Michell Malkin - Obamacare making a mess of medical records 'reform'

Hey, who's up for a stiff dose of "See, I told you so?"

For the past several years, medical professionals have warned that the federal electronic medical records mandate — buried in the trillion-dollar Obama stimulus of 2009 — would do more harm than good. Their diagnosis, unfortunately, is on the nose.

The Quack-in-Chief peddled his tech-centric elixir as a cost-saving miracle. "This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests," he crowed at the time. In theory, of course, modernizing record-collection is a good idea, which many private health care providers had already adopted before the Healer of All Things took office.

But in the clumsy, power-grabbing hands of Washington bureaucrats, Obama's one-size-fits-all EMR regulations have morphed into what one expert called "healthcare information technology's version of cash-for-clunkers."

I reported in 2012 how my own primary care physician quit her regular practice and converted to "concierge care" because of the meddlesome EMR burden. Untold numbers of docs across the country have done the same.

In 2013, health care analysts at the RAND Corporation admitted that their cost-savings predictions of $81 billion a year were vastly inflated.

In 2014, RAND researchers interviewed doctors who spotlighted "important negative effects" of the EMR mandate on "their professional lives and, in some troubling ways, on patient care. They described poor EHR usability that did not match clinical workflows, time-consuming data entry, interference with face-to-face patient care, and overwhelming numbers of electronic messages and alerts."

And the hits keep coming.

Robert Wachter, author of the recently published "The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age," chronicled the damage he's witnessed: "Physicians retiring early. Small practices bankrupted by up-front expenses or locked into ineffective systems by the prohibitive cost of switching. Hours consumed by onerous data entry unrelated to patient care. Workflow disruptions. And above all, massive intrusions on our patient relationships."

The American Medical Association, which foolishly backed Obamacare, is now balking at top-down government intrusion into their profession. Better late than never. The group launched a campaign called "Break the Red Tape" this summer to pressure D.C. to pause the new medical-record rules as an estimated 250,000 physicians face fines totaling $200 million a year for failing to comply with "meaningful use" EMR requirements.
In Massachusetts last month, physicians decried the failure to achieve true "interoperability" between EMR systems despite a $30 billion federal investment through the Obama stimulus. Dr. Dennis Dimitri, president of the Massachusetts Medical Society, noted at a rancor-filled town hall that the mandate has "added significant time to the daily life of most physicians in their practices," WBUR reported. "It has not necessarily lived up to expectations in terms of its ability to provide cues to physicians to make sure that necessary treatments are not being missed. It has certainly not been able to swiftly disseminate information from one clinical setting to another."

That's in no small part due to the cronyism embedded in the federal stimulus "incentives" — a massive chunk of which the White House doled out to behemoth EMR company Epic Systems, headed by Obama crony Judith Faulkner. As I've noted repeatedly in this column the past three years, Epic continues to be plagued by both industry and provider complaints about its creaky, closed-end system and exorbitant fee structure to enable the very kind of interoperability the Obama EMR mandate was supposed to ensure.

Now, even left-wing Mother Jones magazine reports this week that "instead of ushering in a new age of secure and easily accessible medical files, Epic has helped create a fragmented system that leaves doctors unable to trade information across practices or hospitals. That hurts patients who can't be assured that their records — drug allergies, test results, X-rays — will be available to the doctors who need to see them. This is especially important for patients with lengthy and complicated health histories."

The Obama White House has responded by doubling down on its destructive EMR rules that punish both patients and providers. Congress must intervene. Rep. Steve King, R-Iowa, introduced a bill Thursday to repeal the draconian penalties "so that providers can get back to the business they are uniquely trained to do — utilizing their skills and knowledge to heal the sick and support the continued vitality of the healthy."

Prescription: Butt out, Washington. Primum non nocere.

(Syndicated columnist Michelle Malkin is the daughter of Filipino Immigrants. She was born in Philadelphia, raised in southern New Jersey and now lives with her husband and daughter in Colorado. Her weekly column is carried by more than 100 newspapers.)


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Lakes Region Profiles — Living in a poem in the Lakes Region


Sales Associate at Roche Realty Group


I propose that understanding poetry should be easy for those who live in the Lakes Region. Who would not be able to relate to the words of W. B. Yeats when he said, "I hear lake water lapping with low sounds by the shore...I hear it in the deep heart's score" or Robert Frost as he watched the "woods fill up with snow" and heard "the sweep of easy wind and downy flake." These images are easily evoked for a person traveling around the Lakes Region's handsome forests and picturesque lakes. There are a thousand places in the Lakes Region to walk "between the woods and...lake."

