Newsgroups: bit.listserv.xcult-l
Date:         Wed, 2 Sep 1992 09:23:00 CDT
From:         "Phil Gerdes K-State Univ." <PHILG@KSUVM.BITNET>
Subject:      Medical

              <CLINTON@MARIST.BITNET>
From: GMP@PSUVM.BITNET
    For what it's worth, after 30+ years as a medical writer, I have some
serious issues to offer in re: medical care.  I fear we are all too facile
in our commitments to this system or that.

    1. Keep in mind that doctors on average earn less than stockbrokers or
accountants (and probably lawyers). They are an anomalous group, oddly
eleemosynary despite their alleged greed.  Most that I have met tend to
observe the Hippocratic Oath.

    2. Doctors are not responsible for health care costs in the U.S.  Every
other country, save South Africa, has some sort of state medicine. Even the
A.M.A. has gone along with state medicine (Medicare, e.g.).  Virtually every
country with state medicine also has private plans for those who can afford
them.  Thus, medicine, in those countries, provides minimum care to everyone
with extra goodies for those who wish to pay and can do so.

    3. Americans have a peculiar aversion to triage which prevents them
from considering rational medical solutions like the Oregon rationing plan
or the Canadian plan.  There are basic medical rights, but they lie in
sanitation and nutrition. As long as we have grinding poverty and homelessness
we will have shabby looking medical statistics.  They have state medical care
in India, too, for all the good it does the untouchables.

    4. Malpractice insurance costs have very little to do with inflation of
medical costs.  Competition between "for profit" hospitals and our unwilling-
ness to take turns accounts for the fact that an area in our state with 60,000
people has three MRI units within a 40 mile radius.  None of us who can pay
are willing to wait.  Canadians are much more courteous to each other. Conse-
quently, their system works.

    5. There will be no improvement in medical care unless we bite the bullet
and pay for it.  In short, it must become an entitlement.  Now young people
will hate this and old people will welcome it.  Medical care has been a
polarizing issue between the old and the young, somewhat like Social Security.
The problem is, well people never realize they will eventually be sick, so
they have no comprehension of what it is to be sick.

In my own case, I have a very good Prudential full coverage policy paid for
mainly by my former employer. When I go on Medicare, I will continue the
policy as medigap insurance since I average approximately $900 a month in
drugs (which Medicare does not cover). That is considerably more than I draw
from Social Security.  (Thank God for a good portfolio, eh?)  But a friend of
mine, a self employed carpenter has no insurance.  He has been coughing up
blood but I cannot get him to go to a physician.  Our local general prac-
titioners charge $30 a visit.  He will, no doubt, need a chest X-ray, another
$80.  But he smokes three packs of cigarettes a day at roughly $2.00 a pack
or $42 a week and drinks a six pack a day for another $20 or so.  So he
can actually afford medical care, or, alternatively, he could have bought
health insurance.

    The main problem faced by most doctors, they will tell you, is the
apparent unwillingness of Americans to live healthy lives, their inability
to understand how doctors should be used, and their almost universal lack
of compliance with a medical regimen when they visit a doctor.  British
sociologists have noted this is an entirely American phenomenon.

    My point is that throwing money at the problem alone will not help.
Another point to consider is the central role insurance companies play in the
American finance system.  To take medical insurance away from them would pull
the rug out from under our financial base.

    The fact that Clinton has been a bit cagey about prolaiming a solution
is admirable.  Bush's voucher plan is a consummate fraud.  Someone will find
a way to bootleg the vouchers and trade them for wine, exactly as they do
with food stamps now.  I suspect Bush's medical plan is a smokescreen for his
attempt to finance the parochial school system with his spurious voucher plan.

    We learn as we grow older.  When I was 30, I bought a large bridge that
connected Manhattan to Brooklyn.  I also bought dry land in the Everglades
and a solid gold brick.  So far, the medical plans offered by the major
candidate have been as prudent as the aforementioned investments, or, as
in the case of Clinton, "a pig in a poke."

    At the moment, I'll take the pig, in the hope the candidate will find
the right people to listen to when he gets elected.  I recommend Arnold
Relman, former editor of New England Journal of Medicine for surgeon
general, and call on all you to examine the AARP medical proposals outlined
in _Modern Maturity_ or the American Diabetes Association proposals spelled
out in _Diabetes Forecast_ as examples of sensible thinking about medical
issues.
Gerald M. Phillips (Professor Emeritus), Speech Communication
Editor, IPCT: An Electronic Journal for the 21st Century
ISSN 1064-4326
Pennsylvania State University, University Park, PA 16802
Manuscripts are being accepted for the January, 1993 issue
............................................................
I agreed with this person and thought people on this list might like to
see his opinion.

-Phil--------------PHILG@KSUVM----------"Phir Milengay."-------------
"You cannot strengthen the weak by weakening the strong.  You cannot
help the wage earner by pulling down the wage payer.  You cannot
help the poor by destroying the rich.  You cannot help men permanently
by doing for them what they could and should do for themselves."
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