When did healthcare problems start?

[Slartibartfast]

You didn't answer my claim about places like Kaiser that would only hire the qualified doctors. Companies would gain a good reputation for hiring good doctors.

I think I misunderstood your claim than. My apologies.

I certainly think that would happen and those companies can use that reputation to their competitive advantage. However, I think (and I may be wrong) most doctors tend to start smaller private practices and those were the places I was thinking of for having a systemitized rating system. I am not sure if opening the market for bringing on more doctors would or would not change that dynamic.

 

[WI Crippler]

You should see the great students that are left out of the medical field because of the insane standards and stupid crap we have to do. We have to have a "well-rounded education" to get into medical school. Now tell me, why do students have to waste their time studying English and Philosophy and History to get into medical school? I mean I like the classes, but they're almost completely worthless to a doctor.

Some average Joe in a completely unregulated market could open up his own business and call himself a doctor and he probably wouldn't get more than a few patients for a few weeks. He would have no references, no certification, nothing. Why would anyone go to him unless they really had to take a chance? The market tends to clear out the crap and favor those who know what they're doing. The crap loses business while the knowledgable gain that business.

The English classes come in handy, at least the ones I have taken, as healthcare students have to write several research papers. So expository writing and research writing skills are a must.

As far as just having an unregulated market for students, is that you do damage to the profession by allowing people into the field that normally couldn't meet some sort of standard for the particular industry. Healthcare professionals have to be both patient advocates, and advocates for their own profession. Patients may go to an absolute terrible therapist in an unregulated market, and assume that that is the standard for the industry and have a negative impression of that particular field.

I understand your point with regards to some ridiculousness regarding the process, and I think we could open up more schools(with the same standards) to give a little more of an influx of healthcare professionals in areas they are needed, but I don't like the idea of an unregulated healthcare education system, and I appreciate that the professions themselves are willing to undertake the responsibility to regulate themselves.

 

[Aunt Spiker]

Health-care problems started when "healthcare cost knowledge" was divided out separately from "patient awareness" and from "patient concern."

How much does your health-care cost? How much does your health-care actually cover - how much does it pay out every year to everyone?

All people seem to be aware of is what it *doesn't* cover - their co-pay, their out of pocket expenses. . .while being little informed of everything else. Uninformed = unconcerned for many people. Unconcerned = not demanding cost-changes and lower prices for products.

Why is Walmart a huge, booming business? Because individuals shop there all the time - demand low-cost and decent-quality - and their demand drives the Giant's initiatives and purpose and their success drives other businesses that provide *to* Walmart to keep their costs low. The company uses their overall profit-gains to bring down the cost of others.

What if we were no longer aware of the individual cost of all those food-products? What if we paid into a food-insurance pool. We pay $100.00 - and get certain foods when we went there with a $20.00 or $30.00 out of pocket cost? Would the cost of all those items *continue* to be low? No - surely not! They'd go up here, there . . . everywhere.

Thus - without the patients being aware or very concerned with the base cost of each and every single item and charge for the service - there's no reason for them to find ways of making pill-production cheaper and more efficient, etc. Thus - the inherent nature of insurance distances people from the cost of things. . .it's good *and* bad and the only ones who notice are the ones who *don't have insurance*

When I take my kid's to the emergency room (happens a few times a year - for real emergencies - usually bad cuts) I don't get *a bill that itemizes things* I get a statement from my insurance which says "they charged us $$$$" and so "we paid $$$" and "you need to pay $" . . . but what I never know is *why* that initial charge was levied. How much - for what? and if something seems to expensive - who do I complain to? My insurance company? The hospital?
How can customer-concerns matter so much to a pure profit-oriented business (Walmart) where as it means so little and have no vehicle for the health fields which cost *more* money and turn over *more* money each year?

 

[liblady]

Health-care problems started when "healthcare cost knowledge" was divided out separately from "patient awareness" and from "patient concern."

How much does your health-care cost? How much does your health-care actually cover - how much does it pay out every year to everyone?

All people seem to be aware of is what it *doesn't* cover - their co-pay, their out of pocket expenses. . .while being little informed of everything else. Uninformed = unconcerned for many people. Unconcerned = not demanding cost-changes and lower prices for products.

