Quality, Certifications and Guilds- and why medical care costs so much

How can an Army Spec-4 do a vasectomy on a solider, without 8 years of college and a medical degree, yet 3 stitches will set you back $1,400?

Is it that we’re demanding over qualification? And who makes the decision on when it’s ok to do whatever? Before we had unions, we had craft and trade guilds that required competence- now we have unions that just require membership.

America used to be known for making quality. Since WWII we seem to have lost that reputation to the very countries we beat. Germany and Japan both have a better reputation for quality.

An old post on this site recently started picking up comments again- the one on the cost of three stitches at Miami Valley Hospital. Greg had also sent me this post about the decline of the American economy that was interesting:

Decision makers focus on the only metric they care about—the cost and how to reduce it, not the only one they understand.

Ideally, companies exist to provide products and services to people. If the products and services are good, the companies prosper; if they aren’t, the companies fail. That’s risky, so American companies inverted this model. They fed the public the notion, which has rarely been questioned, that a company’s responsibility is solely the financial welfare of its stockholders. Products and services are no longer the goal of business; they are merely means to profit. That reducing quality leads to greater profits quickly became evident.

via The Long Decline of the American Economy.

We try to pull these things together in today’s Vlog edition of the Dayton Grassroots Daily Show v.36


If you enjoyed this post, make sure you subscribe to my RSS feed! If you wish to support this blog and independent journalism in Dayton, consider donating. All of the effort that goes into writing posts and creating videos comes directly out of my pocket, so any amount helps!

Leave a Reply

4 Comment threads
0 Thread replies
Most reacted comment
Hottest comment thread
4 Comment authors
MichaelIce BanditDadtruddick Recent comment authors
Notify of

So you’d be happy having a vasectomy from someone barely trained?  Interesting.
We have plenty of resources to support union labor and trained paraprofessionals–IF we right-size by eliminating the drone class of useless management.


What David is talking about is the training given to medics in Special Forces, where each team has an enlisted medic trained to do surgery at Ft. Sam Houston. In combat, you can’t call 9-1-1. You can’t be taken to MVH. Your medic is it. He probably can’t do a vasectomy, but he can do an appendectomy, or amputate a leg.

Ice Bandit
Ice Bandit

  Gee Dave, I thought you were gonna’ present us with a brain-buster on the conclusion of this year. El Bandito de Helios can solve the problem of high medical costs in an afternoon, and without making even one long distance call to Taipei or New Delhi. Not enough qualified doctors? Well, grant anyone who wants to become El Medico the power to become one, and let the good ones drive the bad ones out of the profession. Remember, David, that every spring hundreds of thousands of bright, competent college students take the Medcat (the med school qualifying test) only to be told there is not enough openings to study. Some med schools have ridiculously low acceptance rates (but not ridiculously low tuition) that are set by state medical boards in cahoots with the AMA. Some states, like Montana, have no med schools at all. But who owns the state universities? The citizenry of course, and if demographics dictate we need more doctors, then the schools should bend to the will of the people and the market rather than the rule of the entrenched. Or, let veteran doctors and hospitals set up med schools of their own. Let there be a doctor on every corner, much the way of convenience stores, cell phone emporiums and Jiffy Lubes. Sidebar. The statistical study of med school acceptances was the subject of El Banditos college thesis 30 years ago, and when the Bandit made the same suggestions he’s advanced today, he was the subject of great derision. “If we throw open med school doors to the hoi polloi and the great unwashed, we will be open and subject to quackery,” was the doctors’  reply. But then, who should surface but the infamous “love doctor” Dr. Burt, whose secret and controversial gynecological malpractice kept Dayton trial lawyers vacationing in Cancun for the next decade. We have quackery now, but an oversupply of doctors, rather than the shortage of medicos our current system guarantees, would put the cranks and quacks on the bench………….


I’m starting to like Greg more and more. Sounds like he gets it that freedom is what can save Dayton in the end!