The Sunshine Principle means that all real and potential conflicts of interest which might bias or skew an individual’s opinion are made public in advance. This represents the very best, and most effective, means of maintaining expertise while also serving the public interest. In addition to “Who’s Who” publications available to the public companion texts containing information on “What’s What” would do away with a great deal of poor testimony and poor informed consent issues. Application of the Sunshine Principle is a reasonable first step. Although based on the “honor” system there is a peer pressure factor which tends to keep it on track. The Sunshine Principle alone does not protect against intellectual dishonesty or fraud.
If the truth shall set you free what then is the role of today’s “half-truth” and non-truth? Have sincerity and conniving replaced honesty? Most certainly truth has been taking a beating and, hopefully, it’s time for truth to make a comeback. Those who believe that “what goes around comes around” will support this effort. What’s wrong with “telling it like it is?” Truth may not always be pretty but it is never unreality. Are most patients capable of dealing with the truth? This publication strongly believes that they are.
Government is a very inefficient and ineffective watchdog over the cost of medical drugs, devices and procedures. If patients were in the “driver’s seat” regarding their health care the United States would have 281,421,906 (year 2000 United States census) watchdogs “riding herd” on medical costs. Although the United States is the best in the world in treating disease (once it strikes), the American health system is one of the worst in first world countries in quality (when factors such as prevention are taken into account). The cost of quality care in the United States is (quite simply)…. exorbitant. The actual cost of manufacturing a single titanium cage used for spine stabilization is less than $100. The cost to a hospital for this device is now over $2,000 and to a patient over $4,000. This demonstration is not unique. Typically, the actual cost of a medical device is negligible compared to the associated regulatory, research, liability, and marketing costs (all of which are controllable). Medicare may pay as much as 7x for the same drug as the Department of Veteran’s Affairs (VA). The system is in desperate need of breeding better watchdogs.
The insidious liability of having one’s health care decisions made for them by others removes the most important incentive from the patient to take responsibility for their own welfare, health and longevity. If the patient controls their own financial expenditures in health care they are much more likely to work to stay healthy and they would probably end up spending a great deal less for better treatment. Why?, it’s simple. Third party payors are constantly expanding administrative expenses and overhead. They’re also on the look to buy wholesale, but sell retail and not pass on this saving to their clients. Patients need to keep a careful eye on the this scene and not allow themselves to be intimidated along the way by “highwaypersons.”
The xylotyl (Necturus maculosus) is a river amphibian who, by some quirk of Nature lives its full lifespan in a immature state bearing gills, rather than lungs, to breath air. History, circumstance, and behavior, sometimes of a totally barbaric nature, suggest the the species Homo sapiens may also still be in a immature phase of development, much like the xylotyl. If homo sapiens do inhabit the tip of the animal pyramid world it is not always evident. Worthy of note is that our nearest biological neighbor, the chimpanzee is 99% gnomically identical to humans. In addition, chimpanzees behave exactly like human infants in their first three years of life. Should an xylotyl mature it is interesting to speculate what behavior to expect from the next evolutionary specimen.
“The Zebra Principle” refers to how congenital abnormalities of development within the human body, and the spine in particular, travel in “herds.” If one zebra is encountered in the wild chances are that there are more of them around. The same is true for congenital abnormalities of the human body, they tend to occur in clusters. If a congenital spine disorder is identified one better start looking for the other accompanying genetic abnormalities.