Measles, Medical Costs, and Malfeasance

THE DOCTOR IS IN-There's an old saying in the medical profession that comes up time and time again: "Everyone wants to be a doctor."  Kind of like how "everyone's an expert".   

There really are experts whose expertise is based on their analysis of the available scientific literature, utilizing decades of their personal training and experience, and always keeping an open mind--yet our society chooses instead to listen to self-promoting experts who have no idea of what they are talking about...but who are "the real experts". 

Meanwhile, the health problems facing our nation remain unaddressed, with those choosing the Scientific Method and time-tested principles being ignored in favor of urban legends, social trends, paranoia and--worst of all--greed. 

It's probably safe to say that the Affordable Care Act didn't end our nation's medical problems, and it's probably also safe to say that there will be no magic bullet for the inevitable and unpredictable medical crises that rear their ugly heads.   

As some of us have warned for years, each new "solution" unavoidably creates a new problem, and the world is too complicated (with human beings too willfully ignorant) to presume that any problem can be forever "fixed".  

The "smart guys" who proclaim they have all the answers, or the "revolutionaries" who have the real truth that the powers that be are withholding from us, are really the last people who merit any credibility.  So we're stuck with malarkey when we really need modern medicine: 

1) The recent measles outbreak points out that our modern, "educated" society has successfully proven that education and judgment can remain mutually exclusive--particularly when the "educated" choose to use their "education" to justify bad behavior. 

If anyone reading this wants to presume that vaccinations are fraught with hazards, and that they are approved by the FDA and federal health panels because of greedy and conspiratorial manufacturing companies instead of thorough and repeated scientific risk/benefit analysis, that's your prerogative.   

But our society need not put itself at risk to cater to your own custom-made and preferred "facts". 

Most of those families who choose not to immunize their children to measles and other preventable infectious diseases are of above-average education and socioeconomic status--they consider themselves higher life forms who rely on "the masses" to get immunized as a way to avoid the "risks" associated with immunizing their own children. 

But measles and other viral pneumonias can occur in anyone, no matter their wealth and education, and whether it's self-imposed idiocy of the "smart", or our society looking askance when immigrants and tourists don't reliably get screened and properly immunized, we don't have to tolerate bad behavior of any sorts. 

Dropping politically-correct pseudoscience, disallowing ANY child from attending our schools without proof of immunization, and demanding that all immigrants and tourists be immunized in order to stay in the U.S., are just three of the ways we can avoid the recent outbreak of measles that occurred in response to exposure at Disneyland. 

And it should be remembered that this outbreak was entirely preventable and should never have happened in a truly educated and responsible society. 

2) The failure of generic drug makers to keep costs down should be the focus of our scrutiny in our fight against astronomical medication costs, and increased efficiency with tough, time-tested methods to lower medical costs is something that our society just does not yet do. 

While Washington, D.C. politicians are "looking into" and creating "fact-finding panels" to explore the ridiculous rise of generic drugs (up to 1000% or higher) that have been manufactured for decades, there is one fact that won't go away--the conflict of interest that too many politicians have from these very same generic drug manufacturers. 

Brand-name manufacturers have been struggling to keep up financially while playing by the rules and doing the proper research that upstanding science-based and private-sector companies have done for decades.  Research, development, FDA approval, marketing and other factors increase their costs for legitimate reasons. 

Yet while there is always the risk of bad behavior on the part of a brand-name manufacturer, the generic drug makers who choose to jack up costs do so simply because...they can! 

Some generics are cheaper than others, but most are still too darned expensive when considering the ease of their manufacturing.  Both legislation to require generics to be sold at 50% or less of brand-name alternatives (instead of the 85-90% figure now allowed) and intervention by health plans will be needed to truly fix this problem.   

These same health plans, so often reviled (and not without good reason) were what got prescription drugs such as nonsedating antihistamines (Claritin, Allegra, Zyrtec) to be available over the counter, so their recommendations on what generic, decades-old medications should be priced would go well with a perpetually-victimized public. 

3) Maybe we should start fearing the health care "experts" and not the medical providers and entities who are trying desperately to provide affordable and quality health care to the American public. 

Single-payer health care has its role for segments of the American People, but there are those who have become so enmeshed with that alternative that they have become "single payer zombies" that would rather gouge out their own eyes with rusted nails than admit that they don't have all the answers, and that one size does not always fit all people. 

Vermont is abandoning its efforts to create a single-payer state, as announced by Democratic Governor Peter Shumlin after years of working with folks like Jonathan Gruber (yes, THAT Gruber, who raised the issue of our collective "stupidity" in accepting the ACA). 

I know it hurts to admit that a well-intentioned plan didn't work as originally planned, but good intentions are as respected by Americans as the prompt and timely admission of policy change when those good intentions aren't bearing fruit. 

Medicaid (called Medi-Cal in our state) is losing its Washington-based financial support as of this year, and reimbursement rates to Medicaid/Medi-Cal providers will plummet to cause financial and medical chaos among the most fragile of our fellow Americans: the working and non-working unhealthy poor. 

Never has the need for cost controls, authorizing only a few qualified Medicaid/Medi-Cal providers, requiring HMO-based coverage for Medicaid/Medi-Cal patients, incentivizing patients to work in order to receive health care (if physically possible), finding new ways to innovatively fund Medicaid/Medi-Cal, and other initiatives been more timely and urgent. 

To do otherwise would be medical malfeasance.  

By the way, encouraging employers (not requiring and forcing, but incentivizing and enabling employers) to create good jobs with benefits is not only the most likely way to create better quality health care...it's also the best way to restore the long-struggling middle class and regrow the American economy to true, solid health. 

And as for you self-proclaimed "experts" out there?  I think perhaps you've done enough damage for now.  

No one is realistically denying you the right to your opinion...but catering to you, and doing what you keep clamoring for, is something that America need not have to do anymore. 

Because you "experts" aren't really as smart, and certainly not as educated or prone to good judgment, as you think you are.


(Ken Alpern is a Westside Village Zone Director and Board member of the Mar Vista Community Council (MVCC), previously co-chaired its Planning and Outreach Committees, and currently is Co-Chair of its MVCC Transportation/Infrastructure Committee. He is also a Board-Certified Dermatologist with clinical experience in clinics throughout Southern California.  He is co-chair of the CD11Transportation Advisory Committee and chairs the nonprofit Transit Coalition, and can be reached at Alpern@MarVista.org  He also does regular commentary on the MarkIsler Radio Show on AM 870, and co-chairs the grassroots Friends of the Green Line at www.fogl.us. The views expressed in this article are solely those of Mr. Alpern.)







Vol 13 Issue 7

Pub: Jan 23, 2015