Doug McGuff - The primal prescription

Special thanks go out to Mark Sisson. I am honored that you thought of me when you contemplated taking on an expos of the American sick care system. To my co-author Robert Murphy, PhD, thank you for your tireless work in bringing rational principles to the field of economics and for integrating your vast knowledge into this book. To my partners at Blue Ridge Emergency Physicians (made extinct by the Affordable Care Act), I would like to acknowledge your twenty years of friendship and professionalism and assure you that our beloved founder, Dr. Jack Warren, is looking down upon you with a cup of black coffee in hand smiling. To Ed Garbe, Sherry Edwards, and Joe Byers (my team at Ultimate Exercise, Inc.), thank you for your boundless energy and enthusiasm in teaching our clients that prevention really is the best medicine. Finally, to Denise Minger, thank you for your excellent work in editing the manuscript for this book and turning my submissions into something worthy of Marks high standards.

M. Doug McGuff, MD

I would like to thank Mark Sisson for introducing me to my co-author for this important project. (Economic theory is great, but I felt much more confident when Dougs ER experience confirmed my analysis.) I am also very grateful for the tremendous work Denise Minger did on our manuscript, to help us make it more accessible for the lay reader.

Robert Murphy, PhD

OTHER BOOKS BY PRIMAL BLUEPRINT PUBLISHING

The Primal Connection: Follow your genetic blueprint to health and happiness

The Primal Blueprint: Reprogram your genes for effortless weight loss, vibrant health, and boundless energy

The Primal Blueprint 21-Day Total Body Transformation: A step-by-step diet and lifestyle makeover to become a fat-burning machine!

The Primal Blueprint 90-Day Journal: A Personal Experiment (n=1)

The Primal Blueprint Cookbook: Primal, low carb, paleo, grain-free, dairy-free and gluten-free meals

The Primal Blueprint Quick and Easy Meals: Delicous, Primal-approved meals you can make in under 30 minutes

The Primal Blueprint Healthy Sauces, Dressings, and Toppings: Plus rubs, dips, marinades and other easy ways to transform basic natural foods into Primal masterpieces

Hidden Plague: A field guide for surviving and overcoming hidradenitis suppurativa, by Tara Grant

Rich Food, Poor Food: The Ultimate Grocery

Purchasing System (GPS), by Mira Calton, CN, and Jayson Calton, Ph.D.

Death by Food Pyramid: How shoddy science, sketchy politics and shady special interests ruined your health, by Denise Minger

The South Asian Health Solution: A culturally tailored guide to lose fat, increase energy, avoid disease, by Ronesh Sinha, MD

Paleo Girl: A straight talk guide to navigating the challenges of adolescence with a sensible, stress-balanced, Primal approach, by Leslie Klenke

Lil Grok Meets the Korgs: A prehistoric boy shows a high tech modern family how to live Primally, by Jane Meadows

The Paleo Primer: A jump-start guide to losing body fat and living Primally, by Keris Marsden and Matt Whitmore

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In the debate over government health care policies, partisanship and the desire to win the argument often leads both sides to talk past each other. Conservative Republicans proudly proclaim that Americans had enjoyed the best health care system in the world, but now President Obamas radical legislation is interfering with the free markets ability to deliver medical services. Liberal Democrats reject this nave vision, arguing that the very real problems of skyrocketing costs and sporadic coverage that existed in 2009 were precisely why President Obama pushed for his sweeping overhaul of the whole system.

Both sides are partially rightbut mostly wrongin this typical battle along partisan lines. The conservative Republicans are correct when they warn that the Affordable Care Act is making medical care worse, but the liberal Democrats are correct when they say the pre-ACA system was broken. Yet when we study the history of US health care and insurance, we can understand exactly why the system was broken as of 2009. We will see that far from being a revolutionary paradigm shift, the Affordable Care Act (ObamaCare) is instead merely a ramping up of trends that have been in place for decades.

There was no free market in US health care or health insurance circa 2009. That is precisely why so many Americans were legitimately scandalized with the system and hence demanded drastic reforms. Yet it also demonstrates that the Affordable Care Act is only making the problem worse.

To fully understand these claims, we need to review the actual history of US health care and insurance up through 2009.

Before the twentieth century, there was no health care system in the United States or anywhere else. Of course physicians and medical care existed, but there was not really a system the way we conceive of it nowadays. Part of our current problem, as well see, comes from the organization of our modern system, which is why its important to realize that things werent always this way. In these opening sections, we draw from the history of medicine as laid out by John F. Fulton in the