Focus 580; We Did All We Could, But Your Health Care Died: The Patients New Role in Vital Reforms

In this part of focus 580 will be talking about health care reform and the role that all of us as health care consumers can take in that reform. And our guest for the program is actually we have to Dr. Tom Minogue is here. He is a psychiatrist in private practice here in our area. He also teaches at the U of I med school. He is a clinical assistant professor here in Urbana-Champaign He runs a consulting firm in Monticello TLM Consulting which provides teaching seminars to other professionals. And one of his areas of special expertise that's psychiatric diagnosis. He is the author of a book that will talk about it's titled We did all we could but your health care died and the subtitle is The patients new role in vital reforms. It's published by Wyndham hall press it is his second book his first and actually I think we talked about the first book. Well actually yes David I was on your program a number of years ago and trust me I'm a doctor came out. That's right so that Book Trust me I'm a doctor understanding and surviving modern healthcare. That's his other book.

And I also am happy to say that joining us by telephone we have Bob faves. He's a cartoonist. You may be familiar with his where he's the creator of the comic strip Frank and Ernest. He's been doing that since 1972. It appears in over twelve hundred papers worldwide and he's received a lot of recognition for his work he's. At his home and we're talking with him too and he will talk with us maybe a little bit about some of the cartoons that he contributed to the book and both of the authors can talk about their collaboration on the effort and your questions are welcome here in Champaign Urbana 3 3 3 9 4 5 5. We also have toll free line good anywhere that you can hear us and that is 800 to 2 2 9 4 5 5. Well Dr. Renaud Thanks for being here. Well good. Good morning it's a pleasure to be here. I've been looking forward to having this discussion with you but also you may not be aware David that Bob faves and I have never met. And you know and and so although we've talked briefly on the phone in the past and mostly e-mailing to get

get the book collaborated on this is really my first opportunity to really talk very much with Bob so I'm probably looking forward to this conversation as much as the listeners because I have a lot of questions for for for Bob and I only hope I have a chance to get some of those and well we'll see what we can do. Well we better bring him in here Mr. Vegas hello. Good morning. Thanks for talking with us today. You're welcome We appreciate it. Bob good morning to you. As I just mentioned I have been I've been looking forward. Yes but now you're going to ask the question. Well I I have a lot of questions to ask you but. Mostly I want to find out if Franken are still going to be commenting on the survivors in the strip. Oh oh. Well we did one. Oh have you done one. OK a little while ago it was a takeoff on Robinson Crusoe and how Friday kicking off the island. Oh that's that's the only one though because I've never seen that show but I recognize that it's a cultural and social phenomenon and I'm one of the few people in the country are ever saying that.

Well I'm proud I haven't either so I'm proud to meet another person who has not seen it. Well you know David I have been. I've been watching Bob's work in the papers for really many years and it was only about two years ago that he and I started collaborating on this book. What really has impressed me is that when I would go into one of the research labs here on campus or one of the classrooms that's where I was more likely to see Bob's cartoons up. I mean of course I would see them in the local paper and whatever. But but it really struck me that that Frank and Ernest struck home so much to people that they had to bring it to work with them. And it's not at all unusual to see his cartoons around campus and I imagine that's duplicated in other areas and so he he commented frequently and healthcare issues and you know to this day I don't know why he does that to be one of the questions I would have for Bob why. Why indeed are so many of the Frank inners

cartoons on health care issues. And when I went to Bob he has a marvelous website I think it's just Frank and Ernest that come is that right. Right yeah. And when you sign into his website you can access thousands of Frank in his cartoons. And so I would go into the website and I would put in like doctor and I get 60 70 cartoons under Dr you put in hospital you get 20 30 cartoons under hospital. So for many many years Bob has been commenting on these health care issues and I would I would occasionally quote him in classes lectures I was giving I would admit over the air that I have bootleg some of his cartoons and but but. And the suits to be very receptive because there's something special. About the visual appeal of these cartoons and no matter what I might write on paper about the strong feelings I have about health care there is something that I cannot convey that looking at for instance the cartoon and the book's cover

