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Snuffing Freedom and Creativity in Medicine

 The nexus between freedom, creativity and wealth creation has long been recognized in Western culture, as has the dichotomy of freedom and security. Without freedom, human beings are unable to innovate and create wealth, and when people surrender their freedom for security, they can end up with neither.

As a young surgeon, I was told by one of my mentors: “Don’t be afraid to experiment.” This was not an invitation to take risks with patients; it was an acknowledgement that the freedom to experiment is the essential ingredient of human advancement. The history of science is the story of men and women who challenged the status quo with new ideas and took risks. Individuals like Ephraim McDowell, who performed the first laparotomy, were often vilified before being vindicated.

The Orwellian-named “Affordable Care Act” (Obamacare) is a freedom killer at a time when we desperately need more freedom, more creativity and more market forces in the medical and insurance industries. There are no “crises” in functioning markets; real competition lower costs and improves quality. Witness the evolution of LASIK eye surgery. The hospitals, insurers and drug companies made sure Obamacare effectively forbids meaningful competition. We need our insurance companies to innovate, not become federal utilities processing transactions, and we need our hospitals to compete, not carve up turf and feed at the trough.

Obamacare centralizes and politicizes care when it needs to be personalized and atomized. We are at the dawn of genetics-based medicine. Future therapies could be crafted and applied based on an individual’s unique genetic code, yet we are moving in the opposite direction. A thick, lathered roller has replaced the paintbrush artistry of individualized care. Generic practice guidelines will be promulgated based on costs and “best evidence,” not necessarily hard data. If guidelines had existed two hundred years ago, we might still be bleeding patients.

The world of Obamacare will be a world frozen in time. How many medical innovations come from countries with socialized medicine? With its guidelines, panels, protocols, and rationing, there will be little experimentation and discovery. The law’s targeted taxation of medical products companies will harm innovation. Our collective debt will sponge available capital and impair our ability to fund research and to develop new medications.

Nearly every federal social policy since the New Deal has spawned harmful, unintended consequences. For the Affordable Care Act, it will be its effect on the doctor-patient relationship. The law will change the way doctors practice medicine. Many physicians have already sold their practices to hospitals, and hospitals do not take the Hippocratic Oath. These business arrangements and the resulting lack of clarity in the doctor-patient relationship will inevitably create conflicts of interest and erode patients trust.

Without freedom, patients cannot choose their doctors, and doctors cannot choose their patients. There is no love in forced marriages. When employed doctors cannot choose the best hospital for a particular patient, hospitals are not compelled to compete on price and quality. When “Accountable Care Organizations” become “too big to fail,” guaranteed an income from a pool of captive doctors and patients, they will have no incentive to innovate.

The proponents of Obamacare preen over its perceived morality of universal coverage, but this crimped vision ignores a separate and more fundamental American morality – the right of individual doctors and patients to contract freely, and the right of all citizens to purchase individualized medical care without coercion. It also ignores the true record of socialized medicine for those honest enough to look – lack of innovation and access, bad care, bankruptcy, force, cruelty and, at times, brutality. Having a card in your wallet guarantees nothing.

Cameron S. Schaeffer is a pediatric Urologist and plastic surgeon from Lexington, KY.

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