Healthcare Hurts

7 Requirements to Pass Health Care Reform

2010-03-12T18:28:00.000-08:00

Health Care Reform must...

1. Be FAIR and equitable to all (no mandatory or punishments) and yet provide a safety net to those in trouble.
2. Apply to ALL Citizens, including all government.
3. Nnot favor big business or any special benefactor interest.
4. Honor the patient first and push toward non-assembly line medicine.
5. Allow complete choice of all citizens to have their lifestyles and care for their own health.
6. Not interfere with consequences of imprudent lifestyle or unsatisfactory choices or lack of personal responsibility.
7. Have a short implementation and not be mired down w rules.

ps, 'Dyck's 5 Steps to HCR' maybe not polished, but it fits these criteria.

Get to the cause:
http://healthcarehurts.blogspot.com/2009/10/healthcare-failure-cause.html

Dyck's 5 Steps to Health Care Reform (a radical change)

2010-02-23T15:46:00.000-08:00

Thomas Jefferson had a radical notion: When the people are well-informed, they can be trusted to govern themselves.

This solution won't cover every contingency in our complex nation. But, it can be the container that will hold everyone. It meets all "7 Requirements To Pass HC Reform." It can be a new way to have affordable, available and competent health care in a nation- that actually cares! And it spreads the burden of achieving it's many benefits equitably to all who participate in health care, including patients, practitioners, government, and corporations. Here it is:

1. Make equal, medical costs for people who have insurance and those who do not. Eliminate this disparity and insurance requirements and influence.

2. Require that if people want to lower their medical costs ( undistorted by insurance influences per #1 above) they must participate in their health care. This means that doctors would also participate by prescribing an expensive drug only after requiring reasonable lifestyle, diet, or environmental changes first. (instant relief and convenience costs a lot and drives this industry!) This is a primary radical change to medical practice and patient role. This is the hinge-pin of the plan.

E.g., for a patient to demand and receive 'immediate relief' instead of consultation for a self-limiting (flu or cold) or lifestyle (reflux) condition he would be asking for the 'Cadillac' plan which would cost much more.

3. For people with pre-existing conditions or with catastrophic illness, or for people on Medicare or Medicaid, the government would participate. Similar to beachfront insurance that is higher cost, this problem would be solved in the assumed higher risk insurance pool... which would carry a high cost. This higher cost would be born by the persons requiring higher cost treatments. For those who cannot afford this the government would be the safety net and step in to deal with this as a social problem as it does others.

4. Retail medical insurance would be free to ensue. Likely there would be more call for catastrophic health insurance. And this could be supplied based on usual actuarial.

5. Health care plans for employers: designs can be numerous and cost efficient by transferring major responsibility for health care to the employee. Personal education and research become important in this environment. The capability to discern among alternative practitioners and treatments becomes important. And this is entirely within the domain of average American and no different from selecting a competent and effective physician or consenting to tests or advice or drugs that may have adverse reactions. This is solving problems more permanently like teaching someone to fish instead of giving them food.

This isn't so new to mainstream America, is it? Integrative medicine got a boost of greater public awareness -- and funding -- after a landmark 1993 study. That study showed that one in three Americans had used an alternative therapy, often under the medical radar. And none of this was 'covered' under conventional insurance.

Integrative Medicine IM, as it's often called, depends on a partnership between the patient and the doctor, where the goal is to treat the mind, body, and spirit, all at the same time. Well known Dr, Andrew Weil is an advocate and practitioner. In many, if not most instances the patient will not require a physician at all.

While some of the therapies used may be nonconventional, a guiding principle within integrative medicine is to use therapies that have some high-quality evidence to support them. But, this is under the discretion of the patient. So, again they have responsibility for their own care.

Participatory Medicine is a new approach that encourages and expects active patient involvement in all aspects of care. It builds on the work documented at the e-patients.net blog, whose slogan is “Because health professionals can’t do it alone.” The group’s landmark 2007 paper “E-Patients: How They Can Help Us Heal Healthcare” tells many stories of engaged, empowered e-patients who substantially improved their own outcome and the outcomes of others by supplementing or even going beyond what their physicians alone could do.

