Eliminate the FDA, the Insurance Companies, and Medical Education Before They Kill You

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I’m a doctor. That’s not quite enough. Some might take that to mean I’m a “Doctor of  Philosophy”. A PhD. In fact, I was rudely thrown out of graduate school. I asked to at least use the office for the summer but they said, “No.”. I needed to pack all my stuff and be out by afternoon. While packing my desk I found a woman’s earring underneath but that’s another story.

(this man threw me out of grad school but, through an odd set of circumstances, we are now best friends)

No, what I really mean is I’m a “MEDICAL” Doctor. In other words, you can come to me with your ailment, I can either diagnose them or tell you you need more serious help and recommend a specialist (for instance, if your finger has been accidentally amputated by a lawnmower , then I am NOT the guy to sew it back on. You need to go to a hospital where they have sewing machines for that sort of thing) and I can recommend treatment for you: take 5 of these pills, for instance, and call me in a week and avoid a diet that is high on carbs for at least this week.

Wait a second? I’ve read through all of this blog. James DID NOT ONCE ever mention going to medical school.

(this could be me and you)

Yeah? So? If you came to me with a headache, for instance, I would ask you a bunch of questions. Did you fall? Did someone hit you? Are you vomiting? Then I would take an ophthalmoscope (that little miner’s light where the doctor says, “now open wide” and a bright light shines directly into your eyes”) and I would  look at the back of the eye  (“the fundus”) to see if I can detect any swelling in the brain or any brain tumors. A simple check on the Internet will show many examples of pictures of a swelled brain compared with an unswelled brain. I might do an EEG also to see if there’s anything abnormal. If I see anything abnormal that requires immediate surgery or a neurologist then I would send you off to a specialized hospital. Else, take two aspirin and call me in the morning.

That wasn’t so hard, right? But to do that I need about 12 years of education and go about $300,000 in debt and then pay massive malpractice insurance. And not only that, what if your headache was the result of an ear infection or an eye infection (easy to tell by various methods that are easily found via Google)? I would have to prescribe you an antibiotic.

Now we’re in trouble!  If you don’t have insurance then it would cost you up to $600 to take a four week regiment of most antibiotics. Not to mention I have to charge you a few hundred dollars for my time even though I only spent ten minutes with you and now I’m going to hop from room to room to see all my other patients.

[And just as a footnote: all I did was look at your eye and maybe do that rap of the knuckles on your spine that doctors always do to justify the $300 cost of your visit. And in order to do that rap on the spine and maybe the little hammer on your knees and let’s check your pulse you have to completely humiliate yourself by taking off all of your clothes, standing on scale that has been specifically designed to prove to you you were ALWAYS three pounds overweight so stop lying to yourself and then you have to lie down on a this weird mechanical chair/couch that the last 30 patients with infectious diseases also had to lie down on and then your head is tilted so you are looking at me at this upward weird angle the way you’ll look at God after you die when you have no idea where you are and all you want to do know is, “is this heaven. Or am I in hell?”

By this point you are so utterly dehumanized and I come in with my white coat and my oddly costume-like miner’s light strapped to my forehead combined with a magnifying glass so now it’s truly like I’m god because I can see right through to you in my sterile environment- I can see everything- and then to finalize the demonization of the doctor-patient visit I ask you the crucial question that you HAVE TO ANSWER before I treat you further – “have you had many sexual partners of late?” – ok, enough footnote. I didn’t even need to footnote this but it’s not crucial to the point. It just adds  the simple flavor. You’re an idiot and doctors act like gods.]

(Hi Kim!)

So now the patient has to spend $1200 (antibiotics + the first doctor’s visit for treatment plus the second doctor’s visit where I walk in andi say, “how are we feeling today?” and I’m smiling and you say, “good, doctor. Very good.” And I say, “well, we’ll see about that” And you’re stripped down again and wearing that beautiful paper gown (so sexy) and I rap on your back, look at your fundus, wrap on your knee, and maybe slip my hand into your vagina (wearing rubber glove, of course) and then say, ‘yes, you are the spitting image of health, tell the nurse up front to make an appointment for about three months from now just to make sure.”) and why should the patient spend anything? After all, although the certificate on the wall says I’m an “M.D” it’s all a lie. I, of course made it  up. I’m the guy who screwed Yasser Arafat out of $2mm and pretended to be a psychic. Why should I be a doctor?

Because the entire industry is completely messed up and we all know that but nobody just simply tells it like it is. We all want to put Band-Aids on the situation instead of transforming the situation. This is  our gut reflex in almost all aspects of life. We’re unhappy in our marriage so we figure maybe some diamonds and an expensive vacation can help. We’re unhappy in our jobs so we figure maybe if we take the boss out to lunch it might help. These are all bandaids. It’s time to just say the truth about what will help.

Most situations require radical transformation. Don’t be afraid to do that or say,”of that can’t be done.” At least consider the transformation.

(she's $300,000 in debt).

Time to end the FDA, traditional medical education and the insurance companies. Just get rid of them.

Let’s start with the worst and most corrupt semi-government institution known to mankind: the Food  and Drug Administration. The administration that lets you smoke as many cigarettes as you need to get lung cancer, drink a ton of alcohol to get liver cancer, but then won’t let you take any of the drugs or treatments for lung cancer or liver cancer.

I have to tell you something: almost every cancer has been cured already. But let’s say  I’m a scientist with a bad personality (I’ve been accused of being a bad scientist with a congenial personality but never the former). Let’s also assume I’ve developed a drug that will cure your liver cancer without chemo. Now what do I do?

Here’s the four steps I would CURRENTLY have to do:

A)     It costs a billion dollars to get a drug through the Food And Drug Administration. This is why I mention the bad personality part. There’s zero chance I’m going to raise this money. Instead, because my personality is so bad I have no friends at the various research magazines so I’ll never get my findings published and consequently I’m going to get fired before I get tenure and I’m going to end up as a cashier at Walmart. What sort of tests do I need to do? I have to round up potentially thousands of people to take my drug, take placebos, check for safety, effectiveness,  blah blah blah. It takes ten years to do this so potentially valuable drugs stay out of the hands of patients who will most assuredly die in this time.

B)      At any one of these four steps, judges at the FDA can decide if I passed or failed my trial. These judges are often people who have worked at my competitors or who want  to work at my competitors, making it extra hard to get through the implicit corruption that surrounds the FDA.

C)      Now I have to convince the insurance companies to pay for my medicine so patients don’t have to pay the full cost. Because I just spent a billion dollars on approving my medicine (over a TEN YEAR period on average) the medicine is VERY expensive so I can make back the cost. Insurance companies don’t want to pay for my medicine. They don’t want to pay for any medicine really. So this is a hard process. And I have to raise another $50 million to survive long enough to hire people who will convince all the insurance companies to accept my drug.

D)     Finally, I have to educate doctors that my drug will cure liver cancer. Doctors could care less about me. They are going on cruises funded by the big pharma companies (who just finished spending billions on their drug trials) and the big insurance companies where they are told what billion dollar drugs to recommend to their patients. They aren’t going to listen to me.

So basically, if I have the cure for liver cancer, nobody is going to ever find out. It’s like a five year old with the talent of Mozart who never touches the piano. Nobody will ever know. I’ll give up in the laboratory before I even tell anyone.  The best doctors do, in fact, educate themselves and illegally prescribe “orphan drugs”:  Drugs that might have been approved for kidney cancer but NOT approved for liver cancer and will recommend those drugs for liver cancer. But most doctors will not do that because it’s technically illegal..And certainly no doctor will recommend a drug that has NOT been approved by both the FDA and the insurance companies.

Wow, you might think. This is a disaster. Will Obamacare help? Will anything help?

And the answer is “Yes”. Here’s the very simple solution:

A)     Get rid of the FDA. Simple.  Let the Internet be a virtual FDA. A drug will have a web page, a scientist with verified credentials will document his research, and comments from users will  describe their experiene with a drug. Many people die and get sick from FDA-APPROVED(!) drugs. The same thing will happen here. But will save the billion dollars and will allow drugs to be quickly tested by the audience that needs it most – people dying of terminal diseases. These people will quickly report back if there is success and we’ll know what works and what doesn’t. If there are bad stories then it’s a guarantee we will hear about them. And it won’t require a billion dollars and ten years to hear about them.

Well, what about the rest of the FDA? Oh, you mean the  part that puts labels on cigarettes and allows hot dogs (also related to intestinal cancers) to be colored red? You can get rid of them also. They cause more cancers than they cure anyway.

(this is APPROVED by the FDA)

But don’t they fight drugs? Uhhh….Good luck with that.

What’s the net outcome of having zero FDA?

The cost of drugs will go down from $600 for a month’s use to $10. And drugs that actually cure things (instead of drugs that had the personalities behind them to raise a billion) will actually make it to market. The net result: more people will live longer. And drug research will be infinitely more productive.

B)      Get rid of 90% of insurance companies. Once drug treatment costs go down to zero and there’s more competition among drugs (because more drugs are available) then why do you need to insure for them? I still might want to insure for things like long-term disability or life insurance but almost all medical insurance will be eliminated. Why is this a good thing? Because medical insurance, which claims to help you, is actually on the other side of the table from you – they will try to deny that you have an illness, or they will try to limit the amount of treatment you get- simply because they don’t want to pay for it. So they are not your friend. As I mentioned in my post “How to Deal With Crappy People” – stop hanging out with the people who are not your friends.

C)      Get rid of Medical Education. Doctors graduate with $300,000 in debt often. So they have to make it up by recommending every treatment possible to you and charging as much as possible so they can pay back their loans. This is not in your favor. Almost everything I can learn in an expensive medical school I can learn with a combination of Passion + Internet + Apprenticeship.

So if someone truly wants to help people and be a “MEDICAL DOCTOR” here’s what I recommend: the following three (or four) step medical education:

(I can totally do this)

1)      At the age of18, spend a year changing bedpans at a hospital and let’s see if you truly have the passion AND compassion to be a medical doctor (most don’t have either but by the time  they finish their $300,000 in debt education they are forced to continue in order to pay back their loans and to justify the 12 year time invested).

2)      Spend a year where you pay a GP (or whatever field you want to go in) to be their intern. This should cost you about $20,000.

3)      Spend a year as an apprentice for the same GP but charge a lower rate to patients.

4)      If you want to be a surgeon, go to a 1-2 year “surgeon school”

5)      A yelp-like system should be created to review both drugs and doctors. Yelp has proven to be extremely efficient for ranking the most important aspect of our society – our culinary tastes. Why not use it for other important things. Like where and how we get treated for illness.

Now you’re an MD. At theage of 20 or22. Not 32.

Net result of all of this:

A)     Cheaper and more drugs

(don't take them all at once)

B)      More diseases cured

C)      Bigger community discussing the diseases and various treatments. This is what social media is for. It should be transformative of the medical industry.

D)     More doctors.

E)      Less expenses all around for the patient

F)      More medical facilities around the country

G)     Less corrupt influence  of the big insurance and pharma companies

H)     Less government expense by eliminating the FDA.

You can argue, “But more people will die from bad drugs.” Many many more people will be saved also. And once a drug is truly discovered (and this will happen much faster in my system) to cure liver cancer then that drug will quickly rise to the top in the yelp-system and everyone will begin using it and all the people with liver cancer will be saved. Let’s not forget, the FDA recalls as many drugs as it approves. How come? Because the real world is different from a laboratory. And once a drug is approved it often is shown to have harmful effects when it’s prescribed. So then it’s recalled, showing once again the FDA does nothing useful but cost people money.

On top of all of this, my system will create many more doctors with much more compassion. And if they want to suddenly change jobs, then let them. They haven’t invested 12 years and$300,000 to be a doctor. But that’s ok, because there’s many people lining up to replace them.

What about all the jobs lost at the insurance companies and the FDA? Well, maybe they should become doctors and help people instead of hurt them!

So, for anyone needing a pap smear, or a check of their tonsils, or having problems with depression or post-traumatic stock market stress, give me a holler. Office hours are open.

Please FOLLOW ME ON TWITTER

And you can buy my book: I WAS BLIND BUT NOW I SEE

 

 

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  • http://www.facebook.com/alicia.a.peek Alicia Austin Peek

    As someone who works in healthcare and sees it’s failings so clearly, but has to feed her family with the only skill her well intended education gave her, this is brilliant.

    • Anonymous

      I was working on a masters degree in health care administration when I came to the realization of everything in this article although that was not the intention of my professors. If you look at the cost of health care after the introduction of medicare and medicaid and they shot straight up.  Private insurance came along too and had much the same effect.  How many people knew that hospitals were run as charities and were free?  And we got rid of this system why?  What drove the price of health care up was money entered a system that was mostly charitable or modest cash pay for those who were not poor. 

    • Anonymous

      I was working on a masters degree in health care administration when I came to the realization of everything in this article although that was not the intention of my professors. If you look at the cost of health care after the introduction of medicare and medicaid and they shot straight up.  Private insurance came along too and had much the same effect.  How many people knew that hospitals were run as charities and were free?  And we got rid of this system why?  What drove the price of health care up was money entered a system that was mostly charitable or modest cash pay for those who were not poor. 

  • mgsquared

    I guess we have these problems in Europe too but on a much smaller scale… you see, when University (including medical school) costs students less that 1,000 euros a semester (keep in mind that they get that money back in monthly sums of student assistance from the government) and then insurance actually does cover stuff such as antibiotics (I am by law, never supposed to may more than 5 euros per prescription.. now matter how much it costs.. I just pay 5) … well, these things you are talking about are not such a problem! 
    Granted, I don’t know how easy it is to implement a new drug here or how much research is being done (less, according to the media) but I am also not thousands of dollars in medical debt. 

    I think you have a lot of valid points. Just a bit too radical for a section of the world where an insurance company that covers 80% of costs is considered good (80%?! How on earth is one supposed to come up with the other 20?! Thank goodness I don’t have to worry about that!)! 

    • http://www.facebook.com/nils.meyer3 Nils Meyer

      The real costs are just hidden because they are covered by taxes, this works as long as the economy is strong enough. It is true though that medical treatment is a lot less expensive in Europe depending on the country. And doctors earn a lot less. 

      • James

        Not true. Governments can often negotiate a better price than a retail price because of the buying power. The Australian government did just that and the US wanted to stop the Australian government from doing so in the free trade agreement a few years ago.

      • mgsquared

        Do a serious comparison sometime. How much we pay in taxes vs. how much you pay. You’re stating the myths that are told to Americans. Our doctors earn crap, our healthcare sucks, bla bla. Actually look it up. Actually look up the numbers and satisfaction and standard of living. I might pay a little more in taxes, but I’m not in medical debt, I get great care and benefits, and I SEE where tax money goes. I also get more of a say in it! 
        Do you? Are you happy with the billions being spent on the army and then the veterans that still end up homeless on the street? All the poor people in the Kentucky hills being hungry and not getting education? 
        People dying because they can’t afford the medical care to live?! 

        Think about it. I’ve lived in the states. Never again. It is the most unfree nation I have ever been in! 

  • HJ

    I LOVE this. All of it…but especially the part about eliminating the FDA, insurance companies, and medical education :-). Maybe add one more year for doctors spent working in an ER?

  • SLM

    How would you treat triple negative breast cancer by doing a 1 year internship with a  GP who has no idea or training in how to treat it? 

    • http://jamesaltucher.com James Altucher

      I’d recommend they go to someone who went to the 1 year surgeon school (which comes after the apprenticeship which comes after the internship, which comes after the bedpan) that specializes in breast cancer. And after that 1 year surgeon school, like any doctor, they will  probably have to work with more experienced doctors to get trusted on the yelp-like system.

      • Jayme_bradley

        smh.  that’s all i have to say about that plan.

    • Paul

      There’s no reason that the current medical residency model couldn’t stay in place for people who want to specialize beyond their GP internship.

    • natural woman

      Although I’d recommend working with a doctor knowledgable in natural medicine, I know of at least 3 ways to cure (not treat) breast cancer by yourself without a doctor and know women who have done it. The information is available, just seek it out.

