Sunday September 29, 2013
Below you will find an upbeat story about a trip to Mexico with a complex man, Tom Cantor, taken three years ago. I hope those who read the article enjoy it, but there is more to him, and his works, than this. I just went to another open house at his Museum to Creationism like the one where we first met. This time, I had asked to participate, to try to provide an alternative to the image of atheist as evil that is promoted by those whom he allows to speak there. He was interested at first, but then backed away, which given the anger against anyone with that label that was generated at the event, may have been a favor.
Tom's company, Scantibodies Inc., has recently included an alternative cancer clinic in the same facility described below. It offers a limited selection of therapy that has not been shown to be effective by the scientific community. Rather than reserved as a last chance option, it offers MRI diagnosis for early detection which may allow time for proven effective therapy with a known probability to extend life. I have been assured by the medical director that if such proven treatment is indicated the patient will be referred appropriately, yet she is not a cancer specialist. As this clinic is just being established, it remains to be seen whether their limited unverified treatment will replace such tested effective regimens. Any potential patient is well advised to investigate all options carefully.
I hope to continue to reach out to Tom, to build on our friendship to get beyond our very different world views. There is a Christianity that does not make all who do not believe into your enemies. For those who who come upon this essay who are troubled by the fear of "eternal damnation" if you are not saved--there is a world that welcomes you that does not live in such fear. You can find people who can help you right on the internet if you just ask.
Friday, October 23, 2010
I'm still sorting this out in my own mind, whether my host, the founder Tom Cantor was candidly baring his soul, or was about the most effective evangelical the world has ever known. Actually, it was both. I'm honored to have been treated to the full thrust of his VIP presentation for embracing his particular version of Christianity, and even though it was no sale, it was a transformational experience in many ways.
The trip started at the Santee facility of Scantibodies Laboratory where I first met Tom a month before an open house at the Creationism Museum, which he sponsors and is part of this complex.
The story of Scantibodies, Tom starting it with his wife in their garage in 1976 to grow to one of the major developers and producers of therapeutic and diagnostic antibodies is the archetype of the American financial success story. But Tom's story is different in many ways, as it intersects with the underside of corporate malfeasance, the ongoing struggle between Christian and secular dominance of our country, and an aspect of globalism that is not described in economic seminars.
It is a complex story with many facets that I was given a glimpse of during the time we spent together. I won't go into many of these details, and will just share a bit of this meaningful experience. We took the back road to Tecate past unspoiled vistas of mountainous terrain, during which time Tom told me the story of how he took on Quest Diagnostics in a five year battle to end their use of a defective diagnostic test that cost the country hundreds of millions in Medicare reimbursements along with great human suffering. . I won't go into the details here, which are worth recounting for the preternatural persistence of Tom in an epic battle where he was ultimately rewarded the accolade of Whistle Blower of the year for 2009 by Taxpayers Against Fraud. Whistle blower is the wrong phrase of his concerted effort of hundreds of meetings and letters to officials at every level of drug enforcement. The story that he told me was confirmed in every detail in this description from the Department of Justice web site.
In anticipation of my trip to Mexico, I joked with some friends that he could hold me hostage unless I succumbed to his evangelizing efforts, and got one man to promise to rescue me. When we walked across the border, and I shared my concern laughingly to Tom, I wasn't reassured when he told me that we were going to be picked up in an armored car. He wasn't kidding, as the SUV that came for us was reinforced with a ton of steel plating and one inch thick bulletproof glass, as seen here.
In a few minutes we were at the gate of the industrial park where the following two videos allows you to share my introduction to the facility, which is a combination of the latest in bio-technology and a living biblical museum, for example the dimensions of the building coinciding with the best guess of those of Noah's Ark, as articulate in Genesis.
Those trucks will leave the bay and go directly to New Jersey as if there were no international border as we see the effect of NAFTA at work. This did not make Lou Dobbs happy when it opened, and was a reason that the U.S. President kept a low profile at the event. Now to the front, where we start to see the multifaceted nature of this facility.
The walk from the driveway to the lobby is punctuated with biblical references, and Tom's personal dedication to making this enterprise a part of his celebration of his personal salvation. What follows shows more than Tom's rejection of the norm of separation between business and religion;, but his affirmation to stand boldly on the edifice of commerce to proclaim both his and His message
Make no mistake, this building in the dimensions of an ark whose reality is doubted by most scientists incorporates the highest level of bio technical, environmental and construction technology. If there were ever a world wide pandemic, being in this facility in a poor Mexican city may be the safest location in the world. Scantibodies produces antibodies for human therapy and testing which require a host, in this case tens of thousands of mice, to be carefully bred and protected from adventitious pathogens. To this end this facility must be hyper sterile. This will be touched on in the next videos, as we jump two millenia from biblical artifacts to explore this most advanced medical therapeutics facility in Mexico.
