By Patrick Wagner, MD
Obamacare, or the Patient Protection and Affordable Care Act (PPACA), is a dangerous law which has been imposed on the American people. It is the final blow in a series of laws that have been steadily inflicted on Americans for the past 20 years. These laws have slowly taken away the liberty of all of us, and the irony of it is the means by which this oppression has occurred. It’s called DUMMY DOWN.
Let’s review the recent history of American medicine. Most of you likely remember our traditional means of health care, because it wasn’t too long ago that PRIVATE PRACTICE was our way of getting better when we got sick. We had a special process called the DOCTOR PATIENT RELATIONSHIP that was its foundation. Everything seemed to fall into place. Either the doctor was able to handle the problem in his or her office or was able to utilize the hospital or other referrals to get you better. There was trust and you recognized that you were getting the best health care possible. Although at times costly, you recognized that the payment you or your catastrophic health insurance company was paying was well worth the services you received. Goodwill flowed. Things were PRIVATE.
It was 1992, the year that MANAGED CARE took over, that the DUMMY DOWN process began. In that year, your health insurance companies, who paid claims for your higher cost treatments (example the admission, surgery and 4 or 5 day stay in a hospital), and I might add responsibly, as they were required to do, changed their vocation. Health insurance companies, with the aid of contract law and the federal government, became ADMINISTRATORS of health care. What we as physicians and you as patients didn’t recognize is that this new entity, which was before a simple means of exchange of money for services, bullied their way into a leadership role over you and me. The DUMMY DOWN had begun, and the propaganda used was based in humanitarianism. These administrators craftily pitched decreased cost and increased quality for you, the patient.
How did our federal government assist in all of this? First of all, they allowed it. It was all about crooked big business, lobby and legislators. Most of us have a sense of that nowadays. But a second and crucial aspect of the assistance relates to a law passed in 1989 called the Omnibus Budget Reconciliation Act, with emphasis on physician reimbursement, activated in 1992, that dealt the final blow. In simple terms, this law set a price on a doctor’s head, the fee that Medicare would allow for services rendered to a patient by a physician, without the input of the physician!
This law in conjunction with the legal and binding administrative function of managed care organizations (all of them!) are the agents of socialized medicine. We have been at this for 20 years. In this period of time, between 1992 and 2012, Medicare has continued to cut payment for physicians and hospitals drastically. The managed care organizations (health care providers) have cut payment way deeper than Medicare. Doctors were forced to join hospital staffs, fee for service is gone, private practice is gone, the doctor patient relationship is gone, and DUMMY DOWN is alive and well. These administrators tell doctors what to do and how to do it. They know nothing about the practice of medicine and surgery and what is safest for patients and could care less. NO LIE!
The goals of your health care providers and Medicare have been to decrease your cost of health care and increase the quality. In the process, the health care providers have become wealthy and cheated you and me horribly. In like manner, government has turned the notion of a humanitarian project (Medicare), chuck full of fraud, into a debt service upon the American people that is so astronomical as to be absolutely impossible for us to ever meet! Now, the government will absorb the health care providers, leave them with a little bit to do and with Obamacare completely take over. As I indicated above, the quality of patient care in this country is dropping off dramatically. Health care providers told me how to care for my patients. I disagreed and moved on. Dangerous cut corners are unethical and contrary to the Hippocratic Oath, PERIOD. Where is the quality in rationing health care to our people, be they seniors or younger folks who just want to get better? This isn’t quality, it’s murder.
I have authored a series of articles that highlight the above changes in kinder tone, but now I move forward to the DANGER AHEAD. Obamacare , the PPACA, is a work in progress. What has happened with this law must be stopped. For surgeons, there is a lead organization called the American College of Surgeons. This body is made up of leadership (surgeons from our academic residency training centers) and “fellows”, or surgeons around the country who pay approximately $1000.00 per year to be in it. This seems to allow the “fellows” a status symbol to make them look better. I never joined.
The American College of Surgeons turns out to be a PAC, fully engaged with the legislators who have aided and abetted the mechanism of socialized medicine discussed above. Residency programs around the country have begun to believe in the Obamacare legislation and have heavily engaged in setting the policy of the law, still in progress. Program directors (academic surgeons) have begun to teach residents to do shift work instead of selflessly taking care of patients. There has been an implementation of 80 hour work week schedules for these residents, who must become surgeons within 6 or so years. This number of hours of work and learning is far too little. Surgeons don’t do shift work. Sad, but DUMMY DOWN has infiltrated our teaching institutions. DANGER.
When people get sick, they demonstrate sickness in various ways. It can be tricky, and requires experience, skill and judgment on the part of the physician. As we all have different fingerprints, we all demonstrate and respond to illness differently. In surgery, there are many subtle ways in which the patient responds to the stress of the operation and the illness. A patient with a perforated appendix can respond in many ways. He or she can die, develop an abscess or maybe just a fever and need to stay in the hospital for a week after surgery. The anesthetic agents used during the operation can be tricky as well. In all instances, the doctor knows what’s best, based on his or her personal experience, skill and judgment. Medical doctors and surgeons truly know how to do it!
Cookbook medicine is another aspect of the Obamacare legislation. Teaching institutions, who should be teaching residents how to take care of patients and moving forward in research, are now creating the rules and regulations of our developing legislation. For example, evidence based practice, pay for performance, maintenance of certification, value based medicine and other entities are what are being pitched to the heartless legislators by our professorial academians. Value in quality and cost containment is the spin. Treating each and every patient as a distinct human being with a distinct illness is not being taught anymore. DANGER.
The greed of the teachers of surgery is UNETHICAL AND A BREACH OF THE HIPPOCRATIC OATH THEY SWORE. They do what they do for survival. They are allowed to do it by the receptive managers of socialized medicine. DANGER.
What do we do to fix it? REPEAL OBAMACARE, NOW. You and I must demand that our legislators repeal Obamacare now! Don’t stop hacking at them. Our local state legislators are fiddling around with SB810. The foolishness of proposing this legislation is contrary to the liberty of Americans. Make our legislators change the laws! They are subjecting all of us to DANGER. Any time you hear a physician say that a single payer health care system is in order, look him in the eye and tell him hell no, we’ve already got socialized medicine. Tell that fool to join us and repeal Obamacare. DANGER ahead my fellow Americans, unless we GET WISE and fix it now!
Patrick Wagner, MD is a retired general surgeon, making his home in Nevada City.