Michael Arnold Glueck and Robert J. Cihak
Wednesday, Dec. 3, 2003

There are some periods in history when you just want to reach back in time and grab them and shake them, saying, "Wake up!"

We're living such a time now. And if you don't want to accost the craven Republocrats, the "bipartisans" who presume to govern us, and holler at them, "Don't you understand what you're doing?" – you're either brain-dead or you know, all too well, that they do know what they're doing.

They're marching us, wide-eyed, awake and deliberately, into catastrophe.

Prior to beating feet out of D.C. for the culinary (as opposed to political) turkeyfest, Congress acceded to the wishes of the Bush administration and passed the greatest expansion of Medicare since its creation in 1965 – another year that found the country entering an interminable, costly war.

The 681-page bill – who really understood it all? – will cost, over the next 20 years, over $2 trillion and add hundreds of billions to the budget deficits and national debt. If history is any guide, these numbers will be low. Very low.

Who wanted this bill? The "bipartisans." Republicans wanted it to take the issue away from the Democrats. Since the bennies don't kick in until 2006, it's an ideal Republican election-year gimmick: Tell the voters about the wonderful thing you've done, but before the bills come due.

The Democrats wanted it. Those like Sen. Tom Daschle, who urged his colleagues to share the credit in 2004 and who displayed his keen grasp of the obvious by noting, "Seniors are a very significant block of voters." And be ye not fooled by the likes of Teddy Kennedy and all the liberal moaning – regard all medical "reform" as advances toward full socialized medicine, including and especially those "reforms" that hasten the destruction of the present health-care system.

The American Association of Retired Persons (AARP), as Beltway-centric a lobby as ever assembled a mailing list, also wanted it, and spent $7 million on advertising, demanding that Congress "do something now!" It's an old, old tactic. Take a problem, redefine it as a crisis, then hype it until it seems the cosmos will collapse unless the government does something now.

The American Medical Association (AMA), ever eager to deliver its profession into serfdom, cited a 1.5 percent increase in physician payments and "regulatory reforms."

Who opposed the bill? A minority of principled legislators, and more than 40 groups, including the National Taxpayers Union and the American Conservative Union, in the Coalition Against Higher Medicare Drug Costs. At a Nov. 20 news conference, the Coalition also demonstrated its keen grasp of the obvious, pointing out that millions of retirees will lose good coverage, that Medicare will go bankrupt even faster under this additional burden, and that this legislation makes real Medicare reform even harder.

And whose opinion didn't count?

The doctors.

On Nov. 19, the Association of American Physicians and Surgeons (AAPS) released "Demoralized Doctors, Patient Problems: AAPS Biannual Survey of Physicians on Medicare and Patients' 'Access to Care.'"

(available in December in the winter issue of the Journal of American Physicians and Surgeons, www.jpands.org).

"This study is concrete documentation of the atmosphere of fear and frustration in which doctors practice today," said Kathryn Serkes, co-author and public affairs counsel for AAPS. "Money is not the issue; control is. More doctors would rather treat uninsured patients, possibly for free, than jump through Medicare hoops."

Among the survey's conclusions:

1. Increasing fear of prosecution or retaliation has had a negative impact on Medicare patients' access to physicians and their ability to receive referrals.

2. Compliance with Medicare regulations is costly, time-consuming and causes reluctance to treat Medicare patients.

3. More governmental interference means less access and quality for all patients.

4. Physicians grow ever more pessimistic about the future of medicine.

And of particular note: Physicians turn away uninsured patients 50 percent less often than Medicare patients (17 percent and 33 percent, respectively).

And so it 'comes to pass' that the new Medicare bill contributes to the accelerating decline of the health-care system and the government's solvency. It makes you want to scream, "Don't you understand where all this is leading?!"

And makes you fear the answer, whether yes or no or, "Frankly, America, we don't give a damn. Just let it last during our time."

Editor's Note: This week's column is written by Dr. Glueck.

Robert J. Cihak, M.D., is a Senior Fellow and Board Member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons. Michael Arnold Glueck, M.D., comments on medical-legal issues and is a Senior Fellow in Medical affairs of the Aretea Institute, a Seattle-based think tank.

Contact Drs. Glueck and Cihak by e-mail.

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