Note: I would be very glad to have experienced health-care workers jump into comments with any additions, corrections (however savage), reality checks, bright ideas, personal insights, or other forms of enlightenment.
One thing about the hardest systems to route around: Being HARD, lacking flexibility, they develop a lot of cracks.
Take a look at any heavily institutionalized or subsidized medical system. I’ll use the U.S. system because the U.S. is home-not-so-sweet-home. But despite the claims that various socialized systems (e.g. Canada’s and the UK’s) are inherently better, many of the same or equally awful drawbacks apply to them.
We glance at our medical system and we see: institutional and bureaucratic coldness; incomprehensible billing; insane costs; opacity; ghastly amounts of malpractice; treatments that seem healthier for doctors’ pockets than for us; rushed and impersonal appointments; ignorance of nutrition; emphasis on sickness rather than maintaining health; doctors who sneer at us if we want a voice in managing our own care; data gathering; in short a system where the patient’s needs seem to come last. And now this already broken system has gone to a centralized command-and-control model (run by bureaucrats who haven’t tended patients in decades, if ever) and is either trying to force experimental vaccines on the unwilling, refuse services to the unvaccinated, or get rid of up to 1/3 of its own workforce in the cause of a global moral panic.
Wow. That’s bad. And it’s all true. To be fair, we also have to credit the system for huge advances in pharmacology, medical technology, surgical techniques, and much more. No doubt about it, modern medicine has produced lifesaving and life-enhancing wonders. But we wonder why such astounding advances have to come at such a human cost.
That negative description above is only what the medical system looks like to our jaundiced eyes. It’s really just one aspect of a more vast and varied realm.
Come closer. See the cracks in what looks like an immovable monolith.
How many of you, without setting foot in a hospital or clinic, without seeing an M.D. or a nurse practitioner: take herbal supplements (in an industry survey, 77% report they do, and even the National Center for Health Statistics says 57.6% do); do bodywork; have hypnosis sessions; use biofeedback; practice tai chi; get chiropractic care; see an accupuncturist; explore traditional Chinese medicine; follow a diet customized to your specific health needs; utilize a float tank; use a TENS stimulator; get massages; perform homegrown physical therapy routines; meditate; or conduct any other type of body or body-mind-spirit practice for your own health and well-being?
A lot of you. In growing numbers.
These are cracks in the system. Ask yourself: how do we widen them to let in more freedom, more choice, greater possibilities of new discoveries in treatment and health maintenance?
How many of you (before COVID travel restrictions, alas) either took a trip for medical tourism or considered doing so – that is, going to Mexico or Panama or India or Thailand or elsewhere to have medical care from skilled (and frequently U.S.-trained) doctors at a fraction of the price for the same procedures here?
Cracks in the system. How do we widen them?
How many of you have ever ordered prescription drugs – with our without a prescription – from offshore pharmacies?
Cracks in the system. How do we widen them?
Ever arranged your own blood draw and customized testing to monitor your own health at one of the growing number of independent labs?
Cracks in the system. How do we widen them?
How many of you have ever received some type of ad hoc medical service from a friend who is a nurse, a veterinarian, a retired doctor, or a medical student? How many of you have bartered for such services or gotten them free out of friendship or for past favors granted?
Cracks in the system. How do we widen them?
Ever hear about anybody who got a 3D-printed prosthetic for a few hundred dollars or for free rather than having to have one prescribed and pay phenomenal big bucks for it?
Cracks in the system. How do we widen them?
Already, just going by what we already have available to us — legally, quasi-legally, or illegally – we personally experience a health care system that is far less monolithic than we imagine.
“Yes,” someone objects, “But your accupuncturist can’t remove your spleen and your neighborhood nurse can’t irradiate your tumor and an ambulance shouldn’t rush you from the site of a car accident to your friendly local veterinarian.”
And that’s true, too. There will always be a need for seriously interventionary care and emergency care, and and bless it, that happens to be what our present medical system is actually very good at. Now, if it were tamed, if it were recognized as merely one useful, but not all-encompassing, part of a varied and complementary health care realm, how much the better. If the medical system as a whole allowed for more individual freedom and choice — with less cosmically terrible and unpredictable costs — well, we’d really have something.
