Promoted as simply a way to help the elderly pay their medical bills, Medicare has led to the federal government controlling the practice of medicine, writes Marilyn Singleton, M.D., J.D., in the fall issue of the Journal of American Physicians and Surgeons. “Federal interference has only served to increase medical costs, herd patients into managed care, and marginalize private medicine, fertilizing the turf for the corporate takeover of medicine,” she writes.
Dr. Singleton, an anesthesiologist, is president-elect of the Association of American Physicians and Surgeons (AAPS).
Medicare is Title 18 of the Social Security Act, which was enacted in 1935. When President Roosevelt first proposed his pension program for the aged, Dr. Singleton writes, it was to be “voluntary contributory annuities by which individual initiative can
increase the annual amounts received in old age.” However, it was from the very beginning funded by mandatory payroll taxes. Contemporary critics of Social Security noted, “The implicit annuity that young workers are investing in has such a low yield that it’s doubtful that many would have participated in voluntary annuities managed by the federal government.”
Many doubted the constitutionality of Social Security. Secretary of Labor Frances Perkins reportedly got the answer whispered in her ear by Associate Supreme Court Justice Harlan Stone at a tea party, Dr. Singleton writes: “The taxing power of the
Federal Government, my dear; the taxing power is sufficient for everything you want and need.”
President Kennedy made Medicare a campaign issue, and it was finally passed in 1965, after his assassination. Dr. Singleton writes:
“Over the years Medicare has had multiple additions, subtractions, and escalating controls on physicians with the stated purpose of improving patient care and saving the government money. Thus far, neither has happened. In the private sector, a program that fell so short of its goals would be jettisoned.”
“A disturbing pattern emerged,” she adds. “Persuasion became coercion, and voluntary became mandatory.”
Physicians must not “trade in individualized care for algorithms and guidelines created with input from profiteers who benefit from their use,” but instead follow Hippocrates’s promise: “I will take care that [patients] suffer no hurt or damage,” Dr. Singleton concludes.
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.