Monday, June 11, 2018

Net Neutrality Is Officially Dead. Here’s What’s Next. – Mother Jones

Will your EHR cloud service be affected?
The battle is on. The recent FCC ruling will open up the threat of measured ISP services. Despite a federal ruling many states are considering legal opposition to the FCC ruling.




After a drawn-out battle between internet advocates and Trump’s Federal Communications Commission, today marks the official end of net neutrality. Led by current Chairman Ajit Pai, the FCC voted 3-2 in December to repeal the Obama-era open internet rules. The decision went into effect on Monday. 
The fight has also started playing out at the state level.  Three states, including Washington and Oregon, have enacted legislation to enforce net neutrality and governors in six states, including Montana and New York, have signed executive orders
to enforce net neutrality. As of May, legislators in 29 states have introduced bills to ensure net neutrality, according to the National Conference of State Legislatures. In its repeal, the FCC asserted that it alone has the authority to write these types of regulations and that states cannot pass laws inconsistent with federal net neutrality rules, something that could lead to a legal battle down the road.


Advocates have warned that the repeal of the 2015 regulation, which barred internet service providers from creating slow and fast lanes for preferred content, would open the door for ISPs to start charging more for preferred content (paid prioritization), slowing certain content (throttling), and fully blocking content. Advocates often point to the situation in Portugal, where striking net neutrality led to tiered-internet packages that charged more for services like Netflix and Spotify. 
A coalition of nonprofits and tech companies, including the ACLU, National Hispanic Media Coalition, Electronic Frontier Foundation, Netflix, and Reddit have called for an “internet-wide day of action to save Net Neutrality” on July 12th. The group is asking websites to display a “red alert” image that will show what the site would look like without net neutrality. It is also asking users to harness their social media accounts to raise awareness and contact House lawmakers to ask them to overrule the FCC.

Net Neutrality Is Officially Dead. Here’s What’s Next. – Mother Jones

Friday, February 3, 2017

When the Doctor Doesn’t Look Like You

So, your doctor doesn't look like you ?  Don't sweat it !

For more than 50 years, international medical school graduates have filled the gaps in the physician work force in the United States. Currently, they make up fully one-quarter of all practicing physicians, and although a majority are foreign-born, approximately 20 percent are American citizens who have chosen to go abroad, most notably to the Caribbean, for medical school.
Regardless of whether they are United States citizens, all international graduates must go through an arduous regulatory process before practicing in this country, a process that includes verification of medical school diplomas and transcripts, residency training in American hospitals and the same national three-part licensing exams and specialty tests that their medical school counterparts in this country take. Many go on to choose specialties or work in the rural and disadvantaged geographic locations that their American counterparts shun. International graduates, for example, now account for nearly 30 percent of all primary care doctors, a specialty that has had increasing difficulties attracting American medical students.
Editorial comment:
That figure, 25% surprised me.  However in some regions of the U.S. the figure is much higher, especially in rural areas, or less attractive settings.
Though these doctors have filled an important national health care need for over half a century, doubts regarding the quality of care they provide have continued to plague them. Health care experts interested in this issue have been stymied over the years by inadequate methodologies for evaluating the effectiveness of large groups of physicians and so have chosen instead to focus on exam scores, an admittedly crude proxy for quality of care.
Though these doctors have filled an important national health care need for over half a century, doubts regarding the quality of care they provide have continued to plague them. Health care experts interested in this issue have been stymied over the years by inadequate methodologies for evaluating the effectiveness of large groups of physicians and so have chosen instead to focus on exam scores, an admittedly crude proxy for quality of care.
But even that data has proven confusing. Studies initially revealed that international graduates tended to score lower, while more recent research shows that they routinely outperform their peers on training exams in areas like internal medicine.
Now researchers from the Foundation for Advancement of International Medical Education and Research in Philadelphia have published the first study incorporating new research methods for evaluating the performance of large groups of physicians. And it turns out that contrary to certain individuals’ worst fears, accent or nationality did not affect patient outcomes. Rather, the main factor was being board-certified: completing a full residency at an accredited training program, passing written and, depending on the specialty, oral examinations, and having proof of experience with a defined set of clinical problems and technical procedures.

Foreign medical graduates also tend to 'cluster' choosing to practice in like minded communities, Asian, Phillipino, Latino, Jewish, and other minorities. These demographics also tend to refer internally when possible.

Racial prejudice exists even in health care.




How Good Are Foreign-Trained Doctors? - The New York Times

Wednesday, February 1, 2017

Did President Trump Just Save Western Civilization?

My mind has been busy analyzing the UNpredictable actions of Donald Trump.

