How Doctors Choose Their Medical Specialty
This is the best explanation I’ve ever seen. Please go to the cartoonist’s website for more.
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Paul Ryan’s Take On Healthcare Reform
Paul Ryan, Romney's VP Pick
Now that Mitt Romney has announced that Paul Ryan is his VP pick, I thought it would be helpful to repost some video and transcripts from a healthcare reform conference that I organized in 2009. Paul Ryan was our keynote speaker at the National Press Club, and I found him to be a bright, articulate, and humble person. I remember that he was eager to please, and that he came to the conference early so that he would have time to listen to the physicians and nurses who had traveled from across the country to speak out about healthcare reform.
I hope the video and transcript give you some insight into his take on (what is now) Obamacare. Enjoy!
*** Congressman Paul Ryan addressed the crowd at Better Health’s “Healthcare Reform: Putting Patients First” event. This is a transcript of his speech: ***
This event is a landmark in how we get discussion and debate going in the 21st century. We are communicating with the grass roots, with medical bloggers here in this room and across the country.
Let me tell you this: I don’t want government interfering in the relationship between doctors and patients…and I don’t want insurance companies interfering either! I want a vibrant health care market that lets patients choose the health care options that are right for them and their loved ones. I want a free market democracy that puts patients first. We can have this, and I’ll say something more about that in a minute.
Right now Congress is rushing through a health care overhaul that goes in the opposite direction. It’s important to analyze the relative financial costs and benefits of these proposals, but our greater challenge is not the dollars and cents. It goes to the issue of continuing the tradition of excellent health care that medical practitioners now provide. It’s about the equal dignity of each human person…and the future of America as a free society. The American character, and the principles of freedom & democracy which protect & preserve it, may be lost beyond recovery if Congress chooses the wrong path on health care reform—the path down which I believe the Obama Administration seems determined to lead our country.
Public health has always been a government priority. Our Constitution’s Framers saw every individual as having a “right of personal security” which includes being protected against acts that may harm personal health. This right is part of the natural right to life, and it is government’s very purpose to secure our natural rights to live, to be free, and to pursue happiness.
Now here is where believers in big government make their big mistake. The right of each person to protection of health does not imply that government must provide health care. The right to have food in order to live doesn’t require government to own the farms and raise the crops. Government’s obligation is normally met by establishing the conditions for free markets to thrive. Societies with economic freedom almost always have a growing abundance of goods and services at affordable costs for the largest number. When free markets seem to be failing to meet this test – and I’d argue today’s health care delivery is an example – government should not supply the need itself. It should correct its own interventions and liberate choice and competition.
We know from survey after survey that a vast majority of Americans are personally satisfied with the quality of their own health care. The problem is really with health care delivery, which is growing too costly and leaving many people without coverage. The proponents of government-run health care claim there are only two alternatives: either enact their plan or do nothing. This is false. Government bureaucracy is not the answer to insurance company bureaucracy.
An authentic solution to the problem of affordability should be guided by the principles of moral and political freedom… respect doctor and patient privacy…restrain spending…and channel the energy of our free market system, not dry it up. There is no lack of sensible alternative solutions proposed by Republicans to put patients first. Senators Coburn and Burr, and Congressman Nunes and I have offered one, called “The Patients’ Choice Act.” It’s an example of how to eliminate government-driven market distortions that exclude many from affordable health care delivery. More uninsured Americans can be covered by spending current dollars more wisely and efficiently than by throwing trillions more at the problem. Our health care delivery alternatives are based on timeless American moral and political truths.
In essence, we believe that the dollars and decisions should flow through the individual patient, not from the government. I want to see a market where providers truly compete against each other for our business as consumers and patients – not a bureaucratized system where health care providers vie for government favor as patients wait in line.
When federal bureaucracy replaces consumer choice and competition, services are distorted and costs escalate. Consider Medicare and Medicaid. Real cost control has become a national nightmare. Fraud has proliferated despite every effort to stop it. Program costs are always underestimated. In 1966, the cost of Medicare to the taxpayers was about $3 billion. Congress estimated that by 1990, Medicare would cost taxpayers only about 12 billion in real dollars. The actual cost? Nearly nine times as high — $107 billion. By 2006, Medicare reached $401 billion, while Medicaid added another $309 billion for a total of $710 billion. The failure to control Medicare’s costs shows us why we should look to free markets and decentralization for the answers.
