among many others.

As a private Consultant first, and later as the Chief Medical Information Officer, Superior Consultant Company, I had the privilege of working with the top 50 pharmaceutical, biotechnology & medical device companies in the world.

Given my expertise and track record, that I can categorically state that the days of detail and/or clinical liaison person as well as any and all financial incentives for physicians, pharmacists, nurses, and allied health providers are over. Similarly, the days of TV ads bombardment and hiring of models for the trade shows are over and should be over (please see "The Prescription Project ).

The NEW ™-old prescription for pharma-biotech-device marketing has been around since September, 1995 when I was invited by the FDA to present my expert opinion on the subject of Pharmaceutical Marketing and Information Exchange in Managed Care Environments.

In my testimony, from October, 1995, I presented the key incentives and disincentives of implementation of then emerging information technologies by the pharmaceutical industry. (see the US FDA Archive). Here are the “nuts & bolts” of my model proposed to the FDA in 1995:

“…The pharmaceutical companies should be moving from drug providers to total health solution providers including an expanded self-definition and developing their identity as a shared vision. Customers and partners who share an expansive vision of health help pharmaceutical companies to identify and create new market opportunities. This enhanced feedback mechanism will move pharmaceutical companies along the path of development into markets that are being formed by new information systems that organize the population with ever-increasing regularity...

...The pharmaceutical companies will use this information technology for mass markets, where one size fits all, moving towards customized health solutions when one size fits one. In this growth, the competencies are naturally growing around disease management. The ever-evolving definition of disease management by customers, including patients and their families, as well as professional providers, both physicians, pharmacies and the allied health professionals, will expand the competencies of pharmaceutical companies...

...This evolution leads to an expanded marketplace that reaches beyond the products into services, including many that are non medical, but nevertheless effect health. The health care consumers ( patients with specific diseases) who interactively help shape the new services, will lead pharmaceutical companies to pay far greater attention to post-market information. For this information to develop, pharmaceutical companies will form new partnerships with information companies...

...The pharmaceutical companies that succeed in such partnerships will be those that are open to participatory information sharing and development. Increasingly, the customers and partners of the pharmaceutical company that succeed in redefining themselves will look to these health solution providers for leadership. Also, creating such a partnership will help deal with the concept of the “fantasy of certainty”©...

...One strategy is to use feedback to help consumers play a more important role. The successful application of this strategy also supports shifting consumers from possible recipients of care to empowered proactive self-care participants…”

In summary, I challenged the FDA to “…regulate less and guide more and become a source of information for all”. During my service on the FDA General Scientific Advisory Board (Consumer Representative), from 1998 to 2002 I continued to advocate and promote the use of the Health Care Value (HCV©) which I originally introduced 1995, based on evidence- supported, repeatable, verifiable outcomes. I also continued to champion the cause of informed health consumer-concerned provider partnerships (PPP) enabled by the ethical and socially-responsible manufacturers.

HCV© is a near-quantitative time-tested measure, accepted by the FDA and a number of forward-thinking, proactive pharmaceutical, biotechnology and medical device companies trying to operate with quality and ethics in the industry's "quality vacuum" created by the ever-mounting requirements for quality performance reporting in the absence of government standards or industry consensus.

Let's now forward to 2007: The US FDA has "dropped the ball" and the overwhelming majority of the pharmaceutical and biotechnology companies are still engaged in the “traditional” marketing methodology of directly and/or indirectly "incentivising" physicians, pharmacists and allied health professionals to increase their respective market share of newer, as well as “me 2” drugs and drug delivery systems.

Instead of educating the providers, empowering the health consumers and empower health consumer-provider partnerships based on HCV© the majority of manufacturers are engaged in a barrage of “no-indications” TV ads devised to create demand “from below” by creating paranoia among the health consumers and overwhelming the providers.

With its corporate values of being science-based, competing intensely and winning, working in teams, creating value for patients, trust & respect for each other, ensuring quality, collaboration, communication and being ethical and accountable, Amgen seems to be "ahead of the pack". Sounds great, but is it factual?

Hence, I am introducing the Pharmaceutical Ethical Marketing & Manufacturing (PEMM©) Index, which is a ratio of the R&D budget to the Marketing & Administration budget by the company across all product lines (% of, or actual expenditures). Currently, the industry-wide PEMM© index is around 0.39. This index will serve as rough, but sorely needed, guide for health consumers and providers.

Since Americans are already subsidizing every manufacturers world-wide sales (as evident by significantly lower prices for the same drugs in Canada, Mexico, Bahamas, Europe, etc.), it is totally reasonable on the part of consumers and providers of health care to expect a PEMM© index of every ethical and carING© manufacturer to be at least a 1.0, and preferably higher. I hereby invite and challenge Amgen and all other manufacturers to make their PEMM© index information public--I am confident Amgen's index will be much higher than industry average.