We now go past the vivarium, with this video that describes some of the critical infrastructure. Near the end you will share the discovery of a creature, doubted to exist, that has recieved a great deal of press during this mid term election of 2010.
We walked through the private elementary school for the children of employees as well as the public, and Tom described the bible centered approach that is used, with techniques to involve the children on multiple levels. Then we went through a door that figuratively separated church and state, creationism from established science and we were upon a space being prepared for a 2000 seat church. He then walked me through the backstage facilities for those who were taking the step to proclaim their acceptance of Christ in the form of baptism, complete with private conference rooms, changing areas and processional walkway to the public immersion in the sanctified water of redemption.
This was only an abbreviated version of this trip, and I hardly touched on the spiritual emotional changes that I underwent. For starters, I don't think I've ever even used the word spiritual in a sentence describing myself, they just didn't go with this hyper realist atheist. I guess the final stop was the convincer that this was not a sham, that the good vibrations I felt among all the employees from the packaging machine operators to the designers of ultra high security biolabs was genuine. It was a visit to the nursery, where the toddlers of workers spent the day. Three year olds are either happy or not. They don't do pretend, unless they are in the mood to. Here the final video of them.
Yeah, I'm getting a bit giddy. It had been a long day.
And then, the drive to the border, the walk through customs, and we were on the way home. I was a bit intoxicated by the whole thing. For this day, not only was I a part of the unique community of Scantibodies Tecante, but of all of Christiandom. For this day, I was not the Jew, later to be the atheist, the one who was different. For this day I was with the Ur-Christian, who espoused the exact words of Jesus and boldly plastered them upon the walls of his monument to God and to Mamon. If he made money, if his persistence in fighting Quest to get them to stop causing untold suffering resulted in a pot of Gold, it was to be put into this effort to prevent suffering. He would marshal his energy for the "little job of saving lives and the big job of saving souls."
But the transformation he offered me was not to take hold. I was not to be born again, any more than my brain was to be transported into one of those mice. For me, both were equally illusory. But I have a new found respect for illusion, for belief. It sure had one hell of an effect in motivating Tom Cantor to create something that should never have been possible. Someone with a BA in chemistry doesn't build an international biotechnology enterprise, or take on the largest diagnostic testing company in the country, and win to the tune of their forking over a third of a billion dollars to the feds.
That morning before we had driven to Tecate, Tom showed me his new building in El Cahon. There he is building a facility to draw blood plasma from four hundred people a day to produce antibodies that he is hoping, betting a bundle, will result in a cure for HIV/AIDS. No one else thinks it will work, any more than they thought he could defeat Quest pharmaceutical, and replace their defective test with his antibodies as the new standard for monitoring treatment of hyperthyroidism.
I think it's a long shot, but from what I've learned about this man, I wouldn't bet against him.
©2010 Al Rodbell
Reference: Letters to speakers at Creation Museum open house
"Concierge" under ACA Betrays the Promise of Medicare
1/3/13
Medicare is more than the the massive byzantine interconnection between Government and health care providers, rather it is a promise to the elderly that has been its justification and its realization over the last four decades. It is a promise that those in the declining years of life faced with inevitable debility and sickness shall not be impoverished by such effects of aging.
Since there were large numbers of such people, from the providers perspective the payment could be less than other insurance, as it would be made up by the volume of patients who would be treated. This universality of care was ensured by this simple rule, if a doctor wanted access to this pool of clients, he or she must agree to charge no more than these lower rates to all elderly under this program. This had been the principle that was enforced by law for Medicare, until the department of Health and Human Services then under the Bush administration, Secretary Tommy Thompson made a change that opened the door to this practice. His justification along with the possibility that under one provision of the ACA, it may no longer apply is discussed extensively in this article. The author makes the case that the Annual Wellness Visit, although explicitly so limited as not even called an examination, is equivalent to the full examination that was a justification for the annual retainer fee. The 2002 decision was an executive branch interpretation of the Medicare law, that could be reversed by the stroke of the pen by this Democratic president. He has not done so.
Last week, the day after another showdown in Washington, when for a single day, before Congress retroactively restored what is known as the "doctor fix", Medicare payment had been slashed. My primary physician, Dr. Bob, is also a tennis friend, and by chance we crossed paths and I asked him what he was planning to do; and his response, which could multiplied by unknown numbers of others of his profession, illustrated what we are facing, "I had my letter written that would have switched my current practice." He was not going to give up taking Medicare, which is a good chunk of his clientèle, but rather was about to sign up with MDVIP, the main purveyor of a packaged version of concierge practice that is now growing rapidly with no public discussion.
