Many years ago America started down a path that has gradually limited the free practice of medicine and the relationship between physicians and patients. You can never really have a private meeting with your doctor anymore, because the government is always in the room with you. Now, under the electronic medical records provisions of President Obama's stimulus package, whatever happens in that room will be reported to the government with the rest of your medical history—without your permission.
American medicine is constrained in a Byzantine web of regulations, legislation and bureaucracy. It is a mess, and the status quo cannot be defended. It should be reformed.
Americans are appropriately concerned at the prospect of socialized medicine. Some advocates want exactly that, and many politicians are pushing us in that direction.
But the system we now have and the course it is on is more accurately described as fascist. Factions vie for the patronage of political-power brokers.
When Hitler was asked why, as the leader of the National Socialist party, he did not nationalize businesses, he responded that such action was not necessary, because "I have nationalized the German people."
This practice has been evolving for generations and takes place at all levels of government. At the state level it takes several forms. Medical licensing was created to protect the public, but it can and has been used to limit the entry of new competition for current practitioners. It has also been used to threaten the careers of currently licensed physicians for reasons unrelated to their professional credentials.
The most conspicuous avenue for political manipulation is the regulation of medical insurance. This takes the form of coverage mandates, requiring insurance for treatments and procedures not wanted by the purchaser and at a price beyond his means. Legislators place the interests of their clients ahead of the public. When insurance itself is mandated and everyone must buy it, an even more powerful magnet for special-interest coverage mandates is created.
Consumers cannot escape from this burden when states forbid competition from insurers in other states. Each state's insurance commissioner and attorney general agree on one thing—that consumers are unsafe in the hands of officials in all the other states.
Medicare regulations are so lengthy and complex that no one can read them let alone understand them. No one can even lift them. Yet violations by a health care provider can result in criminal prosecution. That serves no purpose except to allow enforcers to arbitrarily and capriciously punish innocent victims as their whims dictate.
A few trial lawyers destroy objective law, buy off legislators, place their partners as judges in the court system, and practice legalized extortion. That directly increases the cost of health care for everyone and indirectly wastes much more on the defensive medicine strategies that physicians and hospitals must practice to defend themselves in court.
Medicare reimburses physicians and hospitals for less than the cost of their services. Costs are shifted to other payers, who are blamed for rising costs.
Instead of fighting for their right to practice medicine as they think best, professional associations are transformed into what amounts to public employee unions seeking the favor of and becoming the clients of politicians.
The FDA delays the introduction of new drugs for years and increases their cost in a politicized process that serves an anti-business agenda unrelated to health care.
Federal law prohibits new, more efficient specialty hospitals, under pressure from large hospital groups. It also requires emergency rooms to admit any patient for any reason, which results in such waste as the recently reported 2,700 visits to ERs in Austin by just nine people.
The Roman Republic self-destructed when its client system invented rule by political pull. Such systems inevitably become corrupt until they collapse or an emperor comes along. Similar practices are the cause of our incomprehensible health care mess—and the chief threat to what remains of personal choice and individual rights in medical care.
Reform must reverse that trend, not expand it.
