Free Trade (in Doctors)

If physicians really cared about our health, they'd drop their iron wall against immigrant doctors

A system such as the one proposed by Baker — where patients don't travel to the developing world, but instead it becomes easy for doctors to come and practice here — would create incentives for more developing-world students to pay for and attend medical school, and for the expansion of medical schools overseas.

The likelihood of such a U.S. program is dim, however.

"Doctors are a very powerful lobby. They're much more powerful than textile workers or auto workers," notes Baker, citing occupations whose wages have been diminished by free trade, while their health care has been diminished by a lack of free trade in doctors.

Perhaps it's time for medical patients — that means all of us, sooner or later — to form our own free-trade lobby.


On S.F. sidewalks, the blind are feeling misled by the blind.

A week ago, while walking on Market Street's western sidewalk, I was passed in the opposite direction by a man holding a red-tipped cane, wearing dark glasses, with a yellow handicapped-logo sign hung around his neck. He was traveling 12 mph on a Segway, the gyroscopically balanced scooters that never quite became the next new thing.

This, I realized, was the trigger event in a coming stampede, a vicious cycle where San Franciscans will soon perch dorklike on lawnmower-esque Segways, handicapped placards flapping on all our necks.

Segways are banned on San Francisco sidewalks because back in 2001, when the scooter was introduced, groups such as Senior Action Network and the California Council of the Blind lobbied for a resolution keeping what they saw as dangerous devices separate from pedestrians.

"When a Segway travels at 10 mph or even more, it can, due to its weight, seriously injure a pedestrian," California Council of the Blind President Jeff Thom says of the 83-pound devices. "The blind and visually impaired individuals, children, and others ... either can't, or are less likely to, see the approach of this device."

However, there's an exception to the San Francisco ban; disabled people who use the Segway as a mobility device may ride on sidewalks. San Francisco has purposely kept quiet about this loophole, however, for fear of inviting people to play sidewalk roller derby.

"We had a discussion as to how much to publicize this exception, and were persuaded to make it low-key," wrote Susan Mizner, director of the Mayor's Office of Disability, in a recent e-mail to her counterpart at the National Parks Service. "There was concern of non-disabled people claiming to have a disability so as to be able to ride the Segway anywhere."

Judging from my "blind" sidewalk Segway speedster earlier this month, the cat's been let out of the bag.

A pro-Segway advocacy group recently published a flier urging its handicapped members to come to San Francisco and ride them around.

"Pack up your Segway and enjoy one of the world's most beautiful cities," urges a flier published on the Web site of Disability Rights Advocates for Technology (DRAFT), a national Segway enthusiasts' group based in St. Louis, which is not connected to Segway Inc.

If people take this suggestion seriously, they will set in motion a negative feedback loop where more people ride Segways among pedestrians. Given these awkward devices' great weight, moderately swift speed, and maneuverability that varies with the driver's skill level, they will inevitably run down pedestrians.

As noted earlier, there will be fewer and fewer doctors to attend to these injured people. So their wounds will inevitably fester into permanent disabilities. These newly disabled people will, in turn, ride more Segways, injuring more people, until eventually nobody is left walking.

So when I saw the supposedly sightless sidewalk Segway speedster on Market Street, I imagined a public health crisis.

Perhaps I should quit being so hysterical.

Fred Kaplan, a member of the pro-sidewalk-Segway group DRAFT, tells me the mysterious stranger who passed me on Market Street fits the description of a Concord man named Scott Deaver who has poor peripheral vision and often travels to the city.

"He can see, but his vision sure as hell isn't as good as yours and mine," says Kaplan. "He's ridden a bicycle and he's had problems where police have said, "You're not supposed to ride on the sidewalk, you're supposed to ride on the street.' But he can't see the cars."

Kaplan told me he'd repeatedly asked that Deaver call me, but I haven't heard from him.

But I'll take Kaplan's word for it.

I urge San Franciscans to welcome Mr. Deaver and his Segway to the city's sidewalks. But please, please — don't start riding one yourself should he accidentally run into you. (Kaplan says Deaver's had no Segway accidents.)

The last thing our city needs is an unstoppable Segway plague.

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