“Grandfather, you were there in the 20th century when the medical profession still rendered the best medical care in the world to patients in a private patient-doctor relationship. How did all that fall by the wayside?”

“Yes, I was there for all of it, as most of us were. We saw it coming beginning after World War II with many government attempts to collectivize medicine. Then, in 1965, President Lyndon Johnson bulldozed through the Medicare Act which gave all senior citizens entitlements, whether they needed it or not. This, like any other government plan, included bureaucracies, onerous paper work, lots of controls, which, in essence, carried the seeds of medical rationing and the deterioration of patient care.

“Many physicians, like many AAPS members, the remnant, and many of their patients, resisted and chose another path, retaining, as best they could, private medical care and the trust embodied in the sacrosanct patient-doctor relationship. Nevertheless, continued incursions of government bureaucracies ultimately required every patient be brought under the loving, paternalistic yoke of government medicine — exerted through a blizzard of rules and regulations, endless paper work, bringing and needless frustrations for both patients and physicians. Patients who chose not to participate were precluded from treatment, while doctors were precluded from reimbursement, both in the public and private sectors.

“Eventually, the government even made it illegal for an individual to use his own private resources to obtain the desired medical care.

“Oh, yes, there were show trials, not completely Stalinesque but close enough to coerce and intimidate. The government then established our own American-style archipelago of gulags, a fine sprinkling of federal and state penitentiaries across the nation where doctors, their office personnel, and patients were instructed  (rehabilitated) in the errors of their ways, that is, desiring the medical care a doctor and his patient thought optimal, but that a government bureaucrat deemed ‘inappropriate and/or medically unnecessary.’ This state of affairs began soon after Attorney General Janet Reno declared in 1997 that after terrorism, health care fraud had the highest priority for U.S. law enforcement.

“Yes, a lot of good people spoke out against such tyrannical and arbitrary treatment and acted according to their conscience, but the majority of the people accepted it, grudgingly and sheepishly, and became subservient to the common good. Suffice to say, medical care suffered and rationing became government policy in the name of cost containment, while behemothic health corporations working under monopolistic government protection (and their CEOs) continued to prosper.

“A lot of people opted for home medical care and treatment, receiving such care from their trusted physicians and nurses who were of like mind, taking institutional and regulated, government-approved treatments only when dire, absolute necessity made it unavoidable.

“But you had to have been there to know.... That’s how it was....”

Dr. Dwyer is the President of the Association of American Physicians and Surgeons, and an Orthopedic Surgeon in Chicago, Illinois. His address is 104 South Michigan Ave., Suite 408, Chicago, IL 60603.

Originally published in the Medical Sentinel 1997;2(4):122. Copyright © 1997 Association of American Physicians and Surgeons (AAPS).