What's EMTALA? A Chevrolet?

The doc at M.D.O.D. had a pretty good response for Hugh Hewitt, and he almost convinces me – but no.

Let’s start by asking: was this doc engaged in health care policy leadership during the 40 years that preceded EMTALA? I'd guess not. Were most other physicians engaged? No.

I believe that physicians, by their failure to effectively assert leadership in health care policy, allowed what this doc calls “professional arguers” to gain control of it. I also believe that, up to just a few years ago, physicians were mostly content with this arrangement because they were left alone to charge fee-for-service based on U & C.

Let’s now ask whether the government suddenly overthrew private medicine? Or did the government come in on little cats' feet, step by step, year by year, always with a promise of doing something good for the people? Yeah, you know the answer. And so gradually government insurance types - and private insurance types for that matter – filled the vacuum of health care policy and administrative control that was being ignored by physicians. Nature truly does abhor a vacuum.

And there are consequences for inaction.

Physicians find they don’t like taking policy direction from the administrators who filled the vacuum that physicians largely created.

So yes, I think it’s an excuse - not to mention a fig leaf over the past - for this doc now to suggest that he and other physicians were simply swept along as passive victims of professional arguers, until one day they were ambushed by EMTALA - the final outrage. And after wandering around in their wilderness of inaction for 40 years, this doc now suggests that physicians believe it’s too late for action. Too late! Resistance is futile! So the better course is to “muddle through to the inevitable” which I gather means toss in the sponge and take the John Galt exit off the Hippocratic Highway. Yeah, sounds like a pity-party to me.

I have hoped and advocated for years for physician leadership in health care policy. I still think that is what the country needs. I hope for it – but encountering continual physician excuses for physician inaction makes me doubt it will ever happen.

And so we will get our government health care controlled by politicians and so docs will slowly turn into government drones and so the government will declare a great victory for the people. And the people will rejoice. Remember that, in the end, Winston Smith decided that he loved Big Brother.

Oh yeah, and there will be political patronage jobs in health care until the end of time.

So let it be written, so let it be done.

I can scarcely contain my enthusiasm.