Health News Digest

January 3, 2011

Seven Ways To Improve Health Care And The Environment In 2011

Save health care and save the world

By  Michael D. Shaw

What better time than the beginning of a new year—and a new decade—to post some bold, yet quite practical suggestions?

1.     Encourage telecommuting on a much grander scale.   By some estimates, transportation accounts for 25% of the world’s energy usage, with motor vehicles comprising nearly 80% of that. At the same time, countless office workers will make their daily commute only to log onto to corporate computer systems, which are now, or could easily be modified to be, accessible from their homes. If even 30% of these workers were to telecommute three times per week, the savings in energy and reduction in air pollution would be massive.

2.     Apply rigorous tort reform to medical malpractice.   Talk to any doctor, and the chances are he is practicing defensive medicine. No one really knows how many pointless tests are being performed, but a survey run in 2008 claimed that 25 percent of all imaging tests were ordered for defensive purposes. Some estimates place the annual cost of defensive medicine at $100 billion to $200 billion or more. One suggestion is to replace traditional malpractice jury trials with expert courts.

3.     Temper medicine’s current obsession with blood numbers.   Nothing is easier than running blood on a patient, to determine that his levels of this or that parameter are outside the normal range, or are “high normal.” Tens of billions of dollars in drug revenue derives solely from modifying these levels back to normal, with only marginal actual health benefits being realized.

4.     Promote accountability at the EPA.   Regular readers of this column know that I am no fan of this agency, which tends to focus on tenth-order effects, and fosters a culture of hysterical chemophobia. EPA’s lack of recent accomplishments is shameful, yet they want more money to achieve less and less. Recent retirees from the agency, who come from a more productive era, have told me that it needs to be reined in before it does something so egregious that there will be calls for it to be shut down completely.

5.     Reform the medical education cartel.   There is much wrong here, from slave labor residencies and purposely limited enrollment, to wildly inconsistent admission policies that can put 3.9 GPA Ivy League graduates on the sidelines, while misguided social engineering and in-state preferences can advance clearly inferior candidates. Moreover, do we believe in specialization or not? If a surgeon is content to perform the same knee operations for his entire career—and nothing else—why does he need such an extensive and mostly irrelevant training?

6.     Bring real editorial boards back to scientific journals.   The public is often unaware of the incredibly poor quality of many “scientific” studies, that appear in what once were prestige journals. However, the damage can go far beyond the paper simply being published. Frequently, questionable work is cited and forms the basis of standards, regulations, and practices. Sadly, papers are being published these days which 30 years ago would not have passed muster at a high school science fair.

7.     Promote a healthy skepticism within the general public.   Too many people seem far too willing to accept what those in authority have to say. Fear entrepreneurs succeed in convincing thousands of donors that evil industry is to blame, but the donors don’t always consider that such activist groups surely have their own agendas, as well. At the same time, the government regulatory apparatus—which should be protecting all of us—is so mired in politics that it’s no wonder when things go wrong. These days, a wealth of contrary information is available, for those willing to look. Knowledge is power!

Here’s to a healthy, happy, and environmentally responsible 2011.