It offends the refined sensibilities of many high-minded people that crude law of the jungle should have any place in the sacred and transcendent fields of health, education, art and so on. But the laws of chemistry certainly apply to drugs and their effect on the body, so there is no rational reason to expect that economic laws shouldn’t apply to the organization and administration of health care too. If more people are clamoring for services that fewer people are providing, either the price of that service will go up or the availability will go down; a shortage, with queues, waiting lists, black markets and other forms of rationing will ensue (see: Canada and the UK).
That’s the law of Supply and Demand, and it’s real, it is of the fundamental nature of human action in society, and it is not subject to repeal via political legislation.
It also explains what is wrong with the health care market in the United States and elsewhere.
The practice of medicine involves a whole lot of math and science (something which our public school pupils and public government politicians are woefully deficient in) but at its core it is an art: an art of human and social interaction among doctor, family and patient; the whole patient, not just the pancreas; the patient’s family history, not just today’s symptoms; the patient’s personality type, psychological profile, relationships, work, nutrition, exercise, sleep and drug habits, not just ink bubbles on a chart. Only a highly trained and experienced doctor or nurse or other provider who is free to practice his/her craft without third-party interference can provide the most effective care.
When we need care badly, we want the best practitioners of the art caring for us and are willing to mobilize our resources to get them. And in the freest nation in the history of the world, there has never been greater quality care nor greater access to it by the most common of citizens.
Yet the government-sanctioned system for regulating healthcare services completely undermines this. In the bureaucratic calculus, a bypass operation is a bypass operation is a bypass operation, whether performed by a first-year intern or a 30-year world-renowned veteran. It has a code in the system and a price that Medicare is willing to reimburse, no more, no less, no qualifiers, no accounting for skill, experience, dexterity or judgment (above all no allowance or toleration for judgment!), no exceptions.
If all there were to medicine was the correct generic, commodity cookie-cutter treatment for the matching defined disease or condition, then no doctors would be required; only kindergarten-variety bureaucrats trained to put the square pegs into the square holes and the triangular pegs into the triangular holes.
Do I exaggerate? A physician who treats a patient according to his or her professional judgment differently from what the government-sanctioned protocol produced by the ‘embedded clinical decision supports’ (the computer that tells the doctor what to do) say (s)he should faces denial of reimbursement, second-guessing of his/her decision or worse. It is happening today with Medicare billings and pharmaceutical prescriptions, and it will explode tenfold when the Medicare model is applied to the entire population.
Under Obamacare, the Independent Medicare Advisory Council (IMAC) may deny medicine, devices or treatments to Medicare patients that its ‘comparative effectiveness analysis’ algorithm deems unsatisfactory; that is, too costly (it’s about the cost to the agency, not the effectiveness to the patient). This is government ownership of your life.
It’s time to pull the plug on Obamacare.
More Health care reform resources on the Obamacare page.