The news is filled with stories about a U.S. health care system “plagued with shortages” of money for care, access to care, and doctor time. What they do not mention is the shortage of freedom.
Americans are not free to select their preferred physician or choose the medicines they take into their bodies. Government bureaucrats, not physicians on the scene, triage critically ill patients based on “crisis standards of care”: non-physicians applying a checklist to decide who will live and who will die. Patients cannot choose who will operate on them, where, when, or even if. And of course, Americans cannot decide how to spend their health-care dollars — nameless, faceless bureaucrats do that. This is medical tyranny.
Doctors are equally un-free. Your assigned physician (assuming there is one) does not choose your medications, a pharmacy benefits management (PBM) program does. Operations are performed where the health plan instructs, and by whom they choose. Providers for Medicare and Medicaid patients must simply accept the federal payment (“reimbursement”) schedule.
Supporters of Biden’s Anti-Inflation Act of 2022 proudly announced the act empowered Medicare to “negotiate” drug prices. This brings to mind a soldier (provider) with a handgun negotiating with an M-1 battle tank (federal government as Centers for Medicare and Medicaid Service, CMS.) CMS dictates the payments, telling providers to take it or leave it. As providers are bound ethically to care for their patients, they must simply accept whatever payment schedule Medicare and Medicaid announce.
Both patients and providers live under medical tyranny. For providers, this creates an intolerable ethical conundrum. Medical ethics require a physician to provide the best possible care for the patient. Patients believe (wrongly) the provider has the authority commensurate with their responsibility. This is not reality. Doctors can only prescribe drugs the PBM allows. Surgery is done in the cheapest hospital, not the one with the best results.
Death by Queue
Single-payer health-care systems, the acme of government medical tyranny, are in danger of collapse in the United Kingdom, Australia, and Spain. Some experts warn of a similar breakdown here.