Culling The Herd?

The events in Ferguson, Missouri over the last three months have gripped the media by the throat. The shooting to death of Michael Brown by police officer Darren Wilson is one of the best known news stories of the period, not just in America, but throughout the world.

Wilson’s account is now common knowledge. Asked by ABC’s George Stephanopoulos if he had any reservations, any sense of guilt or remorse for killing an unarmed man, Wilson was emphatic in his denial. He feared for his own safety, so he shot the man.

Apparently, Wilson was within his rights as a police officer to do just that. Most of the gun nuts in America would agree with him. Wilson said he had no alternative, yet the alternative was obvious. Brown took off and Wilson gave chase on foot. The alternative was to stay in his police car and call for back up. Brown had committed an offense – assaulting a police officer – and could have been picked up at a later time. Instead, Wilson chose to aggravate an already dangerous situation by provoking another one-on-one confrontation with a guy he described as, “a demon”.

Had Wilson not been armed he may well have taken the wiser course, stayed in his car and called for assistance. Brown would later have been arrested, jailed, and the riots, violence, and human suffering of the last three months avoided.

It begs the question: is an individual human life of any consequence in this modern age, or is the once-sacred ‘right to live’ now relinquished at parturition? However much a ‘demon’, when Officer Wilson stopped him, Michael Brown’s only obvious ‘crime’ was walking in the middle of the road. For that, and refusing to kowtow to an officious police officer, he received a swift death sentence.

The sacredness of every individual human life, a once moral bastion of civilized society, is again challenged in an article by two doctors, published in the New York Times this week.

Pamela Hartzband and Jerome Groopman are physicians on the faculty of Harvard Medical School. They’re also somewhat courageous. They’re standing up to corporate health care: insurance companies, drug corporations, and financial institutions rapidly buying up the nation’s health services for the sake of a quick profit.

Their ‘opinion piece’ is worthy of note:

When we are patients, we want our doctors to make recommendations that are in our best interests as individuals. As physicians, we strive to do the same for our patients.

But financial forces largely hidden from the public are beginning to corrupt care and undermine the bond of trust between doctors and patients. Insurers, hospital networks and regulatory groups have put in place both rewards and punishments that can powerfully influence your doctor’s decisions.

Contracts for medical care that incorporate “pay for performance” direct physicians to meet strict metrics for testing and treatment. These metrics are population-based and generic, and do not take into account the individual characteristics and preferences of the patient or differing expert opinions on optimal practice…[1]

Sparrow Chat has written at some length of the ever-diminishing medical services being offered in many parts of the US as hedge funds and other financial institutions vacuum up family doctor practices, community-run hospitals, and other local health services under the guise of ‘improving conditions’. These improvements seldom materialize, unless classed as credit card readers in hospitals and doctor’s offices, belligerent demands for cash prior to seeing a physician, or the implanting of cheap, badly qualified, doctor-alternatives in the consulting rooms.

Now, it seems, the doctors themselves are under threat:

… doctors are rewarded for keeping their patients’ cholesterol and blood pressure below certain target levels. For some patients, this is good medicine, but for others the benefits may not outweigh the risks. Treatment with drugs such as statins can cause significant side effects, including muscle pain and increased risk of diabetes. Blood-pressure therapy to meet an imposed target may lead to increased falls and fractures in older patients.

Physicians who meet their designated targets are not only rewarded with a bonus from the insurer but are also given high ratings on insurer websites. Physicians who deviate from such metrics are financially penalized through lower payments and are publicly shamed, listed on insurer websites in a lower tier. Further, their patients may be required to pay higher co-payments…

Alarming? Certainly. The article argues that doctors are being placed under a moral dilemma. Should they prescribe the treatment of the insurance or drug company, or take a different course knowing it will prove best for their patient?

However, if you find that alarming, there’s one sentence in a later paragraph that stands out from the rest:

When a patient asks “Is this treatment right for me?” the doctor faces a potential moral dilemma. How should he answer if the response is to his personal detriment? Some health policy experts suggest that there is no moral dilemma. They argue that it is obsolete for the doctor to approach each patient strictly as an individual; medical decisions should be made on the basis of what is best for the population as a whole. [my bold]

No longer are we, the patient, to be considered individual. We are merely a minutiae in the larger herd. Our treatment should not be based on a doctor’s expertise, but, like laboratory mice, we are individually expendable in the great statistical analysis that will eventually determine what may be the best drug to treat a particular condition – ten, twenty, or fifty years down the road.

Is it not our duty, as citizens, to sacrifice ourselves now on the altar of corporate medicine, so others may benefit in years to come? And, even if they don’t, the medical services corporations will have become a lot wealthier in the process.

It seems we are all Michael Browns, after all.

[1] “How Medical Care Is Being Corrupted” PAMELA HARTZBAND and JEROME GROOPMAN, NY Times, November 18th 2014

2 Replies to “Culling The Herd?”

  1. Could be USA is reaching a tipping point. I am horrified at what is happening to the health care and to the treatment of blacks. All was prepared in advance of these riots for the grand jury conclusion was a given. The reek of corruption is everywhere. And I’m not saying Canada is exempt, we’re not. Just different corruption issues.

    XO
    WWW

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