Labels: ambition, education, school

Like most people, I've been getting 'health care scare' emails, and after a string of replies that consisted solely of links to Snopes articles, I was sent a link to a Snopes article from a certain Dr. Janda. While it's good to see people slowly learning to do at least a little checking, the Snopes article only claimed that it was "correctly attributed," and didn't do any fact-checking on the content of the article.

Snopes had two versions of the piece he had written - the email forward version, and his original. I am not even going to bother reading the forwarded email text, since those inevitably get garbled, but rather the original text that was provided to Snopes.

The basic structure of his article (essay? writing? screed?) goes like this:

• Introduction to him as a doctor and expert
• Assertion that ObamaCare in came 2 parts, starting with the Stimulus bill
• Issues a warning that ObamaCare is as certainly dangerous like smoking
• Discusses Comparative Effective Research:
• ObamaCare cuts costs through rationing
• The FCCFCER is inhumane and overpaid
• There is a formula for Comparative Effective Research: Cost per treatment divided by number of years patient will benefit
• Cites Betsy McCaughey that the standard will have the effect that "if you are over 65 or have been recently diagnosed as having an advanced form of cardiac disease or aggressive cancer, [you'll die]." Says this is on p.464 of the Stimulus
• The plan is the same models as in Britain
• The purpose of Center for Comparative Effectiveness Research is to slow development of meds and tech (HC bill Section 1181, p.502)
• Claims that the Stimulus Bill p 116, 442, 446 guides decisions at the time and place of care; defines penalties for breaking gov't protocol (Stim 366, 478, 511, 518) including prison; claims that Stalin did this.
• Claims section 102 of the HC bill illegalizes private insurance.
• Claims Obama didn't know about section 102
• Claims sec 1233 HC bill mandates counseling every 5 years (annual if chronic illness), and designed to end life sooner.
• Claims topics of these sessions include how to deny hydration, nutrition and initiating hospice care. Claims Obama "hates" prevention.
• Concludes the proposed system is "fascist".

Let's take this one piece at a time, shall we?

• Introduction to him as a doctor and expert
  Dr. Janda begins by telling us that he has "authored books on Preventative Health Care and Health Care Cost Containment." Now, I'm not sure why he decided to capitalize everything, but he has written books on preventative care and health care cost containment. That book was about cost containment in the context of sports injuries, not macro-level policy; so this is mildly untrue but I liken it to padding a résumé. Fine. He gets a pass because everybody on Amazon liked the book. Then he mentions he was presenting "Health Care Reform; The Power & Profit of Prevention" as a keynote speaker at a Congressional Dinner at The Capitol in Washington, D.C. This is odd because that that title is often given as the title of the very text we're reading. Again, this is technically true, but why not just say, "I presented the following presentation"? Strange. Also, I couldn't find a record of this presentation, which is also odd because you'd think it'd be mentioned somewhere by someone for as important as he makes it sound.
  
  Summary:
  True, in the way that most résumés are true.
  


• Assertion that ObamaCare in came 2 parts, starting with the Stimulus bill
  He asserts that the Stimulus was the first part of the health care plan, but doesn't tell us anything about what it did. He cites page 152 (you can read it here), which is a continuation of §13405, "Restrictions on Certain Disclosures and Sales of Health Information" section, specifically the part about disclosures that are required if the hospital or whatnot uses electronic health records. This has absolutely nothing to do with the creation of a new arm of the U.S. Government.
  
  Now, a good writer would have simply told us what he was talking about. I am inferring here that, when he talks later about the Federal Coordinating Council for Comparative Effectiveness Research, which is established by the Stimulus, he means that they are this first part of the Health Care bill.
  
  The problem is that he's conflating a research body with the creation of a Health Care System. This is especially bad because (as I detail below), the FCCCER is absolutely toothless; it has no power to mandate anything at all. Now, why he would lie about something like this, I have no idea. It really has no place in the argument other than maybe adding a little paranoia that Obama slipped something by us.
  
  Summary:
  False, and poorly written to boot.
  


• Issues a warning that ObamaCare is as certainly dangerous like smoking.
  I suppose there might be some creative parallel between smoking and a health care insurance reform bill, but this isn't it.
  
  Summary:
  Non-sequiturs and hyperbole are signs of weak writing. So far this is shaping up to be a pretty poor essay.
  
