American Healthcare Should Adopt the Cocaine Standard

We Americans have a certain schizophrenia about health care. It is “mom-and-apple-pie” to bemoan the wait times, the hours of operation, the check-in, the lack of house-visits and primarily the cost of care. Nevertheless, people view it as a utility. No, that is certainly not correct. Utilities are paid for. The more electricity, water, sewer service and television channels one gets, the more one expects to pay. Medical care in the USA is viewed as a right, like clean air, without even an EPA-like agency to safeguard its continued availability.

Like expecting free water, free food, free housing and free services of a local business woman of negotiable virtue, free healthcare is a myth. It is a personnel-intensive, material-intensive industry which suffers under harsh regulations.

Healthcare is valuable.

Currently, 18% of American GDP[1] goes to providing healthcare.[2] For an average gross income of $52,000, therefore, this amounts to $9300/year. All receive healthcare yet almost half of Americans pay NO income tax.[3] So the current healthcare debate could be rightfully changed in regards to a national free healthcare scheme to:

“Why should about half of Americans pay for ALL of the healthcare?”

There are some obvious answers:

  • Epidemics of preventable disease are costly to all people, not just the victims.
  • Aesthetically, unnecessary disease and death are unpleasant for all.
  • Prolonging a useful career is beneficial not just to the individual but the society.

I understand that this is not the usual argument, which is couched in terms of a moral imperative.

The question is why anyone with enlightened self-interest should choose to lose one’s possessions and livelihood, earned by their own labor, to help another.

If one chooses to be charitable, the argument is no longer a political one and outside the realm of this article. There are numerous opportunities to donate and have been available for over a couple millennia.

The issue is one of political compulsion, and for extraordinary actions, that of using the bayonet of government to extract payment from a free citizenry to supply a service which is otherwise available, extraordinary arguments must be mustered. That is the standard which must be met before “free health care” becomes reasonable for a free and democratic society.

Contrary to fright tactics, healthcare is provided to all in the United States. I am not saying all care, all the time, in all places and for all the levels of care to which a patient might desire. I am saying that free care is provided. People do not die in the streets and have not since the Spanish Flu of a century ago.

What care is provided?

Specifically, every hospital is mandated to evaluate all those presenting with a potentially emergent condition. (Think chest pain, MVA, pregnancy). On-site care must be provided and transfer to a higher level center if that care is indicated. This is not “dumping” as that is prohibited. (See COBRA regs). The hospital and doctors eat the cost.

Newborn infants, even those requiring months of intensive care, are covered with no cost to parents. (Over the years, over half of my patients fall into this category.)

Specific diseases, such as congenital heart disease, are treated gratis by teaching hospitals.

Childhood immunizations are provided free.

Is this enough? For an “immortal” twenty-something, generous in the extreme, as he needs none of the services except the removal of inconveniently-impaled skateboards on occasion. It is hardly surprising that as a group they view compulsory medical insurance as an unfair tax. It is.

For those of us with fewer years ahead than behind, not so much. We all will need health care unless we make arrangements to die in another bizarre skateboard-related mishap. Disease, while not being avoidable, is nevertheless unpredictable. Catastrophic costs visit the provident as well as the foolish. It seems reasonable to insure only against the unpredictably catastrophic and not against what should, for a provident person, be viewed as the “cost of doing business.”

Where then can costs be cut?

Litigation is a runaway train. The USA is blessed with more lawyers per capita than any nation in the history of the world. We have more living lawyers than all of history back to Hammurabi with scant improvement to a more just society.  American juries seem to vie with each other to add zeros to judgments. Outrageous claims are made for “pain and suffering” which have no monetary measure nor recompense. Money is passed out wholesale for illusory injuries such as loss of psychic powers.[4] Even after juries have come to a decision to acquit a capricious lawsuit, jurors still inquire whether they “might give some money to the plaintiff.”[5] From whence comes this supposed charity? Presumably from the innocent doctors.

The whole medical system is canted to the idea that fighting a malpractice suit is futile. No matter how trivial the mal-occurrence, or how avaricious the plaintiff, the doctor will always lose. Applications for hospital credentials give copious space to record each suit but do not even allow the likelihood that a suit would go to trial and the doctor be found innocent, asking again and again “So it was settled?” rather than conceiving of the chance that the defendants prevailed. Wasting weeks in trial and years of litigation does not serve to reduce the price of medical care nor the availability of doctors.