which is a fellow with a tube over his head standing before a nurse at a reception desk with a nurse. I was needing some assistance from the nurse and the nurse asking something like Well what about two weeks from Thursday. And no matter how I could describe in words how much we lacked the ability often to get people in for appointments and how much they they often really need to get in and feel that you know that they're not being treated appropriately I can write that in words and can just kindly There you see Bob's cartoons and it says much much better than I can. And it was why I was very excited when the when Bob was willing to contribute from his archives. Cartoons and Bob as I recall and you correct me on this. I don't think that it was ever necessary to draw any new cartoons I know you did quite a bit of work updating those in the book but it seemed to me like that for every topic I could come up with that you were able to come up with a cartoon that you'd already done

and the topic. Yeah well actually I think you came up with I'm drawing from the archive. Yes there are other cartoons in the book I really reprint. Yes that's right wasn't it. We changed a few I remember you explained to me the the process that Frank an artist had kind of grown over the years and changed and so we had to be cautious about 970 cartoon as compared to a 1999 cartoon. Yes because the style has changed a lot over the last 28 years almost. I prefer to think of it as ten thousand two hundred twenty deadline which really puts it in perspective. Well I'm curious now because since since domino grace the question let's let me ask it and ask why have you done so many cartoons that have to do with doctors and hospitals. Is there a particular reason or is it just that that's you know I think there's no particular reason I think and it's just my voice I have an allergy. And so my

sinuses are working overtime. We need to get you some health care about. That's right but. The way I know there is no particular reason except that I as I think all cartoonist. You are play upon that your ways and that that are important or they have played a role in everybody's lives. That is money banking jobs where bosses marry wives. Medical care so on and it is just one more of those areas there are domains that cartoonists use and we all rely upon heavily upon a lot of stereotyping both in terms of characters and in situations. But also I do have some personal convictions or beliefs about medical care in this country. And I'm

I'm happy to say I'm not happy with my own medical care I've been blessed by having doctors who I think. It would have been exceptionally good for me and I have had no personal problems at all with getting what I think is proper care. But as the advent of a jam OS and other changes in medical care have evolved it has concerned me because what I see happening to other people and I wanted some time to express what my own attitudes were or my own observations were. Well you know much much along those lines and again you know I never really talked about this which is why I enjoy this opportunity. But I sometimes sit back and look at your cartoons and try to figure out if you're Democrat or Republican. And I have no idea.

And I have written the book politically because I my feeling is that that health care. While it touches the political arena and we need to address it in a political arena is is first and foremost a personal and a social phenomena not a political issue. And and so I've kind I'm not that literally asked you the question What is your political affiliation but but simply kind of pointing out that you and I have never really dealt with this issue on that level what we think both of us have tried to do is to you visually and me in words to address concerns that we saw within the healthcare system and it wasn't a matter of what candidate supported or brought up those concerns with us but rather what we saw the needs to be hopefully. Yeah well I am neither Republican nor Democrat I vote I participate but I'm a registered independent. Oh that's interesting. By that I mean I am I am not declared and I have no allegiance

to any party that leaves me free of any A.A.. But yes my. They're just ready to promise that. That are the basis of my approach to the health issue. And that is the first one is that each person has a personal responsibility for his own health. That is I don't think my doctors are responsible for my health. I am. Yes. And actually nobody else is. I can I have I can. Do much to control it already. To determine what it is. By how I choose to live how I choose to behave what I choose to eat and whether I choose to exercise a lot or not. But basically basically it comes down to me. But I do believe in the second principle for me is that I think everybody is entitled to access to medical professionals to help me to to to help each of us.

