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USA HEALTHCARE – A REVISAL

July 5, 2019

So much is in disarray with healthcare in this country. Frustration from physicians, dentists, therapists and related technicians centers around the low and sometimes absent reimbursement for services that require great skill and knowledge. Patients complain about the high cost of medicines and the scanty amount of time the doctor spends with them. We talk about healthcare disparity.

Politicians and government administrators talk about how expensive healthcare hits their budget. As mental health issues continue to escalate, most private practicing psychiatrists do not take insurance because the low reimbursement rate for services would drive them out of business. An emergency room visit for a bad “cold” may cost taxpayers an excessive cost when that “cold” could have been managed outside the emergency room. All the above is true.

Meanwhile the entities that are smiling include the pharmaceutical and insurance companies. Not only do they bathe in financial luxury, but they make the rules of the business. Insurance company CEO’s often compete with each other regarding their ¼ to ½ billion dollar salaries. Yes it is expensive for pharmaceutical companies to get a drug approved for market, usually in the billion dollar range, but once approved, that investment usually turns a profit in the first year of sales. After that, the company goes through smooth sailing with astronomical profits for the remainder of the patent. That is enough incentive for these entities to invest in NOT making any change in the healthcare system. They are doing just fine.

We are now seeing the rise of urgent care centers; they realize this is big business and they want a piece of the pie. Being very convenient for patients, many are turning to urgent care for their primary provider. This hurts the doctor patient relationship since you are most likely not to see the same doctor upon return visits. Many doctor visits are managed by physician assistants or nurse practitioners. Though these specialties do a wonderful job with healthcare education and preventive care, logic tells us that their expertise in difficult diagnosis or managing complex chronic medical issues is second to physicians.

So, without completely socializing medicine, here is my solution:

  1. Increase the professions of nurse practitioners and physician assistants.to manage non-complex or non-urgent issues. Let them set up their private offices and received $72.00 then that is decent reimbursement for the nurse practitioner and a relief for the insurance company. Multiply this kind of incident millions of times throughout this country and you can see how our healthcare cost would go down. That comes to 90% reimbursement to the nurse practitioner (which is great) and a great reduction in cost for the insurance company. Both parties win. With a 90% reimbursement rate, (and allowing for a ceiling) the nurse practitioner could make a very decent living. Maybe not as much as the physician but there would be an understanding that these are very separate entities.
  2. Salaries would expected to be different.
  3. Much of this is already happening BUT the difference is that the billing for services is at a rate the PHYSICIAN would bill thus increasing the cost of medical care in this country. For example; a patient is seen in the emergency room for a bad nose bleed and a nurse practitioner manages the problem without a physician input. The ER may bill the insurance company $1,200.00 for the service since it was done in the ER and receive $850.00 as payment in full. If the same patient saw a nurse practitioner in his or her own office and billed the insurance company for $80.00
  4. like some states allow to do the above. Let midwives manage non complicated pregnancies and deliveries; these cases may not need the input of the physician. They do an excellent job of monitoring and maternal support. Obstetricians now get a flat fee (approx. $800.00) for nine months of non-complicated pregnancy. That’s a lot of time and responsibility to just get paid that amount. It discourages many to no longer deliver babies and resort to just GYN care.
  5. Have them do the job of routine physicals healthcare assessments, and managing minor medical problems. They can be in urgent care facilities and ancillary areas of emergency rooms
  6. The role of the primary care physicians would be different. Their role would be to treat and manage chronic, complex or difficult problems only. They would not have the role of preventive medicine, managing long questionnaires, or administering vaccines. These roles would be the responsibility of the nurse practitioners or PA’s. Physicians, however, would receive a far greater reimbursement for their services since they would be considered as experts in their field and not a “healthcare provider.”

So, if the doctor treats and manages an asthma attack in their office, his or her reimbursement from the insurance company would be very different. For example, today the doctor may bill the insurance company $200.00 for a 40 minute visit and receive $95.00 for the asthma management. In a new system the expertise of the M.D. would command a billing of $350.00 and the reimbursement would be $315.00. That would be great for the doctor since they would not have to see as many patients to stay in business and they could afford to spend more time with the patient. This benefits the patient. The insurance company still benefits since much of their outgoing cost for minor and preventative services are at a lower cost.

