Showing posts with label doctors. Show all posts
Showing posts with label doctors. Show all posts

Monday, August 3, 2015

CALIFORNIA: DOCTOR SHORTAGE LOOMS AS OBAMACARE ROLLS OUT, SAYS EXPERT

Doctor Stethoscope (Joe Raedle / Getty)

America faces a deep shortage of doctors as Obamacare is implemented. That is the view shared by 100 health care professionals who gathered at the 33rd annual meeting of Doctors for Disaster Preparedness in Ontario, California over the weekend. They forecast a future of decreased quality of health care and access to doctors if current policies continue.

“What do I mean by medical meltdown? Well, sadly ,I’m here to tell you that the medical care you’ve enjoyed in the past in your life is simply not going to be there in the future,” said orthopedic surgeon Dr. Lee Hieb, who addressed the conference.
Just like a black hole is so dense that no light gets out, “We have so much regulation that almost no medical care gets out,” Hieb told the audience. “We have over 160,000 pages of Medicare regulation and counting.” She continued, “Obamacare is Medicare on steroids.”
“The reason we have a shortage of doctors today and we’re going to get worse in the future began in the early 70s because the great gurus of government looked around and they said probably…look at all this money that’s being sent to all these specialists.”  Hieb went on to say that government bureaucrats decided to limit the number of specialists.
However, Lieb notes,  that the U.S. is only seeing 350 new general surgeons a year. That is not even a replacement rate, she observed.
Hieb professed that being taxed to death and having to send so much money to the government is a disincentive for doctors to work at full capacity.
“Our young people are not trained as well as we were,” she continued.
“We are now the number one profession for suicide. We lose 400 doctors a year to suicide. That’s like losing an entire medical school,” Hieb stated.
Hieb also cited a shortage of “things” or medical supplies–the first she has seen in her 40 years of involvement in medicine. She recalled almost having to close an operating room for shortages of propofols, which are used to put people to sleep; as well as shortages of tetanus vaccine, shoulder catheters and thyroid medication shortages, among other items.
The cause, according to Hieb, is “this huge over-regulatory environment.”
She elaborated on the thyroid example, saying,
These are old medicines that have lost their patent and they’ve been produced without a problem in these factories for years, but the government rolls in and says you have to bring this factory up to some arbitrary new standard and these guys say, well, we can’t do that because–guess what? you guys price fixed. You tell us what you’re going to pay, Medicare’s going to pay for this stuff. We can bill anything we want to, we get paid what you tell us you get paid, and now you’re telling us we have to spend all this money to modernize our factories. We’re going to lose money, we can’t do that, so we’re going to shut down. So after a few factories shut down in one of these nationwide shortages in classic bureaucratic fashion, the government says well wait a minute, wait a minute, you can’t shut down.
You said, “what, what do you mean we can’t shut down?”
[They say] Well, okay, I guess you can shut down, but you’re going to have to give us six months notice.
They just don’t get it.
She pointed the audience to Venezuela as a picture of the “end game.”
Hieb cited a story written by Dr. Richard Amerling and published in the Wall Street Journal (and summarized in Newsmax) that documented the plight of Pedro Gonzalez. Gonzalez, Amerling wrote, checked into a leading Venezuelan public hospital for life saving heart valve surgery. About two months later, all of the cardiac ward patients were discharged due to lack of operating room supplies according to a letter issued. Gonzalez collapsed and died a week later.
“The free market doesn’t come up with shortages this way, but we are starting to see it,” Hieb said. “If you live in a very affluent area and you’re privately insured and your neighbors are privately insured, you will probably not…won’t see it as quickly as other places.”
Hieb referenced work in an Arizona area where 85% of payers were government-paid through Medicare, Medicaid and Tricare. Four orthopedic surgeons would do the work that 10, 11 or 12 in more affluent Flagstaff would take on. She said the average orthopedic surgeon in America takes care of 12,000 people. Conversely, the region where Hieb worked was serving approximately 90,000, which later ballooned to 120,000 as Hieb left and only three surgeons remained. She said her 53-year-old former colleague from the region died thereafter under the long and strenuous work.
“The big black hole is already starting to open up,” Hieb said.
She mentioned traveling two hours to reach an obstetrician, waiting six hours to be seen by an orthopedic surgeon, or three or four months to see a rheumatologist as problems facing those in less affluent regions.
“In a free market, when there’s a shortage, it gets filled,” Hieb said.
Hieb then launched into health recommendations for “how to save yourself.” She said going into the future, “you want to be so healthy that you don’t need a doctor” in light of the impending medical shortages which she had detailed.
Dr. Hieb is listed in the Doctors for Disaster Preparedness program as “an orthopedic surgeon specializing in spine surgery and a past president of the Assn. of American Physicians and Surgeons.”
Follow Michelle Moons on Twitter @MichelleDiana

