Happy Thanksgiving!

Regular posting will resume on Monday, December 1.

Herrick on Single-Payer Care

The November 24, 2008 Modesto Bee has printed the following OpEd by health care economist Devon Herrick:

Most Americans want freedom to make health care decisions

As a new Congress begins to look at health-care insurance options, some of the members are discussing proposals for a single-payer, universal health-care plan.

That's not the best solution. Senators and representatives would be much better off focusing on health-care solutions that effectively bring down health-care costs, expand access to quality care, and reward patients for shopping around.

Advocates of single-payer health plans want the U.S. government to be the only entity that pays for health care: With Uncle Sam picking up the tab, proponents predict health-care spending would be reduced, administrative burdens would be eliminated, and doctors would be free to practice as they wish.

Do they really believe that adding another major program to the federal government would actually eliminate administrative headaches and make it easier for doctors? We need only to look to our neighbors to the north, in Canada, for a clear view of what we could expect under a single-payer system.

The biggest problem is the wait -- for office visits, diagnostic tests, lab work, even surgeries.

There are only so many doctors and so much medical equipment in Canada. That means that most patients can't get the help they need when they need it. At any given time, nearly 750,000 Canadians are waiting for a medical procedure. According to a report by the Commonwealth Fund, 42 percent of Canadians with chronic illnesses said they had to wait more than two months to see a specialist.

Another major problem faced by those in a single-payer system is the health risk that is faced by participants.

A recent study by the Fraser Institute indicates that much of the health technology in Canada is aging and outdated. Such equipment has a higher risk of failing, may be less accurate, and may not provide the most up-to-date medical readings.

As consumers, we want is health care that is reasonably priced, of high quality and that is convenient -- without having to wait months on end for needed surgery.

Many of us have had experiences with limited access to health care — through HMOs. Such plans tried to control health costs by controlling which doctors patients could see, limiting the specialists that one can visit, and reducing the options that were available.

It didn't catch on because few Americans like limited health-care options. We want to make our own choices, based on what's best for our health and our wallet.

Instead of wasting time on a system that limits our choices, creates long waiting times and has the potential to jeopardize our health, the United States should opt for a system of innovation and choice.

The best reform would liberate doctors to meet patient needs in innovative ways, free patients to become smart shoppers, and allow a competitive medical marketplace to allocate resources, while raising quality and lowering cost in the process. Mandates should be avoided in favor of making more options available through consumer-driven health plans. Most such plans include the expansion of health savings accounts to encourage greater participation. Patients with health savings accounts are significantly more likely to talk to their doctor about treatment costs and options, track their health-care payouts and estimate future expenses.

So, would you rather make your own choices on medical care and cost options or delegate the quality, cost and timing of your care to the federal government?

Now is not the time to move ahead with proposals for single-payer, universal health care. Nor is next year or the year after that. Instead, Congress should act now to let American consumers, not federal bureaucrats, make their health-care decisions.

When we force medical providers to compete on price, we're all much better off.

Herrick is a senior fellow specializing in health-care economics at the free-market oriented National Center for Policy Analysis (www.ncpa.org).

Herrick's economic analysis is spot-on, and I wish more elected officials would listen to him. The serious economic problems associated with single-payer care are the predictable consequence of the fact that it violates individual rights, such as the rights of patients, providers, and insurers to contract freely in the marketplace for their mutual benefit.

Mandatory Insurance Article Now Free

Craig Biddle (publisher of the journal, The Objective Standard) has graciously agreed to make the full text of my article in the Fall 2008 issue on the dangers of mandatory health insurance available for free, to subscribers and non-subscribers alike.

The full article can now be found at:

"Mandatory Health Insurance: Wrong for Massachusetts, Wrong for America"

This issue is heating up much faster than I expected.

Senator Max Baucus, a powerful Democrat, has just proposed adopting the Massachusetts plan on a national scale:

"Healthcare reform gets backing in Congress"

Even more ominously, insurance companies have agreed to support this idea, saying that they'll accept new government regulations in exchange for the federal government requiring all citizens to purchase health insurance:

"Insurers make pitch for health coverage mandate"

President-elect Obama has pledged to make universal health care one of the highest priorities of his new administration.