And and that that is the only place I think where politics may enter into it in that I think there is undoubtedly a role for government in that. Well I think you know that's certainly one of the major thrusts of this particular book that that everyone should have health care II. I used to kind of debate with myself that that proverbial question is that a privilege or a right to get health care and ultimately for me it's pretty well become a non-issue. It's simply something that that I feel is appropriate I don't know if people are entitled to it. If it's a privilege if it's a right. But I would not want to be the neighbor whether we're talking literally or figuratively my neighbor would not want to be neighbor with someone who wasn't entitled to exactly the quality of health care that I get and and I'd want to see that provided for other folks. And if we want to politicize it and call it rights or privileges or whatever and vote on it that may

be what we have to do but but the bottom line is you know if we can't find in the Constitution one way or another doesn't bother me when someone needs care and unfortunately I see folks coming into the office with just kind of horror stories of difficulties that they have had you know working in something of a referral area. You know I have the advantage of. Of getting in a wide range of people from widely diverse areas and and they they bring in their you know their tails if they can't get appointments they can't. They can't afford co-pays they can't afford their prescriptions you know they have concerns of diagnosis and misdiagnosis So I see a lot of problems that people here have been getting their health care and and it seemed to me like having been around the block a few times in the health care arena myself that there was a certain obligation to share some of that information and and I don't know if David at some point wants to get in into it but I

think really the basic thrust of this book which you so nicely illustrated is that these days we have serious concerns about America's health care and I think with legitimate reason and in my mind with these concerns that have come up it's time we had experts trying to deal with this. The politicians and bureaucrats and academicians you know certainly physicians have made effort and many of them have been well taken. But but we have not seen the strength of both the individual patient. In proving America America's health care and I'm not speaking of your issue which I think is extremely well taken of we're all primarily responsible you're absolutely right. But I'm speaking of the individual taking responsibility for improving our system of health care. I have not seen a strength of that nor have I seen the growth that I would like to see of the consumer movement I think we're seeing stronger and stronger consumer

efforts certainly here and in Champaign. And you're probably not familiar with this but we have a very strong health care consumers group. And you know. I may not always agree with what what they have to say but I think that it behooves physicians and consumers to to realize that working for the same goals that yes we can we can both recognize that there are serious serious concerns and we do not have to be at odds as we try to remedy some of these. I should probably introduce Again our guest here for anybody who tuned in last a little bit here in studio with us is Tom minnow. He is a psychiatrist he has practice here in our area. He also teaches you by med school and he is the co co Well I was going to say co-author and lechery that's exactly the right term anyway he's authored a book the text part of a book which looks at the patients role in health reform. He is titled the book we did all we could but your health care died and his collaborator. Is Bob who is the creator of the frank and earnest cartoon strip and he's contributed cartoons

that make in a different sort of way. Some of the same points that Tom does with the text and the book is published by Wyndham hall press. And in fact I think you're going to be doing a book signing this weekend tomorrow pages pages for I don't expect anyone will be there this is the champagne Urbana sweet corn festival and so strong competition for a book signing. Well they can go both. They can go both places. So there's I think two to four tomorrow afternoon at pages and certainly looking forward to having people comment and discuss their concerns of health care it's actually a joint press conference with the champagne County health care consumers who I think will have a lot to say in terms of what's coming up on the political agenda. Yeah. Well I want to raise one point with you Dr. Minogue and that's I think that when when people talk about health care they talk about the things that make them unhappy. One of the things that's at the top of the list

is the relationship they have with their doctor particularly if they're in managed care. People say I don't get to spend enough time with the doctor. I don't I'm not able to answer to ask all of my questions the doctor is not able to get to know me as a person. And that seems to be one of the big complaints and in the book you sort of make the point that people as much as they can need to take control and be very much involved in their own care. You know how in if indeed you're in an HMO. So there are some limits placed on the amount of time you can spend with your doctor what can you do about that. Well I don't know that I would really want to restrict or just HMO because you know I think we might see that problem more pronounced in that kind of setting. But I have to tell you about a marvelous incident just about two or three weeks ago on The Office. There's a nice senior citizen an older lady that I work with that she always

