Jewish World Review Nov. 24, 2003 / 29 Mar-Cheshvan, 5764

Drs. Michael A. Glueck & Robert J. Cihak

The Medicine Men
JWR's Pundits
World Editorial
Cartoon Showcase

Mallard Fillmore

Michael Barone
Mona Charen
Linda Chavez
Ann Coulter
Greg Crosby
Larry Elder
Don Feder
Suzanne Fields
James Glassman
Paul Greenberg
Bob Greene
Betsy Hart
Nat Hentoff
David Horowitz
Marianne Jennings
Michael Kelly
Mort Kondracke
Ch. Krauthammer
Lawrence Kudlow
Dr. Laura
John Leo
Michelle Malkin
Jackie Mason
Chris Matthews
Michael Medved
Kathleen Parker
Wes Pruden
Sam Schulman
Amity Shlaes
Roger Simon
Tony Snow
Thomas Sowell
Cal Thomas
Jonathan S. Tobin
Ben Wattenberg
George Will
Bruce Williams
Walter Williams
Mort Zuckerman

Consumer Reports

The Caduceus Conspiracy: How the People Lost Medicine and How We Can Take It Back | In medicine it's always something! This week the column de jour for many op-ed writers is the crisis of the drug prescription plan before Congress. But let's look deeper.

In American politics, nothing matters unless it's defined as a "crisis." That's one reason why we have the same crises, decade after decade.

In medicine, however, "crisis" has a more specific meaning. It's the moment when you either die or start to recover.


It's been in crisis since the 1950s, when proponents of state medicine suddenly discovered that the elderly weren't all that happy with their coverage.

It's been in crisis since the 1960s, when LBJ, Congressman Wilbur Mills (then chair of the House ways & Means Committee), and what is euphemistically known within the Beltway as the "benefits community," created a Medicare they knew could not be sustained, long-term . . . and threw in Medicaid for good measure.

It's been in crisis since the 1970s, when the HMO Act established a "managed care" system in which the only way to make money was to sell group coverage to employers, then withhold care.

Donate to JWR

It's been in crisis since the 1980s, when employers noticed that the cost of insurance had gone bonkers, and reacted accordingly.

It's been in crisis since the 1990s, when Hillary tried to take over one-seventh of the entire economy . . . and when the trial lawyers conceived that medicine might be improved by a "Patient's Bill of Rights"-generated mass infusions of lawsuits.

And it's in crisis today, as Congress and the administration prepare to tack onto Medicare a prescription drug "benefit," offering as partial justification the fact that, since Medicare will inevitably go broke with or without it, why not just do it now and worry later?

But America's health care system is also in acute crisis. For this is the moment when the system either dies or changes. Continue along the present path, and within a few more years, we will have state medicine. (And doubt not that this is the goal of those who, have willfully wrecked the system to justify governmental takeover.) Or we can create, for the first time, a genuinely free market in health care, based upon the astonishing principle that the American people are capable of figuring out what they need, and then finding it.


It would, first of all, restore the clear distinction between insurance and payment for services. By definition, insurance is the pooling of risk against infrequent but nonetheless predictable events. In medical terms, this means hedging against physically and financially catastrophic events. Payment for services means taking care of more routine, although far from inexpensive matters.

Catastrophic health insurance should be available to all, whether through employment, through groups formed for the purpose of purchase, or through purchase from the federal or state government. As a matter of decency and humanity (not of right), such insurance should be made available at reduced rates, or simply given, to the poor. AS FOR THE SERVICES HALF THREE PRINCIPLES APPLY

First, people should be free to purchase only what they need. Why pay for other people's pregnancies or abortions if you're a man, or a woman who won't be getting pregnant? (Imagine how wonderful if the cable company sold only the channels you wanted, not the whole package).