If we don't want to go down this dangerous path, we'll have to speak out in opposition to this bad idea.

Hence, please feel free to link to this article and/or send it to friends, coworkers, elected officials, and anyone else who might make a difference. A few active minds in the right places could make more difference than you think. And it's your future health care at stake:

"Mandatory Health Insurance: Wrong for Massachusetts, Wrong for America"

Sooner State Says "Later" to Mandatory Insurance

The November 21, 2008 Oklahoman reported that Oklahoma state insurance commissioner Kim Holland wanted to use the power of government to force citizens to purchase health insurance, but she recognized that it might be difficult to pass a Massachusetts-style law. So she proposed an alternate method of mandating health insurance:

Barring a law requiring the purchase of health insurance, which Holland concedes would be a political long shot, "inducements" that penalize those who fail to insure themselves would help, she said.

Among the possible inducements Holland proposed was forfeiture of football season tickets to University of Oklahoma or Oklahoma State University games, forfeiture of lottery or gaming winnings, loss of state income tax deductions or licenses to drive, hunt or fish.

"None of those are very pleasant, but there needs to be a consequence," Holland said.

Oklahomans were justifiably outraged at the possibility of forced to give up their football tickets, and the let her know. As the November 22, 2008 Oklahoman reported, she quickly had to backpedal, saying she was just kidding:

Holland said the idea of a football ticket takeaway is impractical, unenforceable, and wasn't meant to be taken seriously.

"It was one small part of a larger discussion, and it was generally in jest," Holland said of the ticket takeaway concept.

I'm glad that residents of the Sooner state were willing to stand up for their rights, when their football tickets were threatened.

I hope the rest of the country responds as strongly when Senator Max Baucus tries to impose the Massachusetts plan on the entire United States.

(Via Morality War.)

Insurers Asking To Be Socialized

Brian Schwartz has alerted us to the following story in the November 19, 2008 Denver Post:

Insurers make pitch for health coverage mandate

The health insurance industry said Wednesday it will support a national health care overhaul that requires them to accept all customers, regardless of pre-existing medical conditions—but in return it wants lawmakers to mandate that everyone buy coverage.

Of course, these companies would stand to make money in the short term if everyone were required to buy their policies. But once the costs leap out of control, the government will start imposing rationing, clamping down on payments to insurers as well as services covered.

As Grace-Marie Turner of the Galen Institute predicts, this will then destroy private insurance and leave us with no alternative except a "single-payer" (i.e., government-run) medical system.

In his essay "Health Care is Not a Right", Dr. Leonard Peikoff uses the following analogy of the haircut to illustrate this point:

Take the simplest case: you are born with a moral right to hair care, let us say, provided by a loving government free of charge to all who want or need it. What would happen under such a moral theory?

Haircuts are free, like the air we breathe, so some people show up every day for an expensive new styling, the government pays out more and more, barbers revel in their huge new incomes, and the profession starts to grow ravenously, bald men start to come in droves for free hair implantations, a school of fancy, specialized eyebrow pluckers develops -- it's all free, the government pays. The dishonest barbers are having a field day, of course -- but so are the honest ones; they are working and spending like mad, trying to give every customer his heart's desire, which is a millionaire's worth of special hair care and services -- the government starts to scream, the budget is out of control.

Suddenly directives erupt: we must limit the number of barbers, we must limit the time spent on haircuts, we must limit the permissible type of hair styles; bureaucrats begin to split hairs about how many hairs a barber should be allowed to split.

A new computerized office of records filled with inspectors and red tape shoots up; some barbers, it seems, are still getting too rich, they must be getting more than their fair share of the national hair, so barbers have to start applying for Certificates of Need in order to buy razors, while peer review boards are established to assess every stylist's work, both the dishonest and the overly honest alike, to make sure that no one is too bad or too good or too busy or too unbusy. Etc.

In the end, there are lines of wretched customers waiting for their chance to be routinely scalped by bored, hog-tied haircutters some of whom remember dreamily the old days when somehow everything was so much better.

Do you think the situation would be improved by having hair-care cooperatives organized by the government? -- having them engage in managed competition, managed by the government, in order to buy haircut insurance from companies controlled by the government?