comes in with a friend. To kind of be supportive during the appointments and the two I'm always sit there and take notes during the end. It's like having two secretaries in the room every time I say something which I admire them for it is you know they're really getting things down and and working hard. And we had to the appointment time had gone on and I thought I had pretty well covered the issues. I don't frankly know if this was an HMO patient or not and and I'd like to think that patients are not necessarily treated as your nation or HMO patient and you're not. But this was a patient a senior citizen. And so I stood up and and said Well I think that's probably what we'll be covering today and let's get you a return appointment for about another month. And this lady I think she's maybe about a little bit around 80. And she said to me she said No you'll sit down I stood up you'll sit down. I still have questions to ask you. And I thought it was absolutely marvelous and I think that's the first time I've been in practice in psychiatry now for about 20 years but I've been in general

medical and other practice for about 30 years I never had a patient tell me No the appointments not over. You're going to sit down and answer my questions and I just thought this was a marvelous example of exactly what people should do if they feel that they're not having their answer their issues addressed in any other Fanshen. So certainly it's one of the things that they can do that you know that they certainly need to be to be assertive. They also can do and maybe this is a little bit in line with what Bob was saying about being responsible for our own health. But in a different sort of way people often waste an awful lot of appointment time and if what people need to learn how to do is to become managers of their appointments and certainly you know the doctor has an agenda when you go in to see an actor a doctor knows you take a history do a physical make a diagnosis lay out a treatment plan. I mean we do this time and time and time sometimes every three minutes depending on how your appointments are scheduled. But but hopefully. You know for 15 or 20 30 minute appointments

and we have an agenda that we manage but the patient has to come in with their own agenda. The patient needs to know what they are there for and he has to be very clear. And I'll frequently ask patients you know we you please just tell me in one nice clear crisp sentence what is the distress that brings you in to see me. And people have tremendous trouble grappling with that. And I would like to think that that people can become come in more prepared now it's not that certainly patients have limitations and they're not on their own turf when they're in the doctor's office. This isn't a let's shift blame or blame the victim but you're asking what patients can do. And I think to to better manage their own appointment time. And one simple thing and I always tell patients this I think I learned from my accountant who always says through all of your bills in a brown paper bag and bring him into your for your tax appointment you just take all of your medicines before you see me. You put those in a brown paper bag and you bring those in because I want to know so often they'll come in and they'll say. Because I'm always initial interest in drug interactions is a very serious issue these days.

I'll always ask them have any new drugs been added since your last visit because I make sure they're not going to have trouble with the medicine I prescribe. And they say well yeah one of the doctors ordered a new pink pill for me and wish you know when I go to put it on the computer. That doesn't help very much. And but if people bring in their medicines or at least know what medicines they're taking know what dosages. So I think they can really prepare and do a lot more for themselves just in terms of managing an office appointment. I think one of the things that you hear a doctor say all the time is that the patients come in and they sit down and they talk with a doctor and they take you know whatever time is allowed and then they're almost finished and the doctor says something like So is there anything else you know sort of on your mind. And then they tell you why they really came. Yes. And that is something that for some something obviously is really bothering them but for some reason they feel if they can't be up front about that they can't write at the beginning say Look Doc This is what it is. Well that's a phenomena that happens but again it gets back to the idea of properly managing your appointments. Now we should really just very briefly take a step back from that.