And in realizing that we need to route around a system that is so clearly broken (even as it remains tremendously useful), we freedomistas have a chance to help create that more varied and more customer-friendly realm.
Meanwhile, we have the ability to diminish the old system’s importance (and even perhaps some of its arrogance) by taking much of our everyday health management and a considerable bit of our treatment of common problems outside of it.
Besides, the biggest cracks in the system are still ahead of us.
Not very far ahead of us, it appears.
What’s going to happen when already burnt-out doctors and nurses drop out (or get kicked out) even faster when forced to take experimental treatments as a condition of working in large facilities?
We’re likely to see more concierge practices (patient paid and patient centered), more small (even part-time) practices going against the trend of large corporations centralizing everything, more care offered at market prices by practitioners avoiding the entanglements of insurance. Watch for potentially more creative developments, more blurring of lines between what used to be called “alternative” medicine and “conventional” medicine. (Listen for the terms functional, integrative, complementary, or holistic.)
We’ll likely see more surgical centers independent of conventional hospitals. More doc-in-the-boxes with more sophisticated diagnostic and treatment equipment. More MRIs and CT scans offered for a few hundred dollars, prices openly posted, rather than unknown thousands.
And all this simply with available resources – and lots of doctors, nurses, nurse practitioners, physicians assistants and other professionals dropping or being kicked out, then dropping in to make it all happen.
Meanwhile, what are some of our most urgent needs as we consider how to create alternative health systems?
- A free market that makes most health care affordable to people of ordinary means
- Transparency and competition in medical pricing
- Practitioners that are both competent and willing to work with us on maintenance of our own bodies
- Market-based, market-choice insurance for major medical needs
Some of this – the market-based insurance for instance – we can’t easily get without moving the government/insurance industry monolith, and that we can’t directly do. But much else will be provided by people who’ve dropped out of the system but, not wanting to starve or retire, will seek to create and build alternatives.
Some developments may be revolutionary; most will be evolutionary. But even those may go in unexpected directions as medical professionals and patients meet each other on more personal terms.
The existing system doesn’t need to be toppled – yet. And probably never.
It just needs to be made less central – and less centralized. Less all-consuming of everyone’s resources. Less controlled by government and other institutional entities. Less viewed as THE only option.
Are there risks? Heavens, yes!
Some risks fall mainly on the patients, who might have their wallets and their trust pillaged by either untested treatments or outright cons. (But then, the wallet pillaging and faulty treatments are already realities.)
More risks fall to the pioneering practitioners than to the rest of us. Those who let their government licenses lapse or who offer services a little too unconventional or who advertise in unapproved ways or who otherwise step on regulatory toes could face penalties from civil through criminal. They could have their reputations dragged through the mud, their practices raided and shut down, their patient records stolen, their finances pillaged, their credentials pulled – you name it. Central authorities do not like those who step out of their control.
I believe we’re coming up on a time when much more will slip out of governmental control. In the long run – good. In the short run, there’s nothing nastier than a government terrified of losing its grip.
But the good and great news is that even in a seemingly monolithic system like the government-insurance-corporate-medical alliance, there are already thousands of cracks. And the more rigid and entrenched the system becomes, the more opportunities we have for change.
Finally, a note about my personal views – and the views of a couple other smart people who’ve had more contact with the health-care professions than I.
I’ve always tended to consider “alternative medicine” in general as a whole bunch of woo woo. I’ve turned to it only for specific purposes that conventional medicine simply isn’t very good at. I’m certainly not endorsing any particular alternative, or the entire concept of alternative medicine, over standard medicine. I merely look forward to the day when medical minds will be more open to protecting health as well as treating sickness, to considering that human beings are mind and spirit, as well as body, to using science as an effective tool while realizing it’s not the only tool for healing. AND when far, far less of this will be controlled by central authorities in either government or industry.
In researching this blog, I ran into a thoughtful article by Paul Ingraham, a former massage therapist who now looks upon alternative medicine with a jaundiced eye. But he still envisions what a productive partnership between conventional and alternative medicine might have been. His skeptic’s voice is well worth hearing.
