Archive for the ‘“Healthcare” Reform’ Category

“HEALTHCARE REFORM”: SOME HARD TRUTHS

Monday, January 23rd, 2017

Note (06FEB2017): More Republicans now plan not to repeal ObamaCare but to repair it. What would Mr. Peifer say (See below.)? Why? They have no credible replacement even though one has existed since 1994.

“But if thought corrupts language, language can also corrupt thought.” -George Orwell (1903-1950)

Elected and in-office, Republicans now face some hard truths associated with issues challenging this declining nation on fire. One is ObamaCare and the Republicans’ pledge to “repeal and replace” it. Words have power.

“Not on fire,” you say.

Witness the new President’s address at his inauguration; never mind the protests nationwide, some violent. Would you characterize it as conciliatory? Aggressive? Words have power.

“Healthcare”
In any debate, it is reasonable and appropriate to ask the opposition — the entrenched political establishment, Democrat and Republican — to define the terms that it uses; in this case, “healthcare”. Webster’s New Collegiate Dictionary (1977) does not list the term even. Whence cameth it?

What exactly is “healthcare”? As the term denotes, it is a governmentally concocted, pleasant-sounding euphemism that refers to caring for one’s health. (In contrast, “medicine” is not so pleasant-sounding because it denotes suffering.) “Healthcare”, however, is amorphous and includes everything from washing your hair to brushing your teeth to cutting your toenails. Simply put, “healthcare” is not synonymous with medicine. Words have power.

Another governmentally concocted euphemism, “healthcare-provider”, includes anyone and everyone who promotes himself as rendering advice, assistance, or instruction in the care of one’s health. It is intended to diminish the stature of the lynchpin in medical delivery, the physician. Words have power.

What is medicine? It the healing art based upon science the mission of which is the relief of suffering caused by disease and trauma. Its practitioners are known as physicians; those whom they diagnose and treat, patients. Words have power.

Repair Not Replace
Definitions notwithstanding, of “repeal and replace”, “repeal” is the easier; whereas, “replace”, the more difficult — the much more difficult. Accordingly, some Republican legislators now are talking about “repair” instead of “replace”. Surprised?

“An error lurking in the roots of a system of thought does not become truth simply by being evolved.” -John Frederick Peifer

The basis of this “repair” seems to be a new, politically concocted term — “Health Savings Accounts”, which are merely “Medical Savings Accounts” in new verbal clothing. Country-club Republicanism as its worst! The average American cannot afford a car, let alone a “Medical Savings Account” by whatever name.

“Catastrophic Coverage”?
Some opponents of ObamaCare, such as Tucker Carlson at Fox News, are promoting “Catastrophic Coverage” rather than basic medical coverage. “Catastrophic Coverage” may play well on television, but basic medical coverage offers the biggest bang for the medical buck.

Who most needs “Catastrophic Coverage”? The unproductive old.

It has been known for years, for example, that, during the last year of life, Medicare recipients spend 30-cents of every dollar expended on medical care during their entire lifetime. Of the 1% of Medicare beneficiaries with the highest costs in any given year, approximately 50% die. Of the 5% with the highest costs, approximately 40% die. Of the elderly who survive, 50% are demented by the age of eight-five. Therein lie the reasons that Medicare alone is bankrupting these United States of America. Hard truths!

PART TWO

Today, a major question facing physicians and the rest of American society is whether the consequence of past declines in mortality is an increase in active life-expectancy or merely an expanded and grotesque period of frailty, enfeeblement, and dependency. Apparently, the answer is the latter.

“Diaper, madam? Catheter, sir? Don’t worry. The young and productive will be paying tomorrow for the old and unproductive today.”

Not a pretty picture! Even physicians do not like looking at it. Chronic, debilitating illness — not dying — is becoming our worst medical enemy, individually and socially.

Meanwhile, who least need “Catastrophic Coverage”? The productive young who generally require only acute medical care for acute medical problems with occasional exceptions. Therein lies the reason that premiums would be so cheap to insure, really insure, all American young for serious medical events.

