Dr. Costello’s “Best of Health” Quarterly · Vol. II, No. 2 · Summer, 1991
Health Care Tyranny
Social organizations created by humans take on human characteristics and the actions of such organizations exhibit the good and bad in the human character.
It is the flaws in human nature which shackle the individual human and human organizations, be they families, companies or governments, to cycles of prosperity and peril.
There are, at least, two ways to overcome this defect. The first is to change the nature of humankind. The second is to create social organizations which have checks and balances to prevent extremes or mediocrity.
To change or modify the nature and behavior of humankind has traditionally been the function of religion, philosophy and education. There looms in the near future the reality that genetic engineering will change humankind. The debate on the wisdom and ethics of this has already begun.
It is, however, the other side of the discussion which is the point of this article; the concept of checks and balances in social organizations which keep their social results fair and progressing.
In the present day, the United States Government, in the actions of the Health Care Financing Administration (HCFA), has no checks and balances to protect the consumer and producer of health care from being bullied. I suspect there are other governmental bureaucracies which are also so far removed from electoral reprisal that they too have taken on bullying characteristics. When a government bullies its own people, it is called tyranny.
This tyranny has been complained about in the national media and in prestigious medical journals.
The reason for it is simple. Government has become a Third Party Payer. As such, it has a financial interest in what it is regulating. When a regulator and a payer become one source, tyranny follows.
We have antitrust laws to prevent this in the commercial area.
An example of HCFA’s actions is its refusal to publish reimbursement denial rules for payment of claims. The excuse is patients and providers would abuse the denial rule regulations. Who is abusing whom?! There are a myriad of other examples.
In summary, to have a good and just health care system, government should refrain from being a third party payer because when the payer and the regulator become one source, a tyranny inevitably follows.