Author Archives: Fred Kahn, M.D, FRCS(C)

INTERNATIONAL FINANCIAL INSTABILITY & HEALTHCARE

Financial instability, a growing constant in commercial activities since World War II, has embarked on a path of unpredictable and accelerating variables.

As the most recent and rather murky events in Cyprus have clearly demonstrated, uncertainty and instability are the prevailing keynotes at this time. Aside from continuing unreasonable and punitive taxation, beginning with parking meters in our cities, to the promotion and sale of bad paper by major financial institutions, this trend will eventually impoverish everyone.

Unfortunately these events impact healthcare from many perspectives. Ideally a high level response should be everyone’s right, however, we must consider who will pay for this right? Like untying the gorgonian knot, no one is in the position to answer this question at this time. Despite this, we remain trapped in a downward spiral. Diminishing incomes among the masses, rising costs and higher penalties are the order of the day. Unless dramatic and positive change occurs to reverse this trend, it will engulf everyone over the next decade or perhaps even sooner. The poor will not become rich, the middleclass will disappear and the rich will become poor. Neither rhetoric nor adversely inflaming the masses will bring crucial change to this scenario.

Currently there is no strong leadership existing in the individual countries and the world governments, which enlarge without cessation struggling to survive with a shrinking tax base. Rhetoric notwithstanding, they are currently unable to fund themselves and have no evident solutions other than printing more money and thereby further debasing their own currencies and increasing their debt load.
One change that should be considered, and is probably the simplest in the long-term, is the improvement of educational systems. At this stage moral values and standards of integrity can be instilled at the formative level. However, this can only be accomplished when the funding, monitoring and mentoring of teachers enables them to move forward in this direction.

All those engaged in delivering healthcare appear to be more concerned about compensation codes than ensuring that healthcare will be delivered in a prompt effective manner. This has created another maelstrom of confusion deliberately infusing a level of conflict between physician and patient that is unprecedented.

Governments are increasingly focused on diminishing and restricting healthcare provisions, along with their budgets, further inducing instability into the system. In this current of negative forces, the patient often floats on a sea of despair, particularly when emergency care is required. Again, no bureaucratic resolutions are apparent on the horizon. Leadership to reverse this course must be found and implemented immediately.

What happens when your insurer won’t pay?

It’s the fear every consumer has buying insurance. When it comes time to make a claim, your insurer will have some reason not to pay out.

The doomsday scenario isn’t just fantasy, it’s reality, say many people who fight insurance companies on a regular basis.

The issue was highlighted this week when a Saskatchewan judge awarded Luciano Branco $5-million, saying the actions of his insurance companies established “a pattern of abuse” — Justice Murray Acton noting he wanted to send a message to the industry.

The case could be a template for anyone paranoid about getting his or her claim cashed out.

The claimant in this case was a welder who was injured on the job. The judge noted the man, who suffered a permanent disability, was offered a “ridiculously low” settlement as the insurance companies dragged its feet for years on the claim.

While cases like this may not be the norm, Toronto lawyer Sivan Tumarkin has built a legal practice around getting insurance companies to pay up.

“I’m just getting more and more of these,” said Mr. Tumarkin, who used to work for insurance companies in a defense capacity. “I only started doing this because I had people coming to me who were having issues with insurance companies. You have a flooded home and they won’t cover. I have someone [who gets sick] in New York with travel insurance and they won’t cover.”

He says the insurance companies don’t out and out reject claims for no reason but their objections are in many cases for negligible reasons.

Mr. Tumarkin had an older couple as clients recently who put in a health claim for a fracture suffered by the wife while on vacation in the U.S. The claim was paid but the insurance company when back into their medical records and found out some of the information filled out in the application was incorrect and demanded $30,000 back.

The basis of many insurance claim rejections is something on a policy being filled out incorrectly, either on purpose or because of a misunderstanding.

You buy a life insurance policy and say you don’t smoke even though you have the occasional butt at a bar. One day you get killed in a car accident. If your insurer finds out about your occasional indulgence, there’s a good chance they’ll fight the claim.

“The law is you have to answer truthfully but it is ambiguous about the way you might answer the question as a lay person,” says Mr. Tumarkin. “They’ll look at absolutely everything they can to try and not cover you. I’m not saying in every case but a lot of them.”

He says insurance companies in property damage claims on car accidents will drag their feet on an investigation, knowing there is time limit to sue.