On the other hand, I know an extremely rational person, a scientist, a multiple degree holder from one of the country’s top STEM universities, who knows very well how to spot a con or a fraud or simply a faulty dataset when he sees one. But when he got a slow-growing cancer 15 years ago, he didn’t hand himself over to experts. He researched and chose what worked for him, conventional and otherwise. He’s now in the best health of his life despite still having cancer. Along his way he tells me that, though he kept his commitment to the scientific method and to sound, data-based decisions, he also took leaps of faith, and saw what he can describe only as miracles among other cancer explorers he networked with.
So I advocate nothing – except us all having the freedom to seek (or develop) the treatments and the methods we want on the terms we find acceptable.
Claire points out many existing and developing cracks in the system. As these things get increasingly normalized, more people will consider them as viable alternatives to the conventional status quo. The more people who can see and make use of these cracks, the better! The concept of normalization of alternatives is key, here.
A couple of points, and a question:
1) The whole system seems now to be completely run by CEOs, for their own benefit, based on information they get from actuaries and accountants. Like government, this is an example of the absolutely wrong people making their way to the top and then turning a system on it’s head for their own benefit.
2) The CEOs have managed to get government to largely enforce their profit-driven vision by legislation. This is a conspiracy / natural tendency of like-minded people (see above) to form oligarchies.
3) The “insurance via employer” concept is disastrous in many ways, but primarily in that there is the perception on the part of the employees that they are not paying for the insurance. Of course, they are paying, through either visible or invisible paycheck deductions, but this faulty perception can only be resolved through education, which is a different (but related) matter. In any case, whenever the entity paying is not the entity using (or there is that perception), there is a fundamental free market failure. The normal supply / cost / demand relationships no longer apply. Example: If everyone is paying for their own drinks, some order beer, some order vodka, some order top shelf Scotch, and some do not drink at all. If someone else is buying, everyone orders top shelf Scotch, or maybe champagne.
Now the question: How did the “insurance via employer” concept get started?
“How did the “insurance via employer” concept get started?”
Simple. It began as a response to wage and price controls – wages couldn’t be increased, so benefits were added to retain and attract valued employees.
It was a bad idea in retrospect, occasioned by you guessed it – government – addressing one problem of its own making (inflation) by creating more problems.
Thanks for the effort you are putting into this whole series.
A couple months ago, we cancelled our health insurance, being self employed it was over 2 grand per month, got into a Health Share for about 250 per month. For me, it was one way to take my money away from the sick care beast.
We are in our sixties, good health, no meds, made sense to us.
Insurance is another “middleman” which, like student loans, only encouraged price inflation.
The Oklahoma Surgery Center, mentioned in a comment to iia, is a cash business, charging about 20% of retail for surgical services. Odd how 20% is about the same as the copay in most policies… The remaining 80% is waste and skim.
Before insurance, who BTW has to take in more than they pay, prices were reasonable and a hospital stay was not grounds for bankruptcy. Oklahoma does not require the “certificate of need” process and thus allows for more free open-market competition. A good model…https://surgerycenterok.com/
The link to the Paul Ingraham article isn’t working.
Speaking as one who has benefitted greatly from being treated by one of the best surgeons and surgical teams in the world, in one of the best hospitals, but who has also suffered from several incidences of serious malpractice…I have to ask…If there are all these astounding advances, why is life expectancy in the US declining? Nassim Taleb has pointed out that almost all of the increase in life expectancy in the last 50 years has come from the decline in smoking rates, not medicine…
On the health maintenanceI’ve gotten far more benefit from taking vitamins and minerals like Zinc and exercising a lot than from doctors, and alternative health care has made huge advances in our area of AZ…It’s also cheap..Incidentally, my great surgeon is the first doctor ever to suggest vitamins and supplements …..fortunately I was taking them already..
If “Ike” was retiring as one of the best surgeons of today methinks he might be warning us of the Medical Industrial Complex.
Of course, there must still be good doctors and hospitals but IMHO way too many are in it for the money first and the calling of medicine last.
Go to an ER in any major hospital and see what that is like. Surely not something you would want to trust your life too if you had another choice.
Saving mankind is one thing but saving yourself may just be another. With what we are witnessing in the collapsing of most of our major metropolises, I believe we are also witnessing with the major hospitals and medical care corporation. Their drive for more profit is also providing more and more distance between them and the care of their patients.
