Your Doctor, or some random Bureaucrat? Georgia jumps in on the wrong side of the debate over who has final say over your health care decisions

The Peach State, represented by Department of Community Health commissioner Rhonda Medows, has sprinted to the forefront of the effort to secure and safeguard the “right” of state bureaucrats to overrule diagnoses and prescriptions made by doctors to their patients.

In March, Georgia filed, and Florida and Alabama joined, an appeal of a 2008 U.S. District Court ruling that a patient’s physician was better positioned – and better qualified – to make decisions about that patient’s medical treatment than state bureaucrats. The case is currently being considered by a panel of the 11th U.S. Ciruit Court of Appeals in Atlanta. Oral arguments were made on March 24.

The case, Moore v. Medows, has thrust into the spotlight debate about an issue that has long been confined to dark, smoky rooms in state capitals and Washington, DC, and to the back pages of legislation Members of Congress aren’t bothering – or being allowed – to read before their passage.

From state governments to the federal legislators and bureaucrats who had a hand in writing and passing President Barack Obama’s 2009 “stimulus” bill, more and more officials are beginning to make the public argument that it is not a trained doctor with years of experience and personal knowledge of a patient’s medical history and needs who should have final say when it comes to patient diagnoses and prescriptions, but some nameless, faceless bureaucrat inhabiting a cubicle in some nondescript government building, with nothing but an agency-developed cost-effectiveness spreadsheet to guide them in determining what is and is not medically appropriate or necessary for every patient seen within their jurisdiction.

The case currently being decided in Atlanta is evidence of this. In oral arguments before a panel of the 11th Circuit on March 24, attorney Robert Highsmith contended that, while bureaucrats “will consider doctors’ determinations,” the “final arbiter” of medical decisions is “the state.”

The thrust of the states’ argument is summed up in a brief written by the attorneys representing the state of Florida in the case. “Left to their own devices,” they write, doctors “advocate for their patients” – a fact that is clearly resented by state governments for its interference in the execution of their cost-effectiveness analyses.

It’s difficult to overstate the impact a decision in the states’ favor would have in this case. Medical professionals and health care advocates rightly fear doctors’ evaluations, diagnoses, and prescriptions would sink to the status of mere suggestions pending review and approval or disapproval by state bureaucrats.

Imagine, if you will, if every decision made about your personal motor vehicle, from the gas you put in it to the recommendations the mechanic makes for fixing your worn-out brakes or broken transmission, was subject to final review by a DMV-employee-clone state bureaucrat with no experience in the automotive industry. Now extrapolate that scenario to your health care.

Are you concerned yet?

Even if the judges of the 11th Circuit disagree with the appellants’ argument, the fact that three states are currently in federal court seeking official validation of their “right” to overrule physicians and arbitrarily ration medical care is frightening enough.

When government is given free rein to overrule a medical professional’s judgment of care based on their analysis of cost, physicians and their patients no longer have an active role in making decisions about those patients’ care.

The battle is not only being fought at the state level but at the federal, as well, where funding and authorization for “comparative effectiveness research” was included in the American Recovery and Reinvestment Act (or “stimulus” bill). That benign-sounding term refers, quite simply, to the drawing up of those comparative-effectiveness spreadsheets bureaucrats will use to approve or overrule physician diagnoses and prescriptions once the federal government’s power to do so has been affirmed, be it by legislative action or judicial fiat.

Given the track record of the faceless bureaucrats who make the majority of the government’s day to day judgments, the idea that they, rather than the doctor you know and trust, could be responsible for your medical decisions should be a very frightening prospect indeed — and the state government in Atlanta is leading the charge to make this a reality sooner, rather than later.

Note: A fuller explanation of the case itself, which centers on a disabled Georgia resident named Callie Moore, can be seen here.

Tagged as: 11th Circuit, Callie Moore, Health Care, If Bureaucrats Ruled the World, Medicaid, Rhonda Meadows