Why would anyone practice bad medicine on a patient, repeatedly, over decades? Why would someone else offer more poison ostensibly to help this same patient? Anyone refers to Congress; someone else is author Steven Brill; and the patient is named ... Healthcare.
Healthcare is a Patient
A system can be just as ill as the sickest human. Patient Healthcare is critical. This is a direct result of malpractice, a failure to use the four principles of good medical practice:
- Treat causes, not symptoms.
- Make evidence-based recommendations.
- Offer long-term, quantified cost/benefit analysis to patient.
- Create a partnership; a good doctor never forces treatment on a patient.
Malpractice is Occurring on Patient Healthcare
Congress ignored all four of these principles. Congress chose to ignore the cause of patient Healthcare's woes – a cancer, located in the federal bureaucracy.
A good doctor – principle No. 2 – would never say, "I do not know what it is in this medicine. I have no proof that it works. Take it anyway. Trust me!" That is precisely what Congress said about the Affordable Care Act, or Obamacare.
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The standard of care requires a doctor to offer evidence-of-effect. Failure to do this constitutes prima facie evidence of malpractice. What does that say about Congress’ failure to demonstrate evidence-of-effect before passing laws such as Medicare, Medicaid, Emergency Medical Treatment & Labor Act, Health Insurance Accountability and Portability Act, Unfunded Mandate Reform Act, and Obamacare?
Principle No. 3 above involves an obligation to do the value calculation. Consumers do that multiple times every day. Is there one shred of hard evidence that proves We The Patients will benefit from Obamacare? Congress has never shown us any evidence at all, simply exclaiming, “Trust me!”
The worst form of malpractice is Washington’s dismissal of principle No. 4. No doctor would ever, ever force medicine down a patient’s throat against his or her will. That is called assault and battery. If a surgeon operates without consent, that is attempted murder.
Every survey of the American people conducted since March 23, 2010 shows that a majority opposes Obamacare. We don’t want the medicine, yet we are forced to take it.
Congress is guilty of four counts of medical malpractice on patient Healthcare.
Time's Malpractice on Patient Healthcare
Now Time magazine and lawyer-author-patient Steven Brill joins Congress in practicing bad medicine. Their cover story of Jan. 19, 2015 is titled, “What I Learned From My $190,000 Heart Surgery.” Apparently, what Brill learned was how to pile on, as they say in football.
One of Healthcare’s biggest problems is the regulatory burden. It’s like those commercials with an elephant sitting on a man’s chest. How can he, or poor Healthcare, breathe?
Useless bureaucratic mandates, built-in inefficiency, incomprehensible as well as contradictory rules and regulations are driving many (like me) out of clinical medicine while they simultaneously raise costs to individuals and the nation.
Washington never analyzes the cost/benefit. When I tried to calculate the cost of the federal regulatory burden on U.S. taxpayers, there was no hard data. So, I simply added up all the costs that provided any form of care to patients, from doctors and nurses to wheelchair manufacturers and pharmaceutical companies. (I did not include insurance companies, Obamacare oversight compliance officers, or IRS agents.)
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Health CARE accounted for roughly 60 percent of all the money consumed by the healthcare system. Therefore, 40 percent or $1 trillion went to healthcare bureaucracy! And they take the first, biggest bite. We get what is left over.
Imagine how much health CARE doctors could give We The Patients for $1 trillion!
We have a wildly over-expensive, wasteful system burdened by an incomprehensible and imassive (10,516 pages in the Federal Register just for Obamacare) set of rules and regulations. What does Time author Steven Brill recommend? More regulations!
In his lengthy Time article, Mr. Brill offers seven new regulations:
- Mandate medical oligarchies
- Control profits
- Control salaries
- Mandate an appeals process
- Require that medical CEOs be practicing MDs
- Require coverage for Medicaid patients
- Control prices for the uninsured
Note the verbs: mandate, control, control, mandate, require, require, and control. Healthcare’s biggest problems are over-regulation, excessive central control, and inherent bureaucratic inefficiency. So author Brill wants to expand bureaucracy, increase central control, and magnify the waste of healthcare dollars!
Time Editor Nancy Gibbs joined Mr. Brill advocating increased government control asking, “What would it really take to control costs?” Controls are centrally implemented, meaning medical rationing. Is that what the American people want?
In preparation for The Cancer in Healthcare, we performed several surveys. There was only one item on which 100 percent agreed. Regardless of age, gender, economic status or political persuasion, everyone wanted more “control of my health care.”
If you accept entitlements such as government-subsidized health insurance, you reject your control. Yielding control to the government, you get less care and fewer dollars in your wallet as Obamacare is proving right now.
Practicing Good Medicine on Patient Healthcare
Patient Healthcare needs an old-fashioned country doctor. He would discover that Patient Healthcare has cancer – cancer of the bureaucracy. And, Healthcare’s treating physicians – federal bureaucrats – are actively suppressing this diagnosis. They are agents of the cancer.
We need to start with principle No. 1 of good medical practice: treat the cause not the symptoms. If over-control is the cause, the cure is to reduce the level of control. Give control back to the people.
Let individual Americans choose how to spend healthcare dollars. After all, it IS their money as well as their lives. You will no doubt hear someone shout, “I can’t possibly afford to pay for my health care.” The answer is one hard fact, one reasonable prediction, and no empty promises.
Hard fact: According to a Deloitte study, the U.S. spent $3.46 trillion on healthcare in 2012. This means every man, woman, child, and baby spent $11,089 on healthcare even those who never saw a doctor, took a pill, or visited an Emergency Room.
Reasonable prediction: If patients had control of their own spending; if sellers–hospitals, doctors, suppliers–were forced to compete for those dollars; and if the federal bureaucracy were essentially cut out of the equation, the prices for everything in healthcare would plummet into the affordable range.
Empty promises: none. That is for the people in Congress. Good doctors don’t do that.
“Dr. Deane” Waldman MD MBA is author of award-winning “The Cancer in Healthcare;” host of the Newsletter-&-Forum, We The Patients; Professor Emeritus of Pediatrics, Pathology, and Decision Science; Adjunct Scholar (Healthcare) for Rio Grande Foundation public policy think tank; Former Chief of Cardiology (Pediatric) at University of Chicago; and currently serves as “Consumer Advocate” member of the Board of Directors of the New Mexico Health Insurance Exchange. His published opinions are solely his own and do not necessarily reflect those of the Board.
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