Healthcare Reform and the so-called “Stimulus” Plan

Healthcare reform would have been tremendously expensive and problematic even in a robust and dynamic economy.  How much chance does it have in the current train wreck of an economy?  This thought was apparently not in the minds of those who crafted the pork-laden stimulus package.  But they did not stop at mere considerations of cost according to this Bloomberg opinion piece:

One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions. These provisions in the stimulus bill are virtually identical to what [former Secretary of Health and Human Services Department nominee Tom] Daschle prescribed in his 2008 book, “Critical: What We Can Do About the Health-Care Crisis.” According to Daschle, doctors have to give up autonomy and “learn to operate less like solo practitioners.”

Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far.

Hospitals and doctors that are not “meaningful users” of the new system will face penalties. “Meaningful user” isn’t defined in the bill. That will be left to the HHS secretary, who will be empowered to impose “more stringent measures of meaningful use over time.”

What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make.

[Daschle] praises Europeans for being more willing to accept “hopeless diagnoses” and “forgo experimental treatments,” and he chastises Americans for expecting too much from the health-care system.

Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.

So healthcare reform means making medicine even more bureaucratized than it is now?  With physicians being second guessed even more by non-physicians whose only acquaintance with the patient is a name (or a number) displayed on their computer screen?

The arrogance is breathtaking!  There seems to be not even an iota of the hesitation or uncertainty that is all too familiar to physicians faced with a patient whose problem does not fit into a nice, neat algorithm.  Those politicians who support this measure have apparently forgotten (if indeed they ever knew) the admonition of Adam Smith in his book The Theory of Moral Sentiments:

He seems to imagine that he can arrange the different members of a great society with as much ease as the hand arranges the different pieces upon a chess-board; he does not consider that the pieces upon the chess-board have no other principle of motion besides that which the hand impresses upon them; but that, in the great chess-board of human society, every single piece has a principle of motion of its own, altogether different from that which the legislature might choose to impress on it.

Perhaps I’m being overly optimistic, but I don’t think doctors and patients will tolerate this level of intrusion into the health care system.


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