Both PM and IM routinely make use of the not-so-available (can't talk to my doctor) mainstream Allopathic Medicine, and more accessible, less cost Alternative Medicine. Alternative care such as Homeopathy has eluded conventional testing and understanding. But, in spite of this, it often has amazingly effective results at low cost AND often allow a patient to self-treat. And it has been around over a hundred years longer than our current allopathic medicine. Chinese medicine has been around over a thousand years more.

Let's be open to our wonderful world of resources... even if they do not cater to the propaganda of, nor support the big profit margins of the corporations milking the medical industry, e.g. drugs, insurance, law... and other benefactors, e.g. many members of Congress et al, lawyers, etc..

Don't forget about the personal aspects of Patient - Doctor experience and effectiveness. This topic intends to honor this connection. Please see more at Sun Magazine's Then There's the Doctors

PS, the only people who won't like this solution is the patients (only at first), doctors (at first), insurance, drug companies, lawyers, congress, other government. So, why not do it? Let us force Congress to start with this!

Background regarding the cause:
http://healthcarehurts.blogspot.com/2009/10/healthcare-failure-cause.html

Alternative Health Care - WORKS!

2010-01-23T19:16:00.000-08:00

Alternative Health Care is Legitimate Quality Health Care. And it works!! More humane, costs less, not necessarily faster, takes more patient participation, makes one less dependent, many more lasting cures, many other benefits. Let's integrate!

Alternative health care is far far far far far less cost. It often does far less harm. Some examples are: Homeopathy, Chinese Medicine, Vitamin Therapy, Nutrition, Visual Imaging, Hypnosis, Reflexology, Trigger Point Therapy and other manual therapies, Pilates, Prayer, Chiropractic, Shaminism, etc.. Dr. Andrew Weil has written extensively on this topic and is worth reading. One of his early books Spontaneous Healing covers this.

But, it means most Americans have to participate in their care and learn new and fundamental truths. It means beginning to look at health as a whole, connected to the health of the world. It includes the whole of our body-mind-spirit. It includes the environment the body is in and the food that fuels and grows and repairs the body.

This tack to health care does not exclude Allopathic medicine. It simply uses it only when it makes sense to do so. This tack is older and wiser than our conventional 'hotshot' Allopathic medicine which tries (politically and as a business) unsuccessfully to be all things to all people. And it has been coercing and forcing it's will as a business force. It has been deceiving and brainwashing us to believe it alone is a credible.

And although there are many awe-sum scientific breakthroughs, there have also been errors and mistakes. For most of us there has been equally awe-sum price to pay for medical advances. The cost is not only measured in dollars or percent of income. The cost to us is in erosion of humane treatment, lack of access, adverse reactions, lack of care, suffering, humiliation, lack of self-determination and real choice, bewilderment with cost complexities, stress in dealing with one's illness, stress with insurance refusals and requirements, stress in dealing with the system, no patient advocate.

Get to the cause:
http://healthcarehurts.blogspot.com/2009/10/healthcare-failure-cause.html

Dirty Medicine

2010-01-21T18:36:00.000-08:00

What should be treated medically?

Immediate gratification, no pain or discomfort, no changes, continue doing what I want. These child-like attitudes are the American patient. No?

By satisfying these demands, medical and pharmaceutical industry has created a monster and gotten wealthy and powerful.

I am questioning the Need versus Convenience of many of our drugs and our procedures. Let me explain. This may go to the heart of Health Care Reform.

A simplified example would be if someone has reflux (and associated various symptoms). Upon examination it is revealed a diet of excesses (coffee, alcohol, spicy, fried food, raw onions, etc.).