Ahern Park, a 128 acre state park in Laconia, is one of these places. It is a favorite of locals and considered their "secret." With an easy walk from many of the Laconia neighborhoods, a person is instantly transported back to old New Hampshire. Lush open fields give way to a tall pine forest. Deep in the forest, wooded paths lead you to the edge of Lake Winnisquam. A wide gravel trail piled deep in fallen pine needles follows 3,500 feet of jagged shoreline and offers breathtaking views of the lake and mountains. It is truly a walk back in time. Robert Frost would certainly have approved of this unspoiled spot "between the woods and...lake," only one of many such spots to be discovered in the Lakes Region. In addition to State parks and forests, the Lakes Region Conservation Trust properties offer many hikes and walks on old carriage and logging roads.

William Campbell wrote of experiencing dawn on an island with "stretches of water flamed-bathed by the incoming light...as God sends the manifold mystery of the morning and lake round to me." How well this describes the feelings of one who wakes and looks over the waters of Winnipesaukee, Squam, Newfound, Kanasatka, Wicwas, Waukewan or one of many other lakes or ponds. Anyone who is blessed to have a house or camp on one of the hundreds of islands or near the shores of the lakes can relate to this description – a beautiful expanse of water reflecting the colors of the day to come. "God's mirrors underneath the sky." They can join Campbell as he cries out, "O magic region of blue waters throbbing."

Henry Wadsworth Longfellow described a village in celebration, conjuring an image of many a festival in any one of the towns in the Lakes Region. "Group after group appeared... thronged were the streets with people; and noisy groups at the house-doors sat in the cheerful sun, and rejoiced and gossiped together." In all four seasons, communities like Wolfeboro, Meredith, Center Harbor, Gilford, Belmont, Sanbornton, Alton, and Laconia are bustling with local activities and events: fairs, multicultural days, races, carnivals, sports gatherings, holiday celebrations, and this year's inaugural pumpkin festival. There is a sense of community, friendship, and common purpose in the Lakes Region towns, a truth that would lead many to agree with Mark Twain when he said, "Human nature cannot be studied in cities except at a disadvantage – a village is the place. There you can know your man inside and out – in a city you but know his crust; and his crust is usually a lie."

And when the festivals are over and the populace returns to their house or farm, an enjoyable peace settles over the Lakes Region. Now to take the lines of Alexander Pope: "How happy he, who free from care, the rage of courts, and noise of towns, contented breathes his native air in his own grounds."

"Ours is a great wild country: if you climb to our castle's top, I don't see where your eye can stop." What better expression is there to describe Castle in the Clouds in Moultonborough than these words of Robert Browning? This unique treasure of the Lakes Region is a mountain top mansion with an unusual history. It was built in the early 1900s and rests on 5,500 acres of the Ossipee Mountain Range. Its many hiking trails afford spectacular views of the lakes to the south and the White Mountains to the north. Other mountains surrounding the lakes offer an amazing array of hikes where you "don't see where your eye can stop." From the top of Mt. Major in Alton, the entire blueprint of the Lakes Region expands north and merges with the distant White Mountains. A short distance to the west in Gilford, Belknap and Gunstock Mountains present equally remarkable views. Rattlesnake, Fayal, and Red Hill to the north give a different perspective looking southerly as the lakes sprawl out and meet the Belknap Range and hills beyond. Each culminates in breathtaking views that require one to borrow the words of Anne Bradstreet: "The more I look'd, the more I grew amaz'ed and softly said, what glory's like to thee?"

Everywhere you go in the Lakes Region you are confronted with history – the names of lakes and rivers that reflect the Indian heritage going back hundreds of years; the old settlements with roots to colonial days; a monument here, a old building there, that reveals a glimpse of the past. The lakes, as a drawing card for Indians and settlers alike, made this region a treasure trove of the mysteries of history. Each road has a story to tell, each town a secret to disclose. "Through all time I hear the approaching feet along the flinty pathway beat of him that cometh, and shall come...and all town-sprinkled lands that be, sailing through stars with all their history." These words of Ralph Waldo Emerson could have easily been written in the Lakes Region.

"Let the fields be jubilant, and everything in them. Then all the trees of the forest will sing for joy." Could it be this poetic verse by the psalmist was composed while experiencing a vision of a color-filled fall day in the Lakes Region? When Robert Frost penned the words, "There were ten thousand fruit to touch, cherish in hand, lift down, and not let fall," could he have been sitting on a rock at Smith Orchard in Belmont, Stonybrook Farm in Gilford, DeVylder Farm in Wolfeboro, or one of many other Lakes Region apple orchards? Probably not, but one can only guess what works of art have been inspired by the beauty of the Lakes Region. It has and always will be a source of inspiration.