  
• Discusses Comparative Effective Research:
• ObamaCare cuts costs through rationing
  The biggest problem with the bill is how to pay for it, and I am honestly worried about that aspect myself, but rationing of care will happen no matter what plan is in place — right now, heath care is rationed away from people who aren't incredibly rich, and get sick (sadly, this is most people). Health insurance companies do things to get out of their responsibilities (pre-existing conditions, lifetime and yearly caps, etc.) and thereby ration heath care with little regard for the morality or even responsibility of their role as insurers. Not only does Dr. Janda not back up this claim with evidence, the very problem with the current system is that it is rationing health care in a way that makes every single person vulnerable to death-by-denied-claims.
  
  Summary:
  A red herring at best, an intentionally misleading lie at worst.
  


• The FCCFCER is inhumane and overpaid (or generally that $1.1B is too much money for research stimulus), and run by "ivory tower" bureaucrats.
  Here is the Federal Coordinating Council for Comparative Effectiveness Research. The Council "provides information on the relative strengths and weakness of various medical interventions. Such research will give clinicians and patients valid information to make decisions that will improve the performance of the U.S. health care system."
  
  Page 73 of the Stimulus Bill (§804 (b)) creates this Council with this purpose: "The Council shall foster optimum coordination of comparative effectiveness and related health services research conducted or supported by relevant Federal departments and agencies, with the goal of reducing duplicative efforts and encouraging coordinated and complementary use of resources."
  
  The $1.1 Billion is money that is directed towards research, and one of this team's jobs is to direct that money to places that will keep the U.S. at the forefront of medical technology. That's a lot of money for a lot of white-collar jobs that patent a lot of high-value technology, which is I think an extremely good place to put stimulus money. The Council is also limited to use at most 1% of their total budget for staff and administrative support ((§804 (f)). 99% has to go to research.
  
  As to whether they're bureaucrats, the bill does state that they must be "senior federal officers or employees," but Dr. Janda omits the rest of the sentence. The full sentence is: "The Council shall be composed of not more than 15 members, all of whom are senior Federal officers or employees with responsibility for health related programs, appointed by the President, acting through the Secretary of Health and Human Services (in this section referred to as the "Secretary"). The appointment by the President means that they are members of his Cabinet.
  
  As for who was chosen: They are mostly clinicians, but also have the Chief Policy Officer for the Center for Disease Control, a Rear Admiral, and other "that makes sense" places. All but 2 have M.D.'s. The qualifications also require that "[a]t least half of the members of the Council shall be physicians or other experts with clinical expertise" (§804 (d)(2)(B)), with senior members from seven various health care-related agencies including the VA ((§§804 (d)(2)(A)(i-vii)). Based on their credentials, and the continuing requirements for the members, the claim that they're just random government bureaucrats is also false.
  
  Finally, it is difficult to imagine how this entity could be inhumane, because their sole purpose is to fund research based on what they believe is most important to doctors. As noted below, they do not have the power to mandate any kind of care or procedure.
  
  Summary:
  All of the claims in that almost-incoherent paragraph are wild, terrible lies.
  


• There is a formula for Comparative Effective Research: Cost per treatment divided by number of years patient will benefit. Cited as "Section 9201 H.R. 1 Version of the Stimulus Bill."
  
  There is no Section 9201 in that bill. The phrase, "Federal Council" never appears in that bill. I can't find this formula anywhere on the Internet or in the bills — only in this chain mail. Moreover, the Council cannot force anybody to do anything to any patient, because the last thing the Stimulus section that established it has to say about it is this:
  
  (1) COVERAGE. — Nothing in this section shall be construed to permit the Council to mandate coverage, reimbursement, or other policies for any public or private payer.
  
  (2) REPORTS AND RECOMMENDATIONS. — None of the reports submitted under this section or recommendations made by the Council shall be construed as mandates.
  
  Summary:
  A HUGE lie.
  
  
• Cites Betsy McCaughey that the standard will have the effect that "if you are over 65 or have been recently diagnosed as having an advanced form of cardiac disease or aggressive cancer, [you'll die]." Says this is on p.464 of the Stimulus.
  There is no page 464 of the Stimulus bill, which is 407 pages long. Also, being diagnosed with various terminal diseases is already something that insurers deny coverage for all the time. That's part of the problem. That's why people are proposing reform.
  
  Also, Betsy McCaughey is a terrible, terrible person to cite about health care since she's been willing to lie about health care reform for a long, long time and never really stopped: she's the one who came up with those ridiculous death panels!
  
  Summary:
  Exploring bottomless new levels of calumny.
  


• The plan is the same models as in Britain.
  I haven't been able to find a clear yes or no on this; I heard somewhere that it's not that same (that it's less government-centric), but I can't cite where I heard that.
  
