Doc Ippel: Medicare and Deciding About Decisions

October 9, 2014

by Bruce Ippel, M.D.

This is about decisions. It starts with your decision to read it. What about the other decisions in your life? If you’re an adult with, say, a high-school education and not currently in the Army or prison, then you should be making about all of them yourself.

Or not. You probably believe that you should decide what kind of car you drive and what food you eat or what, if any, medicines you take. But throughout history and all over the planet, most people have not been allowed to make these kinds of decisions.

We Americans don’t accept that, never did. Why’s that? The American War of Independence was not just against the king of England. It was mostly that government (King George) insisted on making decisions that the colonists had the right to make (under English Common Law) for themselves — you know, taxation only with representation. The idea of making our own decisions wasn’t revolutionary; it stretched back hundreds of years before America was born.

Making one’s own decisions has layers of benefits — benefits that spread from England to its colonies and eventually to parts of the world as diverse as Hong Kong and Australia. The fact that you’re not at the edge of starvation and don’t have a privy in your backyard in which to relieve yourself is a direct result of that.

When I turned 18, my Uncle Sam sent me a little present. A wallet-sized red, white and blue card that informed me that I was now required to fight a war . . . should he decide to wage one. My Selective Service card. The other day, I got another of those cute little red, white and blue cards from him. My Medicare card.

Now my Uncle decides what medical care I will have. When the Medicare program started, it was pretty freewheeling. Patients and docs could largely do what they wanted. Every year, though, it gets more regimented. Maybe that’s why the Medicare card looks like my draft card, the point being that once government starts making decisions, your freedoms evaporate. Slowly at first. Now faster.

We Americans, including the physicians, bought into that innocent Medicare rollout and watched it balloon, eating tax dollars like so many bags of candy. And like anyone eating too much candy, we started packing on weight. This weight equals money, which equals power. It was trick or treat.

Did you notice something odd about the recent fight between our Democrat and Republican leaders over your healthcare future? It wasn’t about if but about how government should control it? Did you notice almost everyone’s insurance premiums went up — a lot? Did you notice many people lost their insurance and now have to buy policies that are so expensive that it’s a lot cheaper for them to pay the government’s fine? Did you notice the warning that if not enough people buy these policies it would generate a crisis that the government will have to solve?

I noticed, and so did many of my patients. But I’m OK with these changes because my new card allows me to jettison the premium boost that Anthem Blue-Cross was fixing to stick to me. Now you and other taxpayers will shoulder it.

Which gives me an idea. Would you vote for me if I proposed that all of you could get on Medicare, too? I’m pretty sure you would after you get your next insurance premium bill. I can see myself in Congress already. Or maybe higher up.

Look for me at your next 4th of July picnic. That’s where we Americans celebrate our freedom to elect leaders who make decisions better than we ever could.

Ain’t politics wonderful?

Bruce Ippel, M.D., is a solo rural family physician in central Indiana. He and his wife of 42 years have 10 children. For the last 38 years, Dr. Ippel has run a private “hardscrabble” clinic that serves the under-served.



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