Thursday, March 29, 2007

Don't be a pig, when you are in the driver's seat...

...proclaims a recently photographed billboard in Kiev, Ukraine.

It is unfortunate that the California "Governator" does not get to pass by it.

"Selecting" only doctors and hospitals for higher taxation to finance his version of "Zelda's Single Payor Legend" (see older postings), is not just unfair--it's out right stupid.

Whether the Gov. calls it a "fee" or "stooped tax", it will tap 2% of doctors revenues and 4% of hospitals revenues to pay for his "universal" health care.

The Governor also wants his "universal health care" extended, obviously for free, to all illegal immigrants, both currently in California and the 10-15 million of them that will be attracted by free "universal health care".

As a matter of fact, selective taxation only of health care providers makes as much sense as mandating a new "California universal toilet paper".

People who support the Gov. should realize that all increases if implemented, will be passed on to them in a form of higher doctors and hospitals fees, refusals to take care of the indigent, and higher insurance premiums for all legal Californians.

This way not just the health care, but its financing will be universal.

As a physician and a seasoned consultant, I am offering a 3-prong free advice to the Governor:

*stop being a Pig a in the Driver's Seat and leave doctors and hospitals alone,
*impose an additional 2% tax on revenues of your fellow actors, producers, directors, movie
studios and TV executives;
*impose an additional 4% on the revenues of Pharmaceutical, Insurance, Banking, Hi-Tech, Bio-
Tech companies conducting business in California .

Surely, there are as many rich and righteous folk as there are physicians and hospitals whose profit margins are higher than actual providers of health care.

We observe, you decide!

Friday, March 23, 2007

Kudos to AFL-CIO, its Members and Affiliates…

…for their effort to address “mangled health care" head-on!

In Thursday, March 22, 2007 edition of Pittsburgh Post-Gazette, Anya Sostek, staff writer, writes (excerpted with commentaries by Dr. Dorodny):

“…The "Health Care Hustle" Web site invites readers to submit their stories of being broken down and bruised by the health-care system.

The site which opened to the public yesterday and to members last week, already has attracted more than 500 responses,
which is only a drop-in-the bucket, considering the daily obstacles workers and their families need to overcome to access appropriate health carING.

Working America, a community affiliate of the AFL-CIO which represents about 1.5 million Americans who are not part of labor unions encourages users to send automated messages to "greedy corporations," the Pharmaceutical Research and Manufacturers of America, the insurance industry and the Bush administration.

According to Ms. Karen Nussbaum of Working America, the organization plans to launch a major campaign against the "evildoers" who receives the most votes against them.

The “evildoers” only care about their executive compensation, stock options, share prices, private jets, etc.

Currently, workers and their Unions have only themselves to blame for proliferation of and the abuse by the “evildoers” that are “just doing their jobs”.

Strive for universal access to appropriate and affordable health carING is an achievable, but a long-tem undertaking. Universal payer/single payer proposals are abundant, problematic and deceiving.

"The trade union movement today is both more embattled and smaller, and that means that it has to use the weapons of the week," said Prof. Lichtenstein (UCSB). "It's the same thing that any agitational group who is out of power would do."

But creative media campaigns will not properly address what’s on the mind of every worker: health carING. Address these issues and watch your membership and your power soar.

Organize your members and move from an "agitational group" to an enabling one.
Unfortunately, sending automated messages to “greedy corporations” will not work either.

It will not work because Pharma Manufacturers only care about their profit margins. Please read the “NEW Prescription for Pharma Marketing” and related postings on this site.

Similarly, insurance companies have core values divergent from those of workers and their families.

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

*The workers and their families usually does not request, do not order or directly pay for the services.

*The insurance companies, HMOs, never request, do not receive, nor order the services.

*The doctors who order the services do not pay for them, nor receive the services.

Insurance companies, HMOs and other "mangled" health care companies entire purpose is to grab as many pennies from workers health care dollar as they are allowed to by the workers.

They do grab a sizable chunk: 15 cents out of every healthcare dollar without actually working, being sick or providing services.

