Ron Paul’s Answer–Unlicensed Doctors for Uninsured Patients


Neuroscience the Old Fashioned Way

AmericaBlog has video and a transcript of Rep. Ron Paul during the Republican presidential debates, as he answers Wolf Blitzer’s hypothetical question about a 30 year old man who opted out of health insurance and now lies in a coma with a dire but treatable disease. Should we save him?

Paul >> That’s what freedom is all about, taking your own risks. This whole idea that you have to prepare and take care of everybody —

Audience >> [applause]

Blitzer >> but congressman, are you saying that society should just let him die?

Audience >> [shouts of “yeah!”]

Even Paul’s rival, Gov.Rick Perry, was ‘taken aback’ by the ugly mood of the crowd.

This may sound like ‘nut picking’– taking the most extreme statements out of context, but I will swear on a stack of collected Ralph Waldo Emerson that I heard the same kind of things said, shouted, and offered to me as argument at the health reform Town Halls here in Rhode Island.

[Here was a snarky example of a group of firefighters who let a house burn for lack of fees. Xavier Onassis, EMT-P, took issue with the story as reported by USA Today. He says the story was mis-represented in the press, and that dedicated volunteer firefighters had been working unfunded and without adequate support. He has an informed comment here with a link to a more complete story. I apologize here for giving legs to a story that reflected badly on people whose mission is to save lives.]

Rep. Paul did go on to say that no one would be left to die in his hospital, and he invoked the old-fashioned neighborly spirit where churches and benevolent groups would come together to save the guy in the coma (more on that following). Then he said something that the blogosphere has not picked up, though it’s one of Paul’s most radical statements yet…

We have lack of competition. There’s no competition in medicine. Everybody is protected by licensing. We should legalize alternative health care. Allow people to practice what they want.

“Everybody is protected by licensing.” This is a problem? Not de-regulated enough? “Legalize alternative health care.” What is he talking about? Alternative health care is thriving, and often reimbursable by medical insurance. But do we really want to just guess, when picking a doctor, whether they passed their boards, and whether their medical school was accredited? Ron Paul’s son, Rand Paul, is not board-certified by the American Board of Ophthalmology, but rather by an association that he founded and directs. That’s one way to do it. Do we crave the freedom to take our own risks with loosely-regulated doctors who can create their own credentials? Do we want an old-time doctor like R.V.Pierce?

R.V.Pierce,MD, was a good businessman. His hospital covered an entire city block in Buffalo, New York at the turn of the last century. He peddled a pre-FDA concoction called the ‘Golden Medical Discovery’. It made people feel better, allegedly because it was fortified with alcohol and opium. Dr.Pierce’s book, ‘The People’s CommonSense Medical Advisor’ contains scores of testimonials to miracle cures effected by just a few bottles. To the skeptical nurse, these stories are a window into the suffering endured by our great-grandparents, whose lives might be ruined by accidents or conditions now easily treated. Interestingly, R.V.Pierce served in Congress on the Republican ticket.

Back to Rep. Paul’s recommendation that we look to churches and neighborhood yard sales to care for our neighbors in need– check out Providence Journal reporter, Felice Freyer’s article ‘The Price of Miracles’. Neighbors do help, but the care of a baby in intensive care costs thousands of dollars a day, and then thousands of dollars a month after they go home. This is where collective responsibility comes in, and where we uphold our values as a great nation.

Back to Wolf Blitzer’s hypothetical. The life of a 30-year-old man has value. More than $800,000 according to one calculation. And the community that decided a cloud of air pollution and a smoking ruin was better than an intact house– well, just a little shortsighted. At least the firefighters woke up when they saw the neighboring roofs catching sparks.

And if you’re old enough to shudder at the mention of the drug, Thalidomide, then thank Frances Kelsey. As a pharmacologist at the FDA she kept that drug from being widely prescribed in the US. Regulation is good in its place, and what you don’t know can hurt you. Ron Paul’s nostalgia for unlicensed doctors for uninsured patients is not shared by most Americans. Most Americans want some assurance that there are standards, and recourse if they are not treated right.

The suggestion that we would all be better off if it were not for those tiresome standards and licensing requirements is easily refuted if we look back a few generations– and see why these standards were put in place.

The statement that we should just let uninsured people die if charity doesn’t intervene won’t seem so smart when it’s someone you know or care about whose life is in danger. And that would happen sooner rather than later if we lived in Ron Paul’s America.