Out and out rejection of claims to meet some quota is probably more something you see in movies, says Mr. Tumarkin. “There is willful blindness on the part of adjusters,” he says. “There is never absolutely no reason they don’t pay. They’ll just use every excuse in the book.”

Pete Karageorgos, manager of consumer and industry relations with the Insurance Bureau of Canada which represents home and auto insurers, says there are no statistics on what percentage of claims get rejected.

But on the auto front, the industry has statistics that show in Ontario in 2010, the sector took in $9.4-billion in premiums and paid out $8.3-billion.

“It goes to show you the majority of money coming in goes right back out to pay claims,” said Mr. Karageorgos.

He adds insurance is a contract and any insurance adjuster will look at the conditions that could negate the agreement.

“Insurance companies are not just going to take your word for it,” said Mr. Karageorgos. “For any contract to be valid and effective, the conditions on both parties parts need to be satisfied.”

The issue for many people in hiring a lawyer is the up front cost. In the Saskatchewan case, the welder who sued his insurance companies had to be bailed out financial by family members.

One thing you can work out in some cases is an agreement whereby your legal bill is covered based on a contingency fee basis, your lawyer gets his bill paid from the winnings.

You can also consider taking your insurance company to Small Claims Court.

Another suggestion for consumers is buy insurance products from a broker, who is compensated by the insurance company but not employed by them. By using the broker, you have the added possibility of suing the broker if he or she gave you bad information when filling out your policy.

Some policies get reviewed by insurance companies before they are issued and people are rejected or assessed at a higher rate, such as in life insurance. But for low margin products like travel insurance, there is no investigation until a claim is submitted.

“You have the policy underwritten at the time of application not at the time of claim, so there is no surprises and it is completely on the up and up,” said certified financial planner Mark Halpern, of illnessprotection.com.

Sometimes he’ll get a client who wants to say he doesn’t smoke when he does occasionally and Mr. Halpern rejects that business because he doesn’t want to see the claim eventually dismissed.

In other cases, people make innocent mistakes about the type of medication or the maladies they have had in the past.

“It’s really important you keep a record of your medical history,” said Mr. Halpern.

He doesn’t dismiss the notion that insurance companies will reject claims for flimsy reasons and says a broker can be an important advocate on your behalf in that situation.

“If that doesn’t work, there is always [a lawyer],” said Mr. Halpern, noting in many cases the presence of lawyer leads to some type of settlement.

“The insurance don’t like to have bad press but they don’t want these things lingering if there is something [that could work against them]. In the worst case, you might get some settlement,” he says.

Alex Saltykov, founder of InsureEye Inc. which follows the industry, says there are no statistics to show what percentage of claims are paid out.

He says consumers really have to make sure they know what is covered and not because insurance policy are so complicated.

Mr. Saltykov found himself not completely covered for treatment he needed for physiotherapy because he had not read the terms of his insurance contract.

“You want it to be there in the worst moment of your life,” said Mr. Saltykov. “If you are not sure of what should be disclosed, you better disclose it even it makes your insurance go up. Otherwise you risk your company not paying.”

Breaking Branco

The article below obtained from the Northern Miner, April 24th, once again demonstrates the deceptive practices of insurance companies who collect premiums on the basis of false advertising and then fail to honor their obligations to the patient. When will our politicians take note and rectify these serious problems?

