In the United Kingdom, doctors are set to go on strike again.
Last December, it was junior physicians. This time, it is emergency doctors. Both times the issues are work hours and pay scales. Jeremy Hunt, British Secretary of State for Health, has said that the current contract is “not negotiable.”
The British National Health Service is President Barack Obama’s model for how he wants our healthcare system to work. So, it is reasonable to surmise that the U.S. could see doctor strikes in our near future.
The details are interesting, in fact fascinating for me as a doctor but we need to keep in mind the big picture, the reason to have a healthcare system at all: patient welfare. The image of American doctors standing on the picket lines, once inconceivable, is now quite real.
Screenshot (Dr. Deane Waldman, MD MBA)
Who Does Your Doctor Work For?
Whatever you think of the reasons for the British doctor strike, the position of their government, and the potential cancellation of elective tests and procedures, the fundamental question is the following: Who does the doctor work for?
In all government-controlled healthcare systems, whether you call them single payer, Medicare-For-All, universal health care, National Health Service, or Obamacare, the doctor works for the government.
Doctors’ ethical code says we work for the patient. The law says only the doctor, not the government, can practice medicine. Little conflict there. Okay, huge problem there. If doctors work for the patient, there is no possibility of going on strike. If the doctor works for the patient, there is no timecard and no specified work hours. You do whatever it takes for however long it takes to help the patient.
Doctors Work For The Government, Not You
If the doctor works for the government, you go home when the rules say so, theoretically in the middle of an operation. If the government practices medicine on you, then you get what the guidelines and regulations specify, not necessarily the medical care that you – a person and unique individual – need.
To bring it home to the U.S., ask yourself, is Obamacare a government-controlled healthcare system? If it is, then your doctor on strike may be on the horizon.
Obamacare Is Government Controlled Healthcare
Under Obamacare, the government dictates payments, called “reimbursement schedules,” to doctors. With Obamacare’s Independent Payment Advisory Board, the government tells doctors what they can and cannot do for patients. That is government control by any measure you can name.
Under Obamacare, the government also controls the patient, also called consumer. Doctors prefer the name “patient.” A consumer has a one-way relationship: he or she consumes what some faceless entity delivers. A doctor should and wants to have a fiduciary partnership with the patient. That fiduciary relationship is destroyed when the doctor works for the government rather than for the patient.
The patient under Obamacare must buy what the government mandates, or else. The patient has limited access to care, within restricted panels and long wait times. These limitations are created by government budget allocations and takes no account of a specific patient’s medical needs.
Just ask a veteran. Oh, I’m sorry, the one you approached is dead. He is one of 307,000 who died waiting in line for their approved government controlled care.
No Doctor To Strike
The more I think about it, the less likely we will have doctor strikes in the U.S. There won’t be doctors to go on strike. Between early retirements, unfilled training positions, and physicians finding nonclinical, less hassle healthcare work, care providers are becoming an endangered species. Of course, on strike or not there at all, either way, you the patient won’t get the care you need under government controlled healthcare.
Dr. Deane Waldman MD MBA is author of just released “The Cancer in the American Healthcare System;” Host of www.wecanfixhealthcare.info; Professor Emeritus of Pediatrics, Pathology and Decision Science; and Adjunct Scholar (Healthcare) for the Rio Grande Foundation, a public policy think tank. Dr. Deane sits on the Board of Directors of the New Mexico Health Insurance Exchange as Consumer Advocate. Opinions expressed here are solely his and do not necessarily reflect the opinions of the Board.
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