Citizens of the Lakes Region, dust off your poetry books. Yours is the place of which poems are written. It is time to rediscover the Lakes Region in a thousand poems. But why stop there? The Lakes Region can be found in a gallery of paintings, a library of novels, a museum of fine art. Yours is the substance from which these are made. Yours is a place worth painting, a wellspring for novelists, and a muse for poets.

Wallace Stevens wrote, "Perhaps the truth depends on a walk around the lake." These mysterious words surely have many meanings, but perhaps they are telling those who live in the Lakes Region, "Continue to enjoy and appreciate the beautiful place where you live because it is the closest thing to true living in this chaotic world." And for those who don't live here, the words are telling them, "Don't just read a poem. Come live a poem."
Please feel free to visit www.rocherealty.com to learn more about the Lakes Region and its real estate market. Mary O'Neill is a sales associate at Roche Realty Group in Meredith & Laconia, NH and can be reached at (603) 366-6306. rocherealty.com

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Roy Sanborn Column

A Ghostly Disclosure

Last week I received a call to go out and meet with a homeowner who wanted to possibly sell her home. As I approached the house, which turned out to be at the end of a long dirt road, I noticed several out buildings and a barn all of which seemed to be in great condition. I stopped in the large circular driveway in front of the house and could not help but admire the setting and how well kept the home was.

As I went up the steps to the large front porch of the farm house, I noticed an elderly couple sitting at the far end. The early morning light wasn't great as the sun was behind them, but I could see that the elderly gentleman was rather thin and pale and had long grey hair with a bit of stubble on his face. He was dressed in a worn blue suit, linen shirt, was holding an old wood handled hammer, and on the floor next to his dusty boots was a bucket of hand tools. The woman, who I assumed was the lady who had called me, was dressed in a long floral patterned dress and an apron that reminded me of my grandmother. She looked like a typical spinster with a slight build and her silver hair was neatly up in a bun. I looked twice as I thought she had a chicken in her lap but I realized, thankfully, it was just a feather duster. A broom was leaned against the railing next to her. They just kind of stared blankly, seemingly surprised to see me.

I said "Hi, how you doing?" and as I started to approach them, the old buck nodded toward the front door and pointed a long bony finger in that direction. I had visions of Keith Richards for a second, but got the message and turned back toward the door and knocked. A younger and prettier version of the lady on the porch quickly answered the door to welcome me in. As I started to step inside, I glanced toward the end of the porch and the couple was still there, staring off into space.

The homeowner led me to the living room and told me that she and her husband had bought the property about 10 years ago. Her husband had a job opportunity in another state that he wanted to take so now they had to part with it even though they loved it. The home had belonged to her great uncle and aunt whom she knew only for a short time before they passed away. It had changed hands several times since their passing and when it finally came available again they jumped on the chance to buy it. She said she and her husband, along with two children and a menagerie of dogs, have truly enjoyed the home but now it was time to move on.

She gave me a tour of the home and I couldn't help but be impressed with it even though it was built in the mid 1800s. It was tastefully updated, nicely decorated, and yet retained a lot of the early character of a quaint country farm. And, it was spotless. I mean really spotless. I commented on how clean the home was and the lady said, "You know, this home is the easiest place to take care of that I have ever lived in! Even with two kids and the dogs running through it all the time, it's a breeze to keep up with! Even my husband barely needs to do any maintenance around here other than mow the lawn and the place looks great."

I told her I would go back and do a market analysis for her and get back to her with what I thought the value would be. I then asked if there was anything that she would want a prospective buyer to know. She thought for a moment and whispered, "You know, sometimes we hear strange noises at night. Sometimes it is just banging, sometimes like sawing, and other times it a swishing noise, like someone is sweeping the floor."

I said it was nice that her parents had come to stay with her a while and that I had kind of met them on the porch on the way in. She looked surprised and exclaimed, "My parents live in Florida! Someone was on my porch?!" As we stepped out on the porch, off course, no one was there ... just the broom.

So, let's be clear, if you are buying a home in New Hampshire, you should know that there is no line in the Seller's Property Disclosure to tell you if a house is haunted. Remember, this is the Live Free or Die state. There's bound to be a bunch of dead people still haunting more than few homes around here. So if you are faint of heart, scared of things that go bump in the night, worried about ghosts and demons, afraid to hear moans, groans, screams, and the wailing of souls that are trapped between the living world and the dead, you should definitely ask the listing agent if the house you are looking at is haunted or possessed. I promise, if I know, I will tell you because I don't want you haunting me after you buy the place! But you know, you might just get a spirit that keeps your house clean. They ain't all bad, you know...

