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... is for good men to do nothing. Edmund Burke
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As
submitted to http://gov.ca.gov/interact#email,
on
September 26, 2010, at 07:45 PM
Subject: VETO AB 1235 - Corporate Control of
Medical Peer Review
To the Honorable Governor of California,
Arnold Schwarzenegger,
Dear Governor Schwarzenegger, I
had the pleasure to meet you, your charming wife, Maria Shriver, First
Lady Barbara Bush and President George H.W. Bush, in 1991, when you
received the Simon Wiesenthal Center's National Leadership Award
for your support of the organization's holocaust studies, see photos taken
that day, at: http://www.allianceforpatientsafety.org/photos-1991.php.
The President was presented with the Cup of Elijah. Rabbi Marvin Hier,
dean of the Wiesenthal Center, said the cup symbolizes "the great
hope that all who find themselves enslaved shall one day be free."
Little did I know that I would write to you, today regarding the US
Healthcare Holocaust, as some refer to it.
What's really behind all that jumbo mumbo legalese in AB 1235 ? A
dire need to reduce healthcare costs in the US, which are twice as high as in
Europe and Japan per capita, yet our patients are not benefiting from what
they are paying for, as the US is consistently dead last
among industrialized countries in all international studies.
How come ?
Don't we have the some of the best medical schools, the most
advanced Pharmaceutical, Biotechnology, Medical
Devices,... industries in the world ?
What the California Hospital Association, CHA, does not want you, nor
anyone else to realize is that it is in the best
economic interest of any hospital to encourage an environment that
will increase the number of preventable errors and
complications.
Sounds shocking, doesn't it ? I
never thought that I would ever write such a sentence in my life.
Unfortunately, the record demonstrates beyond the preponderance of the
evidence that this epidemic is far worse than ever thought. The numbers are
screaming !
The key to reducing preventable errors depends on who controls the
quality of delivery of care.
Should it be the Hospital's CEO, the Physicians, the Nurses, the
Pharmacists, the Patients,... the Medical Insurance companies, the
Professional Liability Insurance companies, Government agencies,... Who ?
Well, the answer to this question depends on each one of these parties'
economic interests. I
always thought that in the US wealthy people benefit from a far superior care
than poor people.
Wasn't I surprised, when I read the results of the Rand Corporation, see: The
First National Report Card on Quality of Health Care in America.
" All adults in the United States are at risk for
receiving poor health care, no matter where they live; why,
where, and from whom they seek care; or what their race, gender, or
financial status is.
Read Document, see: http://allianceforpatientsafety.org/bigpicture.php #
15
Some believe that in order to reduce healthcare costs all physicians must
become employees of the hospital. Nothing
is further from the truth, as I am about to show you.
“ In most industries, defects cost money and generate
warranty claims. ”
“ In health care, perversely... healthcare professionals
receive a premium for a defective product; Physicians and hospitals
can bill for the additional services that are needed when
patients are injured by their mistakes.”
LL Leape, MD -JAMA 5/18/05 , http://www.allianceforpatientsafety.org/leape2.pdf "Why Pay for Mistakes ?
"
LL Leape, MD -Boston Globe 8/23/07,
http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/08/23/why_pay_for_mistakes/
" There is no
incentive for CEOs to achieve higher quality of care, as it would
reduce revenues for hospitals. ",
" There are some who believe that this whole system has to be blown up and started
over again, I happen to be one of those
advocates."see:
JCAHO President, Dennis O'Leary, MD, on 11/24/2002, http://allianceforpatientsafety.org/oleary.pdf
Indeed, the number of patients that die in Hospitals from
PREVENTABLE Errors, in the US and
California is beyond anyone's darkest nightmares, see:
1) Critical Condition: How Health Care in American Became Big Business
and Bad Medicine,
by Donald L. Bartlett & James B. Steele,
Download PDF
File, http://allianceforpatientsafety.org/bigpicture.php
" Yet one of the deadliest killers is not even
on the list.... The anonymous killer ? Mistakes "
" As for the drug-death mistakes alone, more
than five times as many people die from drugs prescribed by physicians than
from street drugs like cocaine, heroine and Ecstasy."
Donald L. Bartlett & James B.
Steele,
Download PDF
File, http://allianceforpatientsafety.org/bigpicture.php
Just look at these most conservative
estimates, over 6 Million patients died in the last 20 years:
2) "HealthGrades - Patient Safety in American
Hospitals", July 2004,
Study of Medicare patients, i.e. over 65
y/o, documents
evidence that: 600,000
patients die of medical errors in hospitals every three years, Download PDF File,
http://allianceforpatientsafety.org/bigpicture.php
3) Nutrition Institute of America Study
conclusion: 784,000 people die annually due to medical mistakes.