Thursday, May 22, 2014

Marine Can’t Find Doctor Due to Obamacare

A California veteran is having trouble finding a doctor because of a faulty Obamacare plan.
Kyle, affected by chronic Lyme disease he contracted while on active duty, is frustrated with the lack of doctor availability on his Anthem BlueCross insurance plan. “I was on the phone with Anthem for two hours while they were trying to find me a doctor within 20 miles. Finally a supervisor came on the phone and said ‘Sir, we have to go, we have other people to help’ and advised me [that] I need to cancel my plan,” he told KPIX.
State law stipulates that insurers must have enough doctors to enable patients to get an appointment within 15 days within 15 miles of their home. Kyle was not able to find a doctor under these requirements and neither was Anthem. Inaccurately listed doctors are considered a violation of the law. The list of doctors given to CoveredCalifornia was incorrect.
“If we determine that a health plan has violated the law, we will take action,” Marta Green of Department of Managed Health Care said in response.
Internal emails reveal one individual’s warning about listing doctors that are not actually on insurance plans “I suspect that we are going to have a network adequacy issue very soon.”
Kyle advised CoveredCalifornia not to negotiate with Anthem. “I would tell them to get rid of Anthem BlueCross.”

Tuesday, November 5, 2013

Saving Premature Babies: When Doctors Take the Place of God

preemieOver time we have become a nation of subjects, not citizens fully engaged in our own governance. I say this not as a rhetorical device but to point out the enormous areas of our life where we have ceded sovereignty over ourselves not only to elected officials… a necessary evil in any developed society… but to a wide variety of unelected experts.
Perhaps nowhere in our lives is this more the case than in our medical care. Bureaucrats in your insurance company may not pay for certain treatments because you just aren’t that valuable of a customer. Bureaucrats in the FDA may not allow you to have access to a developmental drug for your fatal ailment because the treatment hasn’t been proven safe — losing sight of the point that safety is the least of your concerns. We have accepted these incursions into our lives because we have been sure that in most cases your doctor would approach your care with a bias towards saving your life, not minimizing his workload.
No more.
As we have entered the age of Obamacare, this relationship with our technocratic masters has become more acute. You are no longer deemed competent to purchase an insurance product that meets your needs, medical and financial. Rather the government, acting in loco parentis, tells you what you need. And, at some point, the work product of a government panel will tell your physician whether to treat you or let you die. (See In Britain’s Liverpool Pathway We Get a Preview of Obamacare and Hell.)

Monday, November 4, 2013

You Also Can't Keep Your Doctor I had great cancer doctors and health insurance.My plan was cancelled. Now I worry how long I'll live.

Everyone now is clamoring about Affordable Care Act winners and losers. I am one of the losers.
My grievance is not political; all my energies are directed to enjoying life and staying alive, and I have no time for politics. For almost seven years I have fought and survived stage-4 gallbladder cancer, with a five-year survival rate of less than 2% after diagnosis. I am a determined fighter and extremely lucky. But this luck may have just run out: My affordable, lifesaving medical insurance policy has been canceled effective Dec. 31.
My choice is to get coverage through the government health exchange and lose access to my cancer doctors, or pay much more for insurance outside the exchange (the quotes average 40% to 50% more) for the privilege of starting over with an unfamiliar insurance company and impaired benefits.
Bloomberg News
Countless hours searching for non-exchange plans have uncovered nothing that compares well with my existing coverage. But the greatest source of frustration is Covered California, the state's Affordable Care Act health-insurance exchange and, by some reports, one of the best such exchanges in the country. After four weeks of researching plans on the website, talking directly to government exchange counselors, insurance companies and medical providers, my insurance broker and I are as confused as ever. Time is running out and we still don't have a clue how to best proceed.
Two things have been essential in my fight to survive stage-4 cancer. The first are doctors and health teams in California and Texas: at the medical center of the University of California, San Diego, and its Moores Cancer Center; Stanford University's Cancer Institute; and the M.D. Anderson Cancer Center in Houston.
The second element essential to my fight is a United Healthcare PPO (preferred provider organization) health-insurance policy.
Since March 2007 United Healthcare has paid $1.2 million to help keep me alive, and it has never once questioned any treatment or procedure recommended by my medical team. The company pays a fair price to the doctors and hospitals, on time, and is responsive to the emergency treatment requirements of late-stage cancer. Its caring people in the claims office have been readily available to talk to me and my providers.
But in January, United Healthcare sent me a letter announcing that they were pulling out of the individual California market. The company suggested I look to Covered California starting in October.

