Richard Reece worries about the further “codification” of medicine if the government takes over:
She describes what Medicare does and what a universal coverage system will do ““ make capricious and arbitrary decisions based on diagnostic codes and numeric quotas. Government has no other choice: its functionaries are too far removed from care sites to make clinically relevant decisions based on personal needs, so it must resort to impersonal codes and quotas. Unfortunately, in the clinical trenches, patients, particularly those with multiple chronic ailments, don’t fall neatly into diagnostic niches, and care must be individualized on a case-to-case basis, regardless of the code or quota. A centralized government run system will inevitably suffer in “hardening of the categories.” A system based on universal vouchers giving caregivers latitude to do what needs to be done is more equitable, workable, and humane.
