All Commentary
Thursday, September 1, 1994

Book Review: Code Blue: Healthcare in Crisis by Edward R. Annis, M.D.

Regnery Gateway, 1993 • 278 pages • $21.95

Code Blue takes its name from the most common term used by hospital public address systems to signify cardiac arrest.

The announcement sends an assortment of specially trained personnel scurrying to the designated site. Modern techniques and technology, when given the timely opportunity, have been highly successful in restoring life.

While Code Blue is non-fiction, it certainly can be described as a “whodunit.” In fact, the title and cover would be suitable for a Robin Cook medical horror mystery. The protagonist in Dr. Annis’s book is the private practice of medicine, which has been declared dead by some of its adversaries. Resuscitation requires an understanding of what has gone wrong, and what can be done about it.

In every field, there is an internal rating system. Ed Annis is the acknowledged superstar of those of us who have pleaded the cause of fee-for-service medical practice and maintenance of the traditional doctor-patient relationship.

The past fifty years have brought miraculous health care advances in life-expect-ancy and the quality of life. This is often obscured by focusing on misapplied statistics such as infant mortality rates, which reflect harmful lifestyles and socioeconomic factors which are beyond the control of the medical community.

The same time span has seen a steady encroachment into the process from a variety of third parties, particularly government. The concept of socialized medicine, discredited elsewhere in the world, has been introduced, through gradualism, to the point where we are now, in effect, semi- social-ized. The current proposals for national health care threaten to push us beyond the point of no return.

Code Blue presents a compelling analysis of the chameleon-like nature of the socialistic forces. Each time they are rebuffed, we see the same individuals coming back with the same agenda, wrapped in the banner of their “new” politically correct organization.

Annis ably explains the difference between insurance, which is normally designed to protect against unexpected misfortune, and prepaid health care that prevails today. He shows how the added costs associated with third party intervention, while huge in and of themselves, are effectively doubled by the added costs of doing business on the part of the providers of service. The inequity of current standards of malpractice and product liability is exposed for the costs engendered, but more critically for the progress forsaken.

The flaws in the British and Canadian systems are reviewed, and a chapter is devoted to the half-truths of liberal press and media. The largely unjustified doctor-bashing is also addressed. The highlighted cases of fraud and abuse have predictably arisen from the impersonal paper- based nature of third party payment, which offers irresistible opportunities to the unethical.

My favorite portions are the examples of the way things were in the “good old days.” Most doctors, under age fifty, have little comprehension of what has been lost.

To anyone unfamiliar with the famous Annis-Kennedy “debate,” in May 1962, the intrigue involved and the parallels to the contemporary political maneuvering should be interesting. Under the auspices of the National Council of Senior Citizens, orchestrated by the AFL-CIO, Madison Square Garden was rifled with 18,000 elderly supporters of the King-Anderson (Medicare) bill. President John F. Kennedy was scheduled as the principal speaker. His speech was to be carried live and free by all three TV networks.

The AMA asked for equal time, but was refused. They were able to buy time on one network for the following evening. They arranged to rent the Garden immediately following the spectacular presentation, with balloons, banners, and assorted debris still strewn among the now entirely empty seats. Against that background, Ed Annis stood alone and made his impassioned plea. It was estimated that 30,000,000 people, at or near a record for that era, witnessed the speech. The response was phenomenal. The AMA and legislators were deluged with supportive calls and letters. King-Anderson failed to pass! To find out what happened next, you’ll have to read the book.

After Dr. Annis has detailed what has gone wrong, he concludes with a chapter that offers the only true logical solution: a return to the free market. Dr. Annis recommends the plans of the National Center for Policy Analysis and the Heritage Foundation. Both plans put the patient back in the driver’s seat, demand equity in income tax treatment, and promote Health Savings and Health IRA accounts. The author leans toward the NCPA plan because of its “comprehensive simplicity and logical consistency.”

I recall, less than five years ago, sitting at a table in Dallas with Dr. Annis, and Drs. Francis Davis, Frank Rogers, and Jane Orient, while John C. Goodman sought our support for his fledgling NCPA. The prestige that this conservative/libertarian think tank has acquired in such a short time should offer hope to those who worry about the seemingly overwhelming forces arrayed against us.

It may be wishful thinking, but I sincerely believe that if Ed Annis attained access to the talk- show circuit, there is no telling what might happen. He has already proven once that the sincerely spoken word can sway the masses. Given the opportunity, he might once again be our savior. []

Dr. Primich is a private practitioner of obstetrics and gynecology in West New York, New Jersey.