The bureaucrat? He’s already there

In the ongoing debate over healthcare reform, the Republican Party’s current talking point is that the Democrats’ health plan will put “a bureaucrat between the doctor and the patient,” a development that would make it impossible for doctors to practice good medicine. You’ll hear that phrase uttered by every Republican Party official or operative who’s interviewed on cable news.

Georgia’s own Rep. Tom Price, at one time an orthopedic surgeon, hit that talking point during a recent appearance on The Ed Show: “I think I agree with the American people. And that is that we don’t want to put the government, we don’t want to put bureaucrats between a doctor and a patient. That’s the concern that I have and so many individuals across this land have.”

I agree with Price that it’s generally not a good idea to insert a bureaucrat between a doctor and his or her patient, but Price doesn’t mention that the bureaucrat is already there under the private healthcare system we have today. The bureaucrat is the insurance company employee who decides whether the insurer will give “prior approval” for a physician to order a test or conduct a medical procedure.

If a doctor thinks one of his patients should get a CAT scan or surgery to address a medical problem, none of those things will likely happen if the insurance company doesn’t issue that prior approval. Physicians generally don’t work for free and there aren’t many patients who can come up with $10,000 or $15,000 in cash to pay for an operation that their health insurance carrier refuses to cover.

Bureaucrats? Take it up with your insurer.

The erection of a bureaucratic governmental barrier between doctor and patient was also raised as an issue several years ago when the General Assembly was debating (and eventually passing) legislation to require a 24-hour waiting period for women seeking an abortion.

During that waiting period, physicians are now required to give their patients a state-published brochure that emphasizes fetal pain and other negative aspects of abortion while it promotes the option of putting an infant up for adoption.

The legislation was sponsored by anti-abortion lawmakers in hopes that it would reduce the number of abortions performed in Georgia, but it is exactly the kind of governmental bureaucratic intervention between a doctor and a patient that Republicans now insist is such a terrible part of healthcare reform.

You can’t have it both ways. If bureaucratic intervention is bad, then you need to prohibit insurance companies and anti-abortion zealots from imposing it on everyone else.