example, the CEO of the Hospital Corporation of America makes over one
hundred thirty two million dollars a year! He, and his colleagues in the
hospital, HMO, insurance and pharmaceutical industries are paying the lobbyists
who advised Hillary Clinton how to fix the system. They certainly did not
advise her how to reduce their salaries.
Here, in a
nutshell, is my proposal to restore compassion, sanity and fiscal responsibility
to our health care system, yet retain or increase the high quality, and
freedom of choice that Americans now enjoy.
in medical, nursing, and other health-care related fields like X-ray, laboratory
technology, physical therapy, etc, to allow all qualified applicants to
into medical, nursing, and other schools in the health care field is very
competitive. For example, there are probably 10-20 qualified applicants
for every vacancy in medical school. Most nursing schools have 2-3 year
waiting periods (despite an alleged chronic shortage of nurses). Many highly
motivated and talented people wind up going into other fields. If there
are not enough vacancies, or not enough schools to accommodate the demand,
the class sizes should be increased, or more schools should be built! Since
the prospective students presumably either have or can get the money to
pay the tuition, and are willing to pay the price, more instructors can
be hired, more classrooms can be built, or more schools can be created
With an increased
number of physicians and nurses, competition will increase, and salaries
will certainly go down (law of supply and demand). Assuming that our educational
system is sound, and our testing and licensing systems are reliable and
valid, the quality of the graduates will not be reduced. In fact, the quality
will probably actually increase, since the motivation to become a physician
or nurse will be an interest in the field, and desire to help others, rather
than just a way to get a high-paying job.
A good example
of a profession that accepts all (or nearly all) qualified applicants,
is the chiropractic profession. Chiropractic colleges accept virtually
all qualified applicants. The system weeds out those who can’t complete
the curriculum or pass the licensing exams. The number of chiropractors
is controlled by the market. If the number became too large, and chiropractors
were unable to earn a satisfactory living, fewer people would enter the
profession. The same rationale would certainly prevail if enrollments were
opened up in medical and nursing schools.
benefit derived from the increased number of medical and nursing students,
would be a stimulus for the construction industry, and all related industries
affected by construction, because of the requirement to build additional
schools. This would provide a powerful stimulus to our sagging economy,
and would create a large number of additional non-health-care-related jobs
of the increased competition for medical and nursing students is that the
price of a medical and nursing education will probably decrease. Currently,
with a large surfeit of students, the schools can “charge what the traffic
will bear.” However, under this plan, the competition for students will
increase, and the cost to the students will be reduced to more realistically
reflect the true cost of the education.
government restrictions against the promotion of importation of foreign
drugs in the U.S. by patients for their personal use.
currently sold in the U.S. are available in Latin America, Europe and Asia
for pennies on the dollar of the U.S. price. These drugs are usually made
by foreign divisions of the same companies which make the drugs in the
U.S., and are therefore of equivalent quality. In fact, many drugs sold
in the U.S. are actually relabeled foreign-manufactured drugs.
fact is that it is currently legal for individuals to import reasonable
amounts (usually defined as a three-month supply) of foreign drugs for
their personal use (either by mail or by personally bringing the medications
into the country). However, it is incongruously illegal to promote or profit
from such importation. Consequently, very few Americans are aware of their
drug importation rights, and even those who are aware of this right, don’t
know where to buy foreign drugs, despite the existence of many foreign
pharmacies and mail order firms which currently are sending drugs to patients
in the U.S. Furthermore, despite the legal right of such importation, patients
are often illegally harassed by various governmental agencies (Postal Service,
Drug Enforcement Agency, FDA, and Customs) whenever such legal shipments
are discovered. The solution is simply to allow the promotion of foreign-manufactured
drugs in the U.S.
If U.S. pharmaceutical
companies were required to compete on the open-market with foreign-manufactured
drugs (especially since most drugs in the U.S. are now manufactured in
Puerto Rico by employees paid third-World salaries), the exorbitant cost
of drugs in the U.S. would be dramatically reduced.
to purchase non-controlled drugs without prescriptions.
are often amazed to find that not only are drugs available overseas for
a fraction of their U.S. cost, but also that they can usually be purchased
without a prescription. Prescriptions are the exception, rather than the
rule, in most countries of the world. The incidence of adverse drug effects
is not significantly higher in these countries than in the U.S., nor is
the life expectancy or the health of the citizens of these countries any
less than that of Americans. In most of Latin America, Asia, and Europe,
most drugs are sold over the counter without prescriptions (i.e., antibiotics,
non-addictive pain relievers, etc.). Many patients (or their pharmacists)
know what drugs they need, but must still obtain a prescription from a
physician. It’s ridiculous for a patient to unnecessarily have to go to
a physician and pay $40 to $75 for an office visit to get a prescription
for a drug that the patient knows he or she needs, or has used before for
a particular condition. Reducing this prescription requirement would dramatically
reduce unnecessary physician visits, and greatly reduce the overall cost
of medical care.