      • Anonymous

        Write them out! I don’t mean this sarcastically, please do. You could save a life you will never meet by a simple blog post…

  • http://pulse.yahoo.com/_UTGKOUQMYRSS2LFT2EZHDH5EOI J.

    Definitely get rid of the “health” “insurance” companies.  In addition to their 30% rake-off for overpaid executives, etc., they impose a huge hidden cost in the form of extra employees at doctor’s ofices to try to collect, plus time wasted and aggravation.  I buy meds internationally  over the internet for a fraction of the US cost, often less than what the co-pay would have been. 

  • Jlwillerson

    This is genius. 

    Passion cures a bunch of stuff…in the short run and the long run.

  • http://www.facebook.com/profile.php?id=572545922 Claudia Azula Altucher

    James, you seriously are onto something, between letting me vote online, eliminating the presidency which in the end only throws parties and gives opinions, and now eliminating the FDA and training doctors like this, efficiently I can see a whole new world of no b/s and actually some efficiency!  Loved the post!

  • Mayuresh Gaikwad

    I think one of the problems that can be easily fixed is the cost of creating a doctor. Do you really need 4 years of college education to be able to qualify for Medical school? Most countries accept students in Medical school at the age of 18 (i.e. after they have completed high school). The fees are significantly lower than in the US as these students are also made to compulsarily work as interns and as apprentices at government hospitals for a year each. So they graduate at 24 with a degree + a year each of apprenticeship & internship under their belt. And yes, without the crazy $300,000 debt. Yes, they have worked for ZERO salary for 2 years (intern + apprentice) but that is built into the curriculum for being a doctor.

    So start earning at 24 without a lot of debt (debt would be equivalent to a normal college grad) and charge reasonable amount of fees to your patients

    • http://www.facebook.com/people/Zebram-Zee/100002539017006 Zebram Zee

      i agree.  4 extra years spent in undergrad are virtually useless if you want to be a doctor

  • http://anembarassinglife.wordpress.com/ anembarassinglife

    Seriously?  Next thing you know you’ll be telling us we don’t need all these high priced lawyers. 

  • http://www.szelhamos.com TheAcsMan

    I’m dually biased.

    Firstly, because I’ve worked at some of the best hospitals in the world and have seen that there really are people that have the passion, the knowledge and the desire to help.

    But I’m also the son of a man, a Holocaust survivor, for whom my financial/humor blog Szelhamos Rules is dedicated, who believed that all doctors (anf dentists) were butchers and bloodsuckers.

    Did I mention that he was a dentist in Hungary and that I’m a dentist, albeit Pediatric? Those don’t count.

    Anyway, I agree with many of the points. Life,and the events ultimately leading to death, were much better when there was a single payer (Blue Cross/Blue Shield). Non-profit and whose rates also covered the uninsured.

    Life was also better when physicians would drink your urine and could tell if you had diabetes and would accept a chicken as payment.

    I’m very happy that neither of my kids had any science aptitude and have not gone into medicine. In mind mind, there’s no way to ethically dig yourself out of the economic hole of student loans.

    The FDA? Get rid of them and the morning commute in the DC area would be heaven and I’m certain that I could get enough attestations on-line for my combination penis enlarger – hair growing elixir to finally help pay off my loans

    • Anonymous

      Fools and their money are soon parted.
      The government just gets in and charges everyone to be the fools doorman and bodyguard.
      Either way it sucks, because there are a lot of fools out there, and even more fools that think it is possible to safeguard fools from being fools.
      If people would stop worrying about the proper care and feeding of fools and mind their own business, things would improve significantly for the less foolish.

      • http://www.szelhamos.com TheAcsMan

        I’ve got to admit that you’ve got me fooled on this one, since I’m not certain if you’re serious.

        But in the event that you are, the only response that comes to mind is: “Huh?”

        For my take on “fools” and the “Index of Fools”, see Will Fame Go to my Head?

    • Absurdist

      “I’m very happy that neither of my kids had any science aptitude and have not gone into medicine. In my mind, there’s no way to ethically dig yourself out of the economic hole of student loans.”
      This reminds me of my step uncle.  Both he and my father were district judges.  My step uncle became terribly bitter in his old age.  Of course, you have to run for district judge.

      He told me in his elderly years that he wouldn’t run ever again for public office, or wouldn’t do it in his younger years if he had to do it all over again for a elebenty billion dollars (don’t you just love that number?)

      He said it was all bullshit, politics was crap, he hated every moment of it, it costs over a million now to run for office, even a puny one, the games, the crap; it’s just too much.  He’d get rid of it all in a heartbeat.

      :) 

      • http://www.szelhamos.com TheAcsMan

        It’s very similar, in that politics, the law (particularly judiciary, prosecutorial and public defense sides) and the practice of medicine are public services and increasingly there is little reason for rationally thinking people to pursue careers in those areas.

        Better to be an entrepreneur, make lots of money and use it well to create further wealth and (one aspect of) happiness for others.

  • Paul

    Holy crap, this is good stuff.  Reminds me of an article in The Atlantic that I read a few years ago (http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/).  The whole system is screwed up.  IMO if we just forced doctors and hospitals to publish their pricing, the whole system would get cheaper and better in 12 months.

  • http://twitter.com/JFinDallas JFinDallas

    This is great, we need radical reform like that, outside of the box thinking, the healthcare system in this country needs to be broken, and we need to start a new one from scratch. 
    The way healthcare works in the US drives me crazy (I am from Europe originally) and it is bankrupting this country. 
    Everybody in the healthcare system (doctors, hospitals, drug companies, insurance companies) has a strong incentive to cost going higher and more money being spent, and there is no mechanism in place to control cost, so you get that ridiculous/unsustainable inflation in healthcare costs, we are now at a point where an increasingly large number of people can’t afford good healthcare even when they have insurance

    Very recently, I took my 5 months old daughter to the pediatrician for a routine visit and 2 vaccines, she spent 10 min with the doctor, and a nurse administrated the vaccines,want to guess how much my insurance was charged for that? …. $990, that same week I saw a cardiologist, 10 min of test + 10 min with the doctor, the charge for that one? …. $1570. I know several high powered lawyers and professionals that have big “brains”, went to expensive schools for a long time, they would never even dream to charge such outrageous rate, doctors can because there is no price transparency and they can just get away with it, and it is bankrupting this country.
    I have a very good friend who is a surgeon, he buys a new Aston Martin every other year, I mean it’s great I am very happy for him, but does he really need them ? does he really need to make so much money ? I am all for people making the maximum amount of money they can, especially when they are good at what they are doing, but when it’s at the expense of other peoples life and the fiscal situation of the entire country, that’s a problem for me…
    Nobody seems to be willing to say it out loud but doctors make too much money and they abuse the system.
    We have all this talk about deficits, medicare reform, we need to cut medicare benefits, how are we going to pay for it ?…. Why are we only talking about cutting benefits to the patients and not the benefits to the doctors?
    At this point we have to impose a real healthcare reform that will break the chokehold that doctors and the “healthcare system” have on the country, I know that would be a socialistic approach (OMG he said the S word :-O), we can’t afford to have doctors and the “healthcare system” gobbling up 25% of all the resources of the country, with lower outcomes than a lot of countries that spend just a fraction of that.

    As long as the leadership (or lack of thereof) of this country is bought out by lobbyist for private interests nothing will probably change, and that’s at the root of most of the challenge this country is facing today.

    Required reading : http://www.foreignaffairs.com/articles/67918/peter-r-orszag/how-health-care-can-save-or-sink-america 
    Quick quote that sums it all pretty well : ” It is no exaggeration to say that the United States’ standing in the world depends on its success in constraining this health-care cost explosion; unless it does, the country will eventually face a severe fiscal crisis or a crippling inability to invest in other areas.”

    I apologize for the long comment post but this subject really gets me fired up…

    • Syren

      Foreign Affairs is the mouthpiece of the Council on Foreign Relations.   Their quote:” It is no exaggeration to say that the United States’ standing in the
      world depends on its success in constraining this health-care cost
      explosion; unless it does, the country will eventually face a severe
      fiscal crisis or a crippling inability to invest in other areas.”
      …well, duh. 
      Anything FA or the CFA cites as a solution to problems THEY CREATED will be more self serving kleptocracy.  Use your next issue of FA to line your birdcage.
      James is right in that govt created agencies like the FDA are a failure at best and a danger at worst.  Sure, maybe a ‘yelp’ system would be insufficient for something like heathcare but the system in place now is little better.
      Solutions to these problems lie outside of government.

    • Syren

      Foreign Affairs is the mouthpiece of the Council on Foreign Relations.   Their quote:” It is no exaggeration to say that the United States’ standing in the
      world depends on its success in constraining this health-care cost
      explosion; unless it does, the country will eventually face a severe
      fiscal crisis or a crippling inability to invest in other areas.”
      …well, duh. 
      Anything FA or the CFA cites as a solution to problems THEY CREATED will be more self serving kleptocracy.  Use your next issue of FA to line your birdcage.
      James is right in that govt created agencies like the FDA are a failure at best and a danger at worst.  Sure, maybe a ‘yelp’ system would be insufficient for something like heathcare but the system in place now is little better.
      Solutions to these problems lie outside of government.

    • Anne1958

      The reason the doctor charges so much is that the insurance company actually only pays $50 to 100 of that charge. It is an unending cycle.
      The doctor charges a patient $50 for a visit. Then the patient gets insurance and pays the insurance company. The insurance company wants to keep as much money as possible so they tell the doctor “we’ll pay 50% of your customary charge”
      Then the doctor increases his fees to $100 so that his income doesn’t decrease by 50%. Thus begins an unending cycle of price escalation.
      I am a family practice physician but I plan to leave medicine entirely within the next two months.
      I tried a cash only practice- every office visit was $55 and no insurance accepted.
      The result was almost no patients. Most wanted me to accept insurance. Very few people were willing to pay for their own health care, even the ones without insurance. (I heard many people say, “I’ll just go to the ER so I don’t have to pay”.) And that illustrates a major problem today.
      Patients want health care but they do not want to pay for it.
      Insurance companies want money from patients but they do not want to pay the providers so they try every way possible to get out of paying.
      And, as a doctor, I cannot give my services away for free (well, I did give $20,000 worth of my time to the local charity clinic). I think I should get a decent income if I provide good service to my patients.

  • http://twitter.com/fzeng96 Feng Z

    dude, wouldn’t it be great if all the doctors and nurses look like the miniskirt 300000 in debt blond in your picture? i would be sick all the time.

    congratulations on the new book by the way!

  • DrugMonopoly

    Interesting thoughts, but there are some holes. What’s to prevent shady characters from trotting out snake oil and marketing the heck out of it? They would fund “independent studies” that say their product works miracles. They would get mountains of testimonials. They would run ads day and night with no requirement to list side effects or risks. It would make today’s infomercials for herbal remedies look like child’s play.

    Yelp is good for reviews on independent restaurants. No matter how many Yelpers tell us McDonalds is crap, the Golden Arches marketing machine easily overcomes this and they rake in billions. The same thing would happen in healthcare without checks and balances. Folks who roll out drugs with a large marketing budget behind them can overcome the Yelp system of vetting a product’s efficacy.

    The whole system needs to start by limiting malpractice judgments. Does an incorrect diagnosis really merit a $10 million lawsuit? The same could be done for drug company liability claims. Once acceptable limits are in place, insurance premiums will go way down, prices will become more reasonable, and the system will begin to right itself.

    • Anonymous

      If people still eat at McDs, they have no one but themselves to blame. Everyone knows it will ruin your health. Don’t make the whole of society suffer because some people insist on pissing on their own feet.

      To your first point, you shouldn’t underestimate how much the FDA regime balloons drug prices, and thus how strongly this proposal would drive down prices. A big similar to narcotics. People won’t have a huge incentive to fire up their phony marketing machines to sell $7 bottles of pills. The current late night herbal medicine infomercials live in an environment of radically inflated medical costs.

      Your proposal would only reduce costs by maybe 20%, and wouldn’t fix any of the deeper fundamental issues with the whole system. We need radical change.

  • Brian Utterback

    I agree that the FDA and insurance system are fundamentally broken and that medical education needs an overhaul. However, your system for drug testing amounts to a system for collecting anecdotal evidence. That is worse than fundamentally broken, it is useless. For most drugs it could not provide any useful information, and for the remaining where it might work, it will generally be too late. It is just not possible to ship first and test later. Even with all the incentives to lie and game the system, a very large number of potential drugs do not make it to market because of dangerous side-effects. Would you prefer to find out about that after a few million people take them?

    That having been said, the process could be made much better.

    • http://www.preemptiveplacebo.com Preemptive Placebo

      Human beings have been here in our current form for about 200,000 years.  For about 199,900 years we had a system that effectively – as you put it – collected anecdotal evidence. 

      And despite the fact that we had very limited information distribution systems and limited scientific knowledge – it worked.  Somehow humans figured out that Turmeric is anti-cancer and anti-Alzheimer, and they figured out ways to work it into their daily diet despite the bad taste. 

      Right now when we become ill we submit ourselves to the doctors and trust that the system will provide.  We leave our skepticism at the door and accept their word as fact.  Consequently we are more open to eating our daily Super Burger because the doctor takes responsibility for our health in the same way the mechanic takes responsibility for our car.  Our responsibility is to pay the health-insurance premium. 

      No matter how we sugarcoat it, discovering effective drug treatments is a trial-and-error process.  Billion dollar barriers to that process do little more than hinder its natural flow and transfer responsibility from each individual to the system as a whole.

      Evolution is an individual trial-and-error process that requires flexible adaptation to change.  Right now we feel the need for change in our 200,000-year-old Homo Sapien bones, yet we cling to this hundred-year-old inflexible systems because it is the one we know.

      • Anonymous

        Don’t be too hard on the burger.  Like most things, the FDA has gotten this wrong too.  Its not the burger that is bad but the bun, the fries, the apple pie, and the diet soda and regular soda.  They also bust farmers for selling healthy raw milk and allow others to sell unhealthy pasteurized milk.  Remember the old food pyramid?  Carbs was supposed to be the biggest part of our diet.  You think maybe some lobbying by agri-business had anything to do with that?

  • http://www.shampooprank.com John

    I agree with this post

    There is a site that i found where you can rate doctors…never used it though…

    http://www.ratemds.com/

    also…James…why dont you try to go to cuba, mexico or costa rico where medicine is cheaper

    read this please and watch michael moore’s “sicko”

    http://brandonpearce.com/2011/08/why-i-dont-want-health-insurance/

  • Anonymous

    Hot dogs cause cancer???  I always thought that buying all beef dogs was a way around the ‘ole nitrate stick issue.  Decided to call my doctor (aka, performed a Google search) and sure enough.  Where have I been that I did not know this?  FML.

    You may well have saved the lives of my children, James.  I owe you (another) one.

  • Bob obrian

    Perhaps a rolling 401K for health expenses would help

    The govt gives you a tax break of a few $1000 every year. That break goes into the health 401K and rolls over every year. That way when you’re older and likely will need medical treatment, you have a larger fund to draw from

    When you go to the dr’s office/dentist/pharmacy – you pay from your health fund.

    If you get sick – you pay from your health fund until it is depleted – then you get major medical funding from the government.

    When you die – the balance of the health fund goes into the general major medical fund to help those who have depleted their personal health fund.

    Simple! But, no one makes huge profits so it’ll never happen.

    • http://twitter.com/PaulMaxime Paul Franceus

      This is already there. Look up Health Savings Accounts

      • Bob obrian

        true.. but today’s health saving account – you lose what you don’t use so it does not roll over and get reinvested. Plus there is no major medical as a back-stop.