This system implies that the average salary for a PA or nurse practitioner would be significantly lower than the physician.

  1. PAY THE PSYCHIATRISTS!!! Many don’t realize that many psychiatrists do not accept insurance
  2. and for good reason. Psychiatrist get reimbursed by the insurance company at a rate that is dependent on the diagnosis. It may take many hours of psychiatric evaluation before a diagnosis is reached but the doctor may get paid “peanuts” if the diagnosis is not at all complex. Pay the psychiatrist for their time not the diagnosis. Pay them well for their expertise and many years of training since they are the ones who may prevent your loved one from suicide.
  3. Since most commercial insurance reimbursement amounts are tied to Medicare rates, increase Medicare rates for physicians. This would encourage more M.D.s to accept Medicare and Medicaid but Medicare and Medicaid would not have to pay out as much if much of the preventive and primary care is relegated to P.A.’s and nurse practitioners. Medicaid forces its M.D.s to comply with a plethora of rules in the area of preventive care. If this responsibility was shifted to P.A.’s and nurse practitioners (who do a better job) this frees the physician to do what he or she is trained to do.
  4. Have federal government coop with pharmaceutical companies as an option. The biggest hurdle
  5. for these companies is the initial cost to invent and get certified by the F.D.A new drugs and devices. If the federal government agrees to supply half the cost for research and development and the company adheres to a ceiling on the price of the drug at market then both entities win. The drug company may save 5 hundred million on getting the drug to market and the government saves from having to pay out ridiculous prices the companies may charge.
  6. PAY THE HOSPITALS THEIR WORTH!! They are life-saving institutions and are worthy of their efforts. Yes, an ICU stay for 2 weeks presents with an astronomical bill and a premature neonate stay in the NICU for a month may cost over a million dollars. Place an 80% cap on what insurance companies would have to pay and have the balance paid by government. With savings elsewhere in the system, government supplement should not break the bank.

In general, USA medical care is good, but we all are paying too much for it because of its structure, not necessarily management. In general, most medical care cost are for minor or non-complicated problems. It is just that the volume of these problems is high. Many of these problems are managed by intensive facilities such as emergency rooms and urgent care. If our structure connected people with a team of health care providers that are non-physicians then many visits can be managed via telephone communication, education and reassurance.

Case in point: a 3-year old child develops a fever at 2:00 am.-parents panic and take the child to the emergency room at a cost of $1,200.00. That same child’s parents could call on a pediatric nurse and be given advice to lower the fever and reassure the parents that the child can be seen the next day in the doctor’s office. The cost for that route could be approximately $150.00.

Patients get the idea that any ailment necessitates a trip to urgent care without contacting their primary care provider first. This process has to be stopped. During the days of HMO (health maintenance organizations) patients HAD to contact their primary care providers before any other service could be authorized. That was a good idea to save cost and it should be reinstituted.

Finally, education of chronic medical conditions to the public would be best served by free seminars sponsored by insurance companies and not drug companies. Education lowers health care utilization and costs; this would benefit the insurance companies.

Michael D. Darden, M.D.

THE DATING GAME

March 4, 2019

There seems to be a gap in the mechanics of dating from the current generation of teens and young adults and what dating was like “back in the day.”

Today the proverbial phone number is used for texting-not talking. So here we go:

  •  Person one: “ Whats up with you?”
  •  Person two: “just chillin…why?”
  •  Person one; “thought you might like to get some pizza or somethin”
  • Person two: : “I think Im goin ta just chill here- not tonight”
  • Person one: “ok but hit me up when you can”
  • Person two; “sure”

What happens then is that person one never gets any notice beyond that; no phone call, no text –  nothing. Person one rightfully feels that person number two is not interested in getting together.

End of story. End of a possible friendship or romance. Added to this crude mechanical communication seems to be a paranoia about starting a relationship. I am not so sure where this originates but fear of pregnancy, fear of HIV and other venereal diseases probably plays a big role. So the safe route would be for women to hang out with women and men to hang out with men. Unless there is a homosexual affinity, the issue of sex is removed from the equation and the getting together becomes safe.

