Aberrations of the Medical System
When the free association that exists between the doctor and the patient is disturbed, it is natural for the health of both the patient as well as that of the system itself to become compromised. There are a few primary ways in which this occurs:
1. Financial Overreach
In the case of a medical doctor, if either money or profit should become the primary motivating factors, via patient fees, salary, or kickbacks from the drug industry, the patient inevitably then becomes a customer, the health practice becomes a business or an industry, and “repeat customers” and “large markets” become the goals. This, in turn, can lead to a biasing towards costly and widespread medications, and/or the prevention of a disease from healing fully (the so-called ‘incurable disease management’ approach) such that the patient becomes a repeat customer. It is not only the doctor who may fall into this trap – the patient may also “shop” for doctors based solely upon how much it is that they charge, rather than upon the quality of care that they provide. Cost and quality need not always be dependent on each other – costly medications may, in fact, prove more dangerous than simpler cures. Conversely, quick fixes may prove more dangerous than costlier procedures. A similar conflict of interest plagues medical education, which has been funded by and through the foundations of large industrial conglomerates for more than a century, such that the curriculum itself has been influenced by these interests. On top of it all, both doctors and patients can be prevented from taking medically sound decisions, based upon what an insurance company covers or does not cover. Hence, financial incentive creates a conflict of interest in the healthy relation between doctor and patient. We call this “financial overreach”.
2. Governmental Overreach
If we were to fall ill, it is unlikely that we would ask our neighborhood to vote on our treatment; nor would we expect such treatment to be enforced upon us. Such decisions rely upon the garnering of medical expertise from a capable doctor whom we trust, as well as upon our freedom as individuals to choose a method of care. Similarly, we would not expect the same medicine to be given to everyone, as each individual’s body is comprised of unique characteristics about which only a doctor may have knowledge – such as side effects, allergies, medical history, or other existing conditions. Hence, any medical treatment that is enforced uniformly, or is enforced via a vote by non-experts, is inherently compromised. Even if a certain daily amount of water were to be made mandatory according to a law, there would inevitably be a certain section of the population, howsoever small, who would become victims of such a law. Hence law, as such, which is uniformly mandated to apply or prevent a particular treatment, especially if it is a consensus of average citizens, inevitably distorts the medical treatment.
However, we would like the majority of our neighborhood to support our right to have access to medical care, free of gender or racial discrimination, for example. The laws that enforce the right to medicine help us, while the laws that give the right to enforce a uniform treatment distort the medical profession. These two aspects are very different things, and must not be conflated. Even when the law is used to decide the merit of a doctor (e.g. criteria for medical license), the same problem remains – a group of people can intervene between the doctor and the patient by prescribing what a doctor is and is not allowed to do medically. Hence, uniform legal mandates in medicine create another fundamental conflict of interest in the healthy relation between the doctor and the patient. We could call this “governmental overreach”.
3. State and Financial Interests Combined
The worst distortions occur when the two non-medical giants – governing bodies and industrial interests – collude and combine forces to influence medicine. This is what happens when the pharmaceutical lobby (or any other industrial interest) monetarily pushes the legislators to pass laws that are beneficial to its profit margin. This puts the patient in the position of a “compulsory customer”; or in other words, the patient can get robbed or medicated with legal force. An equally harmful type of distortion occurs in the case of legal restrictions being put in place and applied to emerging businesses in the medical sector, making it impossible for said businesses to manufacture new medical devices and/or to grow medicines and thus to thrive, even if patients and the medical community at large are genuinely seeking such forms of treatment.
When a medical license requires a degree from a medical school that has been influenced financially by industry for decades, it forms another combination of industry and government which can corrode the field of medicine.
Any form of mandatory health insurance also ties together industry and government into a toxic combination; it disturbs the price of treatment, by making it artificially low for the patient with insurance when compared to the high cost for the patient paying out-of-pocket. It also penalizes those who decide to opt out.
Hence, when legal and financial interests combine to influence medical system, the system becomes inherently toxic, and thus cannot work for the health of the people.