Many of you reading this are dejected and frustrated by the “election” results last night.  For those reading this that believe this election represents a disaster for health care in the U.S. and for the physicians who practice medicine, in particular, I have what I think is some good news:  this election didn’t matter in connection with health care.  Remember, Romney has rightly been called Obamacare’s baby daddy.  Both candidates and many of their statist supporters believe that folks have a “right” to health care, whatever that means. 

Whenever someone tells me they have a “right” to health care, I ask them, “from whom?”  “From me?”  This exposes this “right” for the robbery and slavery that it is.  Take it to the next step.  Do you really want to exercise your “right” to health care on a physician who doesn’t want any part of this bargain?  What kind of care do you think you’ll receive?

Years ago, I stopped doing cardiac anesthesia, as well over half of the patients were “covered” by Medicare and payment to me for my services was well below what I thought acceptable ($285 for my last 6 hour cardiac anesthetic).   Soon thereafter I stopped my dealings with Medicare (and Medicaid) altogether as I increasingly saw myself as the recipient of money taken from my neighbors against their will.  As an aside, the angriest patients I’ve ever encountered were the Medicare patients I subsequently treated with no charge whatsoever, their charitable care on my part eliciting patient rage like none I’ve encountered since. 

About two weeks after I quit, an angry cardiac surgeon, inconvenienced by my departure from the group of available cardiac anesthesiologists and with his finger in my face, told me that he was going to see to it that I was forced to do these anesthetics, so as not to disrupt his schedule.  I guess he thought he had a “right” to my services. 

It didn’t help things that I laughed.  I said,  “Dr. X, I’ll be happy to visit with the family before their loved one’s elective surgery and inform them that I want no part of this and that I don’t really want to be here, but someone is making me do this.  Maybe you all would like to wait on an anesthesiologist who wants to be part of this, because I certainly don’t.”  

This cardiac surgeon suddenly understood.  Now imagine this on a large scale.  Angry mobs of folks waiving their Obamacare “insurance” cards in the street demanding their free health care outside a closed and vacant doctor’s office.  This  supposed “right” to health care, cannot undo human nature and the delicate and myriad market forces at work to ensure that all parties in a transaction are willing participants.  If government points its guns at the doctors to make them participate, I maintain that the “healthcare” that is delivered under these conditions will be a different variety than the mobs expected.  In fact, it won’t be healthcare at all.  I don’t know what it will be, but it won’t be healthcare. 

Physicians who have made or are in the process of making the transition to “cash-based” practices, or concierge practices, embracing the principles of the free market,  and rejecting the old statist medical models, will paradoxically thrive in the new dystopic medical marketplace.  Patients will become increasingly reliant on this remnant of physicians whose willingness to boldly step out of the old model will simultaneously save their medical practice and the lives of many of their patients. 

Many physicians will retire soon.  Many sooner than they had planned.  Some will quit and do other things.  This secession from an increasingly government-controlled enterprise is predictable I think.  Some will continue to practice against their will.  The shortage in the supply of physicians relative to an increasing demand for their services will represent an opportunity for those waiting in long lines to re-think what it is, exactly, they have a “right” to. 

I suppose I’m suggesting that the last person you want to trust your life to is one at whom you are pointing a gun.  Perhaps the fear that will result from the care rendered by the “coerced” doctors will inspire a new “wellness.”  Staying as far away as you possibly can from a “coerced” doctor’s office may be the most self-preserving move you can make in the near future. 

G. Keith Smith, M.D.