If this is what would happen under government-managed hair care, what else can possibly happen -- it is already starting to happen -- under the idea of health care as a right?

Whether the insurers realize it or not, they're committing slow suicide, and threatening to take the rest of us down with them.

Whether we let them is up to us...

Which Obama Will We Get On Health Care?

David Catron explains why President Obama will inevitably be pushed towards proposing single-payer health care.

Kennedy Jumps In

The November 18, 2008 Washington Post reports that Senator Ted Kennedy will be proposing his own form of "universal health care" soon.

The Wall Street Journal also notes that some observers expect that the current financial crisis "will be a big barrier" to any such plans -- a slender silver lining to the economic mess.

And this may be a good time to also revisit Dr. Richard Parker's essay, "Ted Kennedy vs. Universal Healthcare: A Double Irony".

Reverse Capitalism in Massachusetts

Massachusetts government regulators will impose tough new restrictions on hospitals attempting to provide build more outpatient clinics to compete with existing facilities. The claim is that these new centers will drive up costs by "duplicating services". Hence, government restriction of patient choice is essential in order to keep costs down for their "universal health care" system.

I don't have a PhD in economics. But I notice that prices keep going down down whenever there are multiple restaurants or grocery stores in the same area engaging in this sort of "wasteful duplication". And customer service improves.

Perhaps there's a word for this sort of government restriction of vital services to control costs in the name of "fairness" that begins with an "R" and ends with "ationing". But I'm not an economist, so I'm not sure what it might be...

(Via Jared S.)

More Massachusetts Madness For Montana Max

Senator Max Baucus (D-Montana) will propose a "universal health care" plan which is basically a nation-wide version of the failed Massachusetts plan.

The Baucus plan does include an individual insurance mandate (unlike the Obama plan, which does not, although President-elect Obama has stated that, "he could support a mandate if the system proves impossible without one".)

In Massachusetts, the approach of individual mandates, employer mandates, benefit mandates, a state-run "insurance exchange", and state-subsidies has merely led to skyrocketing costs and long waiting lists. Individuals, insurers, and providers are prohibited from negotiating in the free market to their mutual benefit, but are instead forced to act against their own rational judgment and instead follow the state's requirements for health care and health financing. The bad economic consequences are a predictable outcome of this violation of the fundamental right to contract.

Adopting the Massachusetts plan at the national level would only multiply these problems 50-fold.

One definition of madness is, "Trying the same thing over and over again, but expecting different results". If that's the case, perhaps we should refer to this as the "Mad Max" plan...

Colorado Hospital Association and Universal Coverage

The American Hospital Association (AHA) will be pursuing "universal health care" in 2009, and according to my sources the Colorado Hospital Association (CHA) is reportedly in agreement with this agenda.

One of the basic principles espoused by the AHA is "Health Coverage For All, Paid For By All" -- a very collectivist slogan reminiscent of the Marxist dictum, "To each according to his need, from each according to his ability."

To accomplish this goal, the AHA advocates the following:

Every individual must have and contribute to the cost of health care coverage

Every employer must take responsibility for providing health care coverage for their employees and contribute to the cost

Every insurer must guarantee access to coverage that is affordable, gives consumers the protection they need, and delivers value

Governments must maintain their current responsibility forcoverage for seniors, disabled and certain low income people

Collective financing will be needed

These goals will dovetail nicely with what we know about President-elect Obama's health care plan, which includes the following:

Mandated insurance for children

State subsidies for those families who don't qualify for other government programs (such as Medicaid or SCHIP)

Mandates on employers to provide a "meaningful share" of employees health insurance premiums (or else pay a special fee to the government for the government plan)

Expansion of SCHIP and Medicaid government programs, "for the children"

Creating a National Health Insurance Exchange to serve as a clearinghouse where people could purchase government-approved plans

New restrictions on insurers so that they could not exclude applicants based on pre-existing conditions

The Obama plan has many similarities to the ill-fated Massachusetts plan, except for not imposing an individual insurance mandate on everyone. Massaschusetts imposes this mandate on all adults, whereas Obama's plan would only impose it on children. For more on the problems in Massachusetts, see some of our earlier posts.