  Summary:
  Not sure. Given the track record of the essay so far it'd be a small miracle if it were true.
  


• The purpose of Center for Comparative Effectiveness Research is to slow development of meds and tech (HC bill Section 1181, p.502)
  That section says that the Center's mission is to "conduct, support, and synthesize research ... with respect to the outcomes, effectiveness, and appropriateness of health care services and procedures in order to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically." It then talks at length about how it will do that (via gathering official data, creating forums, etc.). The group is essentially a data-gathering and disseminating unit.
  
  How that inhibits development and research is anybody's guess since they aren't given any strong-arm abilities.
  
  Summary:
  False.


• Claims that the Stimulus Bill p 116, 442, 446 guides decisions at the time and place of care; defines penalties for breaking gov't protocol (Stim 366, 478, 511, 518) including prison; also claims that Stalin did this.
  Page 116 is about the promotion of heath information technology.
  Page 366 is about how hospitals can report their data using.
  None of these talk in any way about guiding medical decisions.
  Pages 442, 446, 478, 511, and 518 do not exist because the document is 407 pages long.
  
  Summary:
  False, and apparently Stalin is the new Hitler.
  


• Claims section 102 of the HC bill illegalizes private insurance and that Obama didn't know about section 102 when asked in an interview.
  In his essay (I'm using the term loosely at this point), Janda uses the following response from Obama to claim that he didn't know that the plan would illegalize private insurance: "You know, I have to say that I am not familiar with the provision you are talking about." But Dr. Janda omits the following: "I'll — let me just speak for the Obama administration. I have committed myself consistently to a very simple proposition: If you have health insurance, and you like it — and you have a doctor that you like — you can keep it. Period. And I won't, uh, sign a bill that somehow would make it tougher for people to keep their health insurance" (here's the source).
  
  Section 102 is on page 16 of the bill itself (which is here). It basically says that insurers' plans don't have to follow the health care rules (on cost, care, etc.) if the plan is grandfathered in by being active for 1 year beforehand. Dependents are allowed to be grandfathered in with the primary insured person. The insurer also can't jack up their grandfathered insurance plan coverage rates or reduce benefits after they're grandfathered in (§102 (a) 1 to 3). This doesn't apply to limited-benefit plans that I frankly don't understand in (§102 (b) 1 (B)). The following section (§111) is the rules that insurers have to follow for all their new (not grandfathered) plans.
  
  Summary:
  Wildly false, to the point where I wonder if they actually read this section or just picked a number at random.
  
  
• Claims §1233 HC bill mandates counseling every 5 years (annual if chronic illness), and designed to end life sooner. Also claims topics of these sessions include how to deny hydration, nutrition and initiating hospice care. I won't really go into this whole "death panel" thing much, because it has been disproven and discussed over and over and over and over and over and over and over and over and over and over and over and over and over and over.
  
  Summary:
  No points for guessing — false.
  


• Claims the proposed system is fascist.
  Fascism is a lot of things. In short, it's highly eugenic, emphasizes government power, is corporate, and aggressive. I can almost see how Dr. Janda might see something like that in his distorted and frankly insane characterization of the health care bill. But unfortunately, that's all it is: insane.
  
  Summary:
  Justification for institutionalization.

GENERAL SUMMARY:

This is absolutely full of distortions and lies. And actually the more I read it, the more unhinged I realized it was. When I first read it, I thought it was at least relatively sane, in that it sort-of had a structure and didn't misspell things. But after really breaking it down and looking at the arguments, I have to say this person is either intentionally distorting the truth, is completely insane, or more likely is just like so many other Americans who'll believe anything they hear if it's said at high enough volume and justifies their most ludicrous fears.

Now, I've managed to hold a regular 40-hour-a-week job, plus some side freelance work, start setting up my new house — bought with help from the stimulus — write an album, and clean up the house from time to time, all while still learning all this stuff. And I'll tell you, it took me a whole lot more time to write than to read all this.

Yet somehow I don't think the people yelling at the town halls are taking the time to do even a fraction of the research I've done here. Hell, it took me as long as it did to get this written because it took forever to track down every ludicrous claim this quack misinformed doctor came up with, or that he was told. But I did this because I love my country, and I'll be damned if I'm going to let people like him screw up necessary reform by lying.

Be a patriot. Be informed. Forward this to whomever sent Dr. Janda's screed to you. Maybe it will eventually get back to him.

I would LOVE to see what he has to say.

Labels: conspiracy, David Janda, health care, idiots, lies

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