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Columns

It’s Not about Health-Care—It’s about Control

July 19, 2017 - 6:00am

As Congress struggles to do something about the Obamacare disaster, senators may be getting calls pleading, “Don’t take my health-care away!” But the more influential voices will be whispering, “Don’t take my Obamacare dollars away!”

The American Medical Association (AMA), for example, is urging people to call about “cuts” (constrained growth) to Medicaid.

Let’s get the terminology straight: The government cannot “take away” or “give” you health-care. Caring for your health is something you do—or don’t do—yourself. It costs practically nothing; in fact, it saves you money. Nonsmokers save thousands of dollars a year. Walking around the block every day is free—and maybe you’ll meet your neighbor. Healthy foods like fresh fruits and vegetables cost something, but less than Starbucks coffee-flavored milkshakes or fast-food lunches. Being faithful to your spouse pays huge dividends.

You can go to a “health-care provider,” get counseled on smoking cessation, and have all your bad habits, risk factors, and soon probably your DNA and political views recorded in an electronic data base, accessible to the government and thousands of other entities. They will constantly score you—on your value to society, eligibility to own a self-defense tool, suitability for a loan or a job, and eventually perhaps your qualifications to have a child.

Your health depends on basic necessities not included in the $3 trillion poured into the “health-care system” every year. Lacking a place to stay warm and dry, one homeless person lost his feet to frostbite, while Medicaid was paying someone $563 every month just to have him on a list of enrollees. Last year, Nevada Medicaid paid managed-care companies as much as $213 million for more than 30,000 people who received no care at all. Maybe that money was taken from housing or law enforcement.

Does the money given to Medicaid contractors perhaps pay safety-net hospitals to care for the needy who do need care during the year? We don’t really know where all the money goes. A preliminary look at publicly available documents of Arizona’s Medicaid system, allegedly the most efficient in the U.S., revealed that managed-care contractors made more than $225 million in pre-tax profits in just one year. And in 5 years, nearly $400 million of Medicaid funding was transferred to other state agencies.

From a basic economics standpoint, it is just absurd to use third-party payment schemes for routine, predictable (hence uninsurable) costs. It doubles or triples the costs, while making services look free or worth $5 at the time of service. It perpetuates the illusion that somebody else is paying, while managed-care stockholders, administrators, arbitrageurs, and purveyors of ridiculously overpriced drugs or procedures rake in profits.

Of course, there is the risk of a car crash, cancer, heart attack, or other true emergency. I’d like to buy catastrophic insurance to cover my risk for those things, without buying everybody else’s contraceptives, fertility treatments, smoking cessation counseling, drug abuse treatments, and blood pressure pills. Such insurance became very difficult to obtain years ago, and Obamacare outlawed it.

We’re moving toward the end-game of single payer, which assures the continued diversion of funds to the Swamp. These funds are no longer available for people to choose to spend. And worse, the system will carefully control the funds that actually provide care, say by punishing doctors for deviating from government-dictated “best practices.” It will allow nothing it calls “snake oil” (things like vitamin D, hormone supplements for aging, or other generally benign items that people find worthwhile but that drain profits from government-approved treatments). Nothing “futile” like experimental treatment for Charlie Gard. Nothing experimental outside the control of the FDA (that might compete with lucrative drugs). Nothing that is not “value based” (such as life-sustaining treatment including food and water to patients not valuable enough to treat for pneumonia, heart failure, or a bleeding ulcer).

The system is also striving to eliminate nonadherence. Patients will take all their vaccines or lipid-control medicine, like it or not, because the benefit (to “society”) is claimed to outweigh the risk (to them personally).

The system wants Americans to trade their freedom for the illusion of “health-care.” But Americans will soon learn that freedom is of the greatest importance when life is at stake.

 Jane M. Orient, M.D. obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989. She is currently president of Doctors for Disaster Preparedness. Since 1988, she has been chairman of the Public Health Committee of the Pima County (Arizona) Medical Society. She is the author of YOUR Doctor Is Not In: Healthy Skepticism about National Healthcare, and the second through fourth editions of Sapira's Art and Science of Bedside Diagnosis published by Lippincott, Williams & Wilkins. She authored books for schoolchildren, Professor Klugimkopf’s Old-Fashioned English Grammar and Professor Klugimkopf’s Spelling Method, published by Robinson Books, and coauthored two novels published as Kindle books, Neomorts and Moonshine. More than 100 of her papers have been published in the scientific and popular literature on a variety of subjects including risk assessment, natural and technological hazards and nonhazards, and medical economics and ethics. She is the editor of AAPS News, the Doctors for Disaster Preparedness Newsletter, and Civil Defense Perspectives, and is the managing editor of the Journal of American Physicians and Surgeons.


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Comments

Dr. Orient believes in survival of the fittest, and natural selection. All bring cash to the doctor. No doctor, no service, go die. That is her definition of freedom. Note she wants all health care out of the Government including Medicare, Medicaid, state funding, all of it. Back to the 17th century we go.

None of that changes a single fact as stated by Dr. Orient.

Only a matter of time before you get called a racist, or accused of wanting to kill people when you don't agree with the Libs...

Obamacare was designed to fail so the dems/libs would then push us into single payer. Single payer has been their goal along. The dems thought they would be hero's as they swooped in and saved us from the intentional and very disastrous program they created. They were counting on the "stupidity of the American people" to forget it was their fault. The elite would have the best care through private insurance and the rest of us would find ourselves in a health care nightmare like little Baby Charlie Gard in the UK. Cost before care. Remember when Obama said old people would just need to learn to take a pill instead of expecting a pacemaker in response to a question from a lady in the audience.

Most of the politicians in Washington are too busy protecting their “seat” to get anything done. I think it is time for term limits in Washington! Perhaps if they did not have lifetime "jobs" the lobbyist would not have as much sway as they have now.

Not too concerned about "the Plan", as long as they kill "Obamacare" and prevent Washington, D.C. "double-talking" politicians from excluding themselves (and their Bureaucratic Staff members) FROM the new "plan" again (like they did from "Obamacare" when they declared themselves "The American ELITIST Class"). Probably thought they could "get away" with it like they got away with declaring themselves exempt from Stock Market "Insider trading"...You know: The illegal act that put Martha Stewart in prison, and would put you and me in prison "in a heartbeat" (and don't expect "FBI Comey", "Faux iaw enforcement nerd" to save your butt, unless you have as much "booty" as the "Clinton Foundation".).. D.C. Politicians don't even need free haircuts & shoeshines,...Hell, they only work 112 days a year, and I would hope they were smart enough to get their tonsorial & shine needs accomplished "on their own time"...(including 'tips')

EXCELLENT! I have not heard it explained better and I've been trying to get friends and associates understand that it's not about healthcare if there are billions of dollars involved!

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