So as Claire has outlined alternates will be a needed choice of the future but not only because of the possible benefits but also because of the collapse of the current Medical Industrial Complex.
We could say well, government will fill the need and even might that could be true there is the problem that the current governmental system is collapsing too.
So, my opinion is in the short term it isn’t as much about saving mankind as it is ourselves. Like in the collapsing metropolises where we need to flee before we are a victim of their avalanches, we also need to flee the current collapsing Medical Industrial Complex. Today we have the choice of leaving however tomorrow it will not be a choice IMHO it will be our only way of surviving. As I told a friend yesterday, your city is collapsing, get out now while you can still rent a U-Haul.
Move to the rural areas, small towns, find a good doctor or maybe only a nurse, learn to take care of yourself, and don’t rule out anything that is available, mainstream or alternative because in my opinion your life will depend on it. Timing is everything and the time is now.
There is one other point I would like to make; a chicken may be more valuable than gold soon because you can’t eat gold.
I have had more experience than I had intended over the last 9 months with the medical system due to my parents getting older and having issues which have placed them both in the same assisted living facility. As people, I can tell you that everyone that I have dealt with through the medical system – ER, ICU, general hospital, doctor’s offices, skilled nursing facilities, and retirement homes, has overall been very kind and understanding.
I have also had recent experience with working through the insurance system, where an ER visit runs into the hundreds of dollars pre-insurance, an appointment to see a specialist can take months (and require traveling a distance to get a referral for a prescription).
The fundamental underlying principle which ought to undergird the entire discussion is that ultimately we are responsible for our own health. Yes, emergencies and the unforeseen happen (how I know it). That said, it at least appears on the outside that lots of health problems are created by people simply not being responsible in practical and meaningful ways for their own health. It would seem like many other things, we have outsourced our personal health responsibility to a system.
Concierge doctors (home calls and private networks/cash based) will continue to grow, as will effectively non-insurance related practices. To the extent that they continue to provide equivalent service and pass along the savings to their clientele, that should be encouraged and moved forward.
I am not enough of an expert in alternative medicine to comment, but I do know that at least one thing, massage therapy, has a place in sports medicine that it did not have years ago. I would suspect it is not the only such practice (nutrition also falls into this category).
Ultimately we cannot escape genetics and accidents – and as noted above, the fact that our lifespan is diminishing instead of expanding is of note. We will all die eventually (sorry to spoil the ending). That said, there are a lot of simple practices we can undertake which, if we accept the responsibility for our own health, will lessen our reliance and subservience to the system.
The 175 healthcare workers in North Carolina and Lord knows how many in New York fired today (or soon to be) are just a couple of examples of insiders finding out – in a close and personal way – just how corrupt the current healthcare system is. These are professionals with the know-how and, in many cases, the motivation to provide care outside the corrupt system. And most of them still have to make a living. Yes, they will assume risks and, because of those risks, will be hard to find. But the corrupt leaders of this COVID-spiked, top-down, one-size-fits-all monolith are sowing the seeds of their own destruction. The trust in today’s system is no longer there.
Disclaimer, up front: I’m a 61 year old surgical oncologist. I’ve yet to see a miracle from alternative therapy (my favorite for cancer is cannabis…it won’t cure your cancer, but at least you won’t care; please do not regale me with anecdotal tales of miraculous cures. I, like Mr Wilder, will simply grab popcorn) in a patient eschewing rational, studied treatment. I’ve had several dozen patients eschew standard care for relatively routine diagnoses, in favor of alternative treatment. They’re all dead. To be fair, sometimes cancer wins, but that is not infrequently because the patient starts with the wrong person or program. The number of new, targeted, personalized, EFFECTIVE treatments that have become available is TRULY staggering. There are a lot of really mediocre people in Healthcare, many flat-out incompetents, and a number of cons. The system condones mediocrity and sometimes seems to protect incompetence. I agree that it needs to be blown up, from the top down. We physicians were so clinically busy that we allowed the carpetbaggers (first government, the insurance and now the management class) to take over. A majority of these people are truly evil and must be deposed.
