Finally, physicians are concerned that universal health care will compromise their ability to practice according to their own best judgment and conscience.
President Obama’s “stimulus package” included $1 billion for “comparative effectiveness research” in health care. Writing in the Wall Street Journal, Harvard professor Martin Feldstein noted that the government’s eventual goal is to use this research to cut costs and ration medical care by “implementing a set of performance measures that all providers would adopt” and by “directly targeting individual providers … (and other) high-end outliers.”
In other words, your doctor would be rewarded if he practiced according to federal guidelines and punished if he strayed too far from them. Such guidelines must necessarily be based on statistical averages that cannot take into account specific facts of individual patients. But good physicians must consider precisely these specifics when treating their patients.
If you have abdominal pain due to gallstones, who should decide whether medication or surgery would be “most effective” for you? The doctor who felt your abdomen, heard your heart murmur, saw your ultrasound, and knows your drug allergies? Or the bureaucrat who got his job by telling the right joke to the right person at the right Washington cocktail party?
Most physicians I know aren’t in the field primarily for the money, although they do expect to be fairly compensated for a job that requires four years of college, four years of medical school, three to seven years of internship and residency, and often one (or more) years of additional specialty fellowship training.
They do it because they love their work, including the ability to apply those years of training to benefit their patients. They passionately want to use their skills according to their best medical conscience. To practice good medicine, a doctor must therefore be left free to use his reason, his experience, and his judgment — i.e., his mind. ObamaCare would destroy your physician’s willingness and ability to use his mind for your benefit.
If ObamaCare passes, some doctors will grit their teeth and still try to do their best for their patients. But they will have to waste hours arguing with bureaucrats, while their less conscientious colleagues can just punch a clock and go home. How long will the better doctors continue working under a system that constantly punishes them for their virtues? And when the good doctors finally retire or quit in frustration, what kind of doctors will remain?
In Ayn Rand’s classic novel Atlas Shrugged, one of the minor characters was surgeon Dr. Thomas Hendricks, who explained his reasons for “shrugging” and quitting medicine as follows:
I have often wondered at the smugness at which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind — yet what is it they expect to depend on, when they lie on an operating table under my hands? … Let them discover the kind of doctors that their system will now produce. Let them discover, in the operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man they have throttled. It is not safe, if he is the sort of man who resents it — and still less safe, if he is the sort who doesn’t.
The policies of our current president and Congress have turned too much of Atlas Shrugged from fiction into fact. The government has already assumed unprecedented control over the banking and automotive sectors of our economy. Health care is next in its sights.
If ObamaCare passes, thousands of doctors will follow the fictional Dr. Hendricks and shrug.
Will your doctor be one of them?