As I sit down to write my first message to you all as the new Chairman of the Young Republicans of Allegheny County, I still find myself to be very humbled that you have all chosen me to lead our organization. It is truly an honor and I hope that I will live up to your expectations. First, I would like to take a moment to thank our former Chairman, Dan Garcia. Under his leadership, our organization has grown and made great strides and I hope we can all work together to continue this trend. As I look to the accomplishments we have made, I look to ensure that we remember our goals as Young Republicans. First and foremost, we are a political grassroots organization whose ultimate goal is to provide support to Republican Candidates and important conservative issues. Next, we look to improve the world in which we live not only through involvement in political campaigns, but also through community and charity projects. Finally, we look to bring likeminded people together through social and networking events to allow for exchanging of ideas and for plain, simple fun. 2011 will be a year of growth and development for us. Young Republicans from around the nation will be coming together this summer, as we did locally this past month, to elect new leadership. As we look to build as a national organization, we will also focus on building right here. I hope to continue to reach out to new people and continue to bring new members to our organization. This is an important year for us to continue to push forward as we prepare for 2012, a year that will decide the direction of our nation for the next four years. We will also be looking to help our local candidates running for state and county offices, as well as helping several of our YRs running for municipal offices. This is certainly going to be an amazing time to be a Young Republican and I look forward to working with all of you, whether you are a new member or a veteran member, we have an interesting time ahead of us and it will be a time to remember.

Daniel Soltesz

Habitat for Humanity’s ReStore

As we all know, Habitat for Humanity is a great organization that helps families and people all over the world. Through volunteer labor and donations of money and materials, Habitat builds and rehabilitates homes and communities. What you may not know, however, is that Habitat has been rolling out a new initiative to aid in its mission. Habitat ReStore will serve as a retail outlet providing building materials, furniture, major appliances, electronics, home decor items, and more to the needy public at a discounted price. All of the items sold at ReStore will come from solicited donations and, therefore, provides a recycling benefit as well. All of the proceeds from ReStore will go to funding Habitat's core home building programs.

Later this spring, Habitat will be opening its first ReStore in Allegheny County and reached out to YRAC for help setting up the facility (assembling shelves and displays, moving products in, etc.) and making it presentable. This is a fantastic opportunity to get involved with a tremendous organization and contribute to the community we live in. It will also help us extend our relationship with Habitat to some fun home building/renovation events later this summer! Please come out and help!

Michael Trettel

Bowl for Kids Sake Results

On Sunday, March 27^th three teams of Young Republicans headed to Funfest in Harmarville, PA and bowled for charity. In just a few short months the YRAC raised over $900.00 for the Big Brothers Big Sisters (BBBS) 2011 Bowl for Kids Sake. The executive board would like to thank everyone for their efforts.

If you’d like to make a donation to BBBS, please visit the YRAC marathon group page at:

http://runpittsburgh2011.kintera.org/faf/donorReg/donorPledge.asp?ievent=439011&lis=0&kntae439011=64CEA2076AE845D3B59DA892ACC09D39&supId=0&team=4093535

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2011 YRAC Bowl for Kids Sake Bowlers

Kimberly Hanson

Editorial: The Impact of the New Health Care Law on Pennsylvania Physicians

The Affordable Care Act became law in March, 2010. There were several reasons for this law, including the lack of universal coverage, the high cost of health insurance, abuses by insurance carriers, and difficulty in obtaining insurance when a person really needed it. The situation was progressively worsening and the private sector seemed unable or unwilling to address these problems. Congress and the President acted. What can we expect from this act? Will it save money and lives?

The Affordable Care Act has a problematic provision requiring all citizens to purchase health insurance. This provision has troubled many, and is currently being appealed through the courts. If the provision is found unconstitutional, the entire law will have to be rewritten.

The high cost of health care is unlikely to be fixed by the Affordable Care Act. Indeed, the cost of care is likely to go up rather than down due to some of the provisions. The main causes of increased health care cost are not addressed by the Act.

Health care is expensive for the following reasons:

1. There is an increase in chronic illness in society. In the past, most people died of acute illness or injury. As recently as the early 1950s 80% of all people died within a few weeks of an injury or illness. That number is now 20%. With chronic illness comes chronic expense. Imagine twins, one who doesn’t take care of himself and one who does. The reckless twin eats improperly, smokes, and doesn’t exercise. By age 55, his body is wearing out. First comes lung disease, robbing him of vitality, leading to early retirement. Then comes kidney failure, with dialysis and perhaps a kidney transplant. Then comes coronary artery disease with stenting and bypass surgery. By age 75, following several strokes and a prolonged stay at a nursing home, the reckless twin dies. The conscientious twin takes excellent care of himself, watching his weight, exercising, and not smoking. He does quite well, only to be struck and killed by a bus while jogging at age 83.

