DocBrain's Prescription for Healthcare

DocBrain is very angry about health care in America. Over-regulated, micromanaged, and underfunded, health care is less than it could be and you, the patients, are suffering for it. Solutions abound, all focused on increased micromanagement, more regulations, and less funding. Ask any health care provider (not a professor, but a real front line M.D. or D.O.) and you will get the true answers.

Barriers to dissemination of information

• If you have failed standard therapy for a condition or if your condition does not have a FDA approved treatment, your physician may not know what to do, even if there are treatments proven to be effective. Laws and policies prevent dissemination of this information except in certain specific circumstances.
• Most hospitals still depend upon handwritten notes. When DocBrain requested the option of typing a note, it had to go to a committee and it still has not been decided. DocBrain believes that typed notes are easier to read and will argue this with any naysayer.
• Asynchronous data transmission: emails, voicemails, text messaging are rarely used in health care and yet would be vastly superior to the current systems. The VORB (verbal order read back), is the closest thing most hospitals have to verifying orders, but wouldn't a written order (arguably not formatted to the chart), be more likely to be accurate?
• Virtual patient evaluation: If the doctor cannot be there, what about using a remote camera/microphone system? Everyone is so worried about security and privacy, but this issue can be reasonably solved with encryption. This should be the standard for immediate assessment.

Reimbursement issues

• McMedicine could be relatively inexpensive. You go to the clinic for hypertension. They check your pressure, adjust your medications, and you are on your way. But, what if you have found a lump in your breast? What if you are not feeling well? This is where McMedicine fails. You need a diagnostic evaluation. You need an explanation. McMedicine cannot do this. You need one-on-one service with someone who can figure out what is going on. There should be no skimping at this level.
• R and D We need newer and better diagnostic and treatment options.
• Reduce needless expenses. Malpractice is the biggest drain on the health care system and arguably the most useless. DocBrain believes that the oppositional positioning in malpractice cases leads to people becoming entrenched in their positions and care not moving forward. We also get crazy things, such as the increase in lethal c-sections due to pseudoscience lawsuits that blamed obstetricians for birth defects from vaginal delivery (a nod to John Edwards for this one). Furthermore, defensive medicine is extremely expensive.

When your doctor is busy filling out paperwork, you are not getting care. When that paperwork is not organized, no one can benefit from the success (or failure) of the treatment you receive. When information that could help you is suppressed, this cannot be a good thing. When doctors leave the profession, we all lose.

Whose fault is it anyways?

"Why aren't I happy?"
"Why am I not good?"

Rarely, do people answer these questions with the correct answer. The answer always goes to the wrong pronouns: you or them.

Happiness and goodness are, for the most part, internal. There are short term circumstances beyond one's control: a loss; hurtful words or bad behavior on the part of another person that upsets you by interfering with what you want or expect to happen; or contrived circumstances like a Hollywood movie (someone coercing you to take part in a crime). For the most part, we are the prime cause of our own happiness and goodness, and also the prime cause of our misery and evil. We are with ourselves 24/7/365. No one else is.

"I am in misery and it is your fault" is rarely true in a free country. "I am evil and it is your fault" is also rarely true in a free country.

Since happiness and goodness are internal, no external thing can make you truly happy or good. Some counselling, medications and other treatments may help with impulse control, but gaining control of impulses is also largely internal. Putting it another way, what good person would allow his poor control of impulses harm or distress others?

If you focus your attention on doing good and not distressing other people, you will find that your happiness and sense of goodness will increase. If you focus on your misery and justify your evil, your happiness and sense of goodness will decrease. It's that simple.

Government

With a nod to P.J. O'Rourke:

If people strive to be both good and happy, then all a government needs to do is:

• Protect individual property rights
• Apply laws equally to all
• Allow all citizens an equal vote
• Provide a method for all citizens, and particularly children, to obtain a good education
• Allow a free press

Governments that do not provide the above are barriers to the advancement of civilization.

