In Dallas, Texas, a nurse has to pay $ 50,000 to a “supervisory” doctor.
A new book by Dr. Jeffrey Singer proposes a simple idea: “Every adult man and the healthy mind has the right to determine what will happen to his body.” You may believe that the beginning is difficult to disagree with. But in Your body, your health careThe singer shows that the government may interfere with almost any decision we make in health care.
Government regulations restrict which we can seek care, which facilities can we seek care, what medicines we can take and who can prescribe them. In fact, there is almost no medical area where we are able to make unlimited choices.
In Dallas, Texas, where I live, for example, I am not allowed to seek care from a patient nurse in independent practice, even if the services it offers are services trained to provide from government training programs. The only exception is for a nurse who pays a doctor on average $ 50,000 a year to “oversee” her practice. However, this supervision is frivolous and has almost no real content. It is a little more than an accurate bribery that nurses are required to pay doctors for the right to do what they have trained to do. Both patients and nurses pay the cost of this bribery.
You may believe that restrictions as this exist because of the government’s concern that patients could make bad decisions that would be harmful to themselves. However, in states where nurses are able to practice without paying doctors $ 50,000 (27 in total), there is no evidence of damage to the patient.
Sometimes Singer (who is himself a general surgeon) suggests that the great government regulation of medical care is excessive paternalism. But if this is what mainly encourages legislators, why are we allowed to make so many dangerous choices inaccessible by the state? For example:
- There is no law that prevents me from putting a scuba tank and exploring an underwater cave. However, in up to 1 in every 3,000 cave, one dies.
- No law prevents me from hanging. However, among those involved in the sport, up to 1 in 1,000 die each year.
- No law prevents me from mountaineering – an even more dangerous sport. However, one in 80 people trying to climb the mt. Everest die. Of those who arrive at the summit, one in 20 never does it back.
The most important reason for most medical interventions, as Singer acknowledges, is the financial interest of those who benefit from the regulations.
Starting in the middle of 19th Century, the Amercian Medical Association has commissioned to make the doctors’ licensing in every state. Until the second decade of 20th The organized medicine of the century had gained almost complete control of the practice of medicine.
Like the medieval guilds of the old, organized medicine has successfully sought to limit the offer in order to increase the doctor’s income. The singer gives us a brief review of this story, which I have explored in a full -length monograph For the Cato Institute (also the publisher of Singer’s book). It also brings us up -to -date on many studies of nurses’ ability. After all, nurses may be slightly better than doctors for the tasks they have trained to do.
At the moment, America is suffering from a lack of a doctor. One way to resolve this problem is to extend the number of providers and the scope of the services they are allowed to provide. In addition to nurses, there are doctor assistants, foreign medical doctors and assistants. None of them is used throughout what they have to offer.
And here is a fact that some readers may find amazing. Most people know that after students complete the Medical School, they go through a complex process of finding a residence program to complete before they can become complete doctors. But 7 % of medical doctor graduates and 10 percent of osteopathic doctor graduates never find a residence. These students fall into a kind of legal vacuum – they cannot use their skills to meet the needs of patients.
We could largely extend the supply of medical care to this country if the politicians would simply get out and let the market for professional services work.
Without arrangement, what would he keep patients to see providers who are trained in the care they offer to deliver? The singer says that the private sector already has tools that protect us from this possibility. If Singer claims to have surgical skills that has never been trained (for example brain surgery), no hospital would allow him to practice there. No health insurance company will pay for its services. And no poor practice insurer will cover him.
The space does not allow a complete discussion on the many valuable contributions to the health policy you will find in this book. But no reader should miss out on the singer’s excellent treatment of “war on drugs”.
Our singer introduces us to the “iron law of the ban”, which believes that, as the law of banned drugs becomes more intense, the validity of the prohibited drug increases. This is partly because the smaller packages of the drug facilitate smuggling. The law of iron explains why bootleggers smiled whiskey instead of beer or wine during alcohol prohibition. The law of iron explains why hemp has become more powerful, because the cocaine crack has replaced the powdered cocaine, why to break the black market pain pills brought by the heroin and why the collapse of heroin brought fentanyl.
For health policy students, Singer’s new book is an contribution to read.