Luciano Branco’s long and soul-destroying battle with insurance firms AIG and Zurich has finally reached some satisfaction in the courts, with a Saskatoon judge awarding the injured Portuguese-Canadian welder $450,000 in aggravated damages and $4.5 million in punitive damages. It’s the largest award of its kind ever given by a Canadian court against insurance companies.
Branco, now 62, immigrated at age 24 to Canada, where he learned to weld and worked out West and up North. In 1994 he moved back to Portugal, and by 1997 was working at Cameco-subsidiary Cameco Gold’s (now Centerra Gold) huge Kumtor open-pit gold mine in Kyrgyzstan.
During a 12-hour shift on Dec. 25, 1999, he dropped a steel plate on his foot. He finished his shift, packed his foot in ice, and returned to Portugal at the end of his 28-day rotation to recuperate. Towards the end of his next rotation, he stepped on a piece of steel and reinjured his foot, and then sought medical treatment in Portugal, missing his next rotation.
He only reported his injury to the Kumtor operating company on his next rotation in June 2000, when he did not work at the camp. Kumtor continued to pay his base salary of $51,920 to the end of his contract in March 2001 (in fact, overpaying him $12,000 by mistake).
Anxious to get back to work, Branco had surgery on his foot in January 2001, but it was unsuccessful. Despite physiotherapy and rehabilitation treatments, Branco’s Portuguese doctor determined that he was permanently disabled and in chronic pain, a prognosis repeated many times in the following years by specialists in Canada.
American Home Assurance Co. (AIG) was advised of Branco’s work-related injury in mid-2000, which triggered the Saskatchewan Workers’ Compensation Board-equivalent claim handled under the AIG policy. His long-term disability benefits were covered by Zurich Insurance.
To make a long story short, AIG and Zurich refused to pay out the benefits owed to Branco, hoping the outrageously long delays, transcontinental complexities and non-stop legal bills would grind him down and force him to accept a much lower settlement.
In the recent judgment, Justice Murray Acton found that AIG and Zurich had acted in a “cruel and malicious” manner towards Branco for more than a decade, offering him “ridiculously low” settlements, including AIG initially offering him a cash settlement of just US$22,500. AIG didn’t make some of its payments owed to Branco until the day of the trial.
Zurich, for its part, internally approved Branco’s long-term disability payment in 2002, but never informed Branco, who didn’t receive his first funds from Zurich until 2009 and had turned down Zurich’s settlement offer of $62,900, minus $9,000 in legal costs in April 2003. “This court cannot imagine a more protracted and reprehensible behaviour than that of Zurich in blatantly refusing to pay what had been owed in monthly payments for almost eight years,” Acton writes in his decision. “The actions of AIG and Zurich establish a pattern of abuse of an individual suffering from financial and emotional vulnerability.” (The judge said that the mining company had treated Branco fairly, and only the insurance companies were liable for damages.)
The judge noted that prior to his injury, Branco was a “proud, athletic and hard-working individual” who was “warm, friendly and sensitive” and an “excellent employee” at Kumtor. After the injury and the withholding of benefits, however, he had become a “demoralized man full of sadness and loss of pleasure,” and an individual “full of anxiety and depression.”
The insurance companies, Acton writes, “virtually destroyed Branco’s life over the last 13 years,” causing his marriage to break down and financial burdens to be placed on his daughter and other family members, and his legal representation. The judge writes that the insurance companies tried to use Branco’s diminished life to “gain leverage” over him and force him to accept a low settlement.
“That Branco was able to continue to withstand this pressure for so many years from two different fronts is truly remarkable and almost superhuman, even though his resistance may have resulted in irreparable mental distress, which may last for the remainder of his lifetime,” Acton writes. “The question remains: how many individuals have been unable to withstand the financial and psychological pressure of these tactics?”
The insurance companies are expected to appeal the decision.

THE INSURANCE FIASCO – or should it be termed a disaster

In the practice of medicine today, the complexity of insurance is infinite, however only becomes a problem when an “event” occurs.

The following story is becoming more typical and frequent than one realizes or would wish.

The patient in question had a severe automobile accident, not his fault, over five years ago. He has lost his business and his home. Throughout this period, he has undergone countless courses of medical therapy, an unending series of tests and many medical and other assessments. As a final insult, he has been evicted from his home due to his inability to service the mortgage. At this time he is living in semi-abject poverty.

Here is his wife’s recounting of the proceedings; she writes as follows:

We trust this is a good moment to bring you up to date. John has been going through countless assessments and most recently, the ones for his catastrophic designation, which will be finally arbitrated at the end of April. The scheduled hearings with all the experts will last over two weeks. The assessments John went through lasted from forty minutes to two days. The medical evaluations that were initiated by the insurance companies and executed by their “selected doctors” did not lack briefness, trickery and manipulation. Their reviews are insincere and dishonest with ample insulting efforts and frustrating moments to disturb and offend the victim. It must be their principle to close all their prejudiced reports with the same findings – to decline anything and everything.

Our side applied for the arbitration, which will take place in front of FISCO, the Ontario government’s controlling body for all insurance issues. FISCO has no power to decide on financial losses and damages of the plaintiffs, but is the organ and consequently imperative for defining the victim’s rights and the insurers obligations (up to two million) for retroactive and future payments regarding John’s care taking, rehabilitation, medication and treatments. The Superior Court of Justice in Ontario will eventually hear the damage claim.

