Americans no longer have faith in healthcare workers or medical institutions.  According to Wisconsin Public Radio, 2022 was the worst year on record for attacks against providers of medical care. The New York City Council recently created an Office of Healthcare Accountability to "shine a spotlight on hospitals that charge exorbitant prices" and gouge the public.  

Apparently, we trust neither healthcare workers nor medical facilities to put patients first (as most hospital signage proudly proclaims).  This is not a misperception.  It is reality. 

In healthcare, both people and institutions serve a third party, government and/or insurance, rather than patients.  That statement is written with pain by this physician-author who practiced medicine for nearly half a century. 

Both people and institutions in healthcare want to do right by patients, but they cannot.  The masters they serve are government bureaucrats and insurance executives, not sick people. 

Your doctor doesn't choose your medication; a pharmacy benefits manager does.  You don't choose your doctor; a health plan does.  The patient gets the authorized procedure, not necessarily what is judged medically best for that patient.  The hospital schedules (effectively delays) your operation based on what the insurance company process dictates.  And patients wait interminably for care because of provider shortages created by low federal "allowable reimbursement schedules," AKA payments for services rendered.  Death by queue — dying while waiting in line for care not delivered in time — has become commonplace in the U.S. 

Third-party payers disconnect patient, or buyer, in market terms, from provider, or seller.  The third party tells the buyer what the third party will buy for him.  The buyer doesn't choose; the third party does.  The third party tells sellers what they are allowed to sell and what payment they will receive, regardless of published price.

Patients in aggregate, the public, rightly do not trust health care workers or facilities because they don't work for patients! 

This loss of trust is not isolated to healthcare. It is equally true of previously trustworthy, great federal institutions such as the CDC, NIH, CMS, FBI, DoJ, and EPA, as well most news outlets and social media.  Every day, there are reports of partisan censorship and cancel culture.  Americans understand that political advantage rather than public welfare drives decisions at the highest levels of government, both elected and especially appointed officials, along with complicit media corporations. 

The COVID debacle is a prime example of loss of trust in healthcare.  Americans trusted Fauci, the CDC, the NIH, and the FDA to protect us only to learn they pushed a false narrative; suppressed contrary scientific data; and mandated lockdowns, school closures, social isolation, and an untested vaccine — policies that irreparably harmed the public. 

Ex-president Trump has been indicted for mishandling classified documents.  Where is similar prosecution for President Biden's similar behavior?  And where was prosecution of Hillary Clinton for putting uncounted classified documents on her private email server and then hiding them from scrutiny?  Numerous Americans were convicted of illegally occupying Congress on January 6, 2021.  Where were prosecutions, much less convictions, when protesters established the Capitol Hill Autonomous Zone (CHAZ), took over federal buildings, and demanded elimination of police and court systems?  Is this not by definition sedition, as claimed for Jan. 6 protesters?

When Americans see unequal application of the law, they lose faith in the Department of Justice, supposedly the defender of rule of law. 

For more than two years (2021–2023) front pages were dominated by the investigation into alleged collusion between the Trump campaign and Russia.  Representative Adam Schiff (D-CA-30) repeatedly announced, "I have the evidence!"  James Comey, then FBI director, obtained FISA court permission to spy on Americans.  We now know that Comey lied to the FISA courts when obtaining the warrants.  Where is there any consequence for his and his agency's malfeasance?  When Americans see weaponization and partisan manipulation of what should be our premier truth-seeking, supposedly objective investigative body, they lose faith in the FBI.

Mainstream media, both news and social, aggressively push the charge of systemic racism — whites prejudiced against and oppressing blacks.  How, then, to explain YouTube canceling the channel of prominent black female commentator Candace Owens?  The amendment that protects free speech was placed first in the Bill of Rights because it was considered the most important.  The First Amendment doesn't protect "acceptable" speech — it is intended to stop government from "abridging the freedom of speech."

When speech labeled unorthodox is "canceled," when the rule of law is abrogated, when our communications with each other are filtered, and when Washington takes away freedom starting with medical autonomy, no wonder Americans lose faith that Washington is basing its behavior on the most fundamental principle of our nation: freedom. 

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; and author of the multi-award winning book Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine. 

Image via Pxfuel.