![]() IS IT MORAL TO RECEIVE THE COVID VACCINE? by Julio Gonzalez, M.D., J.D. In 1973 a woman underwent an elective abortion in the Netherlands. Like in other cases, her baby's tissues were used for biomedical research; the HEK 293 line taken from the baby's kidneys. Most recently, this cell line has been employed in the development of various COVID-19 vaccinations. As a result, many question the ethics of accepting these vaccines. Such introspection is absolutely appropriate since, at its core, it forces one to analyze the value of human life and the appropriateness of benefiting from another's demise. Although ultimately one's position on the ethical questions posed by the AstraZeneca-Oxford, Pfizer, and Moderna vaccines are personal ones that cannot be resolved by anyone other than the individual, the Catholic Church has laid out some guidelines regarding this issue, and members of its leadership have actually taken positions on this question. Little is known about the circumstances regarding the abortion leading to the harvesting of HEK 293. We know that it took place no later than January 1973, with some sources placing it in 1972. We also know that the aborted child was a healthy one. The HEK 293 cell line was developed at the University of Leiden, Holland, in Professor Alex Van Der Eb's lab, assisted by Frank Graham. HEK 293 is the product of Graham's 293rd experiment with the cells, where he successfully clipped adenovirus DNA onto the aborted baby's genome. Since then, the cells have been employed in a wide array of research projects with direct implications relating to viral disease prevention and cancer research. The procurement of cells from aborted babies for research and development was not unprecedented in the mid-twentieth century. Perhaps the line with the most well-elucidated circumstances were the HeLa cells obtained from the abortion undergone by Henrietta Lacks, an allegedly illiterate black woman in the United States who was never informed of the destination of her aborted baby's corpse. There was also the WI-38 human fibroblast cell line obtained from an abortion performed in 1962 in Sweden from a woman immortalized as Mrs. X who was also not informed of how her baby's discarded tissues would be used. Each cell line has gone on to produce significant advances in medicine and in the biological sciences. The issue of scientific advancement at the expense of a human life has brought commentary from bioethicists and religious authorities throughout the world. The Catholic Church has commented on the matter numerous times, not the least of which was the Vatican’s "Note on the Morality of Using Some Anti-COVID-19 Vaccines" published on December 21, 2020. Its position is clear and based on St. Thomas Aquinas's view that no evil can be justified by the promotion of good. That being said, there are differing degrees of participation in the evil and therefore different degrees of responsibility for the actions under consideration. Certainly, those who actively engaged in the abortion, the procurement of the tissue, and in its initial preparation engaged in indefensibly immoral actions. Additionally, according to Instruction Dignitas Personae on Certain Bioethical Questions, "in organizations where cell lines of illicit origin are being utilized, the responsibility of those who make the decision to use them is not the same as that of those who have no voice in such a decision." Importantly, the Church also discriminates over the presence of available alternatives. Thus, as is the case with the rubella vaccine, the Church holds that it is ethical for the general public to receive the vaccine even though it is derived from human embryonic cells since there is no available alternative. Despite this, the Church insists that all Christians demand the development of morally irreproachable alternatives to those obtained from human embryonic tissue. It also considers the type of cooperation by the vaccine recipient with the evil employed as both remote and passive. In other words, even though one may receive the vaccine with full knowledge that its development was tainted by the use of human embryonic cells, it does not follow that there was any formal cooperation with the abortion or with the decision to use the technology in the creation of the vaccination. Despite this, in accepting the vaccine, there is some degree of legitimization of both the methods used and the evil employed in its development. As an aside, it must be noted that, like many Americans, the Vatican insists that vaccination must be voluntary. Nevertheless, if one were to choose not to receive the vaccine, then he or she still carries the responsibility of engaging in other activities for the prevention of contracting and spreading the disease. Putting it all this together, three bishops from Colorado, Most Reverends Samuel J. Aquila, Stephen J. Berg, and Michael J. Sheridan have articulated concrete recommendations regarding the use of the various presently-available vaccinations. In a letter to the faithful of Colorado, the Bishops opined:
Ultimately, the decision to receive a vaccine developed using aborted human tissue is an innately personal one. The potential recipient must weigh the ethical issues at play against the benefits to one's self and to those around him or her. As one wrestles with this most important question regarding morality, human dignity, and scientific development, the Church's work on bioethics offers guidance on the choice one must ultimately make. In either case, the true solution lies in making the inhumanity and grotesqueness of abortion a thing of the past.
Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He is available for appearances and book signings, and can be reached through www.thefederalistpages.com.
