Health Care Reform Essay by a Physician on Insurance Companies versus the Government

by Epimenides - a physician

"I am no lover of insurance companies. After all, I have sued them, and would do it again tomorrow. But there can be an enormous difference between private insurance corporations, and government. If you examine the issue closely, you will see that corporations are NOT at the root of the problem.

Here's why.

Who "regulates" insurance companies? Who tells them what kind of policies they can and can't write? Who decides that health insurance bought by a company you work for is a deductible business expense, but the same thing bought by you, personally, is not a deductible personal expense? In short, what is it that sets up the rules that favor insurance companies and give them the ability to do what they do? In particular, who gives them rules they LIKE, if they pay the bribes?

Yes, you are right. Government. Government is the absolute, unequivocal, root of the problem with medical care. Rules, regulations, favors, taxation preferences, "licensing" requirements, "capital" requirements, etc... all these things are holy writ from GOVERNMENT, and enforced, at the point of a gun, by GOVERNMENT.

Why can't you and I start a little "mutual" insurance company with our 5-guy family practice? Why can't we buy reinsurance from somebody in Bermuda and provide for our patients based on them paying us $90 a month apiece? Yes, you guessed it - government.

Why can't we, and 3 other groups like us, especially if we are each running our own little mutual company, then cut our costs by doing our imaging at our own imaging center, instead of paying for it to go somewhere else? Ah, yes. Stark laws. Government.

Why can't I enter into a voluntary agreement with a patient, enforceable by a mutually-agreed-upon enforcement company, to prevent him from suing me frivolously? Because one entity claims the monopoly on violence and enforcement - government.

Health care "reform" is a subset of "liberty 'reform'", and without liberty, there will be no real "reform" of anything at all. The antithesis of liberty is government.

And the folks who run it, like it that way."

by Epimenides
physician (verified)

On Sarah Palin’s Death Panel and Dr. Ezekiel Emanuel’s Rationing of Health Care

On Sarah Palin’s Death Panel and Dr. Ezekiel Emanuel’s Rationing of Health Care
- by an anonymous physician (verified)

Well, for the first time ever, I have agreed with Sarah Palin. Boy is my wife gonna be pissed...
I also read Dr. [Ezekiel] Emanuel's entire Lancet article. It is very thoughtful and well organized, but I have two serious concerns that prevent me from accepting it.

First, the article presupposes that some entity (government, presumably) should have the power to apply rationing. For gas and tires in wartime, that’s fine; for health care, or any other aspect of daily life, I can't agree.

Life is not fair. No practicing physician can disagree with that statement. But one of the greatest glories of humanity is the ability of some to overcome difficulty, to figure out a better way, to figure, scheme, plot or even connive to do the undoable.

There are certainly negative consequences when such maneuvers are unrestrained, or even when they are restrained, but this quality, more so than any other, is that which makes humans successful - the most successful - as a species. And it is an innate quality among us.

Even the most disadvantaged among us - the poorest, the disabled, the dumbest (excuse the political insensitivity) - do the best they can every day to try to improve their lot in life. The person who's robbing you at knifepoint may not be doing a particularly good job from a societal viewpoint but the fact is that, from his perspective, at that point in time, robbing you is the best thing he can figure out to do. Otherwise, he would be doing something else.

And it is the freedom to do whatever is the best one can figure out to do that is the hallmark of the unique, and uniquely successful, democracy known as America. To consent to having any entity, and especially the government, apply rationing to the general population is antithetical to the very things that make us human, and American.

On the other hand, resources in life, and in health care in particular, are limited. It is inevitable that when competing for constrained resources, some will succeed and some will fail. Which returns us to the point that life is not fair. But, fair or not, life is much more fulfilling, even in failure, when the opportunity to compete has been offered. To remove that opportunity is a far greater affront than to simply allow one to fail.

If some failure is inevitable, as it is in any competition for constrained resources, there is no more demoralizing event, and no greater evil, than to be disallowed from competing. Thus, the very notion that any entity, no matter how well intentioned, should be given the power to determine our successes and failures for us, without allowing us the opportunity to compete, is itself morally wrong, and is a far greater injustice than that which occurs during the inevitable failures that competition entails.

My other concern with Emanuel's paper is his reliance on vaguely defined "morally relevant principles" - a term he uses throughout the paper, and his desire to adopt not a set of rules for rationing, but a framework of principles. In closing, he states "...society must embrace the challenge of implementing a coherent multiprinciple framework rather than relying on simple principles..."

If ever there was a statement more open to blatant abuse of a system by the politically connected, I have yet to see it. And that, ultimately, is the great threat of government rationing, no matter the way in which it is implemented.

While I stated above that being disallowed from competition is the greatest evil, I was mistaken. Being disallowed from competing, while knowing that others are being given, by virtue of birthright or political connectedness, that for which you are forbidden from competing, is indeed the greatest evil of all.

This is the fundamental injustice, which has led to every great political advancement in human history, from the Greek republic to the Magna Carta to the American Revolution and the Emancipation Proclamation. The notion that America could seriously consider undertaking this kind of morally repressive and morally reprehensible action causes me great fear for our future.

- by a physician acquaintance of mine who wishes to remain anonymous in these politically charged times.