A group of guys get together to play video games while altering their perception via alcohol or drugs and have a relaxed wonderful time. A group of girls or young women are at a party and seem to have great fun socializing, dancing and laughing amongst themselves. There is an element of comfort and familiarity among same sexes.

Maybe we are seeing the subconscious effects of the 1980-2000 media blitz putting fear into sexuality, especially because of the AIDs crisis. Sexuality in the 1970’s was fairly casual and almost conventional.

The biggest worry was pregnancy and gonorrhea. HIV was not a factor until after 1978. For those teens who participated in sex, it was a gradual continuum of “going further and further” over many weeks and months of “going together.” Sex was not initiated on the first or second date. It took time for comfortability to set in. Such is not the case today. Using today’s adults as models, dating implies the possibility of sexual activity. This obviously can be scary for a young lady to get together with a man one on one.

Add in the custom of texting and poor skills at talking face to face, this issue of sex and getting together often goes without understanding. Nothing gets resolved so the safest option is to not “hit the other person up.” It would sound ridiculous but relieving if person one above included in his text:

Person one: “thought you might like to get some pizza-my treat;  but look, this is not like I am trying to have sex with you.    It’s just a friend like thang.”

Without face to face dialog skills, relationships may ONLY be centered around sex for those who choose to participate. These are certainly bad models for those individuals who choose to marry and have children. I can’t imagine a married couple having a worthwhile and needed argument via texting.

It requires the skills of reading body language, refining the meaning of what the other person is saying and meaning. It requires the physical presence if an argument ends up with reconciliation, hugs and smiles that resolve difficult issues. Dating purely though text communication is disastrous when one matures and desires a long term companion.

So, for those of us who are members of “old school dating” we may have to better avail ourselves to sharing our stories as teens and young adults. Our young folks WILL listen. They are very interested in intimate relationships; in today’s fashion of social media and texting, they just don’t know how to go about it.

……..talk with you later,

Dr. D.

WHAT’S IN A NAME ?

December 11, 2018

It has been a while since my last blog, so here goes another……

I just returned from a short trip to Cincinnati, Ohio where I grew up and witnessed something that made me reflect some thoughts. While waiting in line for my airplane to board, I saw about 20 young men, all dressed uniformly in white shirts, black slacks, shoes and black sport coats with yarmulkes and the traditional black hats worn by orthodox Jewish men. Many carried their Torahs with them. These were not older men; most were older teens. They seemed to socialize in a cohesive unit of brotherhood. Even their cell phones were of uniform style.

So what is my point here? In the Christian tradition (as I suppose in all religions) the central theme is to love fellow man and women with all your heart, with all your soul and with all your mind. My personal goal is to simply achieve that theme. Now it does not say to love just certain people; I am of the understanding that it includes ALL of God’s people. To be honest, I felt a stranger to these young men; I was an outsider. I was even reluctant to strike a conversation as to the purpose of their trip.

I knew not all was in line with my goal. How could I love them if they seemed so strange and of very different genres than mind?

Now let me flip the script. Of all human beings, the sector that I feel most saddened about is the black male in America. I can’t say that so much about black females since, in many ways, they are thriving. My maternal grandmother said to my parents that when you have a family (there were 5 of us) you focus on the ones that are in need the most. Black males are in need the most. Yes, many of us are unemployed and just hang out on corners and strip malls. Yes many of us “bum” for money. Yes many young black males skip school just to hang out in similar places with not much to do except pace the side walk like a lion in its cage or talking on a cell phone. To show your underwear covered buttocks on a cold Winter day seems to imply that this mode of display is critical toward your acceptance. Yes, “nigga” and a variety of other foul words are expressed in every sentence. Yes, their coats and hoods are black to match their black skin and hair placing them on “the dark side” as Star Wars implies to be really deplorable.