Sign me up!

The lame-duck President Bush did not care about the worker even before he became a lame duck.

Dear Unions,

Please return to your basic focus on collective bargaining and controlling the purse strings, with a clear understanding of the fact that employees are the buyers (direct and/or indirect) of health carING services.

Employees are the buyers of health care and should drive, if not control, all health caRING decisions.

Workers and their families 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.

Workers and their families can pay for health carING without mangled care companies.

Employees and their Unions do not need the middle men (employer, insurance company, managed “mangled” care company and its stockholders) to take a 15 cent bite out of every health carING dollar!

I, for one, am willing to make a difference and show the way!

We gripe, you decide.

Thursday, March 22, 2007

Shame on John Edwards...

...for shamelessly exploiting the unfortunate progression of his wife's cancer. Her previous bouts of cancer did not stop Mr. Edwards from campaigning in 2004 when his wife was receiving chemotherapy. Her psychological scars of abandonment are probably still healing.

Shame on Mr. Edwards for using his wife's now fatal condition to "breed new life" into his losing candidacy for President

Fortunately, during my 32 years of carING for patients with cancer and other terminal diseases (with and without social stigma attached) I only came across one patient, and one next of kin that were actively publicizing and benefiting from their terminal diseases.

Both individuals were illegally abandoned by their "mangled care" insurance companies, and were doing so to collect funds for life-prolonging treatments.

Fortunately for Mrs. Edwards, she appears to be able to afford the best care available in this country without participating in a public debate and discussion of her most sacred possession: her life--a "living monument" to her husband's ambitions, despite his floundering campaign.

Shame oh her physicians for their willing participation in Mrs. Edwards' joint CNN-FOX disease management circus, and for possible HIPAA violations.

Mr. Edwards' time "invested" in press releases, news conferences, TV appearances, etc might have had a "higher return" should he engage in private carING for his wife.

I wonder if Mr. Edwards can ride the "sympathy wave" long enough to make a difference?

We gripe, you decide.

Be Well!

Friday, March 16, 2007

Hospital Association High-Ranking Executive Attacks Patient Advocates...

...over our recent postings regarding illegal and unethical dumping of patients by at least two hospitals, both HASC members.

If a similar act of dumping was committed by the local animal shelter, if would be braking news on all major networks.

Since patients they dump are of lower socio-economic status, chronically ill, and already medically underserved, the member hospitals believe they can get away with it.

Obviously, they also believe that "shushing" at the advocates would make us (advocates), and their illegal actions go away.

At around 06:16 p.m., today March 16, 2007, we received the following e-mail from Lott (also posted by Lott as a comment on this blog):

"Hey Bob-- After reviewing how you used my last reply to your unsolicited email request that HASC respond to your blog, l just want to wish you and Dorodny all the best in your all-too-obvious quest for attention and to create a following with your extremist positions and comments. Regards, Jim Lott"

This e-mail communication from a professional publicity seeker, was preceded by an unsolicited phone call from Lott to Mr. Robert A. Donin, MPA earlier this afternoon.

During the 3 minute phone call, Mr. Donin, a well-known and respected volunteer health consumer Advocate, was reportedly subjected to personal insults by Lott in his Executive HASC capacity.

Such personal attacks by hospitals' well compensated mouthpiece and policy/communications "leader" on un-compensated health consumers Advocates is the best illustration of their unfair business practices.

A personal apology from Lott to Mr. Donin is in order. So is the immediate intervention by State and Federal authorities to prevent future atrocities against health consumers and along the lines of the earlier posting "Patient Dumping: A Lott of Accusations" (see below).

They dump patients, try to get away with it, and attack advocates. We advocate. You decide.