Why is Walmart a huge, booming business? Because individuals shop there all the time - demand low-cost and decent-quality - and their demand drives the Giant's initiatives and purpose and their success drives other businesses that provide *to* Walmart to keep their costs low. The company uses their overall profit-gains to bring down the cost of others.

What if we were no longer aware of the individual cost of all those food-products? What if we paid into a food-insurance pool. We pay $100.00 - and get certain foods when we went there with a $20.00 or $30.00 out of pocket cost? Would the cost of all those items *continue* to be low? No - surely not! They'd go up here, there . . . everywhere.

Thus - without the patients being aware or very concerned with the base cost of each and every single item and charge for the service - there's no reason for them to find ways of making pill-production cheaper and more efficient, etc. Thus - the inherent nature of insurance distances people from the cost of things. . .it's good *and* bad and the only ones who notice are the ones who *don't have insurance*

When I take my kid's to the emergency room (happens a few times a year - for real emergencies - usually bad cuts) I don't get *a bill that itemizes things* I get a statement from my insurance which says "they charged us $$$$" and so "we paid $$$" and "you need to pay $" . . . but what I never know is *why* that initial charge was levied. How much - for what? and if something seems to expensive - who do I complain to? My insurance company? The hospital?
How can customer-concerns matter so much to a pure profit-oriented business (Walmart) where as it means so little and have no vehicle for the health fields which cost *more* money and turn over *more* money each year?

wait, what? customer concerns don't mean much to walamrt, neither do employee concerns. most people shop at walmart because of the low prices, not for any other reason, and they HAVE to shop there. would they shop elsewhere if they could? yes.

we are usually limited on our choices about hospitals. we are somewhat captive as well. and don't confuse price with cost. none of us have any idea what the cost is, we just know what the price is. and it's too much.

 

[Aunt Spiker]

wait, what? customer concerns don't mean much to walamrt, neither do employee concerns. most people shop at walmart because of the low prices, not for any other reason, and they HAVE to shop there. would they shop elsewhere if they could? yes.

we are usually limited on our choices about hospitals. we are somewhat captive as well. and don't confuse price with cost. none of us have any idea what the cost is, we just know what the price is. and it's too much.

Exactly (to the bolded).

Walmart = low cost.
Low cost = more people shopping at walmart because they *need* to spend the least amount of money on their items they purchase.
People shopping at Walmart = more profit for Walmart.
More profit for Walmart = Walmart is leader of industry.
Leader of industry = it's the ideal place to have your product *sold* (if you're another company).

It's a win-win-win scenario.
Customer demand and expectation keeps people faithfully shopping there.

If people *want* and *demand* and *have no choice* but to shop for the best deals then they *will* shop where they think those *wants* *demands* and *no choices* are going to be met.

So - if Health-care functioned more like a Walmart where lower cost = more customers, more customer = more profit, more profit = greater business growth then health-care *would be cheaper* for everyone. And *not* just overall pocket-expenses for healthcare, but every pill, band-aid and shot *would be cheaper*

It's basic supply/demand. If people demand you provide more affordable healthcare - if you can satisfy *that* demand then *you* will gain more and more *customers* . . . this is where the government is getting in on it. They are now going to be providing affordable coverage, they will be Walmart - but because they're the government and they write the rules there's no need for them to follow the rules, they can just change them (Imagine what would happen if Walmart could change the rules instead of just abiding by them?)

But things change: Walmart continued this genuine practice of "we're the cheapest!" for *so long* that people, now, automatically assume that they are the cheapest and best place to shop . . . when they no longer are for many products - and in many places - competition, also, listened to consumer demand.

Yet they still have people in their bag, don't they? Because in order to learn where certain items are cheaper you *must* change your habits and actually shop cash or window elsewhere for a while.

Some people just buy into the construct and assume they're getting the cheapest deal.
Others don't - and actually find the best deal they can find by shopping around.

 

[liblady]

Exactly (to the bolded).

Walmart = low cost.
Low cost = more people shopping at walmart because they *need* to spend the least amount of money on their items they purchase.
People shopping at Walmart = more profit for Walmart.
More profit for Walmart = Walmart is leader of industry.
Leader of industry = it's the ideal place to have your product *sold* (if you're another company).

It's a win-win-win scenario.
Customer demand and expectation keeps people faithfully shopping there.

If people *want* and *demand* and *have no choice* but to shop for the best deals then they *will* shop where they think those *wants* *demands* and *no choices* are going to be met.


