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home about comments contact us daily choice resources subscribe healthcommentary exploring human potential why is lamar alexander (r-tn) confused? posted on | august 23, 2018 | no comments mike magee the medical-industrial complex in the united states is expert at feigning cross-sector competition while quietly signaling to members that there is plenty of graft and profit in the $4 trillion (20% of gdp) for all. the net output, more evident than it ever was in the days of ’90 era “harry and louise” efforts, is a hidden syndicate and a confused congress and public. consider the sham battle currently between pharmacy benefit managers (pbms), health insurers and phrma. their public finger pointing at each other disguises a deep financial conspiracy that is more than skin deep. the goal is to profit while you confuse. and it’s working. one frustrated health care lobbyist complained this week, “there’s a reluctance to push congress in one direction or another until we understand where they’re going.” wake up call: you’ll never understand – that’s the whole idea. sen. lamar alexander (r-tn) is chair of the senate health committee and is as confused as everyone else wondering aloud whether we need pbms at all. answer: no. why? pbm’s are the offspring of merck, cvs, and unitedhealthcare who decided that their was money to be made, shaving off the top, in data manipulation and supposed cost-containment. don’t be fooled by the fact that pbms have their own lobbying association now – the pharmaceutical care management association or pcma . they’ll spend about $6 million this year on confusion campaigns. but the top guys – cvs health, express scripts, and unitedhealth group – have ponied up another $6 million themselves individually – all while their parent companies fund phrma and the health insurers who they are supposedly opposing. can you spell “collusion?” trump and hhs secretary alex azar could learn a thing or two from the various medical-industrial complex sectors about the “art of distraction”. they’ve been able over two decades to get americans to spend twice the amount of all other developed nations on health services while mothers and children die in childbirth at astounding rates, white male survival curves have turned south, and hospitals have become the 4 th leading cause of preventable death in the u.s. instead of getting drawn into the faux-battle between pbms and their hidden parents, or debating how to buy cheaper drugs from canada, we need to stop with the incremental reform and just get on with a total reboot. for pharmaceuticals for example, here are three easy steps : 1. governmental aggregate purchasing. 2. value based evaluation of an essential drug list by independent government experts who are unconflicted. 3. annual prices set for all drugs on the list using a system of “reference pricing” as they do in europe and canada. category: pbm , pharmaceuticals tags: alex azar > drug costs > health care syndicate > lamar alexander > medical-industrial complex > pbm > pcma > pharmacy benefit manager -- key question for catholic hierarchy: “is celibacy the problem?” posted on | august 17, 2018 | 8 comments mike magee in the british medical journal in 1950, “expert” dr. s.l. simpson stated without evidence that “it is perhaps of clinical interest that for every one case of organic impotence that comes my way, i see at least 10 of psychological impotence.” three decades later i published a paper in the journal urology titled “psychogenic impotence: a critical review” . in that paper i argued for the use of scientific nomenclature (“erectile dysfunction” versus “impotence”), additional research to define the physiology and pathophysiology of erectile function and dysfunction, and for the demystification and greater transparency around this essential bodily function. as is clearly evident in this week’s stunning disclosures of system-wide abuse touching thousands of young lives in pennsylvania, is that the catholic church’s problem is systemic. the three failings that victimized those suffering from erectile dysfunction, namely sloppy nomenclature, weak or absent research and non-transparency, have now trapped leaders of the church in a downward spiral. the critical question that remains unanswered is whether the church’s practice of enforced abstinence from sexual activity, either by skewing selection for the priesthood, or by subsequent creation of deviant behaviors and a range of mental illnesses, creates an unacceptable risk for the future priests and for their parishioners. words matter in science. celibacy? what exactly does it mean? it is a religious, not a scientific term, surrounded by controversy. it is derived from the latin word “caeleb” which means single. some interpret it to mean “unmarried”; others define it as “refraining from sexual intercourse”; and others still believe a celibate life commits one to refraining from all sexual life including masturbation and sexual ideation. this lack of basic agreement on the meaning of fundamental definitions, as with the definition of “impotence”, cripples scientific research from the onset. if the nomenclature is weak, so is the body of research. what passes for research in this field, on both sides of the argument, is as weak and unsubstantiated as was dr. simpson’s opinions on “psychological impotence” in 1950. research has been hampered by limited access to the priests who are the subjects, poor study design, and rapid labeling of scientists who would dare tread into this dangerous minefield. as a result, we really don’t know whether mandating control over expression of one’s natural sexuality results in higher rates of sexual abuse, mental illnesses including depression and crippling anxiety, and higher then normal levels of drug and alcohol abuse compared to comparative control subjects. finally there is non-transparency with its clear record of institutionalized cover-up, information released in bits and pieces under duress, secrecy and the force of litigation which could threaten the church’s survival. so, drawing on my past experience, and as a roman catholic who would like to see the church survive and become healthy, here are my suggestions to the church’s leadership. first, make your priests available to researchers to rigorously and scientifically study the connection, if any, between mandated restrictions on adult sexual function and abnormal sexual behaviors and mental illness. as a derivative of this research, as occurred in the study of erectile function, rigorous scientific terminology to define the meaning of “celibacy” will be well defined. second, commit to the publication of these peer reviewed studies, whether positive or negative results. finally, should it be determined that this practice of restricted sexual expression places the priests themselves and their parishioners at risk, commit to eliminating mandatory sexual abstinence as a prerequisite for entry into the priesthood. if careful scientific examination is able to establish that the risks associated with this practice far out distance the benefits, have the courage to admit and correct the error, which is certainly the road that christ would travel. category: public health tags: celibacy > pennsylvania sexual abuse > priests > prist abuse > roman catholic > sexual abuse -- when coders lose their jobs. posted on | august 15, 2018 | no comments mike magee with health care now consuming close to 1 of every 5 dollars in america, it comes as no surprise that the sector is a major employer. no surprise either that many of those jobs deliver zero benefits when it comes to patient care. in fact, there are now 16 health care jobs for every one physician , and 8 of those 16 are non-clinical. were we to proceed with a centralized health insurance system, while preserving local choice and autonomy over care delivery, estimates are that we would shave up to $1 trillion off of our nearly

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