We are not yet a nation that demands a credit card number before responding to 911, but yes, people are dying for lack of affordable care. It’s years of health and life lost to preventable disease and is a national heartbreak and disgrace.

I actually share Rep.Paul’s frustration with the current system– overtreating here, undertreating there, pill-pushing and flawed. But I wouldn’t throw it away in favor of a Wild West where sick people have no protection from quacks, where we pride ourselves on being strong enough to deny care to people who made ‘bad choices’ not to buy insurance. Especially as uninsured people are often young adults, and often can’t afford insurance.

Like many middle-class parents of young adults, I am benefiting from the health care reform that allows family insurance up to age 26. I want to see this as a beginning of more comprehensive reform that covers everyone. You may say I’m idealistic, but universal health care is more reality-based than a nostalgic vision of an America that never was.

MORE: Mark Karlin on Buzzflash says that a campaign manager for Ron Paul died young, uninsured and in debt. Would it be in accordance with Libertarian principles to provide health insurance for employees? The Huffington Post also has a comment on this sad story. Pneumonia can be fatal, but it is a disease that has a high rate of recovery if treated early. When people hesitate to go to the doctor for lack of insurance there are some whose luck runs out– this especially applies to the young and healthy.

Tears of Aqua Buddha

My first impression of the Rand Paul college prank was that it was kind of nasty and bullying to tie up a fellow student and then tell her to be a good sport, but I’m not objective. I don’t like him.

Today I was making early visits with WRNI on the radio and they played Jack Conway’s commercial and Rand Paul’s counter-commercial. I’m only a simple Pagan, but I think after the election both of them had better go to confession for taking the Lord’s name in vain.

Jack Conway’s commercial doesn’t ask the real question– whether Paul had a convenient conversion when he decided to run for office. Instead, it implies that he’s guilty of disrespecting Jesus and maybe has occult connections. This is the same kind of mud that can get thrown at anyone who isn’t publicly pious enough.

Paul’s rebuttal is a Dolly Parton-like female voice saying that Paul holds Jesus in his heart. Ew. What is Jesus– his human shield?

Shame on both of them for using religion to get votes.

I pray for a leader who will stand up and say that religion is a private matter of conscience, and that the record is public. A leader who respects the law and serves for the benefit of all people, without favoritism.

Instead we are inviting religion into politics and rewarding hypocrisy.

Incidentally, there are many American Buddhists who didn’t ask for their religion to be made into a joke, and if anyone has a right to take offense at Rand Paul, it’s them. A devout Buddhist or an honest atheist won’t be winning any elections this cycle.

Psst–Wanna Buy a ‘Rollodex’ Watch?

It’s not easy working in the medical field. You are accountable for everything, you are required to document everything, and it all can be made public. That’s the level of transparency we demand of people who take responsibility for health and lives.

That goes double if you’re running for public office. You can assume that anything you’ve ever said or done may be used against you. Inflating your credentials is a bad strategy.

You wouldn’t trust a guy who has a bunch of ‘Rollodex’ watches pinned to the inside of his coat, would you? Should a doctor be above suspicion?

Apparently there is no reason one doctor or a few can’t call themselves a ‘board’, certify themselves, and print up a fancy diploma to hang on the office wall.

Dr. Rand Paul took the liberty of bypassing the credentials most opthamologists seek and created his own board instead.

Here’s from the Louisville Courier-Journal…

Along with his wife and father-in-law, Paul founded the National Board of Ophthalmology because the American Board began requiring physicians certified after 1992 to be recertified every 10 years to make sure they were keeping up with medical trends.

The Paul campaign issued a statement Saturday afternoon, saying: “The National Board of Ophthalmology is a non-profit group involved with continuing education and board recertification. It was formed in 1987 by over 200 young ophthalmologists who believed that all ophthalmologists should be recertified. … NBO began recertifying in 2002. It is a completely volunteer organization that pays no salaries.”

According to records with the Kentucky Secretary of State, the organization was first incorporated in Kentucky in 1999. On records in that office, Paul is listed as “owner/president” on some forms and “president” on others.

Asked what requirements the National Board of Ophthalmology has for recertifying doctors, Paul’s wife, Kelley, who is listed on forms as the group’s vice president, said: “I’m not involved in that. I’m not officially talking about that today.'”