After all, John did not cause the accident.
He was t-boned on a Monday afternoon in October 2007 and his mistake was that he showed up in the wrong place at the wrong time. The result of this error is permanent brain injury, back and balance problems, chronic headaches, etc., the loss of all income with only expenses left, including and not limited to all his equity, retirement savings, valuable life insurance policies etc. and a smashed and beyond repair automobile.
John has been disabled and absent from his business and social life ever since. The seventeen year young driver was charged and pleaded guilty. No support or reimbursement has been presented yet.
Is this a scandal? Yes! Is John the only victim of the insurance system? No!

The last year was most stressful.
We have been constantly working on our financial survival and the reinstatement of John’s treatments that had been cut off by the insurer in 2009. One may question why you have insurance at all when they refuse support and follow through when needed. John’s motivation to have the family well provided for has always been evident. His guiding principle to have any thinkable incident insured and financially secured is fact but has not materialized or manifested in any compensation by today.
What has become apparent is the scandalous reality and truth that he was, is and will be at the mercy of the insurance companies, their counsel and doctors, who are deciding on everything including the timing of when to get treatments and of course the payments. It is just a nightmare. Not to mention that down the road the judges and jury will have a say if no prior settlement is achieved.
Actually, October first 2012 was our ‘fifth accident anniversary’!

John went as far as to obtain through Chubb Insurance an umbrella policy of ten million dollars twenty years ago. This was supposed to provide the safety net in the unfortunate situation of an automobile accident where the other driver has no or insufficient insurance coverage. In our case the other driver was covered for two million under her father’s Toronto Dominion Insurance Policy as the principal car owner.
The pending hearings in John’s family tort claim vs. the driver, her father and their TD Car Insurance as well vs. John’s Chubb personal insurance for amounts exceeding the TD coverage will take place in the ‘Ontario Superior Court of Justice’. Three weeks will be needed for the court hearing in case no pre trial settlement is reached.

John’s different life and disability Insurers in Germany (Allianz Insurance and the Unfall und Renten Versicherung) and Switzerland (Winterthur Insurance and AHV) handled and settled our legitimate claims professionally and timely after they had completed their due diligence and comprehensive and ongoing medical assessments. Contrary to that attitude is the behavior of the two major Insurance Companies at whose mercy we now exist.
Their concept of processing a claim is definitely not based on fact-finding or to provide relief and financial help for the victims and their families. Their well-set principle is based on delaying, declining and intimidating.
This is a “business world” in itself, a kind of an ‘insurance mafia’ where the insurance providers are investing substantial funds for delaying and fighting any claims by well thought out legal maneuvers, by screening the victims to their bones and involving investigation agencies to have the sufferers monitored and followed.
The insurers appointed doctors conducting the so-called “independent” and “non-bias assessments” and the insurers lobby and financial power in the political arena and lawmaking body don’t necessarily improve the victim’s position.

The more you get involved the clearer the concept becomes. It did not come as a total surprise that the outcome of the insurers independent assessments are in reality “prejudiced reports” to hide and justify the insurers disapproving rightful demands. They just decline and the victims are left all over again with the same task on hand… “prove it”. Or to paraphrase, prove what?

Everybody who knows John will confirm that he would be the last one who didn’t want to be on the hospitality world stage anymore.
For the longest time after the accident John was in a denial frame of mind and would not even admit or accept that his days are over and that he had become disabled indefinitely. For him not to be able to be with people and create, lead and execute ideas and concepts any longer is catastrophic.
In a split of a second, he was taken away from his successful, fulfilling and rewarding business, family and social life and confined to being a non-entity.

The insurers self-serving delay tactics by ignoring the numerous non-biased doctors and specialist assessments, by declining treatments and payments and even questioning John’s integrity is totally insulting, wrong and harmful. These insurance companies try to wait the victims out, financially and morally until they give up and throw in the towel, pass away or depart this life voluntarily before any settlement is achieved or just give up and face the financial reality of being ruined permanently. Ever listen to an insurance ad? Total deception!

We try very hard to stay positive, ever getting closer to the boiling point. We truly hope that the latest events are an indication that the parties are moving to ultimately determine the severity of John’s injuries and his ability to continue what he always enjoyed doing.
His whole life shows his dedication to his profession, his total commitment to deliver the best and his always-positive approach to people and life.
All this is evident in his letter “to whom it may concern”, his essay “my life” and “other supporting documentation”, not to mention the medical file with “the assessments, expert reports and treatment history” and the supporter list with the “seventy-seven support letters” our counsel and I received describing John.

