Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Path: utzoo!watmath!clyde!burl!ulysses!mhuxr!ihnp4!houxm!whuxl!whuxlm!akgua!sdcsvax!dcdwest!ittvax!decvax!genrad!panda!talcott!harvard!godot!ima!inmet!nrh From: nrh@inmet.UUCP Newsgroups: net.politics Subject: Re: Orphaned Response Message-ID: <2005@inmet.UUCP> Date: Wed, 27-Feb-85 02:18:29 EST Article-I.D.: inmet.2005 Posted: Wed Feb 27 02:18:29 1985 Date-Received: Sun, 3-Mar-85 02:58:15 EST Lines: 85 Nf-ID: #R:mhuxr:-25600:inmet:7800315:177600:4397 Nf-From: inmet!nrh Feb 26 02:04:00 1985 >***** inmet:net.politics / mhuxr!mfs / 4:13 am Feb 23, 1985 >> > Are you really suggesting that the way to lower health care costs is >> > to loosen the standards required to practice medicine?? >> > Marcel Simon >> >> Think about all the activities that you take part in each and every day >> that, were someone important to have made foolish decisions, could leave >> you dead. Ever drive a car above 30 miles per hour? Were the designers >> of the car government certified? Do you know how many people could die >> if electricity were to be cut off to large sections of a city because a >> computer program failed? Should all those programmers be government >> certified? >> >> --Cliff > >A car does have to pass certain safety standards (seat belts, 5 MPH bumpers >etc) and I have to be certified (driver's license) and the car has to >be recertified each year (inspection). Just a few side-notes: Some states have vehicle inspections and some do not. It was found a few years ago that the ones WITH inspection were no safer statistically than the ones without. "60 Minutes" sent a crew to the office of the governer of one of the states with inspection to ask him why the inspection program was going to continue anyhow..... On another front, one little European country had no drivers licenses until quite recently (sorry, can't remember which). >If the kind of blackout you >describe did have the effects you cite (not at all obvious. did anything >of the sort happen after the two big New York blackouts of 1965 and 1977) >the utility would for sure not get any kind of rate increase, and have >to pay some heavy fines, a powerful incentive not to screw up. > >But all this is besides the point. I drive the car myself, so as long >as the car maker provides regulated safety standards, if I use them >improperly or not at all, I only have myself to blame. I have no >such recourse when I am prescribed some drugs by a physician, or >if I am being operated on. I HAVE to trust that doctor. The only >basis for that confidence is that thge doctor has undergone >some training before being able to practice medicine. There's still no need to require that the doctor be certified by the STATE -- a simple call to the AMA (which would certainly prosecute vigorously anyone using their name falsely) would suffice to make sure you had a doctor trained "the good old way" rather than a Doctor Feelgood they've never heard of. >The original posting (by Koenig) proposed the loosening of >these requirements to insure better medical practice and lower costs. >I argue that would be folly, and would invite quacks to provide >inferior medical service, supposedly at lower cost. I'm quite willing to believe that the "average" medical competence would go down -- but think of how high "average" medical competence would be if we forbid anyone except the people who were in the top 10 of their medical schools to practice medicine! On the other hand, we'd wind up with only a couple of thousand doctors, tops (and of course, the rich would get the overwhelming majority of their time). In a sense, this is what we've got now -- an artificially savage competition for medical school because of the immense rewards reaped by an artificially small number of (admittedly very qualified) doctors. Clearly, the public interest would not be served (and is not served) by artificially restricting the practice of medicine to the ultra-competent. The question is, what happens if you don't restrict it at all? The answer is that you get a spread of degrees of competence, but so long as one enforces liability laws, one finds that the incompetent quickly drop out, and so long as professional associations may form and certify professionals, one has the option of paying more for a "guaranteed-competent-by-the-AMA" doctor. How much more? Well, less than we pay now (you see, they have to compete with the people who didn't quite have the sterling academic record, but who could get into medical school anyhow (as such medical schools would be able to turn out "doctors" even without the AMA and the State Licensing Board's approvals), and with the acupuncturists, and with the herb doctors, and with the rest. The doctors at the top would be no less competent -- they'd just have to compete with everyone else, as opposed to letting the State winnow the competition in advance.