It's unfortunate that patients have to manage appointments so carefully. You know I mean we haven't really hit on what are the problems but certainly one of the problems I think is that in spite of all this talk about doctors we still don't have enough doctors. And it you know you can go and talk to your attorney for an hour and he or she doesn't. Move you out of the office unduly rapidly but it's hard to go on to talk for your to your doctor for a half hour an hour an hour and a half. And I simply think that one of the real problems we're facing is that we do not have enough doctors and we need to have patients have the flexibility to be able to say OK you dealt with that and by the way here is something else. A lot of people I think by the object being on same terms with their lawyers if they came in and they said to their doctor I think I'd like to have an hour of your time the doctors say OK that will be $200. Sure how that would work. Well but the thing is people are already currently paying $200 for an hour of their doctor's time. So I'm not sure that that there's a great deal of difference there. And you know and patients in general David do not know and when you see your doctor you know how long your

appointment a scheduled for. I have no idea. You know it's a 220 appointment but you don't know if it ends at 2:15 it to 20 2:30 3:00 o'clock. And so I think one of the things people can do is to say when the receptionist when I make the appointment the reception says We'll see you at 3 o'clock then Mr. Jones and then. Well how long is that appointment scheduled for and then he might want to say you know I don't think 10 minutes is going to be enough for this because I have several things I do. Let's pick another time when Doctor can see me for 20 minutes or 30 minutes. I think it's very legitimate David. OK fair enough we have a caller here locally Let's do that we'll talk with them. Champagne. Well I'm number one. Well documented. Could you expound on your comment that you think there are not enough doctors because there's been a lot of talk over the last few years of closing medical schools and a glut of specialists. So while I might not agree with you I don't know if the industry's prevailing attitude jibes with yours.

Well I think to the caller I don't think the industry's prevailing attitude does jive with mine. I think that there's there's really two issues 1 the total number of doctors. And then secondly the the doctors in specialty practice you know. I don't think it's any great mystery that to me at least that there's not enough doctors just call around. We're not talking necessarily locally now but but but when people call to get appointments they are frequently told well we can see you in three weeks or four weeks or you can be pretty hard to get seen the same day. Now that doesn't mean that there aren't some options a lot of places have convenient carers and there's a walk in clinic stacks in the back seat going to the emergency room. So hopefully you know there are facilities available but just in terms of seeing your own doctor on a regular basis. I just don't think I think this is common experience that people have and it's what illustrate on the front cover of the book with the guy with the tube over the head being told to come back in two weeks I just think you don't have to look at the statistics you don't have to look at research just

call a doctor's office and see how long it takes to get an appointment. And I think that just tells me that there are not enough doctors now the specialty question is an important one. Care is just very very complicated these days and why not. Why I think it's important to have a strong primary care doctor to work with. I don't think that we should be concerned about abusing Sif systems because we're seeing a lot of specialists in the field of psychiatry and I tell you I have all I can do to keep abreast in the world of psychiatry very very difficult. And I see specialists in my own care saw a gastroenterologist yesterday pleased to be able to do that. I think we need more doctors with a strong family practice primary care base but we need more specialists too. And if if the industry disagrees with that. I'd like them to tell me how long they wait for their own appointments. Well that's that one of the things that if you were selecting a doctor one of the things that you might do as you're if you have a choice and you're calling around

you might say OK today I want to make appointment today. Hello is it really going to take me before the doctor will see me. Right. And I think that be very reasonable to do that you know does a doctor in general work in emergency patients. And in fact can you even talk to your doctor. I think a lot of people these days have the experience that it's hard to call in and actually talk to your physician. They might call in and I think this is probably true in many parts of the country they'll call in and first get on hold from the receptionist and then when they reach the receptionist they'll get into the nurses voicemail or put on hold for the nurse for the nurse and then maybe ultimately we'll hear back kind of second or third hand from the doctor. Well can you actually talk to your doctor when you call in for questions. And I think throughout the country people are having trouble doing this. I want to just go back here for a second to our other guest Bob faves and I'm interested in in asking a question. I know that from having seen the strip obviously for a long time I know that you do raise political and social

issues in the strip and yet I think do it in a sometimes kind of a gentle way that maybe makes people more receptive to the idea than if it if it was a cartoon that had a little bit more edge to it. I just wonder how you approach that that idea and and in fact whether you ever want it you're there were ever wanted to be an editorial cartoonist and be very clear that I am that this cartoon is about making a political point. No bones about it. No no I never had any I don't wish to be an editorial cartoonist. It is me in part because I started out as a magazine cartoonist which gives you total freedom to do anything you want to do. And I wouldn't want to be confined one thing to the political arena. Plus I I don't particularly

