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Dr. David McKalip, is a St. Petersburg neurosurgeon, president-elect of the  Pinellas County Medical Association, a board member of the Florida Medical Association and President of the Florida neurosurgical society.  

You might recognize McKalip as the author of this Op-ed piece written for the St. Petersburg Times, or this letter to the editor.

Maybe you recognize his work for Lew Rockwell.  

It's possible you heard McKalip's presentation to the Glenn Beck-inspired South Pinellas 9.12 Patriots.  

Perhaps you saw him on Youtube:

When he isn't busy going Galt, or writing misleading screeds attacking the president's health care insurance reform, David McKalip relaxes by circulating tasteless and offensive picture portraying the president as a witch doctor (complete with bone through his nose).  That certainly seems like odd behavior for a man who is president-elect of a professional association like the Pinellas County Medical Association (Mission: To inform, serve, and advocate).

In an interview with the Miami Herald following the public outcry over his completely inappropriate, outrageous, and insulting behavior, David Mckalip dismissed the criticism by saying,

Because I've been so effective in pointing out how the government plans are going to hurt patients in very serious ways the only way they can neutralize my message is to discredit me personally.

Let me spike that nonsense right now.  If David McKalip simply had a bad sense of humor, or a momentary lapse of judgment, or even if he was culturally insensitive... that would not be worth much comment. However, Dr. Mckalip trades on his professional reputation and credentials to claim expertise in the area of "medical economics" while promoting as true stuff that is false.

Pretending the debate is about government-run health care, when it is really about government managing the cost of health care insurance is a classic bait-and-switch gambit.  Pretending the Obama administration is advocating "single payer" healthcare when it promoting a "public option" is just another variation on that theme.  This sort of bait-and-switch chicanery deserves to be debunked.

Let's begin with his recent letter to the editor, titled Government Would Offer Inept Care.  It'd hard to defend the false assertion the government will be providing any care, but McKalip goes after this straw man with a red herring.   To make his case, McKalip points to "the Pentagon's $900 hammers and $1,500 toilet seats" as evidence the government cannot be trusted.  He then goes on to make the scary claim that "Medicare will soon resort to rationing to make ends meet."   His solution?  

The answer is to put $1,000-$10,000 annually for routine annual health care in the hands of individual patients through tax-free health savings accounts.  HSA holders now have lower insurance premiums, better care and improved wellness. Their insurance backs them 100 percent for catastrophic medical events that occur rarely.

To paraphrase Jon Stewart, "Oh Reaaaalllly?  Do go on..."  Let's see how McKalip develops his argument in his subsequent Op-ed titled, Rationed Care is Bad Care.  As I've said before, McKalip trades on his credentials as a physician to establish credibility as a medical economist.  You may think I am making an attribution.  No, I am quoting him:

Patients have enjoyed confidence in their doctors through the sacred patient-physician relationship designed to minimize their suffering and prolong their lives. In short, they have been able to trust their doctors.

Having established himself as a self-proclaimed trustworthy source, he then goes on to deride current efforts at health care insurance reform, saying

This is the kind of cookbook medicine that American physicians have fought for decades to prevent since FDR.

How does he justify that? By conflating government and insurance companies.  In his mind, they are partners in this scheme.

today's problems with high costs and access to care have occurred during the domination of medical payments by the government and insurance companies.

He then goes on to claim

Congress and the president are trying to use myths to convince you to further trust the government. For instance, they claim there are 47 million uninsured Americans when 9.7 million of these people are not American citizens. While there are less than 5 percent of people who declare bankruptcy for medical reasons, the president claims there is a "medical bankruptcy every 30 seconds." This would mean more than 1 million per year when there were less than 825,000 actual American bankruptcies! Some claim we are 37th in the world for infant mortality when many countries don't count premature babies that Americans try to save.