Fooling The Public
To paraphrase Abraham Lincoln, “You can fool all of the people some of the time and some of the people all the time, and them’s pretty darn good odds.”

Be not fooled by self-styled gurus on television or in the newspaper spinning misinformation. Be not fooled by power-hungry professional politicians seeking to retain control of medicine.

Remember Obama’s promises about the benefits of ObamaCare, such as keeping your doctor and your plan? Once again, those who direct public opinion are acting against the Public Good by promoting inefficient systems politically based and politically directed.

Science And Medial Delivery
A patient’s seeking medical care is a behavior. A physician’s providing medical care is a behavior.

There is a science that describes behavior as well as thoughts, feelings, and physiological responses. That science is Biobehavioral Science.

“What?” you say. “Biobehavioral Science? Never heard of it!”

Therein lies the problem not just for you but for nearly all humanity. Guess what? Ignorant about Biobehavioral Science themselves, were they not, the politicians would not want you to hear of it; especially its derivative, the Science of Human Behavior. To them, it would represent an anathema.

Were they willing to listen, they would screech in terror, “Specificity, Objectivity, and Accountability? Never! Never, I tell you!”

Any system not scientifically based and scientifically directed to deliver medical care to a population must be, by its very nature, fatally flawed and fated to failure — doomed to delivering care that is of decreasing availability and decreasing quality. Less availability. Lower quality.

“An ounce of prevention is worth a pound of cure.” ―Benjamin Franklin

Do you care? Actually, few do until they fall ill or become injured. Too late!

We already are suffering from the Sovietization of American medicine; whereby, for example, you see “Doctor Nurse” not “Doctor Doctor”. When you do see “Doctor Doctor”, he — or increasingly she — is looking mainly at the computer-screen not at you. Why? In order to fulfill the increasing regulatory demands of governmental bureaucrats for increasing documentation of decreasing care.

Meanwhile, a scientifically-based, scientifically-directed, detailed plan for delivery of universal medical care by a competitive private sector characterized by the following attributes is available and has been available for more than 20 years. It is characterized by the following:
1) Simple;
2) Straightforward;
3) Free of special taxes;
4) Minimal regulations;
5) Minimal bureaucracy;
6) Free of fraud at taxpayers’ expense; and
7) Acceptable to insurance companies.

No, it is not the failed ClintonCare. In fact, the opposite.

Will the politicians ever acknowledge it, let alone adopt it? Fat chance! Unless, of course, you make them. It’s your health. It’s your life.

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A Paradox?

Monday, February 15th, 2016

NOTE (22FEB2016): Today, we mark the anniversary of the birth of George Washington (1731-1799). Actually, he was born on the 11th of February, but the colonies switched calendars from Julian to Gregorian; thereby, advancing the date of his birth.

“As a very important source of strength and security, cherish public credit. One method of preserving it is to use it as sparingly as possible;” -George Washington’ Farewell Address (1796)

How does ObamaCare correspond to that directive of the Father of these United States of America? How can we employ a system of medical delivery that does? How can we protect the future of our youth, who represent the future of this nation now on fire?

“Life outside society would be solitary, poor, nasty, brutish, and short.” -from Thomas Hobbes (1588-1679)

What can be more important to an individual than life and health? In that regard, what single advance most has improved the human lot — for the individual and for society? Sewage.

Ah, but what about medicine? Has it, too, not improved the human lot? Yes, for the individual. For society? Yes — and no.

It may seem paradoxical that a physician would give such an answer. It is not.

The well being of society depends upon the overall health of its truly creative and truly productive members. The goal of Public Health is to have maintained the health not of the individual but of the society, as a whole. Sewage has done more to fulfill that goal than any other, single measure. Moreover, the cost:benefit ratio had been enormously favorable.

In contrast, the goal of Medicine is to have relieved the suffering of the individual as a consequence of disease and trauma. All well and good until one looks at the cost:benefit ratio. It has become dreadfully unfavorable.