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![]() THERE'S A NEW STRAIN OF COVID-19, AND IT'S RAVAGING LONDON by Julio Gonzalez, M.D., J.D. There's a new strain of COVID-19 that is spreading panic amongst Londoners. The rapidly spreading variant of SARS-Cov-2 has already caused the cessation of travel out of London and has negatively impacted commerce between England and other European countries like France, the Netherlands, Belgium, and Italy. The new outbreak is being caused by a strain of SARS-Cov-2 called B.1.1.7, less frequently referred to as VUI-202012/01. This variant appears to be much more aggressive than the original form of the virus, so much so that about 60% of COVID-19 cases in Kent, England, are presently being caused by B.1.1.7. Although the strain took off in December, it appears now that it may have been present in the United Kingdom as early as September 20. The strain is characterized by multiple mutations—precisely seventeen—more than has ever been encountered in a single strain. Ominously, half of the mutations affect the infamous spike protein that allows the virus to attach to susceptible human cells. Because the sudden appearance of multiple mutations has been observed in other viruses that have chronically infected immunocompromised hosts, researchers believe that a similar situation exists here and are busy searching for an individual who may have harbored the virus for as long as four months. One mutation in B.1.1.7 known as N501 Y and affecting the area where the virus attaches to human ACE2 receptors causes the virus to be much more effective at binding to susceptible human cells. It also appears that the N501 Y mutation makes the virus much more active in children. However, it appears the new form of the virus is not more resistant to the recently approved vaccines by Moderna and Pfizer so that the vaccines are equally effective at warding off attacks from all strains of SARS-CoV-2. Additionally, it does not yet appear that B.1.1.7 causes any deadlier forms of COVID-19 in its vicitms. I say "yet" because it is still too early to make any definitive assessments about the virus's lethality. The United Kingdom strain is not the first to carry the N501 Y mutation. Disconcertingly, in South Africa another rapid outbreak has been identified that appears to be causing a much more severe form of the disease in younger, healthy individuals. Similarly, in Spain, a superspreading event took place with the same mutation dating back to June. That mutation now accounts for about 90% of all new infections, but does not appear to be any deadlier than conventional COVID-19 infections. So what are the implications of these events to the United States and the rest of the world? As demonstrated in my book Coronalessons, it is apparent that the efforts by the United Kingdom to contain this mutant strain of virus are futile. The probability that travel limitations will limit the spread of a highly contagious virus in circulation since September is astronomically low. In fact, it is reasonable to believe that the B.1.1.7 has mutation has already reached our shores. Fortunately, if other forms of SARS-CoV-2 virus serve as any indication, the variant is likely no more life threatening than prior versions of the virus. Also reassuring, the mutations do not appear to affect the efficacy of the presently deployed vaccines. As a result, our best approach continues to be the continuation of plans implemented by the more conservative jurisdictions within the United States; namely continuing to protect the vulnerable, engaging in reasonable social distancing methods that do not include mandated business closures or lockdowns, and most importantly, that we actively continue to pray for our health and for our country's future. Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He is available for appearances and book signings, and can be reached through www.thefederalistpages.com. ![]() CONGRESS SURPRISES HEALTHCARE PROVIDERS BY TRYING TO RAM THROUGH THE NO SURPRISES ACT. by Julio Gonzalez, M.D., J.D. In a move reminiscent of the shenanigans employed in passing Obamacare, Congress is now attempting to pass another bill designed to fundamentally transform medicine. The No Surprises Act was published on Friday night after a series of backdoor deals led to handshakes between members of the House and the Senate that simultaneously kept medical providers squarely outside of the policymaking process. The No Surprises Acti s designed to address a shortcoming of many insurers who fail to adequately provide coverage for their beneficiaries. Suppose your child develops intense abdominal pain, nausea, and vomiting in the middle of the night. You correctly suspect that she is suffering from appendicitis. Anxiously, you take her to the emergency room partly reassured that the expenses of the treatment are covered by your insurance. Sure enough your child has an obstructed appendix and successfully undergoes an appendectomy. A few weeks later, you get the bill and, surprise(!), the insurer had not contracted with your anesthesiologist, and your anesthesiologist is now trying to collect reimbursement from you directly. You call the anesthesiologist's practice and tell it that you should not have to pay this bill because you are insured. The practice refers you to the insurance company who tells you that it will not pay the anesthesiologist because he is not a member of your plan. In frustration, you do what most Americans would do in this situation and through your i-phone at the wall; incurring another thousand dollar expense! In reality, the overwhelming number of cases where this scenario plays out are resolved via one of many avenues. Either the insurance company or the patient come to an agreement with the provider, or the hospital enters into an agreement with the anesthesia group that would subsidize such situations. Rarely, resolution is not achieved, setting up an exceedingly frustrating, unfair situation for the patient and the physician alike, as well as multiple newspaper articles and calls to politicians. On a policy level, the solutions, although often well meaning, are often onerous. Generally, the approach has been to protect the patient by forcing the physician and the insurer to work out an agreement. The problem comes when the insurer and the physician fail to come to terms. Under those circumstances, the government has deployed numerous ideas on a state level. For example, one is that the government will simply tell everyone what the physician should be paid. The problem with this approach is that unless the physician is paid his or her usual and customary charge as opposed to what he or she actually receives, such laws always favor the insurer because of the protection provided to the insurer. The reassurance from government that the insurer will never encounter a high bill for services it could have otherwise covered is an incentive to keep it from contracting physicians. Why would you contract more physician groups if the state is going to mandate the savings for you? Another approach is to mandate arbitration between the physician and the insurer. Again, this approach generally favors the insurer in a number of more surreptitious ways. First, the insurance company has infinitely more resources with which to enter into arbitration than a small medical practice. Second, the arbiters will generally try to find some fair number and usually employs reimbursement schedules largely generated by the insurance company. Additionally, some solutions tilt the arbitration decidedly in favor of the insurer. And let's remember, the one who was up in the middle of the night taking the life of the patient in his or her hand was NOT the insurance company!! The No Surprises Act is particularly onerous on numerous levels. First, it has a two-day turnaround time provision with which hardly any provider can comply. It limits a provider to four-claims per year (huh?). It asks for a study to evaluate the impact of such actions by January 1, 2023, and annually thereafter for four years. (By that time, if the effect of the Act was deleterious to small practices, it will be