To make life difficult, there are two names that are used for two very different business structures, "concierge," or as preferred by those who adopt it, "retainer" practice. This essay is about the most common business structure, ill call it MDVIP practice, those who continue to take commercial insurance or public programs such as Medicare, or usually both. The second business structure that is NOT being described here ".... often also called concierge medicine" is illustrated in this N.Y. Times article. Here physicians require an annual payment from patients directly for which they accept the obligation to do all required services of their practice no matter how extensive, without accepting Medicare or any other insurance. This is less frequent than the retainer plus insurance model, and does not raise the concerns discussed here.
MDVIP practice is beneficial to the doctor, both in easing personal stress and increasing income. If that were the whole story, if this were provision of other services, then there would be no problem. But the practice of medicine is inextricably intertwined with government licensing and professional monopoly of distribution of life saving treatments. As expensive as a medical eduction is, it is still heavily subsidized. There is a social equation that must be considered. The impending increase in clientele is a public choice that should not be an occasion for windfall increase in revenue for one part of the public health enterprise.
Those who promote concierge practice try their best to ignore certain harsh realities-that it changes the entire principle, the promise of Medicare. Rather than a redistribution from the successful to those less so, this changes the direction of the flow. Those with the wherewithal to pay the annual fee, will (most likely*) have more public funds directed to their own care. Increased visits will generate increased referrals and public payment. While those who are the poorest, will receive reduced service, often by paraprofessionals. This will not be any announcement of a policy change, simply the words of a receptionist, "Sorry, the doctor is no longer taking Medicare unless you are a member of his concierge program."
Addendum as of 9/24/13
This annual fee plus insurance Concierge practice has recently expanded beyond primary physicians to specialists such as cardiologists, as described in this article, Putting a price tag on contacting your medical specialist, in the LA Times of 9/24/13. While the $7500 per year is ostensibly only for easier email communication, it defies belief that such premium clients will not also get quicker appointments. For this specialty, the extra fee under some conditions will be buying life itself!
There is another principle of allocation of medical care that is used in emergency conditions with insufficient capacity called "triage." For this, priority is strictly based on how the medical resources can be used to save the most lives, with no consideration of payment. Medical care always has an element of such an emergency for a given setting and scope. The balance between the market model and the triage principle is a vital issue that must reflect the mixed economy of this country.
Here's the letter that I sent to the publisher of the L.A. Times article:
The move to retainer, (concierge) practice described in this article should be seen as only the beginning of the inevitable consequence of increasing demand under the ACA, while the law only minimally increases supply. This resulting aggregate shortage is similar to that of WWII when existing market-pricing allocation became unacceptable as the greater deprivation would have been on the poor.
The expansion of concierge practice should be an early warning that the ACA ideal of universal care may result in something quite different. Those in the proverbial top one percent of income will draw an even greater share of the medical resources than previously since they are able to afford an annual fee; but unlike when wartime rationing of scarce supplies were subverted by the illegal black market, this time it will be completely legal.
-----------------------------------
* Note: My assumption that those on concierge programs will use more Medicare services has not been verified. It is easily testable by tracking all Medicare payments of those in concierge programs compared to others of the same demographics. This rather easy survey would provide tools to evaluate how this program affects the overall cost of Medicare among various income levels.
------------------
If those supporting ACA are serious about achieving the ideal of making medical care a right, as we now accept the right to a minimum level of food sustenance for all, the effect of proliferation of this type of medical practice must be evaluated. In the absence of such evaluation as is now the case, the argument against the entire program of ACA gains legitimacy.
Link to website of MDVIP, to see the promotion of this type of practice to physicians.
PBS Program on this practice, comments are interesting.
Discussion site on Concierge Practice
Medicare is more than the the massive byzantine interconnection between Government and health care providers, rather it is a promise to the elderly that has been its justification and its realization over the last four decades. It is a promise that those in the declining years of life faced with inevitable debility and sickness shall not be impoverished by such effects of aging.
Since there were large numbers of such people, from the providers perspective the payment could be less than other insurance, as it would be made up by the volume of patients who would be treated. This universality of care was ensured by this simple rule, if a doctor wanted access to this pool of clients, he or she must agree to charge no more than these lower rates to all elderly under this program. This had been the principle that was enforced by law for Medicare, until the department of Health and Human Services then under the Bush administration, Secretary Tommy Thompson made a change that opened the door to this practice. His justification along with the possibility that under one provision of the ACA, it may no longer apply is discussed extensively in this article. The author makes the case that the Annual Wellness Visit, although explicitly so limited as not even called an examination, is equivalent to the full examination that was a justification for the annual retainer fee. The 2002 decision was an executive branch interpretation of the Medicare law, that could be reversed by the stroke of the pen by this Democratic president. He has not done so.
