The Obama Health Care Plan Will Make You Sick

It is interesting that the Obama health care plan will cost more than 1.5 trillion dollars according to the Congressional budget office when European nations are able to provide universal care for their entire population at much less than ½ the cost. This only points out the reality that the Obama plan is nothing more than a political expedient which benefits the insurance industry (depending on which plan you read) , the Trial Lawyers Association, and the substantial minority of congressmen and senators with financial investments in the health care industry. Who loses? Doctors, hospitals, pharmaceuticals, and YOU the taxpayer, YOU the consumer, YOU the recipient of health care, YOU the repayer of the national debt. Why is ABC giving the President an evening on television to promote his health care bill and refusing to allow debate or dissenting points of view? Why is the Kennedy committee in charge of writing a bill that has already failed during the Clinton administration and has no chance of bipartisan support, let alone represent the interests of the American public.
Have you noticed that senior citizens and AARP are largely silent on the issue? They could control the political tide, but President Obama has cleverly kept them out of the fray by exempting them from participation in the program. And why has Congress exempted itself out of the program? BECAUSE THE PROGRAM STINKS!
A look at successful programs in Europe and Asia gives us a blueprint of what does work. And in these programs 35 million people which the Obama plan excludes are covered.
1. A universal government sponsored program provides basic health care for all citizens
2. Employers are not coerced to buy insurance for employees at inflated prices
3. Individuals have the right to individually purchase additional health care insurance at their own discretion
4. Care is rationed according to need and financial ability to pay. Yes, rationed. In this country 90% of the individual health care dollar is spent during the last year of life. Does that make sense?!! No wonder the President exempts senior citizens. His program wouldn’t have a chance in hell of passing if he told seniors they can no longer get exhorbitant life extending care. The chief consideration that seems to dominate the social landscape is what’s in it for me. Kind of like the Congress.
The only way to evolve a rational health care policy for the nation is for the public to vote with their feet: write letters to Congress; talk among ourselves; vote congressmen out of office who vote for a program in which they will not participate.

Technology Got Me Down

As a technophobe I suffer from all of the insecurities and indignities of anyone ignorant of modern technology. In a reversal of the ancient rituals of respecting the elderly and indeed of seeking out the wisdom of the elderly I have to turn to my young daughter to operate my computer, to decipher software, and to even make me aware of what is now possible. It is enough that the modern age forces me to have 3 attorneys each of whom specialize in separate areas of law; I now have my computer consultant, my computer savvy daughter, and my computer using staff to advise and direct me. Then I have my web-advisor, my SEO specialist, and my web designer and web master. In fact they keep me in touch with the cyber world in which I participate. So you will excuse some of my skepticism as I ponder what are the advantages and disadvantages of this technologic wizardry.
While fascinated by the computer and the web and grateful for the power it gives to the individual versus the organization, has the mechanism advanced so far beyond the message that we risk losing an even greater proportion of our children to ignorance and zombie-like behavior. Web3.0 technology, my daughter tells me, is about to become available for the household. This technology is now being used on CNBC to bring data into a 3-dimensional cube with the wave of a show host’s finger. We saw this same technology on election eve when the vote tallies were being evaluated by states and regions and ethnic affiliations. Yet did the message change? At the end of the day, no matter how fascinating the presentation, Barak Obama still had the majority vote and the majority of the Electoral College. The message would have been the same whether an analyst had written it on a ledger sheet as Tim Russert did in the Nixon election, or whether Tom Brokaw used the dazzling impression of three dimensional technology on television.
The United States stands apart as the most advanced and wealthy country in the industrialized world. Yet our children test last in aptitude and achievement scores of the 7 largest industrialized countries of the world. Our gifted students rank last among these countries in terms of aptitude and achievement. Where will imagination come from if every child walks around robot-like, transfixed to the music transmitted to his ears through his iPod. Can anyone drive an automobile without talking on his cell phone? Can anyone date without on-line dating (I couldn’t)? Does everyone need reality TV because they don’t have a life?! Is it not apparent that our children read poorly, write poorly, and speak poorly? And I am communicating with some of our brightest students on the north shore of Chicago.
The greatest social advances, medical advances, philosophic advances are meaningless out of context and if not applied to appropriate situations. Why is technology different?

By the way my computer crashed this weekend and I had trouble with the firewall on another computer. I need to call Pete to get this fixed right away!