This dubious success of the legal trade has spawned another costly extravagance. Regulation upon regulation attempt to institute by fiat what can only be accomplished by professionalism. Every time a surgery starts, even for a cesarean section, a “time out” procedure must be done. This was instituted to ensure that appropriate legs were removed when needed. I fail to see how one is going to open the wrong uterus. The procedure generates one more piece of paper that is never subsequently looked at. After multiple dozens and dozens of pettyfoggingly silly regulations, you create a huge patient chart that has all the forms required and is yet impossible to discern any medical judgment therein. Lawmakers, lawyers to a man, feeling neglected, have instituted all their pet peeves into requirements such as the Congenital Heart Disease Screening, a simple-minded rather insensitive test which any pediatrician worth his salt would ignore in favor of a good stethoscope and a quiet room. The false-positives of the screen generate $9000 every time it fails. I know of no infants it has discovered and many it has failed to discover who had real heart disease.

In a larger sense, the patients’ attitude in regards to healthcare must change if any savings will ever be realized. ER visits are certainly abused.[6] Misapprehensions about the appropriate use of emergency rooms are rampant, with Medicaid and Medicare recipients leading the pack. Fully 64% of ER visits are too inconsequential to justify its use. At the cost of $1200+ for each cold ( disease an infant will get about six times a year normally), they are a waste of money. Considering the 4-hour wait (compared to 20 minutes for an urgent care center and even less for a doctor’s office), they are as burdensome for the patients as they are wasteful.

Abuse of emergency rooms is seen most often by people who are unaware of the value of healthcare. If healthcare is free than a visit to and ER is as good street theater as any.Healthcare is valuable.When no value is ascribed to it, it is treated as if it has no value.

What does have value are illegal drugs. We are beyond the tipping point when 90% of the circulating currency has been used in a drug buy at one time or another.[7] The narcissistic abuse of illegal drugs by an overly wealthy, indulgent and non-introspective population creates its own health care problem. Nevertheless, it is a cash market amounting to $110billion in 2013 and $125billion today.[8] While not anywhere near the cost of national healthcare, it is a fair bit of change.

To dissuade these feckless suffering victims of America’s health care crisis, I propose that they EACH patient fork over a dime bag of cocaine before seeing the doc, a real object lesson in the value of health care.

I suppose that arrangements could be made for the user’s drug of choice, say 10 grams of weed, a couple oxycontin, or a few tabs of MDMA. Conversion table could be posted, giving the waiting public something to do in the interminable wait of overcrowded waiting rooms.

With luck, this would allow patients to accurately assess their needs for professional hospital care. It would provide a fund forthe hospital to cushion any perturbations in the payments cycles, selling off the cocaine as needed to make ends meet and doing in small part what needs to be done to make American Healthcare the envy of a troubled world.

[1] 17.95 trillion USD (2015)




[5] 2013, Floyd Co. Ga, Duke vs et al.





“Bully”: the New “Nazi”- All the Rant and Half the Content


The use of the term bullying” has increased in the USA by over 3-fold since 1990 (Google nGram to 2008 the last year listed). No doubt this is due to a real uncovering of previously concealed activity.

No doubt.

But, come on, folks!

Bullying has now become degraded to mean just about anything.

Like Nazi, fascist, racist, misogynist, conservative, alt-anything, fake-whatever, and ‘low-down-mean,’ the word has become to mean merely: “I don’t like you.”

The last ten years, a time hallmarked in America by the triumph of political correctness, safe-places, adult coloring books, micro-aggressions, shrieking professors calling for death in the name of life, and blocking political speech in the name of the freedom of political speech, have seen people embrace “bullying” as an iron-clad way of castigating those of whom it disapproves.

It used to have a meaning: “Bullying is unwanted, aggressive behavior among school aged children that involves a real or perceived power imbalance.”

That definition specified two things: 1) youth and/or powerlessness, 2) abuse of power.

How has the term been morphed?

Bullying used to be abuse of the weak (physically) by the strong (physically) specifically in an educational situation. The strong were usually the stupid, socially inept, and frustrated. The weak were anyone who could be made a victim.

