In Part 1 of this two-part series, I discussed some of the effects of Obamacare to date.
Of course, the problems didn't start with Obamacare, but rather started years ago with the adoption of Medicare. And today's problems are not just due to Obamacare but the society and nation that embraced it. I don't wish to sound too glum, but Obamacare is just one symptom of the problems that threaten our nation as a whole.
As Jane Orient, M.D., wrote in the recent newsletter of the Association of American Physicians and Surgeons, we are undergoing an attack on our cultural values that have nothing to do with race or religion. The "Western civilization" that is the traditional source of prosperity is not just white, but Korean, Chinese, Japanese, Jewish, etc. "It values faithful marriage, families, education, respect for legitimate authority, hard work and personal responsibility. A primitive underclass culture of immorality, chaotic relationships, grievances, illiteracy, disrespect and a sense of entitlement is ruinous for the individuals who embrace it and the society that supports it."
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Obamacare exists because we have at least one generation of Americans, if not more, who do not understand "entitlement." They do not understand that when government gives something to one person or group it must first take something from someone else. So, now, we have the coming together of an "entitlement generation" and an unethical and corrupt political class that cares more for its own power and prestige than it does for the nation or the well-being of its people. And this oligarchy, of which Hillary Clinton is a shining example, is willing to coddle the entitlement class, hiding the moral and fiscal reality to get votes.
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Thus is born Obamacare– a scheme so patently false and ridiculously naïve that I cannot believe Hillary even believes it will work. Imposing a myriad of more draconian regulations and expanding an already broken Medicaid system is unlikely to provide more quality care or more access to even mediocre care.
Most sadly, we are seeing an ethical drift in the practice of medicine. The same utilitarian principles that ushered in the era of medical "rationalism" in Germany are now being taught to our young physicians. Medicine is no longer focused on the individual but on the population, and the young physician is taught to eschew "futile care" in favor of a more "rational" approach. How do you spell euthanasia? Although we like to think that a few sadists corrupted German medicine, the fact is German doctors competed to fulfill sterilization quotas in order to profit from the government largess and reap favors from the power structure.
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Today we have the Obamacare regulators telling us to tightly control diabetes – even though current data show that the "Pay for Performance" stringent guidelines actually increase diabetic mortality. When the government pays doctors to withhold care – care will be withheld. When the government demands instituting electronic medical records (purportedly for standardization and monitoring of quality) – we institute electronic medical records. In May 2015, every newly graduated doctor took an oath, including an oath to patient privacy. On July 1, every new intern violated that oath as they pushed their patients' private details to a computer server run by bureaucrats in D.C. These young doctors will encounter more and more "mandates" that do not result in compassionate – or even quality– patient care, but which will be accepted as the norm. And from such little things comes the slide into a culture of utilitarian medicine where only the worker bees get care, and where end-of-life planning is really euthanasia. We will be like Germany in the middle of the last century and the Netherlands and other socialized medical countries today – a nation that does not care for the most vulnerable among us: the old, the infirm, the child with disability, the very young or the unborn.
The oligarchs in Congress will not stop Obamacare. But the good news is this: More doctors will continue to opt out of the system and practice for cash. From concierge care to the rich, to walk-in doc-in-the-box medicine for the poor, cash is making a comeback. The Oklahoma Surgery Center has led the way for cash-driven hospitals – excellent care at excellent and transparent prices (because they do not bill the government or third parties). The Association of American Physicians and Surgeons teaches doctors how to restore ethics and compassion to medicine through fee for service, and to give patients good value for their cash dollar. Sadly, I predict the government will not like any breakaway from their system and will try to clamp down on this "gray market" of health care. They will do so by asking state medical boards to require participation in Medicare/Medicaid as a condition of medical licensure. If that happens we are lost.
So in 2016, we must all be guardians of our medical freedom. Watch out for medical boards being co-opted by the feds. It is time for patients and physicians to link arms and demand the freedom to choose how they will receive care. Our freedom and our very lives depend on it.