If you do not follow the comments section then you are missing the important and astute observations of one of CBB's regular readers, Gerald.
In his last post Gerald made it clear to me that maybe a statement of direction is needed for CodeBlueBlog, because there is a point, and there is somewhere I'm going. Here is Gerald's last post, and my reply:
Gerald, from 6/13/2004:
Limit malpractice risk. What else should be done? You keep making various proposals that would rather rapidly increase the cost of health care beyond the highest in the world, growing at 6% a year (that's about three times inflation in this era). Where is this money going to come from?
CBB Reply:
How does it increase the cost of health care to limit malpractice risk on mammography? And, health care costs are not rising at 6% a year if you look at the long-term charts.
I have many specific ideas on how to balance health care and spending, and I intend to make them clear.
However, because I have seen others make rational, fact-filled, markey-savvy proposals that have made no mark on the health care debate, I believe a different approach is needed. That's what my blog is about.
People don't listen to the facts. Part of the reason is the distrust of statistics. People are inundated with statistics and thus tend to discount them (the boy who cried wolf); Statistics are frequently used tendentiously, and people lose trust in statistical importance; AND, most people never learn statistics during their schooling and so are basically innumerate regarding the weight and meaning of statistics in any given argument. How else can you explain ANYONE using life longevity or infant deaths as a measure of how well our health care system operates?? And proponents for change (see Hillary's NY Times piece) do this despite the very solid refutation of these wrong-headed observations many times in many prominent venues.
I think that first, people have to realize what we have. Then they have to understand that these blind, piecemeal, reforms (or worse, a top-down solution) are vitiating, and will destroy what has been the BEST health care in the world, and in history.
To do this we have to dissect out the social issues like insurance and delivery, and respond to the care issues.
Then we have to decide what we want to pay for what we can have. THIS complex decision , as has been shown many many times over, cannot be made by any one person or any group of people no matter how smart or educated or erudite they are. THIS decision must be made -- as much as possible -- by the market.
That's where I'm going.



as the wife of a physician I'll agree that malpractice insurance is out of control. However, I don't see any of the medical blogs saying a word about the insurance industry itself being out of control and controlling health care in this country. I'm very, very disappointed with the medical blogs. No social consciousness at all, no concern for the uninsured. Only bashing trial lawyers. At least Charles Rangel breaks ranks slightly ... also, as a radiologist you do not discuss at all the issue that only full-time radiologists are allowed to read mammograms and that the regulations in mammography are onerous, and were not really written either by radiologists or by female patients - they were written by lobbyists. No criticism whatsoever of insurance investing in the bond market and passing along their losses to doctors in the form of higher malpractice rates. good thing you've never been uninsured and in the health care system ...
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