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I urge all of you who support healthcare reform to write your U.S. representative and senators. You should write even if you do not support reform, because that is how the system works. Of course, political forces can do only so much to reform healthcare, but it is a good start.

Our representatives are facing a lot of pressure from interest groups and need to know they at least have the support of their people at home. Here is the letter I sent to my congressman:

Dear Fred Upton:

Alexander Typaldos

The Millennium Bridge of London was completed in 2000, hence its name. However, the bridge is better known for a lesson it provided in synchronization. Opening day for the pedestrian-only suspension bridge saw thousands of visitors crossing at once. Unexpectedly, the bridge began to sway back and forth, or oscillate sideways.

Videos of the event are surreal because you can see thousands of pedestrians walking in step as they cross the bridge – rocking left and right in unison to keep their balance. The reason for this synchronization is that each individual pedestrian, when he walks, contributes a little force that causes a slight oscillation. Because each pedestrian’s steps are random at the beginning, more pedestrians will inevitably step in one direction than another at various times. When this happens it causes the bridge to sway slightly in the direction of greater force.

A few more people will recognize, perhaps subconsciously, that the bridge is rocking and they themselves will rock back and forth to keep their balance. It so happens that the same motion that keeps an individual balanced also powers the oscillations, increasing their amplitude. This process accelerates until all individuals are synchronized, therefore maximizing amplitude.

In the case of the Millennium Bridge, oscillations were so forceful that pedestrians might have fallen down had they not walked in step.

Individual Rationale

The most crucial point to learn from the example is this: The decision that is in the best interest of each individual opposes the good of the aggregate; and that, in turn, harms each individual.

This is exactly the situation we have in healthcare at present. Physicians, insurers, employers, hospitals, and patients all want changes. They are swaying back and forth in a shaky system, perpetuating its inadequacies just to keep their balance. Yet they are powerless to change the system as individuals or even as entire interest groups.

A Coordinated Response

If the pedestrians on the bridge had formulated a system of two groups – each walking in sync and opposing the other group’s side to side steps – oscillations could have been reduced. This would never have really worked, though, because Londoners enjoyed shaking the bridge! (And that is perhaps another lesson in itself.)

Instead, the builders installed dampers to absorb shock. And they succeeded at eliminating all noticeable oscillations.

Alexander Typaldos

If all take, no one will have anything of value. If all give, everyone will have everything. Things of value are not primarily material. They are the kindness we show to one another; the services we offer, with or without recompense.

Some Americans on the conservative end of the political spectrum think that anyone who has food, a place to live, and modern appliances is in no position to complain about their lot in life. After all, many in this world go without those basic necessities. But the argument is flawed for assuming the only things people need are basic necessities, as if our purpose is merely to self-perpetuate. By this assumption, conservatives of this type reveal their gross misunderstanding of human nature.

When someone’s boss chews them out at work, how much solace will they find in their washer and dryer? When a person is struggling with weight issues, try telling them they have no cause to complain because they have enough food to eat. Do walls and a roof overhead shelter from an abusive spouse or parent within? Can a television set become someone’s friend?

An all-pervasive problem in America

Right-wing conservatives who have worked their way to success, as they define it, may be the most blatant promoters of this fallacy. But they are not the only ones. On the other political end are the liberal unions, who grasp as much pay and benefits as they can, even manipulating the hand of government to fill their pockets. All the while, they justify their own abuses with tales of corporate greed and management excesses.

Unions’ true motives are revealed when they compete with non-union workers for limited benefits. Pilot unions have shown they are willing to use aggressive negotiation tactics to get as much pay as possible, without remorse for other airline workers who have taken corresponding pay cuts.

Lawyers have pushed to make it illegal for anyone without a license to practice law. The goal is for the profession to maintain a monopoly on legal services, although most educated people could practice law competently with a bit of experience. For the same reason, doctors use Latin and Greek words to obscure the otherwise familiar. Musculus quadriceps femoris, for example, literally means “four-headed muscle of the thigh” in Latin. The idea is to place a gap in between “professionals” and “laypersons” that perpetuates a doctor’s role in society.

Bulwarks of the Ivory Tower

When it comes to self-perpetuity, America’s higher education community is our worst offender. At least doctors, lawyers, and workers unions provide valuable services. Academic researchers often concoct studies solely to receive government grants and recognition within their academic community. This life is great fun for the right person. They can engage with intelligent scholars who share similar interests. And they are immune from the economic pressures of the business world, or the workload of primary and secondary school teachers.

It is so much fun that students themselves endeavor to stay in school – lengthening programs, doubling majors, turning masters into doctorates.