Sunday, November 3, 2013

Virginia Democrat Calls For Forcing Doctors To Accept Medicare And Medicaid Patients

You would think that when your party is burying a hole that is getting harder and harder to get out of, you wouldn't want to that hole get deeper faster.  But here is Kathleen Murphy, Democrat running for the House of Delegates against Barbara Comstock, telling a forum in Great Falls that she believes it should law to force doctors to accept Medicare and Medicaid patients.  Forced by government decree, mind you.  A birdie sent me this:

FYI last night at the Great Falls Grange debate, Democrat delegate candidate Kathleen Murphy said that since many doctors are not accepting medicaid and medicare patients, she advocates making it a legal requirement for those people to be accepted.  
She did not recognize that the payments are inadequate to cover the doctors' costs.  She also did not recognize there is a shortage of over 45,000 physicians now and that it is forecast to be 90,000 in a few years.  
Democrats appear to want to make physicians slaves of the state, but Democrats don't admit they would just drive more doctors out of practice into retirement and other occupations.  The Obamacare law and regulations are causing millions of people to lose their health insurance, drop many doctors and hospitals. The HHS internal forecast is 93 million Americans would lose their health insurance due to the Obamacare law and rules about adequacy of insurance.
Many more people will be uninsured.   The penalties for being uninsured start at $95 per year, but the penalties can't be collected by the IRS if a person does not have a tax refund to attach.  
The out of pocket costs required by Obamacare's Silver Plan for a non-smoking mother and father with two children making a gross before income taxes of $50,000 (roughly average salary for VA) would be $13,765 per year including the deductible of $10,400.  That's 28% of their gross income -- not very affordable and about the same as guidelines for a mortgage payment.  For such a family making $100,000 of gross income, The cost would be $21,431 including the deductible of $12,700, or 21% of gross income.   
With such high deductibles doctors are stuck with trying to collect cash from the patients, even at regulated charge structures.  Thus is makes sense for primary care doctors not to participate in Obamacare, medicare and medicaid.  They should encourage patients to participate in Concierge Care and insurance programs run by the doctors themselves with patients who can do simple math.  Patients can take out catastrophic insurance with high deductibles for major surgeries.  Tax deductability for individual medical savings accounts would make health care more affordable.  

The head of Obamacare programs, Berwick, loves the socialized medical system in the UK, but never mentions that malpractice insurance is minimal.  In the UK, panels of doctors review and approve malpractice awards, rather than emotional juries misled by trial lawyers.  Malpractice reform like this with caps on malpractice awards would go a long way in making health care affordable.
I hope physicians rise up and speak out for common sense, protecting quality medical care in the US and giving patients freedom to choose

THIS along with the fact that Terry McAuliffe has already said he'd go to the government shutdown mat to get a state exchange in Virginia.  Unbelievable.  Combine the chaos of thousands of people across Virginia losing their health insurance, we are going to add to that on the state level by forcing doctors to accept patients they can't afford to help?  Unbelievable.  Dark days are ahead, but there is still time.    Three days to make sure this does not happen.  
Democrats in Virginia will drive up health care costs, drive doctors out of the state, and then drive health care costs up even more because there will not be enough doctors practicing in the state. 