In the meantime, here is an unsolicited NEW™ prescription for pharmaceutical, biotechnology and medical device manufacturers: deliver verifiable, evidence-based health care value (HCV©), partner with & educate your customers (consumers & providers of health care, not the PBM managers or HMO executives), and foster patient-provider partnerships---keep your PEMM© index high, and your sales will follow!

Be Well!

People of the State of California v. CMA

" The decision to humanely end the (animal) life may be necessary in the case of severe injury, incapacitating disease, intractable pain, etc." (AVMA)

The American Veterinarian Medical Association (AVMA) defines the term euthanasia is derived from the Greek terms eu meaning good and thanatos meaning death. A “good death” would be one that occurs with minimal pain and distress. In the context of this report, euthanasia is the act of inducing humane death (in an animal). It is our responsibility as (veterinarians and) human beings to ensure that if an (animal’s) life is to be taken, it is done with the highest degree of respect, and with an emphasis on making the death as painless and distress free as possible.

Most recent well-publicized occurrence--Barbaro was an American thoroughbred that decisively won the 2006 Kentucky Derby but shattered his leg two weeks later. He underwent surgery for his injuries, but he soon developed laminitis in his left rear leg. He had an additional five surgeries. His prognosis varied as he remained for an extraordinarily long period of time in the equine Intensive Care Unit. While his right leg eventually healed, a final risky surgery on it proved futile because the colt soon developed further laminitis in both front legs. His veterinarians and owners then concluded that he could not be saved, and Barbaro was "put to sleep".

Why do the opponents of the recently introduced AB 374, who prefer to use the euphemism "put to sleep", recognize the concept of medical futility and quality of life in Barbaro's case, but deny the same privilege to the People of the State of California? If it was up to Mr. Dunn, the President & CEO of the California Medical Association (CMA), poor Barbaro would still be in the intensive care unit suffering from horrible pain and on life support. Why does the AMVA has more heart and compassion than the American Medical Association (AMA) and CMA?

Why than do AB 374 opponents attempt to confuse Californians by interjecting the bigoted and discriminatory "social futility" concept implying that the indigent , medically undeserved and disabled will be "victimized" by AB 374? Are the opponents suggesting that a "price tag" can be placed on a human life based upon a persons socio-economic status!?

How dare that AB 374 opponents imply that California physicians would somehow be "financially incentivized" to act against patient interest, their life-long goals of saving life, and their moral principles to unnecessarily hasten their patient demise?

Why are they (opponents) implying that the disabled have a "lesser capacity" to make a choice based on informed decision? Do the disabled have "lesser right" to self-determination ?

Why are the opponents not informing the general public of numerous redundancy guidelines built-in AB 374 and the similar Oregon, Australian and European Laws?

Why are the opponents not mentioning the fact that there has not been even one documented case of the abuse of similar law in Oregon over the past 8 years?

Why is the wavering Governor of California prefer that AB 347 be turned into an initiative?

One needs to vigilantly protect and vigorously defend one's dignit and right to self-determination.

Be Well!

Request to Chairman Dymally

Given the reintroduction today of the Compassionate Choices Act of 2007 (AB 374), and recent announcement of support by the Speaker of the Assembly Fabian Nunez, Prof. V.S. Dorodny, TRI-PAC Health & Wellness Advocacy and the NEW Institute have appealed to the Chairman of the Assembly Health Committee Mervyn Dymally.

Prof. V.S. Dorodny, a long time health carING and patient rights advocate, is seeking support and endorsement of the subject legislation by the powerful Chairman to reflect the intent and the will of the overwhelming majority of Californians.

We hope that this long overdue legislation (AB 374) will become law.

Thank you Mr.Speaker

Assembly Speaker Fabian Nuñez said Tuesday, February 13, 2007 that he will join Van Nuys Democrat Lloyd Levine in leading a legislative move (AB 374) this year to establish an Oregon-style, physician-assisted suicide law in California.

A Senate committee narrowly rejected a similar bill by Levine and Assemblywoman Patty Berg, D-Santa Rosa, last year.

But Levine and Berg said odds of passage have risen now that they have the support of Nuñez, a Los Angeles Democrat.

The legislation, modeled after the nine-year-old Oregon Death With Dignity Act, would allow adults diagnosed with less than six months to live to receive life-ending drugs from a doctor and take them by themselves.

They would have to be determined to be mentally competent, see two doctors, make written and oral requests for the medicine, be counseled about alternatives and wait through a cooling-off time.