        The value with rolling over health accounts is it will grow and be there when you get older and will more likely use it. Plus, if everyone is in it, there will be a massive pool of $$ to draw from. Today’s health insurance, many healthy young people forgo it ( hey! I’m healthy! ) and is over weighted with less healthy people..  Every gets the same coverage and it eliminates the insurance companies

  • Alfie

    Great topic/ great post. I currently have 3 friends who are battling cancer. All were in the “unlikely category” before being diagnosed. Our system is so sick, even with insurance through the private sector, if you get sick you better somehow keep working, otherwise you lose coverage. Even if you have to be wheeled in after chemo just to stay employed well, if you just do what you have to…
    One of my friends is in IT for a defense company. This is her situation, sense her partner just got laid off, its up to her just to keep at the job so they dont go bankrupt. (her chemo alone cost 450,000!) The other friend who has always followed a healthy lifestyle and has a young family is somewhat protected because he works for the fed. They wont cut him off. And then there is the little girl who I watched grow up who got diagnosed with a brain tumor at 15. This is after a solid year of scans, blood tests to figure out her mysterious symptoms. (For a while they even thought it might be Lyme even though we live in Alaska.) She had to go to Seattle and live by the Children”s Hospital where I visited her. To see the parent’s who are caught dealing with this breaks your heart. So many are wiped out financially… just try to keep your job when your kid is going through this grueling illness… Make a wish granted Ivy’s wish to make a video of one of the songs she wrote when she was 13. (Its on Youtube, Ivy Lynn, “At Ease” She lost her voice during the radiation but luckily had recorded this on Garage, she is lip syncing).
    Anyways I realize this is a bummer comment, apologies. What you are saying though is so true. The system is broken.

    • Anne1958

      I have a medical problem that requires daily medical treatment to keep me alive. It costs $44,000 per month and I know that it costs less than $50/month to make. Here are the numbers- $44,000 x 12 months, estimated 1000 patients on this treatment = $528 million dollars per year. The patent is for 17 years so the company makes about 9 billion before the patent expires. This is a low estimate because they are creating sidelines and there are probably more patients on this treatment than 1000 patients. I cannot believe that this cost anywhere near 9 billion to create and market because much of the research was done with government subsidies.

  • Mansal

    Well, those who can afford healthcare will be disinclined to do away with regulations on doctor’s education and salary. In MANY cases, the high salary of a doctor is what encourages some of the brightest people to go into the field. That means that some of the smartest people are treating me when I am sick / hurt and that is exactly what every person who can afford healthcare wants to hear. It is a real hurdle to make those wealthy enough to afford healthcare change their minds when their health is at stake.

    Furthermore, the FDA being abolished might create some unknown consequences. While I agree that many people die due to the time lapse and cost of drugs in testing, I am not certain it would be equal to the number who would die in the trials. What about long term consequences of the drug? No one knows….yet.

    Also, what would be the structure for finding and funding the researchers who develop that medication? Seems like some corruption issues may come into play. Then again, big Pharma does plenty of lobbying…so I guess the question is “how can we more concretely determine the unknowns when switching?”

    My two cents..

    • http://jamesaltucher.com James Altucher

      That can still exist. I can put out my shingle and say “I am the world’s expert” on breast cancer and still charge the highest prices possible. It’s the regulations that make prices artificially high for poor people. 

      • Mansal

        Yes you can say you are the world’s expert, but people think a medical degree at the best school means the doctor is the smartest / best. There needs to be something to back it up.

        Also, it is the regulations that make prices artificially high for poor people – I agree. BUT, doctors, like lawyers, often go into their field because of one thing..financial security. Doctors have to pay off their students loans – true. This contributes to the artificially high prices – true. Doctors pay off their student loans, but then still charge high prices because those are the “twighlight” years where they make boat loads of money – also true.

        My point was, the regulations artificially raise prices for everyone, but that means that smarter people go into that field. People (like me) want their doctors to be smart even if we have to pay more. Unfortunately, there are people who want the smartest people, but can’t afford healthcare.

        • Anonymous

          The best schools will still exist. They will still graduate the best and brightest, who will still command a premium in the open market.

          The point is not to destroy what is already there. The point is to open the situation up to allow a wide range of alternatives. Don’t destroy the medical schools, just don’t artificially limit the supply of people allowed to provide medical services.

      • Kam3don

        I question whether the “smartest” people make the best doctors. This has
        not been my subjective experience.

      • Kam3don

        I question whether the “smartest” people make the best doctors. This has
        not been my subjective experience.

        • doug

          Smarts – as in the ability to make associations between elements – have never been required of doctors.  Until about a hundred and twenty years ago books were so rare (and doctors couldn’t read anyway) med schools required a lot of memorization.  That set the culture of medical education and since culture changes slowly, if at all, med schools still require students to memorize lots and lots of stuff.  They do not require them to be smart.  Now handheld computer access to all the memory in the world is changing all that and opening the possibilities James suggests.  

          doug

        • doug

          Smarts – as in the ability to make associations between elements – have never been required of doctors.  Until about a hundred and twenty years ago books were so rare (and doctors couldn’t read anyway) med schools required a lot of memorization.  That set the culture of medical education and since culture changes slowly, if at all, med schools still require students to memorize lots and lots of stuff.  They do not require them to be smart.  Now handheld computer access to all the memory in the world is changing all that and opening the possibilities James suggests.  

          doug

  • Anonymous

    I think your “training program” for doctors is a cool idea — but maybe for a new “class” of doctors… somewhere between a “real doctor” and a nurse.

    I still think we would need a few of the traditional doctors available for weird cases or cases with high ramifications (life & death).  You just can’t learn everything about the human body, conditions, etc. in a 2-yr training program because you won’t see everything in those two years…

    • http://jamesaltucher.com James Altucher

      That mightbe an interesting transition. Much in the way Borders and B&N exist (for now) but a new way of selling books (Amazon) has existed for 16 years. 

      • aaron

        I think this is the key. If there is a better model, you do not need to “get rid” of the old one. The better model will just compete it away. Get a bunch of frustrated docs and have them start their own non-accredited Health schools. (not “medical” which implies that you are already sick, and doesn’t focus on prevention aka following the daily practice). setup a network of physicians who could use apprentices, and technical schools that teach the specialties.

      • aaron

        I think this is the key. If there is a better model, you do not need to “get rid” of the old one. The better model will just compete it away. Get a bunch of frustrated docs and have them start their own non-accredited Health schools. (not “medical” which implies that you are already sick, and doesn’t focus on prevention aka following the daily practice). setup a network of physicians who could use apprentices, and technical schools that teach the specialties.

    • a surgical resident

      those people already exist. They are called nurse practitioners or Physicians assistants. You will find them in many Emergency rooms filling the roles of residents or in primary care offices doing routine followup

    • a surgical resident

      those people already exist. They are called nurse practitioners or Physicians assistants. You will find them in many Emergency rooms filling the roles of residents or in primary care offices doing routine followup

  • http://www.facebook.com/joehenriod Joe Henriod

    James is crazy… next thing you know he will be saying the world is round and that we should let women vote!

    • http://jamesaltucher.com James Altucher

      I actually think ONLY women  should be allowed to vote. Men should not go anywhere near a voting machine. 

      • Steven Scotten

        Well, someone’s got to fix the damn things. (ducking and running)

      • Drapetomaniac

        Nobody has a right to create a government therefore nobody has a right to vote.

  • Anonymous

    Get rid of the FDA.  Great.  I like it.  So….where do we start?

    • http://www.facebook.com/carolyn.k.flynn Carolyn Kadlec Flynn

      Elect Ron Paul and he’ll cut many, many government programs…all those that are not listed in the Constitution as a function of the federal government.  Maybe the states would take on some of these functions?

      • Anonymous

        He would try. How much he would accomplish remains to be seen. When acting lawfully the president’s power depends almost entirely on the support of the people.  Everyone wants cuts but almost everyone wants some things left alone. No retiree will want Social Security or Medicare cut but every young person should want them to be completely gone. We have been taught to be cowards. Anyone who does not think they fit this catatgory should count how many insurance policies they have, both those paid for privately and those paid for through government, and how many of those do you worry won’t cover enough. I’ll bet you miss some, it could take quite a while to think of them all, if you even can.

  • Jradxit

    No mention of malpractice or defensive medicine. You think these dead patients families wouldn’t sue the pants off of your hypothetical cottage industry drug suppliers and the self trained doctors you propose?

  • http://www.goldenstateliberty.com GSL

    James, you’re more right than you know. If anything, your criticisms don’t go far enough by also taking on the socialized systems in places in UK, Canada, France, etc. Here’s how to think about the US system relative to others: the costs are ridiculous, and the bureaucracy and regulations of the insurance system are a nightmare, but once you actually get to the point of care delivery, the quality of medicine you receive in America is better than what you get anywhere else. The lesson in this is that no centrally planned bureaucratized system works very well. Also, the real problem in medical education is how specialty societies deliberately limit the number of residency slots: by limiting the number of students that can be certified, they keep their own incomes quite high, but in no way does it help patients.

    I would actually go a step further: don’t stop at 90% of insurers. The biggest reason medical care costs so much is that third-party payment distorts prices. Back in the 70s and 80s, the RAND Corporation did a randomized trial of insurance benefits that found that people will use more health services if they have more generous insurance coverage, with no measurable health benefits. Shockingly, people are less discriminating in their use of medical care when someone else is paying most of the bill. But all the resources within the healthcare system are still scarce, so prices go up.

    So yeah, get rid of the FDA, get rid of medical education, and for the love of God get rid of third-party payment.

    • http://mickeyhobart.wordpress.com/ Mickey Hobart

      Couldn’t that be somewhat addressed by a tax break for non-employer insurance?

    • Kam3don

      “…the quality of medicine you receive in America is better than what you get anywhere else.”

      I have to disagree. I have had far better medical and dental care in South America. It’s not just the fact that it’s cheaper there and there are no third-party payments involved. The actual quality of the care itself was better. I’m not sure how to quantify it, but I felt far more satisfied as a patient. And the outcome for my health was always great, with far less stress, far less waiting, far less paperwork.

      • Anonymous

        Because, as James explained in his article, they are there because of compassion not money.  They are not $300,000 in debt and prescribing you everything under the sun to pay this off.  South America is better than here because it is a more free market system.

      • Curious

        May I ask in which country/countries you experienced this?

        • Kam3don

          Brazil

    • Kam3don

      “…the quality of medicine you receive in America is better than what you get anywhere else.”

      I have to disagree. I have had far better medical and dental care in South America. It’s not just the fact that it’s cheaper there and there are no third-party payments involved. The actual quality of the care itself was better. I’m not sure how to quantify it, but I felt far more satisfied as a patient. And the outcome for my health was always great, with far less stress, far less waiting, far less paperwork.

  • http://twitter.com/ArtGow Art Gow

    There is a company in MN that can ELIMINATE 95% of soft tissue injuries, pains, aches, carpal tunnel, repetitive stress, etc… however chronic they may be… there are also other REMARKABLE work they can do on other ailments and problems… (yes ladies, eliminate menstrual cramps in 20 min… I have never seen it fail once and have treated DOZENS of women myself). 

    They have 750+ professional athletes as clients… total training time needed to become highly proficient = 6 month apprenticeship… total training time to become better than 99% of physiotherapists = 2 weeks…I did demonstrations to physical therapists… “If I do it your way I will go broke… you fixed them in 6 days I could have billed their insurance for 6 weeks”The system is in need of an overhaul… enjoyed the post

    • Anonymous

      Okay, I’ll bite.  What is it?

  • Bill Walker

    100% spot on. When the medical industry works like the computer industry, with no guilds and government-enforced cartels, human life will really change.

    • Bob obrian

      new meaning to the blue screen of death!

    • http://jamesaltucher.com James Altucher

      Totally agree. 

  • AndrewPerkins

    Why have humans diagnosing cases when IBM’s Watson, MD can do it!  At least a visit to him will be 0.000001 second, one of which I can afford

    • Bob obrian

      yeah.. the liability insurance companies will go ape doo doo over that

  • http://www.twitter.com/dcpetersen23 David Petersen

    Doctors need to be used as expensive consultants.  You can’t trust them to do everything for you, but they can provide useful guidance and insights.  If you want optimal health, you’ll have to do the bulk of the research and work yourself.  The system in place does not encourage doctors to provide excellent personal care, but rather mediocre bulk care.

    As far as the FDA goes, dramatic changes rather than elimination are the way to go.  The people do need some protection, as most do not have the time or energy to do proper research. And lack of FDA approval of course should not prevent a drug from being sold or prescribed — that is not the freedom we have been promised.

    • http://jamesaltucher.com James Altucher

      I don’t think the FDA does any protection at all right now. Most drugs have more side effects than good and that’s after 10 years of development and 10 years of testing. And while they are doing testing they aren’t allowed to develop any more. It’s a mess. 

      • Pratcrat

        You are correct. Gov’t agencies do the opposite of what they claim and it’s always promoted as “protecting” or “helping” the people. There may be a few naive, well meaning types among the crats, but most are not. Thse agencies are simply departments of a giant protection racket, protecting their own interests and those of their true customers, the corporations. They pass laws, many written by the corps and special interests who pay them off, like in PA when Monsanto was behind a bill to make it illegal to label milk as hormone free. Sanitation laws simply stripped the right of the farmer to directly sell his products and put him at the mercy of middle men and stripped the people of a choice for nonprocessed food. Small beef producers get paid 30-70 cents a lb at auction. Are consumers protected? Don’t we still have meat recalls identified by their INSPECTION numbers out of the big processing plants?? People have been brainwashed that their masters are their friends, that these unelected gatekeepers and bullies help us. They see the truth in narrow fragmented areas where it impacts their own interests, like Bill Maher getting all upset about drugs being illegal, but refuse to consider that just MAYBE the entire premise (control and aggression of some men against others for the collective good) is rotten.

        • Anonymous

          They are a huge protection racket.  That is why marijuana is illegal as well as many other drugs, because no one holds a patent on them, therefore drug companies can’t profit on them.  Actually marijuana is kept illegal for two reasons, one is the drug companies, and two is legalized government theft of property in the “war on drugs.”

      • Pratcrat

        You are correct. Gov’t agencies do the opposite of what they claim and it’s always promoted as “protecting” or “helping” the people. There may be a few naive, well meaning types among the crats, but most are not. Thse agencies are simply departments of a giant protection racket, protecting their own interests and those of their true customers, the corporations. They pass laws, many written by the corps and special interests who pay them off, like in PA when Monsanto was behind a bill to make it illegal to label milk as hormone free. Sanitation laws simply stripped the right of the farmer to directly sell his products and put him at the mercy of middle men and stripped the people of a choice for nonprocessed food. Small beef producers get paid 30-70 cents a lb at auction. Are consumers protected? Don’t we still have meat recalls identified by their INSPECTION numbers out of the big processing plants?? People have been brainwashed that their masters are their friends, that these unelected gatekeepers and bullies help us. They see the truth in narrow fragmented areas where it impacts their own interests, like Bill Maher getting all upset about drugs being illegal, but refuse to consider that just MAYBE the entire premise (control and aggression of some men against others for the collective good) is rotten.

      • http://twitter.com/abhijeet80 Abhijeet

        And you’re basing this sweeping statement on what data?

    • Anonymous

      They are completely compromised by the drug companies.  What research is needed?  If three people whom I trust tell me something cured them then that is better than all the third and fourth hand information from the FDA compromised “drug trials” that you can give me.

  • pjc

    One of my college friends (we’re no longer in touch, but good friends at the time) is the daughter of a famous oncologist. 

    Like, one of the most famous oncoligists of the last 50 years. Serious rock star.

    Her family had some money. They didn’t live crazy rich, but educational debts were not an issue.

    Her dad ponied up for undergrad, no questions. However, before ponying up for med school, she had to spend a year emptying bed pans. She wasn’t going to get the free MD unless she proved she really wanted it.

    • http://jamesaltucher.com James Altucher

      Great, great story. What ended up happening?

      • pjc

        She emptied bed pans for a year. Not full time, but somewhere between 20 and 30 hours per week. 

        She has an undergraduate degree from an Ivy League college, and schleped poo alongside kids with community college associate degrees for  a year. 