Most physicians would counsel and provide a acid blocker and a flier to educate. But, let's look more closely. First, is the patient 'really' given an informed choice? Is it emphasized the common sense "if something is hurting you.... Stop doing it!?" What about the probabilities of an endoscopy ($2000+) or the Blue Pill ($3/ day forever)? & Insurance will pay !x?*

Should this even be a medical treatment issue at all? Drug companies love the 'spoiled brat attitude' because they can sell lots of drugs that cater to that. They find ways to make it sound like the aspirin has been obsoleted and charge 10x or 20x the cost for not much added value. Physicians do similar by replacing 'doing nothing- medically' (and advising lifestyle changes) with expensive procedures and drugs (maybe some self-protection too). And procedures and drugs then have their own risks and causal affects, deepening the problem.

So, I am introducing the term Value into the health care vision. And, like the good ole days, it still appears to be the ethical responsibility of the physician to ensure the patient gets a good value and wise care. Responsibility can be interpreted here, but in the light of our existing crippled health care system I am thinking this is a requirement.

Physicians must take the lead in educating us. So, they must become educated. They must know about the affects of food (& contaminants), environment, and lifestyle (& attitude) on the health of a whole body. They must not be small minded about natural and alternative means of staying healthy. For example, ever heard of fennel and anis seed, cumin? These herbs can help heartburn and reflux.

Let's change the way we dish out medicine. Push the Patient to take more responsibility for their lives by educating them. Many common sense ideas on the Joe & Terry Graedon (Pharmacologist & Medical Anthropologist) http://www.peoplespharmacy.com/home-remedies/ Show on NPR?

Get to the cause:
http://healthcarehurts.blogspot.com/2009/10/healthcare-failure-cause.html

Can We Start Over in Health Care Reform?

2010-01-19T19:11:00.000-08:00

Trying to solve Everyone's problems will necessarily infringe on rights and create new problems. Diagnostically, it is most sensible to isolate and determine (understand) cause. Then treat the cause.

If I were to begin isolation I would start with significant costs of being sick:

1. Intervening of Insurance (a middle man who takes profit out) and which causes secondary costs of claim disputes, heavy admin requirements on everyone, illogical & unnecessary procedures, errors from complexity, incorrect care decisions, etc.. In other words, it managing by averages to maintain profits... a business model with a captive customer base (shared monopoly?).

2. Intervening of Pharmaceuticals which is linked to Insurances 'allowed' treatments. Any scrutiny on the Insurance-Pharma relationship? High profit drugs replacing older low profit drugs or non-drug therapies. There is a constant pressure for profit and no incentive to produce and distribute cheap drugs or herbs in favor of 'faster acting' or 'more powerful' or 'without a particular side affect'. Although these often product many adverse reactions and then can in fact exacerbate dis-ease calling for more medical treatments. The often dubious rationale of a 'better' drug appeals to society weakness for 'immediate relief' or 'not having to change'. So, if one smokes, over eats, eats poorly, eats things that aggravate, has stress, etc., they can get rid of the problem symptoms with a drug. On some level this is unethical to pander to those needs. That is why ethics versus profit is so important in medicine. People are vulnerable here. There appears to be no advocate that promotes lifestyle changes to cure disease except Alternative Care. And Alternative Care is predominately Not Covered by Insurance.

3. Medical treatments and equipment. I don't understand deeply this category but read that advances in procedures and equipment are very beneficial and often reduces pain and cost. However, I have seen that the relationship between Insurance coverage and procedure is dubious and cloaked. For example, Medicare won't commit to paying or not paying for an MRI until after the patient receives it. So, this category introduces the fact that patients cannot have control or even understanding of what they are being charged medically nor what will be reimbursed. This surely is the kiss of death to any cost containment process-- no control or knowledge.

4. People who are now sick or at risk cost a lot. From an insurance point of view these are not the kind of policy holders desired. Why? Because those who must be paid are bad, and those who have no claims are good-- because we need to make money to run a large company and for our investors who want to make lots of money- as much as possible-- whatever the market will bear!