too late.) Amazingly, the bill specifically prohibits the arbiter from considering the physician's usual and customary charges, and only the physician's usual and customary charges! The arbiter may still consider any numbers provided to them by the insurer including arbitrarily created reimbursement ones such as Medicare and Medicaid reimbursement schedules and Workmen's Compensation rates. Of course, most offensive is the fact that Congress would try to ram this bill down the throats of medical providers and their patients inclusive of its potentially wide ranging deleterious effects without an appropriate debate or due diligence on the matter. The Center for Healthcare Policy Solutions is taking aim at this situation. Unfortunately, because of the lame-duck session in which Congress finds itself, the goal for right now is to have the No Surprises Act defeated in the Senate, as the Democratically controlled House of Representatives has already agreed to pass it behind the scenes. There are indications that the Senate has agreed to hear the bill, but no confirmation from Senator McConnell's office that it actually will. If the bill is pushed off to the next session, then the goal would be to employ a solution such as the New York surprise billing legislation based off 80% of the market's usual and customary charges, or arbitration language that imposes no restrictions on what could be considered by the arbiter. Either way, the issue of a surprise medical billing is too broadly impactful and too complicated to ram through Congress as a surprise to its constituents. Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He is available for appearances and book signings, and can be reached through www.thefederalistpages.com. Please consider supporting the Center for Healthcare Policy Solutions, a 501(c)(4) organization designed to bring some reasonableness to the healthcare debate by contributing $20, $50, $100, or more. Any amount is greatly appreciated. And all assistance is welcomed. Please visit healthcarepolicysolutions.com to learn more and contribute. ![]() BRITISH INFORMATIONAL ON PFIZER VACCINE DAMPERS MANDATORY VACCINATION EFFORTS by Julio Gonzalez, M.D., J.D. A few weeks ahead of when the FDA is expected to grant its Emergency Use Authorization for the Pfizer COVID-19 vaccination, the United Kingdom granted the company its green light for proceeding with the distribution of its much-anticipated vaccine. Formally known as "COVID-19 mRNA Vaccine BNT162b2 concentrate for solution for injection" the UK recently released its informational packet for healthcare providers. The document offers significant insights regarding the vaccine and safety considerations related to its use. It also casts sufficient doubts regarding our present understanding of the vaccine's risks and benefits to sour any attempt at enacting mandatory vaccination policies. Below is a summary of the data shared in the informational: Handling. The solution is a "white to off white frozen solution" available in vials of 0.45 ccs meant for dilution into 5 doses in its final form. The vaccine is to be administered in a series of two, intramuscular injections of 0.3 ccs each, twenty-one days apart. Patients may not be protected for at least 7 days following the administration of the vaccine's second dose, meaning that recipients ought not expect to be protected for about 30 days after they receive their first dose assuming they receive their second dose 21 days later. A vial may be kept at -80 to -60 degrees Celsius for 6 months. A frozen vial may be thawed at room temperature over 30 minutes. Once at room temperature, that vial may be stored for up to 2 hours prior to use, or at 2 to 8 degrees Celsius for up to five days. Once the vaccine is diluted to its usable form, it must be used within 6 hours and may not be refrozen. Safety. The safety of the vaccine has not been determined for patients under 16 years of age, thus it is not recommended for use in children 15 years of age or younger. Additionally, there is no definitive information regarding the use of the vaccine in pregnancy, making it not recommended for use in expecting mothers. In fact, the company is recommending that pregnancy be ruled out in women of childbearing age and that they avoid getting pregnant for at least two months following the vaccine's administration. Additionally, because it is not known whether the vaccine is secreted in lactated milk, it should not be administered to women who are lactating. More broadly, it is not known what effects the vaccine may have on fertility; men's or women. Thus, for now, individuals who are interested in childbearing should take caution. According to the Information Sheet, "[t]he most frequent adverse reactions in participants 16 years of age and older were pain at the injection site (> 80%), fatigue (> 60%), headache (> 50%), myalgia (> 30%), chills (> 30%), arthralgia (> 20%) and pyrexia (> 10%) and were usually mild or moderate in intensity and resolved within a few days after vaccination." Efficacy. Evidence of efficacy was largely based on a study where the vaccines were administered to over 44,000 subjects. In those who were 65 years of age or older, there was a 94.6% efficacy of COVID-19 infection prevention. On those who were 75 years of age or older, the efficacy was 100%. The efficacy in preventing COVID-19 was statistically significantly improved in the group receiving the vaccine over the group receiving a placebo. Conclusion. To this point, precious little is known regarding the performance of any of the vaccines being prepared for administration in the United States. The British informational is amongst the first, government-reviewed sources of recommendations and precautions regarding any of these products. As such, it provides the general public with valuable insights regarding the Pfizer vaccine specifically. In short, the efficacy of the vaccine in preventing disease is impressive. A 94.7% efficacy rate is certainly hard to beat. It is in the risks where the uncertainty lies. Despite the optimism, there is much that remains unknown regarding the effects of the vaccine on pregnant and lactating women. Importantly, the unanswered questions regarding future fertility are problematic for individuals still in their childbearing age. Although these concerns may not be sufficient to block the generalized distribution of the vaccine, it does hamper potential mandatory vaccination efforts. Neither government, nor employers, nor service organizations can safely require a vaccinated status as a precondition to hiring, traveling, gathering, or other social activities in light of these uncertainties. Requiring people to vaccinate as a precondition when nothing is known about the effects of the vaccine on issues as essential as fertility is beyond the pale, not to mention the myriad of questions left unanswered such as immune responses, potential increased susceptibility to other conditions, and length of immunity. We should all keep these questions in mind as developments regarding efforts aimed at mass vaccinations materialize. Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He is available for appearances and book signings, and can be reached through www.thefederalistpages.com. ![]() by Julio Gonzalez, M.D., J.D. Five years ago, I began seeing a menacing trend amongst the various hospitals where I worked. The hospital administrations were requiring all employees who did not receive a flu vaccine to wear a mask during the flu season. In my view, this was problematic on numerous levels. First, the effort seemed scientifically unsound. Quite simply, forcing the few people in a hospital who do not receive a vaccine (a vaccine often with an effectiveness hovering at about 60%), especially if they are asymptomatic, to wear a mask in a facility teaming with visitors that may be actively contagious and not wearing masks themselves, is ludicrous. The campaign begged the question, who are you trying to protect? If you are trying to protect patients, then everyone entering the facility should be masked. If it's the employee, then you stumble onto privacy issues, which is my second problem with the policy. I viewed the meddling of companies into the preventive health affairs of workers as an invasion upon their privacy, a bubble that should be breached only fleetingly and with good reason. Finally, I thought the policy of wearing a sticker or a mask represented a shaming of those who refused to comply with corporate policy by forcing them, and only them, to wear a mask. Remember, unlike COVID, people without respiratory symptoms caused by other viruses are rarely contagious. As Chief of Staff, when my hospital tried to pressure the Medical Executive Committee into implementing the same policy for the medical staff, I vehemently and successfully objected. Later, when serving as State Representative, I was so offended by this policy that I contacted the nurses' lobbyist to see if they were interested in promoting legislation that would prohibit the practice of nurse shaming. It was an advocacy association's dream, the legislator calling it to team up on an issue fraught with injustice. I was disappointed to hear that the association's board had turned down my offer. Enter COVID. With the arrival of the SARS-CoV-2 pandemic, I found it reasonable to have all healthcare workers wear masks during the pandemic, the primary reason being that in the case of this very aggressive virus, people who were asymptomatic could be contagious. Additionally, the issue of visitors not wearing masks had been similarly addressed as they were prohibited from even entering the building. Since then, our understanding of the disease has improved to the point where the mortality associated with contracting the virus has diminished markedly, and now, we're on the cusp of deploying a vaccine that will confer at least temporary immunity upon all those interested in receiving it. But now we have another problem. The CDC has recommended that people receiving the vaccine be handed vaccination cards proving the person's inoculation status. Sounds like a good idea. . . except it's nobody's business whether I've been vaccinated or not, particularly not the government's. Let's play this out. Suppose everyone has the opportunity to get the vaccine like we will in about six months. Then, what difference does it make to anyone else if you've been vaccinated or not? If you're sufficiently worried about contracting the illness, then you will obtain the vaccine. Otherwise, you won't. Thus, if you're sitting in a plane next to some guy who is snoring with a runny nose and you're vaccinated, what's it to you? If you're not, then it was your decision not to receive the vaccine. How about the argument regarding herd immunity? That's a very important one when discussing policy aimed at the complete eradication of the disease. But this argument is moot here because no one believes that COVID-19 will be completely eradicated despite the deployment of a vaccine. If SARS CoV-2 is eradicated, it will be through mutation or its natural dissipation over time, not through vaccination. On the flip side, the deleterious effects of issuing these cards could be ominous. How about, you don't get hired unless you've been vaccinated? Or you can't travel without a card. Oh, and you can't see that movie in the theater either. It is the sticker-or-mask policy to which I objected on steroids. You think the Left likes to sound alarms about its fictitious systemic racism? Well how about the very real systemic vaccinism it is about to zealously promote and embrace? People will be harassed, sued, shamed, tracked, and subdued based on whether they have a current, valid vaccination card or not. . . when in fact, it's nobody's business. Which brings me to my original point. I wish that nurses' association had taken me up on my offer to fight these oppressive policies back when it was merely a seasonal flu issue. Perhaps we would have laid down the framework to use against the incoming wave of vaccinism. Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He is available for appearances and book signings, and can be reached through www.thefederalistpages.com. ![]() THE TWISTED TALE OF HOW A DEAD BABY ENDED UP IN A VACCINE by Julio Gonzalez, M.D., J.D. In 1962, a Swedish woman was faced with an awful decision. She was married to an alcoholic, irresponsible man. Her life was economically and emotionally stressed, and she was pregnant with his baby. Mrs. X already had a number of other children and felt she could not deal with another. Being that abortion was legal in Sweden (still is), she sought to get one. As the story goes, Mrs. X could not find a doctor to execute her baby's abortion until she was nearly four months pregnant. By that time, her baby was in his second trimester of development. He was about eight inches long, and his organs, his brain, his eyes, and his heart had already been formed. He was even capable of feeling pain. Regardless, Mrs. X found a female gynecologist to kill her baby. The corpse was taken to the Karolinska Institute in Stockholm where, without Mrs. X's permission, the dead baby was dissected and some of his lung's tissue flown to Philadelphia where Dr. Leonard Hayflick, a molecular cell biologist, was waiting. Dr. Hayflick had worked with the federal government to gain possession of the cells and eagerly began running studies on them. As fate would have it, while Hayflick was conducting his work in Philadelphia, he was hired by Stanford University. By this time, Mrs. X's baby's cells had become incredibly important to him. For one thing, these "WI-38 human pulmonary fibroblast cells" had become a great source of money for him, as he had begun selling them to other researchers. But Hayflick had signed a contract with his employer and the federal government that allowed him to fund the procurement of the cells, so the cells were not his. Moreover, the contract through which the cells were obtained called for the passing of all remaining cells to the federal government once research was completed. At this point, there were over 350 vials of a million cells each. Hastily, Hayflick called a meeting with his soon-to-be former employers. By its conclusion, an agreement was made allowing Hayflick to keep ten of the vials while the rest would revert to the federal government. Apparently, Dr. Hayflick did not like this idea very much because, just before leaving for Palo Alto, he grabbed all the vials and took them with him. Yes, Dr. Hayflick stole the cells. To be sure, a long legal battle ensued with the federal government that would ultimately result in Hayflick's reluctant resignation from Stanford and in him being labeled a thief. Dr. Hayflick went from being a burgeoning microbiology superstar to an unemployed scientist without a job opportunity in sight. In time though, Hayflick would settle with the federal government and would be hired by Merck, which went on to use the cells in its vaccine development efforts among other projects. Over time, this whole ugly affair was swept under the rug, and Hayflick was restored to a place of national prominence. With those cells, the formerly dishonored scientist went on to discover the Hayflick Limit denoting a limitation to the number of times a human cell could divide. The discovery had fundamental implications to cloning technology, cancer research, and biological engineering. More importantly, Merck would use the cells to develop the Rubella vaccine, possibly saving over a billion lives and making billions of dollars off them as well. Mrs. X never received a penny from the proceeds of the use of her discarded son's cells. Once, a researcher tracked her down and informed her of all that had happened as a result of her abortion. According to the researcher, she was distraught at learning that her baby's cells had been exploited without her permission, but wished to keep the whole episode behind her and protect her anonymity. Thus, we still do not know the identity of the woman whose discarded baby arguably helped save a billion lives. But Mrs. X was no victim here. First, she killed her baby and allowed his body to go into some disposal container. Once she killed him, the baby was nothing other than tissue to her. She expected it to go to the trash. Not