The health care programs being pushed by the Democrats are outrageously expensive and fiscally irresponsible. Like Medicare and Medicaid, they will fail to control health care costs. They will exacerbate our growing debt. They will require crushing taxes. Their approach would spend trillions more dollars, mandate that all but the smallest of businesses provide health insurance, require every American to pay for health insurance or punish them for not buying it, impose a massive new tax burden on employers & heath care practitioners, and make our entitlement crisis worse by adding yet another open-ended entitlement.
The so-called “public option” is presented as a way of “keeping private insurance honest”. Well, if this is their idea of “honesty,” we’re in really big trouble. The “public option” isn’t honest. It is designed to make private insurers go away.
Government has four huge powers that force free market competitors out of business. First, the government does not pay taxes and the private competitors do. Second, it forces competitors to establish high capital reserves while the government has none. Third, the government does not have to account for employee wage and benefit costs – private competitors do. Fourth, the government gets to dictate the prices it pays, which are much lower than its competitors.
It isn’t “honest competition” when government serves as both referee and player in the same game. Before the game begins, you know who will win. Unfortunately, it’s the people who lose. According to one independent study from a reputable actuarial firm, two out of three Americans will lose the health coverage they now have in three years if the House bill becomes law.
Government-monopolized health service contradicts everything America stands for. It conflicts with our people’s character…it conflicts with moral principles…it conflicts with market freedom…it conflicts with democracy…and it conflicts with American health care excellence that still draws patients from socialist utopias for medical treatments in this country.
Bureaucratized health care is not compassionate health care. Let me say that again: bureaucratized health care is uncompassionate, impersonal, and inflexible. When government agents make decisions about how to treat the sick, they don’t decide according to need…they decide according to a budget-driven calculus. Bureaucratic indifference replaces compassionate caregiving by loved ones under free markets offering a range of health services. We need to restore personal, patient-centered health care, the very opposite of the plan now moving through Congress.
The question really before us is about power. Where does the power go? In other words, where do the money and decisions come from? Right now, the nucleus of power in health care lies with third parties – insurers, employers, administrators. Patients and doctors are at the fringe. Should this power be shifted to the government OR to patients and doctors?
It’s a truly critical question. The answer will determine how competition in health care works. Will doctors, hospitals, and patients contend for government favors? A better reimbursement? Coverage of a new cancer treatment? Approval of a new process? The currency in this power structure is political connections, interest group politics, and bureaucratic dictates. OR will providers compete with each other based on price, quality, and outcome for the patient’s business? The currency in this power structure is value, results, and achievement. These principles work in every other market when used – why not health care?
In this debate, direction is destiny. And the destination of the bill now before Congress is government-run health care.
The logic of this bill will require government rationing of health care resources. Last February, the Economic Stimulus package set up a new agency to do this, the Council for Comparative Effectiveness Research, or CCER, modeled on Britain’s National Institute for Health and Clinical Excellence—they call it “NICE”. CCER’s stated purpose is to identify medical practices that produce outcomes that work as opposed to those that don’t work. As long as there is a competitive private health care market, better information on price and quality could help bring much needed transparency to healthcare in America. But under the government-run plan, providers will not be paid for health care which CCER disapproves of. Once competing plans have been driven out, CCER’s approval or disapproval will dictate the care providers may offer, automatically denying treatments for certain categories of patients.
England’s NICE is now a rationing bureaucracy. Under NICE rationing, the government has capped the amount that may be spent on treatments to extend someone’s life by six months. The amount is $22,000, an arbitrary number arrived at not by medical professionals but by government accountants.
The idea that the government should make decisions about how long people should live is deeply offensive to everything America stands for. It is wrong to conclude that because health care resources are limited, therefore the federal government must ration care. This is what free markets are for: finite goods and services, including health care, are rationed by each person judging their unique needs as they allocate their own resources among competing producers. But should government do this with its “one-size-fits-all” template? I believe government rationing is morally and politically abhorrent. It denies basic personal rights. The sick, special needs patients, and seniors – those most at risk when the government involves itself in these tough decisions – deserve better. Like it or not, once government-run health care is a fait accompli, government rationing becomes the logical endpoint.
