The Regulation of Medicine-

                                      Reflections Of An Insider

Introduction:

     I am a member of both groups involved in the Medical Malpractice Crises, that is the Victims and the Providers. I understand the emotions and perceptions of both groups. It is from this vantage point as an "insider" that I offer these thoughts about a future direction in the search for safe health care.

     American physicians like to pride themselves as being practioners of the world’s leading health care system. In many respects this is true. The discoveries of American medical researchers and clinical investigators have transformed medical care throughout the world. We are at the threshold of an almost undreamed of understanding and ability to treat disease through breakthroughs in the Human Genome Project.

     And yet, there is a silent "cancer" eating away at the fabric of our health care system. Despite the successes of American Medicine, we rank only 37th in the world, according to the World Health Organization, in terms of bringing these successes to all of our citizens.

     In the late 1930’s, in an attempt to persuade his citizens that health care was a drain on the national budget and must be provided only to the productive, Hitler created the propaganda movie entitled, "Dasein Ohne Leben" – "Existence Without Life". The premise was that the chronically sick, with no chance of cure, should be liquidated. The Nazi argument was that health care was expensive and limited financial and human resources were to be rationed. Only those with real Life (Leben) – the healthy and productive – should receive optimum health care. Those with only simple Dasein – Existence – were without real life and would have to accept either lesser care or termination.

     Now, at the dawn of a new millennium, ideas reminiscent of Hitler’s evil schemes pervade medical planning. Notions such as "managed care", "rationing", "acceptable minimal standards of care", age limitations (such as in dialysis), and a host of other limits on optimal care are accepted as the norm.

     But the result of "Dasein Ohne Leben" thinking is that millions of Americans are without health care coverage and millions are receiving substandard care or no care

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