Primum Non Nocere

First, do no harm (aka the Hippocratic Oath even though Hippocrates supposedly had nothing to do with it) is something that is drummed into medical students from the first day that they enter med school. Well that principle is about to become a thing of the past.....

Patients count on their doctor to do whatever is possible to treat their illness. That is the promise doctors make by taking the Hippocratic Oath.

But President Obama's advisers are looking to save money by interfering with that oath and controlling your doctor's decisions.

Ezekiel Emanuel sees the Hippocratic Oath as one factor driving "overuse" of medical care. He is a policy adviser in the Office of Management and Budget (OMB) and a brother of Rahm Emanuel, the president's chief of staff.

Dr. Emanuel argues that "peer recognition goes to the most thorough and aggressive physicians." He has lamented that doctors regard the "Hippocratic Oath's admonition to 'use my power to help the patient to the best of my ability and judgment' as an imperative to do everything for the patient regardless of the cost or effects on others."

Emphasis mine.

Now isn't that what doctors are supposed to do - to do everything possible for their patient? According to the administration the answer to that is "oh heck no!"

But President Barack Obama is pledging to rein in the nation's health care spending. The framework for influencing your doctor's decisions was included in the stimulus package, also known as the American Recovery and Reinvestment Act of 2009.

The legislation sets a goal that every individual's treatments will be recorded by computer, and your doctor will be guided by electronically delivered protocols on "appropriate" and "cost-effective" care.

So you and your doctor are no longer going to be in charge of your heathcare - some bureaucrat in DC with a set of charts will be the one to decide whether you live (get treatment) or die (not get treatment).

Heading the new system is Dr. David Blumenthal, a Harvard Medical School professor, named national coordinator of health information technology. His writings show he favors limits on how much health care people can get.

"Government controls are a proven strategy for controlling health care expenditures," he argued in the New England Journal of Medicine (NEJM) in March 2001.

Government controls - isn't that just a lovely euphanism for rationing?????! For all of you who accused me of over-reacting earlier I just have four little words for you.....I TOLD YOU SO!

Least you think that this is another "unintended consequence" - the administration is fully aware of what they are prescribing.

Blumenthal conceded there are disadvantages:

"Longer waits for elective procedures and reduced availability of new and expensive treatments and devices."

Yet he called it "debatable" whether the faster care Americans currently have is worth the higher cost.

Now that Blumenthal is in charge, he sees problems ahead.

"If electronic health records are to save money," he writes, doctors will have to take "advantage of embedded clinical decision support" (a euphemism for computers instructing doctors what to do).

"If requirements are set too high, many physicians and hospitals will rebel - petitioning Congress to change the law or just resigning themselves to ... accepting penalties," he wrote in NEJM early this month.

Emphasis again mine. So getting the care you want, when you need it is not worth the cost to this guy?

Essentially under the administration's plan to reduce health care costs we are going to have to accept the fact that some faceless DC bureaucrat has control of what care you get - not you and your doctor and that care is going to rationed or we are going to get the care we want and face fines and jail time!

Is that the "Hope and Change" (tm) that YOU voted for?????