How Wall St Destroyed Private Medicine
At my annual check-up, my doctor
handed me a sheet explaining the reasons for office fee
increases for Medicare Patients. It is worth reporting
Medicare fixes the prices for
Medicare patients` health care. All office charges for
Medicare, including office visit charges, have been set
by the Federal government since 1984. In real terms
(adjusted for inflation), these fixed prices are less
today than they were three decades ago.
During the last four years, there
have been large decreases in Medicare reimbursements for
laboratory services provided in-house by private
physicians. Payments for in-office blood work, for
example, have been cut 35 to 47 percent. Yet, a
physician`s overhead continues to increase as a result
of uncontrollable costs, such as property taxes,
building insurance, electricity, maintenance,
malpractice and workers compensation insurance.
As one result, my doctor had to
close both the x-ray unit and the state and federally
licensed medical laboratory on his premises. Now
patients are inconvenienced by having to go to other
locations for services that formerly were provided by
the doctor at lower cost. A one day medical check-up is
now a multiple day event and more expensive.
While Medicare payments to doctors
have been cut, regulations have been increasing:
outside diagnostic procedure (CT, MRI scan, sonogram)
ordered by this office now has to be pre-approved by
some outside agency. Many medications are now requiring
pre-approval or step therapy. Each requires filling out
1-2 pages of forms and/or two or more phone calls. This
requires personnel time and therefore more cost.
Consultant referrals are requiring more paperwork and
time to schedule."
My doctor has more people employed
doing paperwork than he does delivering health care.
While Medicare payments for
in-office services to private doctors, including those
for blood work and x-ray units, were drastically cut,
payments to outside corporate facilities for the same
services were increased. It is obvious what is afoot.
Corporate lobbies are using their whores in Congress to
shift income from physician offices to corporate labs,
corporate medical service providers, and hospitals that
are owned by national corporations.
Legislation that cuts payments to
private physicians and increases the payments to large
corporate entities is intended to destroy private
practice and to create in its place corporate
bureaucracies in which doctors are wage slaves. The
physician`s income is diverted to shareholders, CEO
bonuses, and Wall Street. Health care is being replaced
with health business.
As a result of the way American
medicine is being reconstructed, patients will cease to
have a doctor whom they know and who knows them.
Important information is lost in a system of
"health care" in which a patient sees whatever face
happens to be on duty at the corporate provider.
Impersonal health care thus brings a cost of its own,
and its quality can be low compared to private practice.
Indeed, the U.S. is creating a
system that is more costly and less efficient than
single-payer national health systems. But it will enrich
corporations and provide play for Wall Street.
It turns one`s stomach to watch
"free market economists" defend bureaucratized
impersonal health care as
"free market medicine." There is no free market present. Corporate
lobbies and campaign contributions use government power
to create bureaucratized monopolies that destroy
medicine for the practitioner and the patient. Wall
Street pushes for greater shareholder earnings, which
are achieved by denying care.
Just as independent businesses have
been destroyed by corporate chains from
Wal-Mart to auto parts to fast food, medicine is
being destroyed by monopoly capital. The risks of
starting a private business today are many times higher
than they were a half century ago. Chains have turned
Americans who once were independent business men and
women into employees.
The fate of the health care bill
demonstrates the power of private lobbies. What was to
be health care for Americans was instantly transformed
into 30 million new patients for the private health
insurance industry. The
tens of millions of Americans being unable to afford
health care is a law that requires them to purchase a
private health care policy or be annually fined. As most
of these uninsured Americans cannot afford to purchase a
private policy, the plan is for the federal government
to use taxpayers` money to subsidize their purchase of a
policy from private companies.
In other words, tax money is being
diverted to the pockets of private businesses. This is
par for the course in
In today`s America, Karl Marx`s
criticisms of capitalism are understated. Wherever one
looks, the scene is one of the government using
taxpayers` money to enrich private interests. Taxes are
collected from people who can barely make it, and the
revenues are transferred to multi-millionaires and
billionaires. The federal government piles debt on the
backs of heavily-burdened and dispossessed Americans in
investment banksters can pay annual bonuses that
exceed the lifetime earnings of most Americans.
Every aspect of the US military has
been mined for private profit. Supply and other
functions for the military, such as those provided by
Halliburton and Blackwater, services once provided by
the military itself at low cost, have been privatized.
These services now cost many multiples of the cost to
taxpayers of in-house military provision.
"war on terror"
enriches the armaments/security industry and enables
Israeli territorial expansion. The Israel Lobby and the
munitions industry are major sources of funding for U.S.
Prisons have been privatized in
order to create profits for private corporations. The
prisons require high incarceration rates in order to be
democracy" America not only has the highest
incarceration rate and the
highest absolute number of prisoners in the world,
but also a prison population comparable in size to the
prison population of Stalin`s
Congress allows private companies
run by hardline Republicans to count electronically
without paper trails the votes in elections. It has been
proved over and over that the electronic voting
machines, with proprietary undisclosed codes, can rig
any election, especially if there are no exit polls or
the captured media can find a way to discredit the exit
And now we have private health care
destroyed by the greed for profit. There are many
reports of health care corporations, but not private
doctors, rationing and even denying health care to
policy holders in order to maximize profits. There are
reports of people with treatable forms of cancer who
were not told by their corporate health care providers
in order to avoid the cost of their treatment. These
reports are in compliance with capitalist America`s
emphasis on profits
uber alles, to
hell with people, the environment, honor and integrity.
Wall Street is romanticized by
"free market economists." They believe, entirely on
the basis of their ideology, that Wall Street finances
venture capitalists who bring economic progress and
higher living standards. Wall Street does no such thing,
especially since financial deregulation turned Wall
Street into a speculative hedge fund.
Wall Street is concerned with
annual bonuses. It will do anything to get them.
Today the interests of American
capitalists are as far removed from the interests of the
population as the bureaucrats of state owned firms under
socialism. Neither can fail, no matter how incompetent
or inefficient, as they have the public purse as their
The Wall Street investment banks,
which created with the compliance of the regulatory
authorities and the credit rating agencies,
instruments that were sold world wide, thus destroying
the prospects of people in many countries, are devoid of
integrity and honor. Their only god is greed. And they
control the US government, which is too dependent on
campaign contributions to restore regulation.
The lobbies of greed rule America.
The White House, Congress, even the federal judiciary
are impotent in the face of capitalist greed.
There is no government of the
people, for the people, by the people, only the rule of
Paul Craig Roberts [email
him] was Assistant
Secretary of the Treasury during President Reagan`s
first term. He was Associate Editor of the Wall
Street Journal. He has held numerous academic
appointments, including the William E. Simon Chair,
Center for Strategic and International Studies,
Georgetown University, and Senior Research Fellow,
Hoover Institution, Stanford University. He was awarded
the Legion of Honor by French President Francois
Mitterrand. He is the author of
Supply-Side Revolution : An Insider`s Account of
Policymaking in Washington;
and the Soviet Economy and
Meltdown: Inside the Soviet Economy,
and is the co-author
with Lawrence M. Stratton of
The Tyranny of Good Intentions : How Prosecutors and
Bureaucrats Are Trampling the Constitution in the Name
of Justice. Click
here for Peter
Brimelow`s Forbes Magazine interview with Roberts
about the epidemic of prosecutorial misconduct.