But is this community good for society? It might be if the focus of academia were on real-world issues. It would help if doctors and other professionals could dictate what they study. We live in a relatively wealthy society, so we are able to set people aside to explore their interests without a need for immediate productivity. And there is nothing wrong with that concept per se.

Problems arise, however, when these people, whom society has blessed with perpetual capital and no immediate demands, forget their duty to society, however informally it was stated. Then academics become takers, not producers, who stretch the truth to keep funding. As often as we hear claims of potential cures for paralysis and degenerative diseases – and even aging – how many cures do we actually see?

As a society, we have been led on by academics. It is too risky to grant capital without effective oversight. Reputable as an individual or organization may be, they are still capable of betraying our trust when no one is watching.

Acute form of self-perpetuity

The above examples are the chronic form of self-perpetuity. They are systems people create or modify to preserve and perpetuate their own viability, livelihood, and reputation. However, there is also an acute form of self-perpetuity.

Bargain-basement shopping, one-sided contracts, medications that only treat symptoms – these are ways that supposedly enhance and perpetuate one’s existence incrementally. Far too many people willingly enter into deals they know are unfair to the other party, reasoning it is that other party’s responsibility to look out for himself. People who habitually use symptom-reducing meds and max out credit cards go so far as to cheat their future selves, as they would another person.

Basis of Many Conspiracy Theories

Conspiracy theorists, bless their hearts, are oftentimes simply trying to make sense of systems that appear so diabolical that they must be the result of high-level conspiracies designed to kill, brainwash, and exploit the masses. In fact, theorists are attempting to project blame onto a few individuals for a problem closer to home.

Daily, Americans are faced with a choice: Am I going to do what helps me or what benefits the society I live in? When citizens of this individualistic nation, on all levels, systematically choose the former option, the results are indeed diabolical. But we cannot place all the blame on a few people in positions of great responsibility.

The prevalence of AIDS is largely the result of personal choices. Our economic crisis is not the fault of the Rothschilds any more than reckless investors, predatory lenders, and overreaching consumers. Conspiracy theorists will understand these references.

Checks and Balances

It might make for a touching conclusion to appeal to the good in people’s hearts. Unfortunately, that is just not practical. Instead, we need effective systems of checks and balances. Everyone must report to some authority, whether a parent, teacher, employer, law enforcement officer, or congressional committee. In our nation we have rejected the very concept of authority, probably because of rampant abuse of this power in past generations.

People should be viewed as self-interested and self-perpetuating individuals whose selfishness must be continually held in check.

In conjunction with these systems of checks and balances, we as individuals need to learn how to view our lives differently. We are interconnected with those in our society through frameworks of community. A framework can be regional, professional, religious, political. And within each of those frameworks we have a responsibility to use our influence in ways that benefit the group as a whole, not our own personal interest or our family’s alone.

Thus, effective systems punish takers and reward givers; oppose self-perpetuators and support community-minded individuals. The most effective force of all to influence behavior of citizens in a free society is the values that society holds. If wealth is valued over honesty and a good job is valued over politeness, people will lie to make a sale and shaft their way into a promotion. If war is unpopular in this country, America’s youth will shun military service.

Fascial Distortion Medicine’s American Dilemma

Self-perpetuating mindsets are the single greatest hindrance to the spread of FDM in the United States. It offers so much to patients yet so little to physicians. Here is what we tell doctors, MDs and DOs: “If you use FDM you can’t see as many patients or make as much money. You will tire yourself out doing the treatments. And you’ll look silly to your colleagues. But your patients, they will love you! You can be a miracle worker, a life saver in their eyes.”

Physicians respond, more by deed than by word: “What’s in it for me? If I can help patients by making little or no sacrifice, I’ll do it. But when it comes down to helping patients or taking care of me and my family, I’ll choose me. Every time.”

Well, patients are choosing “me” too, and a new healthcare system is coming. Indeed, America has systems of checks and balances. What we need now is the right values.

Alexander Typaldos

It is easy to point out what is wrong with healthcare. It takes somewhat more thought to discover why those problems exist, and still more thought to make policy recommendations about how to solve the problems. Here is such a recommendation, one that will improve healthcare financing. If your agenda is to shrink government, you will dislike this proposal. If your agenda is to enlarge government, you also will shun this proposal. However, if your agenda is to create a system that works for most Americans and is sustainable in the long-term, you may find merit in this plan.

Auto Warranty

Health insurance is more like a car’s warranty than auto insurance. Third party liability, as exists in auto insurance, is not envisioned in health insurance. It offers only the equivalent of “collision” coverage, which covers damage to your own vehicle in an accident without regard to fault; plus a warranty covering damage to parts and systems during normal use.