Rand Paul did respond to the Courier-Journal story…

Rand Paul, Kentucky’s Republican U.S. Senate nominee, responded to Sunday’s article in the Courier-Journal about his National Board of Ophthalmology, explaining why he formed the group and accusing the more established American Board of Ophthalmology of a “kind of hypocritical power play.”

I don’t know if going on the offensive is the best strategy for his campaign, but maybe he can rally support among citizens concerned about the hypocritical power of medical credentialing boards.

Some time back, I was researching childhood vaccines, and came across some surprising statements from the American College of Pediatricians. I then discovered that the ‘College’ was a small organization founded in 2002, and the recognized national board is the ‘American Academy of Pediatrics’. The ‘College’ is greatly concerned with the dangers of homosexuality. The ‘Academy’ is advocating for access to health care for all children.

I wrote about this a while back, here. The post includes a link to ‘Pam’s House Blend’. Pam covered it because she is in a same-sex marriage, which is the kind of thing that the ‘College’ is organized to lobby against.

So it’s too bad that a fancy diploma on the wall might be fresh from the home printer, but there you go. It’s buyer beware, even when you’re dealing with a surgeon. If you can’t follow the rules, then quit, form your own club, and hope no one notices the difference. It’s legal, but it says something about character. Draw your own conclusions, and don’t buy any Trojan Horses.

Nanny State

The Libertarian argument that it’s an assault on freedom for a state to ban smoking in restaurants caught my attention. Rand Paul says that sensible people can just choose to avoid smoky restaurants and bars.

It’s fresh in my memory that people used to smoke in all restaurants, and double in bars. For that matter, when I worked in factories people smoked on the assembly bench right next to me.

I actually tend for some reason to like people who smoke, and would sometimes hang out with the ‘smoker’s support group’ just for the conversation. But that was when I worked in a hospital, and the smokers gathered outside, and I truly had a choice to join them or not. It’s a shame the habit is so bad for you, when there’s so much stress and so few ways to feel good. But that’s another topic.

John Aravosis at Americablog has a good post on this…

This is the problem with Libertarians, but also conservatives (well, any political philosophy, really). The philosophy sounds nice in principle, but in practice it often doesn’t work. As a non-smoker, with allergies, and now asthma because of my allergies, my “choice” was always between joining my group of friends at a particular bar or restaurant, or staying home alone. I wasn’t about to tell 20 people, many of whom I barely knew, that instead of going to a bar tonight (since every single bar was smokey back in the day), maybe we could stay home and play Parcheesi instead. That’s not much of a choice.

This is the heart of the matter. Rigid thinking– whether it’s Catholic dogma or a fundamentalist literalism in the reading of law, or neat philosophical arguments about high principles, does not serve well in real life.

Many of us encountered the smoking/non-smoking situations. (A local restaurant actually built a lucite booth to confine the non-smokers, but that didn’t last long.) We worked it out and now you can eat and breathe and smoke outside if you must.

Fewer of us have encountered the situation of being in a happy group out for fun and realizing that one of us was the wrong race to be admitted to a restaurant or club.

This kind of thing happened, and not just in the South, and not very long ago. Why would anyone would want to bring that back? A neat philosophical argument that of course reasonable people would never patronize such businesses is refuted by recent history.

A business easily makes the calculation that it is better to turn away one customer than risk losing ten. The luxury of being in the majority is that you never even have to notice this, it’s not your problem. The pain of being in the minority is hearing from majority friends that it’s no big deal, one more slight, one more small cut— are you supposed to get used to it?

Reality is messy, isn’t it? Martin Luther King’s life experience was far different from Rand Paul’s. It would be good if white people learned to listen. It would be good if we would stop invoking Dr.King unless to recall his work for civil rights. It would be good if we would listen to Holocaust survivors, and learn that nothing in our current situation compares to what they went through.

The truth is that people are often not high-minded and logical. We will always need some social control against greed, bullying and scapegoating of minorities. It might seem like the jackboot of oppression to have to take your cig outside, but the guy next to you has a right to breathe.

Blind to the Good of Socialized Medicine

Again, not to pile on Rand Paul, but health care is my thing, and I’ve spent the last winter freezing my garbanzos at rallies for health care reform. So this is intensely interesting to me.