Let's take the last one first.  McKalip betrays his confusion.  The claim he is debunking was made by WHO.  They ranked us 37th in overall health care.  I think when it comes to the matter of health care, they have a bit more standing than a neurosurgeon.  On matters of infant mortality, even the CDC doesn't support his claim.  

In 2004, the latest year for which worldwide data are available, the United States had a higher rate [of infant mortality] than 28 countries, including Singapore, Japan, Cuba and Hungary. In 1960, the United States had a higher rate than only 11 countries.

That is down from 23rd in 1990.  When our rate of infant mortality is losing ground ot other countries, there is no question the system is deteriorating.  At best, it is not keeping pace with its peers.  So much for delivery.  This undercuts one of McKalip's main points.

For decades, American physicians have provided the best medical care in the world.

Contrary to McKalip's unsubstantiated claim the American health care system is not the best in the world.  However,  we do lead in one area.  We are the most expensive system on the planet.  That brings us to McKalip's cost argument.  Without any evidence, he makes another fatuous claim that less than 5 percent of people declare bankruptcy for medical reasons.  Again, the ole bait-and-switch.  No one declares bankruptcy for medical reasons.  However, several studies have shown that medical costs are the largest driver of personal bankruptcies.

This is an area that Obama explicitly addressed in great detail during his press conference.  As a reportby the Commonwealth Fund noted,

  The administrative costs of the medical insurance system consume much more of the current health care dollar, about 7.5 percent, than in other countries.

Bringing those administrative costs down to the level of 5 percent or so as in Germany and Switzerland, where private insurers play a significant role, would save an estimated $50 billion a year in the United States.

That is precisely why the Obama administration is focused on creating a competitive environment in the health care insurance industry.  However, if you listen to McKalip's Youtube clip he misleadingly paints the efforts of the Obama administration as a "single-payer" system.  Again he uses that to raise the threat of rationing.  This is a favorite theme of his in all his writings.  Like any good Ayn Rand acolyte, McKalip argues for the individual solution, promising the following miraculous benefits:

Instead of expanding control of third party payers -- the same parties responsible for our current mess -- we can put the control of health care financing right where it belongs: into your hands.  Right now, you can buy a low cost health insurance package and fund your own private health savings account with tax free money. You can use that account to bargain for lower prices from hospitals and demand that your doctor spend more time with you and explain how you can be managed without every test and treatment they can provide.

Who knew going Galt comes with added benefits?  All you have to do to get these benefits is fund your own private health savings plan.  You will do more than save money.  You will also get to serve as your own advocate, operate as your own attorney and doctors will magically change their standards of practice to meet your demands.  

When you write for Lew Rockwell, you can make false claims without fear of contradiction.  However, that is not the case when you publish the same nonsense in a daily paper like the St. Petterburg Times.  Here are a particularly biting response to Mckalip's column:

Having represented injured and ill persons in my law practice for more than 37 years, I have to wonder how Dr. David McKalip has managed to miss the "rationing" of medical care which has been with us my entire life.

For starters, people without insurance certainly know only a weak dribble of care gets through the supply hose to them. This is because our society has elected to ration America's limited medical care primarily to those who have insurance or enough money.

Then there are those who have been injured on the job and frequently have to beg to get what they require unless they have an attorney serving as a battering ram.

Even the insured patient faces the back-office preauthorization team at the health insurance company and the forbidden drug list. Some procedures and drugs, judged to be necessary by many doctors and patients, aren't available because they cost too much.

We are delusional if we feel "rationing" has not been with us for many years. The present system is simply the capitalistic method of rationing that assures the best care for the well-heeled among us. Referring to this system as "the sacred patient-physician relationship" may allow our medical providers to feel good about themselves, but it is, unfortunately, a snow job.

-- Robert J. Carroll, Palm Harbor, FL

At this point, the only question I have for David McKalip is this:   Why don't you put your money where your mouth is?  When are you going to really go Galt ... and disappear?

Originally posted to henry porter on Fri Jul 24, 2009 at 10:06 AM PDT.

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