Sunday, October 20, 2013

Doctor search tool still not working on Covered California website

Covered California certified educator
A highly-touted  doctor search tool on the Covered California health insurance website has so far  proven  to be nothing but headaches for consumers and for officials of the state run insurance marketplace, who have  taken the feature offline for repairs. 
During the first week of enrollment that started Oct. 1, the doctor search didn’t work at all. Top officials touted it on opening day as an important tool for consumers who want to confirm that their doctor is included in any new health plan they may buy.
Early last week, Covered California officials announced the search tool was up and running.  But, within hours, those using it found a slew of problems. 
"I had an ophthamologist friend listed as speaking Farsi, Russian and Spanish, and he doesn’t speak any of those languages," says Dr. Richard Thorp, president of the California Medical Assn. The group represents about 37,000 doctors statewide. 
Perhaps even more awkward, data loaded into the site contained errors that linked doctors to the wrong specialty.  For instance, Thorp says,  a gynecologist friend of his was listed as an ophthalmologist. 
"You can understand that that’s a very different kind of encounter: thinking you're signing up for an ophthalmologist," he says, "and finding out the doctor you signed up for is an OB/GYN doctor or, visa versa, for that matter.”  
Covered California spokeswoman Anne Gonzales says the agency took the doctor search tool offline last Tuesday  to fix improperly loaded data. The agency is also trying to make the slow-working search run faster and to make the function easier for consumers to find and to use. 
"It’ll have better page loading speed. We’re going to reconfigure some of the navigation paths so it’s not so confusing, and we’ll have some expanded search functions," Gonzales says. Officials hope the search tool will be running by sometime next week. 
In the meantime, some are advising consumers shopping for insurance on the website to hold off on enrolling in a plan until the doctor search is working.

Thursday, October 17, 2013

Tuesday, October 15, 2013

Patients Pay Before Seeing Doctor as Deductibles Spread

When Barbara Retkowski went to a Cape Coral, Florida, health clinic in August to treat a blood condition, she figured the center would bill her insurance company. Instead, it demanded payment upfront.
Earlier in the year, another clinic insisted she pay her entire remaining insurance deductible for the year -- more than $1,000 -- before the doctor would even see her.
“I was surprised and frustrated,” Retkowski, a 59-year-old retiree, said in an interview. “I had to pull money out of my savings.”
The practice of upfront payment for non-emergency care has been spreading in the U.S. as deductibles rise. Now, the advent of the Patient Protection and Affordable Care Act is likely to accelerate that trend.
Many of the plans offered through the law’s insurance exchanges have low initial premiums to attract customers, while carrying significant deductibles and other out-of-pocket cost sharing. The second-lowest tier of Obamacare plans inCalifornia, for example, carries a $2,000 annual deductible.
Hospitals say they need to charge patients prior to treatment because Americans are increasingly on the hook for more of their own medical costs. And once care is provided, it’s often difficult for hospitals to collect.
“It used to be taboo to look like you were looking for money at a time when you were supposed to be focused on patient care,” David Williams, president of Boston-based consulting firm Health Business Group, said. “It’s not taboo anymore.”

Wednesday, September 18, 2013

Health care in Syria is 'hell on earth,' doctors say

Syriahospitaldamage.jpg
DO I HEAR OBAMACARE???

Syria’s once sophisticated health system is “at breaking point” and parts of the country are completely cut off from any kind of medical service because of “deliberate and systematic attacks” on medical facilities and staff, senior doctors said on Monday.

Horrific injuries go untended, women are giving birth with no medical care and patients battling cancer, diabetes and heart disease, as well as victims of sexual violence, have nowhere to turn, 55 medical professionals from across the world said in a joint letter in The Lancet medical journal.

More than half of Syria’s hospitals have been destroyed or badly damaged in attacks, nearly 470 health professionals are imprisoned, and about 15,000 doctors have been forced to flee abroad, said the letter’s signatories.

“Such attacks are an unconscionable betrayal of the principle of medical neutrality,” wrote the doctors, who include Gro Harlem Brundtland, former director-general of the World Health Organization and Hany El Banna, founder of the Humanitarian Forum and Islamic Relief.

Of the 5,000 physicians in the city of Aleppo before the conflict started, only 36 remain, the letter said.

Via: Fox News

Continue Reading.... 