Now, it may mean mere words: people being physically assaulted by others because their words were labelled “verbal assaults.” No, no hypocrisy there! Heaven forbid. Even, virtual words, arrangements of electrons, as evanescent as the wind, are blamed for a child committing suicide, salving, no doubt, the realization of failure by a parent and society which has shoveled isolation, alienation, and lack of consolation upon the child; distant sentiments of mere acquaintances becoming more real to the victim than immediate love and acceptance.

It does not hold together. Our new concept of bullying is incorrect.

We have all been littler, weaker, smaller, slower, more alone, and less aware of consequences than some other. All of us, even bullies, have been potential, if not actual, victims.

It is how we respond to that threat, real or imagined, which is a central part of our path from childhood to adulthood.

We may, seeing the immediate success of our own humiliation, embrace bullying when we can do so to our own benefit. It is reported that 90% of schoolyard bullies have been victims themselves. (

We may, seeing the injustice of it, step-in to prevent it. (I have a few stories about that, some remembered bruises and a broken tooth, but that at another time.)

We may, seeing that weakness and righteousness inevitably coincide at times, attempt to change the dynamic: might does not always make right. We call that attempt “government.” It has been a dubious experiment.

We may, in our selfishness, merely build up our defenses, stand behind the bulwarks of strength, age, prestige, education, and success, to throw bon mots at the little schoolyard tyrants of our youth and remembered powerlessness. This, I think, the most popular. The schoolyard bully is a favorite object for disdain in literature. In my own experience, I have to admit, I have found it so. The sixteen-year-old boy, cursed with early puberty, a dull wit, and intemperance, who attacked me on the last day of 9th grade (his last day of academic endeavor, as it turned out) after sucker-punching me from behind was himself seized from behind and dragged off, summarily. Very Satisfactory. I have forgotten his name, which is a pity.

So we have, all of us, been the victim or potential victim of bullying. We have all had the chance to bully; some of us, some of the time, have embraced that.

Let’s explore the other aspect of bullying: the abuse of power. This is more difficult. Particularly difficult because in life, we are not equal.

Please don’t. It is tiresome.

But, the truth is just that. We are not equal.

Some of us are employees. Some of us are bosses. Some are wiser. Some are defective in body, spirit, soul or intellect. Some have been elevated to levels of authority.

Get over it.

The fool who rants that their tenth-grade teacher doesn’t like him may have a point, but he has no standing. He can learn or not learn from the teacher and the experience. Ranting will improve neither his education nor the teacher’s affection for him. The boss that alienates the underling will get what he wants: grudging compliance and no more. The great dictator, whether bombastic and amorphous, or short, fat, xenophobic, and a super-annuated adolescent, will both fail in the long run with a greater or lesser body count.

Lastly, what are we to do with the disembodied use of the term for, bullying for situations where neither of the two conditions exist. If anyone is neither a weak victim, and is, in fact, possessed of all the weapons of the other, and is not at the mercy of the other’s authority, can bullying occur? When it is all reduced to words, facts, and ideas, can anything be said to be bullying?

Words, facts, and ideas are not equal. Words have meanings, qualities, and can be related to each other by sentiments and logic.

A family member, currently suffering from Post-Trump-Progressive-Psychosis (PTPP) made a statement: “Conservatives are selfish.” Turns out that is kind of a lie. Self-identified (doncha love that non-useful term?) liberals GIVE THEIR OWN MONEY AWAY far, far, LESS than those terribly selfish conservatives (based on IRS data, which with Lois Lerner still on the loose should tell you something). And the CONSERVATIVES give away money voluntarily. Just to put it into perspective, the great philanthropist, ex-VPUSA Joseph Biden (D-DE) and his wife (a childhood schoolmate, as it happens) donated to charity $627, for the BOTH of them for TWO years total (2008), working out to less than $15/month (or two venti lattes on the Starbuck Coffee Standard).

In contrast, progressives are touted as generous for using the absolute, and potentially brutal, power of the state to coerce payment from OTHER PEOPLE to fund their charity.

When did blackmail become synonymous with charity?

Socialism, as my fam-mem finally admitted to embracing, was preferable to capitalism, also because “capitalists are selfish.” I asked her who was more selfish: Man A, who risked his own money with no possible chance of recovery, hired people, and paid those people his money, on the chance, that he would make a profit OR the Man B, who demanded that Man A pay (on threat of imprisonment or worse) Man B to make him appear to give the unemployed what they had never earned and thus allow Man B to remain in power? If A has his way, his workers will make money; he might make money. If B has his way, A will lose money and his workers may become unemployed. Non-workers make no money beyond that stripped from the bones of A’s business. B is confirmed in his folly and to his political subpremacy.