like what I would think of as mean humor and much of a troll cartooning although I did it it legitimately makes the point it makes it a point to say what I think of as meaning humor. If you go ahead. Oh I was just going going to say I've noticed the same thing and interesting enough. I mean the same thing in your cartoons and interesting enough David's question of what about you being editorial cartoon was one of mine. I mean that was you know certainly I had the same the same thought but a comment along those lines with regard to your cartoons is is a certain David mentioned a softness or gentleness to them. But many of them also have a certain university ality. I know at least one or two that are used in this book. What one is your character's one saying to the other. It doesn't matter what they were really be talking about but one was saying to the other. Wait a minute this isn't one of those let's take responsibility for our own actions deals is it. And and another one was was God watching

people fall off of a flat Earth and having a discussion with the people up in in heaven of well I guess it's time to go to Plan B. And you know kind of indicating that sometimes we have to shift gears and retool our thinking. And I've always enjoyed kind of the university ality of some of these cartoons and and I think that David's right that they lacked that bitter edge while still getting across a marvelous message. And I remember in one of our very brief conversations you tried to explain to me once something about the language of cartooning and I'm I'm sure I could could do to really learn that it can you can you give a 30 second. Right. What I said I think I think basically you were saying that it's almost like a third language or a different language when one sits down with cartooning and that you were just able to to kind of in still you know use that language to get an idea across in a different way than words.

I was probably touching on it when I when I was thinking about how we use stereotypes and how we draw. Yes every day. But the concern is there are the experiences of every day people but the the the arts in general I think of as being different languages music is a different language as far as I'm concerned. I listen to music halls constantly while I work and I've often thought that I cannot put into words what I feel when I hear the music. And that's because music has its own language and I think art whether in the visual arts are their own language and the unique thing perhaps about cartooning is that it combines verbal verbal construction of with what is really a a visual art. Yes but there is no other case as far as I know where that's that's true. I shan't talk about opera and music but anyway the the idea of it being. But

I'm not not not having an edge so to speak is I think people can tolerate it more when the character makes fun of himself so to speak. Rather than making fun of some other person and it also I I think every art. Every creative effort is a projection in some way or another. The Creator and I have never myself enjoyed making fun of people or treating thing as what I think of as being in any I mean spirited always makes me very uncomfortable and I would like to see that in my cartoons. The end of Frank and Ernest Frank and a few to make fun of themselves not of other people and I think that makes it easier also for people to read them and accept them. That is certainly isn't threatening in any way. Does that help at all.

Oh I think so. Makes sense to me. Thank you for that explanation. We are getting to the point here where we have maybe about 12 or 13 minutes left time's been going very quickly I want to make sure if people who are listening if you have a question or comment you'd like to join as you can do that 3 3 3 9 4 5 5 4 champagne Urbana folks toll free 800 to 2 2 9 4 5 5 and our two guests our cartoonist Bob Davis he's the creator of the comic strip Frank and Ernest and Dr. Tom Minogue is a psychiatrist and he's authored a book titled We did all we could but your health care died and Bob Davis contributed cartoons and the idea is that it's a discussion of the issue of health care reform. What perhaps is wrong with health care in this country how it might be changed and the role of the patient. Yeah. And in fact maybe David it might be worthwhile just to mention briefly why why the title was chosen. Sure of course. You know you're familiar with the old saying is a doctor comes out of the surgery room we we did all we could but you know the patient died.

