HERE'S WISHING YOU ALL A HAPPY AND HEALTHY NEW YEAR, something only you can work toward. 

However, here's a little help.
In the practice of Medicine, the most important element is the Diagnosis.  What follows are two diagnoses, one for the individual and one for the Society of which we are a part.

• A recent series of articles in The Lancet, the product of a massive amount of research from 50 countries, supports the finding that we are living longer  - and sicker - with more pain and chronic illness.  The "golden years" have turned  out to be fools' gold, the direct result of our profligate life-style as related to what we eat, drink, smoke and expose ourselves to over decades.  The treatment is inherent in that finding, although the effects of life-style modification will be less effective in those already over 70 years of age.  But for those who are younger, indeed from childhood, the stakes are hugh.  These many chronic illnesses can be mitigated and even avoided by a clear course correction in our lives, the elements of which have been well-established over decades...and which have been largely ignored.  "CAVEAT EMPTOR".  We in the Health Care Profession have become very adept at keeping you alive, however miserable you may be.   it's your choice. 
• As for Society, a cancer in our midst is the dissolution of Marriage as the foundation stone for that Society.  Today, more than half of births among women under age 30 occur outside of marriage.  And an estimated 60% of children are raised in single parent households.  As noted in a recent report: "This decline of Marriage in Middle America imperils the middle class and fosters a society of winners and losers". And cohabltation is no effective alternative. such arrangements are twice as likely to break up before their child is 12. Once, again, it's your choice.  And choices have consequences, for the individual and for our Society.  

A BLESSED AND MERRY CHRISTMAS TO ALL.

That's the sincere wish.  But wishing won't make it so.  We have to work at creating and keeping the life and society we want for ourselves and for our families. 
That takes, above all, critical thinking...not the wishful thinking so prevalent today.  Three examples will suffice.

1. The deluded perception that there is no God...and that, if there is a God, He doesn't care about us and our embrace of the Seven Deadly Sins.  The only thing that will save atheists is that they are CERTIFIABLE...and crazy people don't go to Hell.
2. The delusion that this world can be just one happy family.  The best medicine for this illness is the article that appeared in the WSJ. Monday, Dec, 24, entitled: "The Return of Toxic Nationalism", by Robert D. Kaplan (Opinion, pA13).

Health care tax hikes for 2013 may be just a start

WASHINGTON (AP) — New taxes are coming Jan. 1 to help finance President Barack Obama's health care overhaul. Most people may not notice. But they will pay attention if Congress decides to start taxing employer-sponsored health insurance, one option in play if lawmakers can ever agree on a budget deal to reduce federal deficits.

The tax hikes already on the books, taking effect in 2013, fall mainly on people who make lots of money and on the health care industry. But about half of Americans benefit from the tax-free status of employer health insurance. Workers pay no income or payroll taxes on what their employer contributes for health insurance, and in most cases on their own share of premiums as well.

It's the single biggest tax break the government allows, outstripping the mortgage interest deduction, the deduction for charitable giving and other better-known benefits. If the value of job-based health insurance were taxed like regular income, it would raise nearly $150 billion in 2013, according to congressional estimates. By comparison, wiping away the mortgage interest deduction would bring in only about $90 billion.

"If you are looking to raise revenue to pay for tax reform, that is the biggest pot of money of all," said Martin Sullivan, chief economist with Tax Analysts, a nonpartisan publisher of tax information.

It's hard to see how lawmakers can avoid touching health insurance if they want to eliminate loopholes and curtail deductions so as to raise revenue and lower tax rates. Congress probably wouldn't do away with the health care tax break, but limit it in some form. Such limits could be keyed to the cost of a particular health insurance plan, the income level of taxpayers or a combination.

Many economists think some kind of limit would be a good thing because it would force consumers to watch costs, and that could help keep health care spending in check. Obama's health law took a tentative step toward limits by imposing a tax on high-value health insurance plans. But that doesn't start until 2018.

Next spring will be three years since Congress passed the health care overhaul but, because of a long phase-in, many of the taxes to finance the plan are only now coming into effect. Medicare spending cuts that help pay for covering the uninsured have started to take effect, but they also are staggered. The law's main benefit, coverage for 30 million uninsured people, will take a little longer. It doesn't start until Jan. 1, 2014.