Now I want to speak from the heart to every provider of health-related services, including doctors and nurses, assistants, educators, hospitals and clinics. Many of you have traveled great lengths to join us today. You will be profoundly affected by the outcome of this debate. EITHER US health care will travel down a path directed by Washington, where you take your orders and instructions from the federal government – a path like that of our friends to the North and many in Europe – OR health care will be reformed to empower practitioners to pursue health care excellence. Countries that have chosen nationalized health services have wiped out individual competition and stunted innovation, by eliminating the incentives to outperform. By law or in effect, medical professionals become government wage earners without adequate reward for exceeding average standards.
Government-driven health care threatens providers in at least three ways:
First: Every aspect of government-monopolized medicine inevitably will be reduced to “cookie cutter” standards. As providers, you know patients’ conditions are not exactly the same. Treatments must be tailored to unique needs. Health care excellence like this is only possible under a vibrant free market.
Second: The cost and price structure of nationalized medical services are distorted by price controls dictated by political demands for low rates of reimbursement. The principal result is to shrink supplies of price controlled human and material resources – fewer doctors, medicines, & hospitals. Then government must manage the decline. The shortages must be spread around by deciding who shall receive and who shall be denied life-saving support. Patients with greater needs and groups deemed less worthy of treatment are the first victims.
Third: Government-run health services build barriers to talented young men and women considering a career in medicine. Today there is a growing need for more talented medical practitioners to care for aging boomers. America needs young people with ability and skill to take on the long years of education and incur substantial student loans to serve our growing need for health care. The best and brightest won’t do this just to become de facto government employees whose practice and reimbursement are dictated by Congress.
If government-run health care becomes law, it will prove lethal to America’s health care providers. We will be on the path to socialized medicine. The Congressional majority ridicules the claim that this is their objective, but the government-run plan which they propose as “an important tool to discipline insurance companies,” in the President’s own words, must lead step-by-step down that road. Mocking a fact does not make it untrue.
Some of the biggest health care organizations are trying to cut a “deal” with the Administration and Congressional leaders. With all due respect, they should know better. This is a fool’s errand. All they can salvage is a temporary stay of execution…because a government takeover of health care in the United States will either squeeze out or take over all private sector providers, large and small.
What is at stake in this battle goes far beyond health care. This debate encapsulates the defining issue of our generation: do we reform and strengthen American free market democracy, or abandon it for European-style social welfare?
If the majority party wanted more competition, why propose government insurance instead of enabling more non-profit insurance?
If they had no intention of transforming the system into Medicare for all, why do they tie all payments to Medicare?
If they were so worried about our skyrocketing national debt and the burden on the next generation, why do they want to create an entirely new entitlement that would deal a staggering blow to our economy – an entitlement that rivals the size and liabilities of Medicare and Medicaid? Just yesterday the Director of the nonpartisan Congressional Budget Office told the Senate that their health care plan would worsen the overall fiscal outlook, and his review so far of the House proposal draws the same conclusion. It makes the fiscal situation even worse.
The fact is, this is ultimately not about health care but about promoting an ideological objective. This nation, founded on the self-evident truth that unalienable rights were granted to all not by government but by “nature and nature’s God,” is to be remade into a “benevolent” social welfare state. Federal health care is but the first step. Until now, people in other countries that have chosen that path might at least come to the United States. But where will Americans go when the US also has government-run health care? There will be no place of freedom left to us.
Every day America’s health care professionals meet the critical medical needs of our people with selfless dedication and passion. They would jump in front of a bus to save their patients. They deserve not just thanks but our recognition that their excellent care cannot continue under a government monopoly.
This is not the time to stand to one side. Providers themselves must engage in the struggle for the future of their high profession and commitment to the wellness of our people.
August is the time for action. This is the time when Americans either engage this debate and tell Congress they reject government-run health care…or sit silently by while Congress forces it on them. The President and Congressional leaders are saying this has to be done immediately – it has to be done right now – and leave the details to them – they know best. Well, whether your pet peeve is Iraq or bailouts or the so-called stimulus, we’ve all heard that line before. You know what they say: fool me once, shame on you. Fool me twice – or in the current political environment – 3 or 4 times – shame on me. Will we heed this lesson?
I am initiating this call to every person and group involved in health care: you must act now! Doctors, your patients trust you, they will listen to your “prescription.” Ask them. They’ll jam the Congressional switchboards. They have done it before and need to do this from now through August. They will defeat this threat to everything America has stood for.
Let’s get government health care off the table. Then we can address real reforms to bring patient-based health care back to America.