Only the patient would be able to make the decision, not a family member or a guardian.
A spokesman for Nuñez, who leads the Democrat-dominated Assembly, said the speaker thought long and hard about taking on the high-profile role of joint author on the effort.

My life. My death. My choice.

Legislative authors of a new bill (AB 374)to empower terminally ill California patients to make their own end of life choices will unveil powerful new support for their legislation at a State Capitol news conference on Thursday, February 15th.

A broad coalition of patients’ rights supporters, including seniors, faith leaders, physicians and terminally ill Californians and family members will unveil a new drive tomorrow at the Capitol to pass a bill (AB 374) that would make it legal for terminally ill patients to obtain prescription medication to ease their dying.

Some Californians with incurable, terminal illnesses are suffering needlessly prolonged, agonizing deaths. The new bill would allow terminally-ill California patients to request, and their doctors to provide, a prescription medication to hasten a quiet, peaceful and dignified death.

The measure would provide safe, legal end-of-life choices for Californians similar to those the people of Oregon enjoy.

The Prescription Project.

FOR IMMEDIATE RELEASE: February 13 2007, Malibu, California--In the wake of Prof. Dorodny’s recent (1998-2002) Consumer Advocate appointment to FDA General Scientific Advisory Board, and in recognition of his work with, and vis-à-vis the FDA and FTC over the past 12 years, and his expertise on the issues of Pharmaceutical Marketing in the Managed Care Environment, Direct-to-Consumer (DTC) and Direct-to-Providers (DTP) information exchange and dissemination, Prof. Dorodny will join the Community Catalyst project.

Consumer-advocacy group has launched a national campaign to try to reduce conflicts of interest between doctors and the pharmaceutical companies that ply their physician-customers with everything from boxfuls of drug samples to free lunches and generous lecture fees.

The Community Catalyst, a Boston-based not-for-profit group, said the two-year long Prescription Project, funded by a $6 million grant from the Pew Charitable Trusts, will attempt to raise awareness of these conflicts and encourage physicians to use evidenced-based systems when they prescribe drugs to patients. Community Catalyst will work with the Institute on Medicine as a Profession, a think tank at the Columbia University College of Physicians and Surgeons in New York to demonstrate how these close financial connections effect quality and costs in health care.

Drug companies spend about $12 billion a year on marketing efforts to doctors, and national spending on prescription drugs—rising at a rate double that of other health services—is nearly $200 billion a year.

Dialing 911

Emergency preparedness made easy is what our new series of Dialing 911 QwikGuides is all about. A matter of vital importance, emergency preparedness nevertheless eludes two thirds of us (Red Cross survey).

Americans make 190 million 911 calls every year requesting help for emergencies endangering life or property. That's about two calls for every three of us. In addition to crime and medical problems, 1.8 million fire and about 40 major disasters create emergency situations for millions of American families.

Nevertheless, once we buy homeowners insurance and/or car insurance, most of us do little else to guard against or prepare for family emergencies.

The brand new Driving Emergency QwikGuide provides vital information about accidents, mechanical breakdowns, tire blowouts, car fires, driving in rain, hailstorm, fog, tornado, flood, earthquake, cold and hot weather. It also addresses SUV driving and car emergency kits. It contains an accident checklist and road emergency reporting advice. It is concise, practical, easy to use, durable, and even washable.

The Family Emergency and Driving Emergency QwickGuides provide vital information to help you prepare yourself and your family for emergencies without spending a lot of time and effort.

You cannot predict emergencies, but you can prepare. Now is a good time.

Dr. Dorodny

Prof. Victor S. Dorodny is the Founder and Chief Scientist of the Naturopathic Evidence-based Wellness (NEW™) Institute in Malibu, California. Prof. Dorodny is dedicated to education of wellness consumers, and implementation his principles of complementary convergence of Naturopathy and traditional Medical Science to achieve and maintain Natural Health.

He is the Chief Medical Officer of the Malibu Medical Reserve Corpse (MMRC)—a volunteer organization under the guidance of the US Surgeon General dedicated to assisting authorities in a form of Medical Disaster Assistance Teams. (MDAT)

He is the past Vice-President, of ICN Eastern Europe, a Division of ICN Pharmaceuticals, Inc, Costa Mesa-based global pharmaceutical company and has many years of experience in pharmaceutical, vitamins and nutraceutical manufacturing.

As practicing/consulting physician, academician and technologist with 30 years of clinical and consulting experience he is an expert on Anesthesiology and Pain Management, Rehabilitation, and Multi-disciplinary approach to the management of chronic disease states.

