Time to Rethink the Core Question: What Is Health Care?

By now we’ve all heard many stories of health policy makers, medical institutions, and even doctors seemingly act against the best health interests of the people and their patients. Doctors ignoring the real facts that Covid was never that dangerous for large swaths of the population, and equally ignoring that the vaccinations may cause serious harm. “Safe and effective,” they keep repeating. 

Last month Alex Berenson provided details of yet another example of a 14-year-old girl named Yulia Hicks. Duke University surgeons took her off of the kidney transplant list because she is not vaccinated. We were horrified in hearing such examples a full year ago, but incredulously they continue. 

Most of us have personal stories of close friends and family acting in equally peculiar ways. In my case, a doctor very close to me advised my daughter to get vaccinated in the summer of 2021 without talking to me at all. He didn’t know anything about her medical history or circumstances that would have potentially made the vaccine dangerous for her. 

I challenged him, and he apologized, but he essentially shrugged off anything I said about the relative unnecessity for her to even take the vaccine, given that Covid was not dangerous for her. My facts didn’t seem to matter. He also shrugged off any potential long-term effects, even as I pointed out the obvious, that many such effects could not even be known at that time. 

These stories go on and on, and extend to opinions of friends and family outside of health care. “You just have to take it,” we are told. 

What is this disconnect? Why are there so many people who believe that it is ok to demand that a girl be vaccinated before she receives other life-saving treatment? Surely, they do not wish her harm. Why are potential risks of the vaccines just ignored by a large part of the medical community? How can they see significant numbers of cases of myocarditis in young men, and not pause for a moment to consider the impact that the vaccine might have on their lives and families? 

I do not believe that all of these doctors think that when they advise these young men to take the vaccine, that they are intentionally trying to cause them harm. In fact, these doctors themselves believe that they are doing what is best for their patients. 

But how is this possible? How can one group of doctors prescribe the opposite as another group of doctors and both believe that they are acting in the best interests of their patients, when all the same data points are there for everyone to see? I believe that the answer to these questions lies in the central definition of health care itself, and the worldviews that create this definition. 

One worldview, the one I possess, is that health care is at essence an individual doctor/patient relationship. The doctor assesses the individual needs of the patient, whether physical or psychological, and plans treatment based on that. In Yulia’s case, my answer is obvious: the doctors must ignore their vaccination policy in the best health interests of one specific patient. It doesn’t even matter to me whether she had Covid before. Her parents’ refusal to get the vaccine, for whatever reason, is all I need to know. Clearly this worldview means there is a different treatment for each individual.

The other worldview, seemingly held by so many inside the healthcare system, does not rely on an individual assessment to understand health care. They view health care as being a general policy that applies to the entire population. If they have determined that in general vaccination is better than not being vaccinated, then they must require that everyone be vaccinated. 

They say that if their policy choice is correct, then they must just accept that there are some people who will not benefit or even be harmed by the policy. The statistics are all that matter. If they follow those, then they are in fact doing what is best for everyone. Doctors can claim that they are in fact working to help people. Their statistics prove it to them. 

This worldview has been brought into stark relief in the past two years with the various policies around Covid, but it has been taking root for quite some time. My father died in 2010, but in the years before his death, doctors had him on a wide variety of medications, so that every day he literally swallowed a handful of pills. 

What were they for? High blood pressure, blood clot prevention, predisposition to diabetes. Note that none of these are conditions from which he suffered in his life, they are all numbers, measurements, and statistics. He wasn’t being treated as an individual with a specific problem that needed to be addressed. He fit in this category, and that other category, and so the solution is a handful of pills every day, just like everyone else in those categories.

But what happens when the statistics don’t bear out the policy decision? We have an immediate example with the Covid vaccinations. All-cause mortality has been on a frightening rise, and it’s becoming more and more difficult to ignore the possibility that the vaccines could have actually caused this. Assuming that there is a connection, surely this flies in the face of the worldview that the vaccination program has been good for all of society. If the overall numbers of deaths have increased, doesn’t that mean that the vaccination program was a failure? Isn’t that the very definition of a public health policy failure? Again, in this case, many doctors seem to be unaware of this fact. How can that be? 

As baffling as this is, I think this too fits well within the worldview. When the medical community completely controls all health care decisions, that defines the success. Another way to think about it is to say that the overarching grand scheme is precisely to remove all decision-making from the individual about their own health care. In this sense, the vaccination program has been a success, regardless of myocarditis, nervous disorders, or even excess mortality. 

Of course things will not go perfectly well all the time, and there may be more harm than good in a particular campaign. But overall, if people just trust what they are told to do by the medical establishment, we will all be better off over the long run. They will just have to do better next time. 

But here we are now at a problem that cannot be solved. There is no reconciliation of the two worldviews.

The health policy worldview determines its success only in the fact that they have controlled the individual health decisions. Any mistakes in policy will be taken into account in the next decision. There never is a policy failure as long as the decision-makers remain in charge to tell us what is best. 

The individual worldview requires that each patient be treated uniquely, with a personal relationship with a doctor viewing their needs and desires as important and unique. This attitude is wholly counter to centralized control of all health care decisions. 

Where are we going? As much as I’d like to think people will ultimately reject top down control of their health care, that’s not what we’ve seen happen. The trend has been in place for at least several decades, and the emotional reaction against personal choice and individual care has been shockingly powerful in the past two years. This is despite solid and growing evidence that the vaccination campaign has been a failure in improving the health of the population. My hope is that there will be some change in attitude or some big event to get us back to health care for individuals, but I can’t think of what that will be.