So - if Health-care functioned more like a Walmart where lower cost = more customers, more customer = more profit, more profit = greater business growth then health-care *would be cheaper* for everyone. And *not* just overall pocket-expenses for healthcare, but every pill, band-aid and shot *would be cheaper*

It's basic supply/demand. If people demand you provide more affordable healthcare - if you can satisfy *that* demand then *you* will gain more and more *customers*


But things change: Walmart continued this genuine practice of "we're the cheapest!" for *so long* that people, now, automatically assume that they are the cheapest and best place to shop . . . when they no longer are for many products - and many places - competition, also, listened to consumer demand.

Yet they still have people in their bag, don't they? Because in order to learn where certain items are cheaper you *must* change your habits and actually shop cash or window elsewhere for a while.

Some people just buy into the construct and assume they're getting the cheapest deal.
Others don't - and actually find the best deal they can find by shopping around.

how can you shop for a hospital? emergency room? choices are limited, usually. and do you really want a walmart of a hospital, or do you want the sak's of a hospital?

 

[Slartibartfast]

Spiker, I think while some elements of the low cost argument is true, I also think healthcare is a different scenerio than buying a clock radio or whatever else someone may get from walmart.

Someone who breaks their arm is not going to simply do without if they do not like the price structures they find and they probably are not going to take the time to shop around, especially since letting a broken arm sit for too long causes more problems than the initial break.

Also, imagine someone who has a problem bad enough for an ambulance. People do not call an ambulance provider and comparison shop. They call 911 and an ambulance gets sent.

The point is that the situation is totally different. While this sort of system might work for people fighting the flu, wanting plastic surgery, or anything else that can wait, it totally falls on its face when there is a real problem and cannot be fully used to solve the problems with pricing in the medical industry.

 

[Aunt Spiker]

how can you shop for a hospital? emergency room? choices are limited, usually. and do you really want a walmart of a hospital, or do you want the sak's of a hospital?

Spiker, I think while some elements of the low cost argument is true, I also think healthcare is a different scenerio than buying a clock radio or whatever else someone may get from walmart.

Someone who breaks their arm is not going to simply do without if they do not like the price structures they find and they probably are not going to take the time to shop around.

Also, imagine someone who has a problem bad enough for an ambulance. People do not call an ambulance provider and comparison shop. They call 911 and an ambulance gets sent.

The point is that the situation is totally different. While this sort of system might work for people fighting the flu, wanting plastic surgery, or anything else that can wait, it totally falls on its face when there is a real problem and cannot be fully used to solve the problems with pricing in the medical industry.

You're getting my point but you're not realizing it at the moment

Often (not always) people *cannot* shop around for emergency care - yep - so there's *no reason* for various aspects to be cost-considerate.

However - people often *do* shop around for everything else if they have the *time* or *option* to do so:

Health insurance - many people, just like auto insurance, shop around for the most affordable options that suit their needs if they're paying for it out of pocket. Many people decided that they, out of pocket each year, only spend a small amount and don't even *need* insurance. .. and if something happens, they'll pay for that out of pocket, too.

Doctors: yep - people shop around here, too, if it's a non-emergency or if people aren't too sick to do so - countless people choose their doctor based on cost, quality, references and suggestions from others.
I do this for the kid's eye-care, dental care and everything else. . . base-cost is still important to me. Just because our insurance will cover it doesn't mean I don't care (however - most people *do not care* because their *insurance covers it* and there's no reasons *for them to care*)

Prescriptions: yep - here, too, many many people get their prescriptions filled where it's cheaper - this is why Walgreens and other places offer more affordable pay-options and plans to sign up for - people, when they have choices, will go where it's cheaper.

Back to ER issues: I even shop for emergency care . . . there are some emergencies in which this is not an option - the only option is "who's the closest, asap, pronto, now!" - but for things that need to be taken care of *at* the emergency room but are not *life/death* - I go where wait time will be: least. Where the care will be: best. Where the doctor's are the most: capable. . . .if I paid out of pocket and was broke then I'd go where care was: cheapest. . . when applicable.

I will drive an extra 15 minutes to go into Little rock to go to the Children's hospital for foreign-body removal because they are more capable (huge reason for us to frequent the ER in the middle of the night or on the weekends, on par with wound-frequency).

