Taking The Oath On Health Care

Health care in America has come a long way from the time depicted in the classic Norman Rockwell illustration “Before The Shot,” which depicts a boy with unhitched pants inspecting with great apprehension the framed degree of the white-coated country doctor preparing a syringe behind him. Doctors, for example, have greatly expanded their knowledge of how to keep boys, and every other kind of human being, healthy and how to cure them if they do fall ill. That’s the good news. The bad news is that doctors and other health care specialists may still be giving shots, but they don’t seem to be the ones calling the shots anymore.

For the past two weeks, The Bee has reported on growing concerns of local health care providers who find their practices have become increasingly shackled by liability insurance premiums that are essentially ransom for risk. Professionals who cannot pay the ransom are reduced to minimizing their personal risks by ordering batteries of tests that further inflate health care costs, or by declining to perform potentially lifesaving procedures that underwriters deem too risky. By unilaterally deciding what procedures they will authorize, for whom, and for how long, insurance company actuaries and underwriters, and not doctors, are effectively determining treatments for the millions of Americans who cannot afford the ever-escalating cost of modern health care.

The fundamental flaw in this model of health care is that the insurance industry is primarily obligated to company shareholders who are more interested in the health of their investments than in delivering the best possible health care to the most people. They don’t have to take the Hippocratic Oath and consequently do not face the ethical obligations of physicians to “prescribe regimens for the good of my patients according to my ability and judgment and never do harm to anyone.”

While businesses and individuals make staggering financial sacrifices to meet successive waves of health care premium increases, most of which are in the six percent to 20 percent range, the outlook for health care insurers looks comparatively bright. Financial analysts are predicting 15 to 20 percent earnings growth for the industry next year. Meanwhile, more and more uninsured people are showing up sick and injured at fewer and fewer emergency rooms to be treated by a diminishing corps of certified personnel still willing to pay exorbitant liability insurance premiums. The health insurance industry’s bottom line may be healthy, but the health care system itself is sick.

Most medical professionals agree that medical liability reform that limits non-economic damages in jury awards is an essential first step toward bringing health care costs back under control. Seven months ago in this space, we urged Connecticut’s lawmakers to take up the cause of reform and to recognize that Connecticut’s health care crisis is also an economic crisis for the state. Nothing was done. We are seven months farther down the road, and the crisis continues. With every state elected official up for reelection this year, perhaps we, as voters, should be asking them to join with the medical community in taking the Hippocratic Oath before more harm is done to the state’s economy and to its people.