Though body size can be altered with environmental or behavioral changes, anatomic shape, which appears to be genetically determined, cannot be changed except by surgery, trauma, or illness.
The current Medicare operation—reimbursing medical goods and services to a growing number of people without basing the reimbursement benefit on the actual cost of the services—is unsustainable, but there are some possible remedies.
The proliferation of enhancement technologies and pharmacological agents has perpetuated the view of American doctors and patients of medical care as a market commodity driven by what consumers want and are willing to pay for.
State laws often require physicians to report suspected abuse and assault, creating a dilemma for physicians who must not only treat the injured patient but act as an informant to police.