Monday, December 21, 2009

History and Prophecy on Banking and War

D&C 87:1 Verily, thus saith the Lord concerning the wars that will shortly come to pass, beginning at the rebellion of South Carolina, which will eventually terminate in the death and misery of many souls; And the time will come that war will be poured out upon all nations, beginning at this place. For behold, the Southern States shall be divided against the Northern States, and the Southern States will call on other nations, even the nation of Great Britain, as it is called, and they shall also call upon other nations, in order to defend themselves against other nations; and then war shall be poured out upon all nations. . . . . until the consumption decreed hath made a full end of all nations; -Joseph Smith Jr. December 25, 1832

War is not only a contest of resolve but also a test of economic strength. War cost money. Therefore, Alexander Hamilton, the first Secretary of the Treasury, convinced Thomas Jefferson to create a Federal Bank and to allow the country to run a national debt during times of war. With a endless supply of credit, a government could manufacture a neverending supply of warplanes, tanks and bombs. During the Civil War, Abraham Lincoln turned to Great Britain for financial assistance against the Southern States. However, when President Lincoln later learned the same British Rothschilds who were funding the Union Armies were also funding the Confederate Armies from their banks in France, he stopped paying interest payments on the nation's war debts and began printing Greenbacks. When a nation prints its own money, the nation's currency becomes devalued which shrinks the value of its debt through inflation. I am sure this action infuriated the European bankers and there is not a few who believe that in retribution, the Rothschild's ordered the assassination of President Lincoln. I don't think going into debt during war time is bad, what is bad is borrowing money from other countries. War Bonds should be sold only to US citizens.

Section 8. The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States; To borrow money on the credit of the United States; To regulate commerce with foreign nations, and among the several states, and with the Indian tribes; To establish a uniform rule of naturalization, and uniform laws on the subject of bankruptcies throughout the United States; To coin money, regulate the value thereof, and of foreign coin, and fix the standard of weights and measures;

"... (we) gave the people of this Republic the greatest blessing they have ever had - their own paper money to pay their own debts..." -Abraham Lincoln

Since the Civil War, European Banks have been enciting and funding both sides of numerous wars. World Banks have systematically taken control of the United States by enslaving all its citizens to the bondage of interest and socialism. The errosion of the Representative Democracy in America has been slow and steady.

The Coinage Act of 1873, de-monetized silver, and put the United States on a gold-only standard. The U. S. Treasury continued to issue silver certificates until 24 June 1968. President Richard M. Nixon announced in 1971 that the United States would no longer redeem currency for gold or any other precious metal, forming the final step in abandoning the gold and silver standards.

“I am a most unhappy man. I have unwittingly ruined my country. A great industrial nation is controlled by its system of credit. Our system of credit is concentrated. The growth of the nation, therefore, and all our activities are in the hands of a few men. We have come to be one of the worst ruled, one of the most completely controlled and dominated Governments in the civilized world - no longer a Government by free opinion, no longer a Government by conviction and the vote of the majority, but a Government by the opinion and duress of a small group of dominant men.” -President Woodrow Wilson

"The budget should be balanced; the treasury should be refilled; public debt should be reduced; and the arrogance of public officials should be controlled." -Cicero. 106-43 B.C.

"if that mischievous financial policy, which had its origin in the North American Republic, should become indurated down to a fixture, then that Government will furnish its own money without cost. It will pay off debts and be without a debt. It will have all the money necessary to carry on its commerce. It will become prosperous beyond precedent in the history of the civilized governments of the world. The brains and the wealth of all countries will go to North America. That government must be destroyed, or it will destroy every monarchy on the globe." -The London Times

"Permit me to issue and control the money of a nation, and I care not who makes its laws..." -Mayer Anselm Rothschild

Templars and Banking

The history of the modern age begins with the crucifixion of Jesus Christ, the martyrdom of His Apostles and followers, and disappearance of the true Church of Christ and the eventual rise of the apostate Catholic Church. To deal with the encroaching Christian religion, Constantine created a hybrid Pagan/Christian religion to end the religious division in the Empire. After the fall of the Roman Empire, the Catholic Church struggled to keep power and control. To prevent heresy, the Catholic church held church services in Latin, and discouraged literacy, restricted the arts and sciences, and limited access to reading the Bible. The western world fell into the Dark Ages. The only easy way for a commoner to learn to read and write was to join a monastery where learning, art, and science were strictly controlled. General illiteracy and scriptural ignorance persisted until Dante published "Inferno" in the lingua franca of Italian and Wycliff translated the Latin Vulgate into English.

Beginning with the First Crusades in 1119 , Western Europe desired to re-take Jerusalem and the Holy Land from the Ottoman Turks. The Catholic Church created The Poor Knights of the Temple of King Solomon or Knights Templar to protect religious tourists who desired to visit Israel and see the sights described in the Bible. While in Palestine, the Order of the Knights Templar identified and excavated holy sites, and secured a vast hoard of religious artifacts and relics. The Order became instantly wealthy selling authentic and fraudulent antiquities in Europe. During the Middle Ages, religious tourism was big. Small towns could bring in serious money by building an ostentatious cathedral featuring a quality relic such as St. Paul's toenail. Pilgrims who didn't have the money to visit Israel, could do the next best thing and visit and pray at a cathedral featuring several museum quality or sham relics and antiquities.

The Templars made money in other ways. The Order was a charity. Therefore, as a charity, they received large donations in support of the Crusades and the cause of the Holy Land. The Templars were also a monastic order, so all those who joined the order gave up all their worldly possessions upon becoming a Templar. In addition to protecting pilgrims, Knight's Templar also fought in the front lines of the Crusades. Templar Warriors were never permitted to retreat in battle and thousands of Templars ran suicide charges into the ranks of the Ottoman Turks only to be cut down by the Turk's superior Damascus Steel Sabers (carbon nano-tube steel).

The Order of the Knights Templar became the most powerful, wealthy, and influential order in the Catholic Church. In 1139, Pope Innocent II decreed that the Knights Templar could pass freely through any border, owed no taxes, and were subject to no one's authority except that of the Pope. In France, the order embarked on the ambitious project of establishing a national and European banking system.

Templars had a papal mandate to protect pilgrims during their travels to Jerusalem which expanded to protecting pilgrims in their travels from cathedral to cathedral throughout Europe along famed pilgrim routes. In addition to protecting people, the Knights also were put into service protecting possessions. Eventually, the Knights and Hospitallars developed the first modern banking and monetary system where pilgrims could deposit gold, valuables, and mortgage deeds at a local Templar house. Pilgrims were then given a signed and ciphered document describing the value of their deposited assets which the pilgrim could then redeem at another Templar house along the pilgrim route. Templars claimed all rights to mortgaged property. Therefore, they instituted the forbidden practice of exacting usury by claiming the interest collected was actually rent.

The party didn't last. By 1300, the Order had lost nearly all its lands in the Holy Land to the Muslims. King Philip IV of France, already deeply indebted to the Templars due to an unpopular and protracted war with England, was denied another loan to fund the war. This denial of credit didn't endear the Order to King Philip. Then, the Templars came up with a scheme to de-legitimize Philip IV's claim of divine right. The Templars claimed that while conducting excavations of the temple mount in Jerusalem, they discovered genealogical records which proved that Jesus Christ was married to Mary Magdalene. The Order claimed that not only was Jesus Christ married, but that he had offspring by her. The Order claimed that they had identified and located numerous direct descendants of Jesus and Mary and that this holy bloodline was married into the rival Merovingian Dynasty (sangréal = royal blood not holy grail).

In response, King Philip IV requested Pope Boniface VIII to renounce and excommunicate the order. The Pope refused. King Philip then kidnapped the Pope, poisoned the next Pope, Benedict XI, and influenced the college of cardinals to elect his childhood friend Clement V as the next Pope. On Friday, October 13, 1307 (origin of Friday the 13th myth), King Philip rounded up and tortured hundreds of Templars and got them to confess to denying Christ, urinating on the cross, idolatry and homosexuality (obscene kissing). Using these confessions, King Philip IV convinced Clement V to dissolve the Order in 1312. The surviving Templars disbanded, scattered, and fled throughout Europe. Many found refuge in Scotland and Great Britain and others in Italy.

Monday, December 07, 2009

Global Warming Fraud, Don't Sign that Treaty

Michael Mann is a climatologist and professor at Penn State University. Mr. Mann studies paleoclimate by looking at tree rings and is responsible for coming up with the famous "hockey stick" graph that is featured in Al Gore's "Inconvenient Truth" Narcimentary, and many United Nation's IPCC publications. Michael Mann also has a website at He has been in hot water of late as recently discovered emails reveal how he and his colleagues fudged the data on the "hockey stick" graph to make it look like human CO2 production is causing global warming. One email contains the quote: "I've just completed Mike's Nature trick of adding in the real temps to each series for the last 20 years. . . to hide the decline"

In response, Michale Mann has been all over the media this week explaining away the new emails and trying to sell the US public on the international climate summit in Copenhagen. Mr. Mann was on NPR and CNN today defending himself and his climate buddies at Penn State. In response to questions about the email, Mr. Mann says he says the statements about his "Nature Trick" and "hiding the decline" was taken out of context and it was just banter. Mann was then asked about the decline in public support for CO2-linked global warming. In response Mann said he felt it was unfortunate because this spirit of not skepticism but "contrariness" was at odds with an overwhelming consensus in the scientific community, and overwhelming evidence by the climate data. He likened Global Warming deniers to those who would try to claim 1+1=3. According to Mann, Not all ideas, like those who oppose a link between CO2 emissions and global warming, merit being published in peer reviewed journals. (No bias there) Michael Mann challenged those who oppose CO2-linked global warming to provide data to prove our side. Of course through the entire interview, Mann gave none of his own except to claim that the EPA, IPCC, and everyone else couldn't all be wrong.

1. We know Michael Man falsified the data in his 1000-year CO2/Surface Temp graph where he hid the global warming that occurred during the Medieval Warm Period and the Temp Declines for the past 10 years.

2. Ice Core Temp/Co2 data prove that Co2 level lag 600 years behind increases in temperature. This means that increasing temp is the driver for increased atmospheric CO2 and not the other way round. Correlation is not causation, especially when it lags behind by 600 years.

3. Increased global temperatures are caused by a combination of changing sun luminosity, sun spot activity (eg Maunder Minimum or Little Ice Age), fluctuations in the Earth's orbit around the Sun, and variability in the Earths tilt towards or away from the sun (Milakovich cycles). Because there is more water in the Southern Hemisphere, if the south is tilted closer to the sun, then you have more ocean warming which makes warmer oceans and more clouds. The warmer oceans can't hold as much diffused/dissolved CO2 which then is then is released into the atmosphere (think flat warm soda).

4. More CO2 means healthier and more lush plants. Do the experiment yourself in a sealed bell jar.

5. The Ice in the Arctic and on Mt Kilimanjaro is receding because temperature is colder. Colder oceans makes less clouds and less clouds make less rain and snow. Colder air means dryer air. Dryer air means the snow on Mt Kilimanjaro is sublimating away and not evaporating.

6. The Climate Summit in Copenhagen will sign over US sovereignty to a global government that will enforce CO2 emissions. Do you want the UN telling you that you can't buy that product or start that business because it produces too much CO2?

7. CO2 emission limits hurt the 3rd world whe need to industrialize to prosper. The token payments to 3rd-world countries is a drop in the bucket that will go into the pockets of corrupt leaders and not to the people.

