Millions of people without medical insurance are overwhelming emergency rooms. Possible bungling and conflict of interest in the FDA drug approval process forces drugs to be withdrawn from the market. The fatallyflawed Medicare prescription bill is muscled through Congress based on grossly underestimated costs, according to a General Accounting Office report suppressed until after the bill’s passage. Tenet Healthcare is fighting allegations of kickbacks to doctors for patient referrals.

All this and the flu vaccine shortage have become fodder for political campaigns. But airing the problems has produced nothing in the way of solutions. Candidates point fingers, often in the wrong direction, but offer little hope for American workers or retirees of major companies whose benefits have been eliminated.

But even as Bush assails lawyers and liberal judges for huge awards (most of which are made by juries) that drive up the cost of malpractice insurance, we learn that accounts for only about 1 percent of healthcare costs. While touting tort reform, he cites government-run healthcare in other countries as failures. Ask a French citizen, if you’re still speaking to any, about their medical system. You’ll hear words like generous, caring, thorough.

Amid the dust-up over serious side effects of Vioxx and other prescription drugs being taken off the market, emerges a willingness on the part of some doctors to take a new look at how medicine is practiced. Magic bullet drugs for every common malady, expensive scans and high-tech imaging, are overused, they say, less because of litigation fears and more because they save time doctors used to spend with patients diagnosing illness.

Here are some tales of hope.

In a recent Op-Ed piece, John Abramson, a clinical instructor at Harvard Medical School, tells of a longtime patient who complained of a painful knee and asked if she needed an MRI and one of the new arthritis drugs advertised on TV. Over 15 years, he had prescribed several different medications for her chronic anxiety and panic attacks, but none provided enough relief to make the side effects worth putting up with. She found the best way to control her anxiety was to walk five miles a day. After 10 years, her knee was showing wear and tear. Abramson quoted the first professor at Johns Hopkins medical school and greatest clinician of his time, “It is much more important to know what sort of patient has a disease than what sort of disease a patient has.” Instead of expensive scans, he prescribed a two-week trial of swimming instead of walking and taking an inexpensive over-the-counter anti-inflammatory. Her pain subsided and they worked out an exercise regimen easier on the knees.

“Most of the knowledge that now guides medical care comes from studies sponsored by drug and medical device companies,” Abramson wrote.

The September issue of the AARP Bulletin drew many letters of praise for two articles: “The Dope on Drug Makers,” an interview with Marcia Angell, and “The Pharmacist Who Says No to Drugs,” a profile of Armon Neel, a retired pharmacist who regularly visits retirement and convalescent homes to check on the drugs prescribed for all patients. In his efforts to improve the quality of life for seniors with complex medical problems, Neel finds obstruction by medical directors at many institutions and complete disregard for his recommendations to streamline drug regimens. Some patients who complained of disorientation, nausea, diarrhea and dizziness were taking a dozen or more often conflicting prescription medications, many not advised for elders, and many with contraindications. At many of the homes he visits there is only one licensed medical professional who comes in only once a week and may never actually see the patient for whom the prescriptions are written or hear their complaints. These rogue medical directors must be among the doctors receiving huge incentives from drug companies.

It doesn’t take the General Accounting Office or administration doctors to see what this massive abuse of prescription drugs is doing to the Medicare budget, particularly now that price negotiation with pharmaceutical companies is prohibited under the Medicare “modernization” law.

If this in an indication of how government would run a healthcare system in this country, it’s no wonder the president is against it. But wouldn’t it be wise for the government to exercise at least some oversight of privately run nursing and retirement homes where Medicare is the primary payer?

The cost to taxpayers of this abuse and the cost in quality of life for those seniors should be incentive enough to offset the interests of Big Pharma. Or has medical ethics become an oxymoron?