We'll be hearing much more about both the AHA proposals and the Obama plan in the near future. For now, I just wanted to alert FIRM readers that these issues may be arising at both the state and national levels here in Colorado.

Stay tuned!...

Montgomery on Moore's "Sicko"

Colorado blogger Jeff Montgomery has recently written a detailed review of Michael Moore's 2007 movie, "Sicko". Given that "universal health care" has taken on new life in the aftermath of election 2008, I thought it would be good to revisit this topic.

He has graciously given me permission to repost his review here in its entirety:

Comments On Moore's Sicko

For a long time I was not going to watch this movie. I held out for a year, after all. However, I know various people in health care, so I agreed to watch it so I could discuss it with them.

Silly me.

The good news is, especially if you are an Objectivist or other type of classical liberal or advocate of individualism, and you haven't seen it already then you don't need to. Save an hour and 58 minutes of your life for something more valuable. It was a chore.

Before I criticize, I have to say that in a very limited context, Moore succeeded on an emotional level. The limited context is that of evoking sympathy for the people in the film and their situation, and in picking attractive aspects of other countries' medical systems to portray. Who cannot feel sympathy for the medical cases portrayed in the film? And taken out of context, it certainly is a pleasant thought to not have to worry about paying for medical care, isn't it? I'm sure other countries have nice hospitals and nice doctors too. Certain other aspects of the quality of life in France, Canada and Great Britain are also attractive: the long vacations, the good schools... the baked goods. After one such sequence of happy people, Moore cuts back to a scene in the U.S. where a confused hospital patient is intentionally dropped off by an ambulance on the street near a city mission. Ouch.

However, it is precisely that limited context that prevents Sicko from succeeding as documentary or political commentary. You can't comment on a society that you don't investigate. Moore is content to show scenes from everyday life, but never delves into the full context of history or the causal workings of government and the economy. He wishes to suggest that the horror stories he shows are the result of "free market" medicine, but he doesn't investigate causes, so he can't do that. Anecdotal evidence is only as good as the theory it supports, and in the case of Sicko, there is no theory.

Well, there is the usual half-hearted stab at greed, but that falls flat like it always does. He doesn't investigate the nature and extent of government involvement in medicine, or compare countries by that standard, and he doesn't touch on economic theory or even the simplest moral implications of the universal health coverage he pines for.

To Moore, society is a metaphysically divided realm, with helpless citizens on the inside, and the incomprehensible machinations of politics and markets on the outside (the noumenal world of politics?). According to the film, what should matter to the average citizen is what's right in front of us, and nothing more; it is a world without causality, where medical care administered through a slot in a prison door would be identical to medical care in a hospital, because either way it magically shows up. The same inattention to causality regarding the source of care also prevents Moore from seeing the causal relations in the wider phenomenon of health care in society in general. Therefore it fails dismally as real political commentary.

Morally speaking, if your world is made of little more than what appears in front of you, you must advocate altruism, the idea that human beings live to serve one another. That is the only way to keep goods and services magically appearing in front of you without considering where they came from; you must harness others to do it for you. It is not something Moore explicitly explores, it is simply assumed to be true. There is not even one second of reflection in the entire film about whether it is right to use others for such purposes. That is a particularly vicious omission, because it means you, the viewer, have been tried and sentenced to serve, with absolutely no chance to speak in the matter. It is assumed you are to be a slave.

There is one more issue I'd like to mention, and that is the general portrayal of America's health care system. The thesis of the film is that in our country, many are left without important medical care, lives are being ruined, lives are being lost, and we have to just do whatever will fix it, period. I don't doubt that plenty of unpleasant things happen. However, the reason for it is simple: we are neither free enough to provide a wide range of affordable, quality medical services, nor socialist enough to provide care for anyone regardless of their condition or ability to pay. The patients Moore highlights are the ones who drop through that gap in coverage.

However, the solution is not to fully socialize medicine, and Moore has not demonstrated anything of the kind because his narrow focus has prevented such analysis. The solution is to undo the controls on the allegedly free medical and insurance industries so they can provide the best products, just like any industry. As always, the solution is thought, and the freedom to act on it.