Patient Dumping: a Lott of accusations

Here is the e-mail we received from Mr. Jim Lott, director of communications for Hospital Association of Southern California (HASC) in response to our posting of March 14, 2007 "Kaiser Permanente Arraignment".
Subject: RE: Possible Spam: "Kaiser Permanente arraignment..."
Date: Thu, 15 Mar 2007 17:34:54 -0700From: "Jim Lot, "
CC: "Mark Gamble"Trudy Duncan" "Jennifer Bayer"

Dear Mr. Donin,
I am saddened and chagrinned by the unenlightened comments made by Dr.Dorodny in your/his blog. Not only would I expect a health care practitioner to have a better understanding of the issues involved with so-called patient dumping, but I think it is irresponsible of him (and you) to imply by the content in your blog that Kaiser is guilty of the charges filed and should be punished...before a trial has taken place. What about due process? I believe in free speech, but Dr. Dorodny's comments are irresponsible. Please consider that to be our (HASC) response to your invitation.
Jim Lott
In further review of the available information, I have to agree with Mr. Lott that naming just the Kaiser Hospital was irresponsible on my part.

Hence, I am going to act in a socially and professionally responsible manner by citing the most recent patient dumping by Hollywood Presbyterian Medical Center (HPMC) of a 41-year-old paraplegic man left in soiled hospital gown, without a wheelchair, on the curb by a hospital-hired van as reported by the Los Angeles Times.

Acting in a responsible manner , the office of the Los Angeles city attorney has begun investigating whether staff from Hollywood Presbyterian hospital dumped a paraplegic man in a gutter in front of a local mission.

Unfortunately, Hollywood Presbyterian Medical Center continues to act irresponsibly in refusing to cooperate with authorities conducting the investigation.

California does not have a State law prohibiting patient dumping, so the LA city attorney's office can only sue Kaiser and Hollywood Presbyterian under state law used to deal with unfair business practices (typically used to prosecute slum lords).

Kaiser Permanente is aslo being pursued on false-imprisonment charges for allegedly leaving a homeless woman on Skid Row last year.

The federal government, however--not the LA city attorney's office--would decide whether this behavior also violates EMTALA.

Hollywood Presbyterian Medical Center has already hired the crisis management firm Sitrick and Co . to help weather the storm of criticism, in an attempt to defuse the situation.

The money would have been better spent on hiring additional social workers and creating a responsible and legal way to discharge patients without skid-row dumping.

The hospital is also quoted as saying that in the future it will require: “…the individual provide written consent to any transportation”—an irresponsible proposal considering that the two recently dumped patients are suffering from diminished mental capacity and are unable to give informed consent.

In answering Mr. Lott’s rhetorical question: ” ...What about due process?” we ask Mr. Lott, what about patients’ due process?

Ms. Jennifer Bayer, public affairs director for the Hospital Association of Southern California, was recently quoted saying fines and arrests are not productive.

We beg to disagree and suggest the following enlightened steps:

Hospitals should be penalized financially in a severe manner sufficient to erode their bottom line;

State of California should immediately suspend hospital's license to operate;

Hospital executives should be held civilly and criminally responsible for patient dumping;

The LA City Attorney office should prosecute them to the fullest extent allowable by law for unfair business practices, false imprisonment and any and all other charges they could come up with.

State Legislature should immediately criminalize patient dumping and attach mandatory jail terms.

Federal authorities should intervene immediately to investigate the violation of patients civil rights and to enforce EMTALA (Emergency Medical Treatment and Active Labor Act).

In the meantime, each sentinel event ("sentinel" because they signal the need for immediate investigation and response) of patient dumping by an accredited hospital should be reported to the Joint Commission for an immediate review of hospital's accreditation and suspension of its Medicare funding. Click here to download Sentinel Events Policy and Procedures

They dump and try to get away with it, we gripe and get called names, you decide!

Wednesday, March 14, 2007

Kudos to the California Association of Physician Groups (CAPG)...

... and its President Mr. Donald H. Crane for the recent decision by CAPG’s Public Policy Committee to support AB 374, the Compassionate Choices Act.

The Committee was strongly drawn to the proven, seven year experience of a very similar law in Oregon.

By giving patients facing imminent and inevitable death the option of self-administering life ending medication, the law ushered in a host of important improvements to end-of-life care: increased referrals to hospice care; improved pain management services; a rise in comfort care teams and high attendance at end-of-life seminars for physicians.

