Mayor Bloomberg’s ban on large soft drinks, trans fats , salt, and now the assault on a new mother’s right to choose how to feed her baby is a stark reminder that whoever pays has the power to control.
The Democrats and the Republicans have done a masterful job of demonizing the physician. The doctor has been the scapegoat for skyrocketing health care costs while giving more power over the medical industry to those entities that have been the architects of the broken healthcare system that we have today. In short, the system is a complex network of corporate middlemen, that have worked tirelessly figuring out ways to skim profits while simultaneously shifting the costs to patients, rationing their care in the form of pre-certifications, increasing premiums, and outright denials on one hand while decreasing physician reimbursements (in the form of bundling), lowering fees, implementing recovery audits to claw back reimbursements, and outright denials of payment after services are rendered on the other. The government has put rules and regulations into place that encourage and reward this behavior, while ensuring that doctors and patients continue to feed a beast that needs increasingly more money to run a system that is based on the management of chronic disease instead of true prevention. It is no wonder that we are spending more money on healthcare and are on more medication, yet we as society are getting sicker.
For those who continue to delude themselves that Obamacare will lead them to the healthcare land of milk and honey, I have some news for you -- it’s never going to happen. Critical thinking would lead one to the conclusion that there is no way to add 30 million more people to a system that is already fundamentally broken. There have been many arguments used to sell Obamcare to the public. Much of it has been disingenuous, peddled not by doctors who are on the front line taking care of patients to the best of their ability, but by corporate interests that stand to gain from profits gleaned from the practice of corporate disease driven medicine. e.g., the pharmaceutical industry, the American Medical Association, AARP, The Hospital Corporation of America, and various unions.
After months of denial that healthcare reform would involve rationing of healthcare for those who are the most vulnerable, the senior citizens who depend on Medicare, the President has come up with a proposal to decrease healthcare costs and guess what….it’s rationing. Under Obamacare, a 15 member panel known as the Medicare Independent Payment Advisory Board (IPAB) was created to ‘oversee healthcare costs’. This panel consists of individuals appointed by the President and confirmed by Congress - two ingredients that make it highly unlikely that they would be truly independent. In addition, there is no mandate that members be practicing physicians which is a recipe for cuts that are highly likely to affect the delivery of quality individualized patient care.
The implementation of the healthcare reform bill that was passed in March has now begun. Unfortunately, it is becoming obvious that the promises made such as: a) you can keep your physician and medical plan if you like them; b) your healthcare costs will go down; c) there will be no healthcare rationing; and d) everyone will be covered simply were not true. We were fed a steady diet of fear, distraction and falsehoods to sell healthcare reform. Why have none of these changes been implemented? Perhaps it is because this is a system that is set up to fail. When people get so fed up with waiting for treatment, or no longer want to put up with being denied care because a decision is made that the costs outweigh the benefits, the government will be ready to step in with the solution of the single payer system. Unfortunately, when that happens medical care in the United States as we know it will be lost forever, and we will be saddled with a system that even the British find untenable.