I'd like to take this matter a step further and to make explicit what was only implicit in the original post. It should be a matter of concern that people paid by the State -- doctors treating Medicare patients -- would be authorized under the House legislation to venture into end-of-life issues when the government's priority is to control medical costs. One need not be an alarmist to connect those dots and wonder how the source of the paycheck might influence the advice given. Whom exactly is the doctor working for?
But this is a general problem that plagues any government intervention in health care, and the advocates of increased government intervention have no answer. Worse, most of them do not even acknowledge that the agent-principal problem exists.
For whom does the doctor work? The patient, whom medical ethics would seem to designate as the principal, or the State, which pays the bills?
I can't blame anyone for finding the end-of-life issue ominous in the context of healthcare "reform." Still, we must get our facts straight.
Friday, August 14, 2009
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