If you have interest in any of the credentials, we would be excited and very pleased to provide them to you.

This automobile accident has such a devastating effect on us.
Not enough, that John couldn’t carry on his profession and business that he loved so much, now we no longer have any hope. It has been taken away.

After we had used up our savings, closed both retirement saving accounts, surrendered John’s very valuable and paid up Life Insurance used up all our investments and savings, we were left with no choice than to take our daughters out of their private school, which they had enjoyed for eight years. Last but not least, John’s Royal Bank’s disability payments came to an end in January 2011 when he turned 66. Since that day, only some small pension payments are received monthly.

It has been really tough and believe us, we are looking more than forward to the day when we may be able to show our appreciation to those who have helped.

And now in its sixth’s year we are close to losing our last family asset, which was already highly leveraged for the reasons indicated. John’s Family Trust owns our beautiful home. Most channels have been exhausted. We must have tried every avenue to get our first mortgage increased to a level where we would be able to consolidate the first and the second mortgage into one, and still have an additional amount reserved (escrowed) to secure the interest and tax payments for a period of up to 18 months so that no default could be possible. The property provides sufficient equity but our almost non-existing income stream made any refinancing an impossible task.

Please forgive us for the lengthy and sometimes-repetitive report. We like to tell you how much we appreciate the opportunity to express our thoughts and feelings and were able to describe what our family has experienced going through the last five years and what may be the next steps in our saga.

We are still blessed with our family and we need to carry on until such time as we have found common ground with the Insurers and their troops.

Thank you for listening, thank you for your compassion and thank you for your friendship and trust and your readiness to bear with us.

Reflections on Neurological Conditions

Many illnesses share common DNA roots. The five most common mental illnesses present in the following order:

1. Autism.
2. ADD.
3. Bipolar disease.
4. Schizophrenia.
5. Depression.

The latest research published in the journal Lancet indicates that all these diseases are the result of genetic variations, some of which have been extensively reviewed. i.e.:

• Chromosome 3
• Chromosome 10
• Calcium channels, which play a significant factor in controlling cell function
• Environmental influences

This synopsis of mental illnesses and the factors involved (many of which are unknown) are challenging, particularly with regard to effective therapies.

Currently, there is an extensive amount of research being carried out in many leading clinical and research centres throughout the world and it would appear that genetic factors may be pre-eminent as the etiological causes responsible for these disease processes.

Laser Therapy is beginning to play a role in this therapeutic area, which of course is important, in order to achieve positive clinical outcomes. Some of the effects of Laser Therapy on neurological tissue include the following:

• Increase in ATP production raising energy levels within the cells
• Increased deoxyribonucleic acid (DNA) and ribonucleic acid (RNA)
• Increased nitric oxide (NO) release
• Enhanced cytochrome c oxidase activity
• Modulation of reactive oxygen species (ROS)
• Modifications to intracellular organelle membrane activity
• Cytoprotective effects
• Down-regulation of pro-inflammatory mediators
• Increase in secretion of anti-inflammatory mediators
• Angiogenesis
• Neurogenesis and neuroplasticity facilitation

All of these physiological activities produce a neuromodulating or neuromedation type of effect, particularly on brain tissue.

This commentary is appropriate as at this time more effective therapies need to be developed to deal with these problems. At Meditech, we have had a long standing interest in these pathologies and recent discussions with several neuroscientists stimulate our efforts to accelerate the development of reliable therapeutic options.

As an increasing number of patients are treated, we gain experience, establish effective protocols and expect that our work in the treatment of these complex and problematic conditions will be particularly rewarding for patients.

THE JOYS OF GOVERNMENT HEALTHCARE

This article published in the Financial Post, Wednesday, February 27th, clearly demonstrates the absurdities resulting from government controlled healthcare. The degree of relevance may best be compared to the book, Animal Farm, penned by George Orwell many years ago.
Unfortunately in our current culture, rhetoric trumps reality, as recently demonstrated by the election of Barack Obama over Mitt Romney. The former is an orator, the latter a skilled proven businessman who is best equipped to run a company (i.e. the USA), balance the budget, and meet the needs of the people.
Evidence based results are no longer a factor in our society and some day we will rue the day this ceased to be the basis of all focus and reason.
Incidentally Laser Therapy, a technology that Meditech International has developed over the past 20 years, would probably take 3400 plus of those patients off the waiting list and improve the patient’s status so they would no longer require surgery or pharmaceuticals, and could resume a normal lifestyle.
The costs for this therapy would be approximately $1500-2000 per patient.
When will governments begin to devote some attention to the welfare of the people rather than the housing allowance of senators?
Fred Kahn, MD, FRCS(C)

WOMAN STILL WAITING FOR SURGERY AFTER 11 YEARS

Wendy Berringer’s feet are killing her. They hurt when she stands, when she walks and when she sits, which is what she was doing Tuesday, in her favourite rocking chair in her Halifax home, telling me about her bunions, a tiny broken bone in her left foot and her creaking left ankle, which cracks and groans and aches, causing her all manner of grief.