This study is based on 152 published peer review
articles.
For the last 50 years, US Doctors were subjected to
the most intensive orchestrated propaganda
campaign vilifying them and pointing the finger at them as the
sole culprit of all the wrongdoing in US Healthcare.
I am happy to report to you this is not the
case at all. Sure we have our share of rotten apples, but that's very limited.
Doctors are not the exclusive source of errors
in the Healthcare industry, far from it.
- Hospitals' CEO are at the origin of the vast
majority of Preventable Errors:
They control the number of nurses, pharmacists, physicians
on staff,... and monitor the quality of delivery of care. Yet, they are
the only ones who are not required to have any license, as Physicians,
Pharmacists, nurses, do.
NO CEO of any hospital is compensated according to
the quality of the delivery of care provided by its
hospital.
Under pressure from the California Hospital
Association, CHA, you and Governor Davis before you, blocked
the implementation of a law passed by CA's legislature mandating the ratio
of nurses per patient. CHA alleged that, if they had to comply with these
requirements, it would increase their overhead in such a way that they
may not be able to survive.
Guess what ?
It was not their overhead they were concerned about,
but their income, as it would have dropped due
to better nursing care, as it would
definitely reduce the number of preventable errors and complications.
Do you know which is one of the leading causes
of preventable deaths in hospitals ? - Falls !
1) Falls, occur when patients need to use
the bathroom and do not get response when using the call
button,
an attempt to climb out of bed
without waiting for assistance, is the main cause of broken hips,
and
leading cause of
accidental deaths in hospitals.
2) 1.5 million medication errors
cause 40,000 – 80,000 deaths / year.
3) 4 –6% of hospital patients
develop hospital acquired infections.
" Hospital errors cause more deaths than
car accidents, breast cancer or AIDS "
According to the National Academy of Sciences.
- Equipment malfunction:
" Dr. Charles Rosen, Chief of Surgery
of Garden Grove Hospital in California, learned from
hospital administrators that he'd spent months operating with
instruments cleaned by what appeared to be broken sterilizers.
Aware that the operating room sterilizers
were defective, the hospitals administrators were now
telling the Chief of Surgery how to explain the situation
when federal inspectors showed up for a big evaluation
the following day, because the hospital had an
unusually high rate of post operative infections.
Charles Rosen, M.D. resigned and went to
federal authorities.
Dr. Rosen was in for a major shock. JCAHO ignored the chief of surgery and
accepted the hospital’s explanation instead.
“ Here I’m telling them about
a major threat to patients and the blatant destruction of
documents and they just basically blow me off. They gave
the hospital a rating of 93. ”
Melissa Davis, TheStreet.com, 7/25/03 http://www.thestreet.com/story/10103544/1/whistleblower-wants-tenet-to-come-clean.html
How many
lawmakers believe that the conduct of this hospital administrator is
criminal?
But, No law was broken by this CEO, according to law enforcement
agencies.
How come ?
Yet, all lawmakers believe that the conduct of the following
peanut company CEO knowingly selling a contaminated product is
criminal, see:
“ We desperately need to turn the raw peanuts on our floor
into money.” email dated 1/19/2009 from the CEO of the Peanut
Company of America knowing peanuts
were contaminated"
http://www.allianceforpatientsafety.org/pca.pdf
Now you understand why US hospitals suffer from an uncommon epidemic of
MRSA,
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus.
There is NO excuse for such criminal conduct over 150 years after Dr. Ignaz Semmelweis pioneered the
prevention of transmission of disease by washing hands (Prophylaxis), in Vienna,
Austria.
He reduced the mortality rate due to
Puerperal Fever from 12% to ZERO by enforcing the washing of hands
with chlorinated lime.
For his contribution to humanity, Dr. Semmelweis was
committed to a mental institution where he died from
injuries that resulted from a beating by asylum personnel. http://www.whonamedit.com/doctor.cfm/354.html - Hospital
CEOs control Peer Review, as they determine which medical records will be NOT
be submitted to medical Peer Review, which physicians will be
compelled to leave their facility and which physicians will be
subjected to a B & P 809 Hearing,... Redding
California was a perfect example of the consequences of a premeditated lack of
peer review: In
1999, JCHAO, CMS, and California Dept. of Licensing Certification
discovered that peer review was not performed beginning, as early
as 1992 at Redding Medical Center, (RMC). Nonetheless all three
entities repeatedly certified or accredited RMC. Patient safety
at Redding Medical Center was compromised until the FBI raid in 2002.
