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Who owns land?


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American independence

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The free market


Crime and punishment

The health industry


The health industry

The United States and Western Europe have different approaches to providing health services, but neither approach seems to produce completely satisfactory results.

In the USA, as I understand it, the main problem is high cost. In Europe, the main problem is long waiting times. Patients may have to wait months to see a specialist.

What annoys me personally, although it's a lesser problem, is that general practitioners habitually schedule appointments too close together so that patients who turn up on time have to wait for long periods in waiting rooms.

The length of an appointment is variable and unpredictable, so it would be understandable if doctors were sometimes late for appointments. But the fact that they're always late indicates that they make appointments knowing that they won't be able to keep them: which is a gross discourtesy whoever you are and whatever the circumstances.

Although there seem to be various different problems here, the underlying problem is the same throughout: the health industry is short of staff. There are not enough doctors, nurses, etc., to meet the demand; which means that they can charge high prices in the USA and keep patients waiting interminably in Europe. It's a seller's market.

An obvious reason for the shortage of staff is that doctors, nurses, etc., are required by government regulation to be highly trained and highly qualified. This is intended to protect patients from incompetents and quacks, and to some extent it probably achieves that purpose. But I have to wonder if there's some better way of achieving that purpose without choking off the supply of staff so drastically.

When I feel ill I have several options:

  • I can diagnose myself, buy some medicine from a pharmacy, and treat myself.
  • I can consult a friend or relation.
  • I can consult some practitioner of “alternative medicine”.
  • I can consult a pharmacist.
  • I can consult a doctor.

Do you notice there's a gap in the market? Whenever I go to see a doctor with some minor complaint, the diagnosis is quite routine and straightforward. It doesn't require a highly-trained doctor. It could be done by a diagnostic computer program operated by a lightly-trained person who is capable of performing some simple tests. Yet no such person seems to exist, and I'm not sure that the diagnostic program exists either, although this is an obvious and ideal task for a computer program.

Actually, if such diagnostic programs existed, I could more often diagnose and treat myself.

I'm not sure how best to relieve the shortage of specialists, but I feel sure that the shortage of general practitioners could be abolished at a stroke by taking away from them all the boring, routine work they do and giving them only work that really requires their skills.

I'm hopeful that this will happen in the near future when good diagnostic programs come on to the market. Then we can feasibly diagnose many of our own ills in the comfort of home, without needing to go and sit around in dreary waiting rooms awaiting the attention of a doctor who seems incapable of keeping his own appointments.