People used to know who their doctor was. His name and phone number were on the wall or the refrigerator next to the telephone. He was there for you and could manage most of your problems.

When I was about 13, my mom took me to our pediatrician for belly pain. He was on his way out the door, but he stopped to take care of me. He diagnosed appendicitis based on history and physical examination. He called his favorite surgeon (“Billy,” a Tucson legend), who came from the golf course to meet me in the emergency room. Within hours, my red-hot appendix was in a jar. My parents paid the hospital bill ($150—10 days’ pay for a construction laborer) as I was discharged a few days later.

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According to the Oath of Hippocrates, physicians have the duty to advise their patients according to the best of their ability and judgment. In In most cases, most physicians recommend vaccination, believing that for a particular patient, the benefit exceeds the risk. Patients or their parents, however, have the right to decline to follow their doctor’s advice.

But with vaccination, government restricts this right. Every time there is a measles outbreak somewhere there is an outcry to restrict vaccine exemptions, to protect the public—and, just coincidentally, vaccine manufacturers.

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While President Trump called for unity and cooperation in his 2019 State of the Union address, the views of the audience showed a sharp and bitter divide, especially on issues affecting the health and medical care of Americans. Most striking was the solid bloc of Democrat “suffragettes” clad in white like Speaker Nancy Pelosi.

When the President congratulated women for their increased representation in Congress, this bloc rose to its feet to applaud uproariously, as if the home team had scored the winning touchdown in the high-school championship game.

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Stocks of hospital and Medicaid-contracted managed-care companies plunged  on the announcement of Judge Reed O’Connor’s ruling that the Affordable Care Act (ACA) is unconstitutional. Some advisors consider this a “buying opportunity,” expecting that the ruling will be reversed on appeal. This shows who the important stakeholders are.

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This is the one hundredth anniversary of the great influenza pandemic of 1918. In his book The Great Influenza, John M. Barry described it as the deadliest plague in history. It killed more people in a year than the Black Death of the Middle Ages killed in a century.

The lack of a vaccine did not cause the flu. All epidemics start with an index case—which may or may not be identified. The great influenza may have begun in a patient in Kansas. The significance of the case was reportedly recognized by a country doctor, who was ignored. As the nation mobilized for World War I, and draftees from across the country were thrown together, illness spread and became much more virulent. Transport ships became “floating caskets.” Troop trains were “rolling coffins.” But Woodrow Wilson denied the existence or severity of the epidemic, and effective public health efforts were thwarted.

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There are three aspects to the caravan: what is shown by the media; what is there to be seen; and what is unseen.

The focus is on the innocent children, as in the widely circulated photograph of an obese woman with two children lacking pants or shoes, purportedly fleeing tear gas sprayed by cruel law enforcement agents. They are far from home, in a very dangerous place, in violation of the laws of Mexico.

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The narrative appears to be that thousands of oppressed peoples spontaneously decided, all at once, to flee a murderous, corrupt government in Central America, and walk to the U.S., in time for election day, to plead for asylum and begin to work hard for a better life in the U.S. (Take note: it is a “caravan” not an “army.”)

We see photos of a mass of walking people, including women, some carrying babies. There are photos of a resting crowd, some tending to infants.

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The Washington Post of October 18 says that the biggest issues in the midterm elections are the threat that Republicans will slash Medicare and Social Security, and maybe get around to repealing ObamaCare after all. It quotes a tweet from Sen. Tammy Baldwin (D-Wis.) that Republican statements about “adjusting” entitlements are “Washington-speak for cutting the Medicare and Social Security benefits you have worked hard to earn and making you pay for tax breaks to millionaires and billionaires.”

So, will rescinding the tax cuts and taxing the “rich” even more fix the problems?

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People are marching with “Health Care Voter” signs, and this is generally believed to be one of the most important issues in the 2018 midterm elections. Republicans who got elected on the promise to repeal ObamaCare, and reneged, may now get unelected. Voters who supported them are dissatisfied, and Democrats demand still more government involvement in medicine.

On Twitter, #HealthCareVoter posts warned that the confirmation of Brett Kavanaugh to the U.S. Supreme Court would “rip health care away from people with pre-existing conditions.” This illustrates several profound misunderstandings.

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The Swamp in Washington, D.C., and its crony capitalist retainers do not want to lose their grip on the trillions of dollars that slosh through the “healthcare” sector — approaching one-fifth of the U.S. economy.

The one thing that would cut costs (not just spending), restore sanity, protect the patient-physician relationship, unleash innovation, and encourage excellent care is to put patients in control of their own money. Under the current third-party payment system, made much worse by ObamaCare, a huge part (one-third? one half? who knows?) of the healthcare dollar is diverted to bureaucrats, compliance officers, administrators, CEOs, managed-care profits, middlemen such as pharmacy benefits managers, and other swamp dwellers who contribute nothing to the actual care of patients. Then a goodly share goes to lobbyists and congressmen to keep the racket going.

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Mike Scruggs