The majority of people, each for their own reason, desire to be good and happy. The definition of happiness is pretty much universal, but the definition of good is and has always been somewhat variable. In the end, we will only be able to have one set of values defined as good. The advancement of civilization (and ethics) is the search for the universal definition of good.

There is no universal good, although there are two candidates:

• The Golden Rule (which, to some extent, exists in almost all cultures): Do unto others as you would have them do unto you. Of course, this can be perverted as in the following sentence: "If I were an infidel, I would want the true believers to cut off my head."
• Live your life as if you would deserve to be happy. Again, this is circuitous, suffering from the same shortcoming as the golden rule.

I will go with DaughterBrain who wrote as a 3rd grader: "Enjoy life. There is nothing else quite like it."

The worst thing

What was the worst thing to ever happen to America?

DocBrain proposes that it was the federal income tax. Variable taxation on individuals pits one person against another. Haves vs have less vs have not. Give to government vs take from government. This was the most un-unifying action in our nation's history. And the worst is yet to come!

Census Sense

According to the US census 2000:

• 75.1% of the population identify themself as white
• 12.3% identify themself as black or African-American
• 3.6% identify themself as Asian
• 12.5% identify themself as Hispanic/Latino (not a racial, but an ethnic identity)

According to a recent TV show:

• 40% minority employment and board of directors membership is the goal that will get you cited as being non-racist.
• A meeting of diversity officers was shown, and it appeared to me that most, if not all, diversity officers for major corporations, were black or African-American. This suggests to me an under-representation of Asian, American-Indian, Hispanic and other minorities as diversity officers.

Here are the racial business problems as seen by DocBrain, listed in the order of importance:

• Minorities who are racist; resistance against the melting pot
• Family structures and communities that promote learning, politeness, respect given and earned vs those that do not
• Role models
• Financial support to optimize one's potential
• Whites who are racist

Those who make a living off of "diversity" of course see this differently. Undoubtedly, they see white racism as the chief problem. The promotion of this paranoia leads to toxic reactions, seen in our society such as doing good in school described as acting "white". There is a natural tendency to stick with your own, but in the US, your own should be fellow Americans, regardless of race, religion or national origin. Furthermore, I am unaware of "diversity" experts looking at black owned businesses to make sure they employ 60% non-minority, just to be fair and unbiased. The concept of "diversity" judges by race and is therefore racist.

The focus should be on raising children to be good thinkers and grounded in the basics of a good education, politeness, open to others of different backgrounds, and brought up in a family ruled by love and earned respect. This is where we, as a society, need to focus our funding, laws and efforts. Not on "diversity".

Illegal Aliens

Why do they come here?

• Jobs, where even the lowest paying job pays better than your native land
• Great welfare system for unemployed
• Great health care for anyone, regardless of ability to pay
• If your child is born here, it becomes as US citizen, no matter how you got here
• Great education for your children
• To be with family who are already here

Why do we have a problem with them?

• We don't want to be cruel by sending them back, by denying them food and shelter, social support services, etc.
• They are cheap labor, filling a need
• They are numerous, too many to deal with through the court system without creating financial burdens for all of us
• We have some degree of admiration for them, as most are hard working, industrious, and have shown the initiative to come here in a desire to get ahead, as most of our ancestors did.
• We have made many hurdles for legal aliens. Have you ever been at a highway construction site, waiting in line behind many cars to merge, taking your turn, when a car speeds along the berm of the road and cuts into line ahead of you? You follow procedure and you are penalized; someone else doesn't and is rewarded. Imagine if you never get through the construction zone because too many people cut into line. Imagine then, that if you try to do the same thing, you get arrested because of your country of origin. Well, that is what is happening. If you tried to do what Mexicans do and if you are from Iran, imagine what would happen to you! And, you might not be a terrorist, just someone with the same motives as the Mexican.

Any solution will need to take into account all of the above. Liberals want to appear "sensitive" to the Latino population, but this is just bias and prejudice against those who are not Latinos. Conservatives want to enforce laws, but the press and the liberals spin this as anti-Latino bias.