The biggest tax hike from the health care law has a bit of mystery to it. The legislation calls it a "Medicare contribution," but none of the revenue will go to the Medicare trust fund. Instead, it's funneled into the government's general fund, which does pay the lion's share of Medicare outpatient and prescription costs, but also covers most other things the government does.

The new tax is a 3.8 percent levy on investment income that applies to individuals making more than $200,000 or married couples above $250,000. Projected to raise $123 billion from 2013-2019, it comes on top of other taxes on investment income. While it does apply to profits from home sales, the vast majority of sellers will not have to worry since another law allows individuals to shield up to $250,000 in gains on their home from taxation. (Married couples can exclude up to $500,000 in home sale gains.)

Investors have already been taking steps to avoid the tax, selling assets this year before it takes effect. The impact of the investment tax will be compounded if Obama and Republicans can't stave off the automatic tax increases coming next year if there's no budget agreement.

High earners will face another new tax under the health care law Jan. 1. It's an additional Medicare payroll tax of 0.9 percent on wage income above $200,000 for an individual or $250,000 for couples. This one does go to the Medicare trust fund.

Donald Marron, director of the nonpartisan Tax Policy Center, says the health care law's tax increases are medium-sized by historical standards. The center, a joint project of the Brookings Institution and the Urban Institute, provides in-depth analyses on tax issues.

They also foreshadow the current debate about raising taxes on people with high incomes. "These were an example of the president winning, and raising taxes on upper-income people," said Marron. "They are going to happen."

Other health care law tax increases taking effect Jan. 1:

— A 2.3 percent sales tax on medical devices used by hospitals and doctors. Industry is trying to delay or repeal the tax, saying it will lead to a loss of jobs. Several economists say manufacturers should be able to pass on most of the cost.

— A limit on the amount employees can contribute to tax-free flexible spending accounts for medical expenses. It's set at $2,500 for 2013, and indexed thereafter for inflation.

CATCHING PIGS

THIS IS THOUGHT PROVOKING.

There was a chemistry professor in a large college that had some exchange students in the class.

One day while the class was in the lab,the professor noticed one young man, an exchange student, who kept

rubbing his back and stretching as if his back hurt.

The professor asked the young man what was the matter.

The student told him he had a bullet

lodged in his back. He had been shot while fighting communists in his

native country who were trying to overthrow his country's government and

install a new communist regime.

In the midst of his story, he looked at the professor and asked a strange question. He asked: "Do you know how to catch wild pigs?"

The professor thought it was a joke and asked for the punch line.

The young man said that it was no joke. "You catch wild pigs by finding

a suitable place in the woods and putting corn on the ground. The pigs

find it and begin to come every day to eat the free corn.

"When they are used to coming every day, you put a fence down one side

of the place where they are used to coming. When they get used to the

fence, they begin to eat the corn again and you put up another side of

the fence.

"They get used to that and start to eat again. You continue until you

have all four sides of the fence up with a gate in the last side.

"The pigs, which are used to the free corn, start to come through the

gate to eat that free corn again.

You then slam the gate on them and

catch the whole herd.

Suddenly the wild pigs have lost their freedom.

They run around and around inside the fence, but they are caught.

Soon they go back to eating the free corn. They are so used to it that they

have forgotten how to forage in the woods for themselves, so they accept

their captivity."

The young man then told the professor that is exactly what he sees

happening in America.

The government keeps pushing us toward Communism/Socialism and keeps spreading the free corn out in the form of programs such as supplemental income, tax credit for unearned income,tax exemptions, tobacco subsidies, dairy subsidies, payments not to plant crops (CRP), welfare, medicine, drugs, etc. while we continually lose our freedoms, just a little at a time.

One should always remember two truths:

“There is no such thing as a free

lunch, and you can never hire someone to provide a service for you

cheaper than you can do it yourself.”

If you see that all of this wonderful government "help" is a problem

confronting the future of democracy in America, you might want to send this on to your friends.

If you think the free ride is essential to your way of life, then you will probably delete this email.

But, God help us all

when the gate slams shut!

Quote for today:

Maybe I shouldn't be doing this, given the emotional reaction this story has had on me - including predictably another bout of atrial fibrillation.
But I can't NOT do it.  My whole life has revolved around identifying and solving problems.  That's how I cope with stressors.  It works for me.