Sarah Palin’s “Death Panel Post” can be found here: http://www.facebook.com/note.php?note_id=113851103434

The Dr. Ezekiel J Emanuel article, “Principles for allocation of scarce medical interventions,” can be found here: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60137-9/abstract
It is in The Lancet, Volume 373, Issue 9661, Pages 423 - 431, 31 January 2009, and is authored by Govind Persad BS, Alan Wertheimer PhD, and Ezekiel J, Emanuel M.D.

Waiting Lines in Canada and England

"Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor’s Business Daily. In England, the waiting list is 1.8 million." - John Mackey

EUNICE KENNEDY SHRIVER was a Health Activist

The NIH pays tribute to Eunice Kennedy SHRIVER. - BRH

STATEMENT OF DUANE ALEXANDER, M.D., DIRECTOR EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT, NATIONAL INSTITUTES OF HEALTH, ON THE CONTRIBUTIONS OF EUNICE KENNEDY SHRIVER

U.S. Department of Health and Human Services
NATIONAL INSTITUTES OF HEALTH NIH News
Eunice Kennedy Shriver National Institute of Child Health and
Human Development (NICHD)
For Immediate Release: Tuesday, August 11, 2009

CONTACT: Robert Bock or Marianne Glass Miller, 301-496-5133,

STATEMENT OF DUANE ALEXANDER, M.D., DIRECTOR
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
NATIONAL INSTITUTES OF HEALTH
ON THE CONTRIBUTIONS OF EUNICE KENNEDY SHRIVER IN ADVANCING RESEARCH IN CHILD HEALTH, HUMAN DEVELOPMENT, AND INTELLECTUAL DISABILITY

The entire world owes a debt to Eunice Kennedy Shriver for her foresight in calling for an institute at the National Institutes of Health to study the myriad aspects of human development, both as it unfolds without problems and when medical and environmental factors prevent it from doing so.

In 1961, Mrs. Shriver persuaded her brother, then-President Kennedy, to include in his first health message to Congress the proposal for an NIH institute focusing on child health and human development research. After the bill that would establish the new institute was introduced, Mrs. Shriver testified in support of that bill and worked to persuade members of Congress to approve it. The institute that now bears her name, by act of Congress, is a tribute to her vision and commitment.

Research that the Eunice Kennedy Shriver National Institute of Child Health and Human Development has sponsored has led to the near-elimination in the developed world of once common causes of intellectual disability. For example, as recently as the 1980s, Haemophilus influenzae Type B (Hib) meningitis was the leading cause of acquired mental retardation in the United States. A vaccine against the disease, developed in the NICHD's laboratories, has been so effective that today the disease is nearly eliminated. Children with the metabolic disorder phenylketonuria, or PKU, develop severe intellectual disability soon after birth. In the 1960s, a blood test for PKU was developed and children with the disorder were identified at birth. NICHD research documented that a diet low in the amino acid phenylanine spared them from brain damage and allowed normal functioning. Another newborn blood test developed through NICHD research for a disorder caused by failure to produce sufficient amounts of thyroid hormone allowed diagnosis and treatment before any brain damage could occur. Other NICHD research documented the benefits and feasibility of mainstreaming children and adults with intellectual and physical disabilities into schools and communities, a practice that is now routine.

She was also instrumental in creating in 1961 what eventually became the President's Committee for People with Intellectual Disabilities (ACF/HHS), and served on that Committee from 1966-1968 and from 1977-1980.

We owe these and numerous other advances in health, especially for those with disabilities, to Mrs. Shriver's determined efforts. She will be greatly missed.

The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute's Web site at .

The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit .

Katie Couric Reveals Backroom Deal on Health Care Reform

Last night, Katie Couric reported on CBS News that Barack Obama made a backroom deal with the pharmaceutical industry. Dr. Sidney Wolfe, a consumer activist, called it "a very bad deal for the American Public." Dr. Wolfe is an expert on issues of drug safety, health care policy, Food and Drug Administration and hospital oversight, OSHA, medical devices, Medicare and Medicaid and doctor discipline.

First Line of Any Health Care Reform Bill

The first line of any health care reform bill should be that the president and congress shall not have any better health care than the people. That would ensure that we get a better system instead of a worse one.

Health Care Reform March on Washington DC, Sept/12/2009

Health Care Reform March on Washington DC, September 12, 2009.
http://912dc.org/agenda/

(tentative - last updated 07/20/09)

We will be putting together the details of the week’s events soon. For now, this is our tentative agenda for 9-10 through 9-12. This is the most up to date, and accurate place for information on the web.

Thursday, 9-10

9:00am to 12:00pm Liberty Summit (REGISTER NOW!)
1:00pm: Press Conference on Capitol Hill (REGISTER NOW!)
1:30pm to 5:30pm: Grassroots lobbying visits on Capitol Hill
Evening: Free time to tour Washington

Friday, 9-11

Morning: September 11th Never Forget Memorial
1:00pm Doctors Rally Against Socialized Medicine (REGISTER NOW!)
2:00pm to 5:30pm Grassroots lobbying visits on Capitol Hill
4:00pm Bureaucrash Happy Hour at Bullfeathers

Saturday, 9-12
8:00am Set up for stages and volunteers; crowd gathers at Freedom Plaza
10:00am March on the Capitol Begins down Pennsylvania Ave. (See Map)
1:00pm March ends and Protest Begins at West Front of the U.S. Capitol

Click here to register for the March on Washington!
http://912dc.org/agenda/