September was a great month for residential sales in the 12 communities covered by this real estate market report. There were 111 homes that found new owners with an average sales price of $378,900 and a median price point of $229,900. This brings our total so far this year to 808 sales at an average price of $342,499 compared to 726 sales at an average price of $315,592 for the same period in 2014. That's an 11 percent increase in total sales over last year. Pretty spooky, right? Happy Halloween!

P​ease feel free to visit www.lakesregionhome.com to learn more about the Lakes Region real estate market and comment on this article and others. Data compiled using the NNEREN MLS system as of Oct. 18. ​Roy Sanborn is a sales associate at Four Seasons Sotheby's International Realty and can be reached at 603-677-7012.

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Jim Hightower - My pick for Speaker of the House

If it were under the big top, it would be a hilarious clown show — with pratfalls, wild posturing, tumbling, juggling and a cacophony of comic chaos.

But alas, it's under the Capitol dome, so it's just the Republican congressional caucus — bumbling, stumbling, and crashing into each other in clownish acts of ideological zaniness, political incoherence and pathetic ineptitude. The present bedlam on the Hill was prompted by House Speaker John Boehner abruptly deciding to zip-a-dee-doo-dah out of office, having finally given up on corralling his caucus of clowns.

Sadly, his withdrawal has only intensified the buffoonery, generating a slapstick intramural contest over which group of far-out right-wingers gets their pick to replace him. Boehner's contingent of anti-government, corporate-hugging extremists want one of their own, while assorted groupings of even fringier, farther-out packs of mad-dog tea party Republicans want someone who'll howl at the moon and literally shut down the government.

When Speaker Boehner gave up his position because he couldn't stand running the show anymore, next in line was Rep. Kevin McCarthy. He started campaigning for the job, but quickly backed off after he let it slip that the House Benghazi hearings were held just to damage Democratic presidential candidate Hillary Clinton and really had nothing to do with national security.

For the moment, Rep. Paul Ryan appears to be the most likely pick, except for two problems: One, he doesn't really want the thankless task of clown-herding, unless he can get all factions of Republicans to a level of consensus (good luck with that!); and two, even though he is an Ayn Rand-worshipping, Koch-hugging, laissez-fairyland ideologue dedicated to killing everything from Social Security to Obamacare, Ryan is just not right-wing enough for the howlers. He's considering whether to run for the job, but even if he does — and wins — the spectacle will continue.

The amusing irony in Ryan's predicament is he helped create his own mess! He was chief architect of the 2010 Republican scheme to take over Congress by recruiting and electing the mad dogs who are now biting him on the butt — and turning the U.S. House of Representatives into the House of Ridiculousness. As Rep. Peter King put it: "We look absolutely crazy."
And Rep. King is right. What's at work here is the Crazy Caucus. At one level or another, nearly all Republican House members belong, but the caucus is driven by about 40 hyper-crazies who believe that the greatest problems facing our country are Hillary Clinton's e-mails, Planned Parenthood, the existence of public services and the "hordes" of Mexicans who sneak into our country so they can vote for Democrats. It's the job of the House speaker to try "leading" these mad dogs to an occasional bit of sanity. Who really wants to do that — or even thinks it's possible?

Well, several of the mad dogs themselves say they should be put in charge. Daniel Webster says he's available (not the smart guy who compiled the dictionary, but a tea party bozo from Florida). Bill Flores, a little-known tea party know-nothing from Texas, says he would unite the House by getting all the members to "spend enough time on our knees praying for each other." That's silly, but the idea of keeping lawmakers on their knees is appealing. Mike Pompeo of Kansas, a prince of right-wing pomposity who was elected by the billionaire Koch brothers to be their personal representative in Washington, says he's ready to lead the House toward a Koch-headed plutocracy.

That's pathetic. But wait — we have another surprising choice. It's a little-known fact, but the speaker of our House of Representatives does not actually have to be a member of Congress. So why don't we choose someone like a kindergarten teacher, a minimum-wage worker, an organic farmer or a circus ringmaster to run the show? Or maybe a group psychologist is what the place really needs.

(Jim Hightower has been called American's most popular populist. The radio commentator and former Texas Commissioner of Agriculture is author of seven books, including "There's Nothing In the Middle of Road but Yellow Stripes and Dead Armadillos" and his new work, "Swim Against the Current: Even Dead Fish Can Go With The Flow".)

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Pat Buchanan - Can Trump be stopped?