Second, people should be free to form purchasing groups, and organizations should be free to offer, specialized services. We're already seeing specialized offerings, such as dental or optometric, coming out of groups such as AARP. Cash also has its place. For example, a Seattle group, SimpleCare, offers routine services at substantial discount —a discount made possible by the clinic's substantially reduced paperwork and administrative costs. Barter might also find a place. And governments at all levels, again as a matter of humanity and decency, should provide routine services to the poor.

Finally, the government should encourage the creation of a freedom-based system through expansion of tax-exempt or deferred medical savings accounts and other tools.

All very fine . . . especially if you believe that the American people are more than a bunch of lazy idiots who want everything handed to them by the federales. But what reason is there to believe that this is the moment of acute crisis?

The American economy is structurally unsound. The proliferation of debt at all levels of government and the private sector; the ongoing hemorrhage of jobs; the trillions now required for homeland defense and foreign adventures; the aging of the workforce; a dozen reasons more might be adduced. Wrecking one-seventh of the economy, turning it from private profit to government liability, could well be the straw that does the deed.

For —let us be honest —the patient in crisis nowadays is America.

Editors Note: Michael Arnold Glueck wrote this week's column.

Michael Arnold Glueck, M.D., is a multiple award winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute Senior Fellow and a past president of the Association of American Physicians and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists. Comment by clicking here.


