There is likely no bigger issue in America today than our health care system. The costs have exploded, and the results are not what we would like for that money spent. Our government is picking up a large portion of the cost with a significant debate as to how we can control those seemingly out-of-control amounts. Dr. Jeffrey Singer addresses some of those issues in his new book, Your Body, Your Health Care.
Singer is a practicing physician who has been a general surgeon in Arizona for 35 years. He has not only thought about the issues of the healthcare system but has dealt with them close up and in person. Whereas many people who author books like this have theorized about the issues, Dr. Singer has confronted them first-hand.
I asked him what prompted him to write his book – what motivated him. He stated ”I noticed that while all of the public policy analysis I conduct at the Cato Institute focuses
on utilitarian and economic arguments, a common philosophical insight that informs all of my work is the presumption of liberty, the presumption of autonomy. This classical liberal insight asserts that all humans have inherent rights; they are sovereign, autonomous beings who own themselves, and that governments do not bestow these rights but rather, they are instituted to secure them.” Too often today our health care system is dictated top down as opposed to patient up.
Singer did a lot of research to write his book, and I asked him what is the most essential lesson he learned from that research. His answer was, “I think the most interesting and shocking thing I learned was how policymakers refuse to recognize that the actual cause of the overdose crisis is drug prohibition. No matter how much their war on some drugs backfires, leading drug traffickers to develop more dangerous and deadly forms of drugs; no matter how many billions are spent, prisons are filled, and cops and politicians are corrupted, they continue to double down on this failed policy. I call it a “war on (some) drugs” because policymakers became realistic and practical after they experimented with alcohol and tobacco prohibition, as I explain in the book. Yet their moralization prevents them from being realistic with the current list of prohibited drugs.”
The book begins addressing the issues of Informed Consent and Self-Medicating. Dr. Singer believes these are critical concepts for our health care system moving forward. He stated, “I believe the internet can empower autonomous adults by making it easier for them to conduct their own due diligence and compare advice from health care practitioners.
Furthermore, younger generations are more comfortable using it. Health care practitioners are human and, as such, have inherent flaws. They can make mistakes. and may sometimes neglect to fully inform their patients before obtaining consent. The internet, especially AI platforms like ChatGPT and Grok, can empower health care consumers.
This is where I split with Singer. Medical care is complex. I am a believer in finding competent medical care and listening to what they instruct me to do. That has kept me quite healthy in my 71 years. You certainly can educate yourself with the information available today, but self-diagnosing and self-medicating is not something I am inclined to do. I stay in my lane and let my Docs do that work.
That doesn’t mean there aren’t many improvements to be made in our system. The Right to Try Bill was a measured step, but the system is still inhibiting that. For example, stem cell applications are still too widely controlled for people who have severe medical issues.
Singer addresses two powerful ideas. A proposal put forth by University of Chicago economist Sam Peltzman is covered in the book. Peltzman proposed that when an FDA-approved prescription drug reaches certain milestones—such as X million prescriptions sold over Y number of years with minimal risks—it should automatically be reclassified as over the counter (OTC). He cited the example of how ibuprofen was made OTC after 18 years with a good safety profile in Canada. I suggested a current prescription drug, Lipitor, should be considered for OTC. That is what happened with Aleve, and it has worked out very well. This would help lower the cost of our health care system and give greater control to the patient. There are certainly more examples.
Another cost saver is reciprocal approvals. The FDA drives up the cost of our medications with testing that is too extensive. I believe the new commissioner of the FDA, Dr. Marty Makary, aims to improve the system and reciprocal approvals would be an easy way to get a jump on that. If the medical system of other countries (Israel, Switzerland, Canada or EU members) approve a drug, put it into application, and find it successful, then why does our FDA need to start from scratch? We have in effect used their population as a case study and know the results from wide-spread usage in other human beings. Why are we acting in such a provincial manner? It certainly is not in the best interests of our citizens.
Dr. Singer’s book is thought provoking while addressing some of the biggest issues facing our medical system today. It is worth your time. After all it is your body, and your health care.
