Because of the “emergency” of COVID-19, the Centers for Medicare and Medicaid Services (CMS) is relaxing some Medicare rules, regulations, and constraints—temporarily. The crisis has helped to reveal the consequences of the government intrusion into medicine that began with the passage of Medicare, writes Tamzin Rosenwasser, M.D., in the fall issue of the Journal of American Physicians and Surgeons.
When Medicare was enacted in 1965, it immediately displaced the private insurance that persons over age 65 already had, Dr. Rosenwasser notes. All such policies were canceled. Promises never to interfere in the practice of medicine were promptly violated, as costs exploded.
With working taxpayers footing the costs of retirees’ care, demand quickly exceeded supply. Every trivial concern is run through the gigantic federal bureaucracy and its contracted carriers, all of whose workers get salaries, benefits, and retirement, Dr. Rosenwasser explains.
The Health Maintenance Organization Act of 1973 was intended to curb the medical inflation caused by Medicare and Medicaid. Managed care incentivizes providing less care, and generates guidelines for what treatments can be authorized. Then came the “prospective” payment scheme by diagnosis-related groups (DRGs), price-fixing under the Resource-based Relative Value Scale (RB-RVS), and the Merit-based Incentive Payment Scheme (MIPS).
All these schemes to restrict care, place a value on medical services, or grade medical professionals are un-Constitutional, but are rationalized as merely being the conditions for receiving payments under the allegedly “voluntary” Medicare system, she writes.
The result is that “a pandemic of government rules, regulations, constraints, mandates, obstacles, trip wires, and nooses has been clamped upon the medical profession, which stress, obstruct, and distract physicians from the critical vocation of taking care of their patients.”
“Burnout” is rampant, and physicians have the highest suicide rate of any profession, Dr. Rosenwasser notes.
Current problems flow from the fact that Medicare itself is “facially un-Constitutional,” as Dr. Rosenwasser argued in an earlier article. It turns younger working taxpayers into “second-class citizens.”
We must return to Constitutional government and sanity, she states. Her recommendations include disengaging from Medicare to the extent possible, eliminating middlemen who add no value to the system, advocating for a return to true insurance rather than prepaid “health” plans, and teaching individual responsibility for our health.
“It is past time to overthrow the Administrative Deep State and restore Americans’ independence, under a Constitutionally limited government,” she concludes.
Read full article (part 2): https://jpands.org/vol25no3/rosenwasser.pdf
Read part 1: https://jpands.org/vol25no1/rosenwasser.pdf
The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.