8. The global warming group argue that a warmer earth will make more clouds which will trap more heat in the upper atmosphere. However, measurement shows that saturated clouds fall to lower atmosphere and there is no warming in the upper atmosphere and in spite of a prediction by 11 climate models claiming radiated heat into space would decrease with higher CO2, Dr. Richard Lindzen at MIT reports the measured data by ERBS satellite showing that radiated heat into space is actually increasing (Lindzen & Choi, GRS, 2009) with respect to suface temperature. Thus no global warming.

Mike would have you believe that Man-made global warming is "settled science" and Al Gore would have you believe that man-made global warming is the "most important moral issue of our generation." The truth is that while proper management of the environment is important, CO2 has nothing whatever causative to do with global temperatures, and CO2 is not a significant greenhouse gas.

Christopher Monckton, Viscount of Brenchley: YouTube Video 1; YouTube Video 2
BBC Documentary: "Global Warming Swindle": YouTube Video; 1,2,3,4,5,6,7,-->[[[8]]]<-- John Coleman, Weather Channel founder challenges Al Gore and Mann: YouTube Video

Don't sign the Copenhagen Climate Treaty President Obama.

Monday, November 30, 2009

Financial Reform and the Non-Profit Community Safety Society Anti-Bank

In previous posts (1, 2, 3, 4, 5) I have identified and discussed how our current system of lending/borrowing is having significant negative effects on inflation, family values, heath care costs, family farms, and housing costs and which contributes to nearly every social problem today. In this post I will discuss the solution. We need a new system for lending and borrowing involving a sort of co-op anti-banking institution. Evidence that supports the need for such a co-op financial institution is found in the many co-op farms, grocery stores, insurance, and utilities popping up all over this nation. In our current system, nearly all profits go to the lender, while the individual borrower accepts all the risk. In a co-op financial, risk would be spread evenly across a community, as well as profits. The Community Safety Society would borrow ideas from Savings and Loans, Credit Unions, as well as Amish and Sharia Law Banking. Here is how it would work.

Current System
In our current system banks borrow our own tax dollars from the FED at prime (currently 0%), then according to fractional reserve banking they lend 10$ for every 1$ borrowed. I should have been a banker. When banks lend to us they need to make a profit, but they not only lend our own money back to us at a higher interest rate, they contractually bind us to an amortization schedule (instead of the balloon payment) that collects 95% interest for 20 years on a 30-year home loan. Their justification for such an obscene profit margin is the illusion of risk. Look at all the bank failures throughout history. But because of fractional reserve lending, and the bank creating money magically out of thin air, that means if people default on their loans, banks repo and sell their home and earn a nice profit. What kills banks is the practice of leveraging their fractional reserve dollars by trading them for stocks and derivatives. When the Stock and Derivative markets tank, the banks have lost their small fractional reserves and cannot lend or pay creditors. and then they go bankrupt. Our current system of indentured servitude and continual bank failures is designed this way on purpose. If home ownership is the American Dream, the home mortgage is the American Nightmare.

So, how should credit work that is immune to fluctuating markets? This system is partly based on Sharia Law Banking, Amish Banking, and Credit Unions. But as I do not entirely know exactly how all these work, I do know that both the Bible and the Qur'an have strict rules or prohibit the collection of usury or interest. This is not an anti-capitalist or free-market system. This is not a communist or socialist system. This is just a credit system that is non-profit, but profit-driven for its members, and is more fair and more immune to the instability of the markets. The name of our co-op anti-bank will be called a Community Safety Society (CSS).

Appreciating Assets
First, the Community Safety Society will only deal with loans and credit on assets that have the potential to increase in value or appreciate and not on assets which will depreciate. That is, our anti-bank will invest in homes, home improvement, real estate, and business ventures. The CSS will not provide credit for automobiles and other depreciating consumer commodities.

2 Ne. 9: 51 Wherefore, do not spend money for that which is of no worth, nor your labor for that which cannot satisfy.

When a member of the CSS seeks to purchase a home, the CSS member will negotiate with the bank to prove his credit worthiness and apply for the bank to purchase the CSS member's property of choice. Instead of lending money to the individual which is in turn used to purchase the property, the bank will purchase the property outright. Instead of charging interest up front on an amortized loan, CSS will charge a modest transaction fee to cover administrative costs. The CSS member may be required to come up with capital as a down payment on the home purchase. This money would be paid to CSS in partial repayment of the property. If 10% were paid by the CSS member, then the CSS member would become a 10% owner of the property, and CSS would have 90% ownership. As monthly payments were made, the CSS member would increase his ownership and equity in the property right from the start until the property was entirely paid for and the CSS became a 100% owner.

Underwriting, Repayment and Foreclosure
1. Loan worthiness will be assessed based on set criteria including: quality and redeem-ability of the asset, collateral, credit history, reputation, and capacity or ability to pay.
2. Repayment will be in monthly payments until the CSS member becomes achieves 100% ownership and the loan amount is repaid.
3. The joint-ownership agreement and contract may contain a time period by which the CSS member must assume full ownership of the property or asset.
4. There is no penalty for extra payments. The CSS member can achieve full ownership at any time.
5. If the home is sold before the CSS member has become full owner and the home is sold for a profit, those profits are divided between the anti-bank and the CSS member according to their percent ownership. Property and business value could be assessed annually and the repayment adjusted accordingly.
6. If the home looses value and is sold at a lose, then the CSS member and the bank share that lose according to each parties percent ownership. I currently prefer this arrangement over putting all the liability on the CSS member who could instead decide to not only default on the loan but also declare bankruptcy instead of take the full responsibility of the lost value of the home. However, I could change my mind.
7. If the CSS member is unable to make payments on the home, the home owner may be bought out by the bank. Every missed payment would detract from the CSS member's equity and ownership of the property until all equity and ownership was forfeited. Having immediate equity in the property would provide an insurance for the CSS member during periods of unemployment. If the CSS member could no longer make payments on the property and had divested himself of all ownership and equity, then the CSS anti-bank could then repossess the property, resell it, and retain any profits.
8. The CSS anti-bank may or may not operate on fractional reserves. Liquidity must be available to make purchases of assets and to satisfy savings withdrawals. If the anti-bank were allowed to lend based on fractional reserves, the bank would be liberated from the risks of CSS members defaulting on their mortgage arrangements. The CSS anti-bank must be able to buyout the home owners who default on their contract. Upon resale of the home, any lost resale value in the home would be factored into the buyout.
9. Reputation of the CSS member would be an important consideration in the decision to enter into any joint-contractual agreements. CSS would attempt to be fair, equitable, and non-discriminatory but as a private co-op-like business, the bank would need to be discriminating based on values and risk determined by its members and governing boards. Amish banking is a great example of using reputation as part of the underwriting process.
10. The greatest threat to CSS would be corruption and rejecting founding principles while being seduced to behave more like a traditional bank. CSS anti-bank could provide debit-cards and checking account services, provide travelers checks, money exchange, and may give loans against home equity for home improvement. Giving loans for cars or other assets that depreciate in value would not be permitted. CSS does not give loans, it purchases assets.
11. CSS would not exchange currency for derivatives. They may exchange currency for municipal bonds from the community. CSS would only invest in stock and stock options when investing in local business who they are in contractual joint-ownership. This would insulate the bank from market volatility outside the community.
12. CSS may apply for non-profit status. Dividends and profits paid to CSS investors and part-owners would be taxable, but CSS itself would reinvest any and all profits into the community.
13. CSS will undergo independent third-party auditing and accounting.

Savings and Dividends
CSS Members who open savings accounts with the CSS co-op anti-bank will exchange their currency for part ownership in the CSS. Currency would be exchanged for securities like a stock. When the CSS makes a profit on its investments, those profits will be shared as dividends with all its members according to thier percent ownership in CSS.

Run of the Anti-Bank
In the event of a run on the bank, and members making significant withdrawals of their savings and divesting themselves of part-ownership in the bank, much of the CSS capital will be locked up in property, business assets, and business stocks. CSS could make arrangements to sell these assets to their part-owners at a discount to raise the necessary capital. KSS members who are part-owners of a property or business could buyout the CSS anti-bank using currency obtained through a traditional banking loan.

CSS leadership and government will be administered by an executive board with board members elected by the general membership. The governing executive board will appoint a president. The executive board and any hired support staff will receive appropriate hourly compensation for their positions. The level of compensation will be determined by the executive board.

Other Ideas
This concept of the Community Safety Society is by no means a finished product. I only recently started thinking about it. This is a work in progress that I hope will solve a critical problem in our country and in the world. This kind of co-op system is working in other communities right now. Co-op Farming, insurance, and even grocery stores are strong evidence for the need for financial reform. Co-op banking would replace the need for co-ops in all these individual areas as all businesses would essentially be co-ops already through the co-op CSS anti-bank.

Community-Based Farming, Community-Supported Agriculture, and Crop Sharing spreads the risks associate with farming to the whole community and not just onto the farmer. Farmers are paid upfront by community members to farm. If there is a bumper crop, the individual community members receive weekly deliveries of fresh produce. If a heavy rain causes tomatoes to split, then the community gets split tomatoes. If there is a crop failure, the community loses out on fresh produce, but the farm remains in business to try again next year. The farmer can sell excess produce to grocery stores and farmers markets.

Co-op Grocery Stores are making loyal customers part-owners in the business and paying out dividends.

Saving and Loan Failure
There were several factors which led to the S&L crisis in the 1980's. First, there was a dip in the housing marking and in housing prices. A slow housing market means less home mortgages and their associated fees. Second, interest rates were at an all time high which made borrowing money from the FED very expensive. The US government passed an unfair law limiting the amount of interest an S&L could offer on its accounts. This cut into the profit margin of the S&L's who had guaranteed obligations to pay generous interest on member CD's. Many investors took their money out of S&L's to invest elsewhere at a higher rate. S&L's began speculating in world markets and investing in risky foreign companies and ventures. S&L's suffered from internal corruption and lack of external oversight and regulation such as independent accounting and auditing. The Tax-Reform Act of 1986 ended the practice of tax-sheltering money in real estate. Deregulation allowed S&L's to behave more like banks and take bigger risks and they over extended themselves competing for investors. S&L's were exploited by a practice known as linked financing by deposit brokers. In this scam, deposit brokers promise banks new investors if they also lend to these same borrowers who were given money to invest and apply for a loan. These sham lenders/borrowers then turn around and give the borrowed money to the broker who then declares bankruptcy and defaults on the loan.

Noetic Science, Consciousness, and Coherence

(The following is just for fun)

I am listening to CoasttoCoastAM talking about physical coherence and human consciousness. I don't like when Art Bell, George Noory, and Ian Pundit tell ghost stories because it creates fear, global dissidence, or as LDS would say "spreads a bad spirit," but I enjoy when they speak on fun topics like what the mainstream would call "pseudo-science" or "meta-science." Tonight's subject is addressing how individual and global human consciousness can affect the physical world. According to the guests on the show, there way be scientific instruments that are able to measure these effects for the first time. However, if CoasttoCoastAM believes in what is called
Noetic Science, they shouldn't have shows dedicated to telling ghost stories, UFOs, and spreading rumors, lies, and fear.

Dan Brown's latest thriller "the Lost Symbol" also discussed ideas and correlations of the emerging field of
Noetic Science and presumed hidden knowledge of ancient civilizations preserved today in societies such as Freemasonry and in the Bible. Noetic Science is a new and emerging "meta-science" that claims that it can scientifically measure the direct effects of collective and individual human consciousness on the physical world. Like the CoasttoCoastAM show, One of Dan Brown's main characters claims they can scientifically measure the effects of prayer and meditation. Dan Brown played with the idea that ancient civilizations understood this science and this knowledge is preserved in the symbolism and ritual of Freemasonry and in the Bible: "Order from Chaos".