Independent “ Blind folded study ” of Tenet revealed that: “
83% of cardio-vascular surgeries were… unwarranted at Redding
medical Center ” and “
59% of the bypass surgeries at Doctors Medical Center in Modesto were
… unnecessary ”
Melissa Davis 11/4/03, TheStreet.com http://www.thestreet.com/story/10124365/1/tenet-tangles-with-california-blue-cross.html
In June 2000, I was shocked when I discovered that the hospital I was on
staff at, Encino-Tarzana Regional Medical Center, was not providing
the medical records of certain physicians guilty of significant
deviations from the standard of practice for review to my
department's Peer and Chart Review Committee, see: " Rape of
the Peer Review Process by TenetHealthsystem ", Download
Transcript in PDF Format, see: http://allianceforpatientsafety.org/rprpusa.php #
25 Similarly to the Holocaust it took
many years for anyone to realize what was really going on, because the Nazis
did a very good job in disinformation with their Propaganda machine. At
the time, nobody in his or her right mind could imagine that any human
being was capable of such cruel and barbarian behavior towards any other
human being. Today, it is
very hard to face this hard core reality and acknowledge that a hospital's goal
is not exclusively to cure and heal, anymore than one could conceive
that a priest might be a pedophile. They say that
"Where there is smoke there is fire". That's only
true, if you are not dealing with a smoke machine. Allow me to
introduce you to the ultimate " Smoke Machine ",
Pittsburgh's Horty, Springer and Mattern, one of the
leading health care law firms in the United
States. Horty's firm has represented over 400 to 500 hospitals,... I
compare Horty & Springer to Joseph Goebbel and Heinrich
Himler's Gestapo, as they are the masterminds of US
Hospital administrators, attorneys,... i.e. the field
SS, teaching them their latest strategies,.they even draft our
laws, such as Congress' HCQIA, see:
Retaliation Against "Disruptive" Physicians - Methods and
Strategies - Sham Peer Review
http://allianceforpatientsafety.org/disruptive.php · 5. "Rules of fair play don't always apply."
- In going up against hospitals, physicians find the deck is stacked
against them. · 6. "Tactics Characteristic of Sham Peer Review" by Lawrence
Huntoon, M.D., Ph.D.
Journal of American Physicians and Surgeons Volume 14 Number 3 · 7. Excerpts from Horty and Springer's courses, website,
educational material,... · 8. Horty Springer Audio Seminar - A New
Approach for Dealing with the Disruptive Practitioner,
Read
More · 9. Horty Springer Audio Seminar -
Whistleblower or Disruptive Physician: How Do You Know the Difference ? · 10. More on Horty Springer Audio Seminars, Read
More · 11. Re-Engineering the Medical Staff, Simplification is Key by
Suzanne van Hall, Esq. How is it
possible when Hospitals' administrators and their attorneys assure you that
they are doing everything to protect our patients' safety ? After all, they
claim that they are liable for our patients' safety. Unfortunately,
this is one of the biggest lies you ever heard.
Joseph Goebbels, PhD observed that: " If
you tell a lie big enough and keep repeating it, people will eventually come to
believe it." J. Edgar
Hoover said: "The
individual is handicapped by coming face to face with a conspiracy so monstrous
he cannot believe it exists." Didn't the Nazis
tell everyone that they are taking the jews to retirement resorts in Czechoslovakia, where they are enjoying themselves
? " On June 10,
1940, the Gestapo took control of Terezín and set up the prison in the Small
Fortress (kleine Festung). By November 24,
1941, the Main Fortress (große Festung, i.e. the walled
town of Theresienstadt) was turned into a ghetto.[1] To the outside it
was presented by the Nazis as a model Jewish settlement, but in
reality it was a concentration camp. Theresienstadt was
also used as a transit camp for European Jews en route to Auschwitz. The arrival of the
Danes was of great significance, as the Danes insisted on the Red Cross's having
access to the ghetto. This was a rare
move, given that most European governments did not insist on their fellow
Jewish citizens being treated according to some fundamental principles.
The Danish king, Christian X, later secured the release
of the Danish internees on April 15, 1945.