The average American now expends half the cost of his medical care during his entire lifetime during the last year of his life — a year in which kindness often becomes cruelty — a year that, from the perspective of society, typically is pathetically uncreative and unproductive; from the perspective of the patient, typically is progressively enfeebling and painful; from the perspective of family and friends, typically is unrelentingly burdensome and depressing.

You might comment, “Wait! In these United States of America, the individual has no obligation to be either creative nor productive. We are not Nazi Germany where the individual exists for the State. Here, the State exists for the individual — doesn’t it?”

Even so, does the individual have the right to rob his productive neighbor to pay for his own medical care, the end result of which will be of no use to that neighbor or to society and likely of little use, if any, to family, friends, and himself? If so, what are the limits of such theft?

Should the individual be paying with his own money, he very well may be entitled to the most expansive and expensive care that he can afford. Is he so entitled when it is his productive neighbor who is paying — and paying involuntarily via taxes collected by the government at the point of a gun if need be?

When medical care is limited to basic care at a primary level — especially of acute medical problems such as fractures and infections — the cost:benefit ratio becomes tolerably favorable. When medical care is expanded to advanced care at a secondary level — especially of chronic medical problems among the elderly, problems  such as non-healing wounds; failing hearts; and, worst of all, dementias — the cost:benefit ratio becomes intolerably prohibitive as witnessed by Medicare/Medicaid well on the way to bankrupting this declining nation now of fire. Once having bankrupted the nation, Medicare/Medicaid will leave precious little medical care for any but the richest.

You might ask, “There must be some humane alternative between callous disregard and misguided ‘humanitarianism’, mustn’t there?”

Fortunately, yes. The alternative is a medial system that delivers care universal but affordable, partially governmentally funded, provided by the private sector under medical supervision, acceptable to insurance companies, and scientifically based and scientifically driven.

For a description of such a system of medical delivery, see Chapter 17 in the semi-fictional novel, Inescapable Consequences. It is drawn from a detailed plan initially presented in the non-fictional book, Healthcare Reform D.O.A., nominated for two, national awards by The American Risk & Insurance Association — an academic arm of the American insurance-industry.

Americans need not be saddled with the ill-conceived ObamaCare favored by the socialistic, irresponsible Democrats nor the hodgepodge of misguided proposals by the feckless, inconsistent Republicans. The choice really is theirs. It is yours.

Choose selflessly and wisely, and your grandchildren will bless you. Choose selfishly and foolishly, and your grandchildren will curse you.

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MEDICAL DELIVERY: A TALE OF WOE

Monday, August 6th, 2012

“An error lurking in the roots of a system of thought does not become truth simply by being evolved.”
– John Frederick Peifer

Forward: Will Mr. Obama’s “Patient Protection and Affordable Care Act (PPACA)” improve the American system of medical delivery, or will the nation slide from American-style medical care into Soviet-style “healthcare”?  Given the data from its model, RomneyCare in Massachusetts, the answer is the latter.(1) The following is a highly abridged excerpt from the semi-fictional novel, Inescapable Consequences; “The Doctor” and “Uncle” are two of the characters therein.‘Tis the kind of tale likely to be told and retold millions of times:(2)

The patient, a thirty-eight-year-old, married, obese, mother of three had a past psychiatric history of a single brief psychotic episode ten years previously, treated successfully with complete remission and without recurrence. Her recent health had been good until the current presenting complaint of several days duration characterized by abdominal pain with nausea and vomiting.

The morning prior to admission to the hospital, she had complained to her husband of a slight sore throat and a persistent mild but increasing nausea. She had declined to accompany the rest of the family to services at church. Upon his return, the husband found the patient still feeling ill. Her nausea had intensified somewhat, and she continued complaining of diffuse, dull abdominal pain.