Our government has become too much under the control of divisive politicial strategies to accomplish good for the people. DocBrain will make only one point here:

The purpose of the US government is to serve the people. The people are/should meet all the following criteria:

• Citizens
• Taxpayers (DocBrain thinks that the US government divided the American people by creating and enforcing an income tax system. Prior to the federal income tax, all Americans were, and should be, full citizens. Since then, only taxpayers should be full citizens, as those who do not pay taxes can vote to enslave the taxpayers to pay more and more, and this is what we are seeing. This burden increases from generation to generation and is despicable at a federal level, where we should be united. This, DocBrain believes, was counter to the desires of the founders of our country. It has produced nothing but further and further separation of people and is one of the worst things our government has ever done!)
• Free men and women (not those currently in prison)
• Alive (nods to Chicago and Philadelphia where the dead vote early and often)

If you have any power in government, help the citizens: that is your only job.

Celebrating Failure

DocBrain is concerned that people confuse social freedom with social good.

Race, national origin and sexual orientation are three characteristics that no one has control over. How can one justify laws against any of these?

Taking from others (criminality), what one consumes or inhales or injects, cleanliness, fiscal responsibility, politeness, keeping one's word, and consideration for your children's well being are all learned behaviors. There clearly can be societal rights and wrongs in these categories. Ideally, these rights and wrongs would be based upon some facts or data.

Fatherless homes account for 63% of youth suicides, 90% of homeless/runaway children, 85% of children with behavior problems, 71% of high school dropouts, 85% of youths in prison, well over 50% of teen mothers.

While one may argue the harm to a child being raised in a home filled with conflict, the above statistics are very revealing.

Certainly, no one should be forced to live in a home where there is severe physical or psychological abuse.

Adultery is a difficult subject, since it is so common and has so many different causes and different definitions. By definition, it is a violation of the contract of marriage. If the violation is based upon the other spouse's violation of the marital contract, it is revenge, which is unethical. If it is a primary violation, it is a sign of inability to keep one's word. In either case, it points to an internal personal weakness. It also points at times to a failure of marital partners to keep their marital contractual vows. The marital ties should be strong before a child is created, thus reducing the likelihood of adultery. The decision to separate based upon adultery should be weighed against the impact on the children and the nature of the adultery. A way to absolve adultery is needed, through understanding the root cause, genuine remorse and atonement.

Lastly, addictions can spin a person's life out of control. Better societal approaches to management of addiction and abuse are needed to preserve marriages with children. Perhaps, one of the greatest benefits of religion are the rules that govern social interactions between husband and wife.

The largest problem, however, is with women who have never married. They generally have children in their teens or early 20's. The pregnancy does not follow social committment between man and woman, but just occurs due to carelessness or often out of a desire to "have someone who loves me and needs me". Children of never wed mothers fare the poorest of all.

Children are the victims of single parent homes. Sometimes, it cannot be avoided, but, when it can, it should be. The parents need to subjugate their own desires to the needs of their children and this should be the social standard. Raising a child as a single parent should be viewed as a tragedy, not something to rejoice or celebrate.

But really, how do you feel?

Apparently, there is concern among some liberals about the term "Illegal Alien". That term seems to make these people "different" from others who are either "citizens" or "Legal Aliens". It just doesn't feel right to make people who have violated a law feel separate or different. We need a different term that somehow makes them feel more comfortable, takes away the stigma, and all that.

DocBrain could not agree more! Stigmatizing people because of their illegal actions is just plain unfair! People are more than their actions, wouldn't you agree? So, here are some new terms for stigmatized people.

Old Term New Term
Illegal Alien Resident non-citizen
Burglar Non-residential entry specialist
Drug Dealer Independent pharmaceutical salesman
Murderer Mortician expiditer
Drunk driver Mobile enteral hydrocarbon expert
Gay beater Promoter of freedom of expression concerning sexual diversity
Wife beater Unofficial female corrections specialist
Racist Ethnic community empowerment activist



DocBrain has done his good deed for the day. Now, these "special people" can hold their heads high. I hope that every open-minded liberal likes my new terms! Sort of warms your heart, doesn't it?