And I think that that as a physician I'm not ashamed to recognize that there are serious dangers and problems and risks in health care and there's been. It's documented in the literature now that health care can be very dangerous. And I think doctors in general try very hard to keep it safe but that doesn't mean that we've done the job that we're we're ultimately capable of doing. One very interesting figure is that that the number of hospital deaths per day in the United States may be equivalent to two airliners colliding in midair every day. And you know one submarine goes down and it's news for how long. One hundred thirty people died. Well the research suggests that hundreds of people die every day in the hospital but yet you know where is the fire and where is the the fevered pitch to to really bring some changes of this there. There was a recent study that they have the World Health Organization brought out about the ranking of the quality of health care systems in the world the U.S. with 37. Well you

know we spend 15 percent of our gross domestic product and health care and yet we're 37 than France was number one. Italy was number two Kingdom was was number 18. But but we're sitting down there it's at thirty seven we have a high infant mortality rate. We don't have as good of a life expectancy as we should have. So I think that there is some kind of a an accumulation of of evidence in recent years that yes we're spending a lot of money and we're on a one to one basis doctor and patient sitting down. There may be a lot of satisfaction and but the statistics which one can argue with certainly but you know these statistics are from very legitimate organizations from published in JAMA for instance from the World Health Organization. So I think there's reason for for patients and consumers to work together and say yes there's there's reason for very serious concern and I would love to hear from people why why this isn't really on the lips of everyone. The concern I looked in the two

Chicago papers today didn't find anything at all about. The politics for the coming presidential election. Now one article I went through fairly rapidly but certainly nothing nothing jumped out at me either. Republican Democratic Ralph Nader anyone who is saying OK now here's an important item in our health nation's health care debate. I mean there are there are some sometimes but it seems like things just mechanically fall from the lips of the candidate you know patients bill of rights you know that's great. Some prescription benefits. But we have all these people who are coming in to see doctors saying I can't afford medicine. People are dying for their lack of health care. And I would love for the listeners to call and say well why where's the fire where's their concern. Maybe I'll give the telephone number again here in case somebody would like to call in and remind you that we do have about 10 words now less than 10 minutes left three three three W while toll free 800 to 2 to WY Hello. Those are the numbers. Maybe

let me ask Bob. I'm just curious if you have some just as somebody who obviously observes the political scene and sometimes reflects that in your work if you have some sort of thought about why it is that this issue as important as it seems to be doesn't get more attention. Well I quite a medical one yeah. Well in part I think because I don't think the politicians have a solution and also part of it is what I think Dr Minogue has referred to and that is that people aren't clamoring for it. So you turn back to Tom you know here you are you're actually not expecting to see who we got a presidential election going here. I heard that you're there. And as as you've noticed noted there have been a few things that have been discovered we're talking about prescription drugs for people on Medicare. And

you know here we we sort of tinker with the system on the edges but nobody is really talking about at least I haven't heard the body lately talking about really dramatically changing the system that we have you don't think that we're going to hear that. Well let's talk about it. Although I'm not a presidential candidate but I can still talk about it but I think you're absolutely right. We have the bits and pieces tinker at the edge approach to it. And I do believe though that had Al Gore and this isn't to come out in support. I do believe that Al Gore in his acceptance speech said that we will move to universal health coverage in this country. And I'm not endorsing his plan by any means or disparaging it but I certainly feel that instead of well you know we can sue arm our HMO and we can have prescription drug benefits and and we will have this chip

program for kids and you know well will support immunizations and all you know it isn't a time to get a universal program to cut all the mucking around the edges and get a universal program that is supportive of everyone where everyone can take responsibility and he doesn't have to talk just about a government giveaway that you know Government's just going to give this money away but we do know that we spend. A trillion dollars a year in health care. Why not make that available to individuals but make them responsible for it. But yet through a program that would allow them to take responsibility for their own trillion you know I mean ultimately I mean you work for the University of Illinois they're paying you a certain amount and they probably give you health care service. But in the the bottom line is that you're paying for that through your work. And so why not give to you and everyone in this country that you know access if you will to

