[ExI] U.S. Medical Care

[Lee Corbin]

Samantha wrote in "The Big Takeover"

> Calling what has prevailed for quite some time in the US a "free market" 
> shows a singular misunderstanding of what a free market is.  This has 
> been at best "state capitalism" for quite a while.

Yes indeed. But there are still some corners where the market is
*relatively* free. Consider the difference between grocery stores
and the U.S. Post Office. Which has longer lines? Which would you
rather visit? Which one has a *real* incentive to try to get you
to come back?

I was extremely surprised to hear from a friend that at the Mayo
Clinic in Phoenix, the staff is trained to be very helpful,
thoughtful, considerate, and caring. It must be, I surmised,
that despite powerful medical regulation, some little flower
of free enterprise still exists there, at least for a while.

A century and a half ago the American Medical Association
began its quest for total control over American medicine.
The first really impressive results were the government
licensing of physicians and the AMA's own control over
the number of doctors.

It's been downhill ever since (once you begin to suppress
liberty, each succeeding step becomes easier). Now, the
hospitals are so over-regulated that they have to have
very large waiting rooms to take care of all the people
showing up.

Does this remind you more of a very large grocery store,
or of a very large U.S. Post Office? Does it remind you
more of a huge car lot or of the DMV (Department of Motor
Vehicles)?

Another friend had to go to the emergency room last month.
He had a frightful pain in his liver (so far as he could
self-diagnose). He had to wait three hours before anyone
would look at him. If he'd died, a small notice would have
appeared in the paper---or not---:

      "Local Man Dies of Treatable Medical Condition"
      Santa Clara, California. Mr. A. B. died suddenly
      Thursday night of a ______, which would have been
      treatable had he only been able to get to a hospital
      soon enough..."

Hospitals don't care if you ever come back or not. It's
all the same to them. They're completely focused on their
deals with the insurance companies, and with their lobbyists
in Washington and the state capitols, the latter constantly
working to create even more legislation favorable to hospitals,
and to stomping out any vestige of profit-sapping competition
that still exists.

My friend was then hospitalized for two days. Realizing,
I guess, that sound sleep is their number-one competitor,
a nurse came in at 4am to *weigh* him. (!) All night long,
in fact, he had to endure chatter and laughing in the
hallway from medical personnel, (who I guess find their
jobs rather boring).

What if my friend had staggered into the hallway and yelled
at them, "That does it! I'm never coming back to *this*
hospital again!". Embarrassed, the medical personnel
would turn their faces away and try to hide their nearly
uncontrollable laughter at this threat.

In an extremely interesting book, "My Stroke of Insight",
Jill Taylor, herself a brain scientist, described in
beautiful detail what it was like to lose most of her
left hemisphere, and the steps she had the fortitude
to take to re-learn how to see detail in the world.

She happens to now believe that her right hemisphere is
more in control of her life, and she believes that all
negativity originated in her left hemisphere, and now,
thanks to her stroke and her hard work, it has been tamed.

But even in her newfound non-critical appraisal of the
world, she cannot resist slamming the medical care she
received in the hospital:

     In the ER, Medical personnel swarmed about my
     gurney "Answer this, squeeze that, sign here"
     [and to a patient who is barely conscious, has
     had a severe stroke, and is almost incapacitated]
     and I thought, *How absurd! Can't you see I've
     got a problem here? What's the matter with you
     people?"

Now if we had liberty in the U.S., there would be many,
many competing hospitals eager for your business.
Managers would lie awake at night---as they do for
grocery stores---thinking of new ways to *not*
inconvenience or annoy patients. But we have such a
regulated system here in the U.S. that hospital personnel
and their managers (except, I guess, at the Mayo Clinic)
don't give a fuck what you like.

Later in the Neurological Intensive Care Unit,

     "One nurse was very attentive to my needs:...
     [But] a different nurse, who never made eye
     contact..., brought me a tray with milk and
     jello, but neglected to realize that my hands
     and fingers could not open the containers. I
     desperately wanted to consume something, but
     she was oblivious to my needs. She raised her
     voice when she spoke to me, not realizing
     that I wasn't deaf...

     I did a lot of sleeping that afternoon of the
     stroke---well---as much sleeping as one can do
     in a hospital...

     I awoke early the next morning to a medical
     student who came rushing in to take a medical
     history. I thought it curious that she had not
     been informed that I was stroke survivor who
     could not speak or understand language. I
     realized that morning that a hospital's number
     one responsibility should be protecting its
     patients' energy levels.

Oh, why? Exactly who has the incentive to do this?
Why, any human bureaucrat of course. They're humane
administrators who'd never allow such a thing, unlike
greedy private enterprise administrators who are only
concerned with making a buck and ruthlessly trying to
persuade you to choose their hospital should another
emergency arise. Oh, trying to get people to understand
is hopeless!

    On the morning of day three, I was moved out of
    the Neurology ICU and ended up sharing a room...
    The TV noise from her half of the room was a
    painful suction of my energy. I consider it
    totally counter-intuitive to my idea of what I
    found to be conducive to healing...

    Unfortunately, it is not common for stroke survivors
    to be permitted to sleep as much as they would like.
    [Nor, apparently, anyone else.]

Fortunately, she was able to make the decision to go
home and rest up before surgery. She considers that it
may have saved her life. In the coming weeks, she and
her mother worked hard each day for as long as Jill
could stand it to make her stronger, (often not more
than 15 or 20 minutes). When she was ready, she returned,
and thankfully the operation to remove the blood clot
about the size of a golf ball succeeded splendidly.


The horrors I've outlined above would occur with far
less frequency in a free market environment. We may
have the example of the Mayo Clinic for comparison.
And I'm sure that if you go to the private clinics in
Mexico or Asia, a lot of attention is paid towards
minimizing your suffering and inconvenience, giving
you enough rest, and maximizing your overall satisfaction.

Here you are not only mistreated by hospitals, they
have become exceedingly dangerous places to even be
in. Staph infection is now a real killer. Much
smaller hospitals, catering to discriminating
customers whose business was valued, would do much
better because over the years, here and there
successful practices would have a Darwinian superiority
and gradually drive to extinction poor practice.

So---in the ways it counts---we already have socialism
here in the U.S. Because of the AMA and the massive
government regulation, just how much worse will total
government control really be? I don't know, but I'm
afraid we're going to find out.

As Fred Moulton has cautioned many times, international
comparisons are very difficult to make. I want to know
by what *logic* things will improve here with even more
impersonal government supervision of hospitals.


If we had freedom here, I would go to a veternary
for almost all medical emergencies to get kind, thoughtful
care. Veternarian medicine has made great strides because
the competition is intense. As a mostly free service
industry, customer satisfaction is at the top of their list.

But the AMA long, long ago precluded that possibility.
It is now absolutely illegal for any vet, or anyone else,
to provide human medical care.

The same goes for cosmetic surgery. They've made
wonderful advances, and the procedures get cheaper
and cheaper, just as you would expect in a free,
competitive business environment. Not so, of course,
our impersonal regimented over-regulated present system.

But to the average person, all this is incomprehensible.
Government bureaucrats, not driven by the evil greedy
profit motive, are to be trusted far more than their
free market counterparts. And regulation by definition
is GOOD. Regulation is when the government keeps private
enterprise from doing bad things, so more is always
better.

The older I get, the more personally terrified of just
how deadly hospitals will become within just a few
short years, and just what possible options I have to
somehow, somewhere, get private care.

Lee