Plato versus Hippocrates

By Wax, Craig M. | Medical Economics, February 25, 2013 | Go to article overview

Plato versus Hippocrates


Wax, Craig M., Medical Economics


In the practice of medicine over thousands of years, the prime directive has been the interests of the patient The secondary directive has been that of physician interest to sustain the practice, himself or herself, and his or her family. The tertiary directive is that of society.

Throughout human history, until the end of the 20th century, the patient interest has been primary. Individual patient needs and wants have been the number one focus of the doctor's time and attention.

Somewhere in the middle to the end of the 20th century, focus shifted from individual patients to the concerns of employer-sponsored thirdparty payers.

In certain empires in history, such as those of Plato's republic, when the state's interest were made primary, physicians responded to the needs of the state by devoting resources to the workers, in the process ignoring the elderly, very young, critically ill, and those who were considered genetically inferior. Such practices can lead to vile immorality and atrocities.

In the 21st century, with the Medicare and Medicaid programs and passage of the Affordable Care Act, is the United States moving toward socialized medicine? In this form of medicine, the state owns the healthcare system and all the resources therein. This arrangement allows the state to act in its own self interest, not in the interests of individual patients.

A WORLDWIDE TREND

Our country would not be alone. Socialized, or government-owned and run medicine, appears to be the trend in the developed world, such as the United Kingdom (U.K.) and Canada.

The problem is, like in other socialist government programs, it is all good until "you run out of someone else's money," as former U.K. Prime Minister Margaret Thatcher said. Then the ethical decline begins as care is rationed for the able workers and withheld from the sick babies and the declining elderly. Every citizen languishes in the notion that he or she will be cared for when ill or hurt by some other responsible party.

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