Although I agree with your editorial on unionization, I must ask why are physicians really forming unions? Why are editors of medical journals, such as the Annals of Internal Medicine (April 20, 1999), calling again for "universal coverage" and "health care as a right?" They are already anticipating the collapse of the "managed care free market system" under its own bureaucratic weight, and are hoping that the government will save us from the crisis with the single payer system.
Misguided free marketeers need to quit defending indefensible HMO policies. Instead, they should militate unequivocally for MSAs and 100% tax deductibility of insurance premiums (for those footing their own medical bills), end employer-provided insurance coverage, preserve patient confidentiality, and help medicine break away from the clutches of government. Perhaps then physicians will replace their leaders, regain their courage, abandon the treacherously murky waters of population-based ethics and navigate the ship of medicine, now dangerously adrift, away from the shoals of fully socialized medical care and safely steer it back to the pharos of the individual-based ethics of Hippocrates.
Miguel A. Faria Jr., M.D.
(Copyright (c) 1999, Dow Jones & Company, Inc.)