Saturday, March 31, 2007

Health Champions Project

Getting back to the main sponsor of last Saturday's 3 hour forum for Democratic presidential hopefuls(see my immediate previous post) The Center for American Progressive Action Fund headed by John Podesta has a HEALTH CHAMPIONS PROJECT that may be worth your consideration.

I'm not quite sure from the site how to become a "Health Champion" and collaborate with this group but I like their 4 goals of:

-Providing affordable coverage for all Americans;

-Controlling health care costs;

-Guaranteeing choice of doctors and health plans;

-Making prevention a national priority

As you know from my previous posts on this blog I resonate with #4 the most and probably number #3 the least.

(But we know how obsessed American's are with freedom of choice of doctors and health care plans? Don't we?)

Lets's hear from you on these #4 goals of The Center for American Progressive Action Fund.

By the way the 3 hour forum should have been televised! given the importance of this issue which may very well elect our next president.

So those out there in TV land pick it up!

Dr. Rick Lippin

Saturday, March 24, 2007

Democratic Blockbuster Event on Health Care Reform

The Center for American Progress Action Fund headed by John Podesta sponsored a three hour live forum today on U.S. Health Care Reform for presidential candidates at the University of Nevada-Las Vegas which was video webcasted. (Should have been televised in my opinion)

SEIU - The Service Employees International Union headed by Andy Stern which includes health care workers had a heavy hand in this production for good reasons.

Seven democratic candidates, in my opinion, all of whom had good appearances, agreed this could be the single most important domestic issue of the campaign for President in '08.

I will be writing a lot more on this in days/weeks to come but here is my ranking for today's appearances in order of who impressed this writer and why.

1) Sen. Chris Dodd for stating correctly that the healthcare issue should not be "stovepiped". Jobs and the general economy have more to do with health care than the medical care industry. He is correct! He also used the word "shame" as it relates to our current system.

2) Cong. Dennis Kucinich for showing the most political backbone for making a passionate moral case for single-payer.

3) Sen. Hillary Clinton for showing great knowledge and passion on the health care issue which she wrestled with in 93/94. Hillary hit a home run today!

4) Former Sen.John Edwards who is the ONLY candidate who has put forth a recent very specific plan (The Conyers/Kucinich bill H.R. 676 is many years old)and hence sets a mark for others. He used the term "mandatory prevention"

5) Gov. Bill Richardson who also did well and talked about a portable "Hero's Health Card" for our Veterans to use anywhere geographically in the Health Care system. (bravo!) As a governor Richardson kept referring to shared financial responsibilities between the Federal Government and the States. He, like others, mentioned the worthy idea of school based health clinics. Prevention starts early.

6) Former Sen. Mike Gravel- Promoted a voucher system but correctly pointed out that we should "not trust our leaders" who are bankrupting this nation over the last 50 years. So "let the people decide" says Gravel. He also spoke about 77 million baby boomers who are hitting retirement age over next 5 years and their voice being heard.

7) Sen.Barak Obama was also good but the least impressive candidate today in my opinion because considering his strong polling numbers HE DOES NOT YET HAVE A HEALTH CARE PLAN! Maybe this relates to his short tenure in federal office which could be his general soft underbelly on all issues? (I'm still watching his smoking habit too). His says his plan will be on his website within 4-6 weeks?

I was genuinely impressed with all seven. The Republican candidates were invited to today's forum but none accepted. Nor are any of their plans remotely worth considering except perhaps "Republicrat" Arnold Schwarzeneger, Gov. of California, who is not running (actually cannot run) for U.S President.

Bravo to the DEMS who stepped up to the plate today on Health Care- Y'all done well

But where was my candidate? -Al Gore?

Dr. Rick Lippin

Wednesday, March 07, 2007

Mental Illness in U.S. Presidents--"Call Me Incompetent But Don't Call Me Crazy"

This is very serious subject for several reasons-

- We obviously need mentally competent Presidents of the United States

- We need better laws to ensure such mental competency both prior to and while holding such an important office

- We need to ensure that psychiatric evaluation,diagnosis,and treatment of Presidents are as free as possible from any influence whatsoever from partisan politics.