Just as I felt a stranger to the Jewish fella’s, I can just imagine the alienation non-black people feel about the black American male. Most social groups of people have strong historical backgrounds that supports their esteem. Jewish people have a strong commitment to each other and many have their Hebrew language to cement their socialness. Many Hispanics have their own language, yet speak the King’s English as well. The Irish have their traditions, parades, Pubs and colors. Whites, who have not gotten over the fact that Robert E. Lee conceded losing to Mr. Grant in our civil war over slavery, have their own confederate flags, stock piles of guns, symbols and secret meetings.

American blacks have much of nothing historically to support esteem. With the consistent killing of young black males, society is telling all of us that this sector must be erased. So American black males are at the lowest rank on the pole. Social depression is like personal depression; it is a disease that is chronic and often difficult to improve. Unlike personal depression however, there is no pill available for social depression.

Being a pediatrician, I am trained toward preventive care. So what can be done to straighten up and uplift the American black male? This is not a simple answer but here is a suggestion that can begin to heal. When I see African patients who were born in the USA, parents usually give them a typical American name. They also have an African name that has meaning. The name ties them to a tribe that had historical unity and great esteem. When black American parents have their children and give them names, they are often based on family or biblical names or fine materialism or smooth sounds (Crystal, Porche, Little B, Snoop, Big Daddy to name a few). These names are like Jazz music. The quality of the sound being heard has to please the mind. Now, all of this is fine; it is a part of black culture in the USA. However, with the advent of DNA analysis, we can trace our ancestry back to African countries we know very little about. It would support upcoming children if they knew they had an American name yes, but also an African name derived from their ancestrial country. For example, much of my DNA comes from Mali West Africa. My name is Michael but I could also have a name like Amadou or Mamadou. I may never use it in the USA but just to know my parents gave me another name tying to my roots serves only to boost my self-esteem. I can then go back and learn about the proud people of my heritage before colonization and to connect with a history not just based on slavery. If slavery is the only background of my history then I am bound to be depressed with low self-esteem.

Get well black males !!   We are ALL supposed to love you too.

….will get back at yah in Spring…

Michael Darden M.D.

GUNS IN OUR SCHOOLS – THE WILD WILD WEST ?

March 2, 2018

Imagine if you will, that America’s “King” and his opportunistic henchmen in Congress pass a law that requires teachers to have personal weapons in their classroom. All students including the kindergarten student will be well aware that their lives are surrounded by adults who carry guns.

Now lets remember that children have an innate desire to emulate adults especially parents and people who occupy a great part of their lives- teachers. Teens want to drive, drink, smoke and engage in sex just like grown people. Kindergarten students want to grow up to be firemen. Elementary students want to be superheroes and older children aspire to become a famous athlete or rap star. Teens absolutely cannot live without their cell phones. So it would be natural for all students to want to be “strapped” as well with handguns.

They would somehow acquire them legally or illegally. To revise a line from one of Prince’s lyrics, “Mommy, why does everybody have a gun?”   No longer would there be fights after school or after a football game. The altercation would be over in a literal flash.  BANG! “you dead !”

So here is my answer to this whole gun thing:

  • Dear NRA: Look at history; we are no longer using dial up rotary phones- the telephone has evolved into miracle devices. So, come out with a new protection device, one that does not kill but still offers protection for anyone who feels they need it. The device may stun or immobilize a person but IT DOES NOT KILL. You have the money and the resources to come up with such a device. Your profits would soar since, like cell phones, most everyone would have one.  The conscience of your company (if you have one) would be better served to know that you are no longer getting rich by killing people, but by protecting people.

Michael Darden M.D.

…talk to you in the Spring….

COLLEGE:  IS IT WORTH THE PRICE ?

August 27, 2017

As a pediatrician I am often counseling high school Juniors and Seniors about their plans after graduation. Most, if not all, tell me they are going to college. I should say that is great!  “You need a college degree to be successful.” “Education is the new currency.” “A high school diploma will get you nowhere.” But what about the price tag? Most seniors in high school know very little about the economics of higher education.

The tuition alone for Princeton undergrad is $41,820.00 per year; for Stanford, it is $65,316.00. The in-state tuition for the University of Maryland is $7,612.00. When you add the room and board and fees, you can easily tack on another $15-20,000 per year.

