On Friday night on The Ingraham Angle, Laura Ingraham reported her conversation with an unidentified doctor in Queens who shared his concern that non-Covid patients are being ignored in the United States as the medical community reacts to the surge of viral cases that are either overwhelming them or are predicted to do so in the near future. The physician was ultimately restricted from openly sharing his opinion by his hospital so a live discussion was ultimately stymied. And although Ingraham did not definitively answer the question on Friday night, the New York physician is absolutely correct. They are.
Since the predictions made by the CDC and publicized by the likes of Drs. Anthony Fauci and Deborah Birx, our various governments, the medical community, and the general public have entered into a state of general quarters where the economy has been trounced and the usual conduct of medical care paralyzed. But the predictions foreseeing 2.5 million deaths in the United States as a result of inaction are nonsensical. This is not to say that the United States is not faced with a serious challenge to the health, welfare, safety of the American people, but either the calculations or assumptions of these predictions are leading to indefensible results. Consider that at the time of this writing, over four months, in the whole world, there are 976,249 confirmed Covid-19 cases and 50,489 deaths. So, after four months of free reign at the global population with infiltration into many underserved, third world, poverty-stricken countries, the Wuhan Pandemic has caused 50,489 deaths. With this backdrop, it is inconceivable that 2.5 million Americans would die in April in the United States alone unless harsh and almost draconian mitigation efforts are undertaken.
Although I review many cases of negative government interventions on healthcare in my book The Case for Free Market Healthcare, this present response overwhelms the magnitude and misguidedness of any other. The reality is that any time an intervention is undertaken by fiat therewill be negative repercussions. Thus far, much of the nation's attention has centered on the economic effects. But it is true that the effects on the health of many patients who do not have Covid are significant. I know this because I see this personally throughout my community on a daily basis and am actually active in the implementation of this plan locally.
Throughout the country, hospitals are no longer performing "non-essential" procedures. People in need of pain-related surgery, low-grade cancers, many diagnostic procedures, orthopaedic interventions, prostate cancer, and hysterectomies, to name a few, are being prohibited from undergoing necessary interventions. Note that just because a procedure is non-essential does not make it unnecessary, but despite this reality, patients are unable to access them regardless of whether their state has 10 reported cases like in Alaska, or 102,870 like in New York.
The needs of non-Covid-19 patients are being placed on the backburner while the nation responds to what has become a massive pandemic. Whether this is appropriate, and whether this prioritization ought to be undertaken in a blanket fashion or regionally tailored is an analysis that needs to be completed.
Editor's note. In erratum: On April 9, 2020, the number of cases cited in this article was corrected.
Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He is the author of The Federalist Pages andThe Case for Free Market Healthcare. He can be reached through http://www.thefederalistpages.com/contact.html or at email@example.com.
An article published by the Kaiser Family Foundation on Wednesday showed the United States ranked eleventh in the world in per capita distribution of hospitals. That article pointed out that the United States had a "lower hospital density than almost all comparable countries." Predictably, there are a slew of other hospital-related resources in which the United States is lacking, including the number of hospital-employed nurses and the number of physicians. Although the Kaiser article does not detail the cause of these shortages, I do so in my book, The Case for Free Market Healthcare. The reason is actually quite simple and predictable: government intervention.
Although the details of the dynamics are too extensive to cover in this forum (I therefore urge you to explore them further inThe Case for Free Market Healthcare), there are a few observations that can be gleaned regarding the degree of error with which we have approached healthcare delivery in our country. First, government has been openly hostile to hospitals, particularly private hospitals, viewing them mostly as vehicles for greedy investors to make money off the sick and the poor. This hostile and destructive attitude led to the passage of the Health Planning Resources Development Act in 1974 that actually rewarded states for implementing "certificate of need" programs to restrict the abilities of entrepreneurs to build hospitals.
Within a few years, forty-nine states enacted CON laws, and their models for governmental interference have since been shown not to lower prices for inpatient services and not improve hospital financial investment in communities as had been touted by the bill's advocates.
But the damage still persists. To this day, despite the certificate of need program's total failure, only thirteen states have rescinded it demonstrating the difficulty of undoing misguided legislation after it has been past.
Government also has and continues to manipulate the market in ways that have destroyed projects aimed at improving the availability of hospital emergency rooms. In 2018, the Medicare Payment Advisory Board advised Congress to cut reimbursements to freestanding emergency rooms operating within 6 miles of their parent hospitals by 30%. Why? Because, according to MedPAC, such systems would encourage providers to treat lower intensity rooms rather than urgent care centers." Which begs the question: what business is it of Medicare, an insurance company for seniors and the disabled where the market decides that it is more efficient to treat urgent and emergent patients?
But I digress. As a result of MedPAC's misguided market manipulations, over 250 shovel-ready or unfinished projects were canned, robbing America of greater healthcare access.
To be sure, the federal government has also engaged in a wide variety of activities that favor hospitals over other models, but in each of unnatural interventions the consequences are the same: government continues to impose delivery models upon the population and with it, its bias of how healthcare upon the consumer. As a result, the market is not free to respond to consumer demands and cost-saving opportunities in an efficient manner. Thus, we are never given the opportunity to develop the right number of hospitals and the correct number of physicians, and nurses, and physical therapists. . . . you get the point. Now, we are faced with the challenges of a pandemic where many, including President Trump, have observed that we were not ready with a coordinated response mechanism. In point of fact, we weren't even ready with a baseline set of operating resources with which to handle the larger numbers that would present themselves, and the blame lies squarely on government for attempting to impose its ideas of what those numbers should be upon us, instead of allowing the market to settle upon them by itself.
Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He is the author of The Federalist Pages andThe Case for Free Market Healthcare. He can be reached through http://www.thefederalistpages.com/contact.htmlor at firstname.lastname@example.org.