only had she cast out any responsibility over that poor defenseless human being, but she also relinquished any ownership to the baby's body. Since Mrs. X's time, other cell lines have similarly appeared. Today, there are at least two cell lines obtained through abortions that are being used for vaccine development in the quest to defeat the COVID-19 pandemic. One line, HEK-293, is derived from the kidney cells of a baby aborted around 1972. The other, PER.C6, is used by Janssen, a subsidiary of Johnson & Johnson, and taken in 1985 from the retinal cells of an 18-week-old aborted baby. The fact is that every abortion of a viable baby is an act of evil for which there is no justification, not even the potential of billions of lives saved. Just ask yourself, would you knowingly stare into the eyes of a fully-grown human being and take his or her life if you believed that by doing so you could potentially save billions? The overwhelming number us of couldn't do it, for if killing one could be justified, why not two? Or twenty? Or six million? And why not for the sake of saving a million? A hundred thousand? Or ten? If we adopted this policy it would make us no different than any cannibal that ripped the beating heart out of his brother's chest merely to appease some man-made god. After all, wasn't that cannibal acting in the hope of saving his brethren? Knowing what we know about human development, making the successful passage through the birth canal a determinant as to whether someone merits being killed in the name of saving another seems to be an arbitrary measure. Yet we have done it, and medications have come into existence because of it. Now, humanity will enjoy the benefits of that decision. . . and deal with it's consequences. Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He is available for appearances and book signings, and can be reached through www.thefederalistpages.com. ![]() WHY DEMOCRATS WANT A SHUTDOWN AND WHY THEY'RE WRONG. by Julio Gonzalez, M.D., J.D. The call is pretty clear throughout Democrat-run jurisdictions and from the party's presidential nominee. We want a shutdown, and we want it now! In New York City, Mayor De Blasio is intent on shutting down public schools as early as Monday. New Mexico is implementing its statewide shutdown for nonessential businesses, and Washington has invoked a stay-at-home order. In Minnesota, health leaders are claiming that a shutdown will be necessary through the holiday season. In California, gatherings of more than three households are prohibited for Thanksgiving, and the host is being asked by the government to "collect names of all attendees and contact information." In Oregon, Democrat Governor Kate Brown has implemented a rule for Thanksgiving prohibiting gatherings of more than six people from no more than two households and is planning on employing the police to enforce the mandate's $1,250.00 fine and potential jail time. For its part, the CDC is asking those who will be celebrating the holiday to "wear a mask with two or more layers," and to "wear the mask over [one's] nose and mouth." And, of course, the Democrat presidential nominee is busy studying how to implement a national mandatory mask mandate in the unlikely event that he should become president. ![]() There are many reasons that could explain this rise in the number of daily cases. First, we could be seeing a new surge like the one being experienced in Europe. Additionally, the increased number could be due to the higher frequency of testing. More likely, the real reason is some combination of the two. The obvious question is why do the Democrats insist on implementing these destructive, draconian measures even after the election is over? Ostensibly, the answer lies in Figure 1 showing the dramatic increase in the number of cases of COVID-19 in the United States over the past month to over 150,000 new cases nationwide per day. Compare this to the prior peak of the pandemic of about 65,000 cases per day in June. ![]() It is natural for a surge of this magnitude to instigate an aggressive response on the part of public health and government officials, but consider this. Figure 2 shows the number of death in the United States per day. Presently this is hovering at just under 1500, significantly less than the over 2,000 cases-per-day mark reached in April, and slightly lower than a smaller peak reached in August. It is this combination of skyrocketing new cases and the absence of an associated increase in the number of daily deaths that explains the statistical finding of a lower mortality rate from the disease, which presently stands at 0.84%. Compare this to the originally reported death rate from COVID-19 of somewhere between 6% and 12% back in March. Why is COVID-19 less deadly now than in March? First, treatments have improved. Our medical community understands the disease process better and there are better medications with which the infection can be treated. And although there has been no biochemical support for the claim, it is possible that the virus is weakening. Regardless, a condition with a less than 1% mortality rate demands greater restraint from government officials than one with a mortality rate that is more than ten times greater. On the flip side, as demonstrated in the extensive examination of the world's early experience with SARS-Cov-2, shutdowns are ineffective except in those rare cases where the policies are instituted prior to the arrival of the virus. Thus, as demonstrated in my book Coronalessons, only countries like New Zealand, Australia, non-Wuhan China (amazingly), and Hong Kong were able to avert the pandemic's entry, and they did so only because they implemented strict, oppressive measures that would have never been tolerated by the American public. Meanwhile, in countries where the virus had already arrived such as in Europe and the United States, the shutdowns proved useless. Thus, at a time when the SARS-Cov-2 has deeply infiltrated itself within our borders coupled with the dramatic improvement in survivability, shutdowns of the type Democrat government officials are calling for simply will not help. So, why are the Democrats pushing this destructive agenda? Only by viewing non-scientific considerations do their actions make any sense. First, continued enforcement of shutdowns and economically destabilizing interventions weaken the power and resolve of the American people. Thus, the people become more dependent on government interventions such as financial bailouts. Additionally, continuing the crisis allows Democrats to argue that fiscally distressed states, which tend to be exclusively Democrat, should be funded out of their chronic deficits. The presence of a shutdown also allows for collateral opportunities. Remember, the only reason Democrats were able to implement mail-in balloting as a viable alternative to in-person voting and to extend the amount of time allotted for those ballots to arrive was because of the alleged threats to the general public from the presence of COVID-19. No doubt the Democrats hope to capitalize on future opportunities stemming from their artificially protracted crisis. Additionally, they can continue to suppress religious worship, the archenemy of socialism, and they can exert expanded power over their constituents veiled under the cover of a medical emergency. And of course, politically, the longer Democrats can sell this crisis, the longer they can sell the illusion of being the saviors of the people. There really is no scientific reason for the Democrats to pursue a shutdown at this point, as it will inevitably not help the American people. In fact, all indications are that it will harm them instead. But for Democrats, the prime consideration is not what benefits Americans, but rather, what benefits the Democrats. And this is the overarching reason why they will continue to pursue shutdowns, whether we benefit from them or not. Reference: Both Figures are reproductions of worldometer.com graphs from Friday, November 13, 2020. Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He is available for appearances and book signings, and can be reached through www.thefederalistpages.com. ![]() TRUMP HEALTHCARE V. BIDEN HEALTHCARE. WHICH IS BETTER AND WHY? by Julio Gonzalez, M.D., J.D. One of the central points of contention in the 2020 campaign for President of the United States is each camp's view on healthcare and which would be better for America and her posterity. Well, thefederalistpages.com has amassed a comprehensive review of both plans and offers a comparison of each with my vision for our nation's healthcare. Here's what we found. OVERARCHING PHILOSOPHY. The starting point for any discussion on healthcare is the overarching opinion on what healthcare should look like in America and how such a view would affect American society. If the starting points are starkly different, then practically everything else flows into diverging paths. In the cases of former Vice President Joe Biden and President Donald Trump, the starting premises could scarcely be more dissimilar. Biden For Biden, the starting point is centralization. Biden believes that concentrating policymaking, control, and financing into one place (the federal government) is to be pursued. As such, for Biden and his followers, placing more power in the hands of the federal government is a plus. Strengthening Obamacare, expanding Medicaid, minimizing the influence of the private sector, and having Medicare play a larger scope in healthcare delivery are all priorities. As we shall see, all of Biden's proposals line up with that view. Trump The Trump viewpoint favors decentralization. The Trump vision for healthcare places a greater degree of control on free-market forces and the various states in the hopes of increasing the autonomy of the physician-patient relationship. However, the President's plan allows for some degree government interference with free-market forces. In his plan, for example, there is ample room for consumer protection and price controls. Gonzalez The Gonzalez plan, as elucidated in The Case for Free Market Healthcare, relies primarily on the free-market to maintain stability and predictability in delivery and cost. It aims not just to place the lion's share of healthcare delivery in the hands of the private sector, but it also maintains that only the free-market is capable of identifying the most streamlined and efficient manner through which such care can be delivered. Government's footprint must therefore be minimized and the patient should be placed at the helm of cost containment and optimal price determination. PUBLIC HEALTH INSURANCE OPTION. The public health insurance is a government run entity that delivers a lower-priced alternative to regular insurance policies. By providing a public health insurance option, Americans who cannot afford private healthcare insurance or desire to obtain a lower price will have access to purchase lower cost insurance plans through a government-administered alternative partially subsidized by tax dollars. Biden The Biden camp favors and actively proposes a public health insurance option. Trump President Trump opposes a public health insurance option. Gonzalez Like President Trump, I vehemently oppose a public health insurance option. In my view this is the quintessential Trojan horse for healthcare. By seeking the advantages of government to favorably compete against the private insurance sector, the public health insurance option will necessarily and overwhelmingly expand, not due to its superiority but because of greater survivability due to undue administrative and financial support from taxpayers. If America bites into this poison apple, it will definitely be placed on the road to universal healthcare and prodigious government control of our lives. Additionally, accepting the public health option will fundamentally transform the mechanics of the Constitution and the basic relationship between government and citizenry. Make no mistake; the implementation of a public health insurance option will place us on a very dangerous road indeed. FINANCIAL ASSISTANCE TO PAY FOR HEALTHCARE. The concept here is that the government would provide subsidies to certain Americans who it believes should be assisted in paying for their health insurance. Biden Favors. The Biden plan would cap payments on healthcare insurance to 8.5% of one's income. It does not explain how such a cap will work. It also will increase tax credits for healthcare insurance and use gold healthcare insurance rates as the standards from which those tax credits will be calculated rather than the presently employed silver plan. Trump Opposes. These selective credits demonstrate undue interference of government on the market and would work as an extension of the disastrous Obamacare plan. The President would much rather do away with Obamacare and pursue healthcare delivery optimization in a totally different, market-based direction. Gonzalez The centerpiece of the Gonzalez plan is a transition of healthcare funding to a health savings account (HSA) based system. As such, our tax incentivization structure ought to be redesigned to encourage the formation of robust HSA accounts by each American. Doing so will unleash free market forces into the healthcare industry and rid us of those artificially contrived contaminants that presently keep the market from achieving its most efficient steady state. A successful transition will mean greater autonomy in selecting one's care and in ridding the individual of the dependence on corporate behemoths or government constraints when seeking healthcare. Removing the middlemen from funding and contracting considerations will necessarily result in greater provider accountability to the patient and improved quality of care. MEDICAID. Medicaid is a federally and state funded, state-administered program designed to provide assistance to the poor and disabled. Biden Favors expansion of Medicaid coverage to include those who are 138% of the federal poverty level and below. Trump The Trump Administration opposes this initiative. Instead, the President's goal is to improve the economy, have more Americans become self-sufficient through great job opportunities, and thus have more Americans contract with private insurers, ridding them of their dependence on government. Gonzalez Like in President Trump's plan, the Gonzalez plan also opposes Medicaid expansion as being counterintuitive to the goal of optimizing patient autonomy. Although I agree with the overall Trump plan of expanding America's economic standing and thereby decrease unemployment, the goal should not be to have more Americans contract with insurance companies for their care. The goal should rather be to have Americans transition to the independence of an HSA-based system of healthcare funding. I also agree with President Trump's plan regarding the fundamental importance of a maintaining a safety net for those who are unable to fend for themselves. STOP SURPRISE MEDICAL BILLING. Surprise medical billing is a situation that occurs when a patient seeks care in a hospital and is surprised by a bill from a physician who does not participate in his or her healthcare plan but who provided medical services in the care of the patient. Examples would be an anesthesiologist or radiologist who does not accept the patient's insurance plan, but who got involved in the patient's care because of his duties to the hospital where the care took place. Although the situation is not uncommon, it usually concludes with a payment resolution between the physician and the patient. Persistent disagreements are rare. However, the offensiveness of the experience and its potentially deleterious impacts on the patient's wallet makes this a very popular issue for politicians. The solution is actually difficult to achieve because most patient advocacy groups and insurance companies desire that the government, whether state or federal, mandate a low fee schedule that would apply in these situations. The goal, particularly for the insurer, is that the government come in and negotiate a price that is favorable to it. As a consequence, the physician would be forced to accept poorer reimbursements than they would be willing to accept, thus further pressuring private practices out of existence and resulting