Doctors Can’t Be Trusted About Healthcare

Cancun   Of all of the bad nominations coming our way, the notion of Georgia Congressman Tom Price running the Health and Human Services has the most impact on millions of people because of the impact of his virulent opposition to the Affordable Care Act and the jeopardy it places not only on 30 million beneficiaries there, but also on millions more because of additional threats to Medicare for the elderly and cutbacks in Medicaid for the poor generally. Some hold out a sliver of hope because Price keeps saying that he’s a doctor, and he wants that to mean something along the lines that he cares about peoples’ health. He’s taken the Hippocratic Oath, so he’ll “do no harm.”

James Surowiecki points out in the current New Yorker, that in fact the record of doctors and the American Medical Association has been to oppose virtually every governmental medical program providing health security for Americans for a century now. Doctors organized to oppose universal health care when it came to the ballot in California in 1917 during the First World War, claiming it was a “dangerous device imported from Germany.” The AMA in the 30’s opposed pre-paid medical groups where customers paid a flat fee in exchange for care and was fined for anti-trust violations. The AMA campaigned against the creation of Medicare, and hired Ronald Reagan to go on the air and warn us about so-called “socialized medicine.” The AMA was in the thick of the fight to oppose the Clinton health plan during his first term and only supported Obamacare after the so-called “public option” was off the table.

Ten thousand doctors have already organized in opposition to Price and his plan to scuttle the Affordable Care Act, and though the AMA has endorsed his nomination as a former member of their delegate board and a long-time friend in Congress, there is a schism mounting within the AMA over its stand as harmful to patients. Most hospital associations have been silent over Price’s nomination, but have come out strongly in opposition to the plans to end Obamacare as catastrophic in terms of patient care, hospital closings, job loss, and economic ruin within the healthcare industry. Nurses’ unions have been pretty unanimous in opposing the end of Obamacare.

Price is likely to hide behind the public’s assumption that as a doctor he’s an expert on healthcare. Reading Michael Lewis’ new book, The Undoing Project: A Friendship That Changed Our Minds, might take away any notion that doctors should be seen as our modern day priests. Experiments conducted under the influence of work by Daniel Kahneman and Amos Tversky found that fairly simply algorithms outperformed doctors in making diagnoses of many medical conditions, largely because of the unchecked biases of doctors for the way they are used to seeing and working. That’s scary, but true.

And, as Surowiecki points out repeatedly, the AMA is little more than a very effective special interest group, a closed shop union for doctors, if you will, and their own reports indicate repeatedly that their primary purpose is protecting the income security of doctors. Putting money in doctors’ pockets should never be confused with providing basic healthcare for Americans. We don’t need an algorithm to know the facts about that.

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