So now, let’s look at this… the cost of a gallon of milk may be $2.49 at your popular grocer but may be $2.79 at Seven-Eleven. When comparing milk to college tuition range of prices, there is a HUGE difference.  Now, one may argue, the quality of education from one school may be far better than another, whereas the quality of milk does not vary much. That may be so, but I would counter-argue that no matter where you get your college degree from in 2017, it appears your chance of getting a top notch job may be no better than the high school graduate who has, by now, accumulated job experience.    

The cost of annual tuition at Prince Georges Community College, here in Maryland, (12 credit hours) is $3,650.00. WOW!!! What a savings! So let’s do some math: If you went to Prince Georges Community College for two years at a cost of $7,300 and went on to University of Maryland for two years @$55,224.00 (tuition and room and board) you would have saved yourself $278,740.00 for not going to Stanford!!!  Think about if you took those savings and invested them into safe markets (mutual funds, IRAs and Roth IRAs) you’d probably be a wealthy 50 year-old retiree.

Now there are exceptions. Getting into medical school, law school and other graduate programs generally require (but not always) 4 years of college and a college degree. But this still doesn’t mean that you have to go to a college that zaps so much of your future income that paying back student loans make take the rest of your life. Go to a school who’s price tag is reasonable; perform the best that you can (you may get scholarships) and ENJOY college life. If you have chosen the right fit for you, these will be the most exciting, memorable years of your life. It is also a time where we meet our long term friends and future spouses.

For those students who have no clue what they want to do, it may be very valuable to consider technical schools in fields that may be attractive. It may be valuable to work first and/or combine work with one or two courses. I will never forget about 10 years ago, a high school senior told me he did not want to go to college, but, instead, wanted to go to HVAC School (training in heating, ventilation, and air conditioning). It took him one year of school and one more year of apprenticeship training before his first job started him at $49,000 per year. He was only 20 at the time!

Finally, there are those students who have a passion for marketable goods and or services that would qualify for them to become extremely wealthy through entrepreneurship. Today’s internet makes many things possible. Yes, a course in business may be helpful, but that does not set your finances back for decades.

So parents, be careful in these new times when guiding your kids toward their careers. Many times YOUR financial plan may be disturbed if you co-sign or take parent loans on behalf of your kids. Let them know that the “YOU ARE GOING TO COLLEGE!” may not apply anymore. Feel them out as to their talents and desires. Sometimes simply working for a while and establishing discipline may be the best thing for them.        

 ….see you in the Fall

Dr. “D”

THE VALUE OF EDUCATION

February 2, 2017

I always ask teenagers, when inquiring about their grades, “why are we going to school anyway?’ The usual answer follows this sequence:

“…to get into a good college” Then I ask why is that important?

“…so I can get a good paying job” Again I ask why is that important?

“…so I can live comfortably and buy the things I want.”

So….. is this the essence of our lives? …to live comfortably and buy the things you want? I certainly do not deny the pleasures of physical comfort, but there has to be more to our life than that.  So we accumulate all the comfort and material things as much as we can and then we die leaving all those things behind us.

It is like planning on robbing a bank with long term intricate planning, careful execution, grabbing the cash and then throwing all the money into the trash can.

It is simply not logical from a global perspective of one’s life.

So….. then Dr. Darden, why do we knock ourselves out trying to get super grade point averages, paying huge amounts of money for private school, college and graduate training? Where is the pay off?

It is at this point that I redirect the teens into thinking and listening. From high school to young adulthood, the cortex (the outer covering) of your brain is in prime condition to receive input from all sources. It is in its prime to analyze, compare and decipher. If the cortex is constantly working hard for you during this period of your life, it (like many other things) becomes accustomed to thinking

and actually gets upset if the thinking process is denied. Talk to a long distance runner and they will tell you even though the runs are hard work they LOOK FORWARD for the exercise. Talk to an obese person and they will tell you they very much LOOK FORWARD to that midnight snack even though they are denying themselves of valuable sleep. Talk to a cigarette smoker who knows the habit is bad but LOOKS FORWARD to going out in the cold Winter air to light up.