Through his employer, the husband subscribed to a “healthcare-plan” issued by a “health-maintenance organization” or so-called HMO, the premium representing a significant portion of his wage. He telephoned the number provided by the HMO for such occasions, receiving only a recorded message with the usual disclaimer instructing him to telephone “911” if he, a layman, determined that the situation was a life-threatening emergency. Then, pursuant to the subsequent instruction by the recorded voice, he left his own brief message with his telephone number.

Approximately one hour later, a woman identifying herself as a nurse returned his call. She had no records of the patient available. As best he could, the husband described his wife’s current complaints and past history including her psychiatric history.

Addressing him by his first name, the nurse quizzed him primarily about his wife’s past psychiatric history, neglecting her present illness.  She then suggested that he telephone the following morning, Monday, to schedule a regular appointment.

He informed the nurse that, since his wife had been feeling increasingly ill for several days, she herself already had called for that regular appointment. The soonest that the receptionist would agree to schedule one was three weeks hence.

The nurse replied by advising him, nevertheless, to try again the next morning and to inquire whether there had been a cancellation. She also prescribed bed-rest and a diet of clear liquids.

Concerned about the typically long wait at the Emergency Room of the HMO, he asked if he could take his wife to a nearby ER. The nurse answered, “You’re free to do whatever you think best, but we can’t authorize an Emergency Room visit ‘out -of-network’.”  Her parting words reverberated in his brain like car-brakes without a lining. “Have a nice day.”

Late that afternoon, his wife was feeling no better. He decided that he would drive his wife to the Emergency Room of the HMO and hope for the best. Upon arriving, he registered his wife with the clerk, who told him that there would be “a considerable wait”.

One hour later, a nurse approached them in the waiting room for a “screening evaluation”. After a brief conversation, she said that she did not believe that his wife’s symptoms warranted a visit to the ER but that his wife would be seen “in due course”. Three hours passed. Feeling as sick as she looked, his wife was pleading for him to take her home. Instead, he took her to the Emergency Room at their local hospital, the financial risk be damned.

There, the clerk advised him that, if his HMO should decide, in its sole opinion, that the patient’s case was not a true emergency, he himself would be responsible personally for all charges. He agreed. He allowed the clerk to take an imprint of his credit card.

Another hour later, a nursing aide escorted them into an examining room. She recorded the patient’s vital signs, noting a slightly rapid pulse and a slightly elevated temperature.

Another thirty minutes of waiting. Then, a man in a white coat with a stethoscope entered. He introduced himself as “Dr. Faki”. Neither patient nor husband understood that Dr. Mohandas Faki was not a physician with an M.D. from an American medical school but a nurse with a Ph.D. from a foreign nursing school, nor did either understand the right to be attended by a physician not a nurse.

The husband again reviewed the course of events and again made the mistake of mentioning that his wife tended toward anxiety and did have a past psychiatric history. Upon hearing about the patient’s psychiatric history, as had the telephonic nurse before him, the “doctor-nurse” focused his questioning in that area.

He then performed a brief physical examination, noting only a slightly injected pharynx and mild, diffuse, abdominal tenderness. He ordered some routine studies by the laboratory “stat”. The couple returned to the waiting room.

Two more hours passed. The nursing aide reported that the results from the laboratory returned as “non-specific” and that the doctor-nurse had said that they should return home then see the patient’s “healthcare-professional” the next day. At no time did a doctor-doctor examine the patient.

Having returned to their home, by late that evening the patient’s husband could see that his wife’s condition was deteriorating further. Her nausea had intensified. She had vomited. Her abdominal pain had intensified. Emotionally, she was becoming distraught.

Her husband tried calming her while he himself was feeling increasingly anxious. Risking the punitive cost, he decided to try a different Emergency Room. He happened to choose a hospital where Uncle’s nephew, The Doctor, held surgical privileges.

Viewing her presenting appearance, the hospital-staff quickly registered the patient then wheeled her into an examining room, where a nurse performed an initial screening. By then, the patient was complaining of increasingly severe abdominal pain in the right upper quadrant. Her skin was cold and clammy to the touch.