That said, what you suggest, widening cracks, is best. What the American people are going to have to come to grips with is becoming discriminating consumers, ferreting out the charlatans, and not expecting third parties to pay for their every unconventional whim. I am unsure that the rank and file is capable of that in large enough numbers to make it all happen. They’ve swallowed this whole COVID mania lock, stock and barrel so the outlook ahead is frankly uncertain.
I’ll give some patient perspective to Minimalmed in a second..First, son is a Licensed Nursing Assistant (“LNA”) at Dartmouth-Hitchcock Medical Center (“DHMC”) in New Hampshire. It’s the premiere MC in three states, and rivals those in Massachusetts.
Son must get the clot shot by October 15, or he’ll be fired. Religious exemption was denied. Son WAS also a nursing student in Concord, NH. While the SCHOOL was precluded from mandating vaccines by law, the affiliated hospital that did clinicals for RN nursing students DOES require the vaccine. With a finagleness that really has to be appreciated, the hospital has ejected my son ( GPA 3.8 ) and now he cannot finish his training. $10,000 down the drain.
Dartmouth is so low on LNAs that they created a new unlicensed assistant to the Licensed Nursing Assistants. Even THERE staffing problems persist.
Regarding oncology – Dartmouth-Hitchcock has a giant 4-story wing for the Norris Cotton Cancer Center. The amount of revenue generated by that wing is outrageous. Efficacy does NOT seem to be important. My friend Denise died of breast cancer a few years ago, and her husband faced a bill of over $250,000 for FAILURE.
Is DHMC interested in a real cure for cancer? They’d have to repurpose or shut down a major revenue source. A serious conflict-of-interest. That wing was created in 1971 after the National Cancer Act of 1971. They’ve been “fighting cancer” for 50 years just at that one place – and Cancer continue to kick their ass.
DHMC saved my life a few years ago, and I appreciate that intervention, obviously. BUT, there is no flexibility in less cut-and-dried therapies and prescriptions. I asked for, and was denied a prescription for ivermectin. I asked for, and was denied a year’s supply of the drugs I take.
Practically every hospital in this part of New Hampshire is “affiliated” with DHMC, and as they get absorbed, one-by-one, in the the DHMC collective, their flexibility and personality each flatline.
I switched to a concierge practice 2 years ago. I switched my health insurance to a high-deductible with HSA as soon as my company offered it. I switched all of my banking to the local credit union.
More importantly, I’ve converted my 1 acre of property in suburbia into a mix of permaculture fruit trees and vegetables, and along with others in the neighborhood, we have started a plant and produce exchange.
Last year, I hosted the 1st Annual neighborhood Veterans Day BBQ. Several of the 40 or so guests commented that they’ve been thinking about something similar, but never did it. We’re currently in planning for the 2nd Annual.
It seems to me that the way to fight extreme globalism is with extreme localism.
Talking with my father-in-law last night, and he told me that he has always prayed, but lately, in addition to praying for his family and his friends, he has begun praying for our country, because it is worse than he has seen it in his 80 years. I told him that maybe it has fallen so far because he wasn’t praying for it all along.
From there, we talked about his life growing up in the Virginia Tidewater. How often, for example, did his parents or grandparents go to the store? How frequently did they even engage in commerce, or use money, when most of their needs were supplied on their farm. Most importantly, are we happier with all this stuff?
I then had an epiphany; we talked about the Model T, available in any color you want as long as it’s black, and with no upgrades that weren’t backwards-compatible to previous production years. Then came constantly-changing styles, colors, and improvements, and planned obsolescence, and how we’re now on a continuous treadmill of buying the newest, greatest thing, and how that behavior, our working to buy the latest and greatest, is what has provided the funding that has allowed government to expand to the monstrosity that it now is.
And the solution became obvious, and can be summed up by following one simple rule:
THOU SHALT NOT COVET.
I think we can do more than just widen those cracks. There is so much dissatisfaction with medical care now, I think there may be a receptive audience to a hardline approach to medical freedom: separate medicine from state. End government licensing and regulation of the practice of medicine. The critics of this will say “then you will have charlatans killing people.” But, with medical errors being the third leading cause of death in this country, and the FUBARed response to COVID by the medical-pharma-government complex, I’d say we are at that point now.
Government licensing of doctors (and other professions) does not keep out the crooked and incompetent practitioners (or even sexual predators). It just gives them cover. People assume that a government licensed doctor (or lawyer, etc.) is OK. Even when they are not.
