By Marilyn M. Singleton, MD, JD
The federal election’s mail-in voting chaos should teach us something about government-run medical care. In several cases, the voting process was as purposefully obtuse as the inner workings of our “healthcare system.”
Our complex system includes the government or private insurers second-guessing your physician’s judgment with a man behind the curtain determining the “medical necessity” of tests or treatment. Is the justification that the physician with scientific knowledge and clinical judgment knows less than the bureaucrat? Or that the bureaucrat’s agenda favors the government pocketbook or his job security over the patients’ best interest?
Patients and physicians long for medical visits of days past. You saw your doctor, not the doctor who happened to be available that day. Your doctor saw you as a person, not merely a list of checkboxes on a computer screen. And most importantly, your doctor took the time to listen. And at the end of the visit, the doctor was allowed to charge you what you could afford to pay—not the price fixed by the government or insurer. Now, massive overregulation labels this type of charitable billing as health care fraud. Let’s get back to basics: you pay the doctor for their services and have major medical insurance for the hospital.
If we have totally government-run medical care, our choices are gone and we are at the mercy of politicians.
The intrusion of personal political preferences has no place in free and fair elections—just as in medicine. A civil society does not condone apparent bias and electioneering by state officials. Nor should we tolerate medical elites who haven’t touched a patient in decades telling physicians how to treat their own patients.
While practicing physicians were reading everything they could find about the new coronavirus, the august bureaucrats were busy giving us “expert” advice that proved incorrect. Of course, the experts never admitted their errors and still have their jobs. Meanwhile we continued to see contradictory information, the mischaracterization of positive SARS-CoV-2 antibody tests as new “cases,” and the media announcing all positive tests a “case” (implying an active illness) and overstating deaths attributable to Covid-19. By design, this misinformation kept us off-kilter and willing to let fear rather than common sense rule our lives. Albert Einstein was so right: “blind belief in authority is the greatest enemy of truth.”
Soon it became clear to clinicians that Covid-19 had separate stages of the disease. Stage I, the viral invasion; Stage II, the abnormal inflammatory response to the infection (cytokine storm); Stage III, exaggerated blood clotting response. Clinicians figured out that each stage needed different treatments. And just like with other conditions, the earlier physicians treat the cause of the illness, the better the patient’s outcome.
Private practitioners and some academicians reported that early use of hydroxychloroquine (HCQ) in Stage I was safe and attenuated the course of Covid-19. President Trump praised the drug’s success. Big mistake. The political winds dictated that HCQ must die (along with some patients). While low-cost, generic treatments emerged, the politicians with their big tech, big Pharma, and media allies ensured that the public would never see the whole picture. In reality fewer people are dying and more people are recovering. But positive news about COVID might have helped the President.
Scoring political points outweighed saving patients’ lives. When the saga of Covid-19 is told, the role of the intrusion of politics into the practice of medicine will leave a permanent stain. Medicine may suffer from the same distrust as does the integrity of the election process. If there is any doubt that the sainted Dr. Fauci and his ilk are overly influenced by politics and their self-interest, two 30-year-old books should resolve the issue: Good Intentions: How Big Business and the Medical Establishment Are Corrupting the Fight against AIDS by Bruce Nussbaum and And the Band Played On by Randy Shilts. History repeats itself. According to Nussbaum, Fauci loved media attention and “this lacklustre scientist [Fauci] was about to find his true vocation—empire building.”
Many posit that the reason a mentally compromised candidate for the United States presidency could stay in his basement and his running mate could refuse to give a single press conference was that “the fix was in.” Middle East peace, confronting North Korean aggression, reining in Communist China, the release of American hostages, the lowest unemployment in history, and a strong economy were flat out ignored by the media. Instead the media pushed a political “platform” of demonizing a President because of a treatable virus with a low infection-fatality rate.
Maintaining medical independence is now more important than ever. Covid-19 was merely one weapon in the political arsenal. The “system” cannot be trusted to look out for you.
Bio: Dr. Singleton is a board-certified anesthesiologist. She is the immediate past President of the Association of American Physicians and Surgeons (AAPS). She graduated from Stanford and earned her MD at UCSF Medical School. Dr. Singleton completed 2 years of Surgery residency at UCSF, then her Anesthesia residency at Harvard’s Beth Israel Hospital. While still working in the operating room, she attended UC Berkeley Law School, focusing on constitutional law and administrative law. She interned at the National Health Law Project and practiced insurance and health law. She teaches classes in the recognition of elder abuse and constitutional law for non-lawyers. She lives in Oakland, Ca.