Surviving the Medical Meltdown (6 page)

Additionally, earlier and more rigid subspecialization has stove-piped learning into narrower and narrower brackets. Specialists may solve a problem in their own realm without realizing the problems their treatments have created in another specialist’s area of expertise. The classic example of this is the use of “statin” drugs to lower serum cholesterol. Although statins have not been shown to decrease all-cause mortality from heart disease, they are being prescribed to
more and more patients. As the drug companies with government backing produce more of these “guidelines” for use of statins, more and more adults will qualify for a statin prescription. Unfortunately, the cardiologist who prescribes the statin may see the patient’s chest pain improve, but that doctor won’t realize that the patient’s worsening dementia is due to the drastic lowering of cholesterol needed for brain function, because as the patient’s memory deteriorates, he doesn’t see the cardiologist; he sees a neurologist. Or when the patient gets muscle cramping and pain, he sees the orthopaedist, and when he gets diabetes, he sees his primary care doc or an endocrinologist. So the cardiologist prescribes statins, blissfully unaware of the actual impact on other body systems. And this is just one drug example, but there are many others. To make this problem worse, as fewer physicians see their own patients in the hospitals (because of the use of hospitalists to cover inpatients) there is less and less face-to-face interaction between doctors of different disciplines – perhaps the best arena for cross-pollination of ideas.

I have often quipped that we need a Journal of Good Ideas – a non-peer-reviewed publication where physicians can report their experiences and ideas that might prove helpful to others, without the need for high-powered proof before publication. For example, it has been my observation that many problems in postoperative inpatients can be averted by ensuring that their caffeine levels are maintained. I have neither the time nor the resources to do the kind of study required to prove this in a standard medical journal, but it is a simple observation that can be tried by others. (Trust me – less time for bowel recovery, fewer headaches, less fatigue, and better postoperative mobilization!)

Fortunately, a new forum for truly out-of-the-box thinking has arisen. The fastest-growing subset of medicine today is in the field of “anti-aging.” The title may be a misnomer, but this area of medical research and practice is dedicated to optimizing health throughout an extended life span. In their journals and their meetings, anti-aging physicians of all specialties and interests discuss improving
health, utilizing not
only
the published long-term literature but also their experience and understanding of
basic science
– in short, they have gone back to the way it once was. The anti-aging medical leaders scour the medical literature
across all disciplines
for ideas and evidence. Then, instead of erecting barriers for the sharing of knowledge, they publish ideas with extensive documentation in non-peer-reviewed magazines and let the discerning physician reach conclusions about the validity of the ideas presented. In essence, they have become the Google search engine for medical information and have combined that knowledge in unique and useful ways.

State medical boards, peer review, best practices, and evidence-based medicine are put forth to improve the quality of medicine and promote safety for the patient. But how many patients die or are disabled due to lost opportunity, inability for ideas to be promulgated, and physicians’ fear of being sanctioned for providing the avant-garde, not just the standard care?

You, the patient, should understand where your doctor is “coming from” as the jargon goes. If your doctor is the classic medical school graduate, she is probably a member of this “Flat Earth Society” (as I once was) that buys into the EBM and best practices and the board regimens. Not to say she is a bad doctor, just that she sees the world in a very stylized fashion. She does not recognize the limitations of the medical literature, the inability of current laboratory tests to really assess deficient states, and the straitjacket of treatment options imposed by the “authorities.”

I would opt for a doctor with a standard degree of MD or DO who advertises “complementary” and/or “integrative” or “anti-aging” medicine. These doctors can be found in yellow pages and via world-health.net, or through the Cenegenics organization, among other sources. As an added benefit, these docs often work for cash, so they will be the “last ones standing” when Medicare crashes and burns. Sometimes it is just word of mouth, but today there are very few cities without such physicians, and it is worth seeking true preventive care from them.

4
THE FINAL GOVERNMENT TAKEOVER

A
s the current medical system collapses of its own internal inconsistencies, people who have been conditioned to look to government for solutions will predictably look to the federal government for help. And government being government will never ignore the chance of using a crisis to further its agenda of power and growth.

But let’s look around us. How has government done in the fields of education, banking, the post office, or the DMV?

In Iowa, in the old days, before the Department of Education was created, every small town of three hundred people or more could afford its own school building and teachers. The local school officials provided order and discipline, and the local elected school board controlled the curriculum. Iowa had one of the highest literacy rates and best academic record in the nation, and it became famous for its Iowa Test of Basic Skills. But now, in spite of spending nearly twelve thousand dollars per student, the twenty-fourth highest spending per pupil in the nation, Iowa ranks thirty-fifth on the ACT in composite scores and forty-first in science. Children who once were able to walk to school (and we wonder about obesity?) are bused or driven to distant conglomerate schoolhouses, while the grand old
buildings of yesteryear molder and decay. We have no local control over curriculum, and little to say about teacher hiring and firing.

Around the turn of the last century, my grandfather and father both were educated in one-room schoolhouses with children of all ages. Both were well-educated men, literate, with Palmer penmanship and math skills. My grandfather “graduated” with an eighth grade education, but my father went on to three doctorate degrees and a teaching stint at Harvard in biochemistry. From a dingy little one-room schoolhouse to an old, no-frills, brick high school in a town of one thousand souls, to Harvard. No state or federal tax dollars involved. Just a lot of honest hard work and straight thinking.

Today, with tax dollars spent at every level, at $12,000 per pupil, a class of twenty-five students could afford paying a teacher $150,000 per year, rent of $60,000 per year, and contribute $50,000 toward the salaries of a principal and secretary (that’s all the administrators I had when I graduated in 1969 from high school), and still have $90,000 a year left over for books and incidentals.

