VI. Too Easy Opinion Faces Ten Tough Questions

T Michael White MD FACP
Sep 16
13 min read

Fixing United States Health Care

Letters to the File

T Michael White MD FACP

******

Letters to the File

VI. Too Easy Opinion Faces Ten Tough Questions

V. The ‘BigGuy’ Is on the Health Care Line

IV. Cold Sweats, Butterflies and Miracles ꟷ Taking on Health Care

III. Privilege = Responsibility ꟷ Sounding Our National Health Care Alarm

II. Ending Vaccine Mandates ꟷ Leadership Opinion = Responsibility

I. An Honest, Truthful Transition

(more to follow)

******

VI. Too Easy Opinion Faces Ten Tough Questions

“The art and science of asking questions is the source of all knowledge.”

Thomas Berger

The WhiteHouse on the BelleAir Bluff

Sunday, September 14, 2025

Dr. Mike (a letter to the file),

Last night your sleep was fitful. As you endeavor to fix United States Health Care, you are distracted by and consumed with worry regarding Florida Surgeon General Joseph Ladapo’s inexplicable undermining of our fine country’s vaccination infrastructure. And you are doubly perplexed that a good man, Governor Ron Desantis ꟷ giving a questionably qualified individual the bully pulpit to proselytize frankly harmful public health rhetoric ꟷ is complicitous.

Ah, but every problem has a solution ꟷ the Tampa Bay Times. Please advocate for this stellar news organization to convene a polite, professional, nationally televised Q&A session with Dr. Ladapo with Governor Desantis and Mrs. Desantis in the audience. Assembled, require Dr. Ladapo to concisely answer the following ten questions:

Have you been vaccinated? Have your children been vaccinated? If you had a pre-school child would you vaccinate? If yes, why? If not, why?
What is your position at the University of Florida? What are your responsibilities? Do you see patients? Are you a public health expert? Are you an infectious diseases expert? Do you care for children? Are you in good standing at the University?
Why do you consider yourself qualified to argue against well-established major public health processes regarding fluoride, consuming raw milk and vaccinations?
You advocate for informed decision making by parents in concert with their physicians. How do parents identify qualified medical opinion? Who do parents who work paycheck to paycheck and who do not have access to physicians turn to? How do parents with insufficient educational prerequisites comprehend and decide?
If an unvaccinated child contracts measles and has a life-changing complication or death, are the parents ethically and legally responsible? Are you (and the enabling Governor) ethically and legally responsible? If the child infects others, do the parents and Florida leadership have responsibility?
As parents make informed decisions, are they made aware that measles epidemics may annually impact educations and undermine family careers, finances and food, housing and transportation securities?
Using Orlando as an example, what impact will a measles epidemic have on Disney World? Please generalize the impact to the Florida economy.
Will hospitals be able to ramp up to care for epidemic disease? Where will funding for enhanced services come from?
If insurance companies refuse to cover measles related care in the voluntarily unvaccinated, who will bear the massive costs of outpatient care and hospitalizations?
Whereas immunity wanes with age, will your advocacy for fewer vaccines and resultant significantly lessened herd immunity place Florida’s immense elderly population at risk for childhood diseases?

Dr. Mike, this public Q&A will greatly facilitate informed decision making. As you ensure your own progeny ꟷ your trailing generations ꟷ are vaccinated (and as you consider being re-vaccinated in your dotage), please strongly advocate for this informative Tampa Bay Times nationally televised Q&A.

Respectfully submitted with fondest personal regards,

Dr. Mike

Fixing United States Health Care --- Letters to the File

https://www.fixingushealthcare.com/

Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you, and my thought processes will be much the better for it. Thank you for considering. Dr. Mike

******

V. The ‘BigGuy’ Is on the Health Care Line

“The separation of church and state is a source of strength,

but the conscience of our nation does not call for separation

between men of state and faith in the Supreme Being.”

Lyndon B. Johnson

“It is impossible to reason without arriving at a Supreme Being.”

George Washington

The WhiteHouse on the Belleair Bluff

Wednesday, September 10, 2025

Hello Dr. Mike (a letter to the file).

To recap, privileged and responsible, you are on a mission to fix our fine United States’ (non) Health Care system. As you step forward, the situation is universally recognized as critical; and at the same time, ꟷ telling yourself (and having too oft been told) the truth ꟷ short of divine intervention, your endeavors will be futile. Privileged and responsible, duty bound, you soldier on.