My wife wants a new set of dining room chairs

My wife wants a new set of dining room chairs. She says our old chairs are not good because if she leans back in the chair her clavicle falls through the openings at the back of the chair. She doesn’t know that her clavicle is in the front of her body. That really wouldn’t matter to her anyway, and if I told her where her clavicle is she would say that when she falls through the chair her whole body falls backwards and so her whole clavicle falls through the chair and that is why we need new chairs.
Isn’t that the way it is? We want something so we think up a reason to justify our want. I want to play golf with the guys. Of course that isn’t what I say. I say I want to get out in the sunshine and admire the beauty of the golf course. God created mountains and sea to admire and behold. Arnold Palmer made golf courses to admire and behold. God’s magnificence is free, Arnold charges.
Everyone agrees that beauty comes from within. A smile is worth a thousand words. Clichés yet true until we look in the mirror. My wife says she likes my protruding belly. I sure don’t. Short is a huge advantage because short people try harder and probably we are smarter. I never feel that way when I am sitting behind a tall person at a concert or when I used to play my version of basketball. Bald is beautiful. Guys with lots of hair waste so much time grooming. This works until I look at the pictures of the past presidents of the American Academy of Cosmetic Surgery and I am the only one with the reflection off my head.
Look, it is good that we like what we like and want what we want. I think perspective is what counts and priorities must be set. It is appropriate to want a youthful face. Cosmetic surgery is a blessing. Then don’t lie in the sun and argue you look better when you are dark. Liposculpture is a huge promoter of self esteem. Then don’t tell me that your biweekly tennis game is exercise and the weight you have gained is muscle. Enjoy who you are and take care of the blessings you have.
I am still figuring out how to convince my wife it is good that her clavicle falls through our dining room chairs.

You Don't Need a Doctor

A funny thing has happened to the medispa industry. They now feel you don’t need a doctor for your cosmetic medical and surgical needs. Their thinking and marketing promotes technician expertise to the public. They often have an emergency room doctor or other non-cosmetic trained physician listed as a medical director. This legitimizes the practice of medicine in the medispa according to state requirements. Often they employ nurses or other paramedical personnel but as near as I can tell a squirrel with its fur shaved is still a squirrel and a nurse who takes a job as a sales lady is still a saleswoman.
About 8 weeks ago I got a call from one of these spas asking if I would be interested in working with them. The deal is they sell surgery to a client for an average fee of $10,000.00 (according to the spokesman who had contacted me) and they schedule the surgery at my surgicenter. They pay me $1500.00 to perform whatever surgery the salesperson has sold the client and after Drs Lack, Rachel, or Franco take care of this person the client returns to the medispa. I actually forgot about the offer until 2 days ago when I consulted with 2 patients who had already had consults at that medispa and had come for a second opinion. Both related the same story. The saleswoman at the spa listened to their requests and outlined a surgical plan. They were each told they would meet the doctor the day of surgery and they were not given the name of the doctor. There was no attempt at education and no discussion comparing risks and benefits and no pictures of before and after patients. One of the patients was quoted $20,000.00 for her fee, but was offered a 50% discount if she would sign up that day. I forgot to ask the second patient what her charge was. Both patients were unhappy with the interview they had received and both said they would not have surgery performed by such a clinic.
Questions arise in my mind:
Why would someone go to a medispa for surgical concerns?
Why is this business venture not prosecuted by the state as fee splitting?
Why are so many doctors employing paramedical technicians to inject fillers and Botox? Are they mimicking the medispa business plan: profit at any cost? What is their training in injections, dosing, methodology, taking care of complications?
What about doctors who do Botox parties. Are patients receiving good medical care or is this the new spa mimic?
Idle thoughts:
You get what you pay for in life
Generation Y, ala Obama administration, is changing the way society seeks expertise and evaluates it. You think I exaggerate? Think about what the Clinton administration did to sexual mores and the proliferation of sexually transmitted diseases among young people. Think about the apathy of the Bush administration and the desecration of small business and subsequent recession.
Edward Lack MD

An Ode to Cellulite: Can a Cure Be in the Offing

Cellulite: Your dimpled past
Has left onlookers quite aghast
When you show your puckered face
The bearer feels herself disgraced.
Away you beggar, you sloth of vision
I will erase your every impression
Whether by sleuth or slight of hand
Your fate is sealed to my command!

Were that I could will cellulite away, I would be rich, I would be famous, I could be King. Alas, it is not yet to be, but not for lack of trying. I had a technique in 1995. It never failed ... except that 3 months later the problem returned. Cutting the fascial fibers that cause cellulite always resolves the problem, a problem I might add that is almost unique to women. It appears that the anchoring fibers from the muscle to skin run more perpendicular in women and more horizontal in men (no aspersions to men behaving in a more predictable straight line and women up and down). Also men have little subcutaneous fat and get beer bellies instead. Women store fat beneath their skin, ostensibly as a competitive advantage to child bearing (as in most things female I am willing to concede this advantage and wish no part of it).

