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Re: IUD and PID From: Robert J. Woolley (wooll005@tc.umn.edu) Sat May 29 15:02:34 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert J. Woolley: "Re: IUD and PID" Previous message: Steven Crawford: "Re: IUD and PID" Maybe in reply to: Deborah J. Wage FNP, CNM: "IUD and PID" Next in thread: Robert J. Woolley: "Re: IUD and PID" In message <v03007802b3758a6fc19f@[208.2.63.62]> writes: > > No doubt, I have met surgical assistants, who by virtue of their daily > lives, COULD perform the surgery as well or better than the doctor they > assist. Licensure does not guarantee competence. Lack of licensure does > not indicate that a person is incompentent. I would compare licensure to a > lab test in so much as it has a sensitivity and specificity for competence. > It is most certainly better than letting anyone who felt they were > competent to hang out a shingle. There SHOULD be some objective measure > that has the appropriate sensitivity and specificity for competence. Are > you really in favor of no certification whatsoever? I am in favor of no *governmental* certification process. Insurers and hospitals already require higher levels of training than mere licensure requires, because they are legitimately concerned about liability. This provides their customers with a significant level of protection, without the consumer having to do one bit of research into a specific provider. But the consumer who wishes to have more evidence of competence can look into who is certified by what board, etc. > > > It seems inevitable that your reason for this is that you think you know > >what is > > better for your neighbor than he does. I find this attitude condescending > >and > > demeaning, no matter how well-intentioned. If you genuinely trusted your > >fellow > > citizens to be capable of figuring out who is best qualified to care for > >them, > > and genuinely thought that you have superior training and skills, such that > > rational people would voluntarily choose to see you and your peers rather > >than > > non-MDs, then you wouldn't feel the need to *force* that choice on them > >by law. > > Your insecurity is showing. > > In a perfect world, perhaps. To expect that level of public knowledge is > unrealistic. I don't see why. > > As smart as everyone knows I am, and I know this might come as a shock to > some of you, I don't know EVERYTHING! I am glad that there are building > codes and licensure for home builders. I would be an easy target for a con > who would build substandard housing. I relied on and am grateful for the > protection afforded by the government when I bought my home. But why do you think that such would not be available privately, if the government got out of that business? You can already, with some effort, hire individuals and firms with construction engineering experience who will be on-sight every day as your house is built, and make sure that it is being built with whatever features you wanted (e.g., a higher level of insulation than code requires, or a more sophisticated ventilation system, or better earthquake/tornado resistance), without you having to know one bit about structural design. With the government out of the way, such companies would instantly proliferate, and compete with each other on reputation for assuring a quality home. I feel the > same about the goverment's protection regarding food, banking, securities, > and manufacturing. Looking at the S&L scandal, which has cost us taxpayers *billions* of dollars, how can you credibly assert that government regulation of the banking industry protects you? I would *much* prefer a private system. You could then choose a bank which makes only rock-solid, conservative investments, but pays you a lower interest rate, or one that makes aggressive investments, with more risk to you, but also a higher rate of return. Why do you not want this freedom? Why do you want to continue paying your tax dollars to compensate for the incompetence and corruption in private banks, which the federal government now insures? It's an insane system. As far as food, how much effort do you think really goes into, say, the city's inspection of restaurants? One visit a year maybe? Why not get the govt out of that business, and instead let private firms certify restaurants? Once again, a variety of them would spring up, and they would develop a range of reputations. The best restaurants might want to put up big signs advertising that they are certified for health standards by a very tough, rigorous program, which everybody knows does not let violations of their rules slide by (but, of course, charges the restaurant a lot of money for the frequent inspections). If you want this very high level of food safety, you can have it. If you prefer cheap, but with less rigorous levels of inspection, you can choose a restaurant with a lesser level of certification, or none at all. While I do realize that no system is perfect, I feel > that the anarchy of the alternative would make me far more likely to fall > victim to well-intentioned incompetence or outright fraud. Ah, but fraud would still be criminal, and, in my opinion, punished even more harshly than it tends to be now. > > > Then you are naive. *Everybody* who seeks to force people to choose *their* > > services (1) claims only to be working in the public interest, and (2) is > > actually working in self-interest. > > Self interest and public interest are not mutually exclusive. Your view is > very cynical and extreme. I think it is the most realistic. > > > I do not believe that an insurer, which has to worry about liability for > > contracting with incompetents, would knowingly allow that. > > Really? Why not. Where would they draw the line? The beauty is that they can draw the line wherever they want, and different companies will draw it differently, and the consumer can choose among them. I simply value freedom more than you do. I value it more highly than just about anything else. Freedom always means that some people are going to make stupid choices, and have to live with the consequences. But in the big picture, that is far more desirable than depriving them of the freedom to choose. --------------------------------------------------------------------------- --------------------------------------------------------------------------- Bob Woolley -- --------------------------------------------------------------------------- St. Paul, Minnesota "A free society is most threatened not by uses of government that are obviously bad, but by uses of government that seem obviously good." -- Charles Murray Next message: Robert J. Woolley: "Re: IUD and PID" Previous message: Steven Crawford: "Re: IUD and PID" Maybe in reply to: Deborah J. Wage FNP, CNM: "IUD and PID" Next in thread: Robert J. Woolley: "Re: IUD and PID"

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