Could it be that it is not market forces that have distorted medicine but actually the fault of those who should have been integral to the evolution of the health care system, physicians? The industry has evolved based on circumstances. Government intrusion with unregulated bureaucracies and the poison of politics can now be described as the monopsony that is basic to the present market distortions. When pricing is arbitrary based on repeatedly ridiculous and failed schemes and driven by an expanding welfare state and an entitlement mentality, the efficiency and discipline of market forces to produce value are nowhere present.

The capture of the physician

Consolidation, mandates, regulation, and lack of physician economic and financial education have resulted in physicians as employees, virtual employees, and the most unfree of any in our country. To pursue one’s interest based on initiative and free-market opportunities, or even to innovate is not an option for doctors. They have been captured into the political, corporate, industrial maze of market distortion that has resulted from the perverse power exerted by government and the corporate opportunists so created.

The fallacy of central management

The reliance on so-called experts to manage health care’s evolution is increasingly accepted. It is nonsense. There is no organization, group of “experts,” political body, so-called “academics,” centralized authorities, or any group of individuals that can possibly understand the interrelationships, organizational complexity of the myriad variables that comprise a system referred to in its totality simply as health care. Addressing it as a system suggests it is an entity that can be somehow understood and managed. Given this, the simplicity of the goal is actually interesting. In the end, it is always a doctor and a patient interacting in a trusting relationship around the individual’s health care needs. It is of course a continuum as efficiency and progress continue. If largely left without interference, value would ensue based on the foundational economic concept that all things are scarce. And of course, it should be incentives rather than punishment and coercion that predominate.

A cottage industry of trust

Perhaps medicine was intended to be a cottage industry of entrepreneurial, critically free-thinking physicians intimate with patients in the traditional and foundational precept of a physician and patient interacting in a trusting relationship unencumbered by myriad outside interlopers inserting themselves into the $5 trillion bonanza largely having nothing to do with the direct clinical care of patients.

The danger of suicidal empathy

The introduction of DEI and “social justice” into the definition of professionalism seems to fit what is labeled by Canadian Professor Gad Saad as “suicidal empathy.” His argument is that this faux empathy is transformed into a “benevolent altruism” that prioritizes the perceived victims, the “marginalized groups,” at the expense of the survival, security, and interests of its own group which can even lead to inappropriate guilt, self-criticism as well as condescension for the other non-marginalized. Such selective empathy is just moral posturing wearing empathy’s clothes. It can have utility for marginalizing merit, political advantage, deciding health care economic policy, expanding welfare, increasing the centralization of government’s health care power and for allocating capital to the profitability of the corporate power structures, hospitals, and NGOs. The problem is that this virtue signaling masquerading as empathy and altruism does not work. “It ends up killing the host.”

Conclusion

Nothing is inevitable unless it is allowed to be. Perhaps if we in the medical profession were not simply passive complainers manipulated by the false and ridiculous demands for professionalism to mean sacrifice so others can profit and made to feel guilt by not acquiescing to the ridiculous calling to altruism that is only meant to steal our freedom, we also could have prospered along with our patients in the most wonderful economic system to date, free-market capitalism.

Allan Dobzyniak is an internal medicine physician.