There are two types of car warranties: powertrain and bumper-to-bumper. Powertrain warranties cover the engine, transmission, and drivetrain – the components necessary to “power” your car. Bumper-to-bumper warranties cover almost everything, including the powertrain.

Powertrain Health Insurance

When discussing health insurance, it would be useful to differentiate between “powertrain”-type health insurance and full “bumper-to-bumper” health coverage. Here are definitions of the terms:

Definition of Powertrain healthcare: insurance covering treatment to a person’s vital organs and systems if it is necessary to maintain the person’s life and basic functions.

Definition of Bumper-to-bumper healthcare: insurance covering the full spectrum of non-elective treatments that are reasonably expected to improve a person’s quality of life.

Details can be worked out. We may want to include treatments for Type I diabetes but not Type II, for example, in powertrain coverage. For the broader purposes of this article, the category of treatments now considered “medically necessary” is being split into two categories, vital and non-vital. These definitions disregard whether a condition is an emergency. This means regular ECGs are more likely to be covered than a fractured ankle under a powertrain plan.

Role of the Federal Government

Powertrain issues – heart problems, cancer, stroke, Alzheimer’s – destroy lives, put people out of work, and bankrupt families. This area is where Americans need help from their government. Limitations on treatments for life-threatening and disabling conditions are more often a product of availability than price. Therefore, the quality of care has little to do with who pays.

The U.S. government should provide powertrain coverage for all Americans. However, it should leave additional bumper-to-bumper coverage to businesses and individuals if they so choose. It should also make self-insurance for bumper-to-bumper conditions a viable alternative.

Big Government versus Small Government

Here is an enduring debate between fiscal liberals and conservatives. Each side would love to savor the taste of victory. Unfortunately for both sides – and perhaps fortunately for our nation – this debate is unwinnable.

Usually, when two sides are deadlocked or engaged in a back-and-forth over long time periods, it is because neither side is addressing the real issue. The question to ask in this debate is how big does government need to be to fulfill its role effectively? The size our government needs to be is the inverse of the private sector’s effectiveness plus the square of its corruption, written in the formula: Size of Government = (Size of Overall Economy - Private Sector Effectiveness) + (Private Sector Corruption)².

Corruption is squared because as it increases, it is seen as more acceptable; and there is less will within the private sector itself to discourage and expose corruption. Of course, this formula applies to government involvement in the economy only, not in social or foreign policy matters.

Problems with National Health Coverage

What turn off many Americans are anecdotal complaints from citizens of nations having a form of national healthcare. Most of these complaints center on two problems, rationing and lack of choice. The problem of rationing is really a blessing in disguise. When people think that if they become ill they can have access to quality healthcare, they are not as inclined to care for their bodies. This concept is no doubt unpopular, but it is established truth in the insurance industry. Rationing is therefore desirable in a national health plan.

Lest anyone think rationing healthcare is totally unacceptable in a modern society, understand that if we do not control rationing, the system will ration itself – and it may not be in a way that we would prefer. Healthcare’s growth as a percentage of GDP is unsustainable. Soon society, including the federal government, will no longer be able to pay, and services will diminish. And even now, the idea that Americans with health insurance have ready access to quality care is a myth. Many Americans hold onto this myth until they or a family member becomes ill. It is then that the reality of healthcare’s limitations becomes apparent; and oftentimes, prevention offers no second chance.

A Pro-Choice Policy

Perhaps the most important healthcare choices are vital in nature. However, on a practical level, the choices Americans really care about are in non-vital matters, such as who their family doctor is and whether they get access to new medications. Life and death matters requiring procedures such as kidney dialysis, appendix removal, and insulin injections are not what they think of when asking for more healthcare choices.

This proposal preserves these choices by limiting government-sponsored healthcare to matters of vital importance, where there is general agreement about proper methods. This broad outline leaves room, as well, for building choices into a government insurance plan.

Perfection is out of reach

While it is utterly impossible to develop a system that satisfies the desires of all Americans and interest groups – so long as corporations profit from bad care, and Americans live dangerously unhealthy lifestyles – it is still quite easy to create a system better than the one we have now. Therefore, you should view this proposal as a new perspective; a different, and perhaps better, way of seeing the issues. This is not a quick fix. Anyone who tells you they have found a quick fix to healthcare is lying. There are just too many factors to consider.

The foremost factor in healthcare reform is the false, illogical theories upon which the medical profession is based. Until medical theory and practice are reformed, tinkering with the financial and business aspects of healthcare will accomplish little. This does not mean we should replace “conventional” medicine with “alternative” medicine. Nor does this mean we should take the best of both schools and form hybrid practices. Rare is the person who does not subscribe to one of those two camps. Alternative or “complementary” medicine is no longer a catch-all category for rejected methods. Instead, it has become a defined, competing branch of medicine; sadly, with illogicality similar in degree to that of conventional medicine.