Thursday, September 12, 2013

Why This Doctor Fears Obamacare

Dr. Tim Shepherd talks about his patients like they’re his own family.
He gets emotional when he thinks about a patient he’s been treating for 20 years, and talks about a new patient who’s making progress like it’s his first grandchild.
He says his favorite part about being a doctor isn’t having specialized knowledge or the power to “save lives.” It’s the opportunity to take care of people.
“It makes it difficult to take care of the whole person if you don’t have the environment where you are free to do that,” Shepherd told Heritage.
Unfortunately, everything Dr. Shepherd loves about his job is now at risk because of Obamacare.
The father of 11 children, including Heritage marketing associate Josh Shepherd, has run afamily practice in Lewisville, Texas, for 35 years. He’s concerned about the impact of the law on the care he is able to offer his patients

Tuesday, September 10, 2013

[VIDEO] Warning: Obamacare May Be Hazardous to Your Health

We’ve talked a lot about Obamacare’s costs—how it will hurt the economy, kill jobs, and cost you and your family more when you pay for health care.
But there’s an even more important cost: your health.
Obamacare will affect the quality of care in this country. It will limit the choices we have in doctors, hospitals, and treatments. People are already learning that their trusted doctors aren’t going to be available to them in the new insurance plans Obamacare is forcing them into.
And disrupting your relationship with your doctor is not how health care reform should be.
The Heritage Foundation, our experts, and our 600,000+ members believe so strongly that Obamacare is bad for your health that we’re putting this message front and center in Times Square.

Saturday, August 31, 2013

Obamacare: When You Have to Find a New Doctor

Stacy WilsonRemember when President Obama said if you like your doctor, you could keep him or her? Americans everywhere are finding out that’s not true.
“I have to find a new doctor,” Dallas mom Stacy Wilson tells Heritage. “I’ve been seeing the same primary care physician the last 15 years and I just got a letter [in the] last month or so saying that she’s moving to a VIP program where you pay in several thousand dollars and you get more time with the doctor, more personalized care, and because of that, well first of all I can’t afford that, and second of all, she’s shrinking her practice down to like 400 patients.”
Wilson’s doctor, an internist, is one of many doctors switching to what is known as “concierge medicine.” A survey of doctors in 2012 found that one in 10 plans to convert their practice to concierge, also known as direct-pay because it eliminates third-party insurance. Many say they are responding to increasing bureaucratic interference and uncertainty over insurance and Medicare payments, and some directly cite Obamacare. This is one way for doctors to guarantee a level of patient care, which they fear is being compromised by indiscriminate regulations.
“I don’t fault my doctor. She’s a small business owner, and she has to do what she has to do for her small business and herself before her patients,” Wilson adds. “If they’re going to put all these regulations on the doctors, she needs to do what she needs to do. If that means shrinking her practice and doing a VIP program, then that’s what she has to do.”
Wilson said it’s simple: “[Obama] lied. It’s one thing to come up with an idea and think it’s so great, and it’s another thing to actually know how the system works and what the details would be. And you can’t make promises like that until you know what’s going to happen, and they don’t even know what’s going to happen now.”

Tuesday, August 27, 2013

[VIDEO] Doctor Shortage Set to Undermine Obamacare

Healthcare professionals are warning that there could be a wide gap between the number of people seeking medical treatment under Obamacare and the number of doctors available to provide it.

A triple threat — more people needing care, tens of thousands of doctors reaching retirement age and a growing number of physicians getting so frustrated with bureaucracy that they want out — could undermine any improvements the law envisages.

Dr. Jeff Cain, President of the American Academy of Family Physicians, told Fox News, "We have an increasing population, we have more Americans that are getting older that need more healthcare. And with the 30 million Americans that are newly insured with the Affordable Healthcare Act, more people are looking for primary care." 

 At the same time, 10,000 baby boomers are set to retire every day for the next 19 years — and that number includes thousands of doctors.

In addition, as Avik Roy of the Manhattan Institute for Policy Research told Fox, "There are a lot of doctors who are just so frustrated; today with all the bureaucracy involved in taking care of patients that they're retiring early."

The rollout of the Affordable Care Act comes at a time when there is already a shortage of doctors in many parts of the country; nearly one in five Americans lives in a region designated as having a shortage of primary care physicians. 


Via: Newsmax

Continue Reading....

Sunday, September 23, 2012

BACKFIRE: Medicare Bills Rise as Records Turn Electronic

When the federal government began providing billions of dollars in incentives to push hospitals and physicians to use electronic medical and billing records, the goal was not only to improve efficiency and patient safety, but also to reduce health care costs.