Thank you very much.
New York Times Scratches The Surface Of A Festering Wound: The Truth About Bullying In Medical Training
Dr. Pauline Chen recently wrote an interesting, if not slightly sterile, article about the prevalence of bullying in medical school. A survey published by JAMA in 1990 suggested that 85% of medical students had experienced some kind of mistreatment during their third year of training, and a quarter of the respondents said that they would have chosen a different profession had they known in advance about the extent of mistreatment they would experience.
One medical school (UCLA) took these sobering statistics to heart and implemented an anti-bullying program of sorts. Thirteen years after it was initiated, more than half of all medical students still said that they had been intimidated or physically or verbally harassed.
I recently wrote a fairly tongue-in-cheek blog post about why doctors are jerks. But I didn’t really delve into the more sinister side of the bullying culture. Some of my experiences in medical training were soul-suckingly bad, and just to add some flavor to Dr. Chen’s analysis, let me share some real-life anecdotes.
My worst experiences in medical training occurred during Ob/Gyn rotations. I don’t know if this has been the experience of other medical students, or if my gender had anything to do with it, but I spent time with a group of female residents who were so toxic to med students that the department chairman actually warned us about them ahead of time in a private meeting. He let us know that these residents had a history of “hazing” medical students, particularly females. I had always been a very conscientious and hard working student, so I presumed that they wouldn’t have much to criticize. My plan was to work hard, keep my head down, and get out unscathed. Unfortunately, nothing went as planned.
The tone was set for me the first day when I witnessed a female, Asian anesthesia resident slap a pregnant Hispanic woman who was in labor. The woman was frightened and spoke no English and was beginning to hyperventilate from pain. The resident was trying to put in an epidural anesthetic and the woman was moving around too much for her to get the needle safely into position. So instead of calling for a translator, the resident started raising her voice, eventually screaming at the woman to calm down. The woman was crying uncontrollably, so the resident slapped her, and told her that she was “going to lose her baby” if she didn’t shut up. The husband was also terrified and could understand some English. He translated to his wife that she was going to lose the baby and started begging her to be calm. I stood in the doorway with my mouth open. The resident told me to get the f-out of there as she threw her gloves at me.
I suppose the humiliation of being caught abusing a patient was enough to channel her hate towards me, so she told the Ob/Gyn residents that I was an incompetent medical student. For the rest of the month I was targeted by the hazing team, and like a pack of wolves they descended, bound to make my every moment a living hell. During the delivery of my first baby (a touching experience that moved me to tears), the new mom experienced a small tear during the birthing process. The residents blamed it on me, and convinced me that I had personally caused her harm by not “supporting her perineum” correctly. I was mortified and fell for the lie – hook, line, and sinker.
When a woman went into labor it was customary for the residents to page the medical student on call and have him or her assist with the vaginal birth or c-section. My peers were paged in a timely manner, while I was either paged at random times or paged to the wrong parts of the hospital so that I appeared to be late to several deliveries (especially when a senior physician evaluator was present to witness it). Once I caught on to this I had to remain awake 24/7 at the nursing station (rather than the more secluded med student lounge) so that I could follow visual cues regarding where and when to assist. After several shifts without sleep the residents began locking the chairs in their lounge so that I would have no where to sit or rest, but would be forced to remain standing “on guard” all night.
One page was particularly painful at the time (but almost laughable in retrospect). A resident took it upon herself to page me just to tell me some important news: I was the worst medical student in the history of the program.
Of course, my final resident evaluation was dripping with venom. I recall statements such as, “Valerie suffers from narcolepsy,” and “she is uniformly late and is never prepared… she doesn’t answers her emergency pages… she occupies valuable space at the nursing station instead of remaining in the medical student on-call room… her performance in deliveries borders on dangerous.” And on it went. I wish I had the maturity to take all of that in stride at the time and see that these women were nuts, and it had nothing to do with me personally. But I was too close to it then, and I bore the pain with a stiff upper lip.
I still think about that poor patient who was slapped, and I kick myself for not standing up to the resident who hit her. I guess I was in such shock that I didn’t know what to do. But living through this abuse helped me to become a stronger patient advocate during my residency years. Just two years after my brush with the Ob/Gyn residents, I gained a reputation for being the intern you never f-with. I know I saved the lives of some who were slipping through the cracks of the system, and I was willing to call in the hospital ethics committee if I had to. Yes, that pregnant woman’s suffering was not totally in vain – because she helped me to find my own cojones. And for that, I will always be grateful.