Bailing Out Maine

Maine governor John Baldacci will ask President-elect Obama to bail out the state's failing Dirigo "universal health care" system with federal Medicaid money.

If universal care is adopted at the national level, who will bail out the US?

(Via State House Call.)

Who Broke Health Care?

Richard Ralston, executive director of Americans for Free Choice in Medicine asks this question in his latest OpEd:

Who Broke Health Care?
by Richard E. Ralston

Many politicians now tell us that health care in America is "broken."

The best initial response to that is to ask yourself whether you think that your own health care is broken. And if it is, do you want to turn your decisions about your own health over to politicians who claim they can fix health insurance? Or, if you are generally satisfied with your health care, do you want politicians to take your current care away and replace it with a uniform government system? That is what they want to do, whether you think your own health care is broken or not.

More generally, we all need to ask why politicians assert that American health care is broken, and what agenda does it serve. We should ask, if health care is broken, who broke it and how did they break it?

Health care was much more affordable in the 1960s. The government paid for less than 10 percent of all health care. Then the federal government created Medicare and Medicaid and wrote 130,000 pages of Medicare regulations. Now the government pays for 50 percent of all health care.

Has that fixed health care, or broken it?

In the same period, state regulation of medical insurance rapidly expanded, adding many coverage mandates that each policy must comply with. In some states you have to buy coverage for electric shock therapy, or in vitro fertilization, or acupuncture, or chiropractic, or hairpieces, or a social worker, or a marriage counselor, or a long list of other things, whether you want such coverage or not. And new mandates are added all the time, driving up insurance costs every year. Moreover, you are not allowed to buy better priced insurance from a competing provider in another state.

Has that fixed health care, or broken it?

The government could easily make reforms that would reduce the cost of insurance without any additional spending: Basic policies without mandates. Tax deductible premiums. Competition between insurance companies across state lines.

Why is it, then, that the more government controls health care in order to fix it, the more expensive health care invariably becomes?

Politicians who broke health care and now complain that it is broken do not want people to be able to afford reasonable insurance. They see that as an obstacle in their path to eliminate all private insurance. They are not in favor of fixing anything, but of making us all dependent on the favor of politicians for our health and well being.

State legislators and members of Congress have destroyed objective law and created a litigation system that is designed not to justly compensate those who have been harmed by medical mistakes, but to create a gigantic and perpetual financial bonanza for a small number of trial lawyers. Liability insurance premiums have exploded and increased the cost of all health care for everyone -- as has the "defensive" medicine of unnecessary tests and procedures that physicians have had to adopt to protect themselves from such legal extortion.

Has that fixed health care, or broken it?

When confronted with claims that health care is broken from the politicians who broke it, the last thing we should do is give them additional powers to break it further. Instead, we need to direct them to reverse the damage they have done, to stop forbidding the options that would make insurance affordable and to start leaving our health care alone.

Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine

Obama's Plan to End Private Health Insurance

Grace-Marie Turner of the Galen Institute makes the case that the Obama plan will end private health insurance as we know it. Here are excerpts from her article:

Obama's Plan to End Private Health Insurance

...ObamaCare would create a new National Health Insurance Exchange (NHIE), which would function as a 50-state clearinghouse in which people could connect with insurers. Through the NHIE, participants would be able to purchase private coverage or buy into a new federal insurance program.

On the surface, this arrangement seems fair. But Obama would also stipulate what type of coverage the private plans had to offer. In other words, the federal government would heavily regulate the cost and content of private health insurance, albeit indirectly.

..."Guaranteed-issue" statutes require insurers to accept all applicants regardless of their health status, and "community-rating" requirements prohibit insurers from pricing their premiums according to expected risk. Both regulations make health insurance significantly more expensive.

If people know they can get insurance at a fixed price regardless of their health status, they have an incentive to buy the policy only after they've gotten sick and need medical care. It's no coincidence that the six states with guaranteed-issue laws have the six highest average premium prices. Of those six states, the three that also have community-rating laws—Massachusetts, New York, and New Jersey—have average annual family premiums that are roughly double the national average.

Nevertheless, Obama supports nationwide guaranteed-issue and community-rating laws. He has pledged that "no American will be turned away from any insurance plan because of illness or pre-existing conditions." He might as well pledge to double everyone's insurance rates.

