One Doctor Cannot Stop an Epidemic Overnight. What Can One Person or Doctor Do to Help Promote Real Health Care Reform?

Short answer: A lot.  Many valuable tips provided in the below essay. 

"What Can One Do?" 
by Ayn Rand

 "This question is frequently asked by people who are concerned about the state of < today's health care system > and want to correct it... More often than not, it is asked in a form that indicates the cause of their helplessness: "How can an individual propagate < the correct ideas > on a scale large enough to effect the immense changes which must be made in order to create the kind of ideal social system < or health care system > which you picture?"

 If this is the way the question is posed, the answer is: he can't. No one can change a country single-handed. So the first question to ask is: why do people approach the problem this way? 

 Suppose you were a doctor in the midst of an epidemic. You would not ask: "How can one doctor treat millions of patients and restore the whole country to perfect health?" You would know, whether you were alone or part of an organized medical campaign, that you have to treat as many people as you can reach, according to the best of your ability, and that nothing else is possible. 

 People approach intellectual issues in a manner they would not use to deal with physical problems. They would not seek to stop an epidemic overnight, or to build a skyscraper single-handed. Nor would they refrain from renovating their own crumbling house, on the grounds that they are unable to rebuild the entire city. 

But in the realm of ideas, they still tend to regard knowledge as irrelevant, and they expect to perform instantaneous miracles, somehow or they paralyze themselves into inaction by projecting an impossible goal. 

If you are seriously interested in fighting for a better < health care system >, begin by identifying the nature of the problems. The battle is primarily intellectual (philosophical), not political. 

Politics is the *last consequence*, the practical implementation, of the fundamental philosophical ideas that dominate a given nation's culture. You cannot fight or change the consequences without fighting and changing the cause; nor can you attempt any practical implementation without knowing what you want to implement. 

In an intellectual battle, you do not need to convert everyone. History is made by minorities or, more precisely, history is made by intellectual movements, which are created by minorities. Who belongs to these minorities? Anyone who is able and willing actively to concern himself with intellectual issues. Here, it is not quantity, but quality that counts (the quality and consistency of the ideas one is advocating). 

 An intellectual movement does not start with organized action. Whom would one organize? A philosophical battle is a battle for men's minds, not an attempt to enlist blind followers. Ideas can be propagated only by the men and women who understand them... 

Today, most people are acutely aware of our cultural-ideological vacuum ; they are anxious, confused, and groping for answers. Are you able to enlighten them? Can you answer their questions? Can you offer them a consistent case? Do you know how to correct their errors? Are you immune from the fallout of the constant barrage aimed at the destruction of reason ? Can you provide others with antimissile missiles? 

 * A political battle is merely a skirmish fought with muskets; a philosophical battle is a nuclear war.* 

 If you want to influence a country's intellectual trend , the first step is to bring order to your own ideas and integrate them into a consistent case, to the best of your knowledge and ability. This does not mean memorizing and reciting slogans and principles; knowledge necessarily includes the ability to apply abstract principles to concrete problems, to recognize the principles in specific issues, to demonstrate them, and to advocate a consistent course of action... 

If you like condensations (provided you bear in mind their full meaning), I will say: when you ask "What can one do?" the answer is "SPEAK" (provided you know what you are saying). 

 A few suggestions: do not wait for a national audience. Speak on any scale open to you, large or small, to your friends, your associates, , your professional organizations, or any legitimate public forum.  You can never tell when your words will reach the right mind at the right time. You will see no immediate results, but it is of such activities that public opinion is made... 

 The opportunities to speak are all around you...Most particularly, do not keep silent when your own ideas and values are being attacked... 

 It is a mistake to think that an intellectual movement requires some special duty or self-sacrificial effort on your part. It requires something much more difficult: a profound conviction that ideas are important to you and to your own life. If you integrate that conviction to every aspect of your life, you will find many opportunities to enlighten others.... 

 If a dictatorship ever comes to this country, it will be by the default of those who keep silent. We are still free enough to speak. Do we have time? No one can tell. But time is on our side because we have an indestructible weapon and an invincible ally (if we learn how to use them): reason and reality. 

 "What Can One Do?" by Ayn Rand < with personal editorial modifications in brackets > 

 Entire essay here.  Additional similar articles here.

The Hammer of Reality

Bill Whittle at PJ Media:

 "Bam! Bam goes the hammer. People receive cancellation notices from their insurance companies. Bam! Obama is exposed as a liar. Bam! Reid and Pelosi were in on it. Bam! When times are bleak for conservatives, we have one inalienable tool--the hammer of reality."

