PUBLIC VIEWPOINT: One Size Fits Some, Not All

NORTHWEST ARKANSAS — Dr. Robert Patton (Public Viewpoint, April 4) is missing the point.

I would not presume to debate his long and carefully reasoned defense of Obamacare through the science of comparative effectiveness, and how “some” patients respond better to less expensive forms of treatment. He believes Obamacare will use this research to make medicine more cost-effective.

I do believe he is leaving out of the equation the nature of bureaucracies, specifically medical bureaucracies. And regardless of how much he dislikes the word, Obamacare, Medicare and all government health care programs are bureaucracies.

The hole in his argument is what bureaucracies typically do with such research. They use research like “comparative effectiveness” to justify a lot of one-size-fitsall rules, and pretty soon, that hardens into a policy that says, “If you don’t use this treatment that we have decided is the best one for everybody, then we won’t pay for it.”

If you recall, Patton’s citationof the science of comparative effectiveness mentioned in every case that the treatments he mentioned worked well for “some” patients. “Some” is not all. But in a bureaucracy, there is no “some.” There is only “the rule that applies to everybody.” That is the problem with medical bureaucracies: They try to apply one-size-fits-all solutions to individual problems.

And that, my friends, is why they never work.

Instead, they become nightmares of paperwork, endless appeals and more paperwork for the unfortunate souls who did not fit into the “some” of comparative effectiveness, after it was transformed into the onesize-fits-all of utopian bureaucratic medical schemes. Ask anybody who has ever been on that merrygo-round trying to get treatment that did not fall into the one-sizefits-all solution decreed by their particular government medical dispensing agency.

All of us will fall into the “some” category at some point.

But medical problems tend to differ with each individual, and none of us ever completely fitthe one-size-fits-all method of dispensing medical care that is inevitable in the kind of massive bureaucratic mess Obama and Pelosi have wrought. It was voted upon behind closed doors and in the dead of night, then forced down our collective throats with an oversized spoon of unconstitutionally seized government power.

If the Affordable Care Act was such great legislation, why did it have to be done in secret, and why did we have to “pass it so we could see what was in it”? That is probably the most breathtakingly stupid statement I have ever heard a politician utter.

I do agree with Patton on a single point: Our system of medical care is broken. I do not know what the solution to that problem is, though I certainly have many ideas on the subject.

However, whatever the cure is, I am certain Obamacare is not it.

Obamacare can only make matters worse than they already are, at a catastrophically higher cost.

JOANN GRAHAM / Bella Vista