The sick and at risk are minority and represent high cost patients. Some of these people are in need and some are not. Some are wealthy and some are indigent. It is obvious, as a society we must be compassionate. We must also be wise so as not to remove consequences that instruct human behavior toward happiness and away from pain or undesirable condition.

5. Oh, I almost forgot the ballooned costs charged to those without health care insurance to pay for the artificially lowered prices insurance companies and Medicare have coerced from medical providers.

A non-cost consequence of our medical system I call the assembly line care. It is de-humanizing and disrespectful. It demeans the patient and the well-intended doctor. It places selfish motive and profits between my self determination and my health, making it stressful and often inefficient or ineffective the cure. It introduces First Doing Harm into what was sacred.

I'm getting old and my mind has let loose of some other points I wanted to make. But, I can still say it doesn't seem necessary for us all to suffer hardship and loss of freedom to accommodate a universal answer to an ill-defined problem. I've mentioned several problems. It seems they can each be tackled with a right-minded attitude. But, these can not be tackled with selfish-mindedness or greed.

Who among us can see with integrity-- without selfish motive (including me)?

LA Times Opinion, What does it mean to start over in healthcare?

Get to the cause: http://healthcarehurts.blogspot.com/2009/10/healthcare-failure-cause.html

A Congressional Draft

2010-01-11T19:08:00.000-08:00

Get to the cause:
http://healthcarehurts.blogspot.com/2009/10/healthcare-failure-cause.html

Congressional Draft is a new concept where citizens are called upon to serve in the legislative branch of government. If confirmed they would serve their country for 2 or 3 years as a representative Of The People. This would function similar to our system of jury duty. Draftees would be paid adequately. They would be covered by reasonable public benefits. They would go through a brief training prior to serving.

The PROS: direct citizen involvement in our government, enhance citizen education and vitality, less chance of war, less tolerance for corruption or ineptitude, no campaigns, no more prima donas who are immune from their own legislation, little or no more big business influences and coercion, no more career self-centered motivation, less legislation, fewer lucrative government retirement packages, much less government expense, etc. etc. etc.. There would be a shift away from the legislation approach to solving all problems. The People's dependence on government would lessen. A return of a more free market system would be enhanced. Save our Democracy from historical fate.

The CONS: citizen sacrifice to serve, it will be an arduous and dirty fight by our existing, self centered legislative branch of government.

Some PROBLEMS to solve: Develop the idea and engage the public. Likely basic shift away from legislative approach to all problems. Who would have the leadership and energy and power and vision and knowledge and integrity and funding to spearhead this effort? (I would volunteer, but I may be missing a few requirements.)

No matter how you feel... tell it... start a dialogue!

"Not rule of majority. Protection of the minority."

2010-01-11T19:03:00.000-08:00

Get to the cause:
http://healthcarehurts.blogspot.com/2009/10/healthcare-failure-cause.html

OK, this is one of the few political things in my life (sorry, but Health Care Reform is important to me). I want to engage with others and find a way to our representatives. If I can't find a way to help them represent me, I want to eliminate them... are you with me on this? I realize there are many interests and that we live in what we like to call a democracy.

Abraham Lincoln described Democracy as "Not rule of majority. Protection of the minority." "I would not be a slave. SO, I would not own one. This embodies my idea of Democracy."

Congress Duality: (they) want to spread mandatory health care insurance cost to the healthy to make it less cost to the unhealthy. And among the more basic things this is devoid of improvements in Patient-Doctor effectiveness or caring, and it completely ignores the foundations of good health (prevention). This is such a mess when there isn't acknowledged in our government leadership (or the public?) a Connection of the Health to food we eat, a healthy earth environment, life styles we choose.

What about those who need help? How does freedom and charity co-exist? Is it best to just Give or to Educate? These are some of the serious questions to engage in personally, and collectively.