Your (well written) draft chapters (that will never be read) are being released on the website Fixing United States Health Care --- Letters to the File (https://www.fixingushealthcare.com/). Today, you are considering a doozy (another snoozer for many): something about a 4-Alarm Health Care Fire ꟷ Access; Public Health; Science; and ‘Better Angels.’ All good. Until…

You are distracted by thoughts of the divine intervention mentioned above. Is there a Supreme Being? Standing beside Niagara Falls or beneath a massive Starlink launch, in concert with Pascal’s Wager, you conclude there must be. That mystery resolved and facing futility, why not petition a heavenly leg up?

You got right to it. 1) covering up your pleasingly accurate “…places to go and people to piss off” bumper sticker, you confidently installed ꟷ MIRACLES HAPPEN ꟷ on the rear of your Yugo SUV; and 2) you began to listen to, play (piano), sing (sorry) and hum the Manhattan Transfer’s Operator (thank you William Spivey/Wyona Carr), “Operator… Information… Please give me the ‘BigGuy’ on the line.” Finally, confronting futility, you are getting somewhere.

Back at it over 18-holes (you do your best thinking on the course), your 4-alarm message was coming together. Retrieving your iPhone from your golf bag, you were chagrined to have missed a call (prominently marked “Buddy, this ain’t spam”) from a 1000 area code. A voicemail was left and transcribed: “Mikey, this is the ‘BigGuy’. I got your message ꟷ yes, your singing could use a little work. I admire your efforts ꟷ keep on keeping on. I am more than a bit slammed right now (Israel/Gaza; Ukraine; Measles; etc.) and choose not to get directly involved. However, you have my full support. From time to time, I’ll make suggestions. For a start, give the Declaration of Independence a look. As always, take care to habitually randomly act kind.”

Beyond stunned, you rewarded yourself with a post-round ice water chased by a house cabernet. While mentally listing the likely perpetrators of this fraud ꟷ each gleefully sniggering at your expense ꟷ it occurred to you to listen to the voicemail. What would the ‘BigGuy’ choose to have his voice sound like? George Carlin! That was proof enough for you. Immediately, no longer alone, you were off to a scholarly read of Thomas Jefferson’s Declaration curious to find its link to United States Health Care. (460 words)

Respectfully submitted with fondest personal regards,

Dr. Mike

Fixing United States Health Care --- Letters to the File

https://www.fixingushealthcare.com/

******

IV. Cold Sweats, Butterflies and Miracles ꟷ Taking on Health Care

“A dream doesn't become reality through magic;

it takes sweat, determination and hard work.”

Colin Powell

“The miracle is not that we do this work, but that we are happy to do it.”

Mother Teresa

The WhiteHouse on the Belleair Bluff

Monday, September 8, 2025

Hello Dr. Mike (a letter to the file).

After significant gut-wrenching soul searching, you have decided you are duty bound to step publicly (not your thing) forward and sound the alarm ꟷ our United States Health Care (non) System, in serious disarray, is leaving increasing numbers of our fine citizens without access to affordable, basic, compassionate health care. Having collected your thoughts (III. Privilege = Responsibility ꟷ Sounding Our National Health Care Alarm), your initial move was to communicate them via email to a legion (one by one) of citizen thought leaders ꟷ no minor task.

Thoughts communicated ꟷ exhausted, you took to your bed.

Deep in dream, a CIA operative (too) accurately reported reactions to your magnificently wordsmithed, earnestly sounded alarm. In descending order:

Directly to spam;
Moved (unopened) to spam;
Cannot be delivered;
Deleted unopened;
Received, read and deleted without response; and a blessed few (this is a most lonely business)…
Received, responded to and forwarded to others for their consideration.

Responses that came your way uniformly agreed that access to care was a major concern, but counseled that inadequate patient literacy, tort reform, clinician burnout and the attack on medical science must now also be addressed. Soberingly, these few kind responses uniformly went on to tenderly convey ꟷ United States Health Care is an irresolvable hot mess well beyond your paygrade. Short of a miracle ꟷ despite best efforts, nothing can/will be done.