The surgeon-on-call that evening already was working on another case in the Operating Room, so a nurse telephoned The Doctor. He ordered her to prepare the patient for immediate surgery, including typing and cross-matching three units of blood, and hastened to the hospital.

By the time that he arrived, the patient was in the Operating Room but going into shock, which the staff, none of whom was a physician, feverishly was attempting to reverse. The Doctor hastily changed from “civvies” into “scrubs”, washed, gowned, and gloved. He took a moment to evaluate the situation before beginning an exploratory laparotomy while the nurse-anesthetist was doing her best to maintain the patient’s vital signs; no physician-anesthesiologist was available. Everyone but the patient was breathing the air of desperate urgency. On her own, she was breathing hardly at all.

Entering her abdominal cavity, The Doctor quickly discovered the cause of the patient’s trouble; a gangrenous gallbladder, now-ruptured. He began to correct the condition by cleansing the cavity of the spilt bile and pus. In the midst of his doing so, the woman suffered a cardiac arrest. Instantaneously, the cardiac monitor screamed its piercing alarm, an unnerving “bleeeeeee . . . .”.

Following a series of frantic efforts, the nurse-anesthetist admitted failure. “We’ve lost the patient,” she reported meekly, gazing fixedly at the floor.

“We?”  The Doctor angrily shot his question at her; his expression, grim; his emotion, impotent rage.

Masking his feelings, he reluctantly entered the hallway, where he found the patient’s husband pacing like the proverbial caged animal. He approached the man slowly and introduced himself. With a quiet compassion in his voice, he informed the husband that his wife had died.

He then attempted to provide what little consolation he could offer. It was difficult for The Doctor to find the right words; actually, to find any words. What could he say?  The wife’s dying had been avoidable. It never should have happened. The medical system had failed her directly and her husband indirectly.

The Doctor’s efforts at sympathizing were in vain; the husband remained disconsolate. The Doctor stood silently while the suddenly-widowed man sobbed.

Then, the tears stopped. Shaking his head, the man looked at The Doctor with a compassion of his own. Paradoxically, he began offering consolation to The Doctor, apologizing for the system foisted upon the country by politicians for whom he himself had voted. Looking into The Doctor’s eyes, he noted tearing.

Whereas the husband felt apologetic, The Doctor felt ashamed, not for himself as much as for his profession or what was left of it. “The medical profession . . . my profession . . . no longer controlled by physicians but by politicians, bureaucrats, lawyers, and profiteers. The consequences? Casualties. This man, his wife, and I are three of them,” he whispered silently to himself.

The husband gently took The Doctor’s hand and held it.“Go home, Doctor . . . get some sleep. You did your best. It wasn’t your fault.” He predicted that, with his wife’s death, the HMO would agree that his wife’s illness had represented a real emergency, after all.

 The Doctor put his other hand on the husband’s shoulder and gave it a slight squeeze. He turned and walked away, leaving the bereaved man behind with his grief-stricken widowerhood bestowed by a system of managed costs euphemistically characterized as “managed care”.

On his way to the locker-room, The Doctor stopped at the desk to request that an aide stay with the husband while the secretary summoned the husband’s brother from home. The secretary said that she would try but that the hospital was understaffed, as usual.

At the moment of the husband’s shock and grief, The Doctor had not wished to disabuse him of his financial fantasy. The Doctor predicted that the HMO would deny the charges, claiming that, in spite of its staff erroneously having told the husband by telephone and at their ER that his wife’s condition represented no real emergency, she should have stayed to be seen “in-network”. He assumed that the charges would force the husband into bankruptcy. Oh, the man would rant and rage and threaten legal action, but, given current law protecting the profiteers, he would find no lawyer to take the case “on-contingency”, and he ill could afford hourly fees.

As for The Doctor’s fees? He would never receive a penny. “The people’s right to ‘healthcare’ . . . their right to my labors . . .” would be his only response, silent and ineffectual.

That night, The Doctor managed to get an hour or so of sleep. Then, he was off to make rounds at the hospital; then, to see patients at the office.