Dr. Hal Scherz: "Circumnavigating Obamacare"

Another great article by Dr. Hal Scherz, founder of Docs4PatientCare "In the three years since the law passed, it is becoming increasingly clear to everyone that centralizing control of the healthcare economy in Washington is increasing costs, causing confusion and making the bureaucracy more difficult to navigate. With each passing month, new surprises are revealed, just as Nancy Pelosi predicted. The newest revelation coming from Washington is the need for Obamacare Navigators. These individuals are “necessary” to assist people signing up for health insurance under the new state exchange systems. The “simple” 21 page application for federal insurance subsidies, along with the 61 page addendum, is apparently not quite as straightforward as promised. It has been suggested that these positions would be “awarded” to deserving individuals - supporters of this administration- union members, former ACORN employees, and other political cronies. The fact that voter registration has been included in the application suggests that only the “right people” will be hired as navigators. The truth is that the ACA is not and never was intended to “fix” American health care. Its purpose is to place control of American’s health care in the hands of Washington bureaucrats giving them enormous power and control of the electorate. If there was any doubt about this reality, it is quickly evaporating as the details of the law become clearer with each new healthcare revelation, now happening almost daily. The only possible way to accomplish the overly ambitious goal of providing health care for all, is with the creation of a massive and expensive new bureaucracy. The paradox should not be overlooked- healthcare spending is bankrupting our country, yet we are primed to spend far more money to create a massive bureaucracy in order to put it under government oversight. How everyone could not predict what we are currently witnessing is amazing. The ACA created 159 new commissions, boards and departments. This translates into a huge, new and expensive bureaucracy. It has been predicted that in California alone, 20,000 navigators will be necessary, which means that nationally, hundreds of thousands will be needed. The number of new government employees needed to staff all of these new agencies is incalculable. Currently, 1/3 of Americans are covered by government financed healthcare, which accounts for 1/5 of our GDP. If some in Washington have their way, and healthcare is eventually totally financed by the federal government, the costs of running the bureaucracy will consume such a large part of our budget, that we will be able to afford little else...." Full article here

Fed Up With Obamacare, Doctors Increasingly Prefer Cash For Care

Dr. Sally Pipes describes in this article an important option for patients concerned about the quality and availability of health care services to keep in mind as they notice growing bureaucratic restrictions on their choice of health care providers, diagnostic testing and procedures under increasing govt regulation: More doctors may be looking to cut out the progressively increasing paper work and extra-ordinary time and money-wasting and cost -inflating effects of government and insurance middle men through direct contracting with patients and direct payment for medical services: "Obamacare’s most intrusive changes to the healthcare marketplace — including the individual mandate whereby Americans must secure health insurance or pay a fine and its massive expansion of Medicaid — are less than a year from taking effect. Many doctors have decided that they’re not interested in seeing how those changes play out in their own practices. Nearly two-thirds of doctors say that they or their colleagues will retire earlier than planned over the next few years, according to a survey conducted by consulting firm Deloitte. Others are considering a departure from the current system of third-party payment. Instead, they’re exploring direct payment, with patients paying for care on their own. Patients should welcome this development. Not only does the move toward direct payment have the potential to reduce health costs — it could also yield higher-quality care..... Nearly 7 percent of doctors say they are planning to change to some form of direct-pay care in the next three years, according to a survey of 13,000 doctors done for the Physicians Foundation. The consulting firm Accenture projects that one in three doctors in independent practice will adopt “subscription-based care models.” One direct payment model that’s growing in popularity is “concierge” care, whereby doctors charge a monthly or annual fee for care — and bypass the administrative headaches associated with insurance and government programs altogether. The American Academy of Private Physicians — which represents cash-only doctors — estimates that the number of concierge doctors has shot up 30 percent in just the last year. Examples of these practices abound...."

"Married to Medicine" - The Scape-goating of Physicians and Propagandizing of ObamaCare

