It is not presently understood why men were so gullible at that particular time, for absolutely no one thought to observe all the DISORDER around them and conclude just the opposite. …

I have sat, a minister and ambassador, covered with gold lace, gaudy with ribbons and decorations …

An adult bears the emblemless marks of experience, not the delusive corrugations of age. …

Can’t you ground someone who’s crazy? …

My company can at least walk away from the HMO, with my resources, and apply them to fund a more effective and efficient provider. Been there — done that.

The Hillarycare plan back in 1993 actually had penalties for going out of the system, OTOH.

and worse, that HMO president is far MORE concerned about the state of his business and his investors and making a profit

The state of that business includes keeping groups as customers for his services … one of those feedback mechanisms I talk about. The gov, OTOH, has a guarantee of “customers” … and the only incentive to make things better is via the political process. In terms of control, that’s like me using a 20-foot screwdriver to steer my car.

You say that bureaucrats have nothing to do with healthcare … since when does such a level of government funding not come with serious strings attached? Control follows funding … or the funders risk charges of waste.

There are many reasons for the overwork of doctors … and not all of them are altruistic. They seek profit, just like the rest of us, by doing what they love to do.

Many of them compromise on patient contact, in order to get more throughput and maximize revenue … for example, you might be surprised to know that pyschatrists do relatively little counseling/direct analysis these days. They leave that to the psychology-trained counselors … and primarily act as prescription dispensers. Another example … GP’s who specialize ONLY in hospital practice, grouping with other GP’s who only work outside the hospital.

The vast majority, IMO, dislike this … but today, thanks to the high level of regulation — and the lawsuit lottery — this kind of assembly-line medicine is the only way they can get a decent return on thier (considerable) investment in their education.

Is part of this also due to price pressure from managed care? YES! However, the need for these shifts in the practice of medicine stem from the years where we didn’t even have THAT feedback mechanism for cost containment. Managed care is our attemtpt to hot-wire that broken feedback loop … and doctors are caught in the middle.

Healthcare is like the environment … it is very hard to preserve and enhance either when you are wondering where your next meal comes from. Cost-effectiveness must ALWAYS be considered, or we will deplete the overall pool of resources we have, to apply to all our needs.

The more direct the feedback, the faster errors are corrected. Placing healthcare under government control works directly against this principle, by insulating the recipient from the costs and placing other decision-makers … who have little direct knowledge of how their decisions affect THAT RECIPIE?NT — in the loop.