So I have a new solution. Dr. Mitchel Goldman at the University of California, San Diego and I have separately treated several cases of cellulite using laser lipolysis (smartlipo at MetropolitanMD) and the results have been excellent. Once again the technique involves cutting the anchoring fibers inserted into the skin. Then I heated the fibers and the overlying skin by warming injected tumescent fluid with laser energy. The heat presumably shrinks the skin, but I do not think that is the mechanism for treating cellulite. I am guessing that if the fibers are altered in some way they will not re-attach to the skin. I have now treated 4 patients, two of whom were thin and two of whom had excess subcutaneous fat. All 4 patients were pleased with their results. The patients are now up to 3 months post surgery and I will closely monitor these results. I am in a quandary whether I would prefer wealth or fame if I solve this problem. Any suggestions will be appreciated.
Edward B. Lack MD

Sun Tan Parlors and Skin Cancer

Suntan parlors are still poorly regulated, poorly understood, and full of misrepresentations to promote their industry. K, a patient at the offices of MetropolitanMD for several years, went to a suntan salon several weeks ago. She likes to go to suntan parlors because she thinks she looks healthier with a bronzed skin color. On that day she felt some burning of her right ear, right neck, and right shoulder after the treatment. She called an employee to examine the lamps to which she had been exposed and they found one of the lamps was cracked. The next morning she had blisters over her right ear, right neck, and right shoulder and intense redness and pain. With medical care the burn subsided over the next week. The suntan salon gave her coupons for free treatments in the future. I wonder how successful they would be if they advertised that patrons could come to their booths to get cancer and if they get cancer they could get coupons for free treatments to get more cancer!
The suntan industry has long been guilty of misrepresentations and outright lies. The National Institute of Health has noted that after UVA suntan treatments changes in the white blood cell count of helper to suppressor cells reflects the same defective reversals as that found in HIV patients. This got something like a page 12 notation in the Chicago Tribune and little attention after that. Skin cancer is the most common cancer in the United States and the 7th leading cancer killer. The incidence increases every year.
This year, with the help of what appears to be several misguided medical groups, the suntan industry is promoting tans to treat vitamin D deficiency - a disease which is not normally known to exist in the industrialized world! These groups cite associations with diseases that have yet to be proven, such a colon cancer. Think about it. How many people with colon cancer have worn red sweaters. Might we infer that red sweaters cause or at least predispose one to colon cancer? Shall we conclude that an arbitrary level of vitamin D which is not found normally in humans is preferable to skin cancer? Shall we conclude that 1/2 truths are better than no truths so we should change our habits to accommodate the marketing objectives of a private industry?
And while we are at it, may we remember that the love affair with sun tans is less than 100 years old compared to the millenia of human existence where the advantages of Darwinian selection determined skin color? I suggest we all do ourselves a favor: enjoy the sun for its healthy benefits (chiefly mental) and wear hats, shirts and shorts this summer. As for suntan parlors: let's throw them in with General Motors.
Edward B. Lack MD www.metroplitanmds.com

MetropolitanMD Donates to PanCan for every Botox and Filler Patient in April

U S Supreme Court Justice Ruth Ginsburg, Dr. Randy Pausch, Patrick Swayze, Michael Landon, Fred Gwyne, Jack Benny, Rex Harrison, Donna Reed, Richard Crenna, Luciano Pavarotti, Joan Crawford. They all had pancreatic cancer and most of them died of the disease. I also had pancreatic cancer. Three of us are still alive.
Do you know anyone who has or had pancreatic cancer? My guess is that you do.
Almost 38,000 new cases of pancreatic cancer were diagnosed in the United States in 2008 and almost 37,000 died of the disease this past year. Pancreatic cancer is the
4th leading cancer killer in the United States and is woefully underfunded by the National Cancer Institute.
PanCan, the Pancreatic Cancer Action Network, is the leading advocacy group for pancreatic cancer in the U.S. as it supports research, patient care, and patient advocacy. PanCan Illinois will hold its annual walk, Illinois Purple Stride on May 2 in Lincoln Park.
MetropolitanMD will donate 25.00 for every patient who purchases botox or a filler during the month of April. We would love for you to join us. We are also hosting a fund-raising page at
http://www.pancan.org/Volunteer/local.html under the name Edward Lack and I will very much appreciate any donations sent to PanCan for the walk. I do not exaggerate when I ask you to make a contribution for your children. The very existence of some of them depends on it.