From the President...
Faith, Hope and Action
Lawrence R. Huntoon, MD, PhD
As government attacks against physicians increase in our country, there is faith that ethics will prevail and hope that action will be taken by ethical organizations. We simply cannot afford to sit on the sidelines and watch government abuse our colleagues and demean our profession. We must not only fortify our defenses but we must go on the offense to "win the war."
Although most physicians would probably agree the HCFA bureaucracy epitomizes modern day oppression, the origin of government tyranny is both ancient and predictable, as it reflects the very core of human nature itself. As Frederic Bastiat (1801-1850) once noted, there are basically two ways to satisfy one's wants and needs --- production or theft. And, the decision as to which course a man may pursue, ethical behavior excluded, ultimately comes down to which method entails the least amount of labor. Bastiat observed that man is forever looking to shift the burden of his labor elsewhere, be it on nature (wind, fire, moving water, etc.), animals or upon other men (by force). It is the latter action, the forced labor of men, Bastiat says leads to discontent and war. And, when this forced labor is coerced under the auspices of government laws and regulations, he terms it "legalized plunder."(1) The resulting loss of productive labor and human energy is enormous.
Armed plunder itself requires effort and sometimes tremendous effort. Thus, while the producer devotes his time to creating the objects fitted to yield satisfactions, the plunderer uses his time in preparing the means of stealing them...For since human faculties are a means of production, he has found it quicker to seize them than to seize their products.(2)
Modern day translation: While physicians are working harder and longer hours producing, a whole army of meddlesome government bureaucrats are devoting their time and energy to figuring out new and creative ways to steal the physician's labor.
Thus, all the efforts that the plunderer has expended for plunder, and in addition those that he has not expended for production, are entirely lost, if not for him, at least for mankind.(2)
Modern day translation: Government Medicare bureaucrats do not produce anything of intrinsic value. Their efforts and labor are devoted entirely to plunder. They serve only to enhance government waste.
It is not at all likely [the producer] will passively await, without taking precautionary measures, the event that threatens him; and all his precautions, weapons, fortifications, munitions, drill, are labor, and labor forever lost, not only for him who looks to it for his security, but for the human race.(2)
Modern day translation: Physicians and their office staffs today waste an enormous amount of time trying to cope with the HCFA/Medicare bureaucracy --- learning CPT codes, coding rules, correct coding initiatives, RBRVS conversion equations, site of service reductions, ICD-9 linking of services and tests, evaluation and management guidelines, ABN regulations, forms for certifying medical necessity, fraud and abuse compliance guidelines and a whole plethora of other things in the name of "precautionary measures" that result in a huge amount of wasted labor. This is all non-productive labor designed to protect oneself against government attack that, according to Bastiat, leads to the destruction of the work ethic.
But, if the producer does not feel that, by thus undergoing double labor, he will be strong enough to resist the threatened invasion, the situation is much worse, and the waste of human energies is on an even larger scale; for in that case his work stops altogether, since no man is disposed to produce merely to be plundered.(2)
Signs we are already headed in the direction of destruction of professionalism and work ethic in medicine are apparent to most physicians today. Our patients are not yet aware of the consequences of government intervention as few physicians are willing to talk about this problem openly and candidly.
My fellow physicians, increasing government tyranny is a growing cancer destroying us, our patient-doctor relationships and the very profession itself. It will take sacrifice, perseverance and action. This is a job for the "Delta Force of Medicine," AAPS, and with your help and support we intend to do it.
At the AAPS board meeting in June of this year the board voted unanimously to "develop educational materials, contacts with experienced lawyers, and methods to aid members in anticipating and responding to problems with Medicare." We're looking for new and innovative ways to provide concrete help to our members who are under attack from this abusive HCFA bureaucracy. We will be going on the offense! We will be "bringing litigation against officials responsible for abuses."
So, let us issue fair warning to HCFA and Medicare bureaucrats and their
minions. The days of just sitting back and taking it are over. We will gather
our troops. Our counterattack is long overdue!
1. Bastiat F. The Law. Irvington-on-Hudson, NY, The Foundation For Economic
2. Bastiat F. War (a chapter in his treatise, Economic Harmonies). Ideas On Liberty, June 2000, pp. 30-36.
Lawrence R. Huntoon, MD, PhD is president of AAPS and a practicing neurologist in Jamestown, New York.
Originally published in the Medical Sentinel 2000;5(5);158. Copyright©2000
Association of American Physicians and Surgeons (AAPS)