Three months ago, this writer sent out a column entitled, "Could Trump Win?" meaning the Republican nomination. Today even the Trump deniers concede the possibility. And the emerging question has become: "Can Trump be stopped? And if so, where, and by whom?"

Consider the catbird seat in which The Donald sits.

An average of national polls puts him around 30 percent, trailed by Dr. Ben Carson with about 20 percent. No other GOP candidate gets double digits.

Trump is leading Carson in Iowa, running first in New Hampshire, crushing the field in Nevada and South Carolina. These are the first four contests. In Florida, Trump's support exceeds that of ex-Governor Jeb Bush and Sen. Marco Rubio combined.

If these polls don't turn around, big time, Trump is the nominee.

And with Thanksgiving a month off, then the Christmas season, New Year's, college football playoffs and NFL playoffs, the interest of the nation will drift away, again and again, from politics.

Voting begins Feb. 1 in Iowa. Super Bowl Sunday is Feb. 7. And the New Hampshire primary will likely be on Tuesday, Feb. 9.

We are only three months out, and Trump still holds the high cards.

After months of speeches and TV appearances, he is a far more disciplined campaigner and communicator. In a year when a huge slice of the nation is disgusted with political correctness, wants to dethrone the establishment, wipe the slate clean and begin anew with someone fresh, Trump is in the pole position.

His issues — secure the border, send illegal immigrants back, renegotiate rotten trade deals that shipped our jobs abroad — are more in tune with the national mood than pro-amnesty, Obamatrade or NAFTA.

Wall Street Journal conservatism is in a bear market.

Trump says he will talk to Vladimir Putin, enforce the nuclear deal with Iran, not tear it up on Inauguration Day, and keep U.S. troops out of Syria. And South Korea should pay more of the freight and provide more of the troops for its own defense.

A nationalist, and a reluctant interventionist, if U.S. interests are not imperiled, Trump offers a dramatic contrast to the neocons and Hillary Clinton, the probable Democratic nominee. She not only voted for the Iraq war Trump opposed, but she helped launch the Libyan war.

The lights are burning late tonight in the suites of the establishment tonight. For not since Sen. Barry Goldwater won the California primary in 1964 have their prospects appeared so grim.
Can Trump be stopped?

Absent some killer gaffe or explosive revelation, he will have to be stopped in Iowa or New Hampshire. A rival will have to emerge by then, strong enough and resourced enough to beat him by March.

The first hurdle for the establishment in taking down Trump is Carson. In every national poll, he is second. He's sitting on the votes the establishment candidate will need to overtake Trump.

Iowa is the ideal terrain for a religious-social conservative to upset Trump, as Mike Huckabee showed in 2008 and Rick Santorum in 2012. But Carson has preempted part of the Evangelical and social conservative vote. Moreover, Sen. Ted Cruz, an anti-establishment man, is working Iowa and has the forensic abilities to rally social conservatives.

Should Trump fall, and his estate go to probate, Cruz's claim would seem superior to that of any establishment favorite. Indeed, for an establishment-backed candidate — a Jeb Bush, Marco Rubio, John Kasich, Chris Christie, Bobby Jindal — to win Iowa, he must break out of the single-digit pack soon, fend off Cruz, strip Carson of part of his following, then overtake Trump. A tall order.

Yet, the battle to consolidate establishment support has begun. And despite his name, family associations, size of his Super PAC, Jeb has lost ground to Marco Rubio. Look to Marco to emerge as the establishment's last best hope to take down Trump.

But if Trump wins in Iowa, he wins in New Hampshire. The Iowa Caucuses then, the first contest, may well be decisive. If not stopped there, Trump may be unstoppable. Yet, as it is a caucus state where voters stick around for hours before voting, organization, intensity and endless labor can pay off big against a front-runner.

In Iowa, for example, Ronald Reagan was defeated by George H. W. Bush in 1980. Vice President Bush was defeated by Bob Dole and Pat Robertson in 1988. Reagan and Bush I needed and managed comeback victories in New Hampshire. One cannot lose Iowa and New Hampshire.

Thus, today's task for the Republican establishment: Between now and March, they must settle on a candidate, hope his rivals get out of the race, defeat Trump in one of the first two contests, or effect his defeat by someone like Carson, then pray Trump will collapse like a house of cards.

The improbabilities of accomplishing this grow by the week, and will soon start looking, increasingly, like an impossibility — absent the kind of celestial intervention that marked the career of the late Calvin Coolidge.

(Syndicated columnist Pat Buchanan has been a senior advisor to three presidents, twice a candidate for the Republican presidential nomination and the presidential nominee of the Reform Party in 2000. He won the New Hampshire Republican Primary in 1996.)


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