Most importantly, a marked increase in the difficult task of physicians and families of engaging in frank conversations about end-of-life options.

The Committee acknowledged that a minority of physicians may oppose this bill, but observed that the participation by physicians was strictly at their option and that this bill
presented a real opportunity to genuinely improve patient care.

CAPG decides, we do NOT gripe, you decide.

Be Well!

Kaiser Permanente Arraingment... being held today in a Los Angeles court.

In adherence to its motto "Customer is always wrong", Kaiser is charged with dumping a confused homeless person in the downtown skid row upon her release from a Kaiser hospital.

In addition to sending some of the Kaiser executives to jail and imposing sky-high fines (to benefit health services for the homeless), the court should sentence the remaining Kaiser national and regional executives to 48 hours sentence by walking around downtown dressed only in a hospital gown without money, food or shelter.

State of California must revoke Kaiser's license to operate, unless and until dumping of patients is thoroughly investigated and prevented from happening in the future.

It's about time we speak with Kaiser in their own language-profits!

Kaiser dumps, we gripe, you decide.

Be Well!

Tuesday, March 13, 2007

Dr. Sokolov's 378 Thousand Reasons...

...for not-caring about the patients and for his "green outlook" on health carING.

To be more specific, there are more than 377,952 reasons for Dr. Sokolov to care more about his clients than he cares about patients/health consumers.

In it's eternal wisdom, the Editor of Modern Healthcare elected to ignore our posting "Health Consumers & Mr. Inlander v AMGA & Dr. Sokolov" of March 6, 2007.

$377,952.16 is just the face value (of 03/13/2007) of Dr. Sokolov's 9,622 shares of Hospira Pharmaceutical that he owns as a Director.

Modern Healthcare editor's core value reflect his allegiance to his advertisers, and their core values (profit) divergent with that of health consumers.

Once a throw-away publication, always a throw away publication.

We gripe, you decide.

Be Well!

Tuesday, March 6, 2007

Health Consumers & Mr. Inlander v AMGA & Jacque Sokolov, MD

Excerpted from Michael Romano's article in the latest edition of Modern Healthcare :

"It’s hardly a secret that the doctors and managers who run the nation’s biggest multi-specialty group practices...firmly believe that their model of integrated delivery is the very best way to provide patients with quality health carING.

Despite the traditional belief, doctor does not always know best! Especially a doctor-turned-consultant-turned-executive-turned investor.

Last week, the Alexandria, Va.-based American Medical Group Association, the trade group for all those large medical groups, held its annual conference over four days at the luxurious Westin Kierland Resort & Spa in Scottsdale, Ariz.

The self-satisfied (God-like) attitude of many AMGA members took a (bit) serious and fully deserved beating from Charles Inlander, noted naysayer (read patient/health consumer advocate) and the outspoken president of the People’s Medical Society since the consumer-advocacy group was founded 24 years ago".

“... the reason you’ve (AMGA) been losing the war (health care policy) is because the focus hasn’t been on the patient. It’s been on the delivery system.”

"For some reason—token, balance, perhaps—the conference organizers invited the consumer gadfly to join a panel discussion.

Panel participants, of course, were the button-down industry veterans to Inlander’s version of a tie-dyed radical about to storm the gates and bring down the system.

After suggesting that universal healthcare is inevitable sometime in the next several years because the public will demand it, he reinforced his point about the industry’s lack of sincere concern for patients by mentioning a keynote address one day earlier by Jacque Sokolov, a physician-turned-consultant and an impressive speaker"

"But, according to Inlander, this highly regarded expert never mentioned the P-word. “Jacque never once mentioned the word ‘patient’ in a 50-minute speech..."-noted Inlander.

Dr. Jacque J. Sokolov is indeed a highly experienced and accomplished expert on most aspects of health care.

I have personally known Dr. Sokolov since early 90-s, and had the distinct privilege of associating with him on a number of projects, as well as on health care panels, forums, and on the speaker circuit.

