The Constitution --- Plain and Simple
Part II: The Practice of Medicine is not an Industry
Curtis W. Caine, MD
In Part I, an exchange between an AMA Trustee and the author revealed: a) the AMA is hurting for members; b) "organized medicine" has accepted and capitulated to outside, third-party control of the patient-doctor relationship-based practice of medicine; c) the AMA it only hopes to lessen and make more bearable the unConstitutional usurpation. On the contrary, leadership in "throwing the interloper rascals out" is what is demanded to reestablish the finest medical care in the history of the world. In view of the AMA's decision to institutionalize medicine as an "industry" and form a union for "collective bargaining," let us explore this concept of medicine as an industry further.
Cardinal rule --- Constant vigilance and a high index of suspicion(1) are necessary to safeguard liberty, and to preserve and secure freedom in every sphere of life, including medicine.
Here we go again! "It seems to me I've heard this song before. It's from a old familiar score. I know it well, that melody."(2) I suspect we are being manipulated once more, subliminally and overtly.
Over the years, I've been made uncomfortable when the practice of medicine was unthinkingly (off handedly) referred to as an industry. Like folks having been programmed to erroneously and unintentionally support freedom's antithesis, and thus inadvertently calling these United States a democracy, when they constitute a republic. Now I am angered because my research and study and observation have led me to be certain the use of the words "industry" and "democracy" has been done, and is being done, on purpose, by design. "Industry" and "democracy" are politically correct concepts, part of the psychologic warfare of cultural Marxism based on organic evolution.(3-5) Follow closely as I make my case:
For a long time the politically correct cliché has been that "health care is a right." Remember? Well it's back.(6,7) Now, added to that fraud which has been given as the reason (excuse) for government/third party intervention in patient/physician sickness care, is another fabrication. Currently on every hand, from outsiders and from insiders we hear, read, and view that "health care" is an industry. So successful has this ploy been that the ruse is already so ingrained and accepted that questioning it it is met with startled amazement. But the maxim says: "Take nothing for granted."(8) So challenge it we must. It appears many physicians have been conditioned (à la Pavlov) to accept this fabrication as true. As a consequence, to them, then, it is perfectly logical, acceptable, desirable, and even necessary for physicians in the industry of medicine to band together in a union. Allowing medicine to be labeled an industry, and accepting that designation, assures that doctors will, over time, embrace the industrial structure and eventually unionize. We must not permit this downhill snowball to roll.
Visualize this future scenario, right hand extended: Hello. I'm Luther Jones. Aren't you Bill Smith? You and I were freshmen together in English 101 at the University of Mississippi fifty years ago, remember? I went into medicine, what trade do you ply? I belong to Local 706. What AFL/CIO union do you belong to? How many days a week do you report to work? (Noun: the work place.) How many hours a day are you on the job? How much an hour do you get? What are your employee benefits? Hmmm! This doesn't sound like the practice of a profession to me. Does it to you?
At the outset let us consider the terms "health care" and its "delivery system," which are likewise intentional misnomers. The word "health" holds out the deceptive, false promise that "the system" will produce health, which by definition is the absence of disease. If universal health care will usher in this utopia, then why aren't the statistics better to the degree we already have government intrusive programs? The answer given is that we would if, and will when, obstructionists (like the writer) to a government run health care industry get out of the way to allow the government system to be fully implemented. All experience confirms, of course, that on its face, this concept, though appealing and vote getting, with government's track record of failure, in this and all other fields, is groundless. For it is government interference (i.e., forbidden by the Constitution and the Medicare law itself) that has produced the present rationing, database of intimate personal information gathering and dissemination, restriction, delay, denial, iniquitously expensive mess we have.(9)
Besides, only The Great Physician restores health. Physicians simply utilize their experience, judgment, and God-given skill to advise and treat the patient, with the latter's cooperation. Even before the advent of Christianity, Hippocrates recognized the healing power of Nature, thus, his advise to physicians to assist Nature in restoring health.(10)
Seldom mentioned is the reality that the phrase "health care" encompasses and includes the "system" --- i.e., hospitals, helicopters, pharmacies, ambulances, home health nurses, over-the-counter health "supplements," HHS, HCFA, FDA bureaucracies, artificial limb makers, clinical laboratories, etc. We are constantly bombarded that "health care" is "too expensive," specifically pointing out high income doctors are the cause. Absent from that presentation is the fact just 19.9 percent of each "health care" dollar is received by physicians. This is a government figure, and thus I suspect is padded to make the income of doctors look bigger. The bigger figure is gross receipts, out of which must be subtracted the cost of practice overhead (much of it the result of government required outlays) to end up with take home income. I have seen figures of net income, before personal taxes, of 7 percent. The other 80 to 93 percent is expended on the list above; government, and all of its intrusive intermediaries.
To emphasize it is the system that is so presumptuous, impertinent, destructive, and expensive, it is essential to point out that the practice of medicine is, in toto, a private pledge between a sick patient and his individual doctor, properly labeled "illness care" or "sickness care," maybe even "medical care," but surely not "health care."
It must be doggedly maintained and continuously asserted that an individual physician's illness care of his individual patient is the practice of a profession and outside of any "industry," particularly the "health care industry." The practice of medicine is a profession. It is not an industry. There are three historically honored professions, made up of: clergymen, attorneys, and physicians. The word "professional," as applied to athletes, administrators, machinists, school teachers, etc. is an adjective, not a noun, and signifies/implies the party is full time, good at, and dedicated to his vocation of, say, piloting an airplane.
