THE BLOG

They Are Still Practicing Bad Medicine -- on Medicine (and Therefore on Us).

09/24/2009 05:12 am ET | Updated Nov 17, 2011
  • Deane Waldman Physician, systems theorist and award-winning author

Imagine that your doctor says the following. What should you do?

You tell me you have trouble breathing, chest pain and swollen ankles. I will do expensive tests but I already know what is causing this. The root cause is a "broken" heart muscle - you need a new heart. That is too radical a treatment for me to do. I will treat you to take away the chest pain and pills to make you pee. You will feel and look better tomorrow. This will be temporary. Please pay the cashier on the way out.

Hopefully you would stop seeing such a doctor and find someone who would practice good medicine on you: evidence-based, and by doing what you need rather than what is best for the doctor.

Now suppose that your name is M. Healthcare. Your doctor says you are critically ill and will not survive without treatment (reform). Your doctor goes on to say the following. What should you do?

You tell me about uninsured millions, unsupportable costs, shortages of providers, and avoidable deaths.
I will do no tests to determine why you have these symptoms.
The system itself is broken but I am not going to do anything about that.
I know you need system replacement but I cannot do that.
I will treat your symptoms and say I am fixing (reforming) you.
You will feel better temporarily but you will not BE better.
Over time your symptoms will get worse.
I will print more money to pay for what I am doing.
Don't worry about the bill. Your children will pay it.

Do I overstate? Is this not fairly close to what is happening right now with ObamaCare?

Some who are opposed to ObamaCare - like me - are opposed not because of party affiliation or partisanship and not because I oppose reform. I want real reform - that actually makes things better - instead of the appearance of doing something.

Given a fundamentally flawed, unsupportable health care system, we need a new one rather than changing where some dollars flow and adding new dollars that we don't have in the first place.

My friend and colleague Dr. Bill Wiese had the audacity to speak the truth. "We already have enough money in the system. It is just distributed wrong." Throwing more money into health care or moving the dollars around will solve nothing.

To have a system that works for us, one that we can actually afford, we need to create a new system instead of tinkering with the old one. Everyone is afraid of such radical change. Sometimes the medicine you need tastes awful.