to make truthful health claims for herbs, biological substances and nutrients.
stores currently offer a relatively low-cost and often safer alternative
to many pharmaceuticals for many conditions. However, under current laws,
manufacturers are prohibited from making any health claims for such products,
even when there is an overwhelming amount of well-documented evidence which
would substantiate such claims. Furthermore, the Food and Drug Administration
is threatening to invoke even greater restrictions on the dosages of nutrients,
despite their near-total lack of toxicity.
and Sandy Shaw proposed the use of a “split label” on nutritional/herbal/biological
products. Their proposal would allow manufacturers to make truthful health
claims on half of the product label. Such claims would have to be substantiated
by significant clinical data, but would not be required to meet the overly
rigorous and excessively expensive (in excess of 200 million dollars) requirements
that the FDA requires for prescription drugs. The other half of the label
would be used by the FDA to provide the “official” government opinion of
the claim. The FDA would thus be forced to fulfill its functions of being
an educational arm of the government (instead of being just another enforcer,
kicking in the doors of health food stores and physicians who violate the
law by making truthful health claims about nutritional supplements). The
consumer could then make a choice of “who do you trust,” a reputable nutrient
manufacturer, making truthful claims, or the U.S. Government? The FDA would,
of course, still assure the safety of the product, and the veracity of
the contents (i.e., to make sure that a product claimed to have 500 mg
of vitamin C did, in fact, contain that amount of unadulterated product).
If the FDA believes the claims to be false, the claim would be submitted
to a jury trial (as opposed to the current administrative procedures),
to determine if the supporting evidence were truthful and adequate.
The power of
the FDA to capriciously and arbitrarily seize nutritional products and
prohibit their sale without demonstrating that they are, in fact, harmful,
or that claims made are not truthful, should be dramatically curtailed.
Such actions by the FDA should be exercised only when a serious threat
to public safety can be clearly demonstrated, or when the jury finds that
the manufacturer’s claims are invalid.
eliminate the requirement for malpractice insurance.
malpractice insurance is so high, is because of the large number of multi-million
dollar awards that have been made for “pain and suffering,” and because
of the incentive for malpractice attorneys to “get a piece of the malpractice
pie.” Malpractice insurance requirements can be eliminated in a number
of ways. First, eliminate “pain and suffering” malpractice settlements.
Malpractice suits would be limited to the cost of the patient’s malpractice-related
medical bills, and for the attorney fees incurred by the injured patient.
physician salaries will probably be decreased by the increased competition
that would result from this plan, physicians will no longer be seen as
“fat cats” with “deep pockets.” Thus, there would be less incentive for
unscrupulous attorneys to specialize in malpractice law.
is for physicians to simply stop buying malpractice insurance, again reducing
the deep pockets. Ultimately, most malpractice claims are due to poor or
adversarial physician-patient relationships, or to patient dissatisfaction
with results received compared to the exorbitant fees that they have been
charged. With lower fees, expectations would be proportionally reduced,
and the level of dissatisfaction with less-than-optimum results would also
be greatly decreased.
should also be given to instituting legally-binding agreements between
physicians and their patients not to sue for malpractice, prior to receiving
care. An alternative to this, would be for a patient to purchase his own
malpractice insurance prior to receiving care (just as an airline passenger
often purchases “flight insurance”). Thus, if the physician performed malpractice,
the patient’s own insurance policy would pay him. Any one or combination
of these plans would eliminate the “malpractice crisis.”
has been hospitalized in the last few years has probably been shocked at
the exorbitant and obscene cost of hospitalization. Instead of blindly
accepting the cost, we should examine what the costs should be, and what
we can do about the unjustifiable and exorbitant fees that are charged.
a routine appendectomy usually costs in the range of from $12,000 to $15,000
in most hospitals in the U.S. Where did this money go? The surgeon probably
made $500 to $600; the anesthesiologist probably earned $500; and the hospital
probably charged $500 to $600 for the surgical suite, techs, and equipment
used. So we’re up to about $1,700. Let’s assume that recovery in the hospital
will be about five days. A nightly stay in the Waldorf-Astoria would probably
cost about $200 per night. That’s another $1,000. Add another $200 per
day for nursing services (that’s another $1,000), and perhaps $50 per day
for food (another $250). That gives us a grand total of about $4,000. Where
did the rest of the $8,000 to $11,000 go? Up in administrative smoke!
