Watch and beware because this is a competitive press and public relations system at work. The first news flurry is often about a non-creative knee-jerk bureaucratic response to a budget cut. The bureaucrat is faced with a budget cut, in order to ultimately avoid it, he or she proposes to eliminate a high visibility program, like healthcare coverage for poor children, because the hue and cry of those affected make the budgeters look for another, less vocal target.  The process is so well worn and successful, that it has a name, ?gold-watching?. Bureaucrat financial lesson number one is when faced with a budget cut, propose to eliminate your most important program; in other words, put your ?gold watch on the table? and the cut will never happen! 

In State of Fear, a fictional novel, Michael Creighton wrote about the role of the press in the national debate about global warming. It is a very controversial book because it questions global warming and a major theme is that the press has manipulated the public with shock and dismay because the press thrives on and profits from it! As an aside, it is the only fictional novel by Creighton that is well documented with footnotes.    

Another force is the Inertia of Status Quo also known as ?circling of the wagons?. Every proposed healthcare solution is physician, pharmaceutical, and hospital centric. Open forum discussions are limited in creativity and scope. Even after seemingly open and free debate, final decisions in favor of status quo are made in the back room (i.e., Nevada State Senate Bill S360 that supported healthcare freedom of practice and choice and healthcare transparency did not make it out of committee even after vigorous and wide public support). 

Watch and beware because the healthcare system status quo and the healthcare crisis exist because many people are making a lot of money from it!  But ask yourself, ?How did we get into this crisis?? By definition, this is a crisis in the status quo; status quo caused the healthcare crisis; do not expect status quo to solve it. 

Status quo made the field of competition uneven and many of you practitioners have felt the impact of ?circled wagons?.  For example, even though licensed, your scopes of practice are under assault in many states.  All non-physician providers feel the constricting power of federally mandated codes that do not meet market demand and prevent easy unencumbered billing and reimbursement.   

In the 1970?s during the Carter administration, our economy was in ?stagflation? which was financially very uncomfortable for most Americans. Prices were going up and the economy was not growing.  In our current crisis, healthcare costs are going up and we are not getting better services. After President Carter left office, President Reagan and Paul Volcker, the Chairman of the Federal Reserve Board, revved up the supply-side economy. They did something different and classic capitalism thrived. It is time to eliminate healthcare stagflation by doing something different.