I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them.--Thomas Jefferson

Sunday, March 6, 2011

Government Medicine, a Formula for Mediocrity.


First Published Nov 2010 in Orthopreneur

There are many reasons to avoid government medicine.  Cost is one.   Although cited as a reason in favor of government intervention, does anyone with at least an eighth grade education really think the government will save money by providing more efficiency and effectiveness than the free market?  Has it in any other area?  With all its regulation, the same government that brought you the $600 toilet seat brought you the $18 aspirin.  (I checked, and that is the going price in our facility which accepts Medicare).  And, then we could discuss the huge moral issues at stake here when doctors become agents of the state.  Few today remember the conclusion of the Nuremburg Doctor Trial wherein they hung the Nazi doctors responsible for the euthanasia program and experimentation on prisoners.   Allied prosecutors concluded that German doctors were not intrinsically evil, but rather, their fault lay in working for the government. Only 18 years before the implementation of Medicare, these prosecutors all agreed with the words of Leo Alexander of the American team when he opined  “We should never let doctors work for the government again.”

Another concern, and the one I wish to discuss today, is how government medicine-- by its very nature-- insures mediocrity in our profession.

In the big scheme of things government induced mediocrity is demonstrated easily.  Politicians and the elite may let the common folk get “average” care, but they themselves want EXCELLENT care.  Which is why two prime ministers of Canada snuck across the border in the dark of night to come to the USA for their own medical care.  If government medicine was so great why didn’t they stay home?  When Boris Yeltsin, needed heart surgery he employed American trained doctors, and even then flew over Dr. DeBakey to the Soviet Union to supervise, because he knew what Ayn Rand had written that, “It is not safe to trust your life to a man whose life you’ve throttled”.  

Saturday, March 5, 2011

Healthcare Bill Takes Away Our Liberty

by Lee D. Hieb, MD

Make no mistake. Every time the government offers you any form of safety or security, it takes away your ability to make choices about your own life. No matter how noble, every government safety imposition diminishes your individual liberty. This principle is no more obvious than in the current healthcare reform, which is why there are so many voices in chorus against this “transformation” of America.

When this law is in full force, individuals cannot choose to self insure, no matter how much they may be able to afford to do so. Now, you can be thrown into jail for not complying with the government’s plan for your own safety. This sounds like something out of a Stalinist show trial: “Comrade, you are guilty of “insufficient self protection”—five years in the gulag!”

Health Care: The Best Plan is to Have No Plan.

 In response to the Obamacare health plan, groups from doctors to union bosses to Republicans (not in any particular order) have put forth their alternative plans.  Today, there are more plans floating around D.C.  than those we used to win World War II.  (And at least the military readily admits that war plans don’t survive the first armed encounter.) No, we do not need any more plans.  The best plan, is to have no plan.  None.  Because plans require planners, and if the Twentieth Century should have taught us anything it is that central planning doesn’t work.

AMA Doesn't Speak for Most Doctors

 First Published at HumanEvents.com 1/5/2010

The American Medical Association officially endorsed the Democrats’ health reform bill.  An eager Barack Obama, of course, used this endorsement to claim that “doctors” support his healthcare takeover.  This misleading statement plays on the common misperception that the AMA represents some huge block of American  physicians.  Not true.  In fact, excepting membership given to students and residents in training, the AMA represents only 17-19% of physicians actually in practice.

Did Natasha Richardson Have to Die?


Liam Neeson, one of my favorite actors, experienced a great tragedy last week in the death of his wife, actress Natasha Richardson. I don’t usually pay too much attention to celebrity lives, but having two teenage boys similar in age to hers, I found Natasha Richardson’s death especially poignant.

As a mom, I must express my sorrow for the family’s misfortune. And as a physician, I have to ask: what can be learned in this case?

For the two or three Americans who haven’t read the details, Natasha’s death was the result of a head injury while skiing -- not a high speed Sonny Bono-type wipe out, but apparently a fairly innocent fall during a lesson. She developed an intracranial bleed, and by the time she was able to receive the necessary level of care in Canada, her intracranial pressure was excessive and ultimately fatal.

