Deep enlightenment for the discerning

Congratulations

You have wisely chosen to pursue the Second Pathway to healthcare enlightenment.  By doing so you have demonstrated a keen curiosity and a healthy skepticism, both of which will serve you well in your quest to survive - and even flourish - within the American healthcare system.

Here you will find a solid background for understanding how the healthcare system operates. With this background, you can begin to predict how the healthcare system will react when you interact with it, and to tailor your decisions and actions to improve your chances of getting what you need, when you need it.  

It is certainly true that if enough Americans become sufficiently enlightened, and as a result begin taking the steps necessary to protect themselves, they will catalyze a fundamental reformation of our healthcare system.  However, this fact is completely incidental to the purpose of the Second Pathway. (It is not so incidental, by the way, to the Third Pathway, that is, to my book, Fixing American Healthcare - Wonkonians, Gekkonians and the Grand Unification Theory of Healthcare. But on this website we're just trying to get you up to speed on what's really going on, so as to help keep you alive.)

We will begin our journey down the Second Pathway by getting right to the heart of the matter, to the one basic concept every American patient needs to understand. We start by considering the critical importance of the doctor-patient relationship, and why we can't have it anymore.

From there, we will examine the essential truth that underlies everything that happens in the American healthcare system - the covert rationing of healthcare.  It is covert rationing that mandates the destruction of the doctor-patient relationship. But even beyond that original sin, covert rationing fundamentally requires a Byzantine healthcare system that thrives only in an environment of obfuscation, confusion and inefficiency. If our healthcare system were not already chaotic, covert rationing would require us to make it so.

We will then survey how covert rationing profoundly affects the daily experiences of the American patient. Covert rationing drastically alters the mission of the modern managed care organization.  It converts federal healthcare agencies from benign and protective watchdogs to snarling packs of carnivores.  And it corrupts the foundational American ideal of the primacy and autonomy of the individual.

When you have finished this journey along the Second Pathway, you will at last understand just how isolated and vulnerable you have become within the American healthcare system, and just how much that isolation and vulnerability has been purposeful, not incidental.  

At the same time, however, you will begin to see the weak spots in what may now appear to be an intimidating American healthcare monolith.  You will see how, by taking appropriate individual action, you can regain a position of strength, and thereby force the healthcare system to deliver to you what is rightfully yours. For the one thing our system of covert rationing cannot simply brush off is a confident, assertive, enlightened and knowledgeable patient.