        Then she did well in med school, and now is a professor of medicine studying the effects of nutrition and exercise on childhood development.

        The broader point is her dad completely agrees with you. Docs should do scut work to prove they want it, not go into mega-debt. 

        The current system selects for kids that have rich parents more than it does for kids with a passion to be a doctor.

        Did you know the tax code has a special expemption for “education”. If a dad wants to give his 23 year old 200K to do with what he will, he has to pay a gift tax. But that same 200K on education is free from the gift tax. Basically a “doctors and lawyers beget doctors and lawyers” tax loophoole.

      • pjc

        She emptied bed pans for a year. Not full time, but somewhere between 20 and 30 hours per week. 

        She has an undergraduate degree from an Ivy League college, and schleped poo alongside kids with community college associate degrees for  a year. 

        Then she did well in med school, and now is a professor of medicine studying the effects of nutrition and exercise on childhood development.

        The broader point is her dad completely agrees with you. Docs should do scut work to prove they want it, not go into mega-debt. 

        The current system selects for kids that have rich parents more than it does for kids with a passion to be a doctor.

        Did you know the tax code has a special expemption for “education”. If a dad wants to give his 23 year old 200K to do with what he will, he has to pay a gift tax. But that same 200K on education is free from the gift tax. Basically a “doctors and lawyers beget doctors and lawyers” tax loophoole.

      • pjc

        She emptied bed pans for a year. Not full time, but somewhere between 20 and 30 hours per week. 

        She has an undergraduate degree from an Ivy League college, and schleped poo alongside kids with community college associate degrees for  a year. 

        Then she did well in med school, and now is a professor of medicine studying the effects of nutrition and exercise on childhood development.

        The broader point is her dad completely agrees with you. Docs should do scut work to prove they want it, not go into mega-debt. 

        The current system selects for kids that have rich parents more than it does for kids with a passion to be a doctor.

        Did you know the tax code has a special expemption for “education”. If a dad wants to give his 23 year old 200K to do with what he will, he has to pay a gift tax. But that same 200K on education is free from the gift tax. Basically a “doctors and lawyers beget doctors and lawyers” tax loophoole.

  • http://termpaperwriter.org/ research paper

    Oh my…. Thats great! We need a ragical reform like that!

  • http://www.facebook.com/profile.php?id=1427573246 Emiliano Sarazola

    Best article ever! James, my congratulations from Uruguay.

    • http://jamesaltucher.com James Altucher

      Uruguay! I’ve only been as close as BA but one day. 

  • http://www.twitter.com/dcpetersen23 David Petersen

    Ever heard of PRATFO James?  It’s lingo Doctors use with each other.  Stands for ‘Patient Researched And Told to Fuck Off’.

    • http://jamesaltucher.com James Altucher

      Funny. I had never heard that before. Thanks.

    • http://www.twitter.com/dcpetersen23 David Petersen

      *reassured, not researched.

    • http://www.twitter.com/dcpetersen23 David Petersen

      *reassured, not researched.

  • SALT

    As a retired Chiropractor in NYC, I could not agree with you more. Many patients would tell me they were going to their “Regular Doctor” (M.D.). Most of the time, something simple was scaring them. I would suggest a simple natural remedy, adjust them and tell them to get a good night’s sleep. If they had a more complex complaint I would tell them OK, go see your MD or go to the E.R. Never had a complaint about this approach. Most visits to M.D.s are unnecessary and a complete waste of time and money. In general, I love M.D.s and most are dedicated………..the insurance companies and Government have destroyed a perfectly fine, useful profession. I have many MD friends and they are all recommending that their children go into a different field. 

    • SALT

      Oh, yes. I forgot. For an established patient the visit to my ofice was a maximum of $40 for an established patient.

  • Lionsandtigersbeach

    With all respect to a good writer, this is medical quakery.  People have no trouble buying a new car or paying for a vacation when they want to feel better after a lousy day with the wife or a lousy boss.  But when it comes to paying for something that will make their life better, they want a free lunch.   Don’t be foolish; see a real doctor.

    • Anonymous

      I wonder where can one find a real doctor, is there a yelp guide for that?

      • http://jamesaltucher.com James Altucher

        what’s a “real doctor”? how do you measure compassion in the ivory tower?

  • http://736hundred.tumblr.com/ 736hundred

    James, Dont you ever get plain worn out by all that is f*cked up in the world?

    Everything is broken.  Everything.

    • http://jamesaltucher.com James Altucher

      You’re not broken. 

      • http://736hundred.tumblr.com/ 736hundred

        Thanks Doc!

        • Brent Hoag

          wait until you get his bill

          • http://736hundred.tumblr.com/ 736hundred

            Well, I follow Altucherism, so it is he who will be getting my bill.

            (was that do the opposite or think the opposite?)

            Doc,  I can’t remember.

  • RickEss

    James, I think you are really on the right track here, but you just need a little more time to work out some of the finer details in what you suggest. On the doctor issue, start with getting rid of licensing requirements, and the market will work out all those pesky details about training and schools.
     
    The FDA is a no brainer. With the technology we have now, the market, non-profits, etc. can help us navigate which drugs work, are safe, etc. We still have tort law to restrain bad players.
     
    Insurance is another one where if we just removed all of the state mandates, cross state restrictions and other regulations that restrict supply, we could get to a better market solution. Once we realize that things like having babies, viagra, and sex change operations are things that are planned and that insurance does not equal pre-paid healthcare, we could come up with true “catastrophic” insurance coverage that only kicks in for big, unanticipated problems.

    People spending their own money is the only force that can drive costs out of the system permanently (see lasik eye surgery and fake breasts for examples of better work at lower and lower prices).

    • http://jamesaltucher.com James Altucher

      If you get rid of the FDA and medical licensing requirements then that will automatically survive the insurance stuff. I agree with you on the last paragraph and its starting from scratch , rather than bandaid-ing  the situation, that will get us to cheaper prices. 

    • Anne1958

      The problem is that most people do not want to pay for health care. As a physician I have seen too many people wearing designer shoes who balk at being asked to pay even a small charge for health care or medications. They say, “can’t you prescribe something my insurance covers because I don’t want to pay for the over the counter medications”
       

  • http://www.facebook.com/people/Jared-Bond/799625435 Jared Bond

    Licensing and lawsuits are what prevents an alternative from rising. Get rid of those and the free market will meet the demand.

    • http://jamesaltucher.com James Altucher

      Totally agree. These disappear when the FDA disappears and the nature of “being a medical professional” changes. It puts power back with the people which leaves less room for malpractice. 

  • Anonymous

    “A yelp-like system should be created to review both drugs and doctors.”
    This is exactly what Milton Friedman recommended many years ago. I am glad you came to the same conclusion as he did.

    • http://jamesaltucher.com James Altucher

      damn, I was hoping to take full credit. Can you link to the book where he recommends this?

      • Anonymous

        Off the top of head I cant think of the exact source where he described the rating system but here is an excerpt from Capitalism and Freedom that deals with a related topic that you also addressed in your post: on medical licensure

        http://www.fff.org/freedom/0194e.asp

        BTW,L’Shana Tova James!

  • http://mickeyhobart.wordpress.com/ Mickey Hobart

    Also need to stop subsidizing demand for health and medical care with welfare and entitlements, to remove international barriers to drugs and foreigners with such skills, and possible more…

    • http://jamesaltucher.com James Altucher

      Definitely an issue. Essentially what I’m suggesting is to start from scratch but a good first step is to eliminate the FDA and then reform the requirements for a medical license. 

  • Christopher Parker

    There is a business opportunity here.  It wouldn’t be too hard to build a completely parallel system that would take care of subscribers.

    What’s stopping it?  The FDA.  Licensing.  Pharma lobbiests and the laws they cause.  The business risk is way too high and it’s not risk from lawsuits, it’s risk caused by government interference.

    Consider the sad sorry state of the railroad industry, c.1930-1980.  Hobbled by government regulation which encouraged a culture of non-innovation and parasitic unions.  When government got out of the way, railroads rebounded, but not before highways had taken much of the business.  What is the equivalent medical competitor to take highways role in this story?

  • http://www.facebook.com/people/Joshua-Holmes/772158900 Joshua Holmes

    The Yelp system for drugs would be an utter failure.  The plural of “anecdote” is not “data”.  Without controlled trials, there is no way to tell if something works or not.  Moreover, what works in some people does not work in others, and side effects can vary significantly.

    There is also nothing preventing the same moneyed powers from compromising the Yelp for Drugs system with fake/paid-for reviews.  Tim Ferriss is making a fortune teaching people that they need to scam systems, fake expertise, and exploit loopholes in order to profit, and he demonstrated it by compromising Amazon’s review system with advertising.  If Amazon can be compromised, so can Yelp for Drugs.  The difference is, the FDA can pull a failing drug and shut down false or misleading advertising.

    What is more important to note is that many ways of providing and funding trained, licensed medical care are either illegal or subsidized out of existence.  The insurance company-pharmaceutical company-giant hospital-Medicare system is as much a product of government policy/interference as Britain’s NHS.  Medical care can be provided from ground-up payments through mutual organizations, fraternal orders, and lodge practice.  But these are either illegal or heavily disfavored by subsidy.  As a result, we get the worst possible system: a government-chartered, heavily-subsidized cartel free to profit without limit.

    • Anonymous

      But that does not negate the fact that a form of what he suggests does in fact exist already.  On the internet there are credible sources who discuss treatements that work but are not approved by the FDA.  People must often go out of the counrtry to obtain be treated because above all the FDA is an enforcer for drug dealers.

      • Brian Utterback

        Proves the point. Most of those treatments that are not approved by the FDA that are discussed by “credible sources” do not in fact work. There is no reasonable way to determine what is a credible source. Even very credible sources like Dr. Oz sometimes go off the rails.

    • http://www.makemenfree.com Makemenfree

      If the FDA is so awesome then it won’t have a problem surviving on its own.  Mr. Altucher is wrong on one point: no need to get rid of the FDA, just sell it to the highest bidder(s).  If the data and research it does is vaunted and so ur-awesome, then people won’t mind paying big bucks for it. 

      I’d say the fact that it is forced upon us indicates that it would be worth about $5 on the free market.  You know, that place where real value is created.

  • http://twitter.com/BrennonW Brennon Williams

    James,

    I worked for two years at a Medical Device startup in San Francisco, and the most terrifying prospect was dealing with the FDA. Fortunately, we managed to get around it, but had our product required FDA approval we would have been sunk.

    According to a Stanford GSB lecture I heard, pharma companies can spend as much as $1.6 billion per drug, which is why meds are so expensive. While the FDA is trying to keep people safe, their inability to do anything in under a year for under a billion dollars makes curing illnesses extremely difficult. You are spot on in that regard.

    I have to disagree with what you say about doctors and health insurance unfortunately (though I’m biased- I come from a family of doctors and my father owns a health insurance company). The human body is extremely complex, and a doctor needs to understand how it works to do his job properly. The training you describe is great for say military medics who only have to deal with battle wounds, however an in-depth understanding of chemistry, biology, and anatomy is required to make a good doctor. I wish it weren’t so (chem and Bio are hard classes, if you can recall from college), but unfortunately it is.

    I’ve looked at the numbers, and I find that privatized health insurance can be very cost efficient. My boxing coach (he gets punched in the head for a living) has a plan costing less than $100/month, such is the magic of a competitive industry.

    Good article James, well thought out. I hate to disagree with you, but I thought you should know the other side of the story.

    Oh, and a great writer once said, “Short sentences are good.” ;)

  • Amy731

    I hope you’re not posting this because you’re frustrated up to here with Claudia’s doctors. I hear Lyme disease can be difficult to treat. Hope she is feeling better and the doctors are treating her with compassion. 

  • Anonymous

    Great post. I agree about the FDA. For malpractice insurance I think doctors should have to carry a set amount (say 50k). If you think your life is worth more, you can optionally buy a 3 million dollar policy. This would dramatically change the cost of medical care.
    And, I’m not sure I agree about doctor training. Are we complaining about how much it costs to be a doctor or about how much they charge? Or about how much they make? Or are we all just complaining?
    Most humans are not mature enough to be md’s at 22. Just a humble opinion.

  • http://www.brookefarmer.com Brooke Farmer

    James, I simultaneously see where you are coming from and vehemently disagree. I have to admit that I am very, very, very glad that the guy who took a scalpel and cut a tumor out of my brain had education beyond Google and Wikipedia on how to do so. 

    And really, as successful as Yelp! is, it is also a major problem in the restaurant industry. I know a man who got his ex girlfriend fired from her position as a server at a local restaurant by having his friends all post bad reviews of her. A lot of people lose their jobs because some overzealous, self important Yelper said something bad. 

    • Jayme_bradley

      finally somebody with a brain…. i can’t believe there are so many retarded statements in this comments section.  there are lots of things wrong w/ the FDA spending, medical education, and everything else.  but the proposed solutions are absolutely asinine.

    • http://www.makemenfree.com Makemenfree

      Since you’re the patient, you should have the right to go to whichever doctor you want to.  If I’m poor, maybe all I can afford is the Wikipedia guy.  But, if he’s done several hundred more cases than the MD, no reason why he won’t be just as good.  The point is I should have the freedom to choose.  ALL of the problems with healthcare today are due to gov’t limitations on freedom.

  • http://twitter.com/jpmorgenthal JP Morgenthal

    Careful James, this is the kind of revolution that government fears. Not that mad, gun-toting, take-it-to-the-streets revolution, because they have more than enough drones and firepower to handle that, but revolution of the system that removes their power and control. The Men-in-Black will be at your door within the week! ;-)

    Seriously, an intriguing post. Wish we could actually set up think tanks, empowered by the government and the people, to take ideas like this, vet them, transform them in ways that insure a safe and secure outcome and then attempt them on a small scale outside the restrictions of regulations and laws that would hinder their existence, but under ethical guidelines.

  • Anonymous

    Hi James, I love your blog, but I have to speak up on this one. I work in the pharmaceutical industry and I must say you are dead wrong about the FDA.

    “It costs a billion dollars to get a drug through the Food And Drug Administration.”

    This is a pharmaceutical industry lie, pure and simple. It’s almost impossible to know the exact cost of bringing a drug to market due to the opaque accounting, but it is almost certainly several hundred million less than the commonly believed figure.
    (http://m.theglobeandmail.com/life/health/new-health/andre-picard/drug-rd-costs-are-less-than-estimated-so-why-the-high-prices/article1917822/?service=mobile).

    The sad fact is that pharmaceutical companies spend at least twice as much on advertising than they do on research and development.
    (http://www.sciencedaily.com/releases/2008/01/080105140107.htm). This is one of many reasons why a ‘yelp’ system won’t work. Another reason is studies have shown that people assume that newer drugs are automatically better than older drugs, even though there is no evidence to support this.
    (http://www.msnbc.msn.com/id/44487999/ns/health-health_care/t/older-pills-often-safer-many-think-new-better)

    And then there is the placebo effect, how can a self-reporting system be used to judge side effects when so many of the people taking placebo report side effects from taking nothing? The only way to assess the effects of a drug (positive and negative) is through rigorous double blind studies.

    “It takes ten years to do this so potentially valuable drugs stay out of the hands of patients who will most assuredly die in this time.”

    This is true for run of the mill drugs where there are already treatments available. Drugs that show potential to save lives can be fast tracked through the FDA process in as little as 6 months.
    (http://www.fda.gov/forconsumers/byaudience/forpatientadvocates/speedingaccesstoimportantnewtherapies/ucm128291.htm)

    And doctors are not as beholden to drug companies as you think, the fact is if you had a drug that was proven (and that’s the hard part) to cure liver cancer, you wouldn’t need to educate people about it, one journal article would probably do it.

    The FDA isn’t the reason drugs are expensive, they are expensive because pharmaceutical companies have a monopoly on their drug as long as it is under patent. With no competition, they can charge what they want, because most people aren’t paying out of pocket and thus don’t see the true cost. Those without insurance and can’t afford it are SOL.

