After eleven YEARS of being dumped on and sneered at (since the administration of another set of reforming Dems on white horses who were going to “fix” healthcare), do you know what “change” would really be, Val? Kevin? It would be one of the big guns in the Obama administration (or the AMA or even AAP) – reading this blog and picking up the phone – or dropping an e-mail – to say, “We don’t like what happened to you, and we’re going to do something about it. And if people/institutions actually broke the laws we already have in place, we’re going to do something about it.”

I really don’t want to hear about making new laws or building new bureaucracies until we enforce/fix what we already have.

As for Mary – so sorry we didn’t have you on the panel. Let’s keep you in mind for next time.

Even though my case (as a doctor beyond-burned-badly in public service – and falling through every black hole of oversight one could fall through) would seem to be the poster-child for government ineptitude in healthcare management . . . and I’ve only been blogging my guts out about it for almost five years . . . I didn’t get an invite.

Probably because, unlike Obama’s current nominee for Surgeon General, I’m an “NHSC” (National Health Service Corps) failure. Doesn’t fit the agenda.

Alas. Woe is me.

The fallacy in this is that we must accept the changes proposed as good, right, and proper. However, if we seem them as deeply flawed, and likely to do more harm than good, we are duty-bound to oppose them, and indeed, seek to ensure that the efforts at reform fail. Change for its own sake is simply stupid. There should be a rational cost-benefit analysis, and that is simply not being provided by those “shaping change”. Further, we are being marginalized regarding any real decisions regarding reform; rather, our presence serves to validate a politcal process that has very little to do with medicine.

At this point, rather than allow ourselves to be used as scapegoats for the horror that has so far been presented to us as reform, we should have the courage to denounce it for what it is: a naked power grab that has nothing whatever to do with medicine, and is all about expanding the role of the state. We are physicians, not politicians. By supporting this “reform” we are moving out of our caregiving roles into social justice, where we have no training and rely on what we feel, rather than rational considerations.

Is reform needed? Sure. Should it come from the government? No. The government already plays a distorting role in healthcare with Medicare and Medicaid, and has contributed heavily to the systematic devaluation of primary care. Considering what the government has done to us thus far, I trust the free market much more than another top down government program.