The Binary Circumstance

There are a couple of interview videos on YouTube where Ron Paul talks with a representative of the Kaiser Family Foundation about his views on health care, a subject near and dear to my heart. As I listened to him talk, it was like I was hearing my own words and my own thoughts.

In Part I, Congressman Paul talks about how free markets have lowered costs and increased options in areas like computers and telephone service, while health care costs have skyrocketed. I have made those comparisons on many occasions and it is so obvious to me that I don’t understand why people can’t see it.

He also talks about how corporations, government programs, and barriers to entry have increased costs. Allowing doctors to protect their turf denies patients other cheaper but equally safe and effective options. If a nurse can do something as well as a doctor, why should we have to pay a doctor’s high price when somebody else can do the job for less? Billions could be saved if patients didn’t have to go to a doctor for things they could do themselves or that could be done just as well by a qualified technician.

I’ve often asked why patients can’t do things like write their own prescriptions if they know how to do it. I can think of more than one case where I wanted to get a drug only available by prescription and had done the necessary research on it. I had to go in and pay my doctor for a visit. He’s usually given me the prescription I wanted because I’ve never asked for anything unreasonable, and the times he hasn’t given it to me, he should have. Furthermore, most pharmacists know much more about drugs than doctors, so they could often be a better and cheaper resource for getting the right prescription.

He sees a migration away from government programs and wants to encourage younger people to move toward Medical Savings Accounts and away from government entitlements. One advantage of a free market that Dr. Paul notes is that patients are free to try other forms of medicine, like holistic medicine for example, because they are controlling the money.

In Part II, he talks about major medical or catastrophic insurance. He rightly maintains that what we have now is really a pre-paid health care system that encourages people to use the system because they feel like they’ve paid for it or somebody else has paid for it. Major medical insurance is cheap and should only cover major illnesses or accidents.

He also talks about Hurricane Katrina and FEMA.

I’m totally in agreement with the views he stated in this interview.

Another change that follow from putting patients in charge of their health care is that individuals would take better care of themselves if they had to pay for basic medical care out-of-pocket. As it stands now, there is little incentive for people to take care of themselves or to spend responsibly when it comes to health care. With shopping mall medicine as I like to call it, consumers would seek out highest quality product for the best prices as they do in everything else.

His basic message boils down to putting health care back into the hands of patients and their doctors as well as other health care professionals and taking control away from corporations and the government.

This is the first time I’ve listened to Ron Paul speak at any length on any one issue and I found him smart and I must admit even sexy. He talks about issues as a problem solver and views problems from many different angles. There’s a quality, an intellectual integrity to his discussion that is totally lacking in the other presidential candidates. There’s a lack of arrogance and the insincerity that is the hallmark of all professional politicians. He’s not out to save people, but to give them the ability to save themselves, and that’s good medicine. What other person running for office has the honesty and the guts to say there’s no entitlement to health care at the expense of others?

It should also be noted, that as a physician (OB/GYN), Dr. Paul has a perspective on health care that none of the other candidates possess.

Interview with Ron Paul on Health Care - Part I.
Interview with Ron Paul on Health Care - Part II.

My other posts on Ron Paul.

It’s always fun to come across some interesting bit of trivia that casts new light on something as topical and popular as universal health coverage which is once again an issue in the presidential campaign.

Hillary Clinton’s current plan for universal health coverage is a recycled version of a plan for universal coverage proposed by Richard M. Nixon in 1974 which was ultimately defeated by labor unions.

In his 1974 State of the Union address, Nixon called for universal health care. On 6 February 1974, he introduced the Comprehensive Health Insurance Act with the following remarks:

“I shall propose a sweeping new program that will assure comprehensive health-insurance protection to millions of Americans who cannot now obtain it or afford it, with vastly improved protection against catastrophic illnesses.”

I wonder if she’s going to give him credit.

Just in time for the holidays, Washington State transportation officials have decided that four ferries that provide car ferry service on Keystone, Port Townsend and San Juan Island routes are unsafe.

From the Seattle Times:

The Steel Electric boats — the Klickitat, the Illahee, the Nisqually and the Quinault — were built in 1927 and serve the Port Townsend-Keystone and the San Juan Islands interisland routes. They are the only car ferries that can operate in Keystone’s narrow, shallow harbor.

The affected ferries were pulled from service after their last sailing Tuesday night. By early Wednesday evening, drivers at the Edmonds dock were facing a 90-minute wait, although that had fallen to 60 minutes by midevening.

For now, the state’s oldest ferries will be tied up at least until the end of January while they are inspected for cracks and leaks in their hulls.

“It’s terrible. It’s like a bridge going down,” said State Sen. Mary Margaret Haugen, D-Camano Island, chairwoman of the Senate Transportation Committee. “The fact they’re facing a two-month outage is terrible.”

This is one of the costs of having only one organization control ferry service. When it goes down, there are no alternatives. In addition, the ferries have been maintained based on the same policies which obviously were not effective in preventing this from happening.

Just wait until they control health care.

This article is a couple of years old so it’s a little surprising I haven’t heard anything about it before. Well, maybe not, given the bias against eating fat that permeates most writing about diet and nutrition.

Eating — particularly eating fat-rich foods — causes cells in the small intestine to produce a hormone called cholecystokinin, or CCK. CCK stimulates digestion and gut peristalsis (the motion that propels food along the digestive tract), and also triggers satiation — the full feeling that prompts you to stop eating.

The study by Luyer and colleagues shows that fat-induced CCK can also dampen inflammation in the gut, as rats fed a high-fat diet were protected against lethal bacteria-induced shock whereas those fed a low-fat diet were not. CCK sent signals to the brain through the vagus nerve, the nerve that provides the electrical regulation for many internal organs, including the gut and the heart. In response to CCK, vagus nerve endings in the gut released a neurotransmitter called acetylcholine. Acetylcholine then bound to proteins on immune cells and turned the cells off.

I guess that’s why ice cream often makes my gut feel better.