A recent post on an online forum for radiologists about a "trashy Bravo TV show" called "Married to Medicine" recently caught my eye. The original radioloigst poster on this blog urged readers to "take it with a grain of salt..it focuses on the gold digging wives of MDs and their fancy mansions and extravagant lifestyles". <<....It perpetuates the myth of the billionaire physician rolling in the dough, raking it in. Especially at a time when doctors salaries have been slashed and most MDs are living an upper middle class life certainly not a Romney life. Ortho, ED, and OB GYN are featured. No radiologists thank goodness....>> I think it is important to understand what is driving this - and the insidious, though critical, political purpose it serves in the context of the rapidly progressing government take-over of health care. In the overall scheme of things, the poster's observation and false sense of relief that radiologists per se were not one of the medical specialities portrayed in such fashion on this particular show, at this particular time, misses the point. Trashy? Yes. But also very dangerous- to dismiss its power in shaping public opinon and support for government policy by using popular culture as a tool of propaganda to villainize doctors in general as the prime cause of America's health care woes. Welcome to 1984- and the rise of State Bureau of Propaganda, staffed by Michael Moore and fellow billionaire Hollywood left-wing elitists. Art, popular culture and mass media all have a tremdously powerful impact on shaping the political and cultural views of the masses. The modus operandi and the purpose of left wing supporters of government-run medicine in Hollywood is to portray and demonize all doctors as exploitative, fat cat billionaire Robber Barons running roughshod over patients. Cast as such, they are depicted as greedily exploiting patients and defrauding 3rd party payers by ordering unnecessary expensive tests with the sole purpose of paying for their own yachts, mansions and spoiled, pampered wives. The consequences of government and 3rd party payer bureaucratic regulations, ever -expanding health system consolidation, unchecked patient demand for services in the ever progressing hyper-inflation of health insurance premiums and prices in medical and services can be thus ignored. We now have the "real" culprit: the unquenched thirst of doctors to bilk patients, the government and the system for ever more Porsches and Rolls-Royces and "deprive patients of their "inalienable right to unlimited medical services, provided by or paid for by others"- at least, as the producers of this show would have you believe... Clearly such vicious exploiters of the helpless and weak proletariat require the heavy regulatory protective hand of benevolent, public-spirited, "chamnpion-of-the-little-people", government politicians to ride in on a white horse and save the day by reining in the financial abusives caused by unchecked greed, and slash reimbursements and the filthy, unearned lucre of greedy, over-paid capitalist doctors", thus protecting the rights of the proletariat from the exploitative bourgeosie. Never mind the irrational, out- of- control medical malpractice laws which forces the hand of doctors in ordering extra unnecessary expensive diagnostic medical testing of marginal utility to avoid avoid potentially professionally catastrophic and bankrupting litigation by ruling out the "1 in 10,000,000 chance of a rare disease".... Or the low deductible, out- of- pocket expenses of most pre-paid health care policies which misleadingly cause the patient/ medical consumer to grossly under-estimate, and thus, grossly over-demand-and-consume inherently expensive medical diagnostic services, regardless of actual actionable medical benefit in some cases. The show is not designed to inform, but to mislead. The purpose, intent and aim is to use the power of pop culture and popular media to shape the opinions of the uneducated underclass who watch trashy Bravo TV- even inflame class envy and warfare by making doctors the scapegoat. The dual goal- direct the voting public's attention away from the 50 years of progressively advancing failed government policies and regulations over the health insurance and medical services industry which actually lie at the root of the problems in the US health care system today. This show represents an example of the propagandization of ObamaCare by Hollywood, warned about by Dr. Paul Hsieh, a radioloigst colleague in Colorado in his blog in Sept 2012 here: http://blog.westandfirm.org/2012/09/propagandizing-obamacare.html Propagandizing ObamaCare "The 9/15/2012 New York Times reports on how government officials want Hollywood to promote ObamaCare in the plots of TV shows like "Grey's Anatomy" and "Modern Family"."

Medical Freedom vs Financial Security for Doctors Under ObamaCare. Both? Neither?

According to a recent article in Forbes online entitled "Obamacare's 73% Medicaid Pay Raise For Doctors Is Delayed": "A huge pay raise promised under the Affordable Care Act for primary care doctors who treat the nation’s poor covered by Medicaid health insurance is nearly three months behind schedule and may take another three months before it kicks in, state Medicaid directors say..." As Ben Franklin sagely pointed out: "They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety." Nor financial security, as it turns out... A word to the wise is apparently insufficient. Those doctors and other medical care providers who were conned into voting for ObamaCare on the hope/expectation /promise of growing fat on increased payments / hand-outs from government -financed medical programs are about to learn the hard way . Making oneself dependent on the false promises and largesse of "beneficent" political operatives and administrators in Washington DC - is neither a tool for personal or professional liberty nor financial security. The ripple effect on voters/ patients/ the US health care system is sure to follow- as well as on your federal and state taxes: If you just happen to be the type that might be re-assured that "the check is in the mail", don't forget that those who are empowered to write, or re-write, your check make the rules- and can change, re-write or cancel either- according to their personal whim, convenience and political expediency. #suckers