So if the brain is trained to study, memorize, analyze, compare, dream and create.  It will yearn for more long after you complete school. You will want to read books, listen to lectures, and seek all forms of information to satisfy your thirsty brain despite the fact that these are not required.

So now one could ask, ”what’s the value in filling up your brain with facts and great skill of analysis and talent?” ah hahhh !! this is the real question !!    So here is my answer: I start by asking why are we here? No one seems to know.

Now my AME church teachings tell me that we are here to fear God and obey His commandments. That may be the last sentence to the answer, but there is a lot more in the “text” that I want to know about. Our whole existence as humans is to simply learn. The brainstem was the very first thing that developed when the egg and sperm got together and the brain is the only organ that gives us “an existence’” Without the brain, we can live, but we become simply “ vegetable.”

Look at the stars at night, feel the wind, watch things grow from nothing, experience the emergence of a newborn from their mother’s womb, simply observe the miracles around you and inquire. You will at some point begin to understand that, although many questions are never answered, there is something beyond our ability to understand the coordinates this universe.

I don’t care what you call it, but it does force you into the spiritual world which is where we all need to be during our last chapters on earth.

I look around and observe people who don’t think but just go around doing what everyone else is doing. They don’t think for themselves. They are not of the living but simply in a semi-comatose state until they die. What a waste of miracle living! ….a disgrace to the entity that gave us life and a powerful brain. That is ungratefulness. Shame on you!! What a wasted life!!

We are supposed to be a species of high intellect; it seems to me that if we don’t achieve this goal, we too will become extinct, not from a meteor that wiped out the dinosaurs, but from our conscientious stupidity that leads to wars of such intensity that we destroy the planet along with ourselves

…..Dr. D

USA HEALTHCARE- GLUTEUS MAXIMUS BACKWARDS

June 28, 2016
  1. The pharmacist calls the physician and says the medicine that was prescribed for the patient can’t be filled because the insurance company has a limit on the quantity from the last prescription.
  2. A CT scan was ordered for a patient with cancer to see if the cancer has come back because the patient experienced symptoms. The insurance company has to give the final approval for authorization and says the process takes up to 5 days. Meanwhile the patient has to wait in fear and agony for those five days. And what happens when the request is not authorized?
  3. A doctor bills the insurance company for $120.00 for service that required 40 minutes of care in front of the patient since the patient’s medical history is complex. The doctor collects $20.00 as a co-pay from the patient and the insurance company pays the doctor $49.79. That is a total reimbursement of $69.79 for the doctor. The doctor has to “eat” the rest.
  4. The doctor prescribes an eye drop for a patient suffering from allergies and uses the brand that best suits the condition. The prescription is not covered by the insurance company because it is a brand product and cost too much. The patient asked how much it would cost to pay cash. The answer: $250.00 for a bottle smaller than the size of your thumbnail. Although the pharmaceutical company paid lots of money to get the drug approved, it now cost them $5.00 to make that bottle of eye drops.
  5. We have a pipeline of new drugs that have come to market; many of them are advertised on TV with names no one can pronounce but did you know most of those drugs are not covered by your insurance company because they cost too much? A class of drugs called biologicals (most end with the letters …mab ) are breakthroughs in science but their use will be limited because of their high cost. The drug Zolair used for severe allergic asthma and other debilitating allergic conditions will set you back about $3,000 per month. If these drugs are of limited use our feedback for further research is limited. I think we will abandon the use of chemotherapy and radiation therapy as archaic medicines to fight cancers and replace them with specific products that just fight cancer cells without destruction of healthy surrounding cells and the part of our immunity that fights emerging cancer cell all the time.
  6. Your health insurance company is extremely proficient at saving costs. They “penny pinch every outgoing expense. That’s fine; just good business sense. But did you know the average PERSONAL salary of your insurances’ CEO is not in the simple million dollar range but 200-300 million dollar ranges and that does not include stock options for those that are for profit corporations. There is an emerging club in the US called the billionaire’s club. These CEO’s along with hedge fund operators often compete as to who make more.
  7. In the sixties and seventies all healthcare insurance companies were non-profit; they did not have to answer to stockholders. When HMO’s emerged and later present companies like Aetna, Cigna, United Healthcare, WellPoint became commonplace, the for-profit healthcare industry emerged. Their PRIMARY interest is NOT your healthcare but satisfying the stockholders. MONEY is the GOD of healthcare in the US.
  8. The reason why most people are not satisfied with their doctor and why most doctors are not satisfied with their profession is because of medical insurance and pharmaceutical greed. In order for doctors or the companies that employ them are to survive economically, doctors must see 6-8 patients per hour. With phone calls or other interruptions, that means your doctor can only spend about 5 minutes with you per visit. It is not that they want to leave the exam room quickly; it is just that they are under economic pressure to survive their career. Now here’s the crazy part. Insurance companies know the doctor visit is 5 minutes and that’s their justification for low payments. So who loses in this cat and mouse relationship? YOU the patient.
  9. State agencies that dictate healthcare policy derive such policy without input from the doctors who actually perform healthcare services. They usually consult or hire medical doctors who are solely administrators and don’t see patients every 5 minutes. These doctors are paid well by their parent companies; many are not given voting rights during corporate board meetings.
  10. It is great to be a pharmaceutical representative; you get a free loaner car, car care and gas when visiting doctors’ offices or hospitals. The pay is good too. You operate on your own schedule. However, when the company’s product that you are advertising becomes generic, you may be suddenly out of a job. They treat the reps well when they are doing well and throw you to the trash when business is not good. It’s like being a coach for the NFL or NBA but you don’t have the financial cushion that millionaire coaches have. Again MONEY trumps everything in the healthcare industry.
  11. I remember during the Clinton Administration, Hilary published a handbook outlying a new healthcare system for the country that had many aspects of The Affordable Care Act that we have today. When that book was published, Hiliary’s life was threatened since her proposal would have upset the power of all those who owned the healthcare industrial complex. It was never mentioned again.