Those who classify the practice of medicine as an industry do so on several possible grounds: thoughtlessness, naivete, ignorance, being manipulated, misplaced confidence in their "leaders," etc. But there is another category --- those who call medicine an industry by calculated intent --- a conspiracy.(11-13) I contend that some physician bashers (including some with M.D. after their name) are doing so on purpose, because they understand and intend the repercussions. Most often we victims do not. Physicians who attempt to defend themselves are then denigrated, criminalized, and silenced with labels of blood suckers, old fogy traditionalists opposed to progress, right wing extremists, being biased, prejudiced, selfish, disruptive malcontents, etc. By allowing health care to be labeled an industry and lumping physicians in it, very deleterious consequences do and will unavoidably ensue, to wit:
--- In an industry, there is naturally and logically labor and management --- the owners and operators vis-à-vis workers. In our context that means management (third parties, so called "payers," insurance companies, regulators, agencies, government, HMOs, PPOs, foundations, hospitals, etc. - them) versus laborers (us - physicians, you and me, a.k.a. "providers").
--- In an industry, individual laborers do not have much clout with management. Therefore, there is an inclination to band with other workers to gain strength in numbers - to have a "UNIfied voice." Have you ever heard that phrase before in "big tent" political parties or medical societies?
--- Laborers collectively are labeled "labor." "It" (labor) not "they" (laborers). As such, each individual worker loses his personal identity and becomes part of the collective. And their UNIfication is a UNIon --- a labor union --- a trade union --- an organization of laborers. Karl Marx and John L. Lewis understood this well. Their emphasis of the dichotomy --- management versus labor --- promotes, and foments controversy, not harmony. Class war --- the opposite of the "domestic Tranquility" sought and intended by the adopters of the U.S. Constitution,14 stated in its Preamble.
--- Forming a union, a labor union, a trade union, a doctor union establishes prima facie --- a) that government and all other outside intruders are recognized and accepted as the managers, and, because the members of the union are physicians, equally installed as a given is that doctors are the laborers in the industry. As such, doctors do not attend, and are not paid by and answerable to, their patients, but are laborers who work for the managers of the industry. They are paid by and controlled by the industry owners and managers ---- i.e., government and its "private" partners. Are there barrister labor trade unions? Or preacher labor trade unions?
Where does this set up leave the sick patient? Pathetically and impotently --- out of the loop. Which is to reveal that to bureaucrats the sick patient is several degrees more inferior to their exalted selves and their system than the also inferior to themselves doctor labor force --- "manpower" --- they push around.
Third party preferred providers, alliances, PPOs, HMOs, Locum Tenens
businesses (which advertise they are an industry), partnerships, etc.
are really unions formed by a third party to which "providers"
are cajoled to "buy $$ into" (i.e., capitalize, pay a fee to join,
etc.), split fees with (withhold) to get what they are promised, assured
prompt payment (discounted for a brokerage fee, of course), and promised
they will make up the loss by being sent "more patients" (sometimes
impersonally referred to as "more volume"). The demise of the
practice of private medicine under the command of an outside-of-medicine,
government-imposed variety of union would be by murder. Part III
in the next issue (Medical Sentinel, May/June 2000) will show that
demise through a union formed inside-of-medicine, from within, is suicide.
But murder is unnecessary, involuntary death by crime, where suicide is
voluntary death and a tragic shame. Dead either way. So, physicians best
stay out of either one!
1. Caine CW. Medicine - an industry of a profession. Part I: AMA recruitment.
Medical Sentinel 2000;5(1):24-26.
2. From "Youth on Parade," 1943. Sammy Conn and Julie Styne, 1942.
3. Thornton J. Strategy for subversion: Gramsci's grand plan. The New American 1999;15(14):7-11.
4. Jasper WF. Demolishing our core values. The New American 1999;15(4):13-16.
5. Grigg WN. Pressure from above and below. The New American 1999;15(4):17-20.
6. Faria MA, Jr. Is there a right to health care? Medical Sentinel 1999;4(4):125-127.
7. Huntoon LR. Health care and the distributive ethic: "Natural Rights" vs. socialism. Medical Sentinel 1999;4(5):177-178.
8. Cronin AJ. The Citadel. Boston, Little Brown & Co., 1937.
9. Faria MA Jr. Vandals at the Gates of Medicine. Macon, Georgia, Hacienda Publishing, Inc., 1995, pp. 209-215.
10. Ibid., p. 169.
11. Caine CW. U.S. Constitution 201 - a conspiracy. Medical Sentinel 1999;4(4):145.
12. Caine CW. Conspiracy - Part II. Medical Sentinel 1999;4(5):184-185.
13. Caine CW. Conspiracy - Part III. Medical Sentinel 1999;4(6):224.
14. Preamble to the U.S. Constitution, September 17, 1787.
This column on the Constitution appears in the Medical Sentinel to
remind us that it is the unConstitutional (and thus illegal) activities
in medicine and all other facets of our lives that have trampled on and
outlawed our God-endowed freedom and liberty.
Dr. Caine is an anesthesiologist in Jackson, Mississippi, and a member of the Editorial Board of the Medical Sentinel.
Originally published in the Medical Sentinel 2000;5(2):67-68. Copyright©2000
Association of American Physicians and Surgeons (AAPS)