Instead, what this means is that we should set aside ambiguous studies and marketing claims, and go through the evidence – studies, patient testimonies, physicians’ observations – with an eye for correlations among facts. Patterns of correlations can be used to theorize. Then we test those theories, not only with double-blinded placebo-controlled studies, but by logical, rational, and reasonable analysis. Are patients responding the way we would expect them to? Are there any symptoms that cannot be explained by our theories?

Tested theories are truth. They do not become truth because truth was present already; it was found, if you will. Various truths can be placed within a framework and cohered. When there are enough truths known in a particular branch of medicine for them to present as a mental image, they can be intellectualized into working models. Such are a physician’s most valuable assets. Technology, formal education, facilities, and skill are dwarfed in significance when compared to reliable medical models that explain why patients get sick and suggest what needs to be done to help. Penicillin would have been useless without the germ theory; or never discovered in the first place.

Many of the treatments in both conventional and alternative medicine are working for reasons other than the ones physicians think. Conversely, treatments physicians claim will work do not for reasons they cannot explain. This indicates, to those who are analyzing evidence logically, rationally, and reasonably, that their models are incorrect. All this talk about truths and models might appear abstract and even irrelevant. However, the Fascial Distortion Model reveals that once physicians correctly understand disease and injury processes, successful treatments will naturally follow. Models, theories, and philosophies ought to be discussed and debated openly, for they are the gems of healthcare reform. Financing is the gold in which they are set.

Automotive Safeguards

Here in Michigan and in other states too, auto repair shops are required to present a written estimate of repair costs. This law prevents an awkward scenario where a car owner discovers, to his dismay, that charges are far higher than he expected. A similar law would be nice in the healthcare industry. Granted states do have laws requiring doctors to post their office visit fee schedules, but this applies primarily to out-patient care.

When it comes to emergency and in-patient care – and prescription medications – patients can do little more than cross their fingers, hoping the hospital bill is not as bad as their reason for the visit. The argument for “surprise billing,” presumably, is that the patient’s health is more urgent and important than financial matters in a crisis. This may be true, but anyone who has gone to the Emergency Room with anything less than an immediate, life-threatening condition will tell you they always find time beforehand to check your insurance.

It is a principle that systems operating behind closed doors are easily subject to corruption. In the healthcare industry, openness is compromised not only by entrenched interest groups, but by the system’s sheer complexity. It is well nigh impossible for any single entity other than the federal government to oversee it. This is not to say the government is unsusceptible to similar corrupting forces. Therefore, a form of national healthcare such as powertrain coverage should be seen as merely the beginning of reform; logical, rational, and reasonable medical models as the end.

Alexander Typaldos

I have received a lot of feedback about making the textbook available online – sadly, most of it negative – so it is probably a good idea to explain the decision in more detail.

Let us start with the major pros, as enumerated by me:

1. Practitioners who cannot afford the textbook can now read it (provided they have Internet access). This may be the case in developing parts of the world.

2. Curious physicians and patients who would not purchase the textbook, but still want to know about FDM, can read directly from the words of the originator.

3. We are trying to change medicine, not sell a gimmick. Thus, we should make FDM as readily available as a scientific research paper, rather than protecting it like a business trade secret.

Now here are the major cons, as enumerated by everyone else:

1. Lowering the price of the book will lessen its value in the eyes of readers. This is a legitimate concern, for it is human nature to assign value to cost.

2. Any Joe can go online, read the book, then mix TMT with his own nonsense. Actually, a free download can prevent this by letting Joe’s patients and colleagues see for themselves what the FDM is and is not.

3. Lost income from book sales will slow the advancement of FDM. The textbook is still for sale, and I do not want anyone who uses TMT to read the textbook online without purchasing a print edition, if they are able to.

Based on these arguments, what would you decide?

I think part of the difference of opinion is generational. The strongest opponents of this decision are at least 15 years my senior. Younger people here in the United States grew up in the era of computers. We believe information and intellectual capital – whether writings, music, or video – should be free and readily available in electronic form.

Differences of opinion are healthy because they keep organizations balanced. So I welcome all polite disagreements. However, the FDM is about changing the way physicians think more than it is about the treatment methods. This change also extends into the business side of medicine. Placing our methodology in the public sphere, to be critiqued and rebutted, is a step away from the norm in the field of manipulation. Placing our medical philosophy in the realm of debate is a rejection of the close-mindedness of all autonomous healing professions of today.

Alexander Typaldos