So, how are scientists supposedly measuring the effect of collective human consciousness or what is called "coherence" vs. "incoherence" or "dissonance?" It turns out that some researchers at Princeton and the
Global Consciousness Project maintain a world-wide network of random number generators known as he EGG experiment. What they claim is that when there is a global incident like 911 or Princess Diana's death, because of global news, this creates a situation where there are hundreds of millions and even billions of people in the world who are experiencing a shared emotion of love or fear and maybe even a shared consciousness. And what this Princeton group claims is that during events like 911, they observed an effect of this shared global consciousness in their worldwide series of random number generators. The Princeton group claims that during global incidents that they are observing an increase in order and coherence among their worldwide network of random number generators or "Order from Chaos".

Richard C. Hoglan who is a common guest on CoasttoCoastAM also says that he was able to measure the effect of how ancient temples and pyramids were designed to focus these effects. Hoglan claims that he was able to use a Buliva watch and a tuning fork and measure a change in the frequency in the tuning fork as he walked up and down Maya pyramids in MesoAmerica. Hoglan claimed that something about the pyramids at Tiqual was affecting the mass and angular momentum of the tuning fork. However, Richard C. Hoglan needs to remember that large structures like Egyptian Pyramids collect and concentrate large static charges on their surfaces. If you take a metal hoop to the top of the pyramid at Giza the dissipation of electrical charge is so great that you can observe St. Elmo's Fire or plasma at the top as the charge is dissipated. It could be that this static charge gradient is the source of Dr. Hoglan's torsion-field effect.

I wonder if you could measure the same effect using a tuning fork which is usually used to calibrate a radar speed detector. However you would need an independent way to calibrate a radar speed detector and then have a continually resonating tuning fork and measure the changes in readings of the radar speed detector. Could measurements be observed in other high-precision instrumentation like laser gyroscopes and interferometry?

Another guest on CoasttoCoastAM, Greg Braydon, claims that on 911 there was a spike measured by the GOES weather satellites measurement of the global dipole moment of the Earth. The claim is that somehow the worldwide response to 911 caused a brief increase in the global magnetic field dipole moment of the Earth.

The guests on CoasttoCoastAM are of the opinion that the 2012 Maya Calender may be pointing to a convergence window of events such as a galactic alignment of the sun in the plane of the galaxy, a 26,000-year and 5,000-year progression of the equinoxes, and a possible record solar minimum or maximum, and a earth magnetic pole reversal which may cause all kinds of unknown affects. They are not speaking of the end of the Earth, but a new consciousness driven by changes in the world. Richard C. Hoglan and Greg Braydon are claiming that changes in the world will cause a change in human consciousness and at the same time that the united global consciousness and coherence could causes physical changes. Richard C. Hoglan calls this medium the torsion field effect, Shumman radio-frequency resonance, and the crystal heart.

One caller made an interesting point that there seemed to be a negative yet powerful amplifying force associated with the Maya doing human sacrifice and pulling the heart out at the top of a pyramid at a certain time. Maya believed that this kind of sacrifice changed the physical world around them in observable ways.

While I am repeating some of this, let me be clear that I don't believe most of it. I do not think anything will happen in 2012 just like I did not believe anything would happen in 2000. The Bible says that after the opening of the 7th Seal which likely refers to the year 2000, John in Revelation says that there would be silence for half-an-hour before there would be the sounding of the 7 Trumpets and the pouring out of the 7 cups of wrath. If 1000 years is 1 day to God, then half-an-hour would be 21 years not 12 years. And then after the sounding of the trumpets the Second Coming of Jesus Christ is sometime after that; at least 3 1/2 more years until Armageddon and the restoration of the Jewish Temple which must occur before Christ's Second Advent.

But being a religious and spiritual person, I believe in the power of prayer and meditation and it is fascinating to think about scientific experiments which possibly could measure an effect of coherent human consciousness. I don't know if all this is true, but the Princeton group claims that their EGG experiment is showing results. Being LDS, I also believe that temples and prayer circles can magnify the power and effect of prayer. Whether the effect of a temple or a prayer circle can be measured using a watch and tuning fork, I don't know. I agree with the guests that temples and pyramids can amplify miracles.

One idea that I was interested in also, was something Ian Pundit and Greg Braydon said about the human response to calamity. Ian was saying about how humans respond to fear and adversity. The Bible says that "perfect love casteth out fear." Accordingly, stress brings out the best or worst in people. Adversity shows people what they are made of. As the Bible says God has raised some up to honor and others to dishonor and that the Saints would come out of the tribulation with their clothes washed white in the blood of Christ. This is related to the fight or flight response. When people face adversity, they engage that adversity with faith, hope and love while others react, regress, and withdraw with fear and anger.

The show seemed to have a good conclusion that said that human consciousness could help things or make things worse. Human consciousness and hope could have the power to reverse and repair the world. However, there is a danger here. I disagree that human consciousness is the power here. Faith in Jesus Christ is the true power, and the real power of temples and Christian prayer circles is not the ritual and building itself, but that these rituals, ordinances and sacred spaces focus our collective faith in Christ which is the only true source of love and power to change hearts and save the world.

Dean Radin who is a Senior Scientist at the Global Oneness Project spoke about some interesting points. First he said that neuroscientists have found that a person's view of self and their worldview determines the quality of their morality. College students read over data on brain function with the following materialistic spin/opinion given by Nobel Laureate Francis Crick who said "We are nothing but a pack of neurons." Other students just read the factual data without the materialistic spin. Then both groups of students were given a test on the material with a promise of a monetary reward for a perfect score on the test and a way to cheat. The results of the study were that college students who had read "We are nothing but a pack of neurons" cheated much more than those students not exposed to this spin. This suggests what we already know, that when we are taught a Nietzsche/nihilist philosophy that there is an end of consciousness at death, or a Darwin/evolutionist view that we are all evolved from "pondscum", or we are taught an Evangelical doctrine that men are created beings no better than "dungbeetles" then we are more likely to eat, drink, and be merry for tomorrow we die. Dean Radin uses this data to justify continued research into Noetic Science because he claims that if we all realize that man is part of a large interconnected mind, and that our individual actions have effects on the system, then maybe our society will behave more ethically. LDS understand that all mankind are spirtual offspring of God the Father and are spiritually begotten and not made. Knowing this helps LDS exhibit a generally higher moral behavior.

Then Dean Radin suggests some very interesting ideas. He says that science is able to differentiate the brain from the mind. And says, the consciousness of the mind can already have affects on the physical world through our brain. So, if our mind can bring order to the chaotic system of the brain, then why could it not affect other systems. Then he wondered about the Internet. The Internet has become nearly as complicated and interconnected as the human brain. At some point could the Internet become senescent, self-aware, or conscious? What mind would be in control. Would the Internet become controlled or biased by a single global mind, or even the spirit of the Earth "Gaya" herself. Radin suggests the Internet may become a way in which the mind of man and the mind of the Earth could communicate and interact with one another instead of through weather and natural disaster. As our mind can control our brain, maybe a global consciousness could control the internet. LDS scripture tells us that the Earth will become sanctified and eventually become likened to a "sea of glass mingled with fire" were man will look into the Earth which will become a great Urim and Thummin and reaveal all things related to a lesser kingdom.

D&C 130:9 This earth, in its sanctified and immortal state, will be made like unto crystal and will be a Urim and Thummim to the inhabitants who dwell thereon, whereby all things pertaining to an inferior kingdom, or all kingdoms of a lower order, will be manifest to those who dwell on it; and this earth will be Christ’s.

1. If adversity drives people to the extremes of fear vs. love respectively then wouldn't these forces be equal and opposite? If equal and opposite forces, how could the effect of those forces be measured? Unless the initial response to 911 was immediate horror, and then people split into groups expressing fear vs. faith and hope and love. However, light and dark are not equal and opposite. Darkness is only the absence of light. Love casteth out fear.
2. Therefore, would an increase in charitable giving after a catastrophe be measurable on a goodwill/chaos/coherence meter?
3. If Christ is not in the equation, then the science is false. But LDS do not throw out the baby with the bathwater. All truth has temporal and spiritual realities. Therefore, could there be a physical, quantifiable, and measurable aspect to the LDS temple and Christian prayer circle?
4. Could Noetic Science be a corrupt philosophy behind an emerging one world government? Which part of this philosophy is true and which part is the lie?

5. An experiement to test this hypothesis: The Super Bowl is usually played on a neutral field. Therefore, during the next Super Bowl, take 50 RNGs to each of the respective cities of both ciites, and 50 around the Super Bowl statium itself and then 50 more in Tokyo or other large city where the people are not not American Football fans as a negative control and see what happens with each touchdown or fumble and win or lose.

Monday, November 23, 2009

Health Care, Finance Reform, and Family Values

I was watching Gov. Mike Leavitt on PBS field questions about health care reform. He did a fine job fielding questions and defending conservative values that bigger government is not the answer to our health care problems. Yes, our country is an unfinished pyramid, but the all-seeing eye at the top is God, not the government. That said, I think many miss the real reasons why health care costs are so high.

Financial Reform
The real problem with cost in America are financial and our system of borrowing and lending. It truly is a system of bondage. As I understand the banking system, banks can borrow tax money from the FED at prime which is nearly free and currently at 0% is free. Then they turn around and lend that money back to us for home loans at a higher interest rate of 5-6%. But what is not discussed is that in addition to the profit margin built into the higher interest rate, the banks also bind the borrower to an unfair amortization schedule that collects 95% interest for 20 years on a 30-year loan assuming minimum payments. On the other hand, when an American family saves money, they earn only 5% interest which doesn't accrue significant interest until after 20 year. This creates the classes in America. There are the working middle and lower classes which pay the interest and a fortunate few who have broken through the interest barrier and earn the interest and are free from paying it. This system also creates inflation as the only way to gain significant equity (if making minimum payments) is for the value of the house to go up.

Sub-Prime Loans
Banks would have us believe that sub-prime borrowers who defaulted on their loans are the cause for the housing bubble bursting. This is a terrible half-truth. What most people don't know is that the banking system operates on a system of fractional reserve lending. That means that for every 1$ they borrow from the FED or elsewhere, they can lend 10$ or more. That means that if a person defaults on their loan and the bank repos. and resells their house for 40c/1$, the bank still made 30c plus all the interest already paid. Also, people don't understand that rich people who were "upside down" defaulted on their second homes and vacation homes as much as the sub-prime lenders did. While this shouldn't have hurt the banks, this did hurt AIG who was the major underwriter for mortgage insurance on all those sub-prime loans that didn't collect an initial down payment. AIG couldn't or wouldn't pay the banks all the default mortgage claims.

Mortgage Backed Securities
If a borrower defaults on a loan, has their house repossessed and resold at 40c/1$, shouldn't that still result in a profit for the bank because of fractional reserve lending? If this is so, why did some banks fail? The reason some banks failed was because they were fooled into "leveraging" their assets by trading their sparse fractional reserve dollars and trading them for speculative and volatile mortgaged backed security derivatives. These toxic assets which were given AAA ratings tanked when the housing bubble burst. Because of "mark-to-market" policies by the SEC since ENRON, derivatives are assigned their current value in todays market and not the value you think they will fetch in the future when you plan to sell them. Greenspan thought derivatives would stabilize the markets, but because of their potential for abuse we have seen wide fluctuations in gas prices, the current bank failure, and the ENRON accounting scandal as a direct result. Banks failed because when they lost their fractional reserves, they could not lend and could not pay. Consequently, some small banks were allowed to fail, other banks were bought out, and others "too big to fail" were given TARP.

