The Hippocratic Oath is an historical document that serves as the ethical basis for a doctor's professional actions

Hippocrates, an ancient Greek physician considered the father of modern medicine, was a man who lived in a simpler time.  There were no corporate creditors, malpractice insurance, health insurance companies, government regulations, and other meddlesome intermediate parties to contend with.  The bond between doctor and patient was intimate and of the utmost trust.  It is easy to understand, then, the weight that a person’s word carried in that time period.  The Hippocratic Oath, as it is known today, is a vow that most physicians take.  While several interpretations of the oath exist, the oath essentially governs ethics and practices of physicians and serves as a moral compass.  Among other things, it states that physicians must treat all patients equally, to the fullest extent of their abilities, without regard to socioeconomic factors.

The undeniable fact is that in today’s world, money matters.  In the face of financial reality, the Hippocratic Oath may quickly erode into the Hypocritical Oath.  Doctors are already faced with considerable constraints by all parties involved, including payers such as the patients, health insurance plans, employers, medicare, other public health plans, and their own financial risk.  However, when it comes to even the most basic but necessary health care, there are many doctors who exhibit considerable greed and callousness with respect to the bottom line.

Anyone that has ever been denied treatment at a physician’s office or a private medical facility that is not, by law, required to treat patients without regard to their ability to pay, be it through health insurance, self-pay, or other means knows first hand the predicament faced.  Patients in such as case are given no other choice but to shop around for providers that will work with the patient to come up with an equitable payment arrangement or, if possible, wait for an opening at a low-cost clinic.  Even those who have what is widely considered to be excellent insurance find themselves dealing with needless bureaucracy when it comes to obtaining treatment and having it paid for per their plans.  Health Insurance companies have been known to deny claims for literally an uncrossed T, and the appeals process is tedious.  Physicians must retain excellent office staff adept at dealing with the games that insurance companies play, a factor that drives up their costs.  While there are other factors at play, the fact is, the system is broken.

While these are just some of the financial realities, providers also deal with the highest overall operating costs and overhead of any business.  A large chunk of this is medical malpractice insurance.  A form of professional liability insurance, medical malpractice insurance protects physicians from negligence and other charges and is required by law to be carried in most jurisdictions.  The cost to physicians is astronomical.  According to the article, the cost of medical malpractice since 1975 has increased by 12% annually.  Expensive insurance is needed for expensive litigation, and litigation continues to spiral out of control.  Physician’s advocates have urged tort reform, including limitations on damages and other mitigating factors that would, in the end, reduce the overall costs of health care.

Taking the costs of being in business into consideration, we need to show sympathy to physicians in most cases.  It is not that they are insensitive, inhumane, or completely duplicitous in the face of the oath they take.  Doctors simply live in the real world, where financial realities abound.  They must make sound business decisions.  Legalities aside, in natural law, if a physician encounters a would-be patient in nature that is in need of medical care, free of humanity’s other laws, a physician would abide by the oath prescribed.  A bad case of the flu, a sprained ankle, or that laceration in the waiting room are of minor import when it comes to the gestalt – the big picture that physicians face.  There are a myriad of factors that these vital professionals juggle.  Don’t be surprised if you find yourself, as a patient, bound by the hypocritical oath rather than the Hippocratic oath.

As our government moves forward with health care reform, we must remember that in order to take care of ourselves, responsibility starts on the individual level.  Medical professionals can only take care of us if we take care of them.  They have bills to pay, and their noble profession is stressful.  Perhaps in considering changing the system, the government should provide incentives for healthy lifestyles, such as smoking cessation, a healthy diet, exercise, while discouraging unhealthy lifestyles that are pervasive in American society.  Let’s end our drive-thru excess of laziness, our couch potato lifestyles, and start somewhere.  Let’s be safe and sound, and take care of ourselves, each other, and most importantly, our doctors.  Health care should be available to all who are in need, regardless of financial standing or class, at a reasonable cost and without sacrificing quality.

