Do You Really Want Washington As Your Doctor?

 Why is the federal bureaucracy your “doctor”?  You didn’t choose them. You don’t want them. Yet, by third parties following their stringent regulations, Washington makes all your medical as well as financial decisions, not you and not a doctor of your choice. What happened to your medical freedom (autonomy) that is supposedly protected by law? What is going on in U.S. healthcare?

Care decisions

You get to see the doctor when a scheduling program decides, not you and not even your assigned doctor. The program puts you at the back of a long line. Average maximum wait time in 2022 was more than four months for an appointment with a general practitioner. Americans are literally dying waiting in line for care.

Which doctor you eventually see is decided by a health plan contract, not chosen by you.

How long you spend with the doctor is determined by efficiency benchmarks on the doctor’s clinical scorecard. The more efficient physician sees more patients per day, therefore necessarily spending fewer minutes with each one.  So, he or she spends as little time as possible with you.

What medications you receive are determined by a pharmacy benefits manager based on a “fail first” approach. The doctor is limited to prescribing drugs from a list of the lowest risk, least effective, and cheapest drugs. After you take the medicine for a while and the drug fails, the doctor may choose from a second tier of drugs: stronger, some greater risks  of adverse effects, and more expensive.  When the second drug fails, he may go on to a third tier, where the drug he or she wanted in the first place may be listed.

Who operates on you and where is not determined by you with advice from your doctor. It is decided by contract, not by outcomes. The patient gets the cheapest doctor and hospital rather than the ones with the best results for the particular procedure that a specific patient — you — need.

Care decisions are made by a computer, a health plan, an insurance company, and a lawyer, not by you or a physician you chose.

And they are all following Washington’s instructions (or else.) 

Spending money

In 2025, employers took $26,993 from the earnings of 84 million American workers and gave that money tax-free to insurance companies as the so-called “employer-sponsored” health insurance benefit (ESI). They were allowed to do so  because Congress has never repealed a World War II wage freeze accommodation passed in 1942. After the war, every other wage freeze was repealed...except the ESI. Those monies are rightfully employee wages — they should be free to spend their money as they see fit, not  as insurance companies do following strict federal regulations.

Thus, Washington is the ultimate arbiter of healthcare spending. In 2025, the U.S. expended nearly $5 trillion on its healthcare system. Less than half paid for patient care: doctors, nurses, hospitals, pharmacies, etc. At least $2.5 trillion was spent on BURRDEN: bureaucracy, unnecessary rules and regulations, directives, enforcement, and noncompliance activities.

For example, the infrastructure for the Affordable Care Act cost $1.76 trillion. To defray this huge bureaucratic expense, President Obama withdrew $716 billion from the Medicare Trust Fund, funds earmarked to pay for hospital care for seniors. The Trust is projected to be insolvent by 2028. Washington diverted monies intended for patient care to pay...itself.

Any mention of healthcare spending must include the multi-billion-dollar Medicaid frauds being exposed, particularly in Minnesota and California, but not limited to those two states. While the scammers certainly bear the first responsibility for their crimes, taxpayers naturally are asking, where are the federal watchdog systems that oversee spending and prevent such massive waste of limited resources? What will be done for the millions of medically vulnerable Americans who were denied desperately needed care due to the inattention and the possible complicity of government officials?

Medical autonomy

A foundational premise of U.S. law is personal medical autonomy or freedom. The patient is the ultimate decision-maker with respect to his or her medical care – not the doctor, the insurance agent, and certainly not some nameless, faceless, unaccountable bureaucrat.

In the U.S., Americans’ medical autonomy has been subverted by the third-party payment structure. Because third parties — insurance companies and government — control patients’ money, third parties can decide patients’ care rather than the individual patient.

Autonomy can be defined as an individual’s freedom from external control or coercion. Clearly, Americans do not have medical autonomy when it comes to their  medical care. Though the law says they should have the final say, the recent COVID experience proves who is in control of Americans’ medical decision-making — it is Washington, not individual Americans. 

The only solution

Doctors know the only way to cure a patient is by treating the root cause. Band-aids, pain-killers and other palliatives may temporarily make the patient feel or look better, but the disease process continues.

U.S. healthcare is sick. It has been getting sicker over six decades — more expensive and less available — despite thousands of federal laws that were supposed to make care affordable and available. In fact, all these regulatory approaches have been fixes-that-backfire. They are the reason healthcare is sicker now than before.

The entire third-party payment structure and regulatory apparatus is the root cause — it has become a cancer. The curative treatment for patient Healthcare is to excise the cancer. Cut out the middleman. In healthcare’s case, that means cutting out millions of unnecessary rules, regulations and middlemen (bureaucrats.)

Financial control means medical control. To restore medical control and thereby reestablish medical autonomy to patients, they must regain financial control. And remember, it IS their money, as well as their lives.

If you want to make your own medical decisions and not be under the thumb of Big Brother “Doctor” Washington, deploy the Empower Patients Initiative, proposed by Americans for Tax Reform. It returns financial and therefore medical control where it belongs, in the hands of you, We the Patients.

Deane Waldman, M.D., MBA, is Professor Emeritus of Pediatrics, Pathology, and Decision Science; former Director of the Center for Healthcare Policy at Texas Public Policy Foundation; former Director of the New Mexico Health Insurance Exchange; and co-author of “Become an Empowered Patient.”  Follow him on X.com@DrDeaneW or visit website www.empowerpatients.info.

https://www.americanthinker.com/articles/2026/05/do_you_really_want_washington_as_your_doctor.html