The fees that
most hospitals charge are absolutely immoral and unjustifiable. Hospitals
attempt to justify their exorbitant charges by claiming that they must
overcharge paying patients to make up for those who don’t (can’t) pay.
If their fees were reasonable, most patients could probably pay them.
One of the
reasons for these costs is the administrative requirements placed on hospitals
by the Joint Commission on Accreditation of Health Care Organizations (JCOAHCO),
a morass of regulations that have been established by an amorphous group
of bureaucratic health-care organizations and governmental regulators.
Instead of having the welfare of their patients as their primary concern,
the major effort of most hospital administrators is “compliance” with the
requirements of JCOAHCO! Elimination of this organization would go a long
way in reducing costs of hospitalization.
were eliminated, it would be possible to establish a new type of hospitals
for short-term stays or “low-tech” treatments (sort of the hospital-equivalent
of a small nursing home or hospice). Everyone does not need to stay in
a tertiary-care level of hospital, complete with MRI and CT scanners, with
a capability for coronary bypass and heart transplant surgery. Some people
merely need a few days of IV antibiotics, rehydration, or observation with
a little nurse-supplied TLC (tender loving care). Such small, low-tech
“hospitals” or over-night clinics would be an affordable option. The problem
is, the JCOAHCO requirements, which set standards for hospitals, do not
differentiate between large and small hospitals. They all must meet the
same ridiculous standards, requiring an excessive administrative overhead,
and making the low-tech hospital an economic impossibility.
the role of third-party payers (i.e., insurance companies) in medicine.
buildings in most cities today are those occupied by insurance companies.
But insurance companies don’t cure anybody! They merely suck money out
of the system, and contribute to the wealth of a parasitic portion of society.
In fact, many people trace the beginnings of the health-care “crisis” and
explosion of fees to the early sixties, when the government and insurance
companies became progressively more involved in medicine. Prior to Lyndon
Johnson’s “Great Society,” the AMA declared that it was “unethical for
physicians to accept payment from third party payers.” However, after Medicare
and Medicaid entered the picture, physicians saw the “pot of gold at the
end of the rainbow,” changed their point of view, and decided that it was
ethical, after all, to accept third-party money. The medical insurance
industry expanded, government intervention in medicine increased, and the
result is our current medical mess!
are taught, in medical school and during their training, to greet the patients
with a friendly “How can I help you?” or “What can I do for you?” However,
nowadays, the first thing a person hears upon entering a physician’s office
or hospital is, “Do you have any insurance?” or “How are you going to pay
insurance companies out of medicine will have a number of beneficial effects.
First, is that the insurance department in every physician’s office and
hospital can be dispensed with, reducing office overhead and the cost of
is very easy for physicians to jack up the price of medical services when
the patient doesn’t care how much he is charged, and the doctor knows the
patient doesn’t care. “Just put it on my insurance,” or “Your insurance
will cover all of this. You won’t be charged a thing.” This is the real
reason for unnecessary lab tests and procedures.
in medicine is not, as Hillary Clinton says, that there are 37 million
medically uninsured Americans. The real tragedy is that medical care is
largely unaffordable for those without medical insurance. We don’t have
grocery insurance or clothing insurance, and we don’t buy gas or pay our
mortgages with our car insurance or home owner’s insurance. Why do we have
to pay our medical bills with medical insurance? Again, insurance companies
don’t cure anybody!
complain that the people who work for the insurance industry have to have
jobs, too. I say, let them go to medical school or nursing school, and
really perform a service in the health-care field, instead of just sucking
money out of it.
who perform charity work a tremendous tax break, on a level equivalent
to tax relief for interest paid on home mortgages.
who could still not afford medical care (despite the cost-reductions which
the above program would generate) would be welcomed by physicians and hospitals
as a “tax break,” instead of being regarded as “non-payers” to be “turfed”
to the county hospital. Physicians would be allowed to deduct from their
income tax a large percentage of the income they would have derived had
their charity patients paid the “going rate.” If such a program is implemented,
physicians will be fighting among themselves to provide free care.
of the above steps should dramatically reduce the cost of medical care,
maintain (or increase) the high quality our system now provides, and increase
access to health care, yet at the same time get the government completely
out of the “health care business.” This is done, in most cases, by removing
the governmental control which has caused the problem in the first place.
On the other hand, the Clinton health-care plan (Fig. 1) provides (1) vast
new layers of bureaucracy, (2) increases regulation, (3) causes higher
costs to the taxpayers, and (4) will certainly result in poorer service,
longer waits, and greater patient dissatisfaction.
If you think
medical care in this country is expensive now,...
until it’s free!