The Covert Rationing Blog

Covert Rationing in a Nutshell

May 20th, 2007 by DrRich

On the website associated with this blog, DrRich helpfully develops the Grand Unification Theory of Healthcare. He sincerely hopes you will spend some time there. But as a public service he offers the following, a brief summary of the five major truths about American healthcare that are revealed by the Grand Unification Theory. Here they are:

1) The rationing of healthcare is an economic imperative, and cannot be avoided.

As long as we have a system in which we create centralized pools of money (some controlled by the government, others by insurance companies) from which virtually all healthcare expenditures must be paid, rationing is necessary. This is because these centralized pools of money, while potentially very large, are still necessarily limited in size; whereas the ultimate cost of buying all the potentially useful healthcare for everyone who might benefit from that care is fundamentally unlimited.

2) Because the very notion of rationing healthcare is taboo in American society, the unavoidable rationing must be done covertly.

That is, we need to develop (and have developed) a system whereby the necessary rationing is done without acknowledging that any rationing is occurring.

3) Those we have deputized to covertly ration our healthcare (the government and private insurers) have only one viable method for doing so. They must apply coercive pressure to the focal point of all healthcare spending, namely, to the physician-patient encounter. Thus, the final common pathway for all covert rationing must be - can only be - the systematic destruction of the doctor-patient relationship.

Under the classic doctor-patient relationship, according to tradition, ethics and law, doctors are expected to always place the needs of their individual patients first, above all other considerations. But under covert rationing, doctors must instead place the needs of their true masters first - that is, of the government agencies and managed care organizations that determine their viability as practitioners. These masters demand (instead of the best possible outcome for patients), reducing the spending on healthcare as much as possible.

4) Without the classic doctor-patient relationship, patients are entirely on their own, groping their way through an (at best) unsympathetic healthcare system, and at a time when they are least able to defend themselves.

Today’s physicians have been systematically and deliberately compromised - which is precisely why so many of them are dismayed and frustrated at what has happened to their formerly noble profession. Patients consequently are left in a position where they cannot rely on their doctors - or anyone else - to guide them through the hostile healthcare system.

5) The key to protecting yourself within a healthcare system where you have been systematically marginalized is to discover, create, invent, or induce methods for self-empowerment.

American patients today are largely on their own, which is exactly where the third-party payers (including the feds) want them. For their own self-preservation, individual patients need to take matters into their own hands.

To summarize,

The covert rationing of healthcare is the fundamental operating principle driving almost every aspect of the American healthcare system. Covert rationing by its very nature places any patient needing medical care at imminent risk. Patients who understand this fact, and who understand how covert rationing works, can take immediate steps to protect themselves. (Those steps are discussed in detail here.) Those who don’t are left to the tender mercies of a healthcare system that has already decided that individuals like them sometimes must be sacrificed (albeit sadly and somewhat reluctantly) for the benefit of the whole.

Posted in An Introduction to Covert Rationing

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