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By Marilyn M. Singleton, MD, JD

At a graduation of a family friend, out of the blue, one in our group began lamenting that progressives tended to live in cities. She proposed that progressives should move to rural areas and “purge [such areas] of those awful conservatives.” Thus spake the tolerant Left. I was stunned. Given the festive occasion, I kindly reminded her that this is America and we are lucky that we have all kinds of people. I wanted to ask her what we should do with the conservatives. Re-education camps? Death by a continuous loop of Bernie Sanders speeches?

It is unfortunate that such unreasonableness isn’t isolated within the D.C. swamp containment zone.

These pied pipers who offer free college, free food, free medical care, and free money for simply having a pulse freely admit they have no idea how to pay for it. Oh, yes: tax the “rich” and corporations who will pass the tax on to consumers and employees in the form of higher prices and lower wages. And eventually the heretofore untouchable middle class will be taxed directly. Let’s not forget that free food and housing are components of slavery.

These Einsteins are scientists when it comes to global warming and evolution but think it’s medically acceptable to permanently sterilize 7-year olds to avoid appearing like a “transgender” bigot. Science lesson: there are 2 genders. Every human has 23 pairs of chromosomes. The X chromosomes and Y chromosomes determine sex. With rare exceptions of random abnormalities, female is XX and male is XY.

These self-described health care experts try to debunk innovative medical care delivery methods like direct pay and direct primary care subscription practices by claiming these are reserved for the rich. A mere $1,500 per year ensures that you and your doctor, make your medical decisions—not the government. These “experts” are the same people who prop up the medical-insurance-government industrial complex at the expense of private physicians, writing laws that favor big-box retail clinics staffed by non-physicians. These swamp creatures equate physicians with “mid-level” practitioners with one fifth the training and education as physicians—but likely demand the chairman of the department when they themselves need medical services.

These compassionate legislators are keen on the government taking over the “social determinants of health,” including loneliness. I anxiously await an army of a government operatives coming to our homes and telling us to be happy or else. Most people just want to control their own lives, even if their life does not fit the government blueprint. If you want your life to be your own, and your body to be your own, then you cannot let the government’s foot in the door.

These forward thinkers decided it was good public policy to ban children’s fathers from the home in order for the family to receive government funds. It became normalized for the federal government to be the daddy.

These elitists castigate the middle class for not wanting homeless people sleeping and defecating in front of their houses for which they worked two jobs, saved, and sacrificed for years. Their remedy is a tent city in a middle-class neighborhood that is nowhere near theirs. These people do not want to admit that the disintegration of the family and the moral decay leading to drug use and detachment from society is the first problem that must be addressed.

And the biggest hobgoblins of them all are the peddlers of faux racism. Americans do not wake up every morning hating on each other. They ponder their family’s safety and keeping a decent job to pay their bills. Something is seriously wrong, indeed demented, when a former First Lady—unchallenged—claimed that white Americans are “still running” from minority communities when they move to another neighborhood. Perhaps they are getting away from homeless encampments (with mostly white people) or poorly run government schools in Democrat-controlled cities. Get over yourself.

Everything is not about race. Get out in the real world and sit at a local bar or cafe in central Mississippi and watch blacks and whites eating and laughing together. Who is the hatemonger?

America has had a few tragic well-publicized racially motivated incidents. Undaunted, we continue to strive for liberty for all—despite the calculated enmity and scab-picking by rich and famous black people who ran away from minorities to live on a $15 million estate on Martha’s Vineyard (and not in Oak Bluffs) and who expect us to swallow their vitriol-laced baloney.

This insanity is patently sick and sickening. It is about power at any cost and not what can help move America forward.

The Charleston Gazette-Mail

West Virginia has taken another step in the right direction in confronting a massive foster care problem by appointing Pamela M. Woodman-Kaehler as the state’s first foster care ombudsman.

The Department of Health and Human Resources position, a required part of a new law that will transfer aspects of foster care to a private management agency, is designed to advocate for the rights of both foster children and foster parents, and also participate in investigations regarding complaints of inaction or questionable actions by a managed care service or other social service agencies.

Creating and maintaining a statewide system for compiling and analyzing data from complaints and being aware of changes in foster care regulation on the local, state and federal level also are requirements of the position.

Why some of these things weren’t being done already might be part of the problem, but hopefully getting on track will lead toward positive and effective solutions.

As the Gazette-Mail has reported, about 7,000 children are in state custody at the moment, while only 1,300 foster-certified homes and roughly 2,500 certified kinship-care homes exist in West Virginia. Abuse, neglect and a near-generational disappearance of parents (either through death or incarceration) fueled by the drug crisis have all contributed to this unfortunate state of affairs. Throw in a system where caseworkers are stretched too thin and likely not paid a quarter of what they’re worth for everything they see and do, coupled with the bureaucracy of the entire process, and it becomes easy to see why the system would break down.