But, in reality, the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care.
Hospitals received $1 billion more in Medicare reimbursements in 2010 than they did five years earlier, at least in part by changing the billing codes they assign to patients in emergency rooms, according to a New York Times analysis of Medicare data from the American Hospital Directory. Regulators say physicians have changed the way they bill for office visits similarly, increasing their payments by billions of dollars as well.
The most aggressive billing — by just 1,700 of the more than 440,000 doctors in the country — cost Medicare as much as $100 million in 2010 alone, federal regulators said in a recent report, noting that the largest share of those doctors specialized in family practice, internal medicine and emergency care.
For instance, the portion of patients that the emergency department at Faxton St. Luke’s Healthcare in Utica, N.Y., claimed required the highest levels of treatment — and thus higher reimbursements — rose 43 percent in 2009. That was the same year the hospital began using electronic health records.
The share of highest-paying claims at Baptist Hospital in Nashville climbed 82 percent in 2010, the year after it began using a software system for its emergency room records.

Friday, August 24, 2012

More than 2,200 Hospitals Face Penalties Under ObamaCare Rules


A provision of ObamaCare is set to punish roughly two-thirds of U.S. hospitals evaluated by Medicare starting this fall over high readmission rates, according to an analysis by Kaiser Health News.

Starting in October, Medicare will reduce reimbursements to hospitals with high 30-day readmission rates -- which refers to patients who return within a month -- by as much as 1 percent. The maximum penalty increases to 2 percent the following year and 3 percent in 2014. 

Doctors are concerned the penalty is unfair, since sometimes they have to accept patients more than once in a brief period of time but could be penalized for doing so -- even for accepting seniors who are sick. 

"Among patients with heart failure, hospitals that have higher readmission rates actually have lower mortality rates," said Sunil Kripalani, MD, a professor with Vanderbilt University Medical Center who studies hospital readmissions. "So, which would we rather have -- a hospital readmission or a death?"

But according to federal government figures, nearly one in five Medicare patients is readmitted to a hospital within 30 days of release, costing taxpayers an estimated $17.5 billion.

"Readmissions has been a low-hanging fruit for Medicare," said Jordan Rau, a staff writer with KHN, an editorially independent program of the non-partisan Kaiser Family Foundation. "They've been very unhappy that about 2 million Medicare beneficiaries are being readmitted every year between 30 days of discharge."

Medicare evaluated readmission rates at 3,367 of the nation's hospitals and will impose penalties on 2,211 starting in October, according to KHN. The analysis shows 278 hospitals will receive this year's maximum penalty of 1 percent. On the other side of the spectrum, 50 hospitals will receive the minimum penalty of 0.01 percent, KHN reports.




Monday, August 20, 2012

Obamacare’s Threat of Centralized Control


I don’t like much about Obamacare. But most urgently, I oppose its imposition of anti-American centralized control–in the sense that it is the antithesis of the Founders’ governing philosophy–and hopeless complexity over a huge sector of the American economy, as much about the seizure of raw power as it is about restraining costs.
That’s the NHS model.  No, not in the method of its funding but the flawed presumption that bureaucrats somehow know best, a point made very well in by Theodore Dalyrimple’s interesting article about the NHS, entitled “Universal Mediocrity” (my emphasis):
In obeying directives not because they are right but because they are directives, doctors lose their self-respect, their probity, and their intellectual honesty. Gogolian absurdity can result—with a hint of Kafkaesque menace and Orwellian linguistic dishonesty. When the British government decreed that every patient arriving in the emergency room should be admitted to a hospital ward within four hours if admission was necessary (and that hospitals would face fines if they failed to adhere to the rule), traffic jams of ambulances formed outside one famous hospital, with their patients prevented from entering the emergency rooms until the hospital could comply with the directive. Other hospitals redesignated their corridors as wards so that they could claim that patients on stretchers had been admitted in time. In a centralized system, the setting of targets will encourage organized deception, as well as distortion of effort.
In the United States, after President Obama’s health-care law proposed fining hospitals that readmitted too many patients within 30 days of discharge, editorials in the New England Journal of Medicine pointed out the dangers posed by that rule. They omitted to say that when giant bureaucracies set targets for others to reach, they intend not so much to procure improvement as to impose control.
They say that power corrupts and absolute power corrupts absolutely. We already see some of that. But more primarily, it is also the enemy of excellence and innovation. Deprofessionalizing medicine into a technocracy–already in its early stages–will not make our doctors and hospitals better, but instead, equalize increasingly mediocre results.



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