National health care [was Re: Medical technology and cryonics]
GMP at PSUVM.PSU.EDU
GMP at PSUVM.PSU.EDU
Thu Jun 4 13:19:00 EST 1992
I second the comments of my colleague (whom I have never met), Dennis Shea.
Medicine must be approached as a commodity. We have never regarded the
practice of medicine as a competitive enterprise. Here in Johnstown and
Altoona markets, hospitals compete for patients. They buy expensive equip-
ment, duplicate services and in general bankrupt themselves trying to
bring in a diminishing pool of patients. So we have a state agency to
referee things. This complicates matters further with hearings, legal
actions, and lawsuits. On the other hand, it is imperative to maintain
standards (without getting carried away of course).
This is an interesting discussion, but my complaint is that 1) there is
still this reverence for physicians at the core of it and 2) there is an
implied disrespect for old people. I introduced the notion of productivity
to the discussion, but after reading the latest draft of one of my Ph.D.
candidates, I' vote for euthanasia for the stupid, regardless of age.
Consider that a hospital can be conceptualized as a community enterprise,
like a school (or in this county -- a nursing home). Doctors, on the
other hand, are private businessmen. They are licensed, they can be
inspected, they are amenable to law suits. We want them to compete. We
do not want hospitals to duplicate expensive services, etc. So, why not
make all hospitals public, eliminate coporate enterprises like Humana,
integrate privately funded research with university facilities which would
remain in another category and let the doctors duke it out.
Doctors are young. They have energy. I have an assignment to write a piece
on "how to identify an incompetent doctor." It is a very easy piece to
write. I merely profile all the doctors I no longer go to.
Finally, it's my money and I pay the insurance. I'll do as I please. Does
this make me any more valuable than the retired coal miner whose company
shafted his pension fund and has to depend on Medicaid. That, in essence,
has been another implication throughout this discussion.
I think Dennis Shea and I are in agreement. Am I correct?
GMP at PSUVM
Gerald M. Phillips (Professor Emeritus)
Pennsylvania State University
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