Negative Effects on Family Values
As I said above, the only way for a family paying minimum payments on a home loan to accrue significant equity is for the value of the home to increase. This is the pressure that has driven the price of homes up and up. This same lending system has also pressured fathers to work more hours, multiple jobs, and for moms to also enter the labor force to meet the rising cost of living. The bubble burst and there was a correction in the market because even with both mom and dad working, the wages have not kept pace with the cost of living. But there are other more serious consequences. With the increase in "productivity" and dad working multiple jobs, and mom also in the work place at the same time (I am not against women in the work place), there is no one home to meet the critical emotional needs of the family. There is no nurturing going on. There is no one home to transmit critical life skills and preventive health to the rising generation. Consequently, when you have unmet emotional needs, that leads to addictive behavior, mental illness, delinquency, teen pregnancy and illegitimacy, gang activity, and poverty. And all of this results in rising health care needs and costs.

Preventive Medicine
Jesus Christ said, "The whole hath no need of a physician, but them that are sick." Other than vaccines which doctors don't need to do at all, Doctors do not do preventative medicine despite what we say. True primary prevention is what you learn from Mom and Dad, at school and at church. It is Mom and Dad that are supposed to teach basic principles of health, diet, nutrition, exercise, stress management, care of a newborn, first aid, etc, etc. If you have to hear this from your doctor, you are likely hearing it too late. Why, because what doctor's do is not primary prevention. What Doctors call "secondary prevention" is screening for the presence of absence of disease. If disease is present, we will institute disease management which has a cost, but in return will grant you longer life. This trade off of cost for life is called the QALY. Nothing a Doctor does saves money, it only costs money and results in longer life. But whether you die in 6 months or 6 years, the cost of dying is expensive but the same. It's a sunk cost. Even if a doctor saves you from dying of cancer, all we really did is save you to die from something else expensive. I worry about ideas of government agencies coming into the home to teach parents the state version of preventive medicine and life skills. Would such an agency have the power to remove children from a home if the parents were not teaching the mandated state doctrine of preventative care?

Dis-incentive System

The government runs the VA system and Medicare so it thinks it can run an insurance program that competes against private insurance. However the VA system and the Canadian system are propped up by the US private system. When people can't get what they need at the VA or in Canada, they go to the US private system. There is also very little incentive in the VA system to work hard and be productive. Consequently, doctors act like they are unionized and don't stay late or do that extra surgery. The consequence is more inefficiencies and longer wait times. The Fort Hood shooter was not kept on staff because of political correctness, but because they needed a doctor. He filled a spot. The US government had a lot of money invested in him. There are lots of great but many bad doctors that hide out in the VA system because they are needed and fill as call schedule. The US needs to decide if it wants to out-source doctors. Because, if you dis-incentivize the system, people will not do it. It's too tough and our brightest people will choose another career path.

Health Care Reforms
I agree with Gov/Sec Mike Leavitt that the debate is not whether we should or shouldn't cover the 50 million uninsured in America. The question is how do we do it. Do we throw up our hands and let the government handle it, or do we exercise our rights to self-government and look for other answers. There are many good ideas on the table.
1. Romney Care: subsidize the purchase of private health insurance.
2. Tort Reform: this helps both doctors and patients
3. Health Savings Accounts with Catastrophic Coverage: isn't this what health insurance should be?
4. Direct Patient/Doctor Billing: more efficient for patients to pay doctors directly and then be reimbursed by insurance.
5. Increased Interstate Competition: Let people go out of state to buy insurance.
6. Fee for Service: I disagree with Mike Leavitt that the government should only pay a set price for a diagnosis. If a person gets a pneumonia or other complication while in the hospital, the government is not paying. That sounds like the quality reform he is talking about. I am glad I work in the ER and am federally mandated to see everyone that comes in the door, because if I was a surgeon, I wouldn't dare do a surgery on 3/4 the people I see because their personal behavior, genetics, and the nature of the procedure have inherent risk of complications. And now in addition to having to treat the complication, the doctor would eat the cost of the complication. If a doctor is incompetent, they should loose their license, but complications happen. No one is out there making complications so doctors can bill more. Doctors would rather do another surgery then have to spend time dealing with a complication.
7. Pre-existing Conditions: I think this kind of policy is the kind of reform government can do. They can give insurance companies operating guidelines in which they must operate to protect the public from being taken advantage of.
8. Medicare: Why do healthy workers pay into insurance their whole life and them when they retire and it comes time for them to have the majority of healthcare costs, they get dumped and put on Medicare and become the responsibility of the US tax payer?

Facility Fee
If you want to make a big difference in health care, you need to make changes that really matter. If reducing the rising costs of health care is the goal, none of the above measures will make much of a difference. They are good suggestions. But they only represent a small percentage of the total health care costs. The real question is, where does all the money go? Well it doesn't go to the doctor. The doctor fee is only 15-20% of the total fee. After, pharmacy and insurance companies take their cut, the majority of costs go to what is called the facility fee. And those facility fee profits go to the bank, or corporate board comprised of the ultra rich who get wealthy upon the talents and labor of others based only upon the "illusion of risk." If you want health care costs to be reduced, you have to change how capital is raised, borrowed, and repaid. And this brings us back to banking and financial reform.

Financial Reform
Some people may not like this, but the model for lending/borrowing reform is the Sharia Law Islamic Banks. If you can get past the Muslim-extremist issues, the Islamic banking system is a great system. If we were to adopt this system in the US to a greater degree, it would be a great PR/political move for the West. So, what is so great about Sharia Banks? They don't collect interest, but they do make profits. I am still studying how they operate. But so, far if a person wanted to purchase a home or business, they would pay a fee to borrow the money from the bank. The bank would not lend the money directly but purchase the home or business for the individual. There would be joint ownership. The buyer could pay 10% down payment and start off as a 10% owner of the house or company. That person would then pay back the loan. With every payment, the leasee would own a greater percentage of the home or business and build immediate equity until the home is paid off.

There are interesting things that could be done to deal with profits and appreciation. There could be an arrangement that if the home or business appreciated in value during repayment, that a portion of those profits would go to the bank and the leasee according to the % ownership each had in the home or business. Individual investors in this new anti-banking institution would become part owners. When an individual opens up a savings account and deposits money, the bank would issue that individual stock. As the bank's investments and properties appreciate and earn profits, those profits would be divided among all the stock holders. A great name for the anti-bank would be the Kirtland Safety Society.

Pay Off the National Debt
The problem with being slaves to interest and indebtedness, is that the whole United States of America is a slave to the multi-national banks and foreign governments who own the bulk of our savings bonds. Right now, nearly a quarter of our yearly budget goes just to pay the interest on the national debt. That is just the interest on 10 trillion dollars. One idea that would solve our nation's debt problem and fix our banking system is to simply print 10 trillion dollars and pay off our debtors. To make sure that printing that much money doesn't devalue our currency, the US could end the practice of fractional reserve banking. The need for banks to borrow more money would offset the glut of extra dollars in the system. Then, our govenment would need to commit to balancing the budget and shun deficit spending and never again sell our savings bonds to foreign governments.

Sunday, September 20, 2009

Viologen-Mediated Direct Carbohydrate Fuel Cell 1

Dear Dr. Dean Wheeler,

My name is David Brosnahan and I was a undergraduate research assistant with Dr. Gerald Watt from 1997 to 2000 and a graduate student from 2000 to 2002. After completing a masters degree in biochemistry, I went on to medical school and on to complete an emergency medicine residency. However, today while surfing the web, I came across the following abstract regarding Methyl Viologen and Glucose Fuel Cells at the website for an 2008 electrochemical meeting in Japan (see link below). I saw your name first of the abstract and I wanted to give you some background into how Dr. Watt got involved with this project.

Dr. Watt had two main projects. His primary project was Nitrogenase. He wanted to understand how Nitrogenase worked so he could replace the inefficient Haber-Bosh process to fix nitrogen into ammonia. His secondary project was ferritin, which is involved in iron metabolism in the body. When I started with the lab in 1997, our lab had national grant funding for both projects. But a year later, the government agency funding our nitrogenase research categorically withdrew funds in this area. Several years after that our ferritin funding ran out. We had been in a publishing drought because we had the correct but conflicting result with another lab who held the political and publishing high ground. The lean years that followed in the Watt Lab were very frustrating but resulted in our expanding our research into new areas. We had to evolve, publish, and compete for grants or die. The best way I and Dr. Watt saw to becoming competitive was to develop projects in the areas of nano-technology and fuel-cells. These were the emerging fields then as they still are today. Before I left,we began to collaborate with with the ChemE department and with other in our department on the nano-battery project. I was pleased that Dr. Watt had the opportunity to take a sabbatical at Langley Research Center to develop his idea. It was fun to brainstorm at the beginning of the project how the heat-stable and self-assembling ferritin protein could be arranged to work as a nano battery.

It was about this time when issues or global climate change and energy independence were rising in the public consciousness when a mishap in the lab got me thinking about fuel cells. We were anaerobically separating the nitrogenase protein using ion-affinity column chromatography when another hydrogenase enzyme in the mixture together with sodium dithionite catalyzed the electrolysis of water and the evolution of large amounts of hydrogen which completely interrupted the separation and the column. Upon observing the hydrogen evolution I kinda had an ah-hah moment and started thinking along the lines of a microbial or enzymatic (hydrogenase) fuel cell that would evolve hydrogen from dithionite. However, the idea of continually having to ferment bacteria, over-express and purify enzyme, and continually replace biological catalysts didn't seem to me like it was a system that would meet the global power demands of the planet (I could be wrong).

So, I started thinking about more direct methods to evolve hydrogen or directly reduce organic molecules. While working with Dr. Watt on a project related to the redox properties of ferritin and other metaloproteins, we routinely used a Coulometer to measure redox properties of redox-active metaloproteins. However, enzymes do not interact with metal electrodes directly, so Methyl Viologen or Paraquat was used to mediate the interaction. I thought, If methyl viologen could mediate between protein and anode, they maybe it could mediate between a hydrocarbon or partially oxidized hydrocarbon and the anode. Methyl viologen works because it its singly and doubly reduced states its heterocyclic, aromatic, conjugated, pi-electron system stabilizes a free radical state which then freely interacts with the anode. This is similar to how the body does it using biological mediators such as NADH, FAD, etc.

So, I started playing around in the lab and MacGyvered a table-top anaerobic fuel cell using methyl viologen added to various hydrocarbons. I tried hexanes, phenol, methanol, formaldehyde, and formic acid as well as glucose under various pH and temperature conditions. Glucose seemed to work the best. However, I didn't know at the time to what extent the glucose was being oxidized. Glucose is a reducing sugar and it is not difficult to get an electron pair out of it. I had tried to measure evolved carbon dioxide without success using GC. However, I stumbled upon the following abstract for a 2008 electrochemical meeting (see link below) and I was excited that your abstract mentioned that you and Dr. Watt had fully oxidized glucose to carbonate. I am excited that someone from the BYU ChemE Department took an interest in this problem. Before leaving BYU, I unsuccessfully tried to get Dr. John Harb involved with the project. However, I think Dr. Harb was more interested in collaborating with Dr. Watt on the ferritin nano-battery project then the fuel cell idea.

The purpose of this email is to verify that you are working on the MV fuel cell project. And if it is, I just wanted to let you know where I left off, and some of the problems I had talking this project any further. As you already alluded to in your abstract, designing a fuel cell which runs on glucose would be a historic breakthrough. Glucose derived from switch grass and other cellulose-based sources is 100% renewable. In addition, as you alluded to in your abstract, designing a fuel cell without needing gold or platinum in the reforming system, anode, or membrane (PEM) is a major hurdle to making fuel cells a viable answer to global energy needs and energy independence here in the US.

