by Richard Amerling, M.D.
Contemplating how we got to ObamaCare brings to mind the L. Frank Baum classic Wizard of Oz. Both require the complete suspension of disbelief in favor of magical thinking and the bestowing of God-like abilities to mortals.
The Yellow Brick Road to OzbamaCare is paved with empty promises, boldfaced lies, and…..price controls. The people are promised access to high quality healthcare at little or no added cost; the proverbial free lunch. All will be “covered” regardless of pre-existing illness, and insurance premiums will actually go down! The government will decide what policies will be offered, and dictate the price. Somehow, private insurance companies will survive.
This is as believable as a tin man getting a heart, a scarecrow a brain, and a cowardly lion, courage. The medical profession (well, some of us) go along, naive as Dorothy, though most doctors dream of going home to Kansas, where medicine is practiced between patient and physician, without third party intrusions.
Price controls, administered by public and private third party payers, have already gone a long way towards destroying the world’s best healthcare. Wage and price controls instituted by FDR during World War II set the stage for tax-subsidized, employer-sponsored health insurance. This tornado uprooted people from individual control of healthcare and started us down the road.
Medicare and Medicaid, enacted by LBJ and a Democrat-controlled Congress in 1965, gave the federal and state governments huge toeholds into the health industry. Both programs have grown exponentially, due in no small measure to heavy-handed price controls. Choosing to pay physicians next-to-nothing for seeing Medicaid patients led to ER abuse and skyrocketing costs, which are bankrupting many states. Medicare price controls, especially on doctors, have also fueled massive spending. Less money for office visits leads directly to more spending on tests, consultants, and hospitals, with lower quality care. Medicare is bankrupt and will implode over the next ten years as baby boomers sign up, doctors opt out or retire, and half a trillion dollars is cut from its budget.
The trip to Emerald City ends badly for most of the players. Brave Toto pulls down the screen revealing the Great Oz to be a snake oil salesman. He gives the tin man a cheap watch, the scarecrow a meaningless diploma, the lion a brass-plated medal, then absconds in a hot air balloon.
Dorothy comes to understand she has always had the power to return home. We, too, have the ability to click our ruby slippers, get out of third party arrangements, and return to the unfettered practice of individualized, high quality medicine. But we need the support of millions of patients who realize that all-powerful wizards are a fiction and that only the free market can actually deliver on promises.
Richard Amerling, MD, is a nephrologist practicing in New York City. He is an Associate Professor of at Albert Einstein College of Medicine in New York, and the Director of Outpatient Dialysis at the Beth Israel Medical Center. Dr. Amerling studied medicine at the Catholic University of Louvain in Belgium, graduating cum laude in 1981. He completed a medical residency at the New York Hospital Queens and a nephrology fellowship at the Hospital of the University of Pennsylvania. He has written and lectured extensively on health care issues and is a Director of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the Physicians’ Declaration of Independence (http://www.aapsonline.org/medicare/doi.htm).
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Obamacare gets the Tin Man his heart, all right – by tearing it out of the living body of the average American citizen.
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Well stated and a very appropriate analogy. I opted out of all Managed Care Contracts 7 and a half years ago after 24 years of indentured servitude. Now the battle must be joined by others before it is too late. The new generation of entitled physicians has no idea what you are even talking about. They only want to know how many days off they get each week, who is going to pay their over-estimated salaries, and when is their shift over? I fear our profession may have already slipped through our collective grasp. Keep up your efforts and know that some of us are right there with you.
Thanks much. It tells a great story in a way that hopefully most can understand. However, until we get the patient and YES, the employer populations involved then it will be a tough fight with lots of political diversions that the Ozbama teams will continue to fly into peoples faces like the flying monkey’s from the Wicked Witch, Nancy Pelosi. The November election is the most critical in the last four decades. We need experienced healthcare professionals to throw down the gauntlet and run for office.
“Doctors are not servants of their patients, they are traders like everyone else in a free society and they should bear that title proudly considering the crucial importance of the services they offer.” Ayn Rand
“It only stands to reason that where there’s sacrifice, there’s someone collecting the sacrificial offerings. Where there’s service, there is someone being served. The man who speaks to you of sacrifice is speaking of slaves and masters, and intends to be the master.” Ayn Rand
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One reason this analogy is so apt is that the Dunhams of Obama’s ancestry hail from El Dorado, Kansas. Obviously, the founders of thaT TOWN BELIEVED IN THE MYTHICAL CITY OF GOLD. BILLBOARDS proudly claim that is also the birthplace of the Wizard of OZ (ie. where the book w3as written)..
As I drove through that long stretch of Western Kansas flatland, the highways shimmered as wet mirage. In the ambient haze I saw what seemed to be castles on the horizon. Anticipation built only to be dashed on the knowledge that those castlers were indeed Coop grain elevators. That speaks to the dreamy worldview that the Dunhams gave Obaama.
In the real world, the way bricks get to be yellow is from urine. Apt.
The doctor from AZ. Don’t quit! Fight! Help your AZ governor fight the Washington DC government, This is exactly how Germany started and if they want to come and get me OK.
When I first heard Obama speak, I got cold all over my body and chills. The first thing I thought was “ANOTHER HITLER”. GOD BLESS AMERICA.
The HMO’s have the American people in a situation where they pay big bucks for health care.
My doctor doesn’t take any HMO’s.
I have lost two doctors because Medicare paying is a mess! I have been appealing some of the doctor chg that I paid up front and Palmetto has resfused to pay. We are still in 08 bills. This is a Senior nightmare.