    Pharmaceuticals is a sleazy business  and definitely need oversight. The FDA is far
    from perfect, but without regulatory oversight we’d be taking questionable drugs for everything from squeaky toes to itchy earlobes.

    I could go on, but I’ve babbled for long enough…

    • hennybogan

      Couldn’t the oversight be provided by the free market?  That is, companies would emerge who test the safety and efficacy of drugs (think Consumer Reports or Underwriters Laboratories).  I could choose to take a drug that is endorsed by these organizations or I could also take drugs that aren’t endorsed by them.  Some drugs may be endorsed by all the organizations, some by only one or none.

      We’d see competition emerge in the drug testing business, quality of this service would increase and costs would decrease.  These services would blow away anything the FDA could provide, simply because there’s free market competition.

      James, the other thing that needs to be abolished is Intellectual Property laws, which are a complete scam.  These laws are essentially government sponsored monopolies which limit competition and drive up costs.

      Property rights are for things that are scarace, ideas aren’t scarace and that’s would IP law limits…new ideas.

    • Anonymous

      I am afraid you don’t know how bad the situation is. The FDA helps it along. Lets take an example, my favorite is the statin drugs. They are virtually useless. They cause a number of serious, ill defined side effects. If you look at the NNP number for a statin, you will find that the best subset of patients that benefit from the drug have an NNP number of 1 ot 20. That is fairly bad. The average individual on the drug has an NNP of 100 to 500 to one. That is essentially non-effective. Now consider that coronary artery disease likely has nothing to do with cholesterol as cholesterol issue are known on only 30% of people having MI’s. Yet 100% of people having an MI have elevation of inflammatory markers. Thus the disease is one of inflammation. That is not being aggressively looked at. Instead, everything is framed in cholesterol as that is were the money is.

    • carla

      Your missing the point….do away with drugs and western medicine…get to the root of the issue to really help people recover. Drugs just suppress symptoms and cause side effects. This is not the answer.

    • carla

      Your missing the point….do away with drugs and western medicine…get to the root of the issue to really help people recover. Drugs just suppress symptoms and cause side effects. This is not the answer.

      • Jayme_bradley

        you obviously aren’t in drug delivery research or know anything about drugs.  not all drugs “just suppress symptoms”…

    • Anonymous

      FDA has approved drugs… that in the research has shown to cause heart attacks and other health issues, and people die! 
      They are paid by the drug companies…. Then after they kill so many more.. they pull them either off the market… or   Black Box them!!! 
      We have corrupt people who have gotten into FDA and USDA and are heading them up and putting big industry first….. before safety. 
      There have been people reporting the corruption… but they get blown away… to keep the big money interests happy!…. 

      What we really need is third party .. unbiased research… to check and qualify all drugs.
      Drugs cause so many problems… with these new ones… and then they bring in the Politicians to get them to make certain drugs… mandated to everyone…
      They should be hung!

      Drugs are big business… back in the early years up to 1980’s… there were not pharmacies on every street corner or in every grocery store… or on line…

      All of this crap is about controlling everyone…. so the big guys and their s … friends make $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

      The drug companies pay out lots of kick backs to get pharmacies and doctors and insurance companies, hospitals… to use their drugs…. and don’t think it doesn’t happen
      I worked in all sectors and we dealt with that….  and they were usually higher costing drugs… than what the patient was on….. and more side effects!

      WE can LEGALLY KILL PATIENTS WITH PRESCRIPTION DRUGS…. BECAUSE THEY ARE APPROVED BY …..F D A…. Isn’t that nice…

      WE have people from Monsanto on the FDA   and the USDA…. isn’t that nice..

      Why don’t we clean up the farming practices and farm real foods locally and get rid of all the processed foods…. that are also adding to all the health problems…

      And FYI… 58 years ago my grandfather died from colon cancer…. and they still haven’t
      found a cure….?????? is there something wrong with this picture…

      Yet in 1972… they told us in health care… that there… was a cure for cancer… but  they were not letting it out because… the pharmceutical company’s and medical communities would not make any money…. 

      So the question is…. why is cancer on the rise?????  you figure it out… it is what you are not told and led to believe by the money makers…..

      Well, based on  continuing education … at a very good university… oncology dept,
      I would not take chemo….. or recommend it to any one I love…..

      and I started to tell you about this,, but cut it out….  with the government the way it is….. well… someday you all will learn…    the true corruption…..

      I have a medical friend…. that treated another way… and then the university where they taught came and said if you want to keep your job…. you have to do one of the regular treatments…..   because if this gets out we will looooossssee lots of $$$$$$$$$$$$$$$$
      so they did surgery only…. it was not necessary,,, because when they got in there it was all gone…. but they removed the body part any ways….

      This is how much corruption…. is involved in our system…. and the insurances are just as big  corruption,  as any where….  and if the (i’s) are not doted and the (t’s) not crossed
      they would send back the paper work and knit pick over stupid stuff like that…. just so as not to pay for …. and deny claims,  and claim the patients were not honest when they applied for the insurance…. just to get out of paying  for treatments…

      Take care of your self…. eat well…. as possible…  get the rest and play and exercise with the family and have fun….  and educate your self the best you can….
      find a good naturopath  or integrative medical group… that treat the whole person…

      • ME

        I totally agree with everything you said. In this so called, “free” country of ours,we are not allowed to choose what treatment we want for our own children. When it comes to cancer treatment,if one decides they would prefer a safer,more sane treatment for their child, the whole corrupt system gets involved. Including children’s services that will remove your child from his/her home,and deliver them to the sickos that will gladly cut,poison and burn them.
        Something definitely needs to change.  

    • http://www.facebook.com/justin.roffmarsh Justin Roff-Marsh

      You ask how a self-reporting system might work, given the placebo effect, etc.

      It may well be that a Yelp-style system is not appropriate. However, that does not mean that the free market cannot figure-out a solution.  I suspect, absent government intervention, people would understand the challenges and base their decisions on the outcomes of independent studies.

      It’s true that many people are gullible today.  However this credulity is, in part, a consequence of the nanny state.

  • Justin Ames

    Thank you so much for this post, James.  

  • http://www.facebook.com/profile.php?id=607318 Vladimir Zykov

    What about drug companies that don’t cure cancer, but do things like invent diseases (“ADHD” in children, partly a product of the school system and standardized testing, but partly of the profit motive as well) — or companies that market antidepressants that actually increase the likelihood of suicide? Yes, doctors would be less tempted to enable such situations if they didn’t come out 300k in debt — but they would not disappear altogether. Wouldn’t regulation in some form (though not FDA in its current form) be a way to stop things like this from happening?

  • Alan Goulet

    James,

    Why limit your proposed system to medicine? What you are proposing is a system whereby any an all people can engage in voluntary exchange of information and goods – A.K.A. anarcho-capitalism. The only limits are that force and fraud are prohibited.

    This of course is the logical conclusion to the ‘classical liberal’ movement of a couple hundred years ago. Unfortunately, we’ve gone off on a tangent of totalitarian-progressivism and totalitarian-conservatism – but we’ll get back on track, sooner or later.

    • Sunny Jim

      And how do you propose that force and fraud be limited in the world of anarcho-capitalism? First, true capitalism does not exist here. Debt capitalism fueled by limited liability and fiat money prevails, and that is fraud from the incept. And how will you limit such fraud, without the use of some sort of de minimis force? Can’t be done without changing the hearts and minds of the people…the teachings of Christ here are essential. Treat others as you would treat others. Until this is achieved on a cultural level, there will always be the need for some sort of force. If a man comes to my house and tries to kill my children, I will put him down if I have to. Would prefer not to, but it would be criminal to let him kill my babies. Anarchy doesn’t work, unless you defer to the one true King, Jesus.

      • Jon Thompson

        Let’s leave God out of the discussion until you can prove it exists. Contracts which are enforced by competing insurance/protection agencies would work infinitely better than a statist solution – which is a non-solution by looking at the results. Anarchy works in all other aspects of our lives – marriage, religion etc. Also, let’s not equate the use of force with the initiation of violence. Two different animals. You may certainly defend yourself in a free society, but according to the scriptures you should “turn the other cheek”.

      • Alan Goulet

        The distinction between initiating violence and responding to violence is key – I apologize for not making that clear. A pacifist might not even want to use violence to defend him/her self, whereas someone subscribing to the libertarian ‘non-violence’ principle would only view the initiation of violence as unethical. I am referring to the latter.

        The concept that the ‘market’ can provide solutions that would replace our current nation-state legal system is not easily absorbed. One might first come to the realization that granting a monopoly on such things to a single entity can not possibly work – the entity (in current times the nation-state) will always create laws and enforcement of these laws that will benefit themselves and those closely connected. Even if this doesn’t happen abruptly, it will evolve thusly over time.

        A good book to read that discusses many facets of a potential society based on voluntary association is ‘The Market for Liberty’ by the Tannehills. Another is ‘The Law’ by Bastiat. You can find both online for free.

        In science we try to come up with unification principles for multiple phenomena. After thoughtful reflection, many have come to the conclusion that the ‘grand unification’ in the realm of ethics is the non-violence principle (again – this is referring to the non-initiation of violence). Once you embrace this principle, you realize that if it applies to individual people then it also applies to groups of people – even if these people have formed a so-called ‘democracy’.

  • doug

    Judged by outcomes, Cuba has a pretty good healthcare system.  I’m pretty sure they don’t spend $300,000 to make a doctor.  However, here is their best trick – which didn’t rate a mention in Mike Moore’s film Sicko – on average Cuban health care customers consume only 1,800 calories a day.  Put American’s on that diet here and boom! outcomes up, costs down.  

    Was Medicare invented to make health insurance companies profitable?  Medicare picks up the cost of poor risks – so the insurance companies don’t need to.  Medicare spends nearly 30 percent of its budget on beneficiaries in their final year of life. Slightly more than half of Medicare dollars are spent on patients who die within two months. Is this going to change? Does Medicare survive under your reform?

    How about that two million dollars spent on each premature baby weighting one pound – and the outcome even with a live child isn’t stellar.  Who pays?   

    And lots more.

    I’m in favor of radical reform (close the insurance companies and the doctor’s union tomorrow) but there are a few more details which will need some work.
    doug

  • Bill Lenihan

    Let the Internet be a virtual FDA. A drug will have a web page, a scientist with verified credentials will document his research, . . . .

    What do “credentials” mean in your system, and who is doing the “verifying” thereof?

    . . . . and comments from users will describe their experiene with a drug.

    Who’s preventing stealth marketing from polluting the Drug XYZ message board thread?

  • Gil

    Wow!  James doesn’t seem to comprehend the concept of an expert or the training required.  He sees a carpenter hitting nails into some wood and thinks to himself “I can do that therefore I’m a carpenter”.

    • Jayme_bradley

      he thinks all “doctors” are general family practice doctors or an internalist who prescribes cholestrol medication, i guess.  i don’t know why this article is bugging me so much. this is all crazy talk.  this is actually what’s wrong with global health.  (third world)…. the locals would rather go to a “witch doctor” first, rather than accept the healthcare of a developed nation.  the infrastructure is all jacked up, even when the W.H.O. goes in to help.  there’s a reason why life expectancy has gone up, and why the 5-year survival rate of cancers have been improving decade after decade.

  • clark

    I read some of this blog post, no way can I read the comments tonight, too much beer.
    As I read the blog, all I kept thinking of was this blurb on the radio about how some researchers had found this virus that doesn’t attack People but it totally attacks cancer, Only, we have to wait for FDA trials before it’s available,… what’s that, like in 12 years? How many People have to die between now and then? Even if it doesn’t work as advertised, shouldn’t it be up to the individual to decide? My Len, no. What do you think this is, a free country or somethin’?

  • clark

    I read some of this blog post, no way can I read the comments tonight, too much beer.
    As I read the blog, all I kept thinking of was this blurb on the radio about how some researchers had found this virus that doesn’t attack People but it totally attacks cancer, Only, we have to wait for FDA trials before it’s available,… what’s that, like in 12 years? How many People have to die between now and then? Even if it doesn’t work as advertised, shouldn’t it be up to the individual to decide? My Len, no. What do you think this is, a free country or somethin’?

  • Syren

    James this is off topic but I had to report that after the hula hoop post, I bought a set of hula hoops for my school.  O.M.G.  We – students, teachers, me – are now hula hoop OBSESSED.  30 fifth graders are just a few moves away from a career with Cirque du Soleil!  It’s genius. Thank you.

  • Burn Rome

    Your assessment of the FDA is spot-on, and having participated and
    excelled in the farce… err field that is Health Science at the
    University level I can attest to its imbecilic approach and above all
    its disastrous implications; its participants are often render
    subservient to the Pavlovian educational approach that I have called
    ‘pump and dump.’ That is to fill your head with as much ‘information’ as
    possible to cover the exams intended material, often but not always
    comprehensibly outlined in a curriculum, and recall said information
    long enough until the quiz/midterm exam/final and then immediately purge
    it from your mind to make way for the other 4-7 classes and labs you
    have that week and subsequently semester. This is the only way to
    approach it as taking the time to actually learn and question the
    materials use or application will directly conflict with the time
    necessary to focus on other classes and render you unprepared for the
    vast amount of outdated theory and/or impractical and obsolete practices
    you are graded upon–many of which render you obsolete in a laboratory
    in the 21st century.

    It was up until I was a Junior that it still
    surprised me to know that the ‘A students’ were often incapable of
    recalling basic acid-base chemical reactions (mainly what a year to a
    year and half of Chemistry classes is dedicated to) let alone its
    applications in Biochemistry and Organic Chemistry.

    That said,
    this subservient underling is the exact model the Medical Industrial
    Complex desires to have under its employ, it seldom questions and never
    resists to its demands as it has been conditioned to not only labor
    under this congenial-servitude but it expects nothing less; and through
    various programs and privileges with Universities it successfully
    creates them. (It is no surprised when you realize that Rockefeller
    himself via Abraham Flexner’s Carnegie Foundation acting as a proxy was
    what instituted the corrupt and anti-market practices of what is known
    as Allopathic Medicine in the US.)

    Otherwise you get trouble makers like Stanislaw Burzynski
    defying the MIC’s sacred cash cow: Oncology. Curing people is bad for
    business, you see. Meeting and filling Market demands is seen with
    nothing less than scorn, theft and reprisal. If you want to see the the
    blatant and overt abuse of the State via the MIC’s clout over Free
    Market progress then take the time to watch: Burzynski The
    Movie – Cancer Is Serious Business. Buy the DVD and give it to your
    arrogant dull-witted Obama-care proponent for Christmas, if it doesn’t
    work than at least you’ll recieve one less card and fruitcake; both of
    which you likely threw away.

    How anyone (that pharma guy below included) can support the Medical
    Industry (read: cartel) after witnessing this is beyond comprehension,
    unfortunately for me I was much like the hypothetical character before I
    left University: disillusioned and with a ‘bad personality’ as result
    of my experiences there. So by the time I saw this it did nothing more
    than further substantiate  my theory and argument.

    At that time I began to take solace in the merits of the Simpson’s
    ‘Virtual Doctor’ spoof, at least it couldn’t make you a fugitive and
    steal your children and while placing you in a prison-gulag via State
    decree for abstaining from killing your children with chemo the Hauser’s
    in 2009.

  • http://pulse.yahoo.com/_POB33ROL73OHJFKK6F2Y25ECCQ JeffreyJ

    Ah yes, a doctor books four patients for the same hour and gives each ten minutes of his time. He then bills each for the full hour (at a much higher hourly rate than most professionals would charge).

    For any other profession, this would be a felony under federal law–maximum-security prison time. But not for doctors. (Land of Equality?)

    ———

    The patient asks: “Doctor, what’s you middle name?”
    The doctor responds: “I’ll have to consult with three other supposedly educated professional doctors, and then we’ll take a wild guess.”

