In my formative years my great uncle Dr. Walter Cale was a horseback doctor in Atkins, Arkansas, known for Atkin’s Pickles. He sold cucumbers for a living to the pickle plant and bartered medical services taking in chickens and eggs. His two-room home office took walk-ins with routine care in the front room and the back room housed his examination table, which he dropped ether solo doing surgeries. He was my physician and gave me the inspiration to shoot for the stars from our poultry farm. He did well financially and had community respect from all.
Post-World War, third party insurance introduced pencil pushers between the doctor and patient. Big government socialists noticed and the American Medical Assoc. was offered the copyright to ICD publications and the American Psychiatric Assoc. was offered DSM copyrights if both organizations would back socialized medicine via medicare/then medicaid. The rank and file were sold down the river, so to speak, with golden retirement parachutes for leaderships.
The ensuing price controls and bureaucracy degraded medicine with physicians chasing the rabbit around the financial track. To reduce the added expense of the middle men, managed care was devised. Doctors found that patients would change MD care for a pittance cheaper charge. The physicians saw patients as a revenue source and not a friend and neighbor. Patients saw doctors as a commodity to sue as an insurance policy if health did not remain perfect. The government was glad to force doctors to take the mark of the beast as hospital privileges required the MD to accept medicaid patients and medicaid which forced MD’s to charge even the poor or uninsured the same price without discount or else be sanctioned.
The low reimbursements required quick throughput, as with cattle, to cover expenses. The huge volume at low profit and degraded quality pleased the government as the MD’s were the highest revenue source for the Treasury as a group. Anecdotally, the expanding knowledge base and time pressures degraded quality. The government introduced electronic health records to slowly force treatment cookbook cascade methods like paramedics use in the military. Additionally, it takes so much longer to see the patient and electronically prescribe with typed notes that significantly fewer patients can be seen through office hours. This results in fewer claims to Centers for Medicare, etc. As in all socialist schemes rationing becomes necessary.
Now fast forward to present day and Covid is making older MD’s consider retirement rather than pay staff and expenses whilst being slowed further by Covid precautions/protocols. The risk of a subpoena by a trial lawyer, on behalf of employees or patients catching Covid, makes retirement look better. Telemedicine is slower, less accurate, depersonalizes, and devoids the last of the physician patient relationship. Older MD’s are a large proportion of practicing physicians. Covid may be the final coup de grâce if they are financially stable. It is now gotten to the point of being hard for a physician to find a practiced physician, good luck to the lay person.
Socialized medicine will be forthcoming rapidly. Already two thirds of physicians are hospital-employed minions controlled by number-driven men in Italian suits and manicured grooming. In one lifetime, this MD has seen the complete replacement of traditional care to a government-hospital industrial complex with a different “provider” yearly, if not semi-annually. It is impersonal and less beneficial than having a trusted doctor lobbying for you sincerely. Covid is the final nail in the coffin. We will be akin to Canadian and British NHS unless you are wealthy and can afford concierge care from a MD who has bailed from centers for medicare which makes it illegal for the MD or patient to bill for services. By the way, one can not bail from medicare Part-A without risking your social security check.
A strange new medical normal with fewer doctors, greater expense, scarce expensive medicines, and degraded services is on the horizon. Maybe we will still be able to leave our homes without Fauci’s/ E.U./U.N. Covid ID of alleged immunity.
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