After the revelation of new information regarding the shooter and his family, I must give up the original rage I felt.  Evidently, he was not a monster - an inherently evil person.  His parents were evidently not criminally inept as parents.   He was evidently not a casualty of a mental health system that has given up on personal interaction ("talk therapy") in favor of prescribing more and more varied drugs that - if taken at all - can be either ineffective or can produce serious side effects.  There is so far no mention of his having used illicit drugs, including Pot. 

So, we must undertake a much broader analysis of the societal environment that surrounded him and that could produce this result...and similar incidents nation-wide.  Herewith follows an initial stab at such an analysis.

1. A loss of belief in God and in the inherent goodness of Man.  Into that vacuum enters Evil, promoted by the more base instincts of human nature that a too rapidly evolving Homo Sapiens failed to sublimate.  Organized Religion is neither a necessary or a sufficient counterweight to that, but it surely helps.
2. A society and personal mind-set that promotes promotes self over 'other", selfish over self-less.
3. A progressive dehumanization effected from early childhood by immersion in media violence, sadism and a studied elimination of any external value system.  This is also a result of the disintegration of the Family and the understandable inability of schools to act "in loco parentis".
4. A demand for more and more "freedoms" without the countervailing responsibility required as a cost of membership in a Society.  
5. A "gun culture" that goes far beyond the guarantees of the Second Amendment and that gets its greatest support from business interests - making a buck.
6. An excessive demand for privacy regarding psychiatric disorders, even where third parties may reasonably be in danger.  Just as any attorney is also a Commissioner of Superior Court with attendant duties, any physician or licensed health care worker should be recognized as being a representative of the larger society when safety is involved, apart from duties of confidentiality.
7. An apparent unwillingness on the part of leaders to take reasonable precautions for the safety of those under their responsibility.  Again, that may impinge on "freedom"...but only to the extent that the requirements of a civil and safe society require. 

Implementation of appropriate changes required to address the above issues will require LEADERSHIP.  What a concept.  But I will personally offer such leadership with specific proposals in future offerings in this section. 

WASHINGTON (AP) -- American fourth-graders are performing better than they were four years ago in math and reading, but students four years older show no such progress, a global study released Tuesday revealed.

Although the U.S. remains in the top dozen or so countries in all subjects tested, the gap between the U.S. and the top-performing nations is much wider at the eighth-grade level, especially in math.

"When you start looking at our older students, we see less improvement over time," said Jack Buckley, commissioner of the National Center for Education Statistics, which coordinated the U.S. portion of the international exam.

Even where U.S. student scores have improved, many other nations have improved much faster, leaving American students far behind many of their peers — especially in Asia and Europe.

With an eye toward global competitiveness, U.S. education officials are sounding the alarm over what they describe as a recurring theme when American students are put to the test. Lamenting what he described as "sober cautionary notes," Education Secretary Arne Duncan said it was unacceptable that eighth-grade achievement in math and science are stagnant, with U.S. students far less likely than many Asian counterparts to reach advanced levels in science.

"If we as a nation don't turn that around, those nations will soon be out-competing us in a knowledge-based, global economy," Duncan said.

American students still perform better than the global average in all subject areas, the study found, although students from the poorest U.S. schools fall short.

But the U.S. is far from leading the pack, a distinction now enjoyed by kids in countries like Finland and Singapore who outperformed American fourth-graders in science and reading. By eighth grade, American students have fallen behind their Russian, Japanese and Taiwanese counterparts in math, and trail students from Hong Kong, Slovenia and South Korea in science.

The results of the study, conducted every four years in nations around the world, show mixed prospects for delivering on that promise. A nation that once took pride in being at the top of its game can no longer credibly call itself the global leader in student performance. Wringing their hands about what that reality portends for broader U.S. influence, policymakers worry it could have ripple effects on the economy down the line, with Americans increasingly at a competitive disadvantage in the international marketplace.

Elevating the skills needed to compete with emerging countries has been a priority for President Barack Obama, who has pledged to train 100,000 new math and science teachers over the next decade. "Think about the America within our reach: a country that leads the world in educating its people. An America that attracts a new generation of high-tech manufacturing and high-paying jobs," he said this year in his State of the Union address.