    • Anonymous

      He does not bill for the hour. Doctors rarely bill for time. They bill for procedure. In this case the procedure is an office visit. The parameters are set by medicare. Also, 10 minutes is alot of time with a patient. If I spent more time than that I would be billing for time as well.

      • Jayme_bradley

        of course, not everybody knows this and posts things they don’t really even understand.

  • Zhibro

    I cannot agree more.
    But I did get useful information from medical study, i.e. necessary nutrition. Then I checked the food, fresh food, not drug. I am recovering at a good pace.

  • Zhibro

    I cannot agree more.
    But I did get useful information from medical study, i.e. necessary nutrition. Then I checked the food, fresh food, not drug. I am recovering at a good pace.

  • Liberty Lover

    I think you’re predictions would likely come true.  However, even if they don’t, the free market would ultimately find a solution which may be completely different from what you predicted.  This would stand in stark contrast to the cronyism that currently exists with the FDA, insurance companies and medical school accreditation.

    I’d love to buy a sovereign island in the Carribean and build an airport, a hospital and drug lab/manufacturing plant and let the free market work.

  • Liberty Lover

    I think you’re predictions would likely come true.  However, even if they don’t, the free market would ultimately find a solution which may be completely different from what you predicted.  This would stand in stark contrast to the cronyism that currently exists with the FDA, insurance companies and medical school accreditation.

    I’d love to buy a sovereign island in the Carribean and build an airport, a hospital and drug lab/manufacturing plant and let the free market work.

  • http://pulse.yahoo.com/_DN5TPCOOQOJ7GU4NRSYBJ4Y2XI H H

    This is truly  depressing. True though.

  • Philosofy123

    The medical establishment is similar to an organized crime focused on enrich themselves.

    If your car is giving you a hard time, you are willing to let your next door neighbor mes with it.  He did not go to mechanical school, but perhaps learned on his own?  You say what if you go to a self taught doctor and he gives you the wrong medicine?  I say, what if the dude with the certificate on the wall gave you the wrong stuff? Sh_t happens.

  • doug

    These ideas are obviously popular which speaks to our levels of discontent.  But as we search for health care happiness it couldn’t hurt to keep the current state of the art of health care in mind.  Treatment of disease requires data/information which points to a diagnosis.  Without a diagnosis the course of treatment can’t be planned.   

    Today in half of all cases physicians do not have data to make a firm diagnosis.

    The really sad part is that in the half of cases where there is data, our health care system fails to follow the best medical practice half the time.  (This is not my opinion but reported by studies.)

    We don’t like it but that level of competence is about the same level of competence of boat repairmen who worked on my boat during a six year period of cruising.  Half the stuff I asked them to fix they screwed up.  My point is that these results may reflect some current limit in the ability of people to manage complex systems.

    doug

  • Anonymous

    This remind me of the midwifery care at a free-standing (as opposed to hospital-attached) birth center I recently received for my first-born. The midwives start as apprentices, and if they can’t handle drawing blood, sticking their fingers into laboring women’s vaginas, being on-call 24/7, and wiping up blood and shit on their first day, they’re dismissed.  It’s a test for passion, as you said.  They spend a while doing the dirty work and slowly advance, finally taking a state exam for their Certified Professional Midwife license (I think the exam was actually written by one of my midwives).  I found out about them through excellent internet recommendations.

    Pre-natal appointments cost an average of $100 each (depending on when exactly the baby comes, since their cost structure was for total care, not by the individual appointment).  They were the same frequency as normal OB appointments, but lasted about an hour each, as opposed to 10 minutes.  Not because they had to, but because babies are born more easily when the mother is relaxed and knows her caregivers.  By the time my baby was born, my two midwives were my friends.  There were no shift changes unless you count that they took turns napping in the exam room during my rather long labor.  I performed my own urine tests at pre-natals (turns out you don’t need to hire a lab tech to put a dipstick in a cup of urine), and they did routine blood sugar and iron tests right there on the couch next to you.  They sent out blood samples for more complex tests, and sent you to other facilities if you wanted things like ultrasounds or genetic testing.  They also had a friendly OB that they could refer you to if anything was outside of what they knew how to safely handle.  I think the birth itself cost $1200, which isn’t cheap, but an uncomplicated birth costs several thousand nowadays.

  • jaf

    James: I am a physician and have to agree with what you are saying. Its a well known fact that the death rate from cardiovascular disease (heart attacks, etc) drops when the cardiologists are at their annual American College of Cardiology meeting. From an internal view of medicine I see that MD’s sometime view patients as a “tree of money” to be exploited (remember the famous Etrade ad “He has money coming out the wazoo …Get that man a private room”). This exploitation is facilitated by the insurance companies that make it “cost free” for the patient. I view all physician advice skeptically just like when the car mechanic tells me I need car work when nothing appears to be wrong with my car. Perhaps Americans are not cynical enough.

    • Wlr1102

      you cannot be serious

  • http://www.peterwrightsblog.com Peter Wright

    Wonderful ideas James, just to let you know that other than brain or open heart surgery (which was available only a short plane ride away in South Africa)  I got quicker, cheaper and equally as good medical treatment from the private sector in 3rd world Zimbabwe, when I was living there 8 years ago, than I can now in North America. 

    Although health care in Canada is nominally “free” we still pay dearly for it through taxes and long waiting periods. It is incredible that I must wait from August to December to have a minor surgical procedure done by a specialist, that would have been done by my own doctor in Zimbabwe the same day or if he was exceptionally busy, later the same week. If it had required the attention of a specialist it still would have been done within 10 days.Health insurance premiums were very low, mainly because frivolous medical malpractice litigation was not tolerated by the courts, resulting in lower costs all round. Admittedly, the government (public) health service was not good but still infinitely better than the services of a witchdoctor in the bush.

  • Anonymous

    The medical education system was fair back in 1970. I has become much worse. Instead of eliminating the education, which actually is necessary, lets reduce the number of doctors we produce. This would assure the absolute best, and it would reduce the cost of medical care substantially. I have found that the more doctors you produce, the greater the number of procedures they preform in order to get the money they desire and thus the greatly increasing cost that we see. Medical economic systems do not follow traditional economic systems because of the concept of economic porfit that is at the root of the system. Economic profit is a special type of monetary incentive and I will leave it to those interested to look it up.

    But the real concept should be, why do you have to go to a government representative and beg for drugs that you know before hand would help you or eliminate your problem? Why does the government have a solid lock on the use of narcotics and pain medications? They certainly don’t prevent drug abuse or addiction. Those are other issues and involve more personality disorders than they do exposure to drugs. We need a system were you go to Walgreens and obtain what you need just like you go to Kroger and get apples and oranges. Some countries actaully do this and they are doing very well. We have the most restrictive drug system in the world and have more difficulty than any other country. Elimination of the war on drugs and getting out of people’s lives might actually solve the spending problem in Washington.

  • James Keith

    Little to nothing happens without the stroke of a
    physician’s pen.  That is a simple
    truth in our current system of healthcare. 

     

    Medicine is a state sponsored fraternity.  Access is controlled by current
    members, the hazing is prolonged and costly, and it’s governed by bureaucrats
    and regulators who have selfish interests.   Doubt me? 
    Check the disciplinary actions of your state medical board.  Moral failure and criminal acts are
    punished for sure.  That’s proper
    and good.  But how about any
    attempt to evaluate performance?  
    Ever try to find out which orthopedic surgeon has the best outcomes
    (clinical and economic) before having that knee replaced?   Ever ask the question, “How do I
    know this physician consistently performs his/her job at a high level?”    You won’t find an answer.   Short of criminality, the medical/regulatory
    establishment has no interest in protecting you from the unknown risks of a
    physician’s pen.   Better it remain an unknown I
    suppose.   More money on that side of the bet. 

     

  • Ross Pomroy

    Next. The Dept. of Education, Teachers Unions and Public Education.

  • Slightlysober

    So where do the Drs. come from that the 18 year olds are suppose to apprentice too, oh that’s right Medical School. Also who posts the drug pages? Why would a anyone do an analysis let alone a credentialed scientist, is said scientist credentialed because of the scientist page they have? I’m reading “The Onion” right?

  • Ross Pomroy

    I know it’s hard to think of what would we do without “Professionals”. Personally I wouldn’t study what an MD does, it would probably be better to apprentice possibly a veteranarian or a chiropractor or a holistic practioner. The key is choice and diversity instead of the “normal scope of care” dictated by the AMA.
     

  • Ross Pomroy

    I know it’s hard to think of what would we do without “Professionals”. Personally I wouldn’t study what an MD does, it would probably be better to apprentice possibly a veteranarian or a chiropractor or a holistic practioner. The key is choice and diversity instead of the “normal scope of care” dictated by the AMA.
     

  • Slightlysober

    So a veterinarian or a chiropractor isn’t a professional, they don’t toil under some equally oppressive Professional Organization rife with corruption?! Currently there is choice and diversity it just that choice and diversity cost extra. As soon as someone is labeled an authority (credentialed) a power differential is established and dollars will seek to influence that authority. As more dollars flow in more power is accorded that authority…wash, rinse, & repeat

  • Drapetomaniac

    To everyone here wishing to better their own health and lower healthcare costs it’s fall and time to consider some vitamin D3 supplements.

     http://www.lef.org/magazine/mag2007/oct2007_awsi_01.htm?source=search&key=William%20Faloon%20vitamin%20D

    I take 10,000 IU of D3 daily during the cold months and about 7,000 IU during the warm months.

    As to ending the FDA, yes. The FDA prohibits drugs designed to treat aging to be marketed. Why? And why should I need a prescription for such drugs if they were available?

    Where do these fools get the idea that I’m their property to be controlled, manipulated, and used like an object?

  • Darren Fast

    I’ve worked in the industry for 16 years and it is definitely broken.  In addition to getting rid of the FDA, you’d have to change the mindset of the general population to convince them that they are responsible for their own health and have to live with the consequences of their choices.  i.e., you can’t sue just because things didn’t turn out like you’d hoped and that everything has potential side effects and might not work for you.  I think you have to add getting rid of the lawyers right along with getting rid of the FDA.

    • Anonymous

      So True Darren,,,, changing the mindset of the general population…
       that they have the freedom to be responsible for their own health ….they are the captains of their own health care also!!…
       the doctor does not live in your body or home… you own that body and your health… and have choices ….keep your freedoms… and take care of it and learn …
      put your own owners manual together… and see how that body works and take care of it…  it out lasts a car… 10 or more times,  and does more than that car… and if we put a price tag on what that body does and how long it lasts,  it would be over $5 billion…in todays markets…..
      and we take better care of the car… than we do ourselves… why…
      because we were taught doctors were God’s….
      as a medical professor told me one day
      western medicine has come a long ways,,, but there is still a lot we don’t know and won’t ever know everything.!
      Western medicine is good a putting people back together from accidents…and a few things… but it does not do a good job on prevention!!!!!
      WE have to do that…..

  • MikeH

    The Yelp system fails in the event you die from treatment – who leaves the negative feedback? Besides, I think that was already tried. It was called snake oil and they ran the guy out of town if he overstayed (unless he sold alcohol, in which case it did make you feel better).

    I think we need to get away from the perception that there is some perfect system that will solve our/the problems – or that anything is really sustainable. History has kind of disproved that. There is always a way to game a system. At best we can hope put in place incentives that discourage inefficient behavior. Note that I say “at best” and “hope”.

    • Drapetomaniac

      Do you think the system in place is the best system for the customer?

      Everything government touches turns to crap. Ringo Starr

  • Anonymous

    James,

    Most drugs do more harm than good.  Just look at all the class action suits on drugs from just a few years ago.  I have had more side effects with most pharmaceutical drugs prescribed to me by ‘doctors’ than the original condition caused.  I almost always use alternative medicine and with great success over the last 20 years.  Homeopathy, acupuncture, diet and excercise, has done more for me than all the doctors and their treatments ever did.  And barely any side effects or none.   The drug industry that sells a drug over TV and Mag ads constantly has just gone wild, they are bad drugs and out of control.  Occassionally one or two does ‘some ‘ good, but for the most part people are better off staying away from them. The drug cos. and the medical establishment is trying to get the whole population on Statins, we will have an epidemic of cancers and other trouble from them within 10 years, bad drugs with bad side effects. People need to listen to their bodies and trust them, not some doctor who is writing prescriptions for every little thing.  That’s what doctors do, prescribe drugs, or they feel they haven’t done their job. ( Told to me by a medical professional who went to Stanford).

    I knew this wonderful elderly couple Rex and Marie, they were 85 and 84 yrs. old , in great health and years younger than their age.  When asked their secret they told us “We stay away from doctors as much as possible.

    • Brian Utterback

      See? This is why the proposed replacement for the FDA cannot work. Here is a case of a person that is using treatments that are not regulated by the FDA or any other government regulatory rules, that have been proven not to work at all. She is using the info provided to her by exactly the system you proposed and it has completely failed. At least the benefits of exercise are accepted, and I can understand being confused by the biased studies showing Acupuncture’s effectiveness, but Homeopathy is just water pure and simple. That’s what relying on anecdotal evidence gets you, treat your cancer with water.

      Certainly the FDA is broken. The regulation of both food and drugs are paid for by the industries themselves, a clear conflict of interest. Good drugs are delayed, bad drugs let through. But there are thousands of drugs that do exactly what they are supposed to do and I would not like to adopt a system that cannot possibly separate the wheat from the chaff, which is what your proposal is.

      About malpractice insurance. I really like the idea presented above about having a cap on the amount that a doctor carries and making that amount mandatory and then allowing the patient to purchase additional insurance, like with flight insurance. Is there any down side to it?

      • judyjudyjudy7

        Brian,

        You are so wrong about alternative medicine, especially homeopathy. You are parroting the ‘it’s only water’  babble by the establishment who hate alternatives to their money tree.  My homeopathist is a medical doctor as well, but left regular medicine because it just doesn’t work, he has been practicing for 30 years, took a big pay cut to do it, but is helping so many, He is one of the most moral and principled doctor I have ever met, though I have had some wonderful regular MD’s, but their form of medicine just didn’t work for me.  They can set a broken leg, and for certain things it is fine, but for most ailments homeopathy works wonders, and prescription drugs make you sicker.  BTY cncer is not treated by homeopathy, but it can make you more comfortable.  One day if you get very ill and nothing helps you, you might resort to trying it and you might be very surprised. Over  40% of folks in France and England see homeopathists for decades and is used by their standard doctors. It has been working for patients for 200 years.  It strengthens the body’s own immune system and vital force and it way more powerful than any ‘drug’.    It has been amazing for me and so many others, but we are led there with the disgust of AMA medicine, prescription drugs, and the ‘last resort’ for help.  that’s how I found it and it has been a miracle in my life.  Get a good book on it and get educated about it. You may need it someday.

           

  • Jayme_bradley

    i can’t believe people are serious about this.

    • Drapetomaniac

      Some people want others to run their lives, some don’t. I DON”T.

  • Jayme_bradley

    yea.. pray for a world where there is no cancer or other serious illnesses.

  • Anonymous

    You have some interesting thoughts that can use some clarity and reality…So do I.  As for abolishing the FDA, I concur, but I have a more simple idea…outsource.  Use the German, French, British versions of the FDA and adopt their oversight.  Drug approved there, drug approved here…simple.  Also, lower costs by allowing people to buy their properly prescribed drugs anywhere.

    As for the health education…I think you are on to something…and that is for 90% of primary care (note…primary care is distiguished from specialty care and facility care), a monkey can be trained to provide those services.  So in your examples, what you are really referring to is your version of an unregulated Primary Care Health Care System.  But that doesn’t address important specialty needs and the training and experience that these services require.

    there is so much more to this…maybe I’ll get back to it.

  • James E. Miller

    This was easily your best post yet James.  No need for academic econ jargon, just simply laying out how the world can work in a better and more efficient way with the technology we have now.  Of course you will have all the “we will die without the government making sure I don’t make stupid decisions” but they are morons to begin with.

