Needlessly Inflated Medical Costs

Medical care need not be so expensive. It could well be within the affordability of most people, with true charity covering the remainder. Other things which needlessly inflate the cost of medical care:

1. Needlessly long training tracks for practitioners before they can begin to return something of value from their training to that point.

2. Hanky-panky between the pharmaceutical industry and the FDA, keeping small competitors off of the playing field.

3. Maybe some naivete in patent law.

4. Undue restrictions in licensure.

5. The classification of many human problems, sins, and foibles into the medical model. Alcoholism led the charge in this. It causes many medical problems but has never responded to application of the “medical model” of disease, which is nonetheless very expensive.

6. Tax advantages to money set aside for “medical care” in the form of insurance premiums. People will spend it rather than lose it and thus distort medical markets, ascribing value to things which are not valuable. I will pick on a small, cheap target as example. The careful and systematic teaching of breast self-examination, intuitively attractive as a prevention of breast cancer death particularly in view of the fact that most breast cancers are found that way, has been shown NOT to prevent breast cancer deaths. Prostate cancer screening by any method likewise has failed. Screening for aneurysms of the abdominal aorta, likewise. The list is in the dozens. I know this is like spitting on the Mona Lisa, but I dare you to examine it carefully and scientifically.

We are prone to go at these things according to their face validity. A real free market would help hugely in sorting the useful out from the not useful, leaving each person at liberty to make his or her selections from what is available. Medicare, Part D, joins hands with other insurance in delaying the discipline of a free market. Senator Bill Frist, Senate Majority Leader, briefly floated the idea some weeks ago of giving everyone a sum of money, I think it was $300, to offset the rise in the cost of gasoline. Notice that giving the money sustains the cost of gasoline. It tends to make people refrain from carpooling, finding more fuel-efficient cars, consolidating trips, driving more slowly, taking public transit, etc. Just so does Medicare, Part D, sustain the high cost of drugs.

7. The imposition of managerial costs into medical billing, which averages something between 18% and 25%. Direct payment by the consumer strips this almost entirely away.

8. The imposition of regulatory costs into medical care. Medicare regulations alone run over 100,000 pages, with more pages on the interpretation and no agreement on that.

With correction of these and other costs, medical care is affordable to most people, and well within the reach of Christian charity.


Excerpt from "Medicare and Insurance"

Military Thoughts

Numbers 1:2-3 “Take a census of all the congregation of the children of Israel, by their families, by their fathers’ houses, according to the number of names, every male individually, from twenty years old and above—all who are able to go to war in Israel. You and Aaron shall number them by their armies.”

The “general equity” of the law of Israel is something we should seek after to understand and apply today, even though the civil state of Israel has “expired.” Here we see an age and a gender of fitness to go to war: men and age 20. The expectation here was very likely not a military draft. Examples of draft-like events occur in the Old Testament and are presented both as exceptions and as things which go awry. The “buy-in” to war requires consent.

Further, the organization here showed clan influence. What about a military which prides itself on dismantling young men, and then reassembling them into what the ruler wants? A part of the process of disconnecting men from their roots is to mix them completely with strangers from everywhere. War accounts and war movies from the 20th century stated or implied that this melting pot approach was in some way a great strength of the American military. Aside from the benefits of avoiding a Bedford, VA, type of event* on D-Day, I doubt that it is a strength. Moreover, as our nation has become polyglot and imperial, I question the kind of cooperation you would get from such a soldiery. Would the prison guards at Abu Ghraib have indulged in such torment if they were representative of a small geographic area and kinship group, and would someday return to have to look each other in the eye and know what they had done?

* Men from Bedford, Virginia serving in the 29th Infantry were among the first to storm Omaha Beach on D-Day and therefore suffered significant losses.

Voting for Ron Paul

Today, Dr. Terrell would have voted for Dr. Ron Paul for the third time (first time in 1988 and second time just before his death in 2008). As a fellow doctor, Dr. Terrell believed that the best chance to solve the problems in medical care and the economy were not found in more bureaucratic legislation, but in more personal freedom and faithfulness to our Constitution.

On Lending

Deuteronomy 15:6 “For the LORD your God will bless you just as He promised you; you shall lend to many nations, but you shall not borrow; you shall reign over many nations, but they shall not reign over you.”

Being in a position to lend is clearly indicated as a superior position to strive to be in. A lender is one who is not here necessarily (or even likely) collecting interest, but one who can alleviate material suffering.

Inheritance

Prov. 13:22 “A good man leaves an inheritance to his children’s children, but the wealth of the sinner is stored up for the righteous.”

The use of the term “wealth” indicates that physical wealth is primarily what is in view here. Proverbs are not commandments, but rather descriptions of how God normally deals with human beings. Proverbs describes His ordinary providence. Failing to leave wealth to children is thus not a sin. A parent however who gives no heed to God’s ordinary providence is behaving questionably in this matter. Our inheritance laws today can set God’s expectation against the civil state. Inheritance taxes are wicked, implying that the wealth ultimately belongs to the state, replacing covenantal succession in the family with the state. Wise parents will invest in their offspring.

Give a Defense

Our calling in work is not normally just to provide ourselves and our families with the necessities of life so that we can use the balance of our time as junior pastors. It is not that there is necessarily something amiss in teaching, lay ministry, lay evangelism, and the like. It is that we are not to neglect our calling in order to invade that of someone else.

1 Peter 3:15 says, “But sanctify the Lord God in your hearts, and always be ready to give a defense to everyone who asks you a reason for the hope that is in you, with meekness and fear;”

A defense is a reaction, not a proaction. But the spirit of our times in the Church is that we are to be proactive in the propagation of the gospel. We are rather inculcated in the idea that we are a massive sales force for the gospel, plotting out what we call “witnessing opportunities,” somehow as if our whole life is not a witnessing opportunity.


Excerpts from "Realizing Our Vocational Calling"

Individualizing Medical Care

The insatiable demands of the production line for monitoring, feedback, control, and payment distract the physician from the ill person. Industries want uniformity of method and product. Medical care is embedded in individuality.

There is only one way to return control of the patient-doctor relationship to the axis that runs between the two. It is to recover a free market in medicine.

Patients who can vote with their feet and their wallets will regulate their care. Others can only pretend to do so.


Excerpts from "Medical Information and Bureaucracy: F. A. Hayek and the Use of Medical Knowledge"