Should the taxpayers have to carry the burden of some old guy’s cataract surgery, or should we just let him go blind? Well, under the current nanny-state system he is covered by Medicare. Medicare patients make up the bulk of the business for eye surgeons.

So Dr.Paul has benefited directly and indirectly from government involvement in medical insurance, in research and in setting standards so that patients can trust something as precious as their eyes to a qualified doctor.

Very good discussion of this in Daily Kos.

And if you want to say to the visually impaired, ‘get a job’, here’s Steve Benin of Washington Monthly, taking apart Rand Paul’s distortion and mis-information about the Americans With Disabilities Act. Paul is again building a straw man, claiming the ADA requires things that it doesn’t.

Somewhere in America

Risking Their Lives

Lest we forget, it was not so long ago that Americans risked their lives to defend our dignity  and help to undo the curse of racial segregation.

I googled ‘lunch counter’ and got a number of these images. This is from the Smithsonian, and I don’t know the names of the young men or the exact place or year, but surely it was the South in the 1960’s.

Sometimes the accumulation of small indignities can become unbearable. Especially when the threat of major harm, and even death, is always in the background.  The men in the picture risked all for equal rights.

Politicians like to re-write the past. Because we have more social freedom, and we find it good, it’s comfortable to believe it was always this way– that reasonable people would always act so. But close to the time and place of this photo a 14 year old boy was tortured to death by grown men for stepping out of line. No mercy.

We love the Martin Luther King who had a dream. But look at the grim faces of these men, and remember that Dr.King faced threats to himself and his family every day, faced prison, and finally was murdered.

What we have now is hard won, and not guaranteed. Many living today remember segregation. Sometimes citizens need the government to step in when the rights of the individual are threatened.  The level playing field only exists in the ideal. Here on earth people need protection and justice.

FAMILY STORY: ten years ago I attended the Green family reunion in Montgomery, Alabama. It was my first visit to the deep South. Montgomery had a museum dedicated to the history of Rosa Parks and the bus boycott. My mother in law said, ‘It takes me back.’

She lived this history. Many Americans lived it and remember.

HISTORICAL VIEW:  An argument that libertarianism without strong legal protections for individuals is a pathway to re-segregation.

Be Very Afraid

Rand Paul in Kentucky. When the Repubs go totally over the edge the hope of a two-party system with a real debate recedes.

Is this significant, a measure of the tone of the debate?

HEBRON, Ky. — After winning Kentucky’s Republican primary Tuesday night, Bowling Green ophthalmologist Rand Paul refused to take the call of congratulations from opponent Trey Grayson, according to Grayson’s campaign manager Nate Hodson.
Hodson did not elaborate, except to say “it happened.”
“This is truly a classless act in politics,” said Marc Wilson, a Republican lobbyist and friend of Trey Grayson.

Six months is a long time.

OUTSIDE AGITATORS: If you grew up in the sixties, it’s very weird to hear Rand Paul vs ‘the establishment’. This link follows the money, most of it was not raised in the Bluegrass state.

ON RACE: Well, you can make an argument, as here via Taylor Marsh, that restaurants should be able to refuse service to any racial or other groups the management doesn’t like, and the public will so abhor this disgraceful prejudice that such business will get no customers. That’s how it worked through most of American history, right? No one ever got ahead by pouring hell and humiliation on a minority. And Martin Luther King had a dream.
Rand Paul repeats the same line on Rachel Maddow.

SPEAKING THE SAME LANGUAGE: That would be, ‘Weasel’. Sarah Palin’s endorsement was warmly received by the Paul campaign. Don’t think either of them is inarticulate. They are actually highly skilled in the faux-sincere techniques of appearing to say something while preserving deniability. I’d look out for ‘dog-whistles’ too since both of them pal around with groups that they wouldn’t want to be seen with on the national stage. Palin and Paul are both very smart people and have cash and influence behind them. Don’t underestimate.

CALLING HIM OUT: Rand Paul is already doing damage control over his convoluted non-support for the laws that banned racial discrimination.

On Thursday Rep. Jim Clyburn (D-S.C.) an iconic figure of the Civil Rights movement seemed visibly angered when discussing Paul’s comments on MSNBC.
“I do believe he is not good for this country going forward,” the South Carolina Democrat declared.

Read Rep. Clyburn’s point by point dismantling of Rand Paul’s argument here.