  • Anonymous

     Since being awakened I have realized that government agencies are nothing more than an avenue for those to be greatly rewarded by the private sector for not doing their job. FDA, EPA, SEC. I could go on, but James has once again presented the problem(s) and solution(s) in a rather enjoyable blog post.

  • http://www.rainmakervt.com Mike O’Horo

    The idea that doctors make a lot of money is outdated.  For decades, it was true, but since the advent of “managed care,” most don’t make much at all.  A lifelong friend is an OB/GYN.  His practice is in one of the most affluent counties in the U.S., and he has privileges at the hospital located in the middle of that densely-populated, rich county.  If he hadn’t purchased his office building many years ago (allowing him to collect rent from the 4 other medical suites within), he’d have almost no net income.  He’s never had a dead baby case or other major malpractice action against him, loves his patients and they love him, his wife runs the office, but the economics still don’t work.  His malpractice insurance was $150k/yr, per doc.  That’s a lot of baseline overhead.  Add the cost of technology, nurses, other insurance, overhead, maintenance, etc.

    His operating costs went up every year, but insurance reimbursements have been declining steadily since managed care’s arrival.  The buying power that many posters attribute to the government or to consumer-organized coalitions, in fact, rests with the insurance companies and the vertically-integrated BigMed companies.  The handful of insurance companies, who write all the employer-funded policies, “own” the patients.  They decide who can treat the patients by establishing a list of docs who have agreed to their reimbursement schedule.  Likewise, the hospitals “own” the docs because, without hospital privileges, you can’t be a doc whose practice includes surgery or major treatment, e.g., OB/GYN. 

    This two-headed cartel calls the economic tune, and the docs dance to it.  There are exceptions, to be sure.  For example, for some reason, anesthesiologists still have huge pricing power, earning $400k and up.  I don’t know why.  But they are the exceptions that prove the general rule.

    This friend’s son just began med school at the age of 28, discovering later than many that he has the passion for medicine.  Like his dad, he loves people and I’m sure that his style of care will be very human.  But he has no illusions that he’ll earn what dad earned in the first 20 years of dad’s career.  I guess that contributes to believing that he’s passed the “passion test.”

    The problem isn’t the docs’ current earning power, but the pricing power controlled by the combination of huge hospital chains and insurance companies.

    Last year, in the face of all this, my friend stopped doing surgery and gave up the OB part of his practice.  He had to eliminate the massive med mal premiums for surgery.  This year, he laid off his nurses and other office employees.  He determined that he’d make roughly the same amount of money as he did with a 5-day/wk, full-service office by concentrating all his GYN appointments into two days and having his wife do what other employees used to do.

    At some point, he’ll lose interest in treating patients and shut down the whole thing, I’m sure.  It simply isn’t worth having that much money, effort and time tied up in something with such a meager economic return.

    • http://profiles.google.com/dr.book.reader y m

      I think in some fields, especially primary care, whether it be family medicine, pediatrics, or ob/gyn, there is a huge range of incomes.  some doctors in those fields make like 200 grand or more, and others can barely make ends meet.  the average for those fields (120-140K) )doesn’t tell you much

      • Absurdist

        Yeah.  I’ve heard that pediatricians make the least amount of money.  That GPs are next.  I’ve also heard exactly what Mike has said.  Many of my docs stopped taking insurance altogether because they were sick and tired of insurance companies telling them what to do.  It had nothing to do with money.  It had to do with how they were allowed to treat me, what they were allowed to prescribe me, etc.

  • http://www.facebook.com/people/Michael-Langley/1410915041 Michael Langley

    I am a retired doctor.  I was getting $65 a visit in 2005 but the FP’s in my town are now charging $180!  One of the reasons is the incorporation of the doctors as hospital employees and not single, stand alone, family doctors, as I was, when I stopped practicing medicine.  The end result is the precipitous climb in medical billing.  Giving the insurance companies more money will not help the problem.  It is very complicated when hospitals bill. They are allowed to jack up the prices because of the new pet scanner, or MRI machine has to be paid for in this manner.  The biggest problem patients are running into are doctors who don’t listen.  That can be intentional or unintentional. Either way, many patients suffer (I did chronic pain management after certifying with the American Academy of Pain Management) I don’t know when other doctors will ever learn and try to talk to their own patients and stop worrying about everything but their patients well being.  The offices now have to have electronic billing and they are trying to get everyone into electronic medical records. (imagine that when your are sick during a power outage and your doctor’s office can’t see you because the computers are down!  I was the only office seeing patients, one day, in a town of 10,000 people because of this!)

    Progress is not always good.  I see medical care getting worse, for people, and not better!

    I even heard a doctor, once, say that the person did not want me practicing cutting edge medicine because I lived in a rural area!    I just got tired of too many cooks being in the broth. But, at least I can live with it.  I am financially impaired now.  But, I do have a beautiful loving wife, and that makes me a rich man! 

    I have come to the conclusion that licensing for any profession seems to be for money and control and very little to do with preventing bad workmanship.  I would think diplomas should speak more to medicine, than politics! Play your politics wrong and you could end up black balled!   Politics and medicine don’t mix  But, that is exactly the prescription that the government is writing!

  • Anonymous

    I actually had really bad migraines on a constant basis and had my health insurance raped and pillaged by a bunch of specialists. Not to mention all sorts of drugs and MRI’s that I was exposed to. 5 years later I realized that I was just not drinking enough water. Migraines all but disappeared. Why couldn’t the doctor ask me if I was just constantly dehydrated?

    • Doc Hawkins

      Well Mike if you was a Sailor or Marine and went to your Hospital Corpsman armed with Navy training, Field experience, and a high school diploma  that probably would have been the 1st question. But we did not have MRI imagers in the desert or jungle.

      • http://badsalesman.blogspot.com/ Mike M.

        Thanks Doc! You are so right. One has to wonder why the doctor’s office checks ones insurance first. That predetermines the path of “care” rather than “cure”. 

  • Sooz

    antidisestablishmedhealthantarianism

    I have yet to read responses, but will do so this very moment.
    The education(business)process will come back and bite this industry in the ass sooner than you can imagine! Then again, I’ve had that feeling, after paying a bit of chump change  myself, for a little less than a decade.

    • Sooz

      A field of study which is about to implode..

  • Josh J Rosenberg

    “Let the Internet be a virtual FDA. A drug will have a web page, a
    scientist with verified credentials will document his research, and
    comments from users will  describe their experiene with a drug.”

    This is where a facebook/linkedin combo can truly shine. Have people sign in with their internet ID and let the market take over. Scientists place their reputation on the line when they post their research, and then users place their reputation on the line when they post a review.

  • AnarchoHypocrites

    I like anarcho capitalist because they are right about 99% of things.  One thing as an individualist they are dead wrong on is intellectual property.  They all hate the fact that thinking is not free and much thought that is unprofitable will go unshared if no protection in copying is provided.  But on the same hypocritcal note they declare man cannot own ideas but can own land.  Now I pull out of my tyranny bag if man can own land then he can own air and sea?  Lets just parse up something that man had nothing to do with among the nobles and put a bag over somebody’s head so they can collect rent on the air they are breathing that belong to the Air Lord’s beause they have title to it.  It never dawns on anarcho-capitalist that a person can actually have property rights without title to the “land”, like the homesteading act which gave people the right to use the land on a first come purpose but if they left they lost it to the next user or settler.  Now how much different is that than air or sea?  What gives me the right to breath the air I puff right now?  Because I’m using it and you aren’t.  I don’t need someone to own all the air in my town to collect the rent on it to prevent moral hazard to air.  So then these same hypocrites are all pro parsing up land and giving it a title as if God’s property were created somehow by their genius, but they have a hard time fathoming property that is actually created by some individual’s mind?  Something that didn’t pre-exist to their own genius of formation can’t be owned, but something prehistoric like land is fine and dandy to own. 

    Like I said land could have properties associated to it like rights of usage based on current usage but not eternal ownership by title.  But God forbid you develop a modern day cotton gin and its becomes the “PEOPLES”.  Copycats are free loaders and land titles are for the tyrants protect “Capital”. Silly, but it all stems from their lack of ability to see how intellectual property can exist without government, and since government is all “EVIL” then it is obvious to them that such notions cannot exists.  Land ownership though is proven to exist in anarchy because all it take is a tyrant to fence it up and hire independent guns to enforce his decree, therefore by anarcho hypocapitalist  this is OK.  Now I’m not liking government any more than any anacrcho capitalist but I at least can see a chink in the armor of this simplistic thinking.  

  • http://www.makemenfree.com Makemenfree

    Mr. Altucher, now I understand why you keep showing up on lewrockwell.com.  Awesome post.  But I disagree on one key point: don’t get rid of the FDA, sell it to the highest bidder(s).  If it’s so ur-awesome at saving lives then it must be worth a bundle.  As you say, we’re going to need a Consumer Reports-like rating agency. 

    However, the fact that we have beg the gov’t for our lives indicates to me that the FDA would be worth about $5 at auction.  It produces nothing of value, and therefore must be forced upon us.

  • Wlr1102

    hold on there, cowboy.  almost all the cancers are cured?  which world are you living in?  (i am a scientist in cancer research)

  • Pfc. Parts

    Good article James. I’ve only recently started reading your columns and I’ve enjoyed them for the most part. I liked this one quite a bit.

    It seems to me you’re arguing for free market competition in medicine. I agree, in fact I think the philosophy you express here can be applied to many other professions with at least equal positive economic effect.

    The problem is defeating the unions who have labored for years to institute laws and regulations that limit competition. In practice your suggestions can’t be implemented without the support of those unions. Your suggestion that a medical student seek a respected practitioner and apprentice rather than pay the $300K entrance fee to some school is a good one *from the standpoint of the greater society*, but it is not a good one from the perspective of the practitioner, who has already paid that fee and may not be motivated by shear altruism.

  • http://twitter.com/KevVigil KVigil

    Sounds good to me!

    And I just ordered your book yesterday. Yay!

  • Doc Hawkins

    1. Book any good Corpsman, medic, or anyone going to the field needs for medical treatment
    “Where there is no Doctor”. Originally written for missionaries in Central America sticking only to medicine with no money.
    2. When Big Pharma was able to advertize prescription drugs changes were made from “getting you well” to “Getting you functioning while dependent on this drug”
    3. The best survival rate of POWs in WWII was a Aussie camp who’s Doctors had only a unlimited source of fresh water. He made the POWs form up and drink a glass 8 times daily. They had fewer medical problems than the town nearby.

  • http://twitter.com/#!/CloseCall_MD Close Call

    Sorry James, normally I love your posts, but the comments about medical education are way off base. 

    Let’s go through your points:

    1.  Volunteer in a hospital:  AGREE.  Almost all medical school applicants have already done this.  It’s called application padding.  Standard fare. 

    2.  Spend a year with a GP:  DISAGREE.  Getting 20k to have some 19 year old kid follow me around, exposing him (or her) to my patients, letting him examine them, ask them sensitive questions, taking up my time during the day, and cutting down my access to patients (and lost revenues)?  Hell no.  Make it 100k and give me the best, brightest, most mature 19 yr old around, and I’d consider it.  

    3.  See above.  So now, I’d be vouching for this 19 year old kid and letting them see my patients without my supervision?  Managing their blood pressure, draining their cysts, treating their pneumonias, letting them have a frank conversation about DNR/DNIs, injecting a shoulder with steroids, performing PAPs, inserting IUDs, titrating their thyroid meds, doing outpatient alcohol detox, treating their depression, anxiety, figuring out of they are having an ectopic pregnancy or PID or diverticulitis, allowing them to run a CT scan (and tons of radiation) on a 2 year old kid who looks fine but fell off the bed and bumped his head and now the parents are super concerned and anxious?  Eh, no thanks.  Not with my patients.

    4. Go to a “surgeon-school” for 1-2 years:  Again, what surgeon in their right mind would sign up to be the “teacher” for this “surgeon-school”. 

    5.  Yelp for doctors:  AGREED.  These new “doctors” would all probably get crappy reviews and creep many people out after the first time they fumble a pap on them or talk to them about STDs.  

    Note to the rest of you who think this is a good idea.  I’m sure you guys will all be running to be seen by these new “doctors”… can’t beat the price!

    It’s a good mental exercise though. 

  • Anonymous

    I have a niece in college working toward medical school. I told her she should just go directly to a medical school in the Carribean; because they don’t require a degree to get in and charge much less. Any MDs want to chime in on this idea?

    • Jarjar

      Not a bad plan BUT they actually cost way more than US schools (especially public) and carry around not so stellar reps-so getting into competitive fields like Dermatology would be tricky.

      • Anonymous

        I’ve done some research since posting. Their reps. go all the way from total crap to pretty good. Cost is far less than U. S. schools even in the best. Her hard and fast speciality is the heart, though not surgery. This limits her to, I think, three possibilities, all of which are about $20,000/year, not counting out of country expenses which they figure would be at least $5,ooo/year. In most universities the bachelors to get into medschool would cost more than that, and the medschool itself many times as much, not to mention the extra four years.  

        • Jarjar

          Woah! these do get pretty cheap!  Some of them though-still pricier than American schools.  I’m looking at this: http://www.valuemd.com/caribbean-medical-schools.htm

          So for everyone’s favorite Caribbean school- Ross, tuition goes by this schedule: http://www.rossu.edu/medical-school/documents/MedRates1112.pdf That’s 10 terms across 4 years, so 2.5 terms per year and $40,000 per year for years 1 and 2 and $45,000 per year for years 3 and 4.

          St. George’s is another school with doctors I’ve seen practicing in the US.  Their student pay this much: http://www.sgu.edu/financial-services/som-tuition.html  That’s $56,000 each year just for tuition.

          American University of the Caribbean: http://www.aucmed.edu/prospective/tuition-fees.html Roughly the same as Ross.

          Saba University: http://www.saba.edu/saba/index.php/admissions/financial-information/basic-science-tuition The best value!  Only $26,000 each year.

          Burnett really is a fine deal: http://ww.biusom.org/tuition.html at around $12,000 per year.  I’m looking for data on how many alumni practice in the US and it’s not out there-so this school’s sort of a gamble.

          Now, American medical schools run from $30,000 to $50,000 per year, which put them in league with Ross and St. George’s with the edge going to public medical schools and their meager rates of $30,000.

          I’d say your niece is best off going the traditional US med school route.  You have to take 1-2 years of prerequisite courses to get into the Caribbean schools anyway.  She should just be an awesome student and find a way to get full rides through all her schooling.

  • Bec

    James, I don’t know if your proposed system would work, but I do know you are very right when you say the medical industry does NOT serve us. Of the five friends/relatives i’ve known with cancer, all but one had traditional therapy, including radiation and all but one are dead. The friend who is still alive has been FREE (not in remission) of his liver cancer for over 20yrs now – When he refused treatment (especially radiation) doctors told him he wrong and tried to make him feel stupid (you’re just a railway worker, not a doctor) and selfish (what about your children?). Yet he did his own research (and this is pre-internet) and used diet and colloidal silver rid his body of the cancer and remain that way – CURED. 

  • Tom

    Most of what doctors know isn’t very useful – like memorizing the names of different muscles.  Who cares?  Has anyone’s life been saved because their doctor remembered the Latin name of a random muscle?  But that’s the stuff they base who gets to be a surgeon on, rote memorization.

    And the FDA is kind of ridiculous at times, it’s biased AGAINST releasing good drugs.  Why?  If they ban a good drug by mistake, nobody will ever know.  If they accept a bad drug, it gets recalled and the FDA looks bad.  So they are super-risk-averse.  And it is absolutely insane to take years to approve cancer drugs when it is literally the only hope some people have.

    Also the FDA approved cholesterol-reducing drugs, even though it has been shown that they do NOT reduce the rates of heart attacks or strokes!!  Yet doctors blindly prescribe them, despite all the scientific evidence that they don’t save lives, while knowing that they are expensive.  Those drugs do reduce cholesterol, but since they don’t affect heart attack/stroke rates all they do is give people a false sense of security about their cholesterol.