Dorodny was founder and president of Health PRO Worldwide, Inc., a Health & Wellness consulting company in Pasadena, California since 1993. Since 1995 he is the Founder & Chairman of TRIPAC, National Health & Wellness Advocacy dedicated to ongoing transformation of health consumers and provider of health & wellness products and services, and team approach to utilization of traditional medicine and naturopathic strategies for optimal health.

He has served as consultant to the Economic and Social Council of the United Nations; Technical Advisor to the United States Department of Justice and FBI; past president of the National Association of Managed Care Physicians (NAMCP). He is a Board Member of Association of Medical Directors of Information Systems (AMDIS); Board member of the IPA Association of America (TIPAAA), National Managed Health Care Congress/Health Information Technologies (NMHCC/HIT); California State Pharmacy Partnership; Health Care Advisory Committee-Assembly; California Legislature and US Congress. Member (A) of the Scientific Advisory Board of the US Food and Drug Administration (US FDA).

A native of Odessa, USSR Prof. Dorodny received his M.D. and M.P.H. degrees from N.I. Pirogov Medical Institute in Odessa, USSR.He completed his residency in Anesthesiology at the USC-Los Angeles County Medical Center, ans is a Graduate USC Executive Management Institute in Health Care in 1993 and received Ph.D. in Health Informatics from International Informatization Academy in 1997. Prof. Dorodny is Board Certified by the American Academy of Pain Management, and is an Associate in Medicine of the American College of Legal Medicine (ACLM).

Prof. Dorodny has made significant contributions to major mass media publications, peer review journals and trade publications. He has authored numerous monographs and books, and his editorial board appointments include Managed Healthcare, and The Medical Reporter. He is the only physician in the USA on the editorial boards of US Pharmacist and Information Security Journal.

He is a frequently invited keynote presenter at national and international conferences, and featured guest on national TV and radio. Prof. Dorodny is an Active Academician with the International Informatization Academy (IIA) and a frequent participant in projects at the Institute for Alternative Futures, National Association of Consulting Pharmacist, and Joint Commission for Accreditation of Hospital Organizations (JCAHO), National Pharmaceutical Council, and US Food and Drug Administration.

_____________________________________
30765 Pacific Coast Hwy., Suite 285, Malibu, CA 90265,

(310) 663-2949, e-mail: healthpro@pol.net

Compassionate Choices

Professor Victor Dorodny, Founder and Chairman, TRI-PAC Health and Wellness Advocacy, created in 1995 with a mission of unrestricted access to affordable, appropriate, quality healthcare.

Since 1994, Professor Dorodny has been intimately involved in the creation, passage, and adoption of the Oregon Death with Dignity Act under the leadership of former Oregon Governor John Kitzhaber, M.D., who is also a fellow physician.

The passage and adoption of the Australia International Euthanasia Task Force is another feather in the cap of Professor Dorodny where he has been an effective proponent and eloquent advocate.

Professor Dorodny is an acknowledged national and international expert, writer and commentator on the medical, ethical and legal issues; public policy, and political arguments of Physician Assisted Suicide currently under national discussion and debate.

During the 2006 legislative session, TRI-PAC Health and Wellness Advocacy under Prof. Dorodny's stewardship was intimately involved in the issue, arguments, and advocating for passage of AB 651 (Berg and Levine). Unfortunately, AB 651 was defeated by one misguided vote (California State Senator Joe Dunn, D-Garden Grove) in the California Senate Judiciary Committee prior to reaching a California State Senate floor vote. Interestingly, Mr. Dunn has recently accepted a position of the CEO of California Medical Association (CMA).

AB 651 was amended into the Compassionate Choices Act. Professor Dorodny and TRI-PAC joined Compassion & Choices in meeting and educating key legislative leaders, government officials, mass media, fellow physicians and the public at large to pass this bill.

Professor Dorodny is a leading and key proponent of Anesthesiologist participation in lethal injection.

American Medical Association (AMA) and the American Society of Anesthesiologists (ASA), the California Medical Association (CMA), vehemently oppose anesthesiologist participation in lethal injection, as well as physician participation in Physician Assisted Suicide. Once again, they have chosen to take the "dark" side on both issues.

Professor Dorodny has been interviewed by CBS Radio & National Public Radio (NPR) and by the American Medical Association (AMA) for a future article on anesthesiologist participation in lethal injection for publication in a future issue of the Journal of the American Medical Association (JAMA).

The goal and intent of Professor Dorodny and TRI-PAC Health and Wellness Advocacy, is to inform, educate, and advocate, keeping in mind that both supporting and opposing viewpoints need to be presented and articulated prior to adoption and passage of public policy and legislation.