Asia continues to dominate the top echelon of scores across subject fields. The tiny city-state of Singapore takes first place in eighth-grade science and fourth-grade math, with South Korea scoring nearly as high. Singapore takes second place to South Korea in eighth-grade math, with Taiwan in third.

The results also lean toward Asian nations when it comes to advanced levels of learning. In Singapore, 4 in 10 eighth-graders achieved the "advanced benchmark" in science, which requires an understanding of complex and abstract concepts in physics, chemistry, biology and other sciences. About 2 in 10 make the grade in Japan, South Korea and Taiwan. In the U.S., it's about 1 in 10.

Reading skills are a major strength for American students. Only a few points separate American students from the top-scoring students in the world. In Florida, which took part in the study separately, reading scores are second only to Hong Kong.

"We cannot rest until every child has gained the power that comes through reading," said former Florida Gov. Jeb Bush, a prominent education advocate. "If Florida can do it, every state can and must."

The Trends in International Mathematics and Science Study and its sister test, the Progress in International Reading Literacy Study, are used to measure knowledge, skills and mastery of curricula by elementary and middle school students around the world. Students in rich, industrialized nations and poor, developing countries alike are tested. In 2011, 56 educational systems — mostly countries, but some states and subnational entities like Hong Kong — took part in math and science exams. Fifty-three systems participated in the reading exam, which included almost 13,000 American fourth-graders.

"These kinds of tests are very good at telling us who's ahead in the race. They don't have a lot to say about causes or why countries are where they are," said Brookings Institution senior fellow Tom Loveless, who in previous years represented the U.S. in the international group that administers the test.

Other findings released Tuesday:

— Some U.S. states that were measured separately were clear standouts, performing on par with or better than some top-performing Asian countries. Eighth-graders in Massachusetts and Minnesota score far better in math and science than the U.S. average. But in California and Alabama, eighth-graders fell short of the national average.

— Racial and class disparities are all too real. In eighth grade, Americans in the schools with the highest poverty — those with 75 percent or more of students on free or reduced-price lunch — performed below both the U.S. average and the lower international average. Students at schools with fewer poor kids performed better. In fourth-grade reading, all ethnic groups outperformed the international average, but white and Asian students did better than their black and Hispanic classmates.

— Boys in the U.S. do better than girls in fourth-grade science and eighth-grade math. But girls rule when it comes to reading.

— On a global level, the gender gap appears to be closing. About half of the countries showed no statistically meaningful gap between boys and girls in math and science.

The tests are carried out by the International Association for Evaluation of Educational Achievement, a coalition of research institutions. The U.S. portion of the exams is coordinated by the Education Department's National Center for Education Statistics.

OBAMA ADMINISTRATION FOREIGN POLICY:  BEYOND FECKLESS...A FAILURE!

This is what the most powerful nation in the world, economically and militarily, achieves by deferring to the U.N., to Russia, to China, to Bibi, and to every tin-pot despot in the world - thereby creating a vacuum into which all manner of mischief and evil can flow.

• Pakistan.  Not an ally...only a debtor nation - and a nuclear one at that;
• Afghanistan.  A nest of opponents, despite our years of blood and treasure;
• Iran.  An enemy of all our efforts throughout the world...and now a nuclear nation in all but admission;
• Iraq.  Only marginally better now than when we invaded in 2003, thanks to our retreat.
• Libya.  Snatching defeat from the jaws of victory, with dead American representatives to boot;
• Egypt.  Allowing a truly democratic Arab Spring to be smothered in its crib, rather than overtly supporting the moderate arm of the movement and coercing the military to go along;
• Israel.  There comes a time, long-since arrived, when "Israel's survival", 100% guaranteed by America's might, must cease to be the rationale for all manner of despotic and even reckless actions by the current Fundamentalist government. 
• And now SYRIA.  Eighteen months of vacuum in the face of a credible democratic revolt against a criminal government.  And now we "can't do anything" to stop the increasingly likely use of poison gas on the Syrian people?  That use in itself could be considered a war crime on the part of  this American administration...at least by me.  I am not a military strategist, especially in playing "catch-up", but what about a "no fly zone" imposed by our Air Forces over the entire land-mass of Syria?  Why, even France, Britain and Turkey have shown signs of life in this regard...ahead of our Foggy Bottom and our cowardly "leaders".