Saturday, January 31, 2015

The NY Times War on Doctors Opens a New Front on Vascular Stenting

The NYT's War on Doctor continues. The target is now doctors who provide less invasive stenting and endovascular services to restore normal arterial and venous blood flow in the setting of activity limiting pain, limb threatening conditions of low flow to limbs and vital abdominal organs. Used judiciously in the right circumstances, the procedure can be a much less expensive and safer alternative to surgical bypass surgery and is especially less expensive when performed by an independent doctor in a less expensive outpatient clinic, rather than a hospital. 

This has also opened the possibility to treating more patients safely, who were previously not good surgical candidates- hence the number of overall procedures and  applications for the procedure has increased- as has the overall cost of doing more procedures. Of course, being as Medicare is already bankrupt, govt officials need a to create a new crisis and scapegoat to justify heavy handed measures to control the costs of their failed socialist health care policies. 

The trend today is for government officials and regulations to attempt to second guess doctors' medical judgement, refuse services outright or, more commonly, refuse or severely discount payments for services already rendered -even retroactively -and to push all procedures into the hospital - even though it can be over twice as expensive - and push all private doctors into bring salaried employees ie "fixed costs" to the government.

Fewer necks to drop a yoke over, and you can then proceed to work them to death for the same and continually lower salary, rather than paying them for their services. 

Enter the faceless, anonymous "medical expert" whose medical training, credentials, experience are never defined but left intentionally vague, yet somehow never in question - and who has never treated a patient, has no actual knowledge of your own case or of any specific case , but sits at a government computer and crunches statistics - and finds patterns of increasing popularity, utilization, implementation and subsequent _costs _ associated with new medical technologies - incontrovertible " proof" of fraud or malfeasance apparently requiring no further evidence or justification - and then manipulates them for political gain by socialist tinkers - working hand in hand with the NY Times and other liberal media rags to engage in a campaign of yellow jounalism: 

"_Medical _experts _are questioning the necessity of some of these treatments, and many believe the condition is more safely treated with drugs and exercise. "

Modus operandi: select a rogue physician who is committing blatant fraud. When none can be found, create one - by choosing an "outlier". 

Use him in a smear campaign of sensationalism and public scare-mongering to tar and feather all doctors of his particular specialty- or doctors in general-   as dangerous exploiters and victimizers of patients who need to be further controlled and regulated by regulators and bureaucrats. 

Use the actual or invented criminal to inculcate guilt in all doctors and create and nurture a public climate of distrust, suspicion, class envy, contempt and fear in all patients- and to prepare the groundwork for more and more regulation over all aspects of medical care by government regulators to ride in on white horses to "rescue" the public in the name of "public safety", "fiscal responsibility" , protection of vulnerable patients / taxpayers from greedy, exploiting profiteering doctors, etc....

The goal is to demonize and criminalize private indpendent practitioners of outpatient medicine and chase them into the hospitals where they can be controlled under someone else's thumb who has oversight and veto authority on their excercise of their best medical judgment and rational thought in patient care. 

The best is when you can write Medicare regulations that are so voluminous, arcane , vague, restrictive or contradictory that no doctor  can interpret them - let alone follow them. Then you can really cash in- and have doctors right where you want them: 

“Do you really think that we want those laws to be observed? … We want them broken. … There’s no way to rule innocent men. The only power any government has is the power to crack down on criminals. Well, when there aren’t enough criminals, one makes them. One declares so many things to be a crime that it becomes impossible for men to live without breaking laws. Who wants a nation of law abiding citizens? What’s there in that for anyone? But just pass the kind of laws that can neither be observed nor enforced nor objectively interpreted — and you create a nation of law-breakers — and then you cash in on guilt.”

— Dr. Floyd Ferris in Ayn Rand’s Atlas Shrugged, Part II, Chapter III

The government's heavy handed government control of doctors in fact bears a striking resemblance to methods employed in post Soviet Russia  by loyal party apparatchiks hell bent on sabotaging free market and democratic political reforms, while maintaining control of the reins of power while laying the groundwork for Putin 's present day kleptocracy:

"That corruption was part of the [ post - Soviet] Russian system from the beginning is something we’ve long known for a long time, of course. In her book Sale of the Century (2000), Chrystia Freeland memorably describes the moment when she realized that the confusing regulations and contradictory laws that hog-tied Russian business in the 1990s were not a temporary problem that would soon be cleaned up by some competent administrator. 

On the contrary, they existed for a purpose: the Russian elite wanted everybody to operate in violation of one law or another, because that meant that everybody was liable at any time to arrest. The contradictory regulations were not a mistake, they were a form of control."