Problems with Health Care: Not Just ObamaCare

By | January 5, 2014 | 0 Comments

  

Some senior medical students expect their internships not to include night duty.
New England Journal of Medicine 2013, 369: 2278-2279

Half of new physicians are women, who on average will work 20% to 25% fewer hours than male physicians – thus exacerbating the physician shortage.
News item

Many older physicians plan to retire as soon as it is financially possible. They blame ObamaCare as well as other factors that decrease professional satisfaction.
News item

ObamaCare includes funds for training only 1700 new primary care “workers,” mainly nurses. Are health-care professionals merely “workers”?
News item

Physician shortage to be met by allowing nurse practitioners and others to practice without a physician’s supervision, to prescribe medications, and to perform abortions.
News item

Physicians pushed to use electronic medical records, which are accessible by federal agencies including the IRS, DHS, and NSA, as well as miscellaneous snoopers.
News item

ObamaCare will force physicians to see more patients in less time, while limiting the tests and procedures the physicians can order. Quality of health care inevitably will decline.
News item

Pediatricians pressured to ask children about guns in the home, seatbelt use, alcohol use, and whether their parents “get along.” Doctors then place the answers in the electronic medical record, where government agencies can access them. In some cases, the doctors notify police.
News item

Many patients in British National Health Service hospitals suffer from poor care, including lying in their own waste, and even dying from lack of water. In one case, a patient survived by drinking the water from a flower vase.
News item

Critics of ObamaCare, including me, have concentrated on the law itself. But we have tended to ignore other problems with our health care. Yet these other problems compound the problems with ObamaCare. For example, take the worsening physician shortage. ObamaCare promised to provide more care to more people for less money. This claim is laughable. Only sleazy pitchmen on late-night TV commercials promise to provide more for less. Like these pitchmen, ObamaCare salesmen proclaimed, “But wait – there’s more!”
This claim raises the obvious question: Who will provide all this care? ObamaCare proponents fall into the classic error of Marxism – they treat individual human beings as mere “economic units.” They treat individual human beings as interchangeable items, as it they were auto parts.
But human beings are not auto parts. They are not interchangeable. They require motivation. In the case of health-care professionals (not “workers”), they also require dedication. If you take that away, you’ll pay dearly.
Look at the news items at the beginning of this column. Read them in sequence. Can you see how they relate to one another? Can you see the pattern? Can you see how they inevitably lead to the final item – the inadequate and even dangerously deficient care in a government-run system of health care? Can you see the inescapable end result of entrusting life-and-death decisions to bureaucrats like Kathleen “Let the Girl Die” Sibelius?
Can you see the risk of demoting physicians from independent professionals to the role of government employees? Can you comprehend the danger of demoting health care to the level that it possesses the efficiency and warmth of the Department of Motor Vehicles, and the power of the Internal Revenue Service?
The New England Journal of Medicine is the leading medical journal in the United States. Regrettably, the journal has become a propaganda outlet for leftist causes. Formerly, it pushed draconian gun-control laws, often using studies of dubious merit. Then it pushed physician-assisted suicide and euthanasia, often refusing to print letters to the editor that objected. Now the journal is pushing nationalized health care, again refusing to publish opposing letters.
Nevertheless, the journal has not lost its objectivity completely. It just published an opinion piece noting that recent medical graduates have less work ethic than their forebears. Of course, the journal fails to mention that this can only aggravate the problems of government-run health care.
Medical students anticipate internships without night call. Granted, the schedules of interns and residents in my day were often grueling. I recall being so sleep-deprived that I was alternately irritable and silly, as if I had been drinking. I recall having responsibility thrust upon me that I felt inadequate to handle. Of course, that was how I learned to handle it. That was how I learned to put my patients’ well-being ahead of my own comfort. That was how I learned to handle stress and fatigue, and to work in suboptimal conditions. That, and not just a diploma, was how I earned the right to call myself a physician.
We all recognize the dangers of the old system. But there also are dangers of the new system – perhaps greater dangers. The author of the article describes interns who rush through patient care in order to leave at the approved hour. She describes lapses in patient care when the day team signs out to the night team, and vice versa – and the team going off duty leaves the hospital while their patients are still unstable and in need of critical care. The idea of staying overtime when necessary may not even occur to these medical trainees.
We raise a generation of narcissists who believe themselves entitled to a life of privilege, unencumbered by night or weekend duty, or by difficult work that they consider “beneath” them. We raise a generation with unearned self-esteem, unrestrained by ethical principles derived from the Judeo-Christian tradition. But then we are shocked – shocked! – when these people become doctors and act accordingly. What did we expect?
So we have a generation of young doctors accustomed to following government regulations, but unaccustomed to acting as independent professionals who use their best judgment for the benefit of individual patients. And we have a government growing larger and increasingly intrusive, making life-and-death decisions for whole groups of patients the bureaucrats have never seen. Have a nice day.
Look at the photo at the beginning of this column. Is this the doctor whom you would choose to entrust with the lives of your loved ones and yourself? But, you see, you may not have a choice. Even without ObamaCare, but especially with it, you may have no choice but to place your life in the hands of undedicated, unmotivated clock-watchers. I wish you good luck and good health – you’ll need both.
Now look at this painting, titled “The Doctor.” My father was a physician and had a reproduction of it on his office wall. Whom we choose as our role model says a lot about us.

 

But soon the ideal the painting represents will be as outdated and obsolete as the clothing styles it depicts. Sitting up all night with sick patients? Being concerned with their well-being to the point that the physician’s own personal life is secondary? What, are you crazy? That would violate the work-hours regulations, and government bureaucrats are notoriously rigid in their adherence to the letter of regulations. If you doubt this, just ask Kathleen Sibelius.
American health care was far from perfect, but it was pretty darn good while it lasted. We’re going to miss it. I pray we won’t have to say the same about America itself.

Contact:
dstol@prodigy.net. You are welcome to publish or post these articles, provided that you cite the author and website.
www.stolinsky.com

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