And, beyond all this, with the feathers flying, Congress remains immune? I really feel sympathy for Congress. They don't have to contend with problems of retirement systems, social security, medicare or healthcare systems of the working class. They have their own. But, they must earn those priviliages. They must please the giant powerful lobbies who get them elected and line up big favors. They must find ways to perpetuate legislation that will assure the advancement and supremacy of the legal professions. They must maintain a public image that doesn't get their constituents mad or tarnish themselves publicly. And they must try to say and do what sounds & looks like sweetness to all ears. Surely an impossible job!

A following Blog explains how we can "get rid of Congress".

Then there's the Doctors (in Healthcare Reform)

2009-12-01T14:39:00.000-08:00

"Who Will Heal the Healers" is an interview about What's Missing in Health Care Reform, in the November 2009 issue of The Sun Magazine http://www.thesunmagazine.org/issues/407/who_will_heal_the_healers. I must say I did not think of doctors this way. But, as I began reading, it felt familiar to me... and right to me. Please take 10 minutes to read it.

Of course it prompts the question, Who is really harmed by our broken and contradictory system of staying healthy versus treatment for illness? Obviously, many individuals- patients and doctors. But, maybe, profoundly, us all............ except for an industry et al (married to our government reps) that profits from it all, saying it EMPLOYS people. But, which may not be good enough here and now.

Diet, Lifestyle and Environment... a direct link to health. For example, junk food, fast food, tobacco, alcohol, fake food, sweet food, fat food, food with colors, additives, hormones, genetic alterations, pesticides, herbicides, bad water quality, bad air quality, sedentary life, denial. On the other end of the cigarette is obesity, addiction, cancers, stress, heart and artery disease, to name some.

At the very front-end of our Health Care is need (getting sick). Isn't it obvious the causes are around diet, lifestyle and environment. Yet, this has not been in the HC Reform debate. WOW!!!!!

The very next and second-most important step in Health Care is patient-doctor event. This critical event has also not been in the HC Reform debate. (except in the cardboard rhetoric... the pretense of caring, but background of rules that say "WE (Insurance + Government) DETERMINE WHAT YOU CAN DO (thru economic coersion)... WE WILL CONTROL"

Please read the interview in The Sun.
.......... and be skeptical of what your representatives are doing to us!

Get to the cause:
http://healthcarehurts.blogspot.com/2009/10/healthcare-failure-cause.html

Solving Health Care Reform-- 5 Questions

2009-11-10T09:32:00.000-08:00

1. How do we go about reforming an out-of-control and extravagantly expensive system of medicines and treatments and practices and insurance controls and influences-- one in which supposed benefactors (who must pay) have no control or understanding of costs? Could our problems be rooted in our tampering and other interference with an intelligent and free market?

2. Can we accommodate the three parts of A.) payers/patients who are sufferers of our broke system, as well as B.) the organizations who administer, influence, and C.) those who actually provide health care?

3. From a business perspective, is it possible to affect the prey without harming the profiting predator or organization? And shall we protect business- big business, e.g. insurance, and medical conglomerations formed in response to insurance at the expense of small medical practitioners and related businesses? And, shall we continue to suppress the Alternative Healthcare industry- much less expensive, many older methods and practices, by allowing the insurance industry and government (Medicare) to prevail by artificial domination- the way they manipulate & coerce the medical industry? And shall we allow insurance and government (by their coercion to providers) to drive up costs for those who choose not to buy insurance (due to little or no coverage for their own choices of health care)?

4. From a private perspective, are the Employees of Profiting Predators or Organizations of an ill-conceived system entitled to protection paid for by the sufferers?

5. Is it acknowledged that the Sufferers and Employees (who are also sufferers) of Profiting Predators/Organizations are human, but Organizations are not? Isn't it apparent that we all have varying proportion of greed and generosity, and so are not without blame? But, as individuals don't we have rights and freedom guaranteed that corporations and governments do not?

