Dear Editor,

The special issue of the Medical Sentinel, “The Police State of Medicine,” was a much needed and well written series of articles. It was much need on two scores. First, doctors who are still unconvinced that the free practice of medicine is under siege by the collectivists in our society should finally have their synaptic connections coming alive. Second, it is a wake-up call to our elected officials that the laws and edicts that they pass so nonchalantly in Congress, can ruin lives and destroy something that is not only critical to society, health care, but that is also irreplaceable once lost.

I find it ironic that so much emotion and displays of shock accompanied the revelations concerning IRS abuse on citizens, yet virtually all of us knew the IRS was one of the most police state-like organizations in existence. Over the last 30 years a virtual explosion of abusive bureaucracies have been created either by Congress or by fiat. They all have common characteristics: They go far beyond their intended purpose, they destroy innocent lives with impunity and with no remorse, and they continue to grow in power and size in an almost exponential manner.

While saddened by all of the stories of ruined lives, I had to admit that Dr. Orient was right in her assertion that this abuse and destruction of lives is the price one pays for entering into “legal plunder.” Most doctors never envision their participation in the Medicare/ Medicaid programs as legal plunder. But as Frederic Bastiat pointed out, no matter how noble a goal is in society, when you forcibly take money from one group and give it to another, that is plunder, i.e., stealing. We are acting as middlemen in this plunder when we accept the funds. It’s like a pawnbroker selling hot merchandise. He didn’t actually steal the merchandise, he only sold it. In his eyes, he was acting in a legal manner by following the rules of the free market. What he ignored, just as doctors do, is the origin of his profits. He never bothered to ask where the merchandise came from.

While most of us can readily see the example of the pawn broker as illegal, in that he is making a profit off of what was stolen from my house, they don’t see federal monies as stolen money. Most physicians instead say that they deserve the money since they provided a vital social service for the payment. The pawnbroker could use the same defense. He had to store the goods, display them, figure up a price, and utilize his time in the store selling the merchandise. He was merely seeking payment for his work.

One of the hardest messages I have found to convey to physicians is that the bureaucrats who made up this system never really intended to reform the system, that is, make it work. Instead, their intention was to destroy the free practice of medicine and collectivize all health care from its very inception. All that is required is to read the words of those who were at the center of these federal plans, such as Senator Ted Kennedy. His goal has always been to destroy the free practice of medicine, not to reform it.

Unfortunately, physicians are too quick to ascribe lofty goals and fairness to collectivist politicians and bureaucrats. They live under the illusion that somehow, if we can just convey to the collectivist rulers that we mean well and are honest good-guys, they will see the error of their ways. In their minds, it’s an image problem. This is naiveté at its worst. The collectivist sees compromise on our part as weakness, and that it is a sign they are winning in a great ideological struggle. They have constitutionally convinced themselves that freely practicing doctors are inherently corrupt entities who cannot act in a socially responsible manner. To the collectivist, only regimented, tightly controlled, and subservient doctors could possibly act in a socially acceptable manner.

I have noticed that the single most often sought after target of the federal chekist is the solo physician. It is the totally independent solo physician or two-man partnership that presents the greatest danger to the medical chekist. The national trend is for doctors to practice in larger and larger groups. This makes control much easier for the medical chekist since dissension within the group is met by hostile rebuke by fellow partners. Also, collectivist plans, such as HMOs and other managed care entities, can capture a large group of doctors much easier than a large number of independent doctors. The same is true for the federal chekist.

My only fear concerning this fine effort on the part of the Medical Sentinel is that it will scare doctors into total inaction. Terrorism is designed to terrorize, and this latest terrorist act by the federal chekist has certainly struck terror in the hearts of all doctors. I have heard many who are reluctant to resist in any way for fear of calling attention to themselves. I am afraid that this latest effort by the medical chekist will serve its purpose, it will paralyze physician resistance. It is reminiscent of the Soviet system of citizen informers that made Russians afraid to speak even to their own children. But then, this may be our last chance to resist tyranny.

Russell L. Blaylock, MD
Jackson, MS

Originally published in the Medical Sentinel 1998;3(6):195-196. Copyright © 1998 Association of American Physicians and Surgeons (AAPS).