However, the major hurdle I faced was developing a fuel cell with adequate current per area. I could get 0.5 V short circuit voltages, but no milliamps. And this is because the reaction in solution is rate limited by the concentration of the MV. For a current to be generated a molecule of glucose would have to collide with a MV molecule which would then need to collide with the anode. That would result in a second order reaction dependent on a small concentration of MV in solution. However, if the MV mediator could be somehow directly associated with the anode, then the reaction would become first-order and dependent only on the concentration of glucose in solution. And glucose is very soluble. It seems from the abstract that you and your team figured out how to make this work. I couldn't think of a way to make a MV anode. I didn't know how to create a MV thin film, or polymerize MV. I discussed with Dr. Harb talking solid MV salt and mixing it straight with plasticizer and seeing if that worked. According to the chemical equations, I'm not sure if water was involved in the redox reaction. Looking up in Google, there are several groups that have discovered how to polymerize MV. If the polymerized MV is conductive or can be directly associated with an anode material, this may be a breakthrough.

Also, one more interesting characteristic of MV is that it can be doubly reduced into a quinoid form is soluble in organic solutions. Both the singly and doubly reduced MV forms carry out the electrolysis of water and form hydrogen gas using a variety of catalysts and photo-catalysts.

I apologize for the length of this email. I would appreciate any reply or information on the progress of this project. I am 100% into medicine now, but like to follow the progress of the research I was once briefly a part of.

David D. Brosnahan

1. MV thin film patent:
2. MV doped silicate anode and methanol Optical Materials Volume 22, Issue 3, May 2003, Pages 221-225 Electroreduction of methyl viologen in methanol and silicate thin films prepared by the sol–gel method
3. MV polymers Journal of Polymer Science: Polymer Chemistry Edition Volume 21 Issue 1, Pages 293 - 300 Preparation of viologen polymers from alkylene dipyridinium salts by cyanide ion
4. MV vs. MV polymers and electroysis J. Chem. Soc., Faraday Trans. 2, 1982, 78, 1937 – 1943Viologen/platinum systems for hydrogen generation
5. MV nanoparticles Electrochimica Acta Volume 53, Issue 26, 1 November 2008, Pages 7655-7660 Electrochemical formation of viologen nano/microsized wires and tubes by potential sweep technique combined with micellar disruption method
6. MV polymer Bioelectrochemistry Volume 60, Issues 1-2, August 2003, Pages 57-64 Voltammetric and spectroelectrochemical characterization of a water-soluble viologen polymer and its application to electron-transfer mediator for enzyme-free regeneration of NADH

Viologen-Mediated Direct Carbohydrate Fuel Cell 2

Dear Dr. Dean Wheeler,

Thank you so much for sending the power point presentation. I thoroughly enjoyed every slide. I was very excited to see that you were able to measure respectable current densities. Several of your slides actually resolved some questions I had had at the time. I especially appreciated the Pourbaix diagram. I just wanted to pass on some more background info that came to mind after going through your power point presentation.In my first email, I described unsuccessfully measuring CO2 evolution by gas chromatography (GC). I understood that CO2 would not exist in significant amounts at basic pH but it was nice to see your potential/pH diagram map out the various phases in this electrochemical system. After seeing your presentation, I had a few additional ideas as possible models to characterize the chemistry better.
When I was playing around with MV and glucose, I was routinely using high-Molar and saturated glucose solutions and a limiting amount of MV. Using Dr. Watt's Schlenk line/manifold, I made a basic, aqueous glucose solution anaerobic and then added an anaerobic solution of MV. The solution immediately turned deep blue. I see that you also discovered that the reaction occurs with both reducing and non-reducing sugars. I think if I had acidified the solution, any carbonate would have been converted to CO2, which I could have then injected into a Hewlett Packard-CG and been able to make a quantitative estimate of the extent of the reaction.

I also noted that you monitored the MV-glucose reaction using a pressurized cell and indirectly calculating the O2 consumption based on pressure differences. A simple variation on this theme would be to measure O2 directly. Dr. Watt had a direct electrochemical dissolved-oxygen probe in the lab. The probe worked by covering the end of the electrochemical probe with a cellulose acetate film with a concentrated KCl solution between the film and the end of the probe. I believe there are several much simpler oxygen concentration probes on the market today.

What I did was created an ambient-pressure reaction cell using two pieces of mortised Plexiglas bolted together which created a central reaction well similar to your reaction apparatus. The oxygen probe fit snuggly into a bore hole drilled into one side of the block; the tip of the probe inserted into the central reservoir. Stop cock vacuum grease was used to make the probe insertion air-tight. Another deep but small-diameter hole was also cut into the Plexiglas. The small-diameter hole was just big enough to insert a long small-gauge syringe needle down into the central reaction reservoir. I found by leaving this deep bore hole open, I could normalize the reaction to atmospheric pressures but the bore hole didn't allow ambient oxygen to enter the reaction system to a significant degree. The bore hole was so deep and so small-gauge, that the diffusion of oxygen from outside was negligible (see figure).

The electrochemical oxygen probe with the cellulose-acetate membrane was very pressure sensitive; so this setup, which operated at atmospheric pressure, allowed me to add and remove small volumes of solution without altering the pressure of the system. And believe it or not, ambient oxygen didn't diffuse into the system. Part of this is because the rate of the diffusion of atmospheric oxygen into and out of solution is porportional to the exposed surface area. In my ambient pressure reaction vessel, the surface area exposed to the atmosphere was only the size of a small gauge needle.

Now that I think about it, Dr. Watt had a glass reaction vessel I found especially blown for the electrochemical oxygen probe. The peace of glassware was composed of inner and outer glass cylinders with 2 communicating ports from the outer to the inner cylinder. One port was sized for the oxygen probe and the second port was sized to fit a rubber stopper. Instead of a rubber stopper I used a cylindrical Plexiglas stopper that fit snug into this second port. This Plexiglas stopper was modified with a small-gauged bore hole drilled lengthwise; providing communication between the inner reaction reservoir and the outside.

This glassware piece had 2 more ports which emanated from the outer cylinder and opened up into the space between in the inner and outer cylinders allowing fluid circulation around the inner reaction reservoir for purposes of temperature control.I used this same cellulose-acetate membrane material used to cover the oxygen probe as a membrane to make a concentrated KCL salt bridge and as the membrane material for my fuel cell. I am not sure if the cellulose-acetate membrane allowed diffusion of MV and glucose molecules or not. I didn't have any Nafion so, it was the best I could come up with.When I used concentrated alkalinized methanol in the reaction, MV was reduced and the solution turned blue. But when the MV was exposed to oxygen again and allowed to oxidize, a yellow-orange species was produced. I am not sure what this species was. It may have been a MV dimer. We never characterized it. The more I reduced and reoxidized MV, the more orange the solution became. This yellow-orange species was not seen with glucose. Using glucose, aqueous MV could be reversibly reduced and reoxidized again and again without degradation.If you want to make doubly reduced MV, you add hexanes or other organic phase over water. You add Zinc powder to an aqueous MV and shake. doubly reduced MV diffuses and is soluble in the organic phase and forms a deep orange color.


David D. Brosnahan MD MS

Viologen-Mediated Direct Carbohydrate Fuel Cell 3

Dear Dr. Dean Wheeler,

I stumbled upon the abstract of your latest paper on on the viologen direct carbohydrate fuel cell in the J. Electrochem Soc. I am very interested how you solved the problem of directly associating the viologen with the electrode to make possible more significant current densities. I am also happy that you have demonstrated that carbohydrate is fully oxidized to formate and carbonate and the reaction is not just the one electron pair activity of a reducing sugar.

Other than paying 24$ is that any other way I can get a copy of the paper? Also, I am curious if there are any other groups working on this project and what kind of response the paper has generated. Also, I am curious if the paper has demonstrated enough of a proof of concept and reduction to practice that BYU is interested in a patent. At the time I spoke with them about it in 2001 after building the first viologen direct-carbohydrate/
formaldehyde/etc voltaic cells they were not interested. BYU seemed to me to be an unusually tough place to file a patent. It seems you have to have whatever packaged with buyers waiting before they take you seriously. Dr.Daniel Simmons found that out with the COX-2 work.

Also, it seems to me that the trick with the viologen electrode is that the viologen is able to stabilize the separation of electron pairs in the carbohydrate into radicals which then can then interact and be conducted by metal. My view has been that the reasons hydrocarbons and carbohydrates fail to interact with metal is the stability of the electron pairing and the inability of metals to conduct electron pairs. Biological physiology uses carbohydrates and fats to store energy and uses mediators such as NADPH and FAD, which act like viologen, to stabilize the single electron radical and single electron transfers.

So, in the case with viologen we are stabilizing single electron transfers and the separation of molecular electron pairing. On the other side, I wonder is a fuel cell could be made that would conduct electron pairs directly using a superconductor as an electrode. I don't know much about superconductors, and if cooper pairs in a superconductor are at all relate to molecular electron pairs. I have wondered if a cryogenic fuel cell could be made using liquid methanol and a superconductor. Is there a salt bridge or PEM that would work at those temperatures.

I am so excited that Dr. Watt was able to pass this project on. This project deals with, I think, the most significant and important scientific problem of our generation. The mediated direct carbohydrate fuel cell gets past many of the hangup of other fuel cell designs. A hydrogen economy has difficulties with storage and hydrogen leaking out of fittings as well as the conversion of current energy infrastructure. Hydrogen, reforming hydrogen, and direct methanol systems also has a problem at the platinum catalysts due to cost and CO poisoning. Enzymatic and bacterial fuel cell systems are just not robust enough for practical use. Direct mediated carbohydrate fuel cells is exactly how biologic systems do it. Cellulose and other waste organics could be used as a renewable source of carbohydrate fuel. Viologen or paraquat, or "roundup" is already produced and used worldwide (not currently in the US) as a common herbicide.

Due to the potential significance of this project to science, geo-politics, and humanity in general; I hope you can understand my continued interest in the project and I hope you are not bothered by an occasional email on this subject. While the ferritin nano-battery was originally Dr. Watt's idea this viologen-carbohydrate fuel cell was originally mine. But I never got past producing the first voltaic cell and associating the viologen with the electrode. But we did work to partially demonstrate that glucose and other carbohydrates were fully oxidized to formate and carbonate and that we were not just seeing the activity of a common reducing sugar.

I am grateful for your work on this project and wish you well in your future work.

David Brosnahan

Viologen Catalysts for a Direct Carbohydrate Fuel Cell J. Electrochem. Soc., Volume 156, Issue 10, pp. B1201-B1207 (2009)

Friday, August 28, 2009

Financial Reform Needed for Healthcare Reform

Hospitals make profits. But where do these profits go? Not to doctors. Doctors bill separately. The facility fee is the major cost of care. If the hospital is paid for the profits go to share holders. If the hospital has a mortage, because of the amortization schedule all the profits go to pay interest on the hospital mortgage, which goes to the banks which goes to other shareholders.

Look at what banks can do. They barrow money for almost free from the US gov with no amortization. They lend 10x that amount due to fractional reserve lending, and they collect 90% interest due to amortization for 20 years on a 30-year loan. When you save money you don't get significant interest until 20 years off. This creates a natural division or class system. Only a few people can break through the wealth barrier.

Business profits, stock dividends, US gov debt interest and hospital profits all go to the same ultra-rich, ultra-elite. Smaller banks would have never failed had they not been dupped into trading their 1/10th fractional cash reserves for worthless mortgage-backed securities.