in the government working as an agent for the insurance companies. Biden Favors eliminating surprise medical billing and is comfortable with price setting in order to achieve it. Trump Favors eliminating surprise medical billing apparently through the development of an arbitration requirement between the insurer and the physician. Gonzalez Recognizes that if the nation's healthcare system were centered on HSAs, surprise medical billing would be a thing of the past as would pre-existing conditions. These would be obsolete terms because everything would be negotiated by the patient. The only exception would be in cases of emergency care for those who do not also have a high deductible insurance plan, in which case, a forced arbitration process would be preferred. CONTROLLING DRUG PRICES Biden Biden favors a centralized control of drug prices including the enactment of mandated prices and price caps. Trump Trump favors a centralized control of prices including the enactment of mandated prices and price caps. He also favors granting the United States favored nation status so that Americans may benefit from the deep discounts being offered by drug manufacturers to certain foreign nations. President Trump has also give some indications that he wishes to stem the power of group purchasing organizations (GPOS), which after price controls seem to be the biggest inhibitors against smaller competitors participating in a robust market. Gonzalez The Gonzalez plan eliminates the need for price controls. Today, there are over 240 medications that are not available or experiencing shortages in the United States. Amazingly, elemental medications such a penicillin, epinephrine, lidocaine, and bicarbonate are often missing and unavailable to our hospitals and patients. Indeed, the most frequently affected medications are non-patented, intravenous cancer medications. As explained in The Case for Free Market Healthcare, the primary reason for these shortages are price controls. In a truly transparent free market, the price of medications will naturally fluctuate to its most streamlined state minus shortages and minus a manufacturing exodus. This situation will naturally take place when HSAs form the staple of our healthcare system. The Gonzalez plan also closes the loophole on GPOs. IN SUMMARY Healthcare is a highly complex and multi-faceted silo in our society. The outcome of this election will play a monumental role in determining which of the two directions, either a free market based system or a government controlled one, our country will pursue during the first half of this decade. The conditions above are just a few of the major factors where the two parties differ. I can expand on many others. If you're interested in other subtopics related to healthcare, or if you have any questions, ask me by emailing me at aragonpublishers@gmail.com. I will be happy to answer your concerns in a public forum through this website. Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He is available for appearances and book signings, and can be reached through www.thefederalistpages.com. ![]() THE REAL CAUSE OF THE UNITED STATES' HIGH COVID DEATH NUMBERS WILL SURPRISE YOU. by Julio Gonzalez, M.D., J.D. One of the many points of contention brought up during Tuesday's fiery presidential debate was the issue of the United States' high coronavirus case and death numbers. The allegation of America's high numbers relative to its population was espoused by former Vice President Biden when he lamented that the United States owned 20 percent of worldwide deaths while possessing only 4 percent of the world's population. Predictably, he then did his best to pin the responsibility for these stark statistics on President Trump. Indeed, as of this writing, the United States has approximately 21 percent of the world's coronavirus deaths and cases, but the reason for this is never reported by the press and has nothing to do with the President's conduct. In fact, the reason may surprise you. As part of my book Coronalessons, which Amazon did its best to ban and whose existence it is still trying to suppress, I assembled data regarding the number of per capita cases and deaths of COVID-19 throughout the world. My team performed univariate analyses comparing the effects of a country's per capita COVID-19 case and death rates with its national healthcare ranking, per capita GDP, physician density, population density, and life expectancy. We selected the countries with the one hundred highest per capita cases of COVID-19 as of May 2, 2020, according to Woldometer.com and employed the demographic data published by the World Bank in our analysis. The nation's healthcare ranking was obtained from the admittedly dated world rankings published by the United Nations in 2000, the last year it did so. ![]() The results were startling. Surprisingly, as the number of physicians per capita improved, the number of cases and deaths from COVID-19 exponentially increased! Figure 1. Relatedly, the better the country's health care system, the worse it performed. And when we looked at the number of hospitals per capita, the greater the hospital density, the poorer the nation performed. In fact, the mildest correlation we found was a nation's per capita testing with the number of deaths and cases. These results were contrary to our preconceived expectations. But the findings were explainable. Amongst the strongest correlations were those between a country's life expectancy and its per capita cases and deaths. Figure 2. This correlation was completely ![]() expected based the virus's heightened threat to the elderly. What's more, for a nation to amass a greater life expectancy and thus a higher elderly population, it requires a robust healthcare system with lots of doctors and a myriad of hospital beds. And what's required to amass these? Wealth. Indeed, there was a direct, linear relationship between a nation's per capita GDP and its per capita cases (Figure 3) and an exponential relationship to per capita deaths. Figure 4 In short, the richer the nation, the more likely its citizens were to contract the disease and to die from it. But still the question remains, how is it that the higher number of per capita cases could be explained by a nation's per capita GDP? Here again, then answer is simple. Travel! ![]() COVID-19 is spread purely through the intermingling of contaminated people with others who would otherwise not have come across the virus. It is to the richer nations that people travel, either due to business or pleasure, particularly early in the pandemic before anyone could do anything about it and before many even knew they were infected. With these factors in mind, one can almost predict the global course of COVID-19. As we know, the pandemic began in Wuhan, China. From there, the principal locations of its initial spread were to Italy and Iran through contacts related to the Belt and Road Initiative into which each country had entered with China. Recall ![]() that even after China knew of the virus's propensity for inter-human transmission it did nothing to stop international travel from within its country. True to our predictions, the spread from Iran, a relatively poor and isolated country, did not blossom, but for Italy, the experience was entirely different. In Italy, the government tried, unsuccessfully, to contain the spread in the northern third of the country where the virus had entered via Chinese interaction, but the virus quickly spread south as Italians easily moved throughout the peninsula. In the meantime, a colossal soccer match in the northern Italian city of Atalanta allowed for the intermingling of Italians and Spaniards where the virus spread next. Shortly thereafter, in Madrid, the international women's march allowed for further spread to take place. A related dynamic began occurring in Europe that was also predicted from our correlations: the deaths of massive numbers of elderly patients. In Italy, the dynamics revolved around the sharing of living quarters between the younger generations and the older ones. In Spain, like in France and England, the decimations largely took place in nursing homes.