Dr. Sokolov practically invented employer-directed managed care as Vice President and Medical Director at Southern California Edison Co—HealthFlex, and, thus became one of the co-authors of the "mangled health carING"---see this blog archive ("Mangled Healthcare" for All).

Unfortunately for then Edison employees, they were not considered to be part of the equation. Otherwise, Dr. Sokolov would have bypassed the archaic "patient-centric", and would have gone straight to the appropriate "health consumer (payors)-directed".

Fortunately for Dr. Sokolov, that position made him a national name in health care and helped launch his worldwide consulting business.

In the ensuing years, Dr. Sokolov served as top executive with Advanced Health Plans Inc. and AHP Development Corp. to "
develop, finance and implement advanced, integrated health systems." He is a savvy investor in health care.

His clients included: physician organizations, hospital systems, insurance companies, managed care plans, and vendors in 100 markets in 40 states, plus three foreign countries.

Dr. Sokolov is no stranger to pharmaceutical and medical device industries either. He serves on the Board of Directors for Hospira, Inc., the global specialty pharmaceutical and medication delivery company since Hospira’s spin off from Abbott Labs in May, 2004.

He also serves as a Director of MedCath Corporation. Please see this blog archive ("NEW Presciption for Pharma Marketing).

He is best remembered for presiding over the decline and, final demise of the Coastal Physician Group, Inc., after a protracted proxy battle with Dr. Steven Scott, founder of Coastal Physician Group, and much-publicized law suit (Scott v Sokolov, 1996, NCBC 2, Durham, North Carolina).

In-fighting under Dr. Sokolov’ tenure as Chairman of the Board & Vice-President for Healthcare, resulted in Coastal Physician Groups' stock price sinking from a high of $42 to around $13.

Fortunately for Dr. Sokolov, he was able to walk away from Coastal (which later became PhyAmerica Physician Group, Inc) with a sizable “chunk-of-cash”.

Currently he is Chairman and Senior Partner for SSB Solutions, Inc. His bio on the company’s website states: “….
Over the past 15 years, he has led consulting engagements with top-tier physician organizations, hospital systems, and managed care organizations in virtually every major market in the country…”

Curiously, but not surprisingly, the patient/health consumer is not mentioned. Is it because patient/health consumers do not pay exorbitant consulting fees, speakers’ honorariums or luxury hotel and airline accommodations?

The long of it:

Mr. Inlander is absolutely correct;

Dr. Sokolov, a former cardiologist, works for " physician organizations, hospital systems, and managed care organizations..."

AMGA is absolutely wrong and was caught "red-handed";

Mr. Inlander "has a heart" & works on behalf of Patients-Health Consumers;

Dr. Sokolov does NOT work for patients/health consumers;

AMGA either knew, or should have known the content of Dr. Sokolov's presentation.

Dr. Sokolov could have removed the "patient-centric" slides to stay within the allotted time.

AMGA is in "damage to its real image" control spin;

Mr. Inlander will not be invited back by the AMGA, but he is always welcome on my blog!

The short of it:I am pointing out the obvious to the obviously blind!

Be Well!

Italian Doctor Enforces Patient's Rights.

In a major victory for right-to-die advocates in Roman Catholic Italy, prosecutors on Tuesday cleared a doctor of wrongdoing after he switched off the life support of a terminally ill patient who had asked to die, as reported by the Yahoo News.

Anaesthetist (in US, Anesthesiologist is a MD; Anesthetist is a Certified Registered Nurse Anesthetist-CRNA), Dr. Mario Riccio removed the respirator of muscular dystrophy sufferer Piergiorgio Welby in December to end a life that the paralyzed patient had repeatedly described as torture.

Supporters have called Riccio a hero for ignoring a court ruling that rejected Welby's high-profile request to have his respirator removed. He is a hero for "walking the walk" despite all adversities and for not abandoning his patient in a time of extreme need, and when his patient ran out of other options.

Opponents, including in parliament, said Riccio was a criminal who should go to jail. Real criminals are legislators, judges, prosecutors and other officials that willingly and maliciously denied the patient his right to self-determination.