Now, I know this is a bit oversimplified, but small businesses would look at it this way. Before drilling down to line items, they would get a big-picture view of where the money is spent. In our administration-heavy education system, where does the money go? Well, simple. It goes to government-ponderous bureaucracy. According to its own website, the US Department of Education in 2010 had nearly forty-three hundred employees and a budget of $60 billion. And they don’t actually teach one child. The Iowa Department of Education spent more than $6.5 million on administration of a total budget of $7 billion, which included such non-school-related items as Iowa Public Television, family support and parental education, special ed services from birth to age three, the state library, and the Entrepreneurs with Disabilities Program. In sum, when government gets involved, money is taken from the direct consumer, and instead of going directly to the producer – i.e., teachers and schools – it is siphoned away into murky, back-hall budgets made for the benefit of other interests – the support of outdated
book depositories, social workers produced in excess of market need, and programs perpetuating nonessential jobs for government employees. And now we are forced into Common Core – a plan so bad that even unionized teachers are balking. It promises to double the rate of student testing, at a cost of thirty dollars per student per test, and requires all new textbooks – money that goes to the private corporations and consortia that hold the copyright. And it has no proven benefit – quite the opposite. It says something when federal agents are being placed into classrooms to ensure compliance to the “Common Core” standards.
¹

Every small town has had its own bank, and usually more than one, but a small bank’s ability to exist independently is in jeopardy due to government involvement. The gross overregulation disproportionately hurts the small bank. Bank examiners used to show up every two to three years, but now there are examiners from various agencies twice or more a year, and the banks pay the cost of their own audits. Before the Federal Reserve was established in 1913, banks of all sizes and types were truly private and independent, and although in those days some failed (taking their clients with them), relatively few people were affected. Before government intervention in banking, we never had prolonged national boom-and-bust cycles with systemic toxicity (e.g., the recent real estate debacle or the Bear-Stearns collapse or, indeed, the Great Depression).

For those who think the Federal Reserve is only an insurance device for banks, the so-called FDIC guarantee, think again. As Thomas DiLorenzo points out, the Fed is responsible for regulating

bank holding companies, state-chartered banks, foreign branches of member banks, edge and agreement corporations, state-licensed branches, agencies, and representative offices of foreign banks, nonbanking activities of foreign banks, national banks, savings banks, nonbank subsidiaries of bank holding companies, financial reporting procedures, accounting policies of banks, business “continuity” in case of economic emergencies, consumer protection laws, securities dealings of banks,
information technology used by banks, foreign investment by banks, foreign lending by banks, branch banking, bank mergers and acquisitions, who may own a bank, capital “adequacy standards,” extensions of credit for the purchase of securities, equal opportunity lending, mortgage disclosure information, reserve requirements, electronic funds transfers, interbank liabilities, Community Reinvestment Act subprime lending demands, all international banking operations, consumer leasing, privacy of consumer financial information, payments on demand deposits, “fair credit” reporting, transactions between member banks and their affiliates, truth in lending, and truth in savings.
²

The issues of federal government involvement in banking are complicated, but the effects are very obvious once you know what you are looking at. Whereas interest rates were once based on real market forces, now the “Fed” sets the rates to suit its own and the administration’s goals. This has led to outrageously low interest rates, which may be good for the first-time home owner, but anyone living on interest from bonds or savings is being devastated by the nearly zero interest rates set by the Federal Reserve Bank.

Small banks that cannot afford navigating the regulatory morass are closing or being purchased by larger and larger conglomerates. We are left with fewer banks, less competition, and ultimately a less safe, less customer-friendly banking environment.

Banks have become the action arm of the government’s social policies. Fannie Mae and Freddie Mac, at the heart of the 2008–09 financial implosion, were specifically told by several administrations to lower requirements for home-buying to allow more lower-income families to buy homes. Under Eric Holder, the Department of Justice has doubled down on this failed policy, ordering banks such as Midwest BankCentre to provide “special financing” in the predominantly black areas of St. Louis for conventional home loan financing at a fixed prime rate for borrowers “who would ordinarily not qualify for such rates for reasons including the lack of required credit quality, income or down payment.”
³

Then of course, there are the post office and the DMV. Given that your time has any value at all, why would you ever choose either of these over the private alternatives, FedEx and UPS pickup and delivery? They travel the world. They are fast and reliable. No standing in long lines in a post office. How nice is it to get your first motor vehicle license through a private dealer rather than your DMV or other similar government-licensing bureau?

Government may supply jobs to the chosen, but government – any government at any level – produces
nothing
, including medical care. The only way government can possibly supply medical care is to forcibly requisition the components from the private sector – what is left of it at the time. Doctors will be forced into government servitude. Hospitals will be nationalized. Patients will be given their national health service identification, and we will all be locked into the type of system that has failed around the world.

“Obamacare,” or PPACA (the “Patient Protection and Affordable Care Act),” was passed over the objections of the great majority of Americans. The system it installs is perfectly designed to destroy private medicine and bring about single-party payer, Canadian-style, universal health care. There are two points worth discussing for the purposes of predicting the future and understanding the present – the role of HHS (the Department of Health and Human Services) and the design of these “accountable care organizations” (ACOs).

Congresswoman Nancy Pelosi famously said that the Congress and Senate needed to pass Obamacare so everyone would know what was in the bill. As outrageous as that statement sounds concerning the nature of our elected officials, the truth is even uglier. In fact, it doesn’t matter what is in the bill – and never did. The twenty-four hundred pages of Obamacare could be an untranslated Greek ode – it would make no difference.
⁴
The only thing of importance is the one line in the bill that authorizes the Department of Health and Human Services (HHS) to write regulations for implementing Obamacare –
regulations that carry the force of law
.