Why do I choose to do this? Years ago my son had a bead up his nose - I saw it when I tucked him into bed one Friday evening. This isn't something you can 'wait for Monday' on - but it's also not 'immediate danger' . . . thus - I didn't call an ambulance I drove him.

I went to the nearest hospital - it was midnight - they, however, weren't able to remove the bead . . . I, then, had to drive to the children's Hospital in Little Rock where they had more experience and *were* able to remove the bead.

Thus - my insurance company covered no one, but *two* emergency room visits - and it made the entire deal take *longer* - thus - the next time we had a FB situation - I forwent the incapable and inferior yet closer and probably cheaper hospital because the first time - they weren't capable of dealing with the situation at all.

If someone broke a leg once - and received horrible care - if they do it again do you think that maybe they'll consider an alternative if *there is another alternative to consider?* Yes! People do this all the time.

It's obvious that when people *can* make a choice - they will *make a choice* that is more suitable to their needs.

If *many many* people make the same choice - then that hospital/clinic will eventually realize there's an issue and make changes to improve their care/etc.

 

[Boo Radley]

If you bothered to read his initial post, you would have seen that doctors used to practice discriminative pricing.
Lower prices for lower income people, higher for higher income people.

:lamo

I did read it. It was written in 1910, a very different world. I have mentioned to the poster of that article elsewhere someothing in the eary 80's. We will never g back to the world of 1910. And this report is hardly the only reason why. All the changes btween then and now killed that world, never to be reborn again.

I stand by what I said.

 

[phattonez]

I think I misunderstood your claim than. My apologies.

I certainly think that would happen and those companies can use that reputation to their competitive advantage. However, I think (and I may be wrong) most doctors tend to start smaller private practices and those were the places I was thinking of for having a systemitized rating system. I am not sure if opening the market for bringing on more doctors would or would not change that dynamic.

Well without the certification that they get now, I would guess that these places would be a lot less popular. But then again, if you can establish a reputation, then it would work out. That's the tough part, though - establishing a reputation. I would assume it would be a like a dentist's office. You have an old man working there that you trust but he wants to retire. He then will pass on the business to a kid that he trusts and so keep the reputation of the business.

 

[phattonez]

:lamo

I did read it. It was written in 1910, a very different world. I have mentioned to the poster of that article elsewhere someothing in the eary 80's. We will never g back to the world of 1910. And this report is hardly the only reason why. All the changes btween then and now killed that world, never to be reborn again.

I stand by what I said.

The classic fallacy that if we go back to the rules of 1910 that we will be exactly like 1910. Not in the slightest. We have all the knowledge now, that wouldn't just go away.

 

[phattonez]

The English classes come in handy, at least the ones I have taken, as healthcare students have to write several research papers. So expository writing and research writing skills are a must.

To a certain extent, though.

As far as just having an unregulated market for students, is that you do damage to the profession by allowing people into the field that normally couldn't meet some sort of standard for the particular industry. Healthcare professionals have to be both patient advocates, and advocates for their own profession. Patients may go to an absolute terrible therapist in an unregulated market, and assume that that is the standard for the industry and have a negative impression of that particular field.

I understand your point with regards to some ridiculousness regarding the process, and I think we could open up more schools(with the same standards) to give a little more of an influx of healthcare professionals in areas they are needed, but I don't like the idea of an unregulated healthcare education system, and I appreciate that the professions themselves are willing to undertake the responsibility to regulate themselves.

How popular would a place like that be? People would only go to places with a good reputation. Why would you blame the industry when you know that there are others out there that are much more qualified that you didn't even try? A place that sucked would not even stay in business to alter the reputation of that industry.

 

[Boo Radley]

The classic fallacy that if we go back to the rules of 1910 that we will be exactly like 1910. Not in the slightest. We have all the knowledge now, that wouldn't just go away.

No, you misunderstand, we are too different for the rules to make any change of a positive nature. We can't have that system today because costs, technology, and approach are far too different. We don't use the family or town doctor anymore like we did then. We have made many medical advances and live in a world of wonders and not home remides.

 

[phattonez]

No, you misunderstand, we are too different for the rules to make any change of a positive nature. We can't have that system today because costs, technology, and approach are far too different. We don't use the family or town doctor anymore like we did then. We have made many medical advances and live in a world of wonders and not home remides.

All that this proves is that things have changed, not that the rules of the past would not work today. You have not provided an argument as to why the rules of before would not work.

 

[Slartibartfast]

Well without the certification that they get now, I would guess that these places would be a lot less popular. But then again, if you can establish a reputation, then it would work out. That's the tough part, though - establishing a reputation. I would assume it would be a like a dentist's office. You have an old man working there that you trust but he wants to retire. He then will pass on the business to a kid that he trusts and so keep the reputation of the business.

I think that the potential for it all to go wrong is greater in the medical field than in another small business such as a grocery store. As I stated previously, a highly publicized failure would be no worse than a nonpublicized failure (if it were the same failure), except for the damage to the reputation. In both cases, if the failure is the same than the occurance of failure is the thing that we should be concerned about when rating the effectiveness of a doctor. Having a success/failure rating would be beneficial in combatting that sort of problem.

 

[phattonez]

I think that the potential for it all to go wrong is greater in the medical field than in another small business such as a grocery store. As I stated previously, a highly publicized failure would be no worse than a nonpublicized failure (if it were the same failure), except for the damage to the reputation. In both cases, if the failure is the same than the occurance of failure is the thing that we should be concerned about when rating the effectiveness of a doctor. Having a success/failure rating would be beneficial in combatting that sort of problem.

Reputation is a huge problem. Jack in the Box lay dormant for a long time because of the E. Coli scare, as did Odwalla. Isn't Pat & Oscar's out of business now? Reputation would be huge for health care. Would you go to a place that just killed a guy because the surgeon did a little too much snip snip?

 

[Slartibartfast]

Reputation is a huge problem. Jack in the Box lay dormant for a long time because of the E. Coli scare, as did Odwalla. Isn't Pat & Oscar's out of business now? Reputation would be huge for health care. Would you go to a place that just killed a guy because the surgeon did a little too much snip snip?

I have been faced with similar situations in the past where I have gone into potentially life threatening scenerios, where something had just gone wrong, based on an assessment of the potential danger over the long term. So I guess I would.

 

[Chappy]

How do you feel about the line I quoted at the beginning of the Wikipedia quote that "There is no evidence that the mass of Americans were dissatisfied with this situation." …

“Absence of evidence is not evidence of absence.” — Dr. Carl Sagan​

 

[phattonez]

“Absence of evidence is not evidence of absence.” — Dr. Carl Sagan​

So then you would think that you would be able to find something that says that people were dissatisfied. I mean, the dissatisfied are usually louder than the satisfied.

The point is that I can't make an argument that they were satisfied and you can't make an argument that they were dissatisfied, there is no evidence either way. Arguing this point then is worthless because there is no evidence either way.

 

[phattonez]

I have been faced with similar situations in the past where I have gone into potentially life threatening scenerios, where something had just gone wrong, based on an assessment of the potential danger over the long term. So I guess I would.

And you think that you would HAVE to make this choice in healthcare, that you have no choice but the bad surgeon?

 

[Slartibartfast]

And you think that you would HAVE to make this choice in healthcare, that you have no choice but the bad surgeon?

I don't understand the question.

 

[Chappy]

The medical profession had changed so dramatically that a two year training program was no longer judged sufficient by medical practitioners at the beginning of the twentieth century. Today medicine continues to evolve, becoming more effective and more complex. Costs have increased because of those changes. The idea that medical school certification requirements is a principle or even a significant cause of higher medical costs is ridiculous.

 

[Chappy]

So then you would think that you would be able to find something that says that people were dissatisfied. I mean, the dissatisfied are usually louder than the satisfied.

The point is that I can't make an argument that they were satisfied and you can't make an argument that they were dissatisfied, there is no evidence either way. Arguing this point then is worthless because there is no evidence either way.

You seem to be saying people must have been satisfied because there's no evidence they weren't. But that's not how logic works as Carl Sagan so elegantly pointed out. It appeared you were attempting to make an argument from ignorance, which is flawed reasoning. Now you're saying that we have insufficient information to know whether people were satisfied or not, to which I say, “Good thing, you shouldn't have brought it up in the first place.”

 

[LaMidRighter]

I don't think that restricting the number of healthcare practitioners is necessarily a bad thing. Prehaps it is a bit overdone, but having professional standards and a selection process whereby the best candidates are taken increases the quality of care, and avoids a supplier-induced demand for healthcare services. . For those who point out that there is mal-practice and mistakes by those who did get chosen, I could only imagine it would be worse if it were expanded to everybody who just wanted to get into a program.

