Reflections on a Medical Career(And The Collapse of Health Care)

Dateline: 20 February 2014

When I was between 12 and 14 years old, I thought I wanted to be a doctor (like my grandfather and my father) and I fully expected to be a doctor. In fact, I remember being very focused on being a doctor during those years. But, as is the case with many youthful aspirations, that changed, and I'm glad it did. 

I don't think being a doctor is all it's cracked up to be. It's a demanding profession that can take a heavy toll on the doctor's family. A lot of people begrudge doctors the money they make, but I don't. There is a price tag that comes with the financial success. I wouldn't want to pay that price. And I don't have a problem with anyone who expends time and effort (a.k.a., work) in making their money, especially when they are in a profession that helps other people. I don't care how much money a good doctor makes. I'm not into class envy like that. Now, if we were discussing bankers… that would be different.

Well, anyway, I'm pretty sure that any doctor in America, who has "practiced medicine" for thirty years or more, will tell you that the medical profession isn't what it used to be. Not hardly. And I've read the opinions of several doctors that are saying that the American health care system is near collapse; that Obamacare will bring the death knell of this country's once-remarkable health care system.

A recent example of this is Dr. Robert S. Dotson, an opthamologist, who has written Reflections on a Medical Career. That link will take you to Dr. Dotson's essay posted at the web site of Paul Craig Roberts. 

As an aside, if you have not heard of Paul Craig Roberts, I suggest that you check out his bio and listen to some of the interviews at his web site. Mr. Roberts is an economist and former establishment insider. Among many accomplishments, he was Ronald Reagan's Assistant Secretary of the Treasury.

Paul Craig Roberts has some amazing insights into this time in our history. His economic and political analysis does not conform to any "party line." He strikes me as a credible and brave voice in a world of government-and-corporate media disinformation and mind-manipulation.

Now, back to the essay of Dr. Robert S. Dotson. I encourage you to read it. If you don't have time, I'll give you a couple of excerpts…

In reflecting back over my many years in the field of ophthalmology (as of this writing, I am 63 years old and feeling pretty shop-worn), I am staggered by the changes that have occurred. When I opened my practice in 1982, Medicare approved surgical fees for cataract and implant surgery were near $1200. By 2012, that approved charge had dropped to about $570 in Tennessee. (There is some variance within states based on rural versus metro areas and between states where some are declared to have higher costs of doing business.)

Additionally, the US dollar has declined in value an average of almost 2.5% per year over the past 30 year period. Needless to say, overhead operating costs – salary, rent, insurance, personnel costs, taxes, and normal business expenses – have exploded during this same 30 year period. My office rent was raised 20% in the Fall of 2011, for instance.

To further illustrate the absurdity of the situation, it is worth recounting an anecdote. Several years ago, a patient excitedly told me of the vision restoring cataract surgery that her poodle had received at the local veterinary college. It “only cost $2600 for both eyes!” At the time, Medicare was paying about $1400 for two eyes in a human – including work up, surgical fee, post-op care for 90 days, and the very real liability associated with being a physician in a litigious society.

I do not begrudge my animal doctor friends their success, but surely the worth of human care should at least approximate that for a poodle. Although I know veterinarians who are struggling in their own practices due to the economic recession, at least they do not have to deal with government fee-setting and the liability and costs associated with treating humans. They are able to price their services sufficiently to keep their practices open and to provide for their own health care and retirement.

Near the end of his essay, Dr. Dotson advises…

Avoid contact with the existing health care system as far as possible. Yes, emergencies arise that require the help of physicians, but by and large one can learn to care for one’s own minor issues. Though it is flawed, the internet has been an information leveler for the masses and permits each person to be his or her own physician to a large degree. Take advantage of it! Educate yourself about your own body and learn to fuel and maintain it as you would an expensive auto or a pet poodle.

Dr. Dotson then lists 17 things a person can do to avoid as many medical encounters as possible. If nothing else, go to the end of his essay and read his 17 suggestions.

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On a related note, another essay worth reading is Paul Craig Roberts' Obamacare: The Final Payment—Raiding the Assets of Low Income and Poor Americans. In a nutshell,  many more low-income people in this country are going to be herded into medicaid by Obamacare, and when they die, their assets will be taken by the state. This "estate recovery" already happens to some degree (that's how I ended up buying my late step-father's home… the state was going to take it if I didn't), but it will now happen on a much larger scale, or so Paul Craig Roberts says. Is anyone else talking about this?

Also, I'm wondering…. does anyone reading this have personal experience and opinions about the decline of health care in recent years, and/or with the implementation of Obamacare?