In hot and humid Florida, bed-shaking rigors awoke you in a cold sweat. Your epiphany: “Just what in tarnation do I think I am doing?” All at once, reality came down on you:

While our fine country is in the midst of a worse than imagined, unaddressed health care crisis;
While many understand there is a crisis but, pleased (for the moment) with their own care ꟷ the “I got mine syndrome” ꟷ care not;
While Rome (health care) is burning, some are actively eroding our scientific and public health foundations of care;
The problem is insurmountable, and solutions are unachievable;
It is beyond embarrassing hubris) for you (not the sharpest tool in the shed) to think that you alone, without resources and support might make a difference; therefore…
Recognizing futility, you must cease aggravating the many (including yourself).

Bleary-eyed, you understood your path forward ꟷ cease and desist; stand down; back off; get real; take a pill. Relieved of responsibility (and with the assist of a pediatric melatonin gummy), you fell back into peaceful sleep.

The dawn brought a re-read of III. Privilege = Responsibility ꟷ Sounding Our National Health Care Alarm and clarity. Privileged, despite odds, you have the responsibility to soldier on. While not taking your quixotic self ( certified legend in own mind ꟷ LIOM-C ) seriously:

Duty bound, you must step up and seriously confront this health care crisis;
Rationalizing, you shall subscribe to the “butterfly effect” ꟷ small actions (even as inconsequential as yours) can have massive impact; and
You shall display (and believe in) the bumper sticker ꟷ MIRACLES HAPPEN! (490 words)

Respectfully submitted with fondest personal regards,

Dr. Mike LIOM-C

Fixing United States Health Care --- Letters to the File

******

III. Privilege = Responsibility ꟷ Sounding Our National Health Care Alarm

"Privilege is here, and with privilege goes responsibility."

John Fitzgerald Kennedy

“You cannot escape the responsibility of tomorrow by evading it today.”

Abraham Lincoln

The WhiteHouse on the Belleair Bluff

Friday, September 5, 2025

Hello Dr. Mike (a letter to the file).

For a lifetime, you have had the privilege of participating in your beloved, sacred medical profession. For seven decades, Medicine (the dreaming, the becoming, the practicing, the experiencing) has consumed you. At times, your journey has been arduous; however, it has always been unfailingly fulfilling. Any sacrifice on your part, has been repaid a thousand-fold. Privileged to have been (and remain) a physician, you have been truly blessed. It is a career and (inseparable) life you would wish for all.

As you wind down and look back, you recognize your profession has been lent to you for only a brief time. At some conscious/unconscious level, you have always understood that this privilege has never been yours for the keeping. It has only been entrusted to you to, to the best of your ability, implement, prudently steward, burnish and ultimately pass on.

From the beginning, you have known, this gift (this privilege) has been accompanied by responsibility ꟷ responsibility to leave your profession better than when it was first entrusted to you. Now, nearing your end, you take this responsibility seriously. In that regard, seeing something, you have the responsibility to say something:

The seeing: health care in our fine United States has become an alarming paradox. On one hand, for those in the right place at the right time, care is beyond splendid. For others, it is, at best, an inaccessible, unaffordable wish ꟷ and those counted among these less fortunate are increasing.
The saying: you must sound the alarm ꟷ our national health care is in disarray. While recognizing and praising much good, we must, together, design and advance the solution ꟷ an organized United States Health Care System ꟷ that immediately provides universal access to affordable, basic, compassionate, safe, timely, efficient, effective, equitable (just), patient-centered care (C-STEEEP).

As you step forward, please recognize that you are not alone in this. Like you (administrator, citizen, clinician, matriarch/patriarch, patient, politician, significant other), others too have responsibility to our trailing generations ꟷ to your and their progeny ꟷ to provide them universal access to affordable, basic, compassionate, safe, timely, efficient, effective, equitable (just), patient-centered care (C-STEEEP). (355 words)

Respectfully submitted with fondest personal regards,

Dr. Mike

Fixing United States Health Care --- Letters to the File

******

II. Ending Vaccine Mandates ꟷ Leadership Opinion = Responsibility

“Opinion is the medium between knowledge and ignorance.”

Plato

“People do not seem to realize that their opinion of the world is also a confession of character.”

Ralph Waldo Emerson

The WhiteHouse on the Belleair Bluff

Thursday, September 4, 2025

Hello Dr. Mike (a letter to the file).

