Tamzin Rosenwasser, M.D on What Patients Need: Freedom

Earth to Berwick & Emanuel: What we need is freedom for our patients.

By: Tamzin Rosenwasser, M.D.


Donald Berwick, in charge of Medicare and Medicaid, says “Too many Americans are being harmed by care that is supposed to help them.” I say “Too many Americans are being harmed by government that is supposed to follow the Constitution and does not.”


We can improve medical care, on our own, if we can get their government bureaucracy to stop robbing us of our time. When Berwick says he messes up his children’s names all the time, I wish he would realize how he is also messing up our lives, and stop it.

Ezekiel Emanuel says, “Washington is never going to do a good job of making smart cuts to Medicare.” “Washington,” a shortcut for “bureaucracy,” is never going to do a good job of anything concerning medical care. The Medicare/government bureaucracy created the problem in medical care. Perverse incentives in Medicare/Medicaid for hospitals, patients, and physicians, have led to the explosion in Medicare/Medicaid costs. That is the direct fault of government interference in medical care. Nothing is more personal than medical care, and nothing is less conducive to having bureaucrats, whose only tool is force, in charge.

Emanuel writes that it is impossible for Medicare to write payment rules that cover all circumstances. It is impossible to devise rules, however complicated, that cover the even greater number and complexity of medical situations, but someone tried to do so, apparently thinking they had a God-like wisdom denied us. Leave the people of the United States alone to do what they have demonstrated many times that they know how to do: solve problems.

Nobody— not government, bureaucracy, Berwick, or Emanuel— nobody is wise enough to make medical decisions for 305 million people. Those people own their own lives. Government does not own them.

“To control Medicare spending and reduce the deficit, we need to stop paying for wasteful procedures, accelerate adoption of the Affordable Care Act reforms and empower doctors, nurses and hospitals to provide higher-quality and more efficient care,” Emanuel continues. Who pays? The taxpayers. But who is “we?” Emanuel, Sebelius, Berwick; those who claim superior wisdom. From Colonial times, right up until 1965, when Medicare went in, how did Americans manage without bureaucrats meddling? Yet Americans created and discovered without government direction, and we can solve every problem in medical care delivery if the government would just leave us alone to do it.

In 1998, the Deborah Heart and Lung hospital in New Jersey, was in trouble for charity care to Medicare patients. We can’t have that! Only the government can say who gets what. This 89-year-old charity hospital was fined $840,000.00 for their charity.

It is only since the government began meddling that we have had these problems. Government destroyed the market for medical insurance for everyone over 65. Government has all but destroyed medical charity. Government created this one-size-is-going-to-fit-all-like-it-or-not system. Despite the lag period, this result was entirely predictable.

In order to evade the responsibility of facing the terrible mess in medical care created by government interference, Emanuel now proposes a giant step forward in the destruction of freedom, in the guise of helping.

He writes, “The responsibility for ending unnecessary medical spending needs to be placed in the hands of doctors and hospitals. This can happen only if we change our fee-for-service payment system.” “We” means him and who else? Also, what about our patients? Are they just an afterthought? Are they lumps of clay there for Berwick and Emanuel to deal with as though they were not real human beings, with their own thoughts, feelings, and preferences, and their rights to liberty? The doctors and hospitals would be forced, of course, by the huge, bogus “health care” bill, to do just what the government says.

No, we do not need command and control from bureaucrats, or thousands of pages of mind-numbing rules. We do not need a government conducting more experiments with our patients and their lives. We need what is our birthright, freedom. Freedom for our patients, and freedom for us to take 7care of our patients, with them and their families being fully informed participants.

Dr. Tamzin Rosenwasser earned her MD from Washington University in St Louis. She is board-certified in Internal Medicine and Dermatology and has practiced Emergency Medicine and Dermatology. Dr. Rosenwasser served as President of the Association of American Physicians and Surgeons (AAPS) in 2007-2008 and is currently on the Board of Directors. She also serves as the chair of the Research Advisory Committee of the Newfoundland Club of America. As a life-long dog lover and trainer, she realizes that her dogs have better access to medical care and more medical privacy than she has, and her veterinarians are paid more than physicians in the United States for exactly the same types of surgery.

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