Case Report: Surgical Removal Of A Muffin Top
"Muffin Top" Excision
At ten months of age I had a life-threatening condition that required risky abdominal surgery. The pediatric surgeon had to open my belly from end to end, right above my umbilicus. I lost most of my colon in the process, but the only apparent long term effect was an impressive seven-inch scar. After forty years of living, the scar had become “stuck,” resulting in a preponderance of skin slowly increasing its droop over the old gash. Basically, I had a non-clothing-induced “muffin top” and no amount of diet and exercise would improve it.
So off I went to the plastic surgeon, knowing that he couldn’t erase the scar but could improve the contours of my abdomen. In effect, I could retain my current appearance (that of a woman who had a permanent belly indentation caused by a lifelong history of wearing high-waisted pants that were two sizes too small) or I could opt for surgery and embody the look of an athlete who had picked a fight with Zorro. The choice was clear. I would settle for the long slice on a thin belly.
The problem with being a doctor under the knife is that you know exactly what the other guy is doing. This procedure was completed under local anesthesia, and so I was chattering away with my surgeon the entire time. Although it took us at least half an hour to numb the area, I could still feel every tug and pull, hear the click of forceps, and the crunch of clamps. It was a little unnerving to have one’s abdominal flesh wide open to the world – something I’d only expected of my patients previously. So my surgeon snapped a photo for my blog (see above) though I opted out of looking at the image in the middle of the procedure. I have my limits.
So why am I sharing this with you, dear readers? Well, I do have a few tidbits of advice for anyone who is planning to undergo a substantial cosmetic surgery under local anesthesia. I hope these are helpful:
1. Wear a comfortable pair of undies. The unisex/unisize disposable options available at the surgical suite do provide comic relief – if you think you’ll be needing that. The pair that I received were the color and texture of surgical booties and about the right size for a guy in the WWE.
2. Try not to kick the surgical assistant(s) during the numbing portion of the procedure (or during any other portion come to think of it). Let’s face it, lidocaine hurts. Each injection feels like a bee sting, and if you’ve got a lot of surface area to cover, you’re going to be spending the first half hour (or more) squeezing something with great vigor. Which leads me to my next tip:
3. Find something firm to grip during the procedure. I found the surgical table arms to be nicely padded and an adequate thickness for death grips. I did wonder if I should have brought one of those “stress balls” with me, or perhaps a pair of hand grip strengtheners from a local gym (see image to the left).
4. Be prepared to make small talk with your surgeon for an hour or more. Preparing some “talking points” in advance could have made my patter more amusing, I suppose. But the art of distraction is a valuable asset in wide-awake surgeries. Your nervousness may actually make you a little extra charming, so don’t worry about what you say. Just do what it takes to keep your mind off the situation.
5. Don’t put your hands in the sterile surgical field. At certain times during the procedure your surgeon is likely to happen upon a spot that isn’t fully numb. You will probably respond with a squeal (or kick) and a loud “Ow!” The surgeon will then ask you what you are feeling and you must resist the urge to show him/her by pointing at it. Many an abdominal wound has been accidentally poked by well meaning patient fingers. Be careful! Just say you feel something sharp and the surgeon will know where it hurts… because he/she just did something to cause the reaction!
6. Get detailed post-op wound care instructions. You’ll probably exit the surgical suite with a lot of gauze and tape all over you, and it will occur to you later on that you haven’t the faintest idea when it’s safe to remove it. Can it get wet? Should you remove the steri strips? When do the stitches come out? When should you begin to use silicon scar gel? Do you need neosporin? Make sure you ask these questions before you’re released back into the wild.
7. Ask about movement restrictions and exercise precautions. You may be surprised by how restricted your movement should be in the first two weeks after surgery. I guessed that back flips would be counter-productive in my case, but didn’t realize that I couldn’t “walk fast” or twist at the waist. Make sure you understand what you can and can’t do to optimize your healing.
8. Take some pain medicine at least an hour before the local anesthetics are due to wear off. This was my biggest mistake. I asked if the wound would be painful later on and my surgeon denied any knowledge of potential post-op pain. So, six hours later when I felt as if someone had attacked my belly with a blow torch, I found some comfort in a maximum dose of ibuprofen and a vodka martini (and for those who know me well – yeah, I couldn’t finish the martini because it tasted gross).