******

As you endeavor, against all odds, to construct an enhanced United States Health Care System, others, seemingly good, intelligent souls, are setting out in real-time to plunder the imperfect care that now exists. Flummoxed, you are confronting…

Yesterday, Florida’s Surgeon General stepped forward, with the Governor at his side, to state that Florida will end all vaccine mandates. The rationale ꟷ in the name of patient freedom, each individual (or parent) must have the right to decide what is administered to her/his body. On the surface, I understand that sentiment. However, weighing the risks (epidemic illness, morbidity and death and downstream education, career and financial consequences) against the benefits of personal freedom in this matter, the ratio overwhelmingly supports vaccine mandates.

Stepping back (farther than you care to), you are trying to understand Florida Leadership’s desire to place personal decision-making ahead of scientific wisdom aimed at the public good. As the kids say, you might find yourself ‘down with that’ provided the following requirements are met:

The Surgeon General and the Governor demonstrate that removing vaccine mandates is the will of the majority of Florida’s citizens;
Most importantly, the Surgeon General and the Governor state that they will take personal financial, moral, political and professional responsibility if the public’s health is harmed;
The Surgeon General and the Governor acknowledge that their quest to remove vaccine mandates will enhance (intentionally or unintentionally) vaccine skepticism;
The Surgeon General and the Governor, eliminating vaccine mandates, will at the same time make vaccines and vaccine administration available at no cost;
The Surgeon General and the Governor will significantly bolster health care services (for example, clinicians and hospitals) in anticipation of regular recurring health care crises;
The Surgeon General and the Governor will require that individuals (and parents) who desire to opt out of vaccinations first demonstrate that they are making an informed decision by 1) taking a course describing the diseases measles-mumps-rubella, polio, chickenpox and hepatitis B; and 2) pass a written exam;
The Surgeon General and the Governor inform individuals (and parents) that contraction of preventable diseases may impact the health, education, financial security and life itself of those near and dear to them;
The Surgeon General and the Governor inform individuals (and parents) that their contraction of preventable diseases may significantly harm vulnerable members (family, neighbors, classmates and friends) of their community; and
The Surgeon General and the Governor inform individuals (and parents) that, in this complex world, they may be held financially, legally and morally responsible for harms caused by their informed failure to protect the public.

Dr. Mike, in your final analysis, if, as the Surgeon General and the Governor step forward to remove vaccine mandates, they are stepping up to the personal (including financial), political and professional responsibility for all of the above, while disagreeing, you must recognize their right to their opinion. If they are not taking responsibility, they must step down. (495 words)

******

Respectfully submitted with fondest personal regards,

Dr. Mike

Fixing United States Health Care --- Letters to the File

******

I. An Honest, Truthful Transition

“Honesty is the first chapter in the book of wisdom.”

Thomas Jefferson

“Three things cannot be long hidden: the sun, the moon, and the truth.”

Buddha

The WhiteHouse on the Belleair Bluff

Tuesday, September 2, 2025

Hello Dr. Mike (a letter to the file).

******

For the past year, you have been seriously contemplating what may be done to improve health care in these fine United States. Steeping up to honesty and telling yourself the (painful) truth:

Communications with learned citizen thought leaders uniformly support opinion that that United States health care is a non-system that is in serious, ever-worsening disarray;
In discussions, dramatic measures have been identified that can be readily implemented to immediately improve health care;
Having had the privilege of a medical career, you personally feel obligated/compelled to try to make a difference;
With all due respect sir, you do not have the gravitas (the personal, political, professional standing) to command a national audience’s attention in these critical matters; so
Given that your well-meaning, quixotic, efforts are proving to be fruitless, you must (to the relief of family, friends and colleagues), for your own mental and physical well-being, relax and stand down.

Honesty and truth are liberating. As you must, you shall stand down ꟷ but only publicly. Privileged with a career in medicine, you shall not abandon your responsibility to strive to do meaningful work that may make a difference. Therefore, you shall:

Introspectively, regularly write formal, thoughtful letters (like this) to yourself;
Formally assemble/collate them in this file;
Quietly publish them on this website: Fixing United States Health Care --- Letters to the File;
Be pleased if any choose to find the webpage and consider its contents; and
Be doubly pleased to (however unlikely) receive reactions regarding what you have right, wrong and or omitted.

******

Respectfully submitted with fondest personal regards,

Dr. Mike

Fixing United States Health Care --- Letters to the File

******

2 Comments