Why is it so essential to have a family doctor physician you trust? The answer is straightforward. Everyone needs a healthcare advocate who knows them, their family and their community, who understands healthcare and medicine, and can guide you when you’re sick and help you prevent avoidable diseases and early death when you are well. In a world filled with confusing medical information and profit-driven interests, having someone you can rely on to provide honest advice is crucial.

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During the pandemic, it wasn’t possible to know how states and nations compared regarding their management of the pandemic, because the disease spread in surges.  A state or nation that was doing well this week might be doing poorly the next.  The question always was, which place would have the lowest case fatality rate at the end of the pandemic — the lowest number of deaths per capita — after most people had become immune and pandemic spread stopped.  It was possible that our short-term strategies, like masking or social distancing, might have produced short-term benefits but no long-term mortality advantages.  Technically possible.  I wanted to wait until the end of the pandemic to see, because it is scientifically important to keep an open mind.

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​What does Flonase cost? $16 at Target.  $15 at Walgreens. $26 at CVS but for twice as many sprays.  But there is a generic that costs $9.69 at Target and $9.18 at Walmart and $20 at Walgreens.  I pushed hard and found five bottles for $25 or about $5 a bottle on Amazon and each bottle has 144 sprays, or twice as many as most other generics.  Which means it likely costs $1 to $2 to make.  (Interestingly, it costs $40 in Canada, where it is still prescription, so thank you FDA for doing at least one thing right and making it generic here.)

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The Mayo Clinic has hospitals in Rochester, Minnesota; Phoenix and Scottsdale, Arizona; Jacksonville, Florida; Abu Dahbi; and an outpatient clinic presence in dozens of locations across a number of different states and countries, including London. 

 

 

It’s a “non-profit organization committed to clinical practice, education and research.” It has $16.3 billion in revenue, $15.7 billion in expenses with an operating income – what would be called profit if it was a for-profit — of $595 million in 2022.  The budget for the State of Rhode Island, for 1 million people, was $15.1 Billion in 2022. The Minnesota budget for 2022 was $60 billion, for 5.7 million people, by comparison. 

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In the United States, we have a health care market, not a health care system that provides the same set of essential services to all Americans.  We’ve all gotten used to that – it makes for health care that is confusing and impersonal.  But most of us can’t figure out how to change it, so we suck it up and take what is dished out, and are grateful that emergency rooms exist to pick up the slack, so that most of us don’t die from trivial injuries or dread diseases, most of the time.  

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