Other Posts by Chris Conklin:

Bill Collectors: From Breaking Laws to Breaking Legs

Bauer’s Blunder: Disadvantaged People vs. Stray Animals

Troubling Travels: Reconciling Safe Skies with Personal Privacy

Debt: A Way of Life

Everywhere you go, every time you turn on the TV or radio, at every turn, and around every corner, it’s all about credit.  “Free” credit reports.  Credit counseling.  Credit Repair.  Credit this, credit that.  Debt is a way of life.  Some of us are late on our bills, or, in credit speak, delinquent.  Yes, delinquent, the word that invokes images of a debtor spraying graffiti on a stop sign or mugging an innocent old lady.  Some debtors are even in default.  Whatever you call it, and for whatever reason, you’re unable to pay your bills.  The calls start flooding in.  Bill Collectors want your money.  They want it now.  Nothing else matters.  If you are one of the many unfortunate souls who should find yourself in a situation where you have to deal with bill collectors, just keep in mind that you have rights.

Most Debt Collectors comply with the main federal law concerning debt collection, known as the Fair Dept Collection Practices Act.  The FDCPA limits the actions of a creditor or debt collector.  Any “delinquents” should familiarize themselves with the law.  It may come in handy for the simple reason that there are many unscrupulous collectors out there that revert to tactics that are reminiscent of the Mafia or loan sharks.  They may issue threats of bodily harm, in the most extreme cases.  They may claim that you can be arrested and spend time in prison.  The fact is, absent extremely extenuating circumstances, this is simply untrue.  Debtor’s prisons do not exist in the literal sense.  In the figurative sense, there’s a maximum insecurity debt prison in the minds of many. Take, for example, a collection agency that simply went too far:

You are totally ghetto. Second of all, ma’am, learn English, get an education. Since you’re sitting on your fat derriere all day long making money off of the rest of the free working population in the country, you might want to try to get educated enough to at least be able to say payment plan, instead of payment pan, you uneducated reject.

Stemming from a prime case in New York, this language used by this particular person at this collection agency was a violation.  Here are a few examples of FDCPA violations:

• Calling at unreasonable hours (i.e between 9pm and 8am)
• Excessive calls intending to abuse, annoy, or harass
• Threatening legal action or arrest not permitted or not actually planned
• Failing to stop all communication after request

In some extreme cases, actions by bill collectors have lead to suicide.  In a disturbing case, a group of bill collectors claimed that they had established a relationship with local law enforcement and that arrest was imminent.  They went on to state that they were sending an officer to a woman’s house in regard to a debt owed by her husband.  A federal court held that a case brought by the husband for intentional infliction of emotion distress could proceed.

Debt collectors do not have the most pleasant jobs in the world.  They are people, too.  Like you, they have bills to pay.  They aren’t superheros coming to the aid of corporations as they are looted and plundered by the masses.  They’re just another voice on the other end of the phone line.  Be careful what you say and do.  Frustrate the process as much as possible.  Make their job harder.  Whatever you do, don’t make it harder on yourself.  Don’t crack.  Do not issue unreasonable or illegal threats in return.  Take advantage of technology, like caller ID and voice mail.  Don’t ignore the problem unless absolutely necessary.  It will continue to spiral out of control.  If you must ignore it, then ignorance isn’t always bliss.

Whatever you do, don’t let it get to you.  Be responsible, be vigilant, and deal with debt in a reasonable manner.  Simplify your life by monitoring your expenses and prioritizing your bills.  “You can’t squeeze blood from a stone,” is a frequent adage that applies.  Ultimately, you are responsible for your debts.  You can be sued.  You have a great deal to lose.  Your life, your health, and your welfare should not be among them.

Other Posts by Chris Conklin:

The Hypocritical Oath: Quality Health Care vs. the Bottom Line

Bauer’s Blunder: Disadvantaged People vs. Stray Animals

Troubling Travels: Reconciling Safe Skies with Personal Privacy

Food Stamps, as they were known before the Federal Government's SNAP Program was initiated

Human Beings, also known as Homo sapiens, are, in fact, animals.  We simply fail to acknowledge that on a daily basis.  Perhaps it is our subconscious goal of distancing ourselves from our barbaric, primal past or from our less evolved friends throughout the animal world.  According to Wikipedia, we possess a “highly developed brain, capable of abstract reasoning, language, introspection, and problem solving,” among other traits, which give us the distinction of being, well, us.  Despite the amazing bounds of human genius, a few bad apples occasionally illustrate that our ability to reason and utilize our language skills are often seemingly nonexistent.  Take, for example, the recent words of current South Carolina Lieutenant Governor (and future Governor hopeful) Andre Bauer (R):

“My grandmother was not a highly educated woman, but she told me as a small child to quit feeding stray animals. You know why? Because they breed. You’re facilitating the problem if you give an animal or a person ample food supply. They will reproduce, especially ones that don’t think too much further than that. And so what you’ve got to do is you’ve got to curtail that type of behavior. They don’t know any better.”

