Thursday, July 23, 2009

Health Care Reform: An Impossible Dream?

By Opeyemi, Feral Physician

Last night our president went to bat for us, with the best healthcare reform program that he has been able to propose, in an environment and a time heavily influenced by special interest groups.

These are special interests who do NOT have the best interests of you and I as their focus.

Thirty years ago, I graduated from college and took a year off to really examine whether I could become a physician. I knew a lot more that the average 21 year old about our health care system, having done an independent thesis on the history of medicine in the U.S. Could I flourish inside the belly of this behemoth of a force called “Conventional Medicine?” Could I even survive?

My background in biochemistry and cultural anthropology (they call this “interdisciplinary studies“, these days) freaked out my pre-med advisors, way back then. But it gave me an “outside insider” angle from which to observe The U.S. Medical Profession. I deliberately capitalize. My anthropologic studies allowed me to see how we had historically created an entire class of High Priests, with the same privileges and shadows as any group with access to great power and status. My biochemistry background allowed me to see how much of conventional medicine is NOT scientific. The U.S. Medical Profession is heavily skewed towards what we now know as “conventional medicine”, having wrestled power from alternative therapies repeatedly. Allopathic (translate “conventional”), vs. homeopathic (1). Thomsonian medicine vs. the status quo (2). The Flexner Report, standardizing The Medical Profession along the model of Johns Hopkins University, and coincidentally contributing to the closure of many medical schools training African Americans and women as physicians, in the 1920’s . Here is a quote from a paper on this topic:

“A hundred and sixty schools were in operation in 1905. By 1927, the number had dropped to eighty. True, most of those that were edged out had been sub-standard. But so were some of those that received foundation money and survived. The primary test was not their previous standing but their willingness to accept foundation influence and control.” (3)

My college research had showed that The Medical Profession feared women, and had already medicalized two of our physiologic imperatives—menstruation and childbirth—into illnesses.

“Wow”, I told myself in 1978. “This system is so flawed, that it cannot possibly survive much longer. We are smart enough to see this, and to join the rest of the “civilized” world and move into socialized medicine, soon.” Women were fighting back, claiming the right to birth plans and to alternatives, like having their babies at home or in free-standing birthing centers. Things were moving in the right direction, back in the ‘70’s. I figured I could wait the Bad Times out.

Boy, was I naïve!

I hadn’t counted on The Medical Profession teaming up with The Managed Care Business. Business and Medicine—strange bedfellows that teamed up with the founding of the American Medical Association in 1847. Founded, in1847, and incorporated, fifty years later.

Incorporated. Beware the corporate body. That institution with the rights, but none of the responsibilities of a human being. See the movie “The Corporation”(4) for a really interesting twist on responsibility and power. Or, rent “The Business of Being Born”(5) to see the directions Big Business and Medicine have taken.

Now it is not just menstruation and childbirth, but women’s third “Blood Mystery”—menopause—that are illnesses in need of treatment.

The very things that I thought would surely bring our corrupt system down have grown like cancer, threatening terminal illness in us, the U.S. public.

If Barak Obama is our David, and Big Business Medicine the Goliath, let us not just stand by and let him try to work a miracle with his slingshot.

Know your enemy.

Understand your enemy.

And get behind whatever reform we can to begin the process of dismantling this monster.



3. “He Who Pays the Piper: Creation of the Modern Medical (Drug) Establishment by G. Edward Griffin
4. The Corporation by Mark Achbar and Jennifer Abbott
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Friday, July 17, 2009

Nuclear explosion at Hiroshima.Image via Wikipedia

Opeyemi Parham was scheduled to interview Sage Maurer on July 9, but Sage was unable to attend and Opeyemi was able to book Emily Lawrence as her guest.
Opeyemi has been the health and wellness correspondent for Local Bias and while the work Emily engages in is not directly health related, Opeyemi conducted a great interview.
I asked Emily if she would send me a blurb to post on this site, so here it is:

Proud of the Cloud: Cultural Fallout in Atomic America
What happens when your high school mascot becomes the shorthand for Armageddon?

Richland, WA (population 38,708) sprang up in 1943 under the auspices of the Manhattan project, producing the plutonium for Fat Man, the nuclear bomb dropped on Nagasaki, Japan on August 9, 1945. As a government town during World War II and the site for plutonium production during the Cold War arms race, isolated Richland played a large part in the defense industry from the 40s through the 80s.