The Roman Catholic Church went as far as to deny Welby a Catholic funeral and Pope Benedict joined the national debate by saying life was sacred until its "natural sunset."

"Natural sunset" is to be determined by each individual, not by an overpaid and overdressed figurehead such as Pope.

Within the various uses of the word today, "nature" may refer to the general realm of various types of living plants and animals, and in some cases to the processes associated with inanimate objects – the way that particular types of things exist and change of their own accord, such as the weather and geology of the Earth, and the matter and energy of which all these things are composed.

This more traditional concept of natural things which can still be found today implies a distinction between the natural and the artificial, with the latter being understood as that which has been brought into being by a human or human-like consciousness or mind.

By the same token, Pope can argue that cancer, heart disease, pregnancy, stroke, coma, and even hemorrhoids are "natural" conditions and should not be interfered with.

Not shying away from double standards, the previous Pope was kept alive by the miracles of modern artificial (not natural) technology.

Dr. Riccio is correct in his assertion that "...even under the law, it's confirmed: there's been no crime of euthanasia, just a patient who refused treatment..."

Italian prosecutors, after more than two months reviewing the case, said Riccio had done nothing wrong since he was acting in the spirit of Welby's constitutional rights and in strict adherence to Hippocratic Oath--an important procedural step that makes future criminal prosecution highly unlikely -- and could be seen as setting a precedent in other right-to-die cases.
"Doctor Riccio's behavior does not appear to be censurable for not having reinserted the artificial mechanical ventilator when the respiratory crisis occurred," the prosecutors wrote in their request to shelve the investigation".

Still, neither Riccio nor the medical panel and prosecutors described what Riccio had done as euthanasia, which is illegal in Italy and carries a 10 to 15 year jail term.

Only Switzerland, the Netherlands, Belgium and the state of Oregon (and Australia, Northern Territory) permit assisted suicide for the terminally ill.

Former Italian President Francesco Cossiga formally demanded magistrates consider Riccio a murder suspect last.

But Riccio's supporters have noted that Welby, lucid despite his illness, had asked to die and that his treatment held no hope of improving his condition. Prosecutors noted those facts in their request to shelve the case

Riccio, who gave Welby a cocktail of sedatives when removing the respirator, had already been cleared of wrongdoing by a medical panel last month. He said the prosecutors' decision was a major step toward strengthening patients' rights in Italy.

"The only one who can ultimately decide on the therapy is the patient," Riccio said.

Let this case serve as a lesson to all California proponents and supporters of patients right to privacy and unimpeded ability to exercise their rights of self-determination.

California does not have to engage in euthanasia, physician assisted suicide, "physician assisted death" or any other "verbology".

California simply has to reaffirm individual patents" right to refuse any treatment, including the life-sustaining one.

We gripe, you decide.

Be Well & Exercise Your Rights Freely & Frequently!

Monday, March 5, 2007

City of Santa Monica promotes promiscuity...

...among ground squirrels by providing them with free birth control, subject to Santa Monica residency requirements, Mr. P. Lamont Ewell presiding!

In an unprecedented display of poor judgement, even for Santa Monica "standards", the City of Santa Monica does it again.

Here we were griping about healthcare-impotent Los Angeles BOS, while the public health masterminds in Santa Monica have come up with a plan to administer inmmuno-birth control to ground squirrel population of Santa Monica at a cost of up to $10.00 per squirrel.

I called the City of Santa Monica today to get a guesstimate of ground squirrels in the city limits and was refused a coherent or substantive answer.

Santa Monica "leadership", probably does not know the exact number of infectious diseases that were transmitted from squirrels to humans over the past 10 years, outcomes and costs of such alleged transmissions?

City of Santa Monica is not interested in protecting its residents and hundreds of thousands of visitors to the city from Hepatitis A in restaurants, farmers' markets, catering companies, bars, wholesale and retail markets.

Instead of pursuing an imaginary zoonatic threat, they could have considered handing $10.00 to each homeless person in Santa Monica in exchange for a pledge not to urinate on the Promenade!

