The Bush administration announced today that a 5.1% cut "across the board" was in store for doctors who see patients in the federal health payment system known as Medicare.? The average income to physicians in the United States has declined by about 10% over the past 10 years (when adjusted for inflation).? All other professions have seen a rise in incomes.? The cost of providing service hasn't declined because doctors have to pay the increased salary that their accountant and lawyer have enjoyed.? Is it any wonder that doctors are choosing to leave the profession of medicine in greater and greater numbers at increasingly greater speed?? The federal government has stumbled upon a politically feasible way to slowly, painfully and absolutely dismantle and destroy the disease management functions of Medicare.? Though it can be clearly shown that less medical care is better for patients in their last months of life and that general practitioners and internists do the best job, this won't ever be accomplished until the reimbursments for providing this care are so low that no one can afford to continue serving this population.? This is called rationing by hassle!
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There is a rapidly evolving "two-tier" system that places those at the federal "tit" in extreme jeopardy.? The ability to see patients and spend time to determine what they need to be well and manage their complex medical problems requires adequate payment.? This will NEVER happen in a federally funded system.? It can't happen by virtue of the economics involved.? Health is attainable through the efforts of each individual in almost every situation.? There are occasionally disease states so severe that no amount of intervention from the medical community creates a benefit.? These are probably less than 1% of all problems seen.? As death approaches most people commit more energy and money to staying alive than at any other time in life.? If the federal government uses this predisposition to garner votes at the expense of the governed it will continue to degrade the medical system.? The only way to politically survive the pain that this problem presents is to blame.................? THE MEDICAL PROFESSION!
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Of course!? The doctors are the problem.? It will be very popular to put doctors in prison and strip them of their licenses.? It would never occur to the morally bankrupt federal disease management industry to admit that it is a mistake to offer unlimited service for free.? The prices for physician visits are being cut 5.1% across the board.? Does that mean that each visit should take 5.1% less time?? Does that mean that rent should be lowered to all doctors by 5.1%?? Should groceries be subsidized to physicians and their families through a new program "Physicians Grocery-Care?"? I would hope not.? Instead, I would think that physicians would take the ethical high ground and refuse to see any new Medicare patients until the government restores sanity to the system by removing Medicare as a guarantee and deregulating medical and other forms of health care so that consumers and providers could meet agreeably in the marketplace.? Is that fair??
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The question of fairness really only matters during election cycles.? The real question is "How can people be motivated to value their lives more?"? The cost of preventive care is infinitessimally low when diet, exercise and healthy relationships are the focal points.? When drugs, vaccines and screening studies are included the economics become much more painful.? I believe that health and wellness research, teaching and community-building ought to be tax-free events.? Federal dollars should first be spent on the defense department and highways.? Social services can and should be the responsibility of the private sector, not a mechanism for securing votes from a "hoodwinked and gullible" public.?
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Doctors should be the very first to acknowledge that a patient has to feel the costs of their decisions and choices or their outcomes are never the best possible ones.? When it comes down to the final days of a person's life, the most recent studies show that a regular primary care doctor gives the best and most cost-effective care.? That's probably because this doctor knows the patient and will discuss the futility of death-extending care when life extension is no longer possible.? It's probably because that doctor genuinely cares.? Systems don't and can't care for people.? Onle people can do that.? We should phase Medicare out and adopt an intelligent system that allows each individual to buy insurance that meets their needs.? These systems would require much more thinking than "It just doesn't seem right to leave old people to die wihtout medical care."? The point is they are receiving treatment but are likely to receive less and less care.? When it comes down to it, what I really want is care.? I'm not interested in treatment that is delivered by an impersonal, underfunded federal bureaucracy.? That seems way too much like veterinary medicine (which, by the way is a vibrant, growing profession because of the lack of federal meddling).?
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Insist on freedom when making choices about your health.? There's no such thing as a free lunch, prostate biopsy or hip replacement.? Someone, somewhere has to give up some of their freedom when others receive "free" treatment.? Health freedom ?legislation was first suggested when our country was founded by Dr. Benjamin Rush.? He thought that we would be in big trouble if people didn't have the right to freely choose health care just as they choose a religion or words they speak.? Well, he was right.? We need to be free to choose what kind of care we want and we need to be willing to accept the responsibility for paying for it.?
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Freedom is worth fighting for..............
