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Neither physicians, nor patients (not consumers) really have much control

over  health care, despite what all the MBAs, Pundits, Consumer Advocacy Committees and Wanabees running all over the country going to seminars, meetings, Health 2.0 and the like. Physicians are always pictured as rich, fat and living off their unfortunate patients who are misled by the government and payors in the name of money. These organizations attribute their own feelings and attitudes upon doctors about the expense of caring for sick patients. They project their own attitudes on physicians.

During my early career years (about 20 or more  years ago) I made a very nice living, if I say so myself I saw  many patients for free. I would do surgeries for free, arranged for charitable care, had colleagues I could refer to who would be gratified that I would send them poor patients because they saw my trust in them to do the ‘right’ thing. I never sent a patient to collections, (doctors would just not do that sort of thing)  Not that I was so wonderful, but the vast majority of doctors would do the same as I did.

Physicians would graciously go to an Emergency department, when called, grateful for the referral. In fact physicians who would not respond to an ER call were shunned, and even reprimanded by the chief of staff or even would have their hospital privileges revoked. Today many physicians, if at all possible will resign from a hospital to avoid ER call.

Did you know that most insurance companies require you to have hospital privileges or have someone who will sign off that they will cover you to be on their panels?

When I observe what is happening in our world I realize that as Americans our greatest entitlement is freedom. That doesn’t mean freedom to ‘redistribute the wealth’, nor free healthcare, nor huge pensions.


The beauty of freedom is freedom allows for corrective changes without concern for rigidity of bureaucracy.The beauty of freedom is the ability for creation of new transformative ideas, and the implementation.Liberty and freedom are risky, and ultimately requires more input and energy than socialism or collective action. Why should your health depend upon a politician who knows little about healthcare, distracted by other decisions such as war,immigration issues, foreign policy and the liittany of challenges facing our nation. What would a former Governor know about running HHS?. Did anyone ask the doctors or for that matter congress and the people if Don Berwick MD was a suitable head for CMS?

As most physicians think in the doctor’s lounge (if your hospital still has one), our system is badly broken, unrepairable except by a sweeping dictatorial reform such as Obamacare,  It.doesn’t matter if it will work or not,

All of this is not unique to medicine, it has become endemic in all of America.

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