The pharmaceutical and medical devices industry is worth billion dollars. The healthcare industry sucks billions of dollars out of the economy in delivering treatment. Underpinning this, you have health insurance and government at all levels. When it comes to the health of the nation, there's no such thing as little government. You have to add up all the costs. That's not just in the dollars you see going out for drugs and other treatment. But also in all the lost productivity and hidden economic costs. If people fell ill less often and could work more consistently, the national medical bill would fall and there would be more to spend on education and little things like roads and bridges.

This needs a revolution. We now focus on building central hospitals to deal with those who are injured or infected with disease. It would be better if we changed the focus to prevention. This requires an active move into the community to monitor people's lives and intervene as early as possible to keep them healthy. If we wait until we are really ill before going to a hospital, the seriousness of the problem means the treatment will take longer and cost more. This gives more profit to the hospitals and the drug companies. More importantly, hospitals are divided up into little kingdoms where the top doctors specialize and earn the maximum profit from their expertise. Except, unlike the Europeans who have national and international government bodies reviewing medical practice to ensure doctors always use the most cost-effective treatments, our doctors and hospitals are allowed to use whatever treatments they want, even though there may be no evidence these treatments are any good.

So powerful are the drug company and the medical professionals lobbies, politicians are very reluctant to impose any controls. The usual excuse is that the healthcare industry is self-regulating. The problem is that doctors' mistakes are buried six-feet under. To protect them, you attack the attorneys who would use the law of tort to claim damages for those injured. For the better protection of us as consumers, we should dismantle these hospital empires, and get doctors out into the community where they can do more good. If there are people in pain, they should be referred to pain management clinics. The best approach is multidisciplinary. You pull together a team with all the best clinicians, therapists, counselors and nursing staff. You review all the treatment to date, looking for any possible oversights or errors. If further diagnostic work is necessary, it is done. If this finds other doctors have made mistakes, this is good because it will improve practice standards and reduce the risk that future people will be mistreated. If everything that can be done to treat the underlying cause has been done, you treat the pain. This starts with a painkiller like Ultram but the use of the drug is in a carefully constructed program. You are counseled. You have therapy. Your family is involved to put together the best possible environment for you at home. Your quality of life is the main focus. There's still a place for Ultram, but the aim is to give you the best possible outcome.