Given the schedule of fees dictated by the government and by the various governmentally-promoted “healthcare-plans”, caring for many of those patients also would generate little financial gain, if any; caring for a few of them would generate financial losses; caring for all would risk unfounded lawsuits filed by unscrupulous, avaricious lawyers.

Months later, The Doctor’s prediction would prove valid. The premiums that the husband had paid to his HMO were for naught when an actual need arrived. His HMO had denied care by delaying care then had forced him, the subscriber, to take the financial fall. Ironically, the same day that the man filed for bankruptcy, the HMO filed a fifteen percent rise year-to-year in its profits.

© Gene Richard Moss (2009)

References
1) “RomneyCare 2.0″. The Wall Street Journal, 06 August 2012, p. A12.

2) Already, under “Expansion of Physician Assistants Training”, the PPACA is directing tens of millions of dollars to training paramedical personnel. Meanwhile, under Medicare, funding for physicians-in-training and payments to physicians-in-practice are being slashed.

MEDICINE: QUANTITY IS NOT QUALITY

Monday, July 23rd, 2012

To reiterate from a previous posting (1), so-called healthcare is not synonymous with medical care. The difference is not mere semantics. “Healthcare” is cutting your toenails. Medical care is treating a cancer with surgery then radiation then chemotherapy.

Recently, a fellow named H. W. Brock . . . neither a Medical Doctor nor a biobehavioral scientist but a financial type . . . wrote a piece claiming a resolution to the problematic situation of delivering medical care in the USA.(2) His resolution? Increase the supply.

Unfortunately for Mr. Brock, his postulates are invalid. As he confuses”healthcare” with medical care, he confuses quantity with quality.

The elements of his so-called supply-sided resolution? 1) Federal training of more physicians. 2) Financial aid for physicians-in-training. 3) Financial incentives for physicians going where shortages exist, medically and geographically. 4) More foreign-trained physicians. 5) Reformation of medical malpractice. 6) Fewer redundant diagnostic tests. 7) More nurses and other para-medical personnel replacing physicians. 8) Promotion of cheap, “retail”, quasi-medical shops.

As always, the devil is in the details. Let’s look at Mr. Brock’s recommendations.

1 & 2) Training more physicians may be a good idea, but who’d be financing the training? With monies from where?

The individual states? The concept of state-based financing is nothing new. State-based budgets, however, are strained . . . California, for example, is broke. Increasing state-based funding for training more physicians seems rather unlikely.

Who’s left? The federal government? The concept of federal financing also is nothing new. It’s been on-going for years through Medicare and other programs; e.g., Title VII of the

“Health Professions Educational Assistance Act” of 1976. Okay, why not just increase it and expand it?

Wait! Congressman John Boehner recently stated flat-out, “We’re broke!” . . . not that a lack of funds usually stops federal spending. Under ObamaCare, for example, Big Government ironically will spend tens of millions that it doesn’t have to train “physicians’ assistants” under “Expansion of Physician Assistants Training (EPAT)“. Meanwhile, current funding for training physicians through Medicare is being slashed. Music to your ears, Mr. Brock?

Stop! Look! Listen! Those who love individual liberty never should forget that government . . . especially Big Government . . . is a dangerous servant and a terrible master. “He who pays the piper calls the tune.” The federal government already is directing American medical care through Medicare and Medicaid. How would Mr. Brock block further empowering its dictatorial control over physicians via increased financing of their training?

Now, who’s left? Private enterprise? Only Big Business could afford financing medical training on a meaningful scale. What would be any reward to any business, say, to offer scholarships? What would be “the catch” for the physician?

3) Rewarding physicians financially for going where shortages exist, medically and geographically, also may be a good idea. Who should do the rewarding? The federal government? Individual states? Under-served municipalities? Private enterprise? Governments already do, to some extent. What must the physician promise in return for increased funding? Mr. Brock might consider that using oneself as chattel for a mortgage is unconstitutional.