Hence, even when organizations employ citizens it imbues them not with rights and freedoms of the citizen. Within those rights of the citizen is an equal opportunity to work and to be employed. It is not a right, however, to have a job. Employment must come from the individual's qualifications, skills, energy and labor. Hence, it is not a right of an organization to make earnings or profits by reason of sustaining employment of the citizens. Employment of people is a byproduct of a fulfilled market driven need and no other reason.

Our major effort must provide, without compromise, for the private citizen- the sufferer in an effort to allow true market needs to be fulfilled, with a free and intelligent market to wield it's controls and incentives. It's about people- suffering citizens, responding to their own needs directly with their choices and their pocketbooks. It's about a market that responds to that, correcting itself!

Get to the cause:
http://healthcarehurts.blogspot.com/2009/10/healthcare-failure-cause.html

Health Care Failure- The Cause

2009-10-14T12:41:00.000-07:00

Things we know:

1. Health care system is an astronomical failure yet many benefit.
2. Our people (we) are really suffering!
3. Insurance is at the heart of influence of medical treatments and costs.
4. We have allowed this to happen and hence share responsibility.

SOMEONE IS BENEFITING - WHO?

This isn't easy to expose because those of us who have gotten into positions of influence are clever at this kind of thing. These are ambitious people, striving for principle or wealth or fame, maybe with a few criminals thrown in. Where the buck stops is with our top executives and politicians.

SOMEONE IS REALLY HURTING - WHO?

A lot of people are hurting. But, some are suffering badly-- children, single parents, families without jobs, low paying workers. Suffering related to money and related to lack of good and proper care. A side of suffering we often neglect is humiliation and not being able to assert ourselves, especially within the health care establishment. The establishment is a monster that hurts.

INSURANCE IS AT THE HEART OF THE PROBLEM

There was a time when there were not many people who had medical insurance.
There was not a problem of medical access and although we thought medical care was expensive it was only an tiny percentage of our paychecks. It's not clear just what logic was used to finagle insurance into something that was predictable like getting sick. Perhaps it started out covering only unexpectedly high medical bills. But, even just this brought about an aberration of sick people's usual treatments because to contain their costs and protect their profits insurance had to begin finding ways to limit their coverage and limit what they paid out. Claims denials, rigorous proof requirements and counter claims and certifications and paperwork began causing others to begin getting crushed under the burden. Those under the crushing weight are the doctors and staff, hospitals and company HR departments, and patients.

WE HAVE ALLOWED THESE FAILURES

Investment Institutions, Government, Oversight, Wars, Torture, Environment, Energy, Usury and Credit Card, Justice, Healthcare, Consumer, Pension Funds, etc...

We keep allowing by not being involved socially, not applying critical thinking, not challenging fine print, not challenging authority, not having time, by acting selfishly, not saying NO. If each of us does not treasure being free from oppression, manipulation, having choice, others will take it from us. They will use it to their own ends (and these people are our leaders and sisters and friends).

Just Some Noticing about Politician's Role in all this.

Why should we keep believing our politicians? (think about this)
Surely we view our politicians with skepticism and general disbelief. Like car salesmen who don't care about our needs and wants and simply want to sell what they have. We have caught so many of them deceiving us over and over and over, we scab over and over.

Are they subject to the laws they 'fight for' for us?
Their Motivation:
A . To Be Re-elected.
B. Image (say things that 'sound good' to all),
C. Support- have lots of political backers, trading favors (influential people, lobbyists, etc.).

But, politicians are really a cross-section of ourselves. Won't you admit that we also grasp for power and position and material comforts. We also want to be secure and insulated from the unknown. We also are not so honorable as we could be when it comes to acquiring or protecting.

THE DIALOGUE
You will undoubtedly be able to add knowledge and experience to this. So much the better. See if you don't agree that this brief is a sound place to start. Let's see if we can use the symptoms to get to a CAUSE, and Not Just Keep Treating Symptoms. Surely we're aware, if we take a pill to deal with our symptoms and that pill causes it's own reactions or symptoms, and then we take another pill to deal with those symptoms, and so on, and so on, it doesn't take long before we're spending lots of money on pills. And we're confused about why we took the first pill. Ironically, this construct can aptly represent our giant top-heavy and teetering no-ballast Titanic - Healthcare System. And it can also represent the long and enormously hungry and ruthless serpent of dependence on Prescription Drugs.