Under ObamaCare, public insurance programs and their private competitors would likely be subject to the same rules regarding benefits and underwriting. But public programs would be supported by a constant stream of tax dollars. They could undercut premiums and offer generous benefits that would bankrupt private insurers—and then cover the losses by drawing on taxpayer subsidies. In other words, the federal government would have the ability to drive up the cost of private health insurance while keeping its own insurance program artificially cheap.

If the Obama plan were implemented, Americans would naturally flock to the new public insurance program. Advocates of government-run healthcare would claim "victory" and demand an expansion of it. Slowly but surely, private insurers would be supplanted by the public program.

Once private insurers are driven out of the market by unfair competition from the government plan, Americans will then be left with a defacto single-payer system -- something President-elect Obama has already said would be his first choice for a health care system.

Americans may wish to recall either the metaphor of the frog in the boiling water or the similar parable of "catching the wild pigs":

[In a classroom discussion a student asks his professor,] 'Do you know how to catch wild pigs?' The professor thought it was a joke and asked for the punch line. The young man said this was no joke. 'You catch wild pigs by finding a suitable place in the woods and putting corn on the ground. The pigs find it and begin to come every day to eat the free corn. When they are used to coming every day, you put a fence down one side of the place where they are used to coming. When they get used to the fence, they begin to eat the corn again and you put up another side of the fence. They get used to that and start to eat again.

You continue until you have all four sides of the fence up with a gate in the last side. The pigs, who are used to the free corn, start to come through the gate to eat; you slam the gate on them and catch the whole herd. Suddenly the wild pigs have lost their freedom. They run around and around inside the fence, but they are caught.

Soon they go back to eating the free corn. They are so used to it that they have forgotten how to forage in the woods for themselves, so they accept their captivity.

The young man then told the professor that is exactly what he sees happening to America. The government keeps pushing us toward socialism and keeps spreading the free corn out in the form of programs such as supplemental income, tax credit for unearned income, tobacco subsidies, dairy subsidies, payments not to plant crops (CRP), welfare, medicine, drugs, etc. While we continually lose our freedoms -- just a little at a time.

Top 10 Myths of Health Care

Patient Power has alerted us to Sally Pipes' new book on the top 10 myths of American health care:

Myth One: Government Health Care Is More Efficient
Myth Two: We're Spending Too Much on Health Care
Myth Three: Forty-Six Million Americans Can't Get Health Care
Myth Four: High Drug Prices Drive Up Health Care Costs
Myth Five: Importing Drugs Would Reduce Health Care Costs
Myth Six: Universal Coverage Can Be Achieved by Forcing Everyone to Buy Insurance
Myth Seven: Government Prevention Programs Reduce Health Care Costs
Myth Eight: We Need More Government to Insure Poor Americans
Myth Nine: Health Information Technology Is a Silver Bullet for Reducing Costs
Myth Ten: Government-Run Health Care Systems in Other Countries are Better and Cheaper than America's
Solutions: Markets, Consumer Choice, and Innovation

The full PDF version of her book is available here for free!

A Few Updates

It looks like Arizona's Proposition 101 (Freedom of Choice in Health Care) just barely failed, 49.9% to 50.1%. (Via Patient Power.)

The UK may start allowing patients to use their own money to purchase small amounts of extra private medical care, without automatically forfeiting their government NHS medical care. (Via RS.)

Canadian patients are facing waits of up to 5 years for government-run sleep apnea testing. Canadian medical guidelines call for a maximum of two to six months for this disorder. (Via DS.)

Mayfield on End Of Life Decisions

Dr. Douglas Mayfield, an anesthesiologist, has submitted the following guest blog post on end-of-life decision making. If you wish for your individual rights be respected by the legal system, you may find his advice helpful:

I am an anesthesiologist. I give anesthetics so that patients will be unaware during painful procedures. Recently, I encountered the following cases.

A 102 year old woman who is comatose and requires a machine to breathe for her. Her heart, kidneys, and liver are failing. Her son, 77, demands that we ‘do everything’ to keep his mother alive.

Because her heart rate is less than 40, a cardiologist will put in a pacemaker to make her heart to beat faster. I will give drugs to combat any deterioration in her vital signs.

