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Health Care and Genetics: Multiplying Paradigms

By: White, Stephen W. | National Forum, Spring 1993 | Article details

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Health Care and Genetics: Multiplying Paradigms


White, Stephen W., National Forum


In his 1985 book MegaTraumas, Richard D. Lamm, former governor of Colorado, imagines the following scenario:

It is the year 2000 and the new president of the United States is about to write her State of the Union message for delivery before Congress. On her desk are the frank and outspoken reports she has requested from her cabinet officers and agency heads; along with them are other memos, speeches, and excerpts. This is the raw material for her speech--and it makes up a fascinating and fearful account of how the United States got so badly off strategic course in the final two decades of the twentieth century.

The most disturbing document on the president's desk is entitled "A Speech by the Secretary of Health and Human Services to the Association for a Better New York, 15 February 2000," about the necessity for rationing health care--a proposal that has provoked a "firestorm of criticism."

The proposal to ration is driven by numerous forces. Hospitals have overbuilt; malpractice litigation is out of control (e.g., 100 percent of the obstetricians in Washington, D.C., in a given year were sued by patients); the practice of defensive medicine is spreading among doctors to avoid lawsuits; hospitals are purchasing high-tech equipment at alarming rates; facilities are duplicated many times over in the same town; more and more of the 37 million uninsured are using hospital emergency rooms, the most expensive way to deliver treatment for primary care; too many doctors are being trained; research is spawning new medical devices faster than the economy can financially assimilate them; greater access to health care for many had become a reality; and, to top it off, we have very few preventive health-care measures in place.

The statistics are dramatic and alarming. …

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