I've personally had 1/3 of my physical therapy class drop out because they could not meet the requirements set down by CAPTE to continue in the program. I don't think dropping the program guidelines so we could have more therapists would necessarily have been a good thing for the healthcare industry or the profession of physical therapy.

Well Crip. Here's the thing, I don't consider the "washout" process to be compatible to the artificial limitation. I would argue that 1/3 would still wash out under a more open enrollment of medical students but it would be a net positive because the pool graduating and going into residency would still increase. I favor more supply for ever increasing demand and absolutely think reintroducing more free market principles would be a great improvement in cost:quality.

 

[Orion]

I just thought I'd shed some history on the matter.

In the pre-civil war era there were three major schools of medicine in use in what is now the Eastern U.S.: industrial based medicine, homeopathy, and the school of the ecclectics. They all developed independently from one another after the establishment of the first colonies. The civil war saw the need to use medicine that was fast acting, had immediate results in symptomatology, and could get soldiers rehabilitated fast enough so that they could be sent back out into the field. In the non-war front, people relied on all three types of medicine, the school of the ecclectics being the forerunner. Apothecaries had known and trusted remedies from all three schools and the public was free to choose. The ecclectics relied on interaction with aboriginals and lab based testing to understand the nature of plants and their wide range of strong effects on the human body. The homeopaths were about utilizing plant essences to trigger subtle reactions in chronic conditions. Industrial medicine believed that not all components of the plants are useful, and therefore only the useful components should be removed and used in concentrated forms.

When the civil war ended, industrial medicine was ahead because it had received the most funding during the war. Eventually this progressed to the creation of the AMA which received full sponsorship from the government. It was at this time that the U.S. formally chose industrial medicine as its standard for healing. The AMA then systemically shut down the other two schools through propaganda campaigns, and established a precedent of harsh rivalry between three systems that were formerly seen as complementary. Attacks on natural medicine became common even though industrial medicine was still sourcing its concentrated extracts for medications from traditional knowledge of plants and their uses.

Homeopathy fled to Europe for the better half of the century where it continued to develop and now we are seeing a gradual resurgence in North America. The school of the ecclectics went extinct because their entire knowledge was based on North American plants, so they had nowhere else to go. Their schools were shut down and the remaining practitioners were either forced underground or were arrested for not practicing medicine that was 'scientifically sound'. The claim was ironic given that the ecclectics actually used scientific methodology, such as double-blind testing, to examine the effects of plants. Their philosophy differed because they believed the whole plant was more effective than its individual parts, whereas industrial medicine wanted to extract and concentrate what they believed to be the 'active ingredient', and put it into a pill form at concentrations that would never be experienced in nature. (This is where all of the 'side effects' come from.) Because the school of the ecclectics also threatened profits due to its reliance on wild plants (which you cannot patent legally), it was necessary to eliminate them. All of the ecclectic literature from that era thankfully still exists, which has led to a modern movement of neo-ecclectic herbalists; unfortunately, the entire lineage of the original practitioners no longer exists and so a great deal of knowledge has been lost.

The AMA then became the standard for the U.S., and only people who were under its tutelage could receive the political title of "Doctor". I disagree with the assertion that Americans chose the AMA and the non-universal approach. It was essentially sponsorship of industrial medicine along with its high ranking profit incentives that lead to capitalistic style medicine. Until the other two schools of medicine were eliminated, most people had at least a basic understanding of what plants in their environment do for health, and those plants were free of charge. Industrial medicine was always the more expensive, but it was the best stop-gap measure if you had an emergency situation, or required immediate surgery (and it still is to this day); but as the AMA knew, people would not pay for it if they could turn to the other schools, or nature, for far cheaper remedies.

Look at today's North American society. Hardly anyone knows anything about the plants in their locale. If the world ended today and we no longer had pharmacies, people would not know how to seek healing in nature. Almost all of the traditional knowledge has been wiped out from our society. This is why it's important to understand that the American people did not choose industrial medicine or choose to have to dish out personal money at high cost for treatments. They were convinced in literally one generation that plant medicine was evil and dangerous through the suppression of the other schools, and that only the AMA could provide sound medical advice.