We need to change how we lend and borrow money. The current system enslaves families and workers. I am all for profits and a free market, but the current system is a monopoly favoring the envestment bankers and ultra-elite. Locking us into our current banking and lending system is the motivation behind plans for a world bank and the cap-and-trade legislation. Furthermore, our current lending systems is responsible for the current housing problems, rising healthcare costs, stress on families, and the failure of the 3rd-world to industrialize.

If you don't believe what easy capital and credit can do, just look at what micro-credit is doing in 3rd-world countries and what school loan programs in the US can do to make higher education affordable and accessible for all.

Wednesday, August 26, 2009

Banking: The Root of All Evil

I should have gone into banking. Think about what just happened in the banking sector. A few big banks printed worthless pieces of paper called mortgage-backed securities. This paper funny money and other securities are called derivatives because they derive their value from other pieces of worthless paper. In this case their value was based on US mortgages. How we let any banks or companies print their own money is beyond me. Next, these few banks convinced other banks that it would be a great idea for them to buy a bunch of these trash derivatives and trade real money for them. Then, when the housing market collapsed, all these banks who owned these derivatives lost all their capital reserves and could no longer lend. Many of these banks then went out of business or were purchased by the bigger banks that were too smart to buy these securities or who were selling them.

The next thing that happened is that the big banks not even hurt by the downturn or maybe only slightly hurt went to the US for help and got it. What did they get? Banks got free money from the government. Banks got zero- or near-zero interest loans. But its worse than that. Banks can operate on a system called fractional reserve banking. This means that for every $1 they barrow, they can lend $10 or even $50. Banks say fractional reserve lending makes it so that consumers won't have to pay for them to store money. But since money is all electric anyways, that kind of reasoning doesn't make any sense. What banks are doing is creating money out of thin air.

Then when banks lend us the money, they lend it to us together with an amortization schedule which requires the barrower to pay interest up front instead of principal. The result is a loan where the first 20 years of payment are just paying rent on the money, and the principle doesn't get paid until the last 10 years of the loan. On the other hand, when you save money with your bank, they only give a small rate of interest at first, and not until 20 years have past does that interest start to significantly capitalize. So, all of us average people making minimum house payments pay all the interest will those that inherited money earn all the interest. And we can't get past the first 10 years because that's about how often we get a stock market crash and our 401ks become 201ks.

The result of this system creates a gap in society between the have and the have-not's. Those that borrow money are paying 85% interest up front, and those that are saving money are only earning 5% interest. This is in contrast to the rich or the banks themselves who are earning the 85% interest and only paying the 5 % interest. Our lending system is a form of slavery or indentured servitude.

And when you can't pay and your house goes into foreclosure, the bank really doesn't loose much money. They have already collected a ton of rent money already. And then they repossess your house and sell it for 50c on the dollar. But don't feel bad, because remember that most all that money the bank lent you, was created by the bank itself. The only reason many banks were hurt by the housing collapse was because they had invested what little capital they did have into these worthless mortgage-backed derivatives. So, when they realized how worthless they were, they didn't have the money to pay regular customers, they became insolvent, and they were allowed to fail. Yet, other banks were given free money with which they could magically create more money to lend and enslave more and more people.

But enslaving individual homeowners isn't enough. Banks want to enslave businesses too. So, banks came up with plan. Since, businesses recognized it was a bad deal to borrow from banks, banks decided to offer only a slightly better deal. They convinced businesses to issue their own money in the form of stock. In this way, businesses could borrow money from the people at a better interest rate. The truth is that the people are too busy paying all their extra cash to the banks very few have the money to invest in business. So, the real people investing in business are the same people who own the banks. The result is that a majority of the profits of a company go to pay the shareholders. Year after year, shareholders skim off all the profits from a company and company employees become slaves to the shareholders.

The negative effects of fractional reserve banking are that it creates a glut of money in the system that drives inflation. The negative effects of banks lending money with an unfair amortization schedule is that borrowers are forced to pay rent first before they can pay back the loan, thus making homeowners slaves to the bank. This again drives up inflation and the cost of housing as the only way to gain equity in your home is for the price to go up because a home owner really doesn't gain principal until at least 20 years out. The negative effect of businesses issuing stocks is that businesses become slaves to the stockholders. Again, the pressure to pay dividends and maintain profits drives up costs. These influences are also the real reason healthcare costs are rising.

So, what should we do? Get rid of fractional reserve banking. Formulate another way to determine interest that is more fair. Or just charge a fee to borrow money and don;t charge any interest at all. The Federal Government should be the only agency allowed to print money. And since they print money, they could also lend it to banks who would lend it to businesses at a fair rate where the business could quickly pay the loan off with little penalty.

However, our government itself is stuck in debt just like the rest of us. And the only hope of the federal government is to hope for inflation, so that makes them interested in continuing these same banking practices hoping that inflation will somehow contract our overall debt burden. But right now, our federal government is enslaved to the world banks and foreign countries under enormous debt. We have become less self sufficient as a nation and depend on foreign companies for many necessities. Therefore, we are also dependent upon our dollar to be strong so that we can afford those necessities produced overseas. And since Nixon took our money off the gold standard, we are dependent upon foreign countries and the ultra rich to lend us money, buy bonds, and buy our excess dollars. Every year over 30% of our federal budget goes to pay rent on the national debt. None of this money goes to pay principle which itself is added to every years are our congress runs yearly budget deficits.

Imagine if our families, businesses, and country could spend its own money on its own needs. Imagine if money could be borrowed and easily repaid. It would be easy to do if we could only lend and borrow money in a more fair way.

Tuesday, August 25, 2009

Secondary Preventive Care Does Not Reduce Health Care Costs

The saying goes, "an ounce of prevention is worth a pound of cure." And that is true when you are talking about primary prevention. Primary prevention is what your mom and dad taught you growing up, such as hygiene, proper diet, exercise, how to handle stress, and spiritual faith so as to not harbor an irrational fear of death. This health knowledge and these life skills can and should be reinforced at school and at church. But they are primarily taught at home to children so that they become habitual and part of a culture of health. Hopefully, these life skills are passed on from one generation to another from parents and grandparents to children and between siblings and neighbors. In case where there are gaps in proper health knowledge and behavior, a pediatrician or other doctor and help remind and reinforce these lessons with parents so that this culture can be perpetuated in the rising generation. However, in a healthy culture, it is the parents that are the primary providers of health skills and disease prevention and not the doctors.

Other than vaccines, which can be given by non-doctors, medicine is not in the business of primary prevention. Doctors really don't have the time needed to transmit information on diet, meal preparation, hygiene, exercise, emotional wellness, end-of-life issues, and substance abuse avoidance. And even when doctors discuss these issues with patients the discussion rarely results in a change of behavior. Furthermore, by the time the topic comes up, the patient probably already has whatever disease the health information would have prevented. And because habits are hard to break, very few people are able to make the changes in their behavior that may slow or even reverse the disease.

There is a myth floating around that more doctor-based prevention will lower health costs. While primary prevention does lower health costs, the truth is, that other than vaccines, doctors do very little primary prevention. Secondary prevention is what physicians do. What is secondary prevention? Secondary prevention involves early detection of disease--period. So, in actual fact, there really is no prevention in secondary prevention. Secondary prevention does nothing to prevent disease onset, it only detects that disease process once it has begun.

Some might think that a doctor's focus only on disease is wrong and doctors should do more disease prevention. However, the reality is, medical doctors are trained and equipped to treat disease. Treating and managing disease is what doctors do. Like Jesus Christ said, "they that are whole have no need of the physician, but they that are sick."

Think about what happens when an adult visits their doctor. Your doctor will likely conduct a series of medical screening tests such as a lipid profile, a fasting glucose challenge, prostate specific antigen, and a colonoscopy. The purpose of these tests are for one purpose only, and that is to detect the presence of disease. None of these tests prevent chronic diseases such as diabetes, hypertension, coronary artery disease, chronic lung disease, dementia, or depression from developing. Only an interplay of genetics, environment, and behavior lead to disease or lead to health. That said, newer genetic testing, and testing for vitamin D deficiency or high cholesterol can inform patients of their risk factors for developing certain diseases, still, the prevention of disease still rests with behavior. That is why real prevention needs to begin at home with parents and children.

But doesn't the early detection of disease like cancer save money? You think it would, but in reality, early detection of disease actually increases health care costs. You don't believe me? We all have been told that 2/3 of health care expenses occurs within the last 6 months of life. With this in mind, it really doesn't matter if you die 6 months from now or 6 years from now, those costs will be the same. What secondary prevention and early disease detection do is make it possible for doctors to slow the progress of disease and therefore extend lifespan. But eventually, one disease or another will progress, become expensive, and kill you. Yes, early detection and management of disease will result in longer life, but that longer lifespan comes at a cost. So, in reality the kind of prevention that doctors do increases health care costs instead of lowering them. This is especially true if you are retired and no longer contributing value to society. And even in the case where a disease can be cured or reversed, the curing of that one disease will only lead to you dying of some other incurable disease.

The cost of disease management and treatment has a name and is assigned a value. Doctors and epidemiologists refer to the cost of disease treatment in exchange for life as the QALY or Quality Adjusted Life Year. A QALY tells doctors, insurance companies, health policy bureaucrats, and patients the cost of a particular disease treatment vs. benefit in terms of quality and quantity of life gained. Every disease treatment and procedure in medicine has a QALY associated with it. The QALY is the cost to manage disease. To give you an idea of what the QALY is and its value, kidney dialysis is the gold standard. Historically, kidney dialysis for those who have suffered complete kidney failure has a QALY of $50,000 per quality-adjusted life year. That means for every good year a dialysis patient gets from being on dialysis, the treatment costs the medical system $50,000. Treatments and procedures less than this mark are considered a good deal, while interventions more expensive than this $50,000 mark are of questionable value.

You can view QALY values by entering the following term into Google: QALY League Tables

If you detect a disease early you may begin by instituting low cost/benefit interventions, but eventually as the disease progresses, the high cost/benefit interventions will follow. Therefore, the only real result of early disease detection is that the low cost/benefit interventions will get implemented before the high cost/benefit interventions. Again, while implementing low cost/benefit interventions will prolong life, it only adds to the bottom line.

Now, please to not misunderstand my intent in writing this post. I am not suggesting that medicine or government or anyone should advocate that disease should not be detected and treated early. My point is that when we talk about reducing medical care costs, we need to be clear about how our health care system is organized, how it operates, and what are its associated costs. Only by a clear understanding of the system can we hope to implement changes to maximize its efficacy and efficiency.

Thursday, August 20, 2009

Support Romney Care not Obama Care

I am an Emergency Medicine Physician who practices in South Carolina and Georgia. Working in an ER and on the front lines of our health care system. I hope that through my few years of working in the field that I have gained somewhat of a valuable perspective on health care issues. ER doctors are trained to be "big picture" kind of people. We don't get down to the nitty gritty like Internists but hopefully we recognize the elephant in the room. But, it is also possible I may be too close to the elephant to see it as an elephant.

Ideal Society and Plan A
So in my opinion, what is the 10,000 pound elephant in the emergency room, and what do I think of Health care reform? In a perfect world no one would ever have to visit an Emergency Room and the Federal Government would not be in the business of administering any social programs. The Founding Fathers specifically commented that they did not want the US to follow in the foot steps of Socialist Europe. The Constitution granted express rights to the Federal Government, and if those rights were not specifically stated in the constitution, they were reserved to the States and the individual. But over the last 200 years we have seen a weakening of States rights and the strengthening of the overreach of the Federal Government and the slow Federalization of America starting with the National Parks and Forests and continuing on with FDRs "New Deal" and LBJs "The Great Society" which began both the Social Security and Medicare.

