Thought for Today

"The kind of doctor I want is one who when he's not examining me is home studying medicine."

~~~~~ George S. Kaufman

Thought for Today

"Some people think that doctors and nurses can put scrambled eggs back into the shell."

~~~~~ Dorothy Canfield Fisher

Thought for Today

"The great secret of doctors, known only to their wives, but still hidden from the public, is that most things get better by themselves; most things, in fact, are better in the morning."

~~~~~ Lewis Thomas

Thought for Today

"Here is a math problem for you: Assume that the legislation establishing government control of medical care is passed and that it 'brings down the cost of medical care.' You pay $500 a year less for your medical care, but the new costs put on employers is passed on to consumers, so that you pay $300 a year more for groceries and $200 a year more for gasoline, while the new mandates put on insurance companies raise your premiums by $300 a year, how much money have you saved?"

~~~~~ Thomas Sowell

Thought for Today

"Among the things that people complain about under the present medical care system are the costs, insurance company bureaucrats' denials of reimbursements for some treatments and the free loaders at hospital emergency rooms whose costs have to be paid by others. Will a government-run medical system make these things better or worse? This very basic question seldom seems to get asked, much less answered."

~~~~~ Thomas Sowell

Thought for Today

"Any serious discussion of government-run medical care would have to look at other countries where there is government-run medical care. As someone who has done some research on this for my book 'Applied Economics,' I can tell you that the actual consequences of government-controlled medical care is not a pretty picture, however inspiring the rhetoric that accompanies it. Thirty thousand Canadians are passing up free medical care at home to go to some other country where they have to pay for it. People don't do that without a reason. But Canadians are better off than people in some other countries with government-controlled medical care, because they have the United States right next door, in case their medical problems get too serious to rely on their own system. But where are Americans to turn if we become like Canada? Where are we to go when we need better medical treatment than Washington bureaucrats will let us have? Mexico? The Caribbean?"

~~~~~ Thomas Sowell

Thought for Today

"Every doctor knows, as I did when I practiced years ago, how much unnecessary medical cost is incurred with an eye not on medicine but on the law. Tort reform would yield tens of billions in savings. Yet you cannot find it in the Democratic bills. And Obama breathed not a word about it in the full hour of his health-care news conference. Why? No mystery. The Democrats are parasitically dependent on huge donations from trial lawyers."

~~~~~ Charles Krauthammer

Thought for Today

"The great secret of doctors, known only to their wives, but still hidden from the public, is that most things get better by themselves; most things, in fact, are better in the morning."

~~~~~ Lewis Thomas

Dr. Alex Lickerman: A Prescription for the Health Care Crisis

Dr. Alex Lickerman, practicing physician and blogger extraordinaire, has just written A Prescription for the Health Care Crisis. I enthusiastically recommend it for anyone with an interest in health care reform. In particular, I think it should be required reading for all of our U.S. Senators and Representatives.

Here's how it begins:

With all the shouting going on about America’s health care crisis, many are probably finding it difficult to concentrate, much less understand the cause of the problems confronting us. I find myself dismayed at the tone of the discussion (though I understand it—people are scared) as well as bemused that anyone would presume themselves sufficiently qualified to know how to best improve our health care system simply because they’ve encountered it, when people who’ve spent entire careers studying it (and I don’t mean politicians) aren’t sure what to do themselves.

Albert Einstein is reputed to have said that if he had an hour to save the world he’d spend 55 minutes defining the problem and only 5 minutes solving it. Our health care system is far more complex than most who are offering solutions admit or recognize, and unless we focus most of our efforts on defining its problems and thoroughly understanding their causes, any changes we make are just likely to make them worse as they are better.

Though I’ve worked in the American health care system as a physician since 1992 and have seven year’s worth of experience as an administrative director of primary care, I don’t consider myself qualified to thoroughly evaluate the viability of most of the suggestions I’ve heard for improving our health care system. I do think, however, I can at least contribute to the discussion by describing some of its troubles, taking reasonable guesses at their causes, and outlining some general principles that should be applied in attempting to solve them.

By all means, go read the whole thing.

For what it's worth, I did, then left Alex this comment:

Alex, this is an excellent, thoughtful, apolitical discussion that ought to be required reading for all of our U.S. Senators and Representatives. Perhaps a few of them would get the message that the subject of health care is far more complicated and interdependent that they realize. Therefore, they need to tread very, very carefully – because any well-meaning “reforms” they enact are far more likely to result in adverse unintended consequences than in real improvements.

Indeed, Congress’ past track record is replete with examples of laws passed with the best of intentions, but that nevertheless ended up causing far more, and in many cases, far more serious, problems than they solved. As just one recent example, consider the case of the Consumer Product Safety Improvement Act (CPSIA). One year ago, it was enacted with the universally approved aim of stopping the importation of dangerous lead-laced toys from China. Only later did we learn that among its myriad other unintended side effects, the law also bans the distribution of children’s books printed before 1985.

CPSIA was intentionally written in such a manner as to give the Consumer Product Safety Commission no discretion in determining whether or not the law applies to a given situation. At the same time, its specific requirements are so nebulous that in reality, the specific requirements of the law are, basically, whatever the Commission says they are. The perverse end result is to make it impractical or impossible for thousands of small, specialized companies with limited resources to remain in the business of furnishing low-volume items intended for children, while rewarding the very same huge, big-box store chains that caused the problem in the first place by importing cheap junk from China – since they are the only ones with sufficiently deep pockets to comply with the new law.

Oddly enough, the exact same House committee chairman, Rep. Henry Waxman (D-CA), who is primarily responsible for the disastrous, gotcha-filled CPSIA is also the prime mover behind the House health care reform bill, as well as the even more disastrous cap-and-trade measure already approved by the House, but thankfully not yet passed by the Senate.

In view of their abysmal record, why should we have any confidence that Rep. Waxman and his myrmidons will do a better job with the infinitely more complex task of health care reform than they did with the CPSIA and the cap-and-trade bill? On the contrary, it seems to me that we would be well-advised to keep these arrogant know-it-alls as far away from our health care as possible.

Ronald Reagan Speaks Out on Socialized Medicine

Good Advice for Patients – and Their Doctors

Dr. Alex Lickerman, the proprietor of Happiness in this World, just put up a thoughtful, masterfully written post, When Doctors Don’t Know What’s Wrong. While it's primarily directed toward patients, I'd encourage all physicians and veterinarians to read it, too. Here's the beginning:

The first patient I ever saw as a first year resident came in with a litany of complaints, not one of which I remember today except for one: he had headaches. The reason I remember he had headaches isn’t because I spent so much time discussing them but rather the exact opposite: at the time I knew next to nothing about headaches and somehow managed to end the visit without ever addressing his at all, even though they were the primary reason he’d come to see me.

Then I rotated on a neurology service and actually learned quite a lot about headaches. Then when my patient came back to see me a few months later, I distinctly remember at that point not only being interested in his headaches but actually being excited to discuss them.

I often find myself thinking back to that experience when I’m confronted with a patient who has a complaint I can’t figure out, and I thought it would be useful to describe the various reactions doctors have in general to patients when they can’t figure out what’s wrong, why they have them, and what you can do as a patient to improve your chances in such situations of getting good care.

Not only should you read all of it, you should share it with as many people as you can – especially your doctor and your veterinarian.