“I had my first appointment with my family doctor for my feet in 2002,” she says. “The original problem was my bunions. They rub in your shoes and you can’t walk properly. They are very sore. My family doctor made me an appointment to see a foot surgeon in Halifax to get the problem fixed.

“That was 11 years ago.”

In what seems like a parody of complaints over medicare waiting lists, Wendy Berringer is still, 11 years later, waiting for that appointment. Her would-be foot surgeon, an otherwise staunch defender of public healthcare, says there is nothing he can do about it, not when Ms. Berringer’s foot problem isn’t life and death — and not when his waiting list is 3,500 names long — and not when he is the only foot and ankle man in the entire province.

“I’ve been alone out here, really, for a long, long time,” says Dr. Mark Glazebrook from Halifax. “Dr. Andrea Veljkovic, in Kentville, is taking a job in Toronto.

“She was out here on a locum and we were hoping to extend her stay but the government said we didn’t have the money for her. Right now I have 3,500 people waiting to be seen by me in consultation. I have a private office where I see my referrals and the referrals are dated 2003 and 2004 now — and I have them chronologically up to 2013 — and I get close to 40 new referrals a week. And it’s for all of Nova Scotia.

“The province now acknowledges that there actually is a problem here, and they want to help us to get it sorted, so the Minister of Health has been fairly co-operative.

“But they still talk about resources and making decisions and, well, come on: maybe foot and ankle is not as important as cancer, and not as important as heart conditions, but a 10-year waiting list is way outside the norm in terms of what you should expect in public care, and if 10 years is the norm in public care than it is time to think of going private. People have the right to be seen for their problems.”

Dr. Glazebrook believes the public health care system is the “jewel in Canada’s crown,” and yet, he says, it is expensive to operate and if the government is more concerned with finding “efficiencies” than in hiring more doctors to tackle what is a Canada-wide wait time problem — that only additional manpower can truly fix — then we, as a country, are eye-to-eye with the proposition of actually having an honest conversation about private medicine.

David Wilson, a former paramedic, is Nova Scotia’s Health and Wellness Minister. He says the province’s NDP government has been “working hard” to ensure “that the province has a good complement of surgeons and specialists.”

How having one foot and ankle surgeon, with a 3,500 person backlog, qualifies as “good” is unclear. But, no matter, the politician says creating a parallel private system or offering health consumers a private option would pull money away from the public till and erode what the province already has, flawed though it may be.

“I think, and this has been a view of our party, and we have been very vocal about it, but I think we have to be very careful because the minute you [talk privatization] you open up the opportunity for profit to play a role and really siphon funds from a public system,” he said.
Dr. Glazebrook says hiring three additional foot and ankle specialists would cure his wait list woes. David Wilson says there is no money to hire them with. And so here we are, in a perfect pickle, with people like Wendy Berringer being told to grit their teeth and get in line.
“I know you have to wait your turn in Canada,” Ms. Berringer says. “I understand that. But sometimes the system doesn’t seem to work for the people that need it.

“I am kind of back to full circle, back to Dr. Glazebrook, and he has a 3,500-person waiting list. I have waited over 10 years to see him and I’m not getting any younger, you know.”

Timothy Caulfield

A Commentary on Electroshock Therapy

Historically, electroshock therapy has been utilized clinically for the better part of the past century. Aside from the trauma to the brain tissue, which may be irreversible, the benefit obtained, no matter how great, is only temporary. This in itself should mitigate against the application of this therapy. Needless to say, psychiatrists, psychotherapists, and others who deal with problematic patients, frequently become frustrated with a conservative approach and when stimulated by patients and/or relatives, may surrender to the temptation to change the therapeutic paradigm.

A preponderance of existing evidence indicates that utilization of ECT is controversial at best. From my personal perspective, I would certainly employ measures that are more conservative, such as psychotherapy, tranquilizers, etc. On the other hand, unquestionably there are occasions where ECT can be used as a court of last resort.