A 94 year old man who requires care 24/7 and cannot eat or speak. If you simply step to his bed side, he cowers and screams in fear and will not stop until you leave.

Because a tube to his stomach (bypassing chewing and swallowing) is plugged, a gastroenterologist will replace it. His family has given consent. I will give small doses of medication to block his awareness of the procedure.

Whatever your beliefs, you know that your life will end. As human beings living and enjoying life, we don’t dwell on death, but it will come. When it does, do you want to be in a situation like those above?

Once I can no longer think, I don’t wish to be kept alive. What your beliefs might be, I don’t know, but I suggest you think about it and take steps to give your decisions the force of law.

Don’t force your loved ones, who care about you, to decide what will happen when your health deteriorates.

What steps do I suggest you take?

1) Create a living will. Leave copies with a family member or a legal advisor, as well in a safe place of your own.

2) Purchase a long term care policy. For mine, I pay $1800 per year. It can yield $4000 per month if I am unable to care for myself. The rate is low because I cannot receive benefits for several years and because I bought the policy years ago. If you want more information, you might discuss long term care with a medical professional whom you trust.

Regarding your living will, be specific. Under what circumstances do you not want to be kept alive? Perhaps you wish no extraordinary steps to be taken. But whatever you believe, make your own decision now.

Why do I mention a long term care policy? Because the cost of caring for the patients above, and for thousands, perhaps millions, of people like them all across this country, is paid by Medicare or other government programs.

I encounter such cases often and I don’t want the end of my life to be paid for by other people’s hard earned money. If you don’t want this, or something similar, to happen to you, take reasonable steps now to make sure that it does not.

If you have any comments or question, you can reach Dr. Mayfield directly at: mayfwriter@aol.com

Happy Election Day!

In honor of election day, there will be no blog post today.



The following two quotes pretty much summarize my views on this American institution.

The first is from Sydney J. Harris:

"Democracy is the only system that persists in asking the powers that be whether they are the powers that ought to be."

The second quote is commonly (but erroneously) attributed to Benjamin Franklin:

"Democracy is two wolves and a lamb voting on what to have for lunch."

WSJ on AZ "Freedom of Choice in Health Care"

The November 1, 2008 issue of the Wall Street Journal makes some interesting observations about the proposed Arizona ballot initiative:

Who could be against an initiative that protects the right of patients to choose and pay for a doctor or a health plan? The answer is proponents of a health-care system run by the government. For them, enshrining into law protections for private health plans is anathema. Believe it or not, the Phoenix Chamber of Commerce also opposes the initiative. Its big health-insurance members want to protect their interests as contractors to the state's Medicaid plan.

Democratic Governor Janet Napolitano argues that Proposition 101 would limit future health-care reform options. Eric Novack, a physician and the chairman of Proposition 101, responds, "The only option that our initiative rules out is a mandatory single-payer system." Single-payer health-care systems, as in Canada, make it illegal in most cases for people to go outside the government's system and contract for their own medical services. Arizona's proposition forbids those kinds of restrictions.

...Proposition 101 goes to the heart of the national health-care debate. Universal coverage plans, regulated by government, nearly always try to restrain costs by restricting the choices individual can make. This assumes a uniformity in the real-world of patients or the practice of medicine that simply doesn't exist, especially amid rapid developments in medical science. Who should decide -- the patient or a government treatment schedule -- whether a cancer sufferer should be able to try an experimental therapy or under what circumstances a senior citizen gets a hip replacement?

Allowing patients to choose their own medical treatment, get third or fourth opinions, or seek out experimental medicines saves lives. Randy Kendrick, an early supporter of the initiative, says her ability to look around for treatments among doctors after a serious leg injury saved her from what her original physicians said would be a life confined in a wheelchair. Courageous patients and innovative medical clinicians find each other constantly this way. The patient-clinician interface is one reason the U.S. remains a locus of medical progress. Ensuring this progress continues depends on maximizing patient choices. A publicly bureaucratized system will slow it.

That is indeed the fundamental issue: Is your life your own, or are you allowed to seek your own self-interest only by permission of the state? Arizonans will get to decide.