What we have lost and why we need it back
The traditional medical profession in America has been radically attacked throughout the 20th and now 21st century by those who wish to destroy the contract between a doctor and a patient, and to replace it by a system wherein the replacer controls the destiny of both. It is time to characterize this power grabbing demon middleman for who he is, a dictator of “healthcare insurance.”
“Care” insurance dates back to 1935, in the name of compulsory care of the elderly and disabled populace by the government in the name of “social” security. Reagan defines multiple attempts by government to gain full power of “healthcare” for all Americans that through the years was rejected by the electorate, ultimately becoming successful as a subordinate of social security in the name of “Medicare.” Medicare is compulsory “healthcare insurance” for all Americans over age 65, whether they need this assistance or not. Finally, special interest in the name of “managed care”, a partnership of government run healthcare insurance and the purveyors (providers) of private “healthcare insurance”, has arrived, and this common interest has decimated the medical profession.
In essence, the ethical and effective art of medicine is now replaced by a disguiser or misrepresentor, a deceitful insurance agent, and “healthcare insurance” is not diagnosis and treatment of medical and surgical disease, a process which requires a physician. “Healthcare insurance”, both government-run and now crony capitalist (special interest)/government-run, is a self-serving, very profitable, and resource destroying enterprise. Junk social and political science blend with junk medical science, and we have an ineffective parasitic monster, completely eroding access to diagnosis and treatment of disease. Furthermore, there is complete wearing away of access to the physician of a noble, incentivizing profession.
An insurance agent underwrites or sets his name to a health insurance policy, becoming answerable to the customer and thus providing his treatment on consideration of receiving compensation as part of the customer’s premium payment. Furthermore, he shrewdly selects the risks and rates the acceptability of the risks he purveys. The doctor is now controlled by the “health insurance agent/bureaucrat”, and his skills and judgment are reduced to code, and he becomes the front man for the insurance company; the scapegoat. The physician loses incentive and love of profession and becomes introspective, otherwise defined as burned out. The patient becomes completely dependent on a corrupt system which defines him as a “life” or as a “unit”, or as a data point of “code”. Only an inexorable propagandistic challenge on an emotional basis (advertising and junk “news”) keeps him purchasing the instrument of this wrong direction, self-serving, resource depleting enterprise. Even though he knows something is wrong, what’s the alternative?
There is loss of confidence and security, the kind of security we’ve been promised by expanding government for a long time. People self-treat their fears and insecurity with prescriptions, overeating, holistic medicine, tetrahydrocannabinol, and Web-MD, to name a few of the junk science options. They get fed up and dial out.
The education system in America has been easy territory for the “healthcare insurance” providers. Medical education is a hierarchical system and the doctor moves up the ladder and ultimately becomes qualified and certified to practice medicine or surgery. The truth is that an intern (a brand new doctor) is the lowest level of medical humanity, and the teacher dictates his/her education. That is the way it must be, strictly growing in experience and delegating and teaching as he/she matures into the position of independence. Indeed, medical educators, never leaving a bureaucratic way of life, avoid independent practice in society, and become the automatons of the health insurance agents, thus rationalizing their survival and avoiding burnout. Doctors are now unincentivized “health insurance provider” employees or workers, and we rely on increasingly unqualified people with unqualified jobs, because the boss is unqualified to diagnose and treat disease! The end result is a bureaucratic system and a lost resource, the value of “healthcare insurance” not worth the paper it is written on.
We need our doctor and patient contract back, so that when we get sick, we get the best way to eradicate the disease, and so that doctors can enjoy their noble profession again, and such that it is affordable for everyone. It is time for an attitude change, a transformation of thought. We must re-introduce discipline, constraint and truth. We “can do” this! We “must do” this! We will do this!
Patrick Wagner, MD lives in Nevada City.
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