The White Buses, in cooperation with the Danish Red Cross,
collected the 413 who had survived. On June 23, 1944,
the Nazis permitted the visit by representatives from the Danish Red Cross and
the International Red Cross in order to dispel rumors about the extermination
camps. They also erected fake shops and cafés to imply that the Jews
lived in relative comfort. Apparently the Red
Cross representatives were easily fooled by the Germans as the tour was
conducted by following a pre-determined path designated by a "red
line" on a map... the Red Cross formed a positive impression of the town.[3] The hoax against
the Red Cross was apparently so successful for the Nazis that they went on to
make a propaganda film at Theresienstadt. Production of the film began on
February 26, 1944. Directed by Jewish prisoner Kurt Gerron (a director, cabaret performer,
and actor who appeared with Marlene Dietrich in The Blue Angel), it was meant to show how
well the Jews lived under the "benevolent" protection of the Third Reich. After the shooting
of the film, most of the cast and even the filmmaker himself were eventually
deported to Auschwitz. Gerron and his wife were murdered by gas chamber on October 28, 1944." http://en.wikipedia.org/wiki/Theresienstadt_concentration_camp " Of the vast marority
of Czech Jews were imprisoned in Terezin, 80 percent of those were
deported to Auschwitz, Maidanek, Treblinka and Sobibor." http://www.jewishvirtuallibrary.org/jsource/vjw/Prague.html Similarly to
the Gestapo and US Senator Mc Carthy, Hospital administrators and their
attorneys terrorize all healthcare providers through a Chilling CODE
of SILENCE, FEAR permeates trough the whole health
care system. Many physicians
keep quiet on reporting errors and incompetence: “ 45% weren’t
always reporting impaired or incompetent colleagues ” - “
46% of
physicians who knew of a serious medical error were not reporting
the error, at least once, to authorities ” Institute of
Medicine 12/3/2007 “
Not even whistleblower laws, designed to give legal protection to
those trying to report wrongdoing, safeguard the doctors in
many cases. ”
“ Physicians who spoke upabout poor care faced reprisals,
including peer review hearings, demotions, temporary loss of
credentials, involuntary transfers or outright dismissal. ” The cost of
Courage: How the tables turn on doctors Steve Twedt, Post-Gazette,
10/26/2003, http://allianceforpatientsafety.org/twedt-cost-of-courage.pdf
As Lincoln said: "You can not fool everyone, all the
time." Dear Governor
Schwarzenegger, You
know how guilty the american jewish community feels due to the fact that they
did not do as much as they could have to assist their brethren
in the Holocaust. Do you
want to feel the same way regarding what you could have and should have done,
when you were Governor of CA ? Igerntvu
moust toch eine grenze zein ! ! Here is
your opportunity to play the role of "The Terminator" in real life,
as the "Governator" of CA, like the Danish king, Christian X did
for the Danish jews in Terezín.
That's what Los Angeles County Supervisors did recently:
" L.A. County supervisors want to see doctors' peer review documents
from hospitals.
They cite patient safety and malpractice claims. Hospital administrators
are opposed."
By Molly Hennessy-Fiske, Los Angeles Times, August 28, 2010. " The biggest issue for me is the
risk management aspect of it — that is, let's not do it again, Molina said. "Because if you
don't know, you can't correct it."
http://articles.latimes.com/2010/aug/28/local/la-me-peer-review-20100828 In fact, LA County
Supervisors simply apply the basic "Four Eyes" audit
principle pioneered by City Chamber and Tax Office Counter-Agent
named Leopold Wätzinger 3) from the city of
Linz, Austria. A counter-agent is
not someone who works against or hinders something, the Faustian-like spirit
that always negates everything, which is sometimes unjustly attributed to
auditors, but rather a counter-accountant following the
principle of four eyes, an auditing official in the positive sense 4). http://www.linz.at/english/life/CCA_history.asp The introduction of AB 1235 reads like
a political pamphlet with all the right slogans, but the Devil is in the
detail. AB 1235 is a beautifully gift wrapped,
chocolate coated deadly Poison Pill, a Trojan Horse. In the name
of Tzedaka, meaning "righteousness" in Hebrew, http://en.wikipedia.org/wiki/Tzedakah
and Tikun Olam, "repairing the world" in Hebrew,
http://en.wikipedia.org/wiki/Tikkun_olam, you
must VETO AB 1235. I
hereby, incorporate all of my previous letters to you urging you to VETO AB
1235. Respectfully
submitted, Gil Mileikowsky MD -
President and Founder of http://allianceforpatientsafety.org/ - http://allianceforpatientsafety.org/socalphysgm.pdf " All that
is necessary for the triumph of evil…
… is for good men to do nothing."
Edmund Burke |