We gripe, you decide, if you want to eat in Santa Monica.

Be Well!

Saturday, March 3, 2007

"Board of Stupidvisors" (BOS)?

If one Googles "Board of Stupidvisors" one will come up with over 600 mass media references for a number of counties.

Why do residents of so many counties appear to be "lees-than-tickled" with our elected "servants"--members of the respective counties Board Of Supervisors (BOS)?

Maybe, it's because mine (BOS representative), for example, is more interested in watching himself on TV surrounded by men/women in uniform and flashing lights, than protecting the health of county residents.

Even though in Los Angeles County the final responsibility for health care services, public health, and emergency preparedness rests with the Committee of the Whole (meaning all persons elected to the BOS), there are definite "champions":

Gloria Molina, the first latina elected to BOS in 2/1991 distinguished herself in the health arena by protecting county library services whenever there was a fiscal problem with health services. A former smoker, she voted to re-appropriate (take away) $60 million in Tobacco Securitization towards County USC Replacement Project to be opened 11/2007. A "4 vote" item stuck in a budget request eliminating possible objections and/or discussions. Maybe she should use her quilting skills to patch up county's health system that's falling apart.

Zev Yaroslavsky, my BOS representative and a budget "expert", has been re-directing Master Tobacco Settlement Funds to non-tobacco related activities since 1998. Being in charge of the County Fire and County Sheriff departments allows Mr. Yaroslavsky ample media exposure. I wish he was as interested in provision of emergency health service in medically under served Malibu. Yes, MELibu, that does not have a single medical facility open after hours. Similarly, he does not seem to be interested in emergency preparedness, and did not support Malibu Medical Reserve Corps (MMRC).

Yvonne Braithwaite Burke--Member of the BOS since 1992-- continues to preside over the slow and painful demise of the King Drew Medical Center. Under her l"eadership" the BOS and its appointees failed to hire required number of outside doctors and nurses to roam the hallways to protect patients from medical mishaps. Burke proclaimed she: "... would not allow hospital to shut down, no matter how bad its problems and over my dead body..." She, and her colleagues, hired Navigant, an outside firm to turn around King Drew Hospital, spent hundreds of thousands of taxpayer dollars, but did not accomplish what they said they would.

Smartvisor Don Knabe is responsible for the Department of Consumer Affairs and leads the health carING by example--he is the Vice Chairman, Health Sub-Committee, National Association of Counties.

Smartvisor Michael D. Antonovich (also responsible for the office of the Coroner and Mental Health Services) reacts quickly and appropriately to the recent case of Hepatitis A in a cook with a major catering company. He states, that the case: "... demonstrates the major impact that this food-borne disease can have on restaurants, catering companies and consumers..."

Despite the fact that LA County Public Health Department took appropriate action to inform those who were at risk, and to offer prophylaxis for those for whom it was still potentially effective, it is still a prevalent serious disease.

His motion, scheduled to be heard on Tuesday March 6, 2007, which if passed, will instruct the Director of Public Health to review the relevant public health literature, and report back to the Board in 30 days with an analysis, including cost-benefit calculations concerning the question of whether Hepatitis A vaccinations should be required for food service workers in restaurants, catering companies, and in wholesale markets.

In the presence of abundantly clear and convincing evidence of the Hepatitis A vaccine safety & efficacy, it's really a matter of dollars and sense. Sense of doing the right thing to protect residents of and visitors to our great County of LA.

The non compliant restaurants, catering outfits, wholesalers and retailers must be fined severely to generate additional revenue for Hepatitis A vaccination oBoldf their employees.

Mandatory multilingual education, when monitored and enforced, can be as effective as vaccinations in preventing the spread and outbreaks of this serious disease.

Talking about proper hand washing techniques, recent studies have demonstrated the effectiveness of 6-step technique, as part of the safe hand washing is extremely effective in preventing the spread of the Avian Flu.

In our humble opinion, an ounce of prevention is better (faster and cheaper) than a pound of cure. Which box are you in LA County BOS Members.

We gripe, you decide!