G. Keith Smith, M.D.

Some of you reading this are celebrating.  ”Now we all get to have free health care!”  ”It’s about time the government took over this industry!”  I have tried to connect some dots from the physician’s side by asking the question,”..from whom do you now have a right to health care?”  Now let’s take a look from the patient’s side.

This is an emotional issue because people’s lives are at stake and it is therefore understandable that not all the arguments about this issue have been rational.  We are where we are in healthcare now, I have argued, precisely because of government intervention, not from some lack of it.  This is very tough for most people to see, but articles like the one from the Associated Press’s Chief Medical Writer, Marilynn Marchione, make it more clear.  Unintentionally.  ”Large Study Finds That Mammograms Often Bring About Unneeded Treatment,” reads her headline.  

Those of you supportive of national health care wearing your pink ribbons to raise breast cancer awareness need to try to connect the following dots.  I’ll see if I can help you.  

1) Government promises to provide health care to all

2) Government sets up “exchanges,” containing only health plans that provide a federally-defined set of services.  

3) Government accepts applications for “scientific grants” to determine which services are “necessary.”  

4) Government justifies removal of certain services from the “approved list,” citing certain study results.

The study in the New England Journal of Medicine says the following according to Marchione:  …”more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.”  ”Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don’t need treatment, the study suggests.” 

Did you get that?  You see, now that the government is going to pay for the care, the government is going to decide what care you get.  They will have no trouble finding “scientists” to find whatever they need for them to find, not unlike the global warming “scientific” findings.  I guess the federal government doesn’t have to list their conflicts of interest when they are commissioning a study!

I was taught in medical school that a surgeon who has never taken out a normal appendix has missed the diagnosis many times.  In other words, a certain percentage of these operations are necessarily unnecessary in order to catch all of the sick patients.  Then there’s the piece of mind issue:  ”Your breast has a cancerous lump, but studies show that we should leave it in you and the government won’t pay for its removal anyway.”  Shouldn’t the patient and her physician decide together?  Is it not clear that deciding what care you receive goes hand in hand with ceding authority to pay for your “care”

Mammograms are the poster child of preventative health screening.  Prostate antigen screenings are another preventative tool that are under scrutiny by government-paid researchers, finding (SHOCK!) that this is also unnecessary.  So much for a focus on preventing disease.  If government is going to make women keep their cancer, I think they should let them keep their large sodas too.  

G. Keith Smith, M.D.

Allow me to introduce you to Anya Rader Wallack.  Her career and background read like a most wanted list for fans of the free market in health care.  Let’s just say that she is to free markets in health care what Ron Paul is to the federal reserve system.

Ms. Wallack is president of Arrowhead Health Analytics.  Their website is here.  This outfit has been created to help private and public sector businesses deal with the health regulations and reforms that Anya, their president, has advocated for many years.  Can you say cottage industry?  Remember my blog about the lady I met on the plane who ran a consultant company to help others deal with the rules and regs from the consumer product safety commission…..which she wrote as their chairman?!

She is considered an expert on health reform.  Her experience includes a term as interim president of Blue Cross Blue Shield of Mass. Foundation.  She worked on Hillary Clinton’s Health Task Force.  Her testimony has been sought by our friends in Washington.  She tried unsuccessfully to implement a single payor plan in Vermont under Howard Dean’s government.  She has a Ph.D in social policy from Brandeis (don’t think she’ll be voting for Dr. Ron Paul).  She is a former employee of the ultra-leftist lobbying firm, Kimbell, Sherman and Ellis.  She developed a cost-containment plan for the state of Massachusetts (gee…I wonder why they needed that??). Now she is special assistant to the governor of Vermont and also the chair of the Green Mountain Care Board, a five member panel that will create a universal care system for the state of Vermont.  This board is busy “holding education meetings twice a week to get up to speed on health care data and evaluation systems,” according to Alan Panebaker who recently interviewed her.  She has recently written in the New England Journal of Medicine: 

“we must align incentives for payers, providers and consumers so that the risks and rewards embedded in provider payment systems, benefit designs and cost sharing all promote a higher value health system and better health.  Continuing, “..the project will expand to include ‘anchor’ specialists attached to advanced primary care medical homes, with bonus payments linked to both quality and total cost of care.”  The New England Journal is demonstrating the same socialist editorial skill as the Journal of the American Medical Association, it seems.  I am unable to find articles about the provision of high quality and reasonably priced health care brought about by the adherence to the principles of the free market in either one of those rags.

I have written before about Hayek’s “Fatal Conceit.”  This refutation of all forms of socialism relies on the fact that society has evolved, a process completely disregarded by socialists who want to plan society, by contrast.  Ms. Wallack demonstrates this logical error as well as the hubris of knowing, of course, what is best for everyone else.

I’d never heard of Ms. Wallack until today when I noticed a small news piece announcing her travel plans to New Hampshire.  She plans to cross the Connecticut River, leaving Vermont for New Hampshire, to discuss her views on universal health care for the state of Vermont, to a gathering on the Dartmouth (New Hampshire) medical campus.  This is interesting because many patients in Vermont, seek their medical care across this same river in New Hampshire.  Ms. Wallack’s problem is clear, isn’t it?  Vermonters with the health coverage she proposes will either have to stop travelling across the river to New Hampshire, or those in the medical business in New Hampshire will need to be on board with her plans.  This is typical of planning of the type she admires.  Wallack has to have the support of the facilities in New Hampshire or her plan goes down the toilet.  This is an example of how a “great idea!” expands, becoming more and more coercive to cover for the unintended consequences of socialist planning.  All of this would of course be solved if the entire country were required to subscribe to her plan!  Or the whole world!

If health care is “free” in Vermont, will folks from New Hampshire cross the river the other way?  Will the Connecticut River more resemble the Rio Grande with health illegals streaming across to Vermont to get their free health goodies?  Once the health care is “free” in Vermont, Vermont won’t need raiders from New Hampshire to bankrupt their system.  Their own state residents will be sufficient for that purpose.  Every state that has tried this has failed.  Tennessee, Washington, Massachusetts.  It seems that Vermonters like Ms. Wallack are determined to fail as well.  Ho hum.

G. Keith Smith, M.D.