In 1943, the local high school mascot was the Beaver.

In 1945, it was the Bomber.

And by 1988, the Bomber was an atomic mushroom cloud.

This is the complicated tale of that mascot—and a peace meeting between Richland Bombers and Japanese Atomic holocaust survivors.

Proud of the Cloud is the story of evolving cultural memory--and what happens when the very lifeblood of your community becomes vilified by the world.

Filmmaker Emily Lawrence is currently editing Proud of the Cloud in the Berkshires, and will be scheduling periodic rough-cut showing in the upcoming months. For showing information and production updates, please visit or email Proud of the Cloud premieres in 2010.
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Sunday, July 12, 2009

Saturday, July 11, 2009

Market Failure by

The other day, House Minority Whip Roy Blunt (R-Mo) said the following in a radio interview:
HOST MIKE FERGUSON: What is the proper role of government, and what are the potential impacts of the direction that we’re going right now?

BLUNT: Well, you could certainly argue that government should have never have gotten in the health care business, and that might have been the best argument of all, to figure out how people could have had more access to a competitive marketplace.

Government did get into the health care business in a big way in 1965 with Medicare, and later with Medicaid, and government already distorts the marketplace.
This is a sentiment commonly expressed by conservatives and libertarians. It's also totally ridiculous, an example of an almost childish kind of magical thinking. I am as big a believer in the power of the marketplace as anyone, but the market is not the Force. Its powers cannot be harnessed to achieve all policy goals. There are very obvious limits to what the free market is capable of producing. For instance, the market will NEVER lead to the provision of goods and services that are unprofitable. That's why you can't buy an Ipod for a dollar or be chauffeured across town in a limousine for 50 cents an hour. That's why you can't by private flood insurance if you live in flood plain or by auto insurance if you're legally blind. The market won't provide these goods and services to you because doing so makes no economic sense.

For some reason, though, conservatives and libertarians like to pretend that these basic rules don't exist when it comes to health care, that if we just did away with Medicare, Medicaid, and various regulations, the market would somehow magically produce affordable medical care and health insurance for everyone, including the elderly and those with pre-existing conditions. It is difficult to overstate how divorced from reality this fantasy is.

The free market had plenty of time to work its magic prior to the passage of Medicare, but for obvious reasons, it failed to provide the elderly with any affordable options. Because elderly people require much more in the way of medical services, on average, than younger people, it makes no economic sense to offer them health insurance, at least not a premium levels that most people can afford. The result was an epidemic of uninsured elderly Americans who were being bankrupted by medical bills. That's why Medicare was necessary. It was a response to a massive market failure.

There are plenty of legitimate criticisms that can be made about how Medicare is run and how its fee-for-service model creates unhealthy cost incentives. But make no mistake, something like Medicare is necessary. The market is simply incapable of providing the elderly with affordable access to medical care. So unless you want to live in a world were most old people can't afford to see doctors, the government has to play a major role.

And, of course, the problem is not limited to the elderly. When it comes to health care, market failures are pervasive. Unlike with auto or home insurance, where the risk of loss (getting in an accident, having a fire, etc.) is relatively even from person to person, health insurance companies have an enormous amount of risk-related information at their disposal. The short and long term costs associated with most medical conditions are relatively easy to estimate. Thus, someone with juvenile diabetes or a congenital heart condition provides a very different risk profile than someone without those conditions. Factors like race, gender, income-level, and lifestyle also significantly affect one's risk profile. As a result, there will always be a large percentage of people for whom it makes no economic sense for a profit-seeking company to insure, at least at affordable premium levels.

The bottom line is that, when it comes to health care, all the market is really capable of doing is providing reasonably affordable care to the young and healthy, people for whom the risk profile is essentially random and therefore the economic model more closely resembles that of other major types of insurance (car, home, life). But a system that only covers the young and the healthy is, by definition, a failure. That's why every other industrialized country has long since adopted some sort of government insurance system. Expecting the market to provide affordable health care to all is like expecting the market to provide everyone with an affordable personal chef. It's never gonna happen.

Monday, July 6, 2009

Put the Lime in the Coconut

I'm not a Doctor, and I don't play one on TV. Opeyemi Parham MD is a Doctor, and she is hosting Local Bias this week.

Herbalist Sage Maurer will be her guest. For information on Sage, please go to: