Undermining Market Forces: A Fundamental Flaw in American Healthcare (Editorial‪)‬

As physicians, many of us are living in a world we could not have imagined 30 years ago. We entered medicine expecting to dedicate our lives to helping people, and we anticipated that our dedication would be appreciated and our efforts would be reasonably well rewarded socially and economically. Instead, our ability to practice medicine is hampered by "gatekeepers" whose responsibility is to maximize the profits of insurance companies, not the welfare of patients. Their frequently uninformed decisions determine what care an individual may receive, and although they affect treatment directly, they are protected from action that would hold them responsible for these decisions. In addition, Americans in general have developed an extraordinary sense of entitlement regarding healthcare. Not only do American consumers demand the best healthcare, but they seem to believe that it should be free. There is no interest in cost-effectiveness with regard to one's own personal healthcare, and patients are often prepared to litigate if any information is missed, or delayed in its discovery. How did we get in this mess? Each of the issues above is worthy of an editorial, but this editorial will focus only on the last issue.