Bringing in privatized entities in the form of managed care was a controversial decision, although the Legislature seemed to think it was, at the very least, some form of action that might make a difference.

The ombudsman position carries hefty responsibilities, but they are crucial to understanding and working through the problems the state foster care system faces.

As for Woodman-Kaehler herself, the Harrison County Child Protective Services worker earned a solid endorsement form Sam Hickman, executive director of the West Virginia chapter of the National Association of Social Workers, who said he thinks highly of her work.

We wish her luck in this new, vital role. A lot of children are counting on this overhaul of the state’s foster care system. West Virginia can’t afford to let them down.

Jane M. Orient, M.D.

By Jane M. Orient, M.D.

People are dying all over the country from opioid overdoses. There’s a movement to have the antidote naloxone available in all ambulances and even over the counter. This temporarily reverses the fatal effect of opioids, which stop the patient’s breathing. First responders themselves may need a dose because of contact with a tiny amount of fentanyl, an extremely potent narcotic, while attending a patient.

No, the fentanyl does not come from the patient’s bottle of legal prescription drugs.

Rep. Bill Foster (D-Ill.) introduced a proposal that he claims would “go a long way to fight the practice of doctor shopping for more prescription pain pills amid a deadly opioid crisis.” Doctor shopping “involves visiting multiple doctors.” Hardly new, this proposal, now passed by the House of Representatives as an amendment to a $99.4 billion Health and Human Services appropriations bill, lifts the ban on funding a Unique Patient Identifier (UPI).

The UPI is part of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. You don’t have one yet because former congressman Ron Paul, M.D., (R-Tex,) sponsored a prohibition on funding it as part of a 1999 appropriations bill. Rep. Foster’s amendment repeals Dr. Paul’s prohibition.

So how is this 1996 idea supposed to work? And why would it be better than the Prescription Drug Monitoring Programs (PDMPs) now in effect in nearly every state? Every prescription for a controlled substance must be reported to the PDMP, and the doctor must check it before writing a prescription, to be sure the patient is not lying about having prescriptions from other doctors. This costly program that creates time-consuming hassles for doctors has not prevented opioid deaths.

PDMPs are ineffective because doctor shopping is not the cause of the problem. Only 2.5 percent of misused prescription pain medicine was obtained by doctor shopping. And this small percentage apparently increased after PDMPs. More than 97% of misused medications are obtained from a single physician—or from an illicit source. The spike in opioid deaths after 2013 was caused by illicit fentanyl, as Dr. John Lilly concludes from painstaking analysis of official data.

If Rep. Foster’s amendment is not removed, you might have to have a UPI to get legitimate medical care—“no card, no care”—but the drug cartel won’t mind. You can shop drug dealers as much as you like. There is a flood of fentanyl, mostly from Mexico or China, coming across our borders. Rep. Foster is apparently unaware of the armed lookouts protecting the smuggling routes in the Tucson sector. And once here, the drugs go to distributors—such as illegal aliens protected in sanctuary cities.

So, what about the other touted benefits of the UPI? “Specifically, assigning a unique number to a patient would give doctors a way to immediately identify a patient’s medical history,” said Rep. Mike Kelly (R-Pa.). He says it “would lower the cost of medical mix-ups due to misidentification.” His elderly father was nearly given the wrong medication.

To prevent medical errors, you need alert nurses and doctors—and the UPI is not going to fix the hazards of the electronic health record. The EHR, touted as the solution that will bring efficient, quality care, has created its own type of errors.

There is no guarantee that a UPI will improve access to the record, and critical information will still be buried in voluminous, repetitious data of dubious reliability, some of which may have been cut-and-pasted from another patient’s record. There may be critical gaps as patients withhold information they don’t want in a federal database. The new problem that brings the patient to the hospital won’t be in the old record—but may be the result of an old misdiagnosis that should be corrected instead of copied.

Patients need to be able to shop for doctors, especially if the one they have has not solved their problems. Some of them desperately need opioids, which are increasingly difficult to obtain. They do not need a UPI, and neither does their doctor.

The UPI is ideally suited for government tracking and control of all citizens. People like J. Edgar Hoover or Lois Lerner might find it very useful. But it would be the end of privacy, and the foundation for a national health data system.

Dr. Orient is the executive director of the Association of American Physicians and Sur- geons and is a policy expert with the Heartland Institute. For more reactions to the mid- term election, go to heartland. org under news and opinion. The Heartland Institute is one of the world’s leading free-market think tanks.

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