In the current medical climate, there is an overwhelming desire, if not need, to obtain “a quick fix” – ie. the so-called Instant Gratification Syndrome. This should definitely be replaced by less intrusive methods, requiring patience on the part of the therapist along with the client. More practitioners should give this matter considerable thought and reflection.

In our experience, in a small group of patients where ECT has been previously utilized, replacing this therapy with Laser Therapy has proven to be beneficial and obviates the need for more intrusive therapy. Studies in this area are continuing and indications to date are that wider adaptation of Laser Therapy is warranted.

Laser Therapy is used to widely irradiate the cervical spine, the brain, and of course the cerebrospinal fluid and its components. This creates a potent calming, or neuromediation effect, which is often dramatic from a therapeutic perspective.

For additional information contact Fernanda Saraga, Ph.D, Meditech International Inc., fernanda@bioflexlaser.com

GAMBLING COMMENTARY

It should be of interest to most citizens that legislation produced by governments is periodically reversed and all too frequently devoid of any perceptible reason. The purpose generally is to increase its revenues, thereby broadening its powers. Change is certainly an important component of our culture, for if we are to progress, occasionally we must move in a new direction. On the other hand, change should be implemented to positively impact the population’s needs and certainly not to create negative influences.

It was not too many years ago when gambling at almost any level, even card games privately conducted in the home, were considered to be criminal activities, particularly when an exchange of currency was involved. Citizens could be arrested at random, fined and even imprisoned, following due process of course. Now, governments around the globe are intensely pursuing efforts to popularize gambling under the guise of bringing wealth to the communities, but in actuality, simply to enhance “their coffers”. From criminal activity, it has been converted to an important “source of revenue” simply to provide governments with more clout.

All this has been done by the stroke of a pen, facilitated by lobbyists, and other nefarious influences. Does this make sense?

It is widely known that gaming at any level, especially when organized, nurtures criminal elements, initiates personal economic disaster and brings to bloom all the negative aspects of human activity, particularly those which can be considered to be criminal in nature. Prostitution, addiction to alcohol and drugs, theft and every known depravity follows in its wake, like a river surging through a broken dam. Moreover, in communities where it has been implemented, it almost immediately results in a form of “chronic depression” aside from the routine matters of degradation.

In recent decades, Indian reserves across North America, after approval by federal, state and provincial governments, have made casinos a staple on their lands. In no instance has it brought benefit to the population of those communities, except to the 2 or 3 band members who “manage the tribe’s funds”. The latter appear to spend it on fast cars, travel, alcohol and other addictions, followed by many months spent in rehab facilities. Only a modicum trickles into education, health care, better housing, matters where purportedly more support is to be provided.

Politicians, of course, will always state that this activity creates new jobs. And so it does. But are these productive and long-term jobs that create a positive impact on people’s lives? Definitely not. Gambling does nothing to improve the human condition and only serves to widen the hole of blackness and despair wherever casinos are located, be it major cities, resorts or reservations.

Clearly, gambling as a solution to economic problems created by the greed, stupidity and fraudulent practices conducted and sanctioned by governments and the financial sector, create problems significantly more extensive than those it pretends to relieve. All citizens should stringently oppose these measures in the interest of long-term public welfare. It is imperative that voters express total opposition to this intrusion, which has always been contrary to the public interest. The so-called benefits that it delivers, primarily to governments, lobbyists and a select few managers, simply impose another oppression on the populace. Once entrenched, legalized gambling, like a bad disease, will never disappear and this negative impact will expand exponentially.

The Psychological Status of Wound Patients

A disproportionate number of patients in this category have been suffering from lesions in existence from a matter of months to over five years. They have been exposed to an extensive number of therapeutic modalities at multiple centres. These range from dermatological offices to specialized hospital wound clinics. Generally and invariably, they have seen a number of specialists including vascular surgeons, dermatologists, infectious disease controllers, neurologists and family physicians. Most have been treated with several courses of antibiotics, comprising oral, topical and intravenous delivery, along with analgesics, sleep medications and an almost unlimited number of dressing options. Topical applications are so diverse that the attempt to classify them, boggles the mind. Some incorporate silver, others are iodine-based – the list is without end.