Additionally, throughout this time, travel was robustly taking place between China, Europe, and the United States. Like a hidden landmine ready to go off, the virus took hold in our population before we even knew it. Ours is the richest country in the world, and perhaps the most heavily visited. It was, predictably, the ultimate destination for SARS-COV-2, and without any means of detecting it, there was nothing the President or any other authority could have done to prevent it. Needless to say, shutting down travel from China on January 31 was logical and helpful, but in the end it was insufficient to keep the virus from reaching our shores, and our nation's epidemiology behaved exactly as our model would have predicted. Before closing, one other point is in order. If Biden is going to spuriously accuse the President of doing a poor job merely based on the United States' relative contribution to the global prevalence and death rates of the virus, he should even more zealously criticize New York, which is singlehandedly responsible for 15% of the nation's COVID-19 deaths. Governor Andrew Cuomo recklessly ignored the already established pattern of nursing home vulnerabilities by irresponsibly and selfishly insisting that hospitalized elderly patients be transferred there. Under his watch and because of his actions, New York's nursing homes became a cesspool of death and infection when many of the fatalities could have been prevented. So what's the real cause of the SARS-CoV-2's attack on the United States following China's disregard for the wellbeing of its neighbors? The answer is the world's attraction to the United States because of its wealth coupled with the relative advanced age of its population due to its superior healthcare. But neither the mainstream press nor Mr. Biden will ever admit to this because it would decimate their false claims against President Trump. And thus the true cause of our plight with this pandemic remains hidden from the public. For more findings on the COVID-19 pandemic that are not reported by the press, such as information on hydroxychloroquine, the timeline of the pandemic, China's and the WHO's roles in propagating the disease, and the disruption of constitutional constraint by certain governors, please go to our store and get your copy of Coronalessons. Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He is available for appearances and book signings, and can be reached through www.thefederalistpages.com. ![]() HOW I WOULD TREAT THE PRESIDENT OF THE UNITED STATES. by Julio Gonzalez, M.D., J.D. By now, most of us have learned that President Donald J. Trump has tested positive for COVID-19. As was the case with the illness affecting Prime Minister Boris Johnson, a condition affecting the health of a world leader carries with it major ramifications to practically every aspect of life. As such, preserving the health and wellbeing of such a leader, irrespective of any campaign challenges, is of paramount importance. So the question now becomes, what's the best way to treat the President of the United States when he is suffering from COVID-19? The most important initial step is not to panic. Remember, the death rate associated with this illness is about 0.65 percent; that is, less than one in one hundred patients afflicted with this condition actually succumbs to its effects. Yes, the death rate is higher amongst elderly patients who contract the disease, and the President is 74 years old, but the President is a robust, highly active, and exceedingly strong individual. Physiologically, he is much younger than his chronological age would imply. Next, of course, I would examine the patient to ascertain the full extent of the virus's effects on his physiology at this time. Forget about telemedicine. There is no substitute for a careful and meticulous physical examination when planning out a patient's care. And yes, I would don full protective gear in so doing. Having established the President's state of health, what's next? First, it is imperative that the President be well hydrated, appropriately nutritioned, and rested. Next, if there are any organ systems that are affected, they need to be supported. For example, if he is suffering from nausea or vomiting, he would be placed on clear liquids or hydrated with intravenous fluids. If he has respiratory issues, then perhaps medications such as bronchodilators and antihistamines may be in order. If he is having a fever, then an antipyretic such as acetaminophen may be in order. And now to the controversial interventions. Yes, SARS-CoV-2 has been with us for nearly a year at this point, but we still do not have consensus on the best treatments for this condition. Although medications such as remdesevir, hydroxychloroquine, and azithromycin are supported to varying degrees in the literature, there is no consensus on how they are best deployed and under what circumstances. One thing is clear: thus far, there is no cure for COVID-19 other than the body's ability to eradicate the submicroscopic invader. So, with the available literature, and my personal experience with patients afflicted with this condition, here is what I would do. First, I would place the President on 200 milligrams of hydroxychloroquine daily, with a loading dose of 400 milligrams. I would continue the regimen for at least two weeks. Additionally, I would start the President on 500 milligrams of azithromycin daily for about ten days. I would also start the President on zinc and vitamin D, as it appears that deficiencies of these substances make a patient more vulnerable to the disease. I would then monitor carefully. If the President develops more severe respiratory symptoms, then a glucocorticoid such as dexamethasone may be indicated in order to prevent the cytokine storm. Remdesevir is a valuable weapon in the event the President's course should worsen, and of course, I would offer similar treatments for the First Lady and Hope Hicks, the President's Senior Counselor. Additionally, in an effort to protect those around him, I would isolate the President. Finally, I would pray for the President's recovery, as I would for the First Lady, Ms. Hicks, and all those afflicted with this potentially devastating disease. Most importantly, I would pray for this nation and for goodness, love, and light to overwhelm the evil, hatred, and darkness that is afflicting us. Of course, this latter intervention is one in which we can all fervently engage. Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He is available for appearances and book signings, and can be reached through www.thefederalistpages.com. |
AuthorDr. Julio Gonzalez is an orthopedic surgeon living in Florida. He is a lawyer, author, and former member of the Florida House of Representatives. He is available for speaking engagements at thefederalistpages@gmail.com Archives
January 2021
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