What happened to smearing your turd on a card at home and mailing it
in?

PF

It amazes me that so many supposed physicians-- you, Harris, Riley,
Howard, the Chinese cardiologist, CBI, etc-- have so much time to
argue their points on usenet. Obviously their job frustrates them so
instead of calmly addressing the issue they (or in this case anon)
resort to name-calling. Physician heal thyself!

As to the point in question, if you don't believe me maybe you should
check out the codes themselves and ask yourself what level of risk
this or that element of the code is eliminating and then consider for
what other reason the code might exist. For example (since we used a
plumbing example) for many years the building code in NYC (a heavily
unionized and guild-ized city) required the use of cast iron and
poured lead joints for all DWV despite the fact that the rest of the
country and especially those non-unionized non-guild areas had long
ago changed to PVC.

For your information PVC is so much easier to install that anyone can
do it and in time it costs (varying estimates) from a fifth to a tenth
of the time to install as does cast iron. That means a fifth to a
tenth of the plumber's time and the risk that some unlicensed handyman
might do the job. But those weren't the reasons advanced for the code
provision. Nah, it was that PVC might crack under tension and spill
live sewage all over the place or that the PVC might degrade and
crumble in sunlight or that fire might burn the PVC releasing toxic
chlorine gas and killing the inhabitants (images of troops in WW1 were
frequently used).

Of course there's a smidgen of truth in all three. PVC does crack
under tension but usually it's a tiny crack or a huge bang and it will
be immediately visible to the installer. It does degrade in sunlight
and crumbles but few DWV lines are in sunlight, the only part is
usually that that pokes through the roof and everyone recommends
painting that part. Even if you don't the deterioration will be very
slow and if totally ignored the symptom of slow pipes will point to a
need for replacement. And the question of chlorine gas? If you're
worried about a small quantity of piping behind one-hour-rated
sheetrock instead of that PVC-covered furniture out in the open your
priorities are out of kilter. To get to the pipes, flashover would
have had to occur and you'd be dead anyway.

No one (at least not on the guild side) pointed out that cast iron
rusts and crumbles and that it too can crack under stress and that
there's some risk to both the homeowner and the plumber in pouring hot
lead joints from the fumes and the burns.. and then there's the
instances of fire where the lead heater is overturned...  

Well eventually, with so many home owners and handymen simply ignoring
the code and putting in PVC and even plumbers using it (they didn't
like pouring lead either) the Board of Estimate (who are responsible
for the code in NYC) wilted and allowed PVC for dwellings up to three
stories in height. Commercial establishments and apartment buildings
still have to use cast iron but I believe they're now permitted no-hub
couplings. You see plumbers don't make too much from individuals but
they need to keep the businesses where the real bucks are.

Should I go on about the current fight over unvented gas space heaters
(they threaten not only the HVAC people but the gas suppliers), or BX
vs NM, or the use of PEX, or flexible gas connectors, or arc-fault
circuit breakers? Nah...

The epidemiologists had their moment of glory in London with the
cholera-contaminated well, the FDA in driving the real snake-oil
salesmen out of business and cleaning up the slaughter houses in the
early 1900's, and most building codes in stopping the obvious hidden
dangers in the first half of the twentieth century but all have taken
on a life of their own to preserve various vested interests. No
conspiracy theories, just fact.

And just how would you know that? Oh, I know, it's that god-like
characteristic which seems to afflict most physicians after a while.
Naturally being deified you can read the minds of the supplicant,
er...patient.. as he grovels for a tiny bit of relief from his pain.
Doesn't work over the internet.

As to the point, I'm simply saying that it's perfectly reasonable to
require a car-owner to submit his vehicle for inspection to the
appropriate authority: it's not reasonable to require him to submit to
the physician's wishes no matter how well intentioned. Fortunately we
have yet to descend to the level of the old Soviet Union where if you
didn't agree with the state, you must be nuts and therefore subject to
compulsory medication...in your best interests of course.

If you say so.

Hmmm, "clueless turd" eh? I hope your beside manner is a little better
than it would appear from your writing skills.

Consequence has nothing to do with it. The question is really "Who
decides?" You and your friends seem to think that you have some
control: I say the customer has the sole right of decision.

Is this why you're so hot under the collar? The big bucks? Hmmm... if
the OP had no money and no insurance would you be so keen in giving
him a DRE? No? Just natural selection at work I suppose.

As to your overall point, you're wrong. A mixed system is quite
possible and feasible. What it's doing to you with a tiny bit of
competitive free market is to drive your income down to a more
realistic level. You may not see it as realistic and in fact may feel
stiffed because you spent all that time at medical school and all
those bucks and all those underpaid hours as an intern but the facts
are that the earnings of lots of physicians are way way beyond what
Mr. Average sees as reasonable and the way to get them down is a
little old-fashioned competition.

Oh yeah, there's a little problem with the competition. It's not quite
like other businesses where you compete to gain market share and
increase profits by providing better service to the public. Here
there's an intermediary, the insurance company. I and my employer pay
big bucks every month so that the insurance company will find the best
value for money in physicians (I happen to pay a lot more than I use;
it's by no means free). But unfortunately for you, you're finding that
they're bigger than you are. You went from a non-compete nice little
god-like situation having banker's hours to... whoosh... being
pressured by the monopolistic insurance company (effectively) on
behalf of the powerless customer. Couldn't happen to a nicer group.  

You could do what the French do: go on strike. Or you could pressure
the government to make those big bad insurance companies pay you more
money. Unfortunately medical charges are not viewed too kindly these
days for which state of affairs you can thank Big Pharma (for whom you
work anyway <g>). Or you can just rue the day you decided to become a
physician (you should have been born 20 years earlier or become a
plumber <g>) and say "Serves them right" when the medical schools are
no longer graduating new doctors and the public has to line up for
days to have a DRE. Or, maybe you should consider medicine a calling
instead of a business. We haven't had too many Albert Schweitzer's in
the last few years. Either way customers (patients to you) are going
to get more rights, insurance companies are going to squeeze you even
more, and ungrateful SOB's such as myself are going to irritate the
hell out of you.