Dr. Paul Hsieh answers the question posed in the title in his recent commentary in Forbes. See here.
He outlines four important ominous consequences of basing health care on spending other people's money.
Everyone should read this excellent article in its entirety but let me briefly highlight and comment on the first in the list.
"Doctors will be increasingly expected to save money' for the system ' ."
This is already happening.Various medical professional organizations are re-writing traditional medical ethics, pushing the fiduciary duty of the physician to the patients in the memory hole and substituting the bogus concept of the physician as a steward of society's medical resources. I have ranted about this before but the caravan rolls on and increasingly the rhetoric in various medical forums emphasizes saving money for the system. The medicine of the collective is replacing the medicine of the individual. This is being promoted in part by what I have called the progressive medical elite who, to a frightening degree, seem to occupy the leadership position in many influential medical organization . Their unspoken mantra is that medical care is too complex and too important to be left to the individual patient and his physician. Wise leaders with ideas need to be in charge. Of course, it is promoted by the third party payers, private and public who may well consider the medical professional elite in this ethical paradigm shift as useful idiots.
The notion of "the system" [in regard to medical care] while a rhetorically useful notion for a certain agenda, is basically fallacious aggregating elements that do not belong together. In short, there is no system for health care just as there is no car delivery system or a home building system. It makes no sense to speak of the situation in which someone buys a new car as a cost to the car supply system or a person buying a home as a cost to the home supply system.All of these are transactions in which there are buyers and sellers and exchanges take place.Mr Jones gets a CT of the abdomen.. This is not a cost to any system. It is a cost to Jones and/or his insurance company while to the providers of care it is a payment.. One person's cost is another person's income.To call this a cost to a system is nonsense.Unless all the health care is provided, operated and owned by a single entity, usually the government., then the services provided could be considered a cost to the system.
Who gains from acceptance of this bogus notion of physicians as stewards of some mythical collectively owned medical resources? The third party payers and the medical elite progressives who stand to gain from their position of prestige as experts and rule makers gain and the rest of us lose.