2. Increasing government interference with free market activity within the health care sector leading to unintended (and expensive) consequences. For example, consider the MRI scanner in Western Pennsylvania. The annual operating cost of a MRI scanner is at least 1 million dollars. MRI has many uses, but most significantly in imaging areas that are hard to see by less expensive modalities such as CT and ultrasound. MRI excels in areas of the body where dense bone interferes with visualization of soft tissue. The most useful areas for MRI are the brain and spinal cord. Physicians involved in treating diseases of the brain and spinal cord were quite interested in MRI when it first became available in the late 1970s. Within a few years of the availability of MRI scanners there were three in Western PA, eventually expanding up to about a half dozen. Physicians who had the most need for MRI (neurologists, neurosurgeons and orthopedic surgeons) banded together and purchased a scanner. Scan time was valuable and scans were performed around the clock and only on those patients who clearly had a need. This was efficient. Scans were interpreted by those physician-owners who had training in MRI interpretation. It was a joint, cooperative effort, with tough scans studied by multiple physicians. The remaining scanners were located in major teaching institutions, where interpretation of the scans was primarily by radiologists, only some deeply committed to the new technology. In 1989, the Omnibus Budget Reconciliation Act was passed by the federal government. This law made it illegal for physicians to refer patients to facilities where they had a financial interest. The neurologists, neurosurgeons and orthopedists sold the MRI scanner, and official interpretation of MRI was largely ceded to the radiologists. With no allegiance to a common facility, many groups including local hospitals and investor groups purchased and installed MRI scanners. With the advent of teleradiology, a radiologist in a central facility could interpret MRI images from multiple sites, making it easier for the spread of MRI imaging. The number of scanners in Western PA burgeoned to 163 scanners as of 2010. With this proliferation of scanners, the decision to obtain a scan is no longer based on need, but upon fear of missing an obscure condition. The number and per cent of negative or non-actionable scans has greatly increased, meaning more tests performed with less benefit. The cost of just this one modality in a small part of America has skyrocketed, with the largest part of this attributable directly to the OBRA legislation. The belief in Congress was that physician ownership was a moral hazard. Just considering Western Pennsylvania, OBRA replaced the moral hazard of one joint venture on 1 MRI scanner with the cost of maintaining 163 scanners and paying for many thousands of unnecessary scans.

3. Lack of skin in the game. If you can have a piece of cake or the whole cake, both for free, which would you prefer? Those who don’t have to ante up co-pays utilize services more than those who have co-pays. It is no coincidence that the ERs are havens for those who have minimal or no co-pay responsibility for the visit.

4. Protection of insurance carriers from competition. Government regulations and bureaucracy limit entry of start-ups into the insurance industry and limit entry of out of state insurers. As an example of the government/insurance company collusion, consider the primary care physician in New York state who attempted to start his own limited form of insurance by guaranteeing his patients 24/7/365 care for a fixed amount per year. The state insurance commission filed charges against him for violating insurance laws. Such an arrangement would have been beneficial to both the physician and his patients and likely would have cost less than having a third party insurance company pay for this service.

5. Charity has been supplanted by entitlement programs. Charity is ennobling. The providers give back to the less fortunate. The less fortunate, in appreciation for the process, will feel obligated to pay it forward, thereby spreading good will. Entitlement demeans the provider (who often is paid pennies on the dollar) and damages the entitled by giving them the false belief of deserving what they haven’t earned. The argument that the poor, feeling less shame, would receive better care with entitlements was disproven in a study conducted in the 1970s which showed no improvement in overall health care among the poor, when charity care was replaced by entitlement programs.

Pennsylvania has a physician shortage. Medicine becomes more complex each year, with a need for specialists as well as primary care providers. A rushed physician does not satisfy the patient who wants time and attention, and a physician who takes time with each patient cannot maintain a practice when third parties have near monopolistic power to dictate fees. Indeed, time spent with the patient is poorly reimbursed by insurance companies although highly valued by the patient and family. Busy-work such as useless documentation is reimbursed, not compassionate care, mainly because documents can be examined for completeness, but compassionate care, the hallmark of quality medicine, is hard to measure. So, insurers pay for a chart that is complete, not for patient satisfaction or a job well done. The problem is complex. A fresh approach that increases personal responsibility for health maintenance, trusts providers to act as compassionate professionals, and returns charity into the healing arts is certainly an alternative worth comparing to the collaboration of big government with big insurance. Furthermore, we are lucky to live in the United States. Each state could serve as a place to test different solutions to the health care problem, with outcomes and costs being used to decide which approaches are best. This would certainly be more scientific than imposing a sweeping, untested national health care system.

As a youth, it is important to learn before acting, lest impulsiveness and immaturity lead to folly. In middle age, we feel as if we are at the top of our game and we feel compelled to do something in order to be somebody and to make a difference. In old age, we realize that sometimes the greatest wisdom is to do less to accomplish more. The interrelationship between diverse things becomes clearer the more we know. Health care is a piece of the social puzzle of politics, and as such, cannot be solved in isolation. I am hopeful that the young Republicans of today will thoughtfully lead America to a healthier and happier future.

Dr. Malcom P. Berger, MD

The

Young Republicans of Allegheny County

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A Message from the Chairman