An audio excerpt of Bauer’s words can be found on YouTube.

This metaphor, comparing those on government assistance to your neighborhood stray dog or cat, sparked a national controversy. State democrats and republicans alike called for Bauer to drop his bid for the gubernatorial seat.

Bauer spoke these choice words at a town hall meeting at which he went on to state that public school students receiving free or reduced lunch consistently posted the lowest test scores, claiming that he could produce a graph proving these statistics.  This presents a classic ‘chicken or the egg’ dilemma with respect the the culture of poverty.  That is, more likely that not the lower test scores are indicative of poverty-stricken areas where low-income, struggling families legitimately require the benefits, as opposed to the fact that such households are receiving free or reduced lunch which, in turn, is contributing to lower test scores.  Bauer urged greater parent involvement in education, such as attending PTA meetings in order to maintain benefits.  Bauer admitted to his poor choice of words and metaphor, claiming that the remarks were intended to show the need to “break the cycle of dependence on government aid.”

Analysis aside, these words of wisdom and others like it originate from those elected to lead a wonderful state that is in crisis mode.  Once a mecca for tourism at Myrtle Beach, the host of prime real estate on Hilton Head Island, and home to a bustling manufacturing and production industry spearheaded by BMW, Michelin, and Boeing, South Carolina has suffered extensively in the midst of the recession.  The state currently ranks among the top 5 in the nation in unemployment.  It has also consistently ranked among the bottom of the barrel nationwide in education.

Economic conditions warrant the use of public assistance for the most needy families, the majority of which constitute a large, but understated class of the workforce known as the working poor.  With the few manufacturing and industrial employers that remain, there exists very few lucrative or even remotely viable employment opportunities.  Workers that are lucky enough to remain employed have suffered pay cuts, loss of benefits, and less hours.  Bauer’s contention that parents should participate in their child’s education is a pipe dream to citizens such as this — families who work around the clock to support dependents.  Between work, maintaining a household, and sleep, these people are able to find little, if any time, to attend a PTA meeting.

Andre Bauer, in the meantime, would be wise to choose his words carefully as he maps his political future, just as a struggling but resurgent Republican party seeks to regain its footing nationwide and redefine its platform.  It’s a jungle out there.  There are a lot of stay “animals” – homeless, jobless, penniless, disillusioned “animals”, with a voice and a vote.  Nowhere in the Constitution does it state that voters need a job to exercise their civic duty.  Bauer should not forget that nature can be cruel.  As Bauer pursues an already embattled gubernatorial seat, the less baggage that he carries with him, the better.

Catch Jon Stewart’s discussion of Bauer’s Blunder on the Daily Show.

Other Posts by Chris Conklin:

The Hypocritical Oath: Quality Health Care vs. the Bottom Line

Bill Collectors: From Breaking Laws to Breaking Legs

Troubling Travels: Reconciling Safe Skies with Personal Privacy

The Bill of Rights was added to the U.S. Constitution at the insistence of Anti-Federalists as a check on the power of the Central Government and to guarantee individual liberties.

Recent events have solidified the fact that a certain level of security in the world’s airports is a must.  It is of utmost importance to remember that we are entitled to certain inalienable rights which are enumerated in the United State Constitution.  The Fourth Amendment provides American Citizens, and, by extension, all people subject to its jurisdiction, with privacy rights.  Part of the Bill of Rights, it states, in part:

“The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated.”

One must ask what constitutes an unreasonable search.  On the one hand, we live in uncertain times where safety and security is paramount.  On the other hand, we need not forget that we are entitled to our rights.  The Transportation Security Administration is a seemingly omniscient presence in the nation’s airports.  Air travelers are subject to a certain level of scrutiny, including extensive searches of person and property.  Few, if any, holds are barred.

