The Doctor-Patient-Government Relationship

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And lest anyone thinks Obamacare mitigates that reality, think again. Obamacare authorizes the creation of an Independent Payment Advisory Board (IPAB) consisting of 15 unelected “experts” tasked with keeping Medicare spending under control. If Medicare spending exceeds predetermined targets, the IPAB is required to propose legislation aimed at reducing future spending. It also requires the Secretary of Health and Human Services to implement those reductions, unless Congress intervenes. Yet Congressional intervention is decidedly lopsided. If they introduce cuts to spending, all well and good. On the other hand, if they introduce spending in excess of the IPAB’s recommendations, overturning those recommendations requires a simple majority in the House — but a three-fifths majority in the Senate, plus the president’s signature. In the Senate, that’s a higher threshold than it takes to pass a Constitutional amendment.

Obamacare ostensibly prohibits the IPAB from raising taxes or rationing care. But the board itself gets to define “rationing” completely insulated from administrative or judicial review. The prohibition on raising taxes is equally meaningless. Adding insult to injury, the editors at National Review have discovered that Congress is forbidden to repeal the IPAB unless it does so within a brief time-frame in 2017. If it doesn’t, then the IPAB becomes a permanent fixture by 2020 — even if Congress repeals the healthcare act. This is a blatant attempt by Democrats to bind future Congresses to the current statute. That effort is completely illegal. Yet barring a Republicans sweep in the 2012 elections, or at the latest, the 2016 elections, the IPAB will become a permanent feature of American healthcare.

How does this bode for the doctor-patient relationship? Dr. Jill Vecchio illuminated that reality at an anti-Obamacare rally hosted by Americans For Prosperity on June 29, 2012:

According to the government, I can only recommend a screening mammogram for women over 50 every other year until 74, then never again. That violates the American Cancer Society guidelines…The American Cancer Society says every year after the age of 40 until the woman no longer wants to have a mammogram.

Screening mammography has been proven to decrease the number of women who die by breast cancer by 30-40 percent–just screening mammography. These government rules that I will have to abide by will cause me to violate my Hippocratic Oath. And I won’t do it. I will violate their guidelines every day, many times a day. As a result of that..I will be fined, I won’t be paid[.]

In other words, many doctors will face a nightmarish choice: do I incur the wrath of government bureaucrats and practice medicine in the best interests of my patients–or succumb to a system where bureaucratically determined cost considerations override patient necessities? A third option is obvious: many doctors will quit practicing medicine altogether. As for the doctors willing to remain in such a system, Americans might ask themselves how eager they are to be treated by someone willing to betray a patient’s best interests in favor of government-mandated rationing and collectivism.

Under Obamacare the doctor-patient relationship will inevitably become the government-doctor-patient relationship — in precisely that order of priority. Thus, assumption number two is a fraudulent as assumption number one.

Both assumptions, like so many other issues, reveal the bankruptcy of progressivism. It is an ideology that assumes most human behavior is static rather than dynamic. Only a progressive could believe that the vast majority of doctors will continue to practice their craft under increasingly onerous conditions, or that equal numbers of would-be doctors will continue to pursue a career path underscored by ever-increasing amounts of medical school debt, coupled with fewer opportunities for remuneration and autonomy. Only a progressive could fail to see how an American public infused with greater and greater levels of self-entitlement won’t overwhelm the system when healthcare becomes “free.” Only a progressive could fail to see that yet another massive entitlement program will contain precisely the same “unforeseen” cost explosions that have plagued every entitlement program ever enacted, thereby hastening our rendezvous with national insolvency.

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  • WildJew

    My immediate concern is the economy. If Obama is re-elected and this monstrosity continues to be put in place, I do not see any economic recovery; only further economic stagnation. Businesses are terrified what this man is doing to the free market. You talk to people who are working for the government, they are fine with Barack Obama but those of us out here in the real world, things aren't so good. The real estate industry has been decimated and property values have plummeted. People are watching their savings and property diminish under this nightmare Americans elected and support. Often I think I live in a nation full of idiots.

    • Bobby195

      You got that right………

    • deprogrammer

      So it's Obama's fault that the real estate bubble broke? Which broke BEFORE he became president? Property values are dropping down to what they should have been. If you over invested at the peak of the bubble and now are upside down then that is how the market is supposed to work.
      It sucks but that's the "free market". Lots of people get hurt and a few make huge amounts of money.

      • davarino

        Mmm, that makes me feel much better. Is that all you got?

        • Roger

          Nope, but you seem averse to reality.

      • fiddler

        Ever hear of Fannie Mae and Freddie Mack? How about Barney Frank and Chris Dodd? How moral is it to get people into homes they can't afford and eventually lose while being saddled with bad debt. But hey, it made the Democrats LOOK great.

        "The road to hell is paved with good intentions".

      • Roger

        Obama made it all worse.
        Communism does that. Marxism does that.

        Having a leader that wants his muslim heritage to win every conflict does that.

  • H&R_ Barack

    ObamaCare where HEARSE and NURSE shall become relative terms.

  • Bobby195

    Instead of climbing the ladder to success, all the mooch's want is someone to give them the ladder. No work ethic at all. If this bastard gets re-elected the nation that we used to know will be gone forever.

    • dennis metz

      the nations has been trashed for a while now, the only real hope is if texas becomes a county and straightens the mess out and gives honest hard working people a place to live and work, reform welfare and afirmative action be gone

  • ApolloSpeaks


    Growing physician shortages + growing physician demand (32 million new people covered by ObamaCare) = long and growing waiting lines to see doctors and get necessary medical care.

    In Canada and Great Britain the waiting lines to see doctors and enter hospitals are one million strong. According to the Massachusetts Medical Society waiting time in their state since passage of RomneyCare is now 48 days (double the national average) as more and more doctors turn away patients.