Reality and Settling for Plan B
The other side of the issue is the human side. Yes, in a perfect society all accidents and ER visits would be preventable, everyone would have access to health care, and have their own doctor, and everyone would be able to pay for it all. But the reality is we don't live in a perfect society. While our laws should reflect and protect our ideals, we cannot and should not prohibit Plan B when we fall short of Plan A. What do I mean? I mean, when a patient comes into the ER and I recommend the optimal treatment plan, some patients reject that plan. While, because of my ego, it is very tempting to tell the patient, "It's my way or the highway buddy." In reality, It is my duty is to help the patient accept the next best Plan B or even Plan C if that is all they will or can accept. In the same way, while federal social plans are not the ideal, if that is what is required then limited programs should not be rejected without consideration. We just must always never loose sight of Plan A and that some form of limited social program may be a Plan B and may be better than the Plan C we currently have.

Right to Life and Health care
So, how does acceptance of Plan B apply to health care reform (as well as many other issues)? It is the most sacred duty of the Federal Government to protect life. And health care and access to health care is a large part of that protection. Currently, I am convinced that all Americans have a right to health care access. And the fact of the matter is that there is a shortage of primary care doctors in this country and there are millions of American citizens and illegal aliens living and working in the US who do not have insurance and therefore do not have access to doctors. This lack of preventive and specialty care is a violation of basic human rights. Therefore, a Plan B is needed.

Plan C and Our Current Universal Healthcare System
You may not realize this, but the United States has Universal Healthcare. ER doctors are federally mandated by EMTALA legislation to evaluate and treat every single patient that comes through the door and provide for them every resource available for any emergent condition or transfer and/or refer them to someone who can provide that emergency care. And ER doctors do this all over the country regardless of your gender, race, ethnicity, insurance status, or ability to pay, and even when we know you aren't gonna pay and even when you lying about your intentions to pay. It doesn't matter. In the ER we see everyone. And because we get a lot of non-ER business, instead of screening people and sending them away, all ER doctors do a lot more general medical care and urgent care then we do emergency care. In fact, we even build Fast Track, Urgent Care, and/or Express Care treatment areas staffed with PA's to focus on administering this non-emergent care. And because it is way more convenient, people and doctors themselves depend and abuse the ER like crazy.

Fractional Reimbursement
Why don't ER Doctors medically screen patients and just send them away to see their own doctors if they are not emergent? We don't send patients with non-emergent complaints away usually because so many serious illnesses start out with common complaints. Anthrax or N.Meningitis can start out with just simple cold and sore throat. Without talking to the patient, and getting their whole story it's impossible to tell if someone is just a cold or if they are at risk for something deadly. And because people can't get in to see their own doctor the very next day for followup, the risks of sending out patients to die, and the risk of getting sued for tens of millions of dollars is too much risk. And besides, once you have the history, that is the part that takes the longest, and since you have to fill out the same amount of paperwork anyways, you might as well treat their runny nose symptoms and charge them hoping that you some of them will pay you or that you can collect 35c on the dollar for Medicaid and 65c on the dollar for Medicare. Only the government can steal a $1 of services for 50c and get away with it. Try that Walmart . We aren't taking about haggling here. Instead, imagine walking into Walmart brandishing a police badge and a gun and tell the person at the register that they will give you the $1000 plasma screen TV for $500. That is the kind of thing the federal government does everyday in healthcare.

The Federal "Mercy" System
The ER is the safety net of the US Healthcare system. We see everyone. If you can't get into see your doctor, the ER will see you. Middle of the night, the ER will see you. No insurance, the ER will see you, No money, the ER will see you. Picked up drunk staggering down the street, the ER will see you. Demented nursing home patient with family who haven't visited you in months, the ER will see you. While my brother-in-law, who is a Federal Attorney, represents the Federal Justice System, the ER represents the Federal Mercy System. I feel like such an enabler some days doing my job. ER staff joke amongst ourselves that we are no friend to society, Darwin, or Natural Selection. The majority of people we help have emergent problems they they brought upon themselves by a series of poor decisions and we help many patients just so they can go on to make the same mistakes again. But, I always try to remind myself that I represent Mercy and I need to leave the Justice part to my brother-in-law. Although, it would be nice to have a Judge in the ER to provide some legal backup when I want my patients to stop smoking or eat right. Patient noncompliance has been determined to be a major contributor to healthcare costs and inefficiency.

Incentivize or Outsource
However, handling everything through the ER is not a good Plan B. Treating people in the ER is more like Plan D or Plan F. If there is one area on my medical boards that I could improve on it was in the area of Preventive Care. Doesn't the motto go "an ounce of prevention is worth a pound of cure." Accordingly, our health care system should encourage, incentivize, and enable more college graduates to go into medicine and healthcare-related fields. Our system should encourage, incentivize, and enable medical students to go into primary care specialties like family practice, pediatrics, internal medicine, and OB/Gyn. And our system should encourage, incentivize, and enable preventive care, along with quality and efficiency. But if we take the wrong steps, we can make the mistakes of Europe and punish doctors and then be forced as England does to outsource and import doctors from developing countries.

VA System vs. Fee-For-Service
There are a number of problems with our healthcare system that leads to its many problems and inefficiencies. The US currently operates both a Canada/French-like single-payer system called Medicare, and an England-like national healthcare system known as the VA system. You many not be acquainted with these systems unless you have been in the Military or their dependent. For the most part, they work okay. But much of their success I believe is that they are supported by the private sector. Many private doctors work in the VA system for extra money and bring some of their energy, motivation and ingenuity with them from the private sector. And further more what people don't understand is that when people in the Canadian system or the VA system cannot wait for urgent care, both go directly to the private US system to get exactly what they want and need when they want and need it. In this way the US private system is propping up the Canadian and VA systems.

Don't be fooled into thinking that the VA operates in a vacuum. If there were no private influence, I believe the VA system would run much more inefficiently then they already do. What do I mean? If you want to experience Canada-like wait times for procedures just get involved with the VA system. While the system does do a great job with primary and preventive care, I believe it lags far behind in specialty care. Some of that has to do motivation. Many doctors in the VA are salaried and do not operate on a fee-for-service basis. That means they get paid the same whether they see 30 patients or 5 patients. Consequently, it is routine that VA operating rooms and surgeons perform less procedures and operations. Doctors get to the hospital late and leave early. And why not? Why work more if you're not getting paid more. Surgeons who work at Private Out-patient Surgery Centers are well-compensated for each procedure. In fact, recently news sources reported a surgeon in India set a record for performing 24 knee replacements in a single day. While records for the sake of records is not the goal, quantity as well as quality is a factor in overall system efficiency.

Physicians or Technicians
Internal Medicine Doctors such as "House" on FOX are the "detail guys" and have historically prided themselves on focusing on all the subtle intricacies associated with the human body, health and illness. Surgeons have always been the "OR Jocks" of medicine. They get paid more for what they do with their hands more then the time they spend thinking about a problem and discussing treatment plans with the patient. But the issue is the trend in medicine has been to compensate procedures more and office visits less. That means that clinic-based practices have been forced to see more and more patients for the same compensation. Accordingly, Doctors have adapted by hiring mid-level providers like PAs (Physician Assistants) to see the routine stuff. But what this means in the end is that a patient is less likely to see his or her doctor at all, and it mean that if they do see their doctor the time they are able to spend with them is much less.

Facility Fees
Surgeons have had gone through some evolution as well. When a Doctor performs a procedure or test, they get a certain amount of money for doing the procedure or interpreting the test. If that doctor also owns the testing equipment, then the doctor can bill and collect an additional fee for the equipment. And if the doctor owns the hospital building where the procedure or test was performed, then that doctor can charge and collect what is known as a facility fee. Over the years, the reimbursement for many operations has gone down. A surgeon who takes out an emergent gallbladder or appendix at the hospital may only get $50 or less for the procedure if anything at all. Now Doctors and Surgeons are building their own Surgery Centers, Specialty Hospitals and purchase their own MRI scanners so the doctors who own the buildings and machines and can collect the facility fees. Hospital have responded to this and many times will build the out-patient surgery centers and will settle with being part-owners (49/51) with the surgeons. According to them, its better to have half the pie then no pie at all. The point of all of this is that the majority of healthcare costs are not going to doctors or even to maintain and expand the facilities. The majority of healthcare costs (the facility fee, and profits) are going to stock and bond holders. If you want to reduce costs, then we need to change how the US borrows and lends money at least to raising captital to build hospitals.

Same-Day Surgery
Out-patient surgery centers affect the ER patients because Surgeons are not very enthusiastic about covering the ER at night and coming in to do an emergent surgery in the ER that they wont get paid for. Also, when it comes to gallbladder surgeries. Because, surgeons don't make any money doing the operation in the hospital's OR, surgeons tend to prefer that the patient get discharged home and follow up to have the gallbladder removed in the Surgery Center. Many other operations that required one or two-day stay in a hospital are now being done as a same-day procedure. Now, it seems like this could result in greater risk to the patient, but actually, I have to admit, I am not seeing complications coming into the ER very often, and I think staying out of the hospital prevents many complications like infection with hospital superbugs and medication errors.

Consultant vs. Primary Doctor
Cardiologist used to be the quintessential internists. Cardiology still is the most competitive sub-specialty of internal medicine. But now-a-days cardiac cauterization and coronary stents are replacing bypass surgeries and putting Cardiothoracic Surgeons out of business. Cardiologist don't get paid well to consult with patients but to be technicians. Consequently, many cardiologist have become increasingly uninterested in admitting patients for anything other than what will require a heart cath. They are happy to consult on patients because it turns out that consulting on a patient is worth more than being the admitting physician and doing the work of an initial history and physical.

Observation Unit
Additionally, Cardiologist prefer not to even admit patients with chest pain unless it is going to lead to a heart cath. Many patients with chest pain don't need a heart cath and just require a treadmill or nuclear stress test to rule out the heart as the cause of their chest pain. However, stress tests are a test that cardiologists can do in the clinic and therefore make more money in the clinic because the own that machine. Consequently, cardiologist prefer the ER to be very disciminatory and send as many patients at possible home to follow up in clinic instead of being admitted and not going home until they have been stressed and completely ruled out. Sending patients home without a stress test means more money and less work of the cardiologist and more risk for the ED doctor and patient. Because internal medicine and cardiologist do not want to admit all these chest pain patients, many ERs operate what we call on Observation Unit adjacent to the ER. This is a unit where ER doctors admit patients overnight and can repeat blood work and obtain a stress test in the morning and have their chest pain completely ruled out as cardiac before leaving the hospital. The advantage of the Observation Unit is that the ER doctor can bill for the admission, the cardiologists can charge for being a consultant, and the patient gets their stress test. However, operating an ER-run Observation Unit has it's own issues and is not always possible.

For-Profit Hospitals and Debt
Hospitals can be big money-makers but at the same time are expensive and require a lot of capital investment. It is very unwise to go to a bank for a loan because of the unfair amatorization schedule makes paying off a large loan nearly impossible. So, what happens is companies print their own money in the form of stocks and bonds. This is almost worse than borrowing from the bank. Instead of being a slave to the bank you are a slave to the bond and stock holders. All the profits doctor's labor to earn go to nameless and faceless people to pay dividends on these investment. Consequently, very little money gets invested back into the hospital and into doctor's salaries. If people want to know the reason for higher healthcare costs, doctor salaries have not gone up significantly relative to inflation, the truth is that there are many non-doctors skimming off all the profits from hospitals. Not anyone can be a doctor. You have to have at least an above-average intelligence. And if you want more doctors, and considering the high costs of medical education, then you have to be willing to pay a reasonable compensation making medicine worth doing. But, if there is a place to find cost-savings, I think it a hospital owned by the doctors who work there would run much more efficiently and economically. But that would require physician groups being able to obtain loans at special subsidized rates making paying off the loan much easier. And if the doctors owned the facility and the equipment, they could collect those profits now escaping into mysterious pockets and they would not be tempted to own their own duplicate MRI scanners and same-day surgery centers but fully utilize the ones that are jointly owned by the hospital.

