Health Care and The Days of Judgment . . .

Many religions have some form of confession, repentance and a day of judgment. All of us however face a day of judgment every time we submit a health insurance claim! Will they say yes or no? Can I have the treatment or not? Did they pay or deny?

Most of us accept and pray to some supreme singular entity, beyond our comprehension, who makes judgments about our lives. Will the year be peaceful or troubled? Will we be successful or fail? Will we live or die?

But what or who is this mysterious and nameless entity that makes our health insurance decisions? It cannot be doctors - there are not enough to make the thousands of daily decisions. Nurses? How qualified are they to judge the subtleties of proper care of someone they never met? Administrators or government employees? Are they calling the shots (pun intended)? This system has a wonderful backup, in case you appeal or complain. That is the underwriter, another mysterious entity who usually decides that you are not entitled to almost anything, because 1) The treatments are not deemed "necessary", or 2) They are not approved treatments.

This nation is facing a health care crisis primarily for one reason. The people who best know the patient and can best decide the most effective and economical care - The DOCTORS - are being removed from the equation. Everyday there are more rules, regulations, restrictions, pre-existing circumstances and limitations to deal with.

It is no longer what the patient needs, but what the system will allow. It is no longer what I, the doctor, knows is best for the patient, but what the system calls the acceptable "standard care". If the doctor strays beyond the normal routine path, there is a whole flock of lawyers ready to pounce. Thus that extra CT scan or ECG, or blood test is always in order and indeed ordered, adding staggering 20-25% to our total annual health care cost.

Under the system that I trained, the doctor and the patient worked effectively, efficiently and economically.

Our present health system is a mess, but I oppose the vague and complex near 1000 page program. I don't want another nameless, faceless, self-omnipotent entity controlling my life.

I have only one God and I would like to keep it that way.

Neil Raff, MD