    • dennis metz

      having a shortage results in them pushing losers and unqualified jerks through the system, our system is full of under qualified people at all levels of health and many of them could care less about patients or bed side manners

  • ApolloSpeaks

    This healthcare nightmare is not what Americans want. Forget about what Justice Roberts did for now. DONE IS DONE! Use the hidden horrors of ObamaCare: scarcity, rationing, agonizing waiting lines and higher taxes, to kill the Obama presidency on November 6th.




    • Looking4Sanity

      No one is going to believe it until they are subjected to it, and then it is WAY too late.

      • daisy

        Absolutely. It isn’t real to them yet because they haven’t experienced it. And those who KNOW healthcare in the UK don’t believe it will be like it is there.

        • Looking4Sanity

          Unfortunately, that is the world we live in today, Daisy. The vast majority have no interest in the Common Good any more. It's all about what they can get for themselves and hang everyone else. They are too blind to realize that they are, in reality, building their own gallows.

    • mlcblog

      Our only hope is a Repub sweep in 2012 and even then we need a strong spine of political will to repeal this disaster.

    • Roger

      I will not forget what Roberts did.
      It wasn't just the Obamacare betrayal, it was the EPA unleashed and the Arizona state knee cap.

      Roberts needs to resign, but he better wait until after January when Obama has been replaced first.

  • Johncdavidson

    The minute you walk in the door of a VA Clinic you are no longer considered a person; you become a negative number.

    • mlcblog

      That's funny, a negative number, if it weren't so sad. I used to work at a large VA hospital so I know the gallows humor it takes to survive the circus of events. We used to say, Do they sell tickets?

      A govt hospital is extremely inefficient. I have worked in a private HMO, too, and they are very efficient and try to be cost-effective yet provide good health care and have been doing it for years. Employees were expected to perform well, up to standard, or they were not kept on.

      • Johncdavidson

        I've heard and have several friends that have some real horror stories about the VA system here in Ohio. One was a former co-worker that took a trip 70 miles to get medication; was denied, drove home, next morning, blew his brains out in his driveway.4 years later, the fellows grandfather 80 who's wife was sent to nursing home was found by grandaughter lying naked after appointment cancelled by social worker to get someone to look out for him. It just a shame.

        I did get congressman to file 6 complaints with the VA committee in DC that I had with large clinic in Columbus. They did stop charging for eye glasses later. Most of the primary doctors are foreign just fullfilling residency requirements that basically just allolwed to refer patients to specialists. Those appointments usually are for a month later.

        I just keep the coverage so they'll have to pay for the local emergency room care here. There drugs are priced twice what you can pay for them on the street.


  • Steve Chavez

    ANALOGY: "ObamaCar."

    What would happen to the AUTO INSURANCE INDUSTRY if they were suddenly forced to cover PRE-EXISTING CONDITIONS that includes everything that is wrong with your car like ENGINE REPAIR, TIRES, AND BODY DAMAGE and from people who barely started a policy, and paying its first premiums but OBAMACAR DEMANDS FULL COVERAGE??? What happens if the insurance REFUSES?

    • deprogrammer

      We aren't talking about cars we're talking about human life.
      Those are different you know.
      *sigh* FPMers always seem to have problems distinguishing people from inanimate objects.

      • Roger

        Yet the analogy stands.

        Reality is a harsh place for you, isn' t it?

      • Karen

        right…a totally ridiculous analogy that doesn't make any sense whatsoever. some people just want to be afraid.

  • oldtimer

    I'd like to know what "affordable" means. My friend's minimum indivudual coverage(hospital/emergency/dr., if admitted to hsp), because of the measures that went into effect this year, went up 81%. That's outrageous! I don't know what it was, but if it was $300 pm and went to $540, what will it be when the next round goes into effect. I sure could not afford to pay close to/or more than $1000 per mo, can you.

  • mrbean

    The assumption that you have a right to healthcare is invalid. How did this assunption come about? The full story is a long and complicated one, but the essential cause, is simple. The essential cause is the assumption that if people have medical needs which are not being met, some say it is society's responsibility to meet them. In the current debate over health care reform, universal access has become the unquestioned goal, to which all other considerations may be sacrificed. The assumption is that the needs of recipients take precedence over the rights of physicians, hospitals, insurers and drug companies — i.e., the producers of health care, the people who deliver the goods — along with the rights of the taxpayers who are going to have to pay for it. In other words, those with the ability to provide health care are obliged to serve, while those with a need for health care are entitled to make demands. It is patently Marxist as "Each according to his needs, and each according to his abilities" – or what one man is incpable of or unwilling to provide for himself shallbecome the forced burden of another.

  • clarespark

    Dr. James Pagano, an ER doctor, wrote two blogs on this subject. The more recent one is here:…. Read the interesting comments too, that add more statistcs on the inevitable outcome of ACA.

  • Looking4Sanity

    I pity all those who fear hunger, sickness and death and live under this regime. Each day will be a burden and a curse to them.

  • Tatersalad

    "Read My Lips – No New Taxes" !!!!!!!!

    Democrats are running away from this countries biggest tax hike in American history:




    4. Barack Obama evoking Jesus to sell us the more taxes while we are "broke":

    5. 20 New higher taxes that American citizens will "enjoy" now that Obamacare is constitutional:

  • jacob

    I had today the oportunity of lisistening to a speech by President REAGAN, warning us about the end results
    of this OBAMACARE, words that to me are simply prophetic…

    He said that it was going to be the Trojan Horse for socializing the USA and there is where we are headed
    to if we allow this disgraceful President to be reelected…

    And then it will be of no use to weep like women for what we refused to defend like men…..

    • Roger

      Our leadership looks awfully shallow when you hear Reagan speak again.