And now the licensing system is being used to suppress dissent, by threatening the licenses of doctors who are trying to treat COVID with HCQ and Ivermectin, and who are speaking out about the risks of the vaccines.
My personal approach to health is that it’s my responsibility. Health does not come from doctors, needles or drugs. It comes from a healthy diet and lifestyle, and using common sense. Prevention is better than cure. I avoid doctors unless something is broken or bleeding.
I also accept the fact that we are all going to die at some point. The refusal to accept this fact is partially the cause of the extreme COVID measures, from lockdowns to toxic vaccines, which ironically, are causing more suffering and death than doing nothing would have. IMO.
I believe in quality of life as well. A number of my family members have died from cancer. Conventional treatments failed them. They wanted to die at the end. I would not take treatments for cancer. I have tried to prevent it, with healthy diet and lifestyle. If I get it, I will accept my fate, rather than go through hell to gain a few extra months of living in agony.
I don’t recommend alternative medicine as a way of treating life threatening illnesses, I recommend it as a way of becoming healthier in your everyday life, in which there is lots of visual evidence that Americans are much less healthy than they were 60 years ago…Hypnotism to cure an addiction to smoking, for example, works…Basic vitamins and supplements work…When I was in High school in the1960s, there wasn’t one fat kid in the entire school..That has changed profoundly and only gets worse with age..One of my parents had to sue the District to get a reasonably healthy menu in the school cafeteria…Outdoor recess and gym classes should be mandatory..For all the good things medicine has done recently with respect to cancer, they don’t make up for the huge increases in heart disease, diabetes, and various ailments caused or aggravated by overweight, inactivity, and poor diets….
[…] https://www.clairewolfe.com/blog/2021/09/28/our-job-part-ii-b-cracks-and-opportunities-in-the-medica… […]
I’ll play Devil’s Advocate. Several of you have commented about the “Evil CEOs and Administrators.”
OTOH follow hospital or insurance executives around for a while, and you’ll see that 90 percent of their decisions begin with “In accordance with Federal/State regulation…” It’s probably 99 percent of the decisions that adversely affect patients.
Funny how the businesses that regularly shaft customers are the ones most regulated by government.
The above may be influenced by me living next to a very patient-care centered medical center. To the level that if you are hospitalized you get a menu, call the kitchen, and order what you want to eat. (Within dietary restrictions.) Every meal.
Larry – yep, between the bean-counters and the lawyers, hospitals have little choice – right?
Except they’re literally murdering people. If even ONE large regional medical center publicly pushed-back, I really think this nonsense would come to an end. BUT ZERO have done so. Where is Mayo? Harvard? Johns-Hopkins? Dartmouth-Hitchcock? Cedars-Sinai?
All have been silent. They ARE the problem. They’re aiding and abetting murder.
My son has given-up on becoming an RN due to the flagrant disregard shown towards the rights of healthcare workers. He has 5 years invested in educating himself, and worked the last 18 months at a hospital – without a vaccine. He’s going to be fired by October 15, 2021 because he refuses the vaccine, and they denied his exemption.
I’ll toss this in. In many states, a “certificate of need” is required before any new healthcare facility can be built or substantial changes made (like a MRI machine where one hasn’t been before). As you might guess, this certificate is controlled by a government bureaucracy. It keeps competition under strict control, to the detriment of patients.
I feel a good step forward would be wiping this system from the face of the earth.
Larry A I would put it all under;
selling them the rope on Friday you hang them with on Monday
A general statement could be made that some of the biggest supporters of Obama care were these very same health organizations, hospitals and insurance companies due to their thinking of all the $$ that could be made by it.
However now it seems as if we have a type of “single payer” kind of system that “everything” is being determined by government mandate where the health organizations, hospitals and insurance companies are merely only a conduit or front for these government mandates while the $$ are greasing their palms. It’s isn’t easy to find a MD (forget about a hospital for sure IMHO) that isn’t just completely pushing the party line (AMA & CDC) that is a critical thinker while seeking the truth for themselves.
I can’t believe I missed this post! I just cancelled my secondary insurance. There’s no point in paying a fortune to not get healthcare. We’ll see how it goes!