The above are a fraction of complaints that can be logged about our healthcare system. My contention is that healthcare is more about financial gain than care for the human body, mind and spirit. I was taught in church that there is only one God; paganism is an insult to God. Yet it is clear that the American way of life treats money as our primary god. It is the main purpose while we are living beings.

“ Well Dr. Darden what would you to improve the system?” one would say.

I would have to remove the premise that human health be put in the same category of goods and services that our economy is based on. Human health is precious and cannot be equated with a certain value. Just ask a person who just lost a child to gun violence or a drunk driver accident. Love ones would sacrifice everything to save another loved one from dying; material wealth has no meaning at that time.  That means that health be removed from our system of economics and consolidated into a right and not a privilege. Just as we have a right to liberty and the pursuit of happiness lets add in that part that says LIFE. So that puts healthcare solely in the lap of government and not in institutions that exist only to make money. If you visited India (much less wealthy than the USA) and got sick or required surgery or mental health care, your services would be free whether you are a citizen or not. If you went to Germany or France or Canada the same would be true. Now I know that to change our healthcare system that dramatically would never happen. So let’s begin perhaps with using our existing insurance companies but requiring health insurance to be non-profit. Those insurances that want to abandon this approach could do so and revert to life and indemnity plans not involving healthcare. Blue Cross and Blue Shield are non-profit so let those companies “take the lead.”

The other item of change would require a salary cap of the CEO’s of all companies now that they would be non-profit. The third leg of the triad would involve the pharmaceutical companies since they too are “fleecing” the healthcare business of trillions of dollars. Remember when new HIV drugs came out and only Magic Johnsons of the world were able to afford them?  Now those same drugs are available via Medicare and Medicaid. The problem with pharmaceuticals involves the high cost of research and development and drug companies say they must charge very high prices for new drugs to re-coup this cost. The ultimate solution to this problem would place drug research only in government institutions such as NIH. Private companies could still invent new drugs but there would be a cap on their retail price in line with the government based drugs.

Such a system would certainly lower healthcare cost in the USA; it’s just that no one would become billionaires working in the system. Where is the value in that amount of greed anyway?

Dr. “D.”