Government Controlled Medical Practice in the U.S.

The very first paragraph of the Medicare law states the following:

"Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, ... or to exercise any supervision or control over the administration or operation of any (medical) institution, agency, or person."

How pathetic a joke this statement has become. To be sure the Medicare bureaucrats and their academic health care planner allies do not actually enter the doctor's office to select the antibiotic, although I have no doubt they would like to if they could figure out a way to do it. But supervise and control doctors, hospitals and other medical entities they do in exquisite detail. Their invasion includes things like telling doctors what items to ask the patient, what body parts to examine, what categories of tests and treatments are preferred, and how and by what means these things must be written into medical records. They work their will by control of payments. Do it their way or you don't get paid.

They get the money to make the payments from us, from our payroll taxes and our income taxes. That's been a problem through the years because what they spend on us is always a lot more than what they collect from us even though the actual percentage of our paycheck that they take has multiplied many times over since the program began. Nowadays they put a lot of it on the tab, the national debt which is now 106% of GDP, up from 62% 10 years ago.

Ever worsening government interference bugged the hell out of me while I was in practice. I recently had occasion to meet some of my old colleagues and it's only gotten worse. They all tell the same sad story of the tremendous time and resources wasted on bureaucratic nonsense that does not add an iota of benefit to actual patient care. Well, you might think, that's the doctor's problem and none of my concern. Unfortunately that's far from true. All the billers and coders and IT personnel, etc, add greatly to the cost of medical care and bring no health benefit. And all the time wasted by your doctor in dealing with this nonsense translates to less time he or she can spend with you.

In the past few years CMS, the agency that runs Medicare and Medicaid, has come up with even more complicated regulations that went into full effect in 2017. A recent internal study announced that these new rules appear to be of no value in reducing cost or improving medical care. No study was needed. Any practicing doctor could have provided this information. The most depressing fact is that the ever increasing cost and complexity of government regulation is driving doctors rapidly our of private practice and into salaried positions with large medical conglomerates. It's the same with independent hospitals. That's not good folks - that is, not if you like being treated as an individual and not as a commodity.

Government has a legitimate function in making sure that acceptable health care is available to those who for one reason or another can't provide if for themselves. But for the rest of us government should bug off; it does nothing but screw things up.