Gone are the golden days of air travel, when a simple x-ray and possibly a wanding sufficed.  Travelers are now subject to extensive and invasive searches.  Whole body imaging has been the buzzword in recent media.  A form of Advanced Imaging Technology, whole body imaging is used in six airports worldwide as the primary security device with plans to add more nationwide.  Advocates of the technology cite speed as a justification for the technology.  Regardless of whether this technology is expedient or thorough, another privacy concern is the fact that these devices, or their operators, are capable of storing and transmitting images.  The procedure, as it stands, is to have a screener in a separate room viewing a monitor.  Absolutely no cameras, cell phones, or other devices capable of storing or transmitting the images are permitted.  The fact that this capability exists has many privacy advocates up in arms.  These concerns are raised in a CNN article.

As terrorists devise increasingly intricate methods of bringing about evil, one must also wonder to what end security must reach.  Full body scans may not be enough.  A full body scan or x-ray can be set off by any metal components on a person, such as those placed for medical reasons, including hip replacements and bone screws.  However, what initially appears to be a medical device turns out to be something far more sinister.  There are many who believe that, regardless of the extent of our air security, aggressors will continue to succeed.

In addition to scans of the person, belongings are searched as well.  The  TSA has strict rules pertaining to carry-on liquids and other items.  There are a number of ambiguities.  For example, the site states that matches in general are expressly prohibited in both carry-on and checked baggage, yet it also states that one book of safety matches are allowed in carry-on luggage.  To further confuse the issue, strike-anywhere matches are prohibited.  What, exactly, is the rule?  No strike-anywhere matches, no matches at all, or just your run of the mill, non strike anywhere matches in carry-on luggage only?

Regarding privacy, the TSA appears to be limited to safety concerns only, such as explosives and weapons, states U.S. District Court Judge Algenon L. Marbley in a recent verdict against the entity in which a traveler was arrested for possession of three fake passports.  “The extent of the search went beyond the permissible purpose of detecting weapons and explosives and was instead motivated by a desire to uncover contraband evidencing ordinary criminal wrongdoing,”  While a crime was clearly committed, it was not proper for the TSA to handle the matter.  In another, perhaps more egregious case, Stephen Bierfeldt, a campaign representative for Ron Paul’s Campaign for Liberty was questioned regarding his possession of a sum of $4,700 in campaign proceeds.  This prompted a lawsuit by the American Civil Liberties Union (ACLU).  He was asked about his employment, the reason for his travel, and the reason for possessing such a large amount of cash.  In the aftermath of the suit, the TSA censured the employee for inappropriate tone and language.

It would appear, then, that there is a somewhat reasonable semblance of privacy in air travel.  The TSA cannot be an omniscient, irrelevant examiner of the totality of a traveler’s existence.  It must stay on task.  Criminal matters are delegated to other organizations, such as local police or the proper federal agency, such as the DEA, FBI, etc.  Certainly, there can be no total, all-encompassing privacy shield when it comes to air travel.  There is, however, a line that the TSA may not cross.  The exact location of the line is something that shall be in a perpetual state of flux depending on case law and TSA policies.

As travelers, it is critical that we remain open minded yet also question authority.  Moreover, we need to help foster safe skies and make the TSA’s job easier.  If there are any items that you feel may be inappropriate for air travel, it is best to err on the side of caution and leave those items at home.  In the event that you are questioned by the TSA, remain polite, answer their questions honestly and to the best of your ability, but remember that you have rights.

Also remember that the flight crew is tasked with ensuring your safety and comfort.  Be polite to them and your fellow passengers, and remain in your seat.  Northwest Airlines Flight 253, the same flight on which a terrorist attack was thwarted on Christmas day in Detroit, recently had an additional scare.  A Nigerian national was detained after he raised suspicion by spending an excessive amount of time in the lavatory amid what appears to be a legitimate illness.  More information can be found here.  The passenger allegedly became irritable with the crew when he was questioned.  The aircraft and its contents were pulled aside and screened.  The lesson to be learned by this?  The Constitution may grant you a right to privacy, but even those private bathroom moments aren’t always so private.

Other Posts by Chris Conklin:

The Hypocritical Oath: Quality Health Care vs. the Bottom Line

Bill Collectors: From Breaking Laws to Breaking Legs

Bauer’s Blunder: Disadvantaged People vs. Stray Animals