Debt, Family, and Vice
I would be very remiss if I did not discuss a huge contributor to ER abuse. The sexual revolution, resultant illegitimacy, borrowing and lending, and consumer debt are factors destroying families. We already know that sex and money are the main causes of divorce. But these problems affect families in other ways. Debt put a lot of burden on families. The home mortgage is an extreme hardship and with increasing costs of housing requires both mom and dad to work to pay the bills. With both parents working, spouses are not as emotionally available to each other or their children. When people experience stress and they do not have a person in their life to talk it out with, these people tend to turn to inappropriate mechanisms to escape the stress such as emotional eating, impulsive shopping, smoking, illicit drug use, prescription drug use, alcohol abuse, and sexual promiscuity.

Illegitimacy and Poverty
The sexual revolution following the discovery of birth control promised sexual liberation to women. But it turns out that many women don't get pregnant because they don;t know how to use contraception. According to my wife, many high school girls don;t feel valued in their own families and consciously or unconsciously desire to get pregnant because becoming a mother is an instant way to feel real important and find identity and purpose in life. If an unwanted pregnancy ends up in abortion, the guilt of having an abortion can lead to sever stress and depression and result in further damaging coping behavior. If a young woman keeps the baby, the mother and child will require additional social services and in many cases we see the culture of poverty and illegitimacy perpetuated throughout multiple generations. Illegitimacy is a major contributor to poverty, gang activity, crime, drug use, and all of those things lead to ER visits.

Life Skills
The pressure on the family due to debt and illegitimacy is preventing major life skills from being transmitted from one generation to another. Maybe I just cannot remember what I did and didn't know before I learned medicine, but many people are just so clueless about their bodies and when anything unusual happens them them physiologically, they have no one to explain it to them and invariably they are in the ER for reassurance after extensive expensive testing. People get up from bed and twist their knee a little and come into the ER thinking their leg is going to fall off or wanting an immediate fix. A woman who was breastfeeding developed a clogged milk duct and had to be instructed on how to treat it to prevent a breast infection which she had never heard of. Her mother;s generation didnt breast feed so she had no one even if they were home from work, to discuss it with. And her anxiety over her health prompted an immediate ER visit. This is just one of many examples of ER visits that could be prevented if families were the repositories of some basic health and diet knowledge.

Work Excuses
Busnesses and Schools need to stop requiring doctors to write these work excuses. If they want them, they should hire their own doctor to do them. People come into the ER all day long to get these because they are required, or the employee is skipping out on work and they want to provide falsified evidence of an illness.

Perscription Drug Abuse and Disability
One of the major abuses of the ER is people who come in lying about pain to get perscription pain medicine to take themselves or sell. There is no monitor for pain. It is a completely subjective experience. Therefore, doctors try and trust the patient and base their treatment of pain based on how the patient is experiencing it. Unfortunatly, some patients intentunatly lie about their pain. How do I know patients lie? I know because these same patients come back suicidal or wanting drug rehab which requires an additional ER visit, and confess to me they lie to get pills. While these patients may only represent 1 in 10 patients. Their impact on the ER is much more than just the lying and phych visits. Studies have shown that the major reason people go to the ER is that they cannot be seen by their doctor. But, having worked in the clinic, I discovered that the same drug seekers and disability scammers in the ER are the same ones in the clinic. So, instead of the clinic doctor seeing a legitamate patient, the doctor is seeing a drug seeker and the legitamente patient is forced to be seen in the ER. State programs that monitor prescription drug dispensing by pharmacies is a great tool to identify patients who doctor shop to abuse or sell pills.

Private Insurance vs. Medicare
The federal government already controls much of what goes on in healthcare. Since 2/3 of medical costs are paid in the last 6 months of life, it is not a stretch to realize that Medicare is paying for most of everyones health costs. And because Medicare is paying for a majority of all healthcare costs already, it is not a stretch to realize that they determine how much everything costs. Private insurance base much of their reimbursement policy on Medicare policy. Private Insurance is partly to blame. Private Insurance companies are the last people that want to insure the elderly. Private Insurance are only interested in people who are employed because they know people who are actively employed are generally very healthy and very unlikely to incure major medical costs. But once a person gets seriously ill, that person will generally lose, their job, lose their insurance, and then end up on Medicare, Disability, and Medicaid. When a person retires at age 65, then they are again dropped right at the moment when they can expect to need the majority of their healthcare costs. And who then is left to pick up the lab? The Federal Government Medicare program. It just doesn't make sense that a person who pays a company for insurance coverage over a lifetime can get dropped by that company and picked up by the taxpayer. It seems to me that private insurance should cover a person for their lifetime and money should be put away in medical savings account to be used later on during that last 6 months when 2/3 of the costs will be required.

Tort Reform
ER Doctors are under enormous pressure and we are federally required by EMTALA to see everyone. While people should be compensated for medical mistakes, doctors and especially ER doctors should never be sued for tens of millions of dollars especially considering the constraints of the job. I have poeple come into the ER all the time either threatening to assault me, kill me, or sue me. Believe it or not, we have enough pride in our work that the drive to help people is enough to be motivated to do our very best for the patient and be as diagnostically accurate as possible. No doctor likes to see a patient come back worse then before. If a doctor is guilty of medical negligency, that doctor should go to jail if intentional, or his medical licence should be suspended or revoked if he is incompetent, but no doctor should be the victim of obsene jury reward of mega-millions for emotional damages because of a human mistake.

Government Option
Pres. Obama and many Democrats have made it a priority that all Americans have health insurance and access to medical care. Accordingly, Pres. Obama has followed the tradition of the Democrat Party and LBJ in proposing a huge government-run insurance option to compete against private insurance. While there may be 45 million uninsured in America, I think that a government-run program would end up eating up a much larger market share than that. You can bet small businesses will drop insurance coverage when employees are able to get it for free. You can bet Private Insurance companies will find ways to drop the most sick patients when they know that the government will be there to pick up the tab. Also, Pres. Obama says people can keep their doctor. Well, if reembursement drops, you can bet there will be many doctors who decide that they will not accept governement insurance. Private Doctors are not required to see everyone who walks into their office like the ER. Government intrusion into the Private Insurance arena will have very negative effects on the natural market's ability to operate. I think government needs to and should regulate Private Insurance but not compete against them.

Romney Care
CNN ran an article yesterday from an NH doctor criticizing the Massachusetts healthcare reform plan affectionately known as Romney Care after Previous Governor and Presidential Candidate Mitt Romney. Instead of a bloated beurocratic Governemnt Insrance plan, Massachusetts is simply subsidizing the poor to buy their own private health insurance. State law determines what plans meet specific standards to be eligible for the state plan. The result is that Massechesettes has the highest rate of insurance than any other state. Consequently, the article on yesterday complained that there were more people going to the doctors and ERs and that was somehow a big negative of the plan. Well, Im not sure that that kind of complaint is logical. If what you want is people to see their doctor and get preventive care, then when you insure everyone you are naturally going to get more people seeing their doctors, and more people seeing their doctors means longer waits, and longer waits means more ER visits. So, I guess I can anticipate that the ER business is going to be busy, but this time, I might actually get paid for what I do.

Preventive Care and Cost
Secondary Preventive Care does not reduce healthcare costs. When I say secondary preventive care, I am talking about the kind of prevention your doctor does which detects disease early instead of late. The real teacher of primary health prevention involving proper nutrition, diet and exercize is the family, church and school. I hear people talking about wanting to pay for doctors to talk to patients about psych issues, addiction, diet, exercize, smoking, and end-of-life issues. Don't get me wrong, I'd love to get paid to talk to people. But, a lot of this stuff should be handled in a family setting by parents and children. This is the kind of prevention that is worth a pound of cure. The kind of prevention that doctors do is called secondary prevention. Secondary prevention is about detecting a disease early. But if you detect it early, that means you were already doing all the bad stuff in the first place leading you to get the disease. And chances are that you wont change any of your lifestyle, exercize, and diet habits that led you to that point.

Secondary Prevention
So what does secondary prevention do? It allows you to live longer with your disease state. But one you have the disease, you have it and will likely die from it or a related complication. But the issue here is that while secondary prevention catches the disease early you are still going to die, and the cost of dying of a particular disease is going to be the same wether you die of that diesease now or later. But as far as cost go, it is actually cheaper if you die younger. I am not advocating anything like that. I am just saying that studies show that smokers actually may cost less than non-smokers as far as overall healthcost because they die younger. I mean the expensive last 6 months are going to be expensive at 55 or at 95. But if you die at 55, then you save all the intermediate costs associated with daily managing and treating all the many exacerbations of that chronic condition. So, the issue is not about saving money, but how much we are willing to spend in return for what kind of quality of life.

This stands for quality-adjusted life year and is a medical cost-utility analysis measurement. This is the kind of calculation that medical statistitions, epidemiologists, and masters of public health people come up with to put a number value on how much a particular procedure or treatment cost vs. how much benifit the patient receives. There are some interesting factors that go into obtaining these values. After the costs of a procedure or treatment is obtained, to determine the benifit of that procedure or treatment to the patient you do make a Time Trade Off or Standard Gamble assessment of their health. That is, you ask patients with and without the treatment if they could expect to live 10 years in their current state of health, if they could trade 1o years for X number of years of perfect health, how many years would they trade 10 years for. The lower the number X is the poor quality of health the patient is experiencing. Either that or the patient didn't understand the question. Standard Gamble involves asking the patient to imagine a scinario in which a certain proceedure carried the risk to restore them to perfect health or kill them. With regard to their current health, what level risk of immediate death would they accept to be restored to perfect health. The higher the risk the poorer the patients health. Therefore, using these two mechanisms and others like it, a cost-benifit value can be calculated and assigned to any procedure or treatment.

Gold Standards
The Gold Standard when it comes to the QALY is hemodialysis. When Medicare decided to cover hemodialsysis for those who have suffered kidney failure, the cost vs. the quality of life of this procedure was $100,000/quality-adjusted life year. Treatments and procedures more expensive then HD are considered by some to be too expensive and not worth it. However, you have to be careful with this data because even this kind of data can be fudged. Looking at a paper comparing hemodialysis, peritoneal dialysis vs. kindney transplant, the paper showed that the current cost of HD was 55k/yr, while PD was 35k/yr and KT was 45k/yr. But this was only the first year. If you read the paper closer, they confess that KT over the rest of the patients life end up to be 150k/yr being much more expensive than regular HD. Why is kidney transplant end up more expensive? This may be because kidney transplant patients take powerful cancer and immune drugs to avoid rejection and can get serious blood infections. Also, all kidney transplant patients eventually go into rejection and end up on dialysis eventually. But it seems for the first few years.

Decision Makers
Another brother-in-law who is very talented when it comes to residential and office remodeling work I think expressed the correct view that the QALY should not be used by government and insurance companies. QALY data is useful only for the doctor to explain and educate patients and families on what they can expect from the particular intervention. And then it should left up the individual and to the family to decide if the benifit is worth the risk and the cost to obtain the proceedure or treatment. But this is exactly the kind of thing government and insurance beaurocrats shouldn't get involved in.