Thursday, January 22, 2009

Medco's David Smith, Jr. urges feds to stop care for sick & elderly

Yes, I know, the title of my posting is a bit traumatic. But it is also very much true. Mr. David Smith, Jr. says that determinations about appropriate medical care cannot be left to physicians! What?

Is Mr. David Smith, Jr. (Medco's CEO) going to be awarded an honorary MD?

Let's think about what HHS Secretary (nominee) Tom Daschle's buddy Mr. David Smith, Jr. (CEO of Medco) thinks about the future of Medicare:

Fix Medicare

Culturally, we are conditioned to expect and implement heroic methods, even in cases where treatment is futile, and often resulting in unintended negative and painful consequences for the patients and devastating financial consequences for Medicare. This inherently uncomfortable issue forces us to confront our own mortality and requires strong leadership with candid conversation – it can’t be left to doctors, hospitals, or insurers. Government needs to set policy and establish rational rules for the level of care based on medical science – it’s not the private sector’s role to pass judgment on hope. Protocols based on scientific standards would ease the burden on families, physicians and, yes, patients. This is not withholding or rationing essential healthcare – it’s stepping up to the important and necessary reality so that resources are available to those who can be helped.

Wellness and Prevention

Here’s where we must have inspired and credible political leadership to fill the current void and raise the collective national consciousness.

Most of us can remember how government-led campaigns changed behavior through vivid imagery that etched into our memories messages with impact: Smokey Bear’s sad reminder that “Only you can prevent forest fires”; the crash-test dummies Vince and Larry, serving as a testimonial for seatbelt safety by suggesting that “You can learn a lot from a dummy”; …

The private sector can never be expected to drive behavioral change, although we’ve seen employers make valiant attempts at implementing programs to lower healthcare costs – efforts that unfortunately are doomed to fall short. These range from positive reinforcement – discounted health club memberships and bonuses for employees who meet certain fitness targets – to surcharges for employees who smoke. Meantime, HMOs and other insurers have adopted low- or no-cost preventative programs for baby wellness visits, routine check-ups, mammographies, and other procedures that are designed to detect issues early instead of simply providing treatment after the fact. Such initiatives are only likely to succeed if we make wellness a national imperative, something that requires political leadership and personal responsibility. In the end, each of us must take on greater accountability for making positive choices in our lifestyle.

Mr Snow’s complete presentation is available at

Where is the AMA? Where are the other related medical societies. And, more importantly, where are the physicians and surgeons who "just want to practice medicine"?

Americans should be careful. Physicians should take back their profession

1. Have you Goggled "hospitalist" yet?

2. When you go to the hospital, do you even know your medical team and their qualifications (if any)?

3. Have you checked to determine whether your physician and surgeon is board certified? (

4. Do you get (I mean really get) that businessmen and politicians are planning on taking over the delivery of medical care?

It is not going to to be open to public debate. The implementation of the "Hospitalist Program Model" was never even explained to the general public.

5. Have you found out whether your local hospital is owned by a corporation that exists states away from you?

Does that seem right to you? Who do the physicians work for and answer to? Not you.

6. Have you asked your own physician and surgeon what his or her position is on socialized medicine?

Remember, the US Government now owns priority shares of banks! The US Government owns the banks. Did we ever think that would happen? And it is the priority share holders (not the common share holders) that get the dividends.

It is ironic to me that David Smith, Jr. (Medco) and Former Senator Tom Daschle (who is in search of his own legacy) contend that Medicare is a perfect example of how the Federal Government can provide medical care . . . however David Smith, Jr. states that

Government needs to set policy and establish rational rules for the level of care based on medical science – it’s not the private sector’s role to pass judgment on hope
So who exactly will decide when old or sick people die? The CEO of Medco?

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