Curmudgeon's Corner

The Power of No

Posted by Al Campbell on April 9, 2010

Healthcare, Political, Quality of Life, U.S.

An article appearing in the April 6th New York Times titled “In Medicine, the Power of No” caused me to think again about the coming changes in our nation’s health care system.

The author, David Leonhardt, discussed the basic belief of Americans in general that more health care is better health care, and drew the contrast of that belief with the coming changes.

Remember the movement to health maintenance organizations some twenty or more years ago?  That was designed by some of the same people, or their protégés, who participated in the development of ObamaCare.  HMOs were designed to rein in spending by controlling the provision of health care according to what the ‘learned few’ knew to be right.  Hospitals had to close wings.  People queued in lines to see their prescribed physician.  Treatments were tightly controlled and scrutinized by the “bean counters” that had ultimate control over the provision of health care.  Doctors rebelled against the constraints on their practice patterns.  Can you see “big Pharma” rolling over as their profits are drained with the changes that everyone just knows will occur if we’re to afford care?

Recall the recent scare concerning the recommendation to reduce the frequency of breast cancer screening?  That was an instantaneous disaster from which those espousing that backed away expeditiously.

We are not of a mind to accept someone telling us we can’t have this test or that treatment.  Without the new health care system saying “no” nothing is going to change.  Without reining in the trial lawyers that helped create the defensive practice of medicine, nothing is going to change.

Leonhardt drew the conclusion that, “From an economic perspective, health reform will fail if we can’t sometimes push back against the try-anything instinct.”

This is not to say that there is too much medicine practiced in too many situations.  That is true in our current environment.  That is among the reasons that health care costs continue to spiral upward at unaffordable rates.  The real key in ObamaCare will be to reverse the natural tendency of us all to try one more thing as we seek a cure for what ails us or a loved one.

Our basic belief system, so far as health care is concerned, flies in the face of ObamaCare as it is currently constructed.  We are very much unaccustomed to being told “no” when it comes to what we think might lengthen or improve our lives.  The firestorms that will ripple across America as this new health care system evolves, and as people experience the realities, will be a huge threat to our politicians who told us they knew what was best for us.  A majority of us knew better and we’ll still “know better” when our care is limited or perceived to be limited.

ObamaCare will need several generations to pass before people don’t remember that they had “better” health care before government ruined it.  We don’t take “no” well at all with regard to our health care options and those of our relatives and friends. 

New medical breakthroughs are trumpeted on a regular basis today.  The costs of those new breakthroughs will not be affordable if ObamaCare is to work. 

Whether or not ObamaCare is right-minded won’t much matter when we’re told “no”!