11/14/03: Mosquitoes kill us; DDT doesn't
11/07/03: Avoiding the Schiavo Scenario: Readers Speak Out With Life-and-Death Comments
10/31/03: The Terri Schindler-Schiavo Case: Speaking out for those who can't
10/24/03: Want health service — go on a diet?
10/15/03: The War on Legal Painkillers: Sen. Kerry owes an apology to the more than 48 million Americans who suffer chronic pain
10/13/03: Medicare defrauds itself
09/19/03: Politics prevents women from learning about abortion/breast cancer risks
09/12/03: Medical mischief
09/05/03: Unholy medicine
08/29/03: The California Tea Party and West Coast Determinism; Voter anger coming your way soon
08/18/03: The outlaw prosecutors: A Justice and Civil Liberties Issue
08/08/03: "Toxic Teeth?"
07/25/03: Resuscitating the Constitution; CPR American Style
07/25/03: Drug reimportation: Bill translates to goodnight, patients
07/11/03: Costly Medicare Changes, Without Real Reform
07/04/03: The Painful DEA II: War on legal drugs ensnares too many doctors and not enough dealers
06/20/03: The Medicare Mess: Will President Bush call Congress' Bluff?
06/13/03: Diagnosis: School Insanity: A suit for sanity and school discipline
06/05/03: Soaring Medical Costs: Rational ignorance or rational enlightenment?
05/30/03: A Tale of Two Admirable Women: Jessica and Annika
05/23/03: Latest medical innovation: Cash
05/09/03: We feel your pain; Physicians have it too no thanks to the DEA
05/02/03: Medical Quarterbacking
04/25/03: CNN the "Conscience-Not Network"
04/21/03: Medical Miranda?
04/11/03: Are childhood vaccines shots in the dark?
04/09/03: The PETA Principle -- The lambshank Redemption
03/28/03: American conscience?
03/21/03: West Wimps or Wings: Treatment for Hollywood Hypocrisy
03/13/03: Worldwide schmaltz shortage looms --- all because of a featherless chicken
03/06/03: Legal metastases are killing us
02/28/03: Outside the Jury Box: Seeking Justice rather than a Lottery in Medical Liability
02/21/03: Workforce temperature rising; employer TLC in demand
02/14/03: Malpractice Insurance: They Reap What They Sue
02/12/03: Hawk, Dove or Groundhog: Diagnosis Critical List; Prognosis Uncertain
02/07/03: How about tax cuts for the "rich" and "poor"?
01/31/03: AIDS Bug Chasers
01/24/03: Libertarian moment or movement?
01/17/03: It's not just 'sue the docs' anymore
01/03/03: A pox on the critics; diagnosis sour grapes
01/03/03: If protesting is good for your health; then at least let's root for the home team
12/20/02: Obesidemic (obesity epidemic) or not?
12/20/02: Time for voluntary informed smallpox vaccinations
12/13/02: The real reason the state opposes homeschooling?
12/06/02: Conscience of a former conservative: Portrait of a political metamorphosis
11/27/02: Thanksgiving dinner hazard?
11/22/02: Time to think outside the box and inside the nucleus
11/15/02: The military should be protected from abusive environmental laws in times of war
11/11/02: Does Kyoto Treaty pose more harm than global warming?
10/31/02: Deep thoughts on Baseball, the World Series and Life: How about them Anaheim Angels?
10/23/02: "Pediatric rule" guinea pigs
10/23/02: Once the World Series ends, we need to create a Donnie Moore Day of Remembrance: Sports and mental health
10/18/02: Congress to senior patients: Do as we say not as we do for ourselves
10/11/02: Using pollution "scare labeling" to political advantage
10/04/02: The Great Asbestos Heist: Did Litigation and Junk Medical Science Helped Bring Down the World Trade Center?
09/27/02: The imminent rise of civic feminism: A far healthier national alternative in war and peace
09/20/02: A Ray A Day" to replace the daily apple?
09/13/02: Beware of celebrities hawking drugs
09/06/02: Avoid 9/11 overdose: Give blood to begin "September of Service," SOS
08/28/02: From Doubleday to strikeday: Baseball's collective anxiety attack
08/23/02: Should she or shouldn't she?: An alternative view on treating menopause with HRT
08/16/02: Cooking up defenses against germ warfare
08/02/02: Medicine, crime and canines
07/26/02: Lies, pathologic lies and the Palestinians
07/19/02: Medicare Drug Follies as in "now you see it, now you don't"
07/12/02: Anti-Profiling: A New Medically False Belief System
07/08/02: Don't procrastinate, vaccinate!
06/28/02: The scientific advances on the safe and effective deployment of DDT are being ignored, or denied. Why?
06/21/02: Sex and the system: In seeking healthcare men are different from women
06/14/02: The FDA, drug companies and life-saving drugs: Who's the fox and who's the hen now?
06/07/02: Medical Privacy Lost: A hippo on the healthcare back!
05/24/02: To clean up America's game: A (soggy) ground rule
05/10/02: Free speech is good medicine
05/03/02: Medicine's Vietnam
04/26/02: Attack on alternative medicine could lead to alternative lawsuits
04/12/02: Insure the 'crazies'?
04/09/02: No Time for Litmus Tests: In War We Need a Surgeon General and NIH, CDC, and FDA Directors
04/02/02: The scoop on soot: A dirty rotten shame?
03/22/02: Too many beautiful minds to waste: The first annual Caduceus Movie
03/15/02: Terror and transformation: Defense essential for health & state of mind
03/08/02: Diagnosis: Delusional
03/06/02: The great matzah famine
03/01/02: Is new Hippocratic Oath hypocritical?
02/15/02: Why the recent moaning about cloning?
02/08/02: Searching for Dr. Strangelove
01/15/02: Score one for the value of human life
01/04/02: Medical-legal-financial wake-up call
12/28/01: Who's afraid of a 'dirty bomb'?
12/21/01: End of medicine?
12/14/01: More heroes: Docs deserve a little credit after 9/11
11/16/01: Do we need 'Super Smallpox Saturdays'?
11/09/01: Why the post-9-11 health care debate will never be the same
11/01/01: Common sense good for our mental health
10/26/01: Your right to medical privacy --- even in terror time
10/12/01: Failed immigration policy ultimately bad for nation's mental health: Enemy within leads to epidemic of jumpy nerves
09/28/01: Can legal leopards change their spots: A treat instead of a trick
09/21/01: Civil defense again a civic duty
08/30/01: Shut down this government CAFE
08/23/01: School Bells or Jail Cells?
08/15/01: Time to take coaches to the woodshed
08/10/01: Blood, Guts & Glory: The Stem of the Stem Cell controversy

© 2002