As Margaret Thatcher observed, “Socialism works wonderfully until you run out of other people’s money.”

My fam-mem would not answer with anything other than insults and shortly accused me of bullying her.

By most standards, the woman in her eighth decade, is, intelligent, accomplished, and self-sufficient. While she is older, and for many years was larger, faster, more clever, and rather more diabolical than I, she has never been, and certainly is not now, in my power (where is a D-minor organ chord when you need one?) In her advanced years, she has taken to waving the red flag of socialism and shouting obscenities at public meetings and on Facebook.

I have not seen her in a number of years so any putative bullying on my part, had I wanted to attempt it, must have been accomplished trans-continentally, using mere words, ideas, and logic, one must presume.

Words and ideas are not equal.

Some words, ideas are indeed stupider than others.

Some logic is flawed.

Some ardently held opinions are wrong morally, politically, and rationally.

Those ideas should be ridiculed and those who hold them should be righteously embarrassed for having done so.

No bullying necessary.

[A word of disclaimer: Currently, I am a private contractor, sole proprietor of my own services, and an author. Prior to that, I was an employee. Other than some teenagers I have hired to do yard-work; I have never been an employer. I have been under authority and have had people under authority to me. I, like Will Rogers, belong to no organized political party.

In 2016, for the first time in almost fifty years, I could not hold my nose hard enough to vote for either the Crook, or the Creep. Just so’s you know]

Contraceptives and the Man-Tax

Less than a year ago the Little Sister of the Poor case was suffering under the formidable displeasure of Barack Obama and his contemptible Department of Justice. At the time, I mentioned that health care choices, are, in fact, choices. Those goods and services will be paid for, whatever the voter is told. As an example, free birth control (meaning oral contraceptives, OCP) are a choice, and not one with universal appeal. “free” OCP means that all the people in the USA pay for each prescription whether you agree, disagree, wish the money to be spent on relief of the mentally deficient, or for more nuclear devices. We all pay for a portion of the population.

I was taken to task by a young lady of my acquaintance and her sister. What I said was apparently Horrible. It transpired that I was unaware that it was a woman’s right to get free stuff to prevent her pregnancies, of which I nor any mere man, had much to say about.

A mere ellipsis here on the argument of necessity:  no man is to have any voice in reproductive decisions, yet it is frequently proclaimed as being self-evident that reproduction is a right. Nevertheless, there is currently no alternative for human male reproduction than the willing agency of the female of the species. Thus by the argument of necessity, the male has an authentic voice in this discussion, but I digress.


What the argument, of course, comes down to is an entitlement: women, due to their gender alone, should get an entitlement which, I have been assured by the young friend, neither I nor any man may have any vote, argument or opinion.


Let’s take that a little further.

If we assume that a woman uses an average OCP from 14 to 50 years at $30/month and also assuming no pregnancies or, heavens, no breastfeeding, that amounts to $12,240/lifetime. Given that there are about 150 million females of this ilk, the cost is $540billion dollars in US taxes a year. Considering what the taxes are already, perhaps this is inconsequential.

Now, ladies. Have you ever considered the cost of being a man?

I am not talking about the outrageous cost of razor blades, ER visits after bar fights, extra luggage fees for heavier clothes or the usurious cost of paying for a pick-up truck.


I am talking about food.

Men out mass women on average. By weight, the muscle mass is greater. Even for the same muscle mass, the caloric necessity is greater.

Now, given that we are not all (insert name of your favorite muscled stud-muffin), nevertheless, we men have to pay the piper.

On average, men must eat 8% more per day than women. Moreover, the caloric requirement does not disappear at fifty or so. The numbers decrease but only in proportion.

Doing the same sort of math, a man, merely due to his gender, is now spending about $25,200+ per life time for keeping up his end of the war of the sexes. That would generally, given man’s shorter lifespan, mean slightly over $1 trillion in the man-price per year.

So, to sum up: if all Americans must pay for about a half trillion dollars for OCP for the nations’ women then it seems only apt that the girls pony up the trillion and a half for the boys’ daily tofu stir fry, doesn’t it?

What goes around comes around.