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Carter: Freedom of choice in care
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This past weekend as we celebrated Independence Day, many of us paused to acknowledge the heroic efforts of those who have fought and those who are still fighting for our independence. We are blessed to live in the greatest country in the world and, for that matter, the greatest country ever known to mankind.

The 56 men who signed the Declaration of Independence in 1776 were from all walks of life.  Although all of the signers are described as being professional politicians, they represented many different professions.  

The only physician to sign the Declaration of Independence was Dr. Benjamin Rush from Pennsylvania. One of the foremost respected physicians of his time, in 1787, Dr. Rush tried to have the protection of “medical freedom” inserted into the Constitution.  

Dr. Rush warned that unless Americans were guaranteed their medical freedom in the Constitution, “the time will come when medicine will organize into an underground dictatorship and force people who wish doctors and treatment of their own choice to submit to only what the dictating outfit offers.”  

Although unsuccessful in his attempts to have “medical freedom” added to the Constitution, some believe that Dr. Rush’s predictions could potentially become true.        

President Barack Obama has made health care reform his number one domestic priority and has said that he hopes to have his programs through Congress and in place by the end of the year. Many are concerned that we are well on our way to government-run health care and that socialized medicine is almost here.  

In anticipation of these oncoming universal health care mandates, at least one state, Arizona, is introducing a resolution in their legislature that would amend the state’s constitution to assure their citizens have the freedom of medical choice.  

In November 2008, Proposition 101, The Freedom of Choice in Health Care Act, was on the ballot in Arizona and was narrowly defeated by less than 0.5 percent of the vote. Supporters of the new measure believe that this year, a different political landscape in Arizona combined with the fear surrounding proposals coming out of Washington, will lead to a different result.

Needless worry or legitimate concerns? Certainly a case can be made for both.  

Like many, I believe that the health care system in our country is the greatest in the world. However, during the nearly 30 years that I have practiced pharmacy, I have seen a steady trend of erosion of patient rights that has escalated recently.

Most doctors will agree that patient drug therapy is no longer being decided by physicians or pharmacists but instead by insurance companies. Hardly anyone can afford to buy a medication that is not on their insurance’s formulary. And getting a prior approval for coverage of a medication outside ones formulary practically requires an act of Congress.

Many patients who have been stabilized on a particular medication for years are forced to change because it is no longer covered on their insurance.  

Drug manufacturers, whose research and development efforts have resulted in breakthrough drugs over the years, are now questioning whether to continue these efforts out of fear that their new drugs may not be covered on most insurance plans.

Patients are often forced to leave a physician who has provided care for them for years because the physician is no longer in their insurance’s network. The physician-patient relationship, so vital to quality health care, is now jeopardized by the decisions of insurance companies.

As President Obama and Congress grapple over the changes that are to be made to healthcare in America, perhaps they would do well to remember the Hippocratic oath that physicians adhere to in their practice — “to help — or at least to do no harm.”