Often despite best efforts, wounds continue to increase in dimension at a gradual pace, whether diabetic, atherosclerotic, venous, inflammatory, iatrogenic or of other origin. As the days pass and turn into months, even years, the patient becomes increasingly depressed with the feeling that there is no light at the end of the tunnel. In essence, they lose faith in the power of the healing professions. Many become resigned to their fate; others become angry at the journey that eventually may encompass the loss of a limb. Gradually, they lose interest in the proceedings and cease to care with regard to the objective or the end result. The wound and the extremity on which it is located, from their perspective, ‘now belongs to the therapist’. In the course of this development, they tend to become non-compliant with regard to the prescribed regimen and often, somewhat like alcoholics, disappear for a week or two until someone in their family persuades them to continue with treatment, which by then may present new complications.

At the same time, no matter how caring or attentive the therapeutic environment may be, there is always the danger at this stage of failing to penetrate the patient’s mental armour. They become guarded and somewhat reclusive in communicating their problems and anxieties and may retreat into a shell, which inures them from outside influences and the reality of their situation. On occasion, indeed, they lose total interest in their progress and the objective of the therapeutic exercise, along with the administration thereof. Even when significant healing is demonstrated by serial photographs, they become disinclined to reveal any interest or emotion with relation to these positive events.

The most negative factor often prevalent and frequently reinforced has been the debridement process. The administration of this step is often heavy-handed, painful and engenders the feeling that it may even be destructive. Whereas on occasion it may be required, in our experience, natural debridement, based on the use of hydrogen peroxide and saline compresses, is vastly preferable. Moreover in our opinion, it is better tolerated, more effective and permits new cells to survive.

In an effort to penetrate the negative mindset of these patients, one must reflect on their psychological status and educate them about treatment objectives. The Meditech Laser Therapy Program for Wound Healing stresses a positive approach, along with the development of relevant insight into the patient’s psychological status. The latter involves psycho-therapeutic techniques including guidance to enhance comprehension conversion to become a participant in the healing process and sharing the responsibility for the outcome. It is mandatory that all centres specializing in wound healing understand and incorporate these principles into their programmes.

For references regarding the Meditech Method for Wound Healing, email Fernanda Saraga, our PhD Director of Research: fernanda@bioflexlaser.com

BioFlex Laser Therapy Advantage

The Filipiuk Comment

With the US election results now behind us, the markets are squarely focused on the “fiscal cliff” threatening the country. If Congress and the President don’t come to terms before the end of the year, the economy will be hit with tax increases and spending cuts that could lop 3.6% off the GDP. This would put the US economy into a full-blown recession. Many are hopeful that a compromise will be reached, but one must remember that, even if there is a deal done, the US government still must grapple with the reality of a gaping annual budget deficit that is unsustainable. Up until now, the US economy has been kept above recession levels owing to a trillion-dollar annual increase in government spending. Much of this extra money is being provided by the US banking system and the Federal Reserve. The Fed is printing money, and buying government bonds and mortgages to fund this deficit. It has also cut interest rates to zero so that the financing of this debt hurts as little as possible. Recently, the Fed extended its “Quantitative Easing” program indefinitely, claiming that it was to help the unemployment rate. In reality, it is likely that it is just allowing the government more time to get its house in order: i.e. to kick the can down the road. Ever since Obama’s re-election, the stock market has been going down, partly as a result of the slowing global economy but also of the uncertainty surrounding the future government policy. Even if the “fiscal cliff” is avoided, the US economy won’t he helped much, as it still faces gargantuan deficits and spending cuts to come.

I recently came across a fascinating video created by Paul Grignon, entitled “Money as Debt”. The 47 minute film explains in very simple terms the history of the modern banking system, how it has deteriorated, and how it can possibly be fixed. It is a truism that, in order to succeed in any realm of life, whether it is sports, business, or investing, it is essential to know the rules of the game. This video demonstrates how the banking game is structured and is very thought-provoking. For example, the fact is that we live in a debt based money system, in which money is created through the issuance of debt. Since there is an interest charge on debt, more money must be created year after year to service the debt (or money) that has already been created. Eventually this compounding goes exponential and is unsustainable. We are potentially at that point right now. The fact that a system that functions this way was ever allowed to become the mechanism for how our world creates the money for its economy is mind boggling. I think that many people still find the concept of money’s being printed out of thin air to be surreal. It is an unconscionable privilege bestowed on a few, and its consequences can be devastating. Most of us have to earn our money through work, yet commercial banks and central banks can print it at will. I really encourage clients and others to watch this video and form their own opinion.