9. Keep the scar protected and moist. Healing skin loves to be moist, especially early on. Ask your surgeon how best to accomplish that.
10. Get the stitches out on time. Don’t leave them in too long or you will be at risk for a larger or thicker scar. Disolvable stitches are convenient, but they do cause more inflammation which can lead to larger or more robust scar formation.
11. Tell your surgeon that you love the results (if they’re good!!) He/she will really appreciate the feedback.
I’m very pleased to report that my abdominal recontouring was a success, and I hope you’ll learn from my mistakes if you’ve got one coming up. Now I must strive to keep a new muffin top from growing by eating a healthy, calorie controlled diet (excluding real muffins!?) and exercising regularly. 😉
How Sprained Ankles Can Lead To Cancer Drug Rationing
New York Times blogger Tara Parker Pope describes how her daughter was recently “the victim” of excessive medical investigation. Apparently, the little girl twisted her ankle at dance camp and experienced a slower than normal recovery. Four weeks out from the sprain, Tara sought the help of a specialist rather than returning to her pediatrician. The resulting MRI led to blood testing, which led to more testing, and more specialist input, etc. until the costs had spiraled out of control – not that Tara cared much because (as she admits) “I had lost track because it was all covered by insurance.”
Instead of any twinge of guilt on the part of Ms. Pope for having single-handedly called in the cavalry for an ankle sprain, she concluded that her daughter was a victim of medical over-investigation. But what would any physician do in the face of a concerned pseudo-celebrity parent (with a huge platform from which to complain about her medical treatment)? The doctor would leave no stone unturned, so as to protect herself from accusations of “missing a diagnosis” or being insufficiently concerned about the ankle sprain.
The responses to Ms. Pope’s personal “horror story” about over-treatment (and the waste of billions of dollars inherent in the US medical system) were amusing. One commenter writes, “Why not think of the unnecessary $210 billion as a fiscal ‘stimulus?’ Makes as much sense as any other program in the Age of Obama/Krugman.” And another, “[Of course there’s over-treatment] because the federal government subsidizes it! Medicaid, Medicare, and third party private insurance all promote the use of wasteful health care spending. And Obamacare will put that process on steroids.”
Whether or not you agree that socialized medicine reduces healthcare costs, it seems to me that we all have a responsibility not to over-utilize medical resources so that they will still be there when we really need them. Over-investigating every pediatric ankle sprain will simply drain our collective resources, ultimately resulting in further healthcare rationing. New York Times writer Peter Singer has argued that rationing is inevitable and decisions about cancer drug treatment will become the purview of US government agencies as time goes on. I’m pretty sure he’s right.
That being the case, why spur on rationing? Ms. Pope’s victim mentality demonstrates her lack of insight into the true causes of rising healthcare costs – one of which is patient demand. Ms. Pope herself is contributing to the healthcare waste she despises by requesting excessive testing in an environment where physicians are afraid to say no due to legal pressures (or a NYT writer’s bully pulpit). Demand drives costs, and there is a finite limit on our resources. Personal responsibility must play a role in healthcare utilization, just as efforts to protect our environment and scarce resources require participation by individuals. Ultimately, one child’s ankle investigation comes at the price of another patient’s cancer treatment.
Was it the physicians’ responsibility to put the brakes on her daughter’s over-testing? Maybe, but I’d prefer to live in a world where patients can invoke additional testing when their personal judgment suggests that it’s important. Ms. Pope knew better, but requested the additional testing because her insurance paid for it. Free care leads to more care – especially more unnecessary care. Ms. Pope’s daughter was not a victim of over-testing, but a beneficiary of that luxury that may soon evaporate.
We can create a healthcare system where no ankle gets more than a physical exam and ibuprofen (so we can forcibly prevent over-utilization), or we can teach people to use healthcare resources responsibly. Unfortunately, that will require that patients have a little more financial skin in the game – as Ms. Pope has demonstrated. The alternative, a distant oversight body regulating what you can and can’t have access to in healthcare, is where we’ll probably end up. Some day in the future Ms. Pope will recall the day when she was able to get unlimited medical investigations for her daughter without question or cost, and she’ll marvel at how that freedom has been lost. By that time, I suppose, I’ll be one of those people who is being denied cancer treatment by my government.
