Jonathan highlights an Instapundit discussion that caught my eye, too. The discussion is about mammograms and the latest proposed guidelines for screening: do the guidelines represent good science, or are they simply meant to save money (these are not mutually exclusive goals)? I don’t know the science, and don’t have any reason to distrust the health care professionals proposing the guidelines, but I understand that an element of distrust is introduced by the current health care debate.
Anyway, the above linked discussion brings up many interesting points. One is the Public-Health fallacy that Jonathan discusses. Another is the changing relationship between doctor and patient in a system where the federal government intrudes so heavily. Guidelines become suspect. Who is the real beneficiary of the guidelines – the individual patient, or the ‘greater good’ of the population as designated by a government official? The government guidelines, or official, become a third party between the patient and the doctor. The relationship is altered. To some extent, this is already the case with third-party payers and the current level of regulation, but the proposed health care bills take it to another level, entirely.
You see the same phenomenon of distrust when a patient talks about ‘greedy’ doctors and drug companies. I think that distrust will be transferred to Washington under the ‘D.C.-centric’ health-care bills that are being considered. And, in the political fight between constituent groups (patients and others), we may end up with a system where large public health bureaucracies will need to be placated first – a bit like California and the public service unions, or the British NHS*. The entire nature of the doctor-patient relationship will be changed. What do you all think? I’m a physician, and like many physicians, have my own levels of distrust. They are currently being directed at the government takeover of health care.
*I recently watched an old “Yes Minister” (Brit sitcom from the 80s) in which a government minister tries to shut down a hospital with no patients (it has a very large staff). A funny joke, yes? Well, the running joke of the show is that the unions resist by making the following claim – who cares if there are no patients? The greater good is served by all those public sector jobs. So, who “owns” the doctor-patient relationship in that sitcom scenario? Soon, alas, to be ours, perhaps?
Update: Think I used the word distrust enough in the above post? It’s like I’m trying to make a point, or something….
Another Update: Hey, a belated thanks for the link, Instapundit!