Storm-Trooping Our Way To
Health Care Reform
By Ralph Reiland - op -ed writer for Tribune Review
It's not exactly what you'd expect while waiting in your
doctor's office, browsing through a 1997 issue of People --- just like a
six-year-old in Miami didn't ever expect to be looking down the barrel of a
machine gun at five in the morning.
"A swarm of armed men invaded the West Virginia
medical offices of Dr. Danny R. Westmoreland," writes Dr. Miguel Faria, a
neurosurgeon and editor of The Medical Sentinel. "With their guns drawn, the
intruders ordered everyone, including a nine-year-old child, to stand against a wall
while the office was ransacked. The marauders were agents of the federal
'health police,' and they had violated the sanctuary of Dr. Westmoreland's office,
which is also his home, and terrorized patients at gunpoint in order to execute
a search warrant against the physician."
Eventually, the criminal charges against Westmoreland
were dropped. "I am appalled," said U.S. District Judge Joseph R.
Goodwin, after hearing the patients' eyewitness accounts.
"I am shocked. This
is something this court will not tolerate. It's one of the most outrageous things
I've ever heard."
Outrageous, but not all that unique. "The home and
office of Dr. Jeffrey J. Rutgard in San Diego were subject to an armed invasion by
the 'health police,' during which the records of 20,000 patient
visits were confiscated," reports Faria. In the end, the government's Medicare
commissars judged some one percent of Rutgard's treatments to be
"unnecessary," enough to saddle him with a 10-year prison sentence, a $150,000 fine and an
order to pay $16.2 million in "restitution."
These raids are an outgrowth of the Clinton
administration's Operation Restore Trust (ORT) --- not "trust" in the
Fourth Amendment but "trust" in the idea that storm-trooping is a fine way to root out
any alleged fraud or abuse in our health care system. "Laws intended to
thwart the drug trade or piracy on the high seas
are increasing turned against law-abiding citizens, including physicians," says the Association of
American Physicians and Surgeons. "An astonishing 85 percent of persons who
have their property taken are never even charged with a crime."
What we're getting is HillaryCare in small doses ---
"a step at a time," as her husband explains, "until we finally finish this."
Under Mrs. Clinton's Rube Goldberg scheme of criminalization and top-down
rationed medical care, any physician who provided "unauthorized"
treatment would have been subject to $50,000 fines, forfeiture of property, and --- in some
cases --- life imprisonment. "ORT has produced $200 million in
fines and criminal convictions of scores of physicians who had committed no
crime against persons or property," says Faria, "but had
merely run afoul of an obscure bureaucratic technicality."
Last July 29, The Wall Street Journal reported on a
Kaiser Foundation survey of 1,821 doctors and nurses: "A whopping 87 percent
of doctors said they had patients who were denied coverage by health plans"
and "nearly half of doctors and nurses said they were forced to exaggerate
the severity of a patient's condition to get coverage for treatment."
The system, in short, has tossed no small number of doctors into the same boat as
Westmoreland and Rutgard, i.e., one raid away from being declared an enemy
of the state, guilty of stepping outside the central plan, guilty of
misallocating our "collective" resources.
What the feds have delivered is a "Hands up,
doc!" world of top-down surveillance and centralized rationing where the shots
are increasingly called by an expensive and growing gang of bureaucrats,
lawyers, accountants and HMO administrators. Do too little and you're tossed
into the shark tank of malpractice; do too much and it's "fraud," a
violation of some hallowed guideline of "cost-effectiveness." It's a
setting where individual-based treatment takes a back seat to cookie-cutter medicine,
where fiscal pressures dictate treatment, and where the decisions of a medically
illiterate MBA trump the autonomy of physicians and
patients.
The price, on top of the 19 percent decline in medical school applications since 1996? "We're about to lose a whole generation
of our most skilled and senior doctors to early retirement," writes
Washington Post columnist Charles Krauthammer, himself a medical doctor. "Early, and
in a way, forced" --- forced by a system of "rationed care, rushed care,
standardized care" and "ever-shrinking reimbursements" where
physicians are second-guessed by "some 24-year-old HMO functionary who knows as much about
medicine as he does about cartography demands to know why Mrs. Jones, the diabetic
in renal failure, has not been discharged from the hospital yet."
The goal, it seems, is doctors-as-sheep, herded into line
by a self-anointed mob of statists, folks who are as sealed off from the
consequences of their visions as they are convinced of their own moral
superiority. Instead, I like the prescription offered to America's doctors by Laura
Pulfer at The Cincinnati Enquirer: "You were the smartest kids in
the class, so why are you letting everybody else tell you how to do your job? You
are the people with the magnificent arrogance to put your hands around a
pulsing, human heart. So what's the problem? Are you scared of a bunch of bean
counters? You whipped their butts on the SATs, and now they're making the
medical decisions in consultation with you. Consultation? Why aren't you
running the show? Are you really prepared to become just another employee? When I
get sick, I'd still like to know there's a doctor in charge."
With permission of
Ralph R. Reiland from
Pittsburgh Tribune Review May 8, 2000
Professor Ralph R. Reiland is an associate professor of economics
at Robert Morris
College and a local restaurateur. E-mail him at:
rrreiland@aol.com