Sunday update

It is very difficult, obviously, to tell what the Administration's rescue plan actually means, but I was appalled by one quote in the lead story of the Sunday Times, from Alan Blinder, a Princeton economist and one-time member of the Board of Governors of the Federal Reserve. "If the plan works," the Times writes, "it will attack the central cause of American economic distress: the continued plunge in housing prices. If banks resumed lending more liberally, mortgages would become more readily available. That would give more people the wherewithal to buy homes, lifting housing prices or at least preventing them from falling further. This would prevent more mortgage-linked investments from going bad, further easing the strain on banks. As a result, the current downward spiral would end and start heading up.

“'It’s easy to forget amid all the fancy stuff — credit derivatives, swaps — that the root cause of all this is declining house prices,” Mr. Blinder said. “If you can reverse that, then people start coming out of their foxholes and start putting their money in places they have been too afraid to put it.'”

Prof. Blinder, let me suggest an alternative explanation. Subprime mortgages were the only way to create the housing boom, because the American economy has not distributed greater benefits to enough people (or built enough new houses) to allow people to pay for them legitimately. I don't see how what the federal government is doing can possibly re-invigorate the housing market, which needed a drastic correction anyway. I don't know how widely these views are held, but actually, the amazing rally on Wall Street late last week suggests that a lot of people think we'll be back doing business as usual within a couple of weeks. NOT.

On another front, I just discovered the following letter written by a physician. (Frank Rich confirms the story about the "release" of McCain's medical records today.)

Dear Colleagues and Friends,

John McCain is a 72 year old man with recurrent melanoma, hyperlipidemia, degenerative joint disease, and recurrent difficulty with certain efforts at recall. These are the limited facts the American people have had access to. Over 1000 pages of medical records were shown to selected journalists for 3 hours with less than 48 hours of notice. The only medically trained journalist was Sanjay Gupta, MD from CNN. This is the extent to which the American people have been informed.

While I am certainly sensitive to the confidential nature of medical records given the anxiety expressed by many of my patients regarding the risk of lost coverage or lost jobs in this current health economic climate, there are certain exceptions for disclosure regarding public safety. As John McCain knows, a pilot’s records are comprehensively available for review by a certifying agency (the FAA, I believe) to insure the fitness of the pilot and the safety of passengers and the public at-large. In the election of the President of the United States of America, that certifying body is the American electorate.

A recurrence of metastatic malignant melanoma would essentially destroy John McCain’s capacity as the Chief Executive and the American people have yet to receive a full accounting of the facts regarding his actuarial risk. If he has had regional metastasis, his risk could be 30% or greater for distant metastasis to the brain, bone, and lung. As you all know, melanoma is one of the most insidious, pernicious, and aggressive malignancies our patients must deal with and that we attempt somewhat pathetically to control with interferon, interleukins, and dismally active and terribly toxic chemotherapeutic regimens. In addition, we lack the simple data to sensibly evaluate his cardiovascular risk as we would any septuagenerian in our exam rooms.

John McCain should be held accountable by the American people and its agents, the free press, to release without restriction the entirety of his medical records. Any hesitation to do so would clearly imply that there are significant medical concerns about his ability to fulfill the duties of the President.

Sincerely,

Michael D. Fratkin, MD
Internal Medicine
Hospice and Palliative Medicine
Eureka, California

Don't miss the longer post, below.