It should be no surprise to you Donald Trump grew up as a CEO of an enterprise.  His mantra is take charge and own your decisions.  CEOs report to their Board of Directors and must inevitably satisfy them and the shareholders. Shareholders like dividends,  from profits.  Enough said?  The U.S.A. by any financial analysis is in debt by  20 trillion dollars.  How much are our assets ?  Accountants will tell us that our net worth is the amount of assets less our liabilities (debt). Are you getting the picture?

The mainstream media spent the weekend lying about President Donald Trump instituting a Muslim ban, lying about the contents of the recent executive order, lying about those impacted by the new guidelines and lying about why seven specific countries were included in the travel restrictions.

President Trump was painted as a monster for placing a temporary ban on accepting Syrian refugees - while other world leaders bent over backwards to virtue signal and express their willingness to destabilize their countries.

While the mainstream media, politicians, corporations and Hollywood celebrities were virtue signaling - President Trump made a few phone calls and may have just saved Western Civilization


The financial facts are outlined in this You Tube Video by Stefan Molyneux, the voice of Freedom Radio.


Trump has the integrity to lead, and not follow.  The media only reports part of the story choosing to focus on the headline rather than the meat of the story.  Hence the great outcry when 500 . or so regugees and Visa card holders were temporarily held from entering  OUR country. They were individually vetted and those who cleared were allowed admission to our free country.  Freedom cannot endure without order and a plan. Yes, many were inconvenienced.  Trump has our attention, and hopefully those who sit on the couch never questioning, nor participating in the American experiment will wake up.  It will take some time to filter the swamp.

Trump is the ultimate negotiator. He leads with a high price from which he can afford to offer relief when the other side contributes to the deal.

Mr. Molyneux has given me great hope with his knowledge and explanation of what Donald Trump was up to this past week, while women were marching (by the way that march was planned months ago as a victory parade for the defeated Hillary Clinton,  not as an anti-trump protest)

DISCLAIMER:  I am not an avid supporter

Monday, January 23, 2017

The Story of Your Enslavement

It seems fitting to analyze the quick shift from liberal to conservative government.  Can we even define the change in those terms.?

The ruling congress is Republican while the President can hardly be called a Republican except for his ties and history of capitalism.  The Democrats have been flailing about  with larger and larger government and never ending hackneyed sound bytes about social welfare and increasing health care bureaucracy while at the same time blabbering on about health care savings.

Are we enslaved by either system?  Do both systems prey upon us in a universal manner ? The video should prick your interest.

Wednesday, January 11, 2017

Healthcare Stole the American Dream - Here’s How We Get it Back | Dave C..., Bay Area Cancer Patient.. - gmlevinmd@gmail.com - Gmail

Healthcare Stole the American Dream - Here’s How We Get it Back |



Health Train Express   Remove
17 hours ago  .  Save  .  Twitter  .  Facebook
Healthcare Stole the American Dream - Here’s How We Get it Back |   TEDx TalkThanks to Rob Lambert M.D. a pioneer in direct primary care for bringing this to m.. Read More →
20 hours ago  .  Save  .  Twitter  .  Facebook
Something all patients should know if you live in California and five other states, Oregon,  District of Columbia,Vermont, Washington and California. It is an ..Read More →
20 hours ago  .  Save  .  Twitter  .  Facebook
Doctors giving regular checkups will get the most bang for their buck if they advise adults to quit smoking, convince teens to never start, and keep children 

Tuesday, January 10, 2017

13 Questions to Ask Before Getting Married - The New York Times

When it comes to marriage, what you don’t know really can hurt you.
Whether because of shyness, lack of interest or a desire to preserve romantic mystery, many couples do not ask each other the difficult questions that can help build the foundation for a stable marriage, according to relationship experts.
In addition to wanting someone with whom they can raise children and build a secure life, those considering marriage now expect their spouses to be both best friend and confidant. These romantic-comedy expectations, in part thanks to Hollywood, can be difficult to live up to.
Sure, there are plenty of questions couples can ask of each other early in the relationship to help ensure a good fit, but let’s face it: most don’t.
“If you don’t deal with an issue before marriage, you deal with it while you’re married,” said Robert Scuka, the executive director of the National Institute of Relationship Enhancement. It can be hard to keep secrets decade after decade, and reticence before the wedding can lead to disappointments down the line.
The following questions, intimate and sometimes awkward, are designed to spark honest discussions and possibly give couples a chance to spill secrets before it’s too late.
  1. Photo


13 Questions to Ask Before Getting Married - The New York Times

Where Are the Stars? See How Light Pollution Affects Night Skies | Short...