Sunday, May 02, 2010
--Thomas Jefferson, letter to Mesrs. Eddy, Russel, Thurber, Wheaton and Smith, 1801
File this under: "Duuuhhh..."
Federal Reserve Study: Economic Freedom Matters
By Michael D. LaFaive
A new study published by the Federal Reserve Bank of St. Louis, called "Economic Freedom and Employment Growth in the U.S. States," concludes that there is a link between economic freedom and employment growth. Other studies have come to the same conclusion. One of the things that makes this one different is its findings on labor markets. The authors write: "In addition, we find that less restrictive state and national government labor market policies have the greatest impact on employment growth in U.S. states."
Obamacare
"While President Obama continues traveling the U.S. heralding the passage of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act, businesses across the U.S. are growing more and more discontent—and for good reason."
Read more at The
Heritage Foundation.
WHY ARIZONA DREW A LINE
Last Friday, Gov. Jan Brewer of Arizona signed a law -- SB 1070 -- that prohibits the harboring of illegal aliens and makes it a state crime for an alien to commit certain federal immigration crimes. It also requires police officers who, in the course of a traffic stop or other law-enforcement action, come to a "reasonable suspicion" that a person is an illegal alien verify the person's immigration status with the federal government.
Predictably, groups that favor relaxed enforcement of immigration laws insist the law is unconstitutional. However, the arguments we've heard against it either misrepresent its text or are otherwise inaccurate, says Kris W. Kobach, a law professor at the University of Missouri at Kansas City and Attorney General John Ashcroft's chief adviser on immigration law and border security from 2001 to 2003.
It is unfair to demand that aliens carry their documents with them:
* It is true that the Arizona law makes it a misdemeanor for an alien to fail to carry certain documents, but since 1940, it has been a federal crime for aliens to fail to keep such registration documents with them; the Arizona law simply adds a state penalty to what was already a federal crime.
* Moreover, as anyone who has traveled abroad knows, other nations have similar documentation requirements.
"Reasonable suspicion" is a meaningless term that will permit police misconduct:
* Over the past four decades, federal courts have issued hundreds of opinions defining those two words.
* The Arizona law didn't invent the concept: Precedents list the factors that can contribute to reasonable suspicion; when several are combined, the "totality of circumstances" that results may create reasonable suspicion that a crime has been committed.
The law will allow police to engage in racial profiling:
* Section 2 provides that a law enforcement official "may not solely consider race, color or national origin" in making any stops or determining immigration status; in addition, all normal Fourth Amendment protections against profiling will continue to apply.
* In fact, the Arizona law actually reduces the likelihood of race-based harassment by compelling police officers to contact the federal government as soon as is practicable when they suspect a person is an illegal alien, as opposed to letting them make arrests on their own assessment.
Source: Kris W. Kobach, "Why Arizona Drew a Line," New York Times, April 29, 2010.
For text:
http://www.nytimes.com/2010/04/29/opinion/29kobach.html
The source for this summary is from http://www.ncpa.org
WHAT'S KEEPING DOCTORS SO BUSY IN PRIMARY CARE?
Dr. Richard Baron -- an internist in a five-provider practice in Philadelphia with roughly 8,500 patients -- conducted a yearlong study using his practice's electronic health record system to evaluate the average daily workload of a primary care physician.
The results, published in the New England Journal of Medicine, offer "a rare, quantitative look into the mechanics of office practice. Baron found that on an average workday, each primary care provider in his practice:
* Saw 18.1 patients.
* Handled 23.7 phone calls.
* Answered 16.8 e-mails, mostly dealing with test result interpretations.
* Dealt with 19.5 lab reports, 11.1 imaging reports and 13.9 consult reports.
* Issued 12.1 prescription refills, excluding those issued during patient visits.
Overall, the practice's physicians worked roughly 50 to 60 hours a week, Baron found.
Baron said that the results show the need for a new payment method that accurately reimburses primary care physicians for the actual work they do. According to Baron, who chaired the American Board of Internal Medicine in 2009, the study should signal to policymakers and payers that "... the way you pay us doesn't work for the work we actually need to do."
While Baron said reimbursing for each phone call or e-mail a physician handles would be impractical, he suggested that adopting capitation, in which physicians would receive an annual lump sum per patient, would better cover the amount of time primary care physicians actually spend on patients.
Source: Zach Swiss, "What's Keeping Us So Busy In Primary Care?" American Health Line, April 29, 2010; based upon: Dr. Richard J. Baron, "What's Keeping Us So Busy in Primary Care? A Snapshot from One Practice," New England Journal, Vol. 362:1632-1636, No. 17, April 29, 2010.
For text:
http://content.nejm.org/cgi/content/full/362/17/1632
I can understand this strategy from the MD's perspective since they don't get paid for answering emails, phone calls, etc. But then, what job does? It goes with the territory. It's a necessary function of "your job."
More importantly, how is this going to improve the quality of care for the patient? Seems to me, this will only facilitate more the feeling of being rushed through the doctor's office. The more patients the doctor sees, the larger "the annual lump" the MD receives.