http://worldnetdaily.com/news/article.asp?ARTICLE_ID=25911

Dream, or fight?

© 2002 WorldNetDaily.com

When war comes, peacetime problems fall into two categories: those that can wait, and those that have to get fixed now. When recession comes, abuses that were tolerable in time of prosperity become luxuries we can no longer afford.

In that spirit, we offer a half dozen serious proposals regarding a medical-legal-financial system that, for economic and security reasons, has to get fixed now.

One. Allow more medical competition. A good start here would be to abolish medical licensure but not certification. Before you chomp on us, let us say that there's a world of difference between certification and licensure. The former confirms that a doctor has been through a prescribed course of study and has passed certain examinations administered by professionally and legally recognized authorities. The latter says that only those with a certain piece of paper can practice, and can end up in jail if they practice without it. As Milton Friedman has pointed out, certification provides consumer information. Licensure creates monopolies, restricts supply, and runs up costs.

Two. Decriminalize the practice of medicine. No, this isn't an extension of point one. It means ending the adversarial relationship between providers and insurance companies and the government. Especially the government. Billing procedures and regulations have grown so complex and often contradictory that they make the IRS Code a model of clarity and rationality by comparison. No doctor can understand them, or keep up with the changes. Almost always, billing is handled by secretaries or other clerical personnel, using computer programs that may or may not be up to date. Mistakes are inevitable. But absent clear evidence of willful fraud, these should be treated as honest errors, not criminal acts. Ironically, honest physicians have gone to jail while the real crooks – those who know how to beat the system – either go free, or settle for pennies on the dollar.

Three. End lawsuit abuse. Today, there are three kinds of legal problems destroying medicine. One is the breakdown of the system. A malpractice lawsuit can take three years or more just to see the inside of a courtroom. Justice delayed is justice denied – especially when the plaintiffs are individuals who can't wait and the defendants are corporations with plenty of staff attorneys who can. Conversely, there's the "deep pockets" syndrome. Too many corporations settle frivolous or predatory lawsuits just to get them out of the way – a practice that inevitably attracts more frivolous and predatory lawsuits. Then there's the practice of "defensive medicine" – performing all kinds of unnecessary tests and procedures not to benefit the patient, but to "self-insure" against future legal action. All these run up the costs for everybody.

Four. Exercise alternate means to settle disputes. In a recent statement, Orange County Citizens Against Law Suit Abuse noted, "Conflicts are inevitable, but messy lawsuits are not. Should you become involved in a dispute, first seek resolution through meetings, letters, phones calls or a more formal moderating process called Alternative Dispute Resolution." Most people know about ADR, but few realize its extent. Today there are many fine ADR firms and services with competent and disinterested specialists available. Also, historical experience with ADR in other fields (commercial banking, for example) indicates that complainants actually win more often than they do in court. The system is not stacked against the individual. By seeking other opportunities for resolving conflicts, you will most likely save precious time, money and energy.

Five. Allow patients greater choice in how they purchase medical care. Most people get their care via one of two heavily subsidized, hideously inefficient systems: the government or employer-provided insurance. People on Medicare and Medicaid get what the government provides, whether it's what they need or not. People with employer-provided insurance get what the employer offers. Time to open up to a variety of other arrangements, from tax exempt medical savings accounts to co-ops, barter and that strangest of all arrangements, cash-for-service.

Six. Get people more involved as both medical and legal consumers. Perhaps a good first step would be to trash the word "consumer," which implies passivity, and return to those honorable terms, "patient" and "citizen." It should be the right of patients and the duty of citizens to participate actively in fixing the medical-legal mess.

At this point, a question arises. Are we dreaming, or maybe not yet fully recovered from the holidays? Can people really take on the government, the insurance giants, the HMOs and hospitals, the trial lawyers? Here, we invoke a wonderful old Madison Avenue adage: Nobody really knows what happens when you advertise. But everybody knows what happens when you don't.

Take out "advertise," and insert "fight," and you've got it. More specifically, fighting for these proposals would, in the end, allow us to spend less time and treasure fighting each other, and more on the battles, foreign and domestic, that need to be fought for the benefit of us all.

Michael Arnold Glueck, M.D., of Newport Beach, Calif., writes extensively on medical, legal, disability and mental health reform. Robert J. Cihak, M.D., of Aberdeen, Wash., is the immediate past president of the Association of American Physicians and Surgeons. Both doctors are Harvard trained diagnostic radiologists. Collaborating as The Medicine Men, they write a weekly column for WorldNetDaily as well as numerous articles and editorials for newspapers, newsletters, magazines and journals nationally and internationally.

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