Medicine and the New Slavery


My father was a small town country doctor and dentist.  He made house calls,  He set his own hours and determined his own time off.  As he got older, he limited his practice hours, and the type of dentistry he did in order to maximize proift per time worked.  At the most, he made $25,000 a year -- enough to live comfortably, but not enough to completely pay his only child’s post graduate education.  He considered himself a free man.

I paid my way through a private Medical School by joining the Navy. After four years of college, four years of medical school, five years of Orthopaedic Residency and four years of payback time supporting the Marine Corps, I spent another year training to be a spinal specialist. That year, 1989, as a Board Certified Orthopaedic Surgeon, I grossed $15,000.

No, Barack, Medical Care is Not a 'Right'


At last night’s presidential debate, Barack Obama led the charge for government run health care by declaring in no uncertain terms that health care is a “right”. I suppose he thinks Tom and the boys accidentally left that one out of the Constitution. Or maybe it is an extension (in his mind) of the right to life.

But let’s think about this a minute. When our American form of government was created to form “a more perfect union” by insuring the “rights” of its citizens, it recognized only the “inalienable rights”. And to protect those rights, which I’m pretty sure only included life, liberty and the pursuit of happiness, the government was empowered to use force if necessary.

We created armed forces (and finally an adequate border patrol) to protect our people’s life and liberty from foreign invasion, and then police to protect our pursuit of happiness in the form of private property. So how will we insure medical care?

Atlas Is About to Shrug


Physicians are not generally thought of as businessmen, and many are not. But most of us are true cottage industries -- a one man or woman show with payroll to meet, buildings to purchase, books to balance. As a physician, I usually confine my comments to medical topics and let the political pundits weigh in on matters in their lane. But listening to the heavy hitters discuss the election outcome, I have not heard the real reason for the Democratic victory -- that we as a nation may have reached Ayn Rand’s tipping point.

I have heard too many explanations: McCain lost because people hate Bush. He lost because of Iraq, or the economy. He lost because conservatism is too strident, or because of Palin. Republicans haven’t enunciated their case. McCain was not a true conservative, Republicans have moved too far to the left, or maybe too far to the right.

How Will Doctors Handle Uncle Sam Health Care?


We can criticize socialized health care, citing statistics and chronicling the historical record of runaway costs and deterioration of quality.  But you have to deal directly with Medicare and Medicaid (or perhaps be a former Soviet citizen) to really appreciate the Twilight Zone nature of government-run programs.

Among federal Medicare regulations -- which are over 130,000 pages long -- there is more than ample room for confusion and some humor. After a long search for traction weights (those five pound blocks of metal used to pull fractures out to length) I found them propping open doors to patient rooms in the ER. It is a punishable offense under Medicare regs if the hospital is caught propping open these doors because they are fire doors.

Obama's $25,000 Error

 By Dr. Lee D. Hieb
Originally published at HumanEvents.com 8/24/09
I’ve been seriously underpaid.  According to President Obama, I get $30,000 “right away” for amputating a diabetic Medicare patient’s leg. So I checked the two inch thick book of procedure codes, then called the biller and found that instead of  $30,000, I actually get $554 or $857 depending on the level of amputation. Obama probably thinks that difference of $300 will incentivize me to take off more of the leg.

And does “right away” mean within two years?  Just ask the car dealers how easy it is to get the government to pay you even after you have spent hard cash rendering a service and have a “clean claim” as the Medicare bureaucrats call it.  Don’t feel bad, guys. After I bill the whopping $554, which covers the patient’s admission to the hospital, the surgery, and 90 days of follow on care, I will be paying out $15,000 in malpractice insurance before I get paid. And that’s only if it takes 90 days.

Fix American Health Care By Fixing the Market


American government policy has made a mess of medical care. But, predictably, the politicians -- and this is truly bipartisan -- do not blame themselves.

Governments never blame themselves. The Soviet government’s policies caused mass starvation and industrial collapse, but did they blame themselves? Hell no. They blamed the only people who knew how to make the farms and factories run. The engineers and specialists, so called “spetzi”, were labeled wreckers and class enemies of the people, imprisoned in the gulag or shot. That didn’t work out well for anyone.