The Democrats, and some Republicans who favor the status quo, have been in shock since the election. As a manifestation of this the amount of vitriol directed toward the new President and his many supporters is unprecedented. Also the losers have been intensively pushing the narrative that Russian interference with the election, in collusion with the new administration, is responsible. Of course the Russian government, as well as many others, have been spying and playing dirty tricks on us for years as we have in exchange. This is all public knowledge. Nevertheless until the election the Obama administration for the most part was accommodating to Russia and Putin. They tried the Russian reset. Early on they aborted the planned missile defenses in eastern Europe. Very little was done to prevent the takeover of the Crimea or the overture in the Ukraine. And famously President Obama assured Vladimir that he would be more flexible after the election. But it was the 2016 election result that irked President Obama into expelling Russian diplomats and imposing economic sanctions on some of its citizens.
But if the Russians truly favored Donald Trump and exposed the emails of John Podesta and the DNC to help him, it did not turn the election. The emails verified things that were already assumed to be true, namely that political parties and politicians tell their constituents what they want to hear but say and do the opposite in private. They confirmed the obvious fact that the major news media heavily favor the Democrats and do what they can to help their cause. But it was not the emails of John Podesta or the knowledge that their newspapers favored Mrs. Clinton that induced the good people of northeast Pennsylvania, who have a 3:1 Democrat registration preponderance, to vote to elect Mr. Trump. The election surprise was the culmination of the growing dissatisfaction in much of the citizenry with the direction in which our country has been heading and the blame was placed squarely on the progressively intrusive dysfunctional activities of the federal government.
The federal interference has been involving many areas of our lives, and about these I have my opinions as much as anyone else, but no real expertise. In the medical area I can speak with some authority since I have done a number of types of medical practice in my career and have watched the federal involvement almost since its beginning. Our government has for decades been collecting tax money to finance the medical care of a large mass of citizens who are well able to manage their own affairs and would be much better off doing so. At the same time it has often ignored or given short shrift to many needy persons who have suffered medical misfortune. The limited access, very high deductible solution of Obamacare has proved to be unworkable.
The Medicare program, the ultimate free lunch, incentivizes waste and abuse, spends far more per beneficiary than it takes in, and so despite steadily increasing tax levies over the years has been progressively adding to our national debt. In its desperate attempt to control this situation without major rationing of care, the government has imposed burdensome regulations. The federal government is at this point mandating for private medical practitioners what electronic equipment and software they must buy, what types of personnel they must hire, what specifically they must note in their records, what way they must prescribe their medications, and increasingly what types of tests they must perform and what medical guidelines they must follow in their treatments. Incident to this regulatory activity they are taking from patients what they value most, the time and undivided attention of their doctors.
Other federal programs are equally troublesome. Reimbursements for Medicaid patients are often only a fraction of the cost of their care, but at the same time the program is plagued by even more waste and abuse than Medicare. Recipients are routinely provided with excessively expensive treatments that cannot be afforded by those who are footing the tax bill to pay for them. Also the Veterans Administration program is a well-known bureaucratic nightmare and I have personally experienced it when I practiced for a while as a full time VA doctor.
Those who call for a federal government takeover to correct these problems are seriously misguided. Some quote the experience with such plans in other countries. I have studied these things but have no personal experience to report. However I can say with confidence from my experience that there could not be a worse solution for the political entity that is the United States of America.
Those responsible for federal policy on medical care in the Trump administration understand these problems and have good ideas on what to do about them. Nevertheless we have all gradually adjusted our lives to what we have and therefore it is going to be a very, very touchy task to move things to something more rational without causing at least temporary harm. I'll be watching closely and will continue to comment as things unfold.
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