4) Importing more foreign-trained physicians may sound like a good idea economically. Is it a good idea medically? On average, is an American-trained physician more competent than a Grenada-trained physician who passed the examination designed by The Educational Commission on Foreign Medical Graduates . . . even without the time-honored cheating?(3) Under whose knife would Mr. Brock care to put himself when his is the life at stake?

5) Reforming medical malpractice, unquestionably, is a good idea. America has become a nation imprisoned by lawyerism. Too many laws; too many lawyers; too many lawyer-politicians; not enough law . . . think the now-disgraced, lawyer-politician John Edwards or the honest companies bankrupted by greedy lawyers (4).

Who’ll perform the legal reform? A federal government dominated by lawyers? On what constitutional grounds . . . not that the federal politicians and bureaucrats care about the Constitution unless it suits them to do so? The fact is that both physicians and lawyers are licensed by the individual states not by the federal government. Isn’t reform a task for the states . . . but, ah, the ease and joy of central versus provincial (i.e., state-based) control; eh, Mr. Brock?

6) Who can argue against reducing the number of redundant diagnostic tests and procedures? Aren’t many of those tests ordered, however, to preëmpt unfounded lawsuits?

Defensive medicine aside, Mr. Brock neglects to tell us The How. Rap physicians’ knuckles? Fine physicians? Imprison them? Execute them? Nothing as quick and simple as negative versus positive control; eh, Mr. Brock?

7) Allowing nurses and other para-medical personnel to masquerade as physicians may increase the supply of “healthcare-related” services but can it maintain quality of service? Nurses aren’t trained to make diagnoses. Sorry, Mr. Brock, it’s true. With all due respect to nurses, essentially, they’re necessary, valuable, and hopefully caring technicians trained to carry out physicians’ orders. With the use of improving technologies, as time passes, they may become competent to do more. Even so, should nurses and other para-medical personnel operate with no medical supervision? Moreover, who, ultimately, should be responsible . . . medically and legally? Mr. Brock gives us no clue whom to sue.

During the days of the now-defunct Soviet Union, its dictators boasted having an ample supply of “physicians”. . . well, not exactly physicians but physicians-in-name; what we in the USA now call “nurse-practitioners”. The average Soviet citizen rarely was attended by a legitimate physician . . . only the politicians, high-level governmental bureaucrats, and military officers. Do we Americans really want the Soviet-style medicine that Mr. Brock is promoting?

Furthermore, will lower fees compensate for lower quality? Even if they do, won’t those lower fees gradually rise towards the fees charged by real physicians?

8) Promoting cheap, “Wal-mart style” quasi-medical shops to handle “common minor ailments” . . . shops already appearing in supermarkets . . . staffed by quasi-physicians acting in isolation from real medical support undoubtedly will increase availability of “healthcare-related” services. Mr. Brock neglects to state, however, who determines what is a “common minor” ailment. The customer? The nurse? The assistant to the absent physician? The check-out clerk? As a financial type, Mr. Brock might keep in mind that there’s a cost to everything. How about your life, Mr. Brock? Still a good value?

No, Mr. Brock, your “solution” won’t resolve the situation-in-question. Fortunately, however, there is a valid resolution, and it comes from biobehavioral science . . . not from the pseudo-science of economics nor from the polemic of politics nor from the mumbo-jumbo of mysticism (www.inescapableconsequences.com).

So, what’re the odds favoring us Americans resolving scientifically the current dilemma in delivery of medical care? After all, we have the way. We have the means. Ah, but do we have the will? What say, Mr. Brock?

References
1) Categories/Biology & Medicine/”Healthcare” Reform/ ‘Healthcare’ Is Not Medicine”.

2) Brock, HW: “A Supply-Side Solution for Health Care”. Barron’s, 23 July 2012, page 30.

3) Lyons, RD: “Cheating On Exams For Doctors Causes Alarm”. The New York Times, 03April 1984.

4) “The Tort Bar Burns On”. The Wall Street Journal, 23 July 2012, page A12.