THE BLOG
07/11/2008 05:12 am ET | Updated May 25, 2011

Fourth of July Appeal

Two hundred and thirty-two years ago, we overthrew an oppressive government. Today we again suffer government oppression. Fortunately, we need to act against only one part: the regulatory arm. We in healthcare ask this of you the Public for both your sake and ours.

We are drowning in rules and regulations; unfunded mandates and contradictory requirements. How can we take care of you when you - via your government - make it impossible?

The USA spent over $1.5 trillion dollars last year on healthcare. Thirty percent - more than $500 billion - did not go to us (in healthcare) in any form. It was consumed by activities that add no value: bureaucracy, inefficiency, regulatory compliance, and defensive medicine. Imagine what useful things we could do with all that money.

The huge waste is only the beginning. Ask yourself: why do we have rules and regulations in healthcare (or in anything)? Answer: to protect us from harm and to insure quality. Do the current rules and regs do that? Consider some examples.

Start with something that should be simple: getting a medical license. I have had licenses in five States. Each and every time, the process required going back to college for verification, checking every hospital in which I ever consulted, and filling out innumerable forms. The cost in time and money, multiplied by every doctor or nurse, is in hundreds of millions a year and for what? Is diabetes or asthma different in Massachusetts than California?

HIPAA is the latest regulatory fiasco, the proverbial 800-pound gorilla or hippoas I called it . Intended first to protect our medical insurance (it doesn't), it morphed into an effective obstacle to information sharing all in the name of confidentiality. It costs a fortune; creates a huge, expensive bureaucracy; generates hassle and frustration; impedes communication; increases errors; encourages lawsuits; with absolutely no evidence of a problem in the first place and no proof that it works now.

We are supposed to provide good care despite government-created conundrums. What should we do when HIPAA says we must not read medical information before FAXing it while the Patriot Act requires that we read it? Why am I prohibited from emailing my consultation letters while the referring doctor complains that she does not get timely feedback?

It is the accepted standard that your doctor or nurse makes evidence-based decisions and bears the consequences of bad outcomes. Managers and regulators affect patients at least as much as doctors and nurses. They are not required to have evidence before deciding, nor feedback (with teeth) after they make decisions? Why are they held to a lower standard?

You know we have worsening shortages of both nurses and doctors. Who in their right mind would work in a field where the whole system is designed to make your professional life impossible?

I could go on and on. Look up Government Accounting Office Report (GAO-04-637). It shows that even when the Federal Government passes reasonable legislation - UMRA, the Unfunded Mandates Reform Act - Congress does not follow the rules that it created. Look at the rules governing medical malpractice and ask if this system helps or even protects you.

On the Fourth of July, we health care workers request relief from the oppressive burden of government over-regulation. Without such relief, we cannot provide you with the care you need.