YOU SAY TOMAYTOES, I SAY TOMAHTOES

In the ACC News Digest on 1/6 a piece from the Washington Post is cited reporting that a small group of influential hospitals was celebrating a provision in the health care bills rewarding hospitals for their efficiency in Medicare spending. It goes on to say that hospitals in big cities and in the South could see loss of funding. The same Digest issue reports on a Boston Globe column citing the President’s praise of the cost-effectiveness of the Mayo Clinic juxtaposed against the clinic’s recent decision to stop accepting Medicare payments at its primary care facility in Glendale, AZ due to losses of $840 million on its Medicare patients.

In our local paper on 1/9 an article from the LA Times is reprinted with the headline, “Health Bill Could Save Money, Jobs.” Economists from Harvard University and USC apparently are predicting the new legislation could slow the growth of medical costs and result in job creation “through proposals for greater competition in insurance markets, better coordination of care and shrinking administrative costs.” However, conservative economists and many business leaders, the article goes on to report, argue that the legislation would increase costs by dint of new taxes and penalties and negative impact on jobs and the economy.

When faced with contradictory views by the so-called experts, who are the layperson, the “common citizen,” to believe? After all, it should be remembered that in the not-too-distant past these same “experts” missed the impending collapse of the domestic and international economy.

For me, the answer is to return to principles and fundamental beliefs. The marketplace can, at times, be brutal, but ultimately, in its collective wisdom, is smarter than you, me, or our esteemed legislators. As I’ve stated in prior posts, I don’t see that a larger, more bloated government has either the judgment to “correct,” or power to control the strong current of market forces. Their job should be to protect it from abuse, and, in a carefully considered way, try to buffer the highs and lows, so the oscillations don’t shake the foundations of our institutional structure to the ground. They’ve failed their responsibilities in their former charge and as a consequence are now going beyond “buffering” with a desperate attempt to redirect the disordered flow, both in their economic and health care policies.

At the start of our medical careers physicians are required to recite the Hippocratic oath. Perhaps the most oft-quoted snippet is the statement, “First do no harm.” Maybe those that govern us would do well to heed the same advice.

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