    • Jarjar

      You know what’s interesting is that this Lancet meta-analysis (http://www.sciencedirect.com/science/article/pii/S0140673605673941) found a 20% reduction in heart attacks and strokes for each mmol/L reduction in LDL cholesterol.  Are you talking about the drugs that just stick to cholesterol in your gut and stop you from absorbing it?  Yeah, those don’t really work, but doctors don’t prescribe them anymore either and patients never really took them because it made them get diarrhea.  

      Statins for all!

  • Absurdist

    Okay.  I live in Mexico City.  Here is how I see it.  

    1. No FDA down here.
    2. I agree with you regarding getting rid of the FDA.
    3. Here is what I would like for you to do in the future (but I am just one of 1000’s that follow you): Whenever you make a broad statement such as “almost every cancer has been cured already”, can you please cite your source?
    4. Medication costs:  I can tell you that, even without an FDA here, medications are still extremely expensive.  We have the same manufacturing companies here (Pfizer, etc), and the meds are super expensive.  And no, they aren’t covered by any plan.  Yes, they are cheaper than the states.  In the states, my meds cost $14k USD.  Here, they cost $1k USD equivalent.  But people here do not make anywhere near that kind of money, including me.  It is almost impossible to pay for meds.  And because of the overuse of anti-biotics, we still need a script.  But it’s super easy to get a script.  I can also get all kinds of meds that have been manufactured all over the world, so that’s nice.
    5. Getting a medical degree here is exactly as you specified, and we have some of the best doctors in the world.  People finish up their medical degrees at about 23 or 24 years old.  They don’t take all those BS courses like philosophy and stuff that they won’t remember in 10 years; same with other degrees.6.  Unfortunately, I can’t get a  lot of the generics that I can in the states because of the pharma companies crowding out the generics down here and taking control of the market.  And that’s not the FDA or anything like that.  That’s frakkin’ Mexico.But I agree with everything you said.  I would just like you to start citing your sources on a lot of sweeing and generalized factual statements that you make.  One additional thing:  I have never had to have my vagina checked out when I go in for a normal checkup.  Women have special doctors for that.  And my GP has always been an internist.  Nor have I ever had to talk about how many sexual partners I have had with my internist; only with my OBGYN.  So, just FYI.  There are differences for women.  We do have a specialist that we go to for those kinds of things, and no, we don’t have to answer the embarrassing questions with our normal doctor when we are having a standard illness.  Just another one of those “please cite your sources” so you aren’t trying to overdo your information.  :)Michelle

    • Absurdist

      Sorry, I have no idea why my spacing didn’t come through.

  • Manuel

    I have an easier solution: leave the U.S. and move to ANY of the HUNDRED countries who provide virtually free healthcare to its citizens.

    In my country, IN EUROPE, I pay €5 to see the doctor and the medicine is usually another €5 lol.

    But I guess, long live the USA…yay!

  • Aaron

    You don’t need to pretend to be a doctor.  Robots will be taking care of that.

    http://www.slate.com/articles/technology/robot_invasion/2011/09/will_robots_steal_your_job_3.html

  • Jarjar

    Would it really change that much if we got rid of the FDA?  No matter what, it’s going to be expensive to test drugs.  It’s not as simple as giving someone a drug and sending them a follow up email.  Initially, people should be taking the drug in a supervised setting in case it makes their throat close off or something and that costs money.  We need more questions answered than just ‘did you feel better?’ or ‘what side effects did you experience?’  Placebo effect makes subjective outcomes a little too subjective to be useful.  We need to do tests!  Give people MRIs, check tumor markers, white cell counts, blood pressures and temperatures.  There’s no way to tell if something is working without objective measurements and that’s going to cost money.

    Drug testing is expensive.  That’s the unfortunate reality.  Although someone else posted an article (http://www.theglobeandmail.com/life/health/new-health/andre-picard/drug-rd-costs-are-less-than-estimated-so-why-the-high-prices/article1917822/) in these comments that I liked and it turns out that even with our current system, testing on average only runs between 50 to 200 million per drug-way more palatable than 1 billion.  

    Do people really want to be guinea pigs that badly?  If I was someone with cancer and 6 months to live, sure I’d be desperate, but I’d like to think I’d have the clarity of mind to realize that trying an untested drug is probably just going to make me puke and be miserable for the rest of my short life.  

    • Anonymous

      Ross was one of those I came up with but didn’t come up with those #s. Saba’s rep. seems pretty good. Never even found Burnett. I didn’t spend long on it because she won’t do it anyway. Her scholarships pay more than the cost of tuition and books, so she is essentially paid to go to school. Better than free except for the extra four years. She’s going to U. of Memphis and I don’t know why anyone accepts their accreditation. I have tutored students of U. of M and all of those I tutored passed English 101. I would guess that most of them should have flunked out of sixth grade english.
           Accurately predicting the actual market distortions of government intervention, or their relief on its cessation, is not  possible. That is one of the basic tennants of Austrian Economics. Many meticulously researched books have been written on the subject. So what would be the effects of doing away with the FDA and similar agencies? I for one would like to stop paying for these essentially worthless monstrosities and find out! Over time everything paid for indirectly becomes more expensive relative to those things paid for directly, Medical care, Tuition, Auto. repair, riduculous. The internet will eventually do away with most traditional school classes. Insurance of all kinds is another matter. A couple of posts below this Absurdist, in Mexico says she pays the equivalent of $1,000 for drugs that would cost her $14,000 in the U. S. No FDA, no insurance. The only valid role I see for government regarding medicine is mandating workman’s compensation. Here that is insurance paid for through employee and employer contributions, which pays for medical care required to repair injuries incurred at work, and even that should be more closely watched for fraud.

    • Anonymous

      Ross was one of those I came up with but didn’t come up with those #s. Saba’s rep. seems pretty good. Never even found Burnett. I didn’t spend long on it because she won’t do it anyway. Her scholarships pay more than the cost of tuition and books, so she is essentially paid to go to school. Better than free except for the extra four years. She’s going to U. of Memphis and I don’t know why anyone accepts their accreditation. I have tutored students of U. of M and all of those I tutored passed English 101. I would guess that most of them should have flunked out of sixth grade english.
           Accurately predicting the actual market distortions of government intervention, or their relief on its cessation, is not  possible. That is one of the basic tennants of Austrian Economics. Many meticulously researched books have been written on the subject. So what would be the effects of doing away with the FDA and similar agencies? I for one would like to stop paying for these essentially worthless monstrosities and find out! Over time everything paid for indirectly becomes more expensive relative to those things paid for directly, Medical care, Tuition, Auto. repair, riduculous. The internet will eventually do away with most traditional school classes. Insurance of all kinds is another matter. A couple of posts below this Absurdist, in Mexico says she pays the equivalent of $1,000 for drugs that would cost her $14,000 in the U. S. No FDA, no insurance. The only valid role I see for government regarding medicine is mandating workman’s compensation. Here that is insurance paid for through employee and employer contributions, which pays for medical care required to repair injuries incurred at work, and even that should be more closely watched for fraud.

  • Derp

    I agree 100%. This 5 years of surgical residency is entirely redundant. All my attendings agree that I could just go out into private practice now and starting doing colectomies, thyroidectomies and Nissens now, but because the “American Board of Surgery” insists, I have to waste several more years pretending I don’t already know everything.

  • Jesse Petersen

    Haha, I was going to write this exact same article! I wasn’t sure who would’ve read it though…
    2 weeks ago I got pink eye. After some online research, I deduced that it was probably the viral type, but there was enough uncertainty to consider medicating against the possibility that it was the bacterial type. You see, conjunctivitis comes in 2 main forms, bacterial and viral, the latter of which is untreatable except by the body’s own immune system (which I was trying to boost with vitamins), but the former of which is VERY easily treatable by antibiotic eye drops.

    They’re just eye drops, so it should be pretty simple to get, right? WRONG!!! I don’t have health insurance, since it is very costly, so a doctor’s visit is out of the question. The last uninsured doctor’s visit set me back $1100, which I have yet to pay off, and cured NOTHING (I had mono. Prognosis: go home and sleep, but pay me first!). So a doctor’s visit was out of the question. I asked around at local pharmacies, and no one would sell me polytrim (the most common antibacterial eyedrops), not even under the table, because there are harsh FDA laws against selling them without a prescription.

    So now we’re at the heart of the matter: a nearly unmistakeable sickness that is easily treated by a product with extremely minimal side effects, yet is untreatable unless you go through the Cartel. We are legally forced to live like this; there is no reason something so simple should not be available on every drug store shelf. How many people did I give it to, when it could have been treated? How many people suffer (or die) for much worse problems simply because they can’t afford to pay for treatment? And how many people go bankrupt paying for ridiculously overpriced services, simply because they’ve got no other option?
    Oh, and not that it justifies it, but when the hell did “we” vote for this??

    Thanks for covering this, since it seems very few people will talk about how truly evil the FDA is.

    • http://twitter.com/BarrieAbalard BarrieAbalard

      Jesse–in the future, for minor things where you need a prescription, try an urgent care place or a CVS Minute Clinic. While you’ll still have to pay something, it shouldn’t cost anywhere near $1100–they use nurse practitioners. I think the Minute Clinics are relatively inexpensive. Some other stores have similar clinics, I think–maybe Walgreens or Wal-Mart? Do some looking around so you’ll know what to do the next time. Unless you live in the back of beyond, there should be something within 25 miles of you. Good luck. I’ve used clinics and urgent care centers with success in the past.

      I totally agree with you about access to common, useful drugs. You should be able to walk into a drugstore and just buy those eyedrops you needed. I’d be in favor of making someone sign something saying they couldn’t sue anyone if they bought the drugs without a doctor’s diagnosis and something went wrong–and I think that’s reasonable–but they should have access to the drugs, IMO.

  • http://twitter.com/BarrieAbalard BarrieAbalard

    Interesting inflammatory post. :) I’ve recently figured out a lot of what you wrote, though your solutions top the ones I came up with.

    Insurance companies are the spawn of Satan. Any business whose profit model rests on figuring out how to screw the customers who paid them money in good faith can never be counted on to do anything but evil. Health care costs in this country started spiraling when the insurance companies got involved. I’d cancel my policy but my husband freaks out every time I mention it. Seems he’s afraid I’ll get some dread disease and die because we won’t have money for treatments or some such foolishness. Never mind that my parents lived to be 89 and 90 and they didn’t even take care of their bodies the way I do. 

    What the hell, if I come down with something horrible, I’m going to ask Dignitas in Switzerland for their assistance in slipping painlessly into the next world (if there is one). After I have one hell of a party first, of course. Champagne’s on me.

    Keep shining your pitiless light on the world, James, and writing about it. I mean that as a compliment.

  • Randy

    This article is a complete joke. He doesn’t even mention Tort reform which would be huge to curb expenses. 

  • Rod

    I worked a while in the medical field in the UK. A doctor once told me that 90% of GPs (general practitioners, the first doc you see in the UK) work could be done by someone with 6 months basic training and an option to forward people they felt worried about! So yeah, I’d say you were spot on!

  • Anonymous

    Let’s not waste any more time discussing what we all know:  the FDA is a total fraud.

    Instead, let’s talk about how I can get in touch with your nurse.  I think I can help her work off some of that $300K debt.  And save myself the money I’m spending on my FDA approved Viagara at the same time…

  • inetvid

    Awesome post!!  The FDA by far is the most corrupt and inherently evil institution in the history of the modern world!  Their primary purpose is to severely limit competition in the medical industry by driving up the cost to entry, thus ensuring that the existing multinational corporations continue to thrive.  Public health and safety are totally irrelevant to this government org.

    The only other thing I would emphasize is that (in my opinion) almost all diseases can be cured using plant-based medicines, dietary restrictions and/or detoxification protocols.  Today’s chemical-based and bio-engineered drugs are mostly ineffective and toxic and most would not be on the market if not for the insidiously corrupt FDA. 

  • http://biotechnologynetwork.wordpress.com/2012/01/03/pharma-industry/ pharma industry

    Hello..
    The information you shared in the post is nice and some how practical. The expereince will help many people in knowing the facts related to the medical. I am glad I visited here and come to know about it.

  • Cliffton

    without tort reform good luck

  • Tim Keating

    WHILE I WANT MY DOCTOR WELL EDUCATED, THE COST IS RIDICULOUS MY SISTER IN LAW A STANFORD GRADUATE AND M.D. FROM STANFORD HAD TO TAKE A YEAR OF FROM SCHOOLING SO SHE COULD PAY OFF ONE LOAN TO GET ANOTHER TO FINISH HER EDUCATION. THAT IS HOW RIDICULOUS IT IS.

  • http://profiles.yahoo.com/u/IG4L6GEQBG4KJGDFNRI5CKP4B4 John

    Your article is on the right track..or at least in the right direction. But it lands in a weird place. It is as if you want to be ethical and do good. But you still can’t shake off that “modern” mentality. The source of the problem is with the doctor. Period. If a persona chooses to go far in debt to practice, then yes, they will be corrupt and therefore become a poor excuse for being a people servant we call “doctor”. And ethical doctor will become an MD, like you said, but will not try to be “state of the art”, which is nothing but a fancy term for sellout. There are tons of non-medicinal ingredients that prevent or cure problems that doctors usually ignore. Most pills are unnecessary. We are literally creating illnesses, thanks to the rich asshole, and then begging for the rich asshole’s friend to cure it. We should all be wearing dunce caps on our heads. 

    A doctor who whole-heartily takes on the role of community servant, which is what a doctor is supposed to do, will take live chickens as payment if need be. Or patients can help build em a house. Or local taxes can help support the doctor. What we don’t need is 400 doctors in a single town, all competing for business. Running health care like a business is the first step to failure for the people. We tolerate it and we are fools. Ole Doc Baker would have given his own life to save a fellow man. But you won’t find a single doctor in the modern world that would do that. They lose patients every day. Yet, they lose not a wink of sleep in their penthouse suite bed.

  • Anonymous

    We’d need an “FDA” to regulate purity and dosage of all the over the counter drugs. Antibiotics would have to be regulated to avoid drug-proof epidemics though, but everything else be OTC. Imagine the fun. Want some vicodin? Just find it on the shelf and buy it. Makes life easier for Rush Limbaugh. Want a tan? Buy some OxSoralen and microwave yourself at a tanning spa. Just be sure you don’t live by George Zimmerman. Long range trucker? A bottle of meth will hook you right up. (and get you hooked!) Having trouble sleeping? Easy, get a vial of propofol and a spike at the local drug store. No questions asked. Ventilator sold separately on eBay.

    What could POSSIBLY go wrong???

  • http://www.nicholsfinancialservices.com/for-all-of-your-payroll-newark-business-services-trust-nichols-financial-services/ Insurance Agency Newark NY

    Thanks for share…..

  • lori142423

    your right cept for one thing the system is broken and they arent going to fix it cause we are under some sort of genocidal thing but slow and very concealed…gmos are produced with the help of agent orange which is also used in the vietnam war… the chemicals that are put in our foods most are banned in other countries…how know that they are genocidal i looked up illluminati cards is a game made back in 1995 however these cards eerily show what genocidal plans they have for us the twin towers that fell were predicted by these cards , fukoshima earthquake 2011, frankenfoods, flesh eating bacteria and not to mention the population reduction card…..so i assume its their game plan after all…they knew this was coming and theres a card for almost every disaster there is..and you can buy these on ebay 911 was not a conspiracy it was a planned genocide because its even in kids cartoons just google johnny bravo and 9/11 prediction an episode that aired 5 months before it happened they know all about it there was an image with burning towers in the episode ……we are under a genocide..sorry to say ..slow but were under one…its why the fda approves bad drugs only and never any good ones..they are being told not to…shoot i am allergic to tide didnt realize it all these years till i put on a pair of clothes drenched in the stuff i couldnt stop the rash it was terrible same rash i had going on 13 years as a kid nobody knew what was wrong…told me i had worms nope just plain old evil chemicals getting in my skin thanks to tide..