Last week, the day after another showdown in Washington, when for a single day, before Congress retroactively restored what is known as the "doctor fix", Medicare payment had been slashed. My primary physician, Dr. Bob, is also a tennis friend, and by chance we crossed paths and I asked him what he was planning to do; and his response, which could multiplied by unknown numbers of others of his profession, illustrated what we are facing, "I had my letter written that would have switched my current practice." He was not going to give up taking Medicare, which is a good chunk of his clientèle, but rather was about to sign up with MDVIP, the main purveyor of a packaged version of concierge practice that is now growing rapidly with no public discussion.
To make life difficult, there are two names that are used for two very different business structures, "concierge," or as preferred by those who adopt it, "retainer" practice. This essay is about the most common business structure, ill call it MDVIP practice, those who continue to take commercial insurance or public programs such as Medicare, or usually both. The second business structure that is NOT being described here ".... often also called concierge medicine" is illustrated in this N.Y. Times article. Here physicians require an annual payment from patients directly for which they accept the obligation to do all required services of their practice no matter how extensive, without accepting Medicare or any other insurance. This is less frequent than the retainer plus insurance model, and does not raise the concerns discussed here.
MDVIP practice is beneficial to the doctor, both in easing personal stress and increasing income. If that were the whole story, if this were provision of other services, then there would be no problem. But the practice of medicine is inextricably intertwined with government licensing and professional monopoly of distribution of life saving treatments. As expensive as a medical eduction is, it is still heavily subsidized. There is a social equation that must be considered. The impending increase in clientele is a public choice that should not be an occasion for windfall increase in revenue for one part of the public health enterprise.
Those who promote concierge practice try their best to ignore certain harsh realities-that it changes the entire principle, the promise of Medicare. Rather than a redistribution from the successful to those less so, this changes the direction of the flow. Those with the wherewithal to pay the annual fee, will (most likely*) have more public funds directed to their own care. Increased visits will generate increased referrals and public payment. While those who are the poorest, will receive reduced service, often by paraprofessionals. This will not be any announcement of a policy change, simply the words of a receptionist, "Sorry, the doctor is no longer taking Medicare unless you are a member of his concierge program."
Addendum as of 9/24/13
This annual fee plus insurance Concierge practice has recently expanded beyond primary physicians to specialists such as cardiologists, as described in this article, Putting a price tag on contacting your medical specialist, in the LA Times of 9/24/13. While the $7500 per year is ostensibly only for easier email communication, it defies belief that such premium clients will not also get quicker appointments. For this specialty, the extra fee under some conditions will be buying life itself!
There is another principle of allocation of medical care that is used in emergency conditions with insufficient capacity called "triage." For this, priority is strictly based on how the medical resources can be used to save the most lives, with no consideration of payment. Medical care always has an element of such an emergency for a given setting and scope. The balance between the market model and the triage principle is a vital issue that must reflect the mixed economy of this country.
Here's the letter that I sent to the publisher of the L.A. Times article:
The move to retainer, (concierge) practice described in this article should be seen as only the beginning of the inevitable consequence of increasing demand under the ACA, while the law only minimally increases supply. This resulting aggregate shortage is similar to that of WWII when existing market-pricing allocation became unacceptable as the greater deprivation would have been on the poor.
The expansion of concierge practice should be an early warning that the ACA ideal of universal care may result in something quite different. Those in the proverbial top one percent of income will draw an even greater share of the medical resources than previously since they are able to afford an annual fee; but unlike when wartime rationing of scarce supplies were subverted by the illegal black market, this time it will be completely legal.
-----------------------------------
* Note: My assumption that those on concierge programs will use more Medicare services has not been verified. It is easily testable by tracking all Medicare payments of those in concierge programs compared to others of the same demographics. This rather easy survey would provide tools to evaluate how this program affects the overall cost of Medicare among various income levels.
------------------
If those supporting ACA are serious about achieving the ideal of making medical care a right, as we now accept the right to a minimum level of food sustenance for all, the effect of proliferation of this type of medical practice must be evaluated. In the absence of such evaluation as is now the case, the argument against the entire program of ACA gains legitimacy.
Link to website of MDVIP, to see the promotion of this type of practice to physicians.
PBS Program on this practice, comments are interesting.
Discussion site on Concierge Practice
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