A SUMMARY

Consider the simplicity of direct medicine. This is where, as a patient, I am treated, then billed for medical services. Note the alternative of being charged for the enormous cost of overhead to support an insurance middle-man being involved to make sure I don't spend more than he thinks is required. Most of this latter cost would be the middle-man and his affect on medical administrative micromanagement load. Consider one's control of costs: If the bill looks accurate I pay for it... that's all! If it doesn't, I question it. This, versus not knowing or understanding costs or treatments or coverages ahead of time, or reimbursement.

If I can't pay, I seek alternatives as there are in all businesses. Some people won't pay and there will be these losses. Again same in all businesses.

If there are those who should need help to manage their health care let there be help available as would naturally occur in a free market. If people want insurance to help them if they unforeseen incur high medical costs, let them purchase policies.

And what about people in need right now who have high or very high medical costs? This doesn't appear to lend itself to an insurance solution (see below). However, I would be open. If it takes our tax dollars or beefing up Medicare for this, so be it- a far more palatable solution to what we have now. In my opinion it would be the right thing to do if we tackled this as a social problem, separately and intently. This approach is intended to free us from the mistakes chaining us to an untenable healthcare system with it's unreasonable cost inflation history, its diminishing value, and its arrogance toward human dignity.

Let's aim for simplicity so all will understand and be a good health care consumer.

RATIONALE

Insurance is a service and a business. It needs to have profits to attract investors and grow. Investors are speculators who essentially want to make money or gain influence and therefore demand business growth. Growth/leverage potential seem limitless. It sells, loosely defined- security, or piece-of-mind, typically aimed at protecting people against unpredictable significant financial loss. However, this doesn't fit well our current model of "health care insurance." For regular insurance most people hope they will never need to make an insurance claim.

For health care insurance everyone has claims regularly, even predictably. As a business-only Insurance will do what is legally minimum to satisfy it's contractual obligation to it's customers and whatever is necessary to satisfy their primary charge- to cover expenses and earn increasing profits. Non-profit organizations are still businesses and as such most are motivated by similar human gains of position, salary, power, fame, etc. via 'good scores', notwithstanding the rare altruistic individual. However, altruism and any other morality is an individual characteristic which does not translate to any organization whatsoever.

It is frightening to consider (and I'm terrified now of) organizations so audacious and reckless to believe they can make sound and caring decisions (manage health care) for others and at a net savings in cost. But, they don't care about us personally!

Medicine is a also and service and a business. It is mainly one skilled person who dispenses medical diagnosis, consultation and treatment to another person. (Of course, there follows an industry that supports this construct.) Because the doctor cannot be cloned there is limited potential for growth/leverage of a single doctor, yet a practice can grow in numbers. Implied is a responsibility to be competent and do their best, irrespective of cost, to save a human life, to do no harm. There is implied public trust that medical professionals care about people, yet are objective and detached to the extent that treatments and products are not 'sold' but rather they are dispassionately called-for or 'needed'. This is one of the few businesses that doesn't 'sell'. It sometimes has investors, but is predominately a Practice of individuals. And, they do care about us.

AND SO THE CAUSE

Insurance. A business that has first loyalty to its investors or principals does not seem a likely choice to make personal health decisions. It is not difficult to see how there would be gigantic overhead imposed on all parties: in duplicating, protecting, sending, tracking, receiving, tracking and verifying medical information from the patient, the doctor, the lab, the hospital, multiple government agencies, disputes, claims, limitations, rules, deductibles, co-pays, pre-pays, authorizations, penalties... to name some of what's obvious. This morass imposes costs and stresses beyond reason.
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