their share of the trillion let them be financially responsible for paying for that and to manage it well. And I think that we can do that I think we have good universal coverage whether or not it should be by a single payer that's another issue. We have a couple of callers who will try to get in in the time that's left here. Champagne is up next line number one. Hello. Yes I certainly agree with you. The doctor's been saying I think we have to be responsible. And also regarding universal care we have some friends in Canada and it seems to be working quite well there I was wondering if a doctor could comment on the comparison of our system and the cost in the Canadian system and the advantage dissipated. Thank you. Thanks for the call. Go ahead. Well the Canadian system one sometimes hears disparaging remarks about it but when I go up to meetings in Canada and talk to the people up there they're very satisfied with their system and I know that they bring it in a much

lower cost than we do and they've been at it for a number of years and I'm not sure I can. I mean I'm I'm not a research person or an academician and I'm a practitioner so I'm not sure I could compare the the German to the Canadian to whatever system. But I do know that there's a lot of satisfaction with the Canadian system that it is universal that they don't wind up sending out bills. And everyone gets covered and that there's a general level of satisfaction I think that we could have a lot to learn from the Canadian system. And yet at the same time that the one also always hears those stories and perhaps these are from people who want to argue against universal health care that says yes but when some really important comes along to Canadians What do they do. They go across the border they come to the United States. They're concerned about how long it may wait for a particular procedure or maybe it is that the system there would to review your case and say well maybe you want to have this done but we don't think it's necessary so we're not going to pay for it.

Yeah I'm not sure David that one has to buy into the Canadian or any other system and block. I think I think you know who has a perfect system in in in air travel or anything. But I think there's something to be learned from our neighbors to the north that they've done a fairly decent job of being sure that there's a reasonable level playing field in health care. One other call here this is also champagne this is line number two. Hello. I'm my on line number two. Yes. Oh haha you know hello. I read your first book. Oh thank you. I'm a firm believer in preventative medicine but it's becoming. Increasingly difficult to practice because many of these tasks that I have read are necessary are being cut and it's difficult to get them for instance. Your analysis has been cut out from physical exams by most of the doctors in Champaign-Urbana area and also instead of doing training kaleidoscopic they're doing barium X-rays and

is. One does not know exactly what procedures to use to change this. Well the caller brings up a number of interesting points to the core of it is a question of prevention. And while testing is important and certainly has changed over the years you know a really important element of of prevention is some simple basics that we keep forgetting about only keep this real short because I know we have some other callers but you know testing is fine. But but what about that time to go in and have your doctor take a good history and to do a good hands on physical. I think that may be disappearing in this country at least as much as a lot of routine testing is and certainly in the old days I mean I used to be a family doc. Some would come in we'd order a 5 6 7 test routinely. Now folks feel in medicine that they're more targeting the test we don't really need this one let's get what we're what we really need. But but the bottom line is is that we have to use the tests appropriately as

necessary I would certainly support that. But we also need to go back to where doctors are talking to patients spending time with them and doing good solid exams has a real good part of preventive medicine. I just make one more time for doing them less with a new doctor. It's been 15 minutes. And then make another point and I went back three times. Well you probably one of those folks who would agree we don't have a doctor there. And what do you do about it. Yeah well well let's let's support to getting more doctors in this country and then be like the patient who who would let me leave the room until she was done he asked me the questions. Tell the doctor to sit back down. Have you tried. I did thank you will thank you for the call. I am afraid we're going to have to leave it at that because we've used up our time. We want to say to our guests thanks very much Mr. faves Thanks for talking with us today. Bob faves he's cartoonist creator Frank and Ernest and he also contributed

cartoons to the book here that Tom uno guest on he's provided the text and the title of the book is we did all we could but your health care died. He is a physician a psychiatrist in practice here in our area he also teaches at the U of I med school. The book is published by Wyndham hall press is available in bookstores and as we mentioned before he'll be doing a book signing at pages for all ages. Tomorrow it 2:00 o'clock and Bob just wanted to say to you was kind nice meeting you today over the radio. Appreciate the opportunity. And thank you very much for participating. Well it was it was my pleasure. Great and thanks to thanks to both of you.