The Doctor Is Out

[The following is a facsmilie of an editorial submitted to the Springfield News-Leader on February 17, 2010 in answer to a column written by Dr. John Lilly.]

At the present moment, there are over 40 million people in this country with no health insurance, a good portion of them children. I am a university professor and receive e-mails from students who are too sick to come to class and who try to tough out dangerous conditions with the idea that if the pain becomes too great they will go to an emergency room. The country is drowning in debt, a good portion of which is generated by a health care non-system which drains almost 20% of the lifeblood of this country. And in the face of all those trillions of dollars poured down the health care sinkhole, our nation has one of the worst levels of infant mortality in the industrialized world and our life expectancy lags as well.

So I was again amused to see Dr. John Lilly, the former President of the Greene County Medical Society and a Young Conservative to boot, recommend in the Springfield News-Leader (February 17, 2010) that we institute a truly competitive system so that doctors would not be affected by the cuts that Medicare needs to make in order to maintain its fiscal stability. We now spend over $7,000 per capita on healthcare – that is $7,000 for every man, woman and child in this country and even in the face of that he fears that doctors will be shortchanged and thus will withhold their services. If he would consult his history, he would find that when medicine was “competitive” on the old frontier, doctors were paid in bushels of corn or with anything that people could pay and the doctors accepted it because medicine was their calling and when the community suffered they suffered as well.

What he really wants is something quite different than a return to the good old days. Medicine has never been nor can it ever be a competitive enterprise. When you purchase a commodity in a marketplace, you take account of the price and decide whether you can afford what you want and/or whether the commodity is priced fairly. The seller will make similar calculations in deciding at what price to sell or whether to sell at all. Both sides in a truly competitive market can try to find others from whom to buy or sell or decide in the end not to buy or sell. Immediately it is plain that medicine cannot be placed in this model. Those in need of healthcare services are often in no position to forego them. Life is at stake and the physician who does not hearken to the humanistic values of the now all but defunct Hippocratic Oath descends to the level of the extortionist. No one should work for “free,” but the physician who does not understand the difference between healing and haberdashery needs some therapy of his own.