I had planned to write on this topic in the future but was stimulated by a remark that Sen. Dick Durbin (D-Ill and new Senate Majority Whip) made in January of this year that our current Vice-President was "delusional" about Iraq and the daily vitriol that spews forth on a number of mostly progressive liberal blogs about the sanity of our current president and vice-president. Reflecting upon Mr. Reagan's Alzheimers disease while still in office was another stimulus to this piece.

As a physician I go out of my way NOT to tele-longdistance-diagnose anyone as was done by former Sen (Dr.) Bill Frist in now landmark Terri Schiavo case where Frist insisted she was not in a persistant vegitative state.(He then tried to recant saying he was speaking as a Senator not a Doctor?)

But back to the more to the general issue of presidential mental health

About a year ago (Jan 2006) an excellent article which studied biographical source material in 37 presidents from 1776 to 1974 was published in The Journal of Nervous and Mental Diseases on the topic of Mental Illness in U.S. Presidents... and concluded that 18 presidents (49%) met criteria suggesting psychiatric diagnoses and in 10 instances (27%)"a disorder was evident during presidential office, which in most cases probably impaired job performance". Thankfully the authors concluded that no national calamities appeared to have occurred due to presidential mental illness. Here is the abstract for the article. (Sorry folks you must cough up some bucks for a full reprint)

Presidents with mental illness provide opportunities to discuss the stigma of mental illness,the treatment of mental illnes, the possible abuse of psychiatry (see Citizens Commission on Human Rights) and issues surrounding privacy in a public figure whose privacy rights in my opinion need to be subjugated by the public's right to know the health and competency of their President who is also their Commander-in-Chief.

In 1967 the 25th Amendment to the U.S. Constitution was ratified which addresses transfer of power in cases of presidential illness or death precipitated by the tragic assasination of President John Kennedy in 1963.

The prestgious College of Physicians of Philadelphia, of which I am a fellow, under then Executive Director Dr. Marc Micozzi launched several initiatives beginning in 1996 to better understand presidential health and disability with special emphasis on improving the 25th amendment by giving it,in Dr. Micozzi's words, "operational definition by statute or regulation"

Currently,for example, the 25th Amendment does not address who makes the final medical determination that the president is unable to hold office? (That's not good)

An educational exhibit took place at the College between 1996 and 1998 entitled "When the President is Patient" which traced George Washington's thigh carbuncle/abcess to George(Papa)Bush's thyroid condition.(see NY Times Coverage)

Sen. Arlen Specter (R-PA) delivered Opening Remarks (Nov 19, 1997) at a College Forum on Presidential Diability and the 25th Amendment where he closed by stating he was very interested in whether the College "will recommend legislative action to strengthen our current system for providing for the health of The President of the United states".(now that's a positive way of saying it) But Specter also raised the issue of the nation possibly being better served if White House Physician were required to consult with an independent panal of physicians for a mandatory second opinion. ("The panal will see you now-Mr. President")

In it's final report on the College's Presidential Health Task Force chaired by Dr. William Kissick the group concluded that "the current system of providing for the health of the president of the United States has in the past failed to serve effectively the president himself and the public, and has even been exploited as a means of deceiving the public about the state of the president's health.This committee went on to propose that an Act of Congress be passed into law to create a physician panal to provide a second opinion to the White House physician. A draft bill was even prepared by this committee. (Alas, I do not know the current status of this draft legislation?)

Needless to say the College of Physicians of Philadelphia deserves significant credit for these initiatives in the late 1990s. And special thanks to Dr. Marc Micozzi for spearheading these efforts and to Sen. Arlen Specter for assisting the College.

The College did not, to my knowledge, specifically focus on Presidential mental disability in any of its activities and deliberations?

Sufficed to say that psychiatric status is often ommitted from any or most of our own health evaluations. Yet for the President of the United States - past, present and future- I would focus on that first and foremost.

In our increasingly volatile world it seems like a pretty important priority to me?

Don't you agree? Let's hear from you!

Dr. Rick Lippin