Yet that’s not stopping government intervention into the doctor-patient relationship from state to state, completely oblivious to the lack of jurisdiction to interfere in this professional relationship. Imagine if the government started wanting to regulate how people practiced their faith?

Yet Virginia is the 8th state to join the sad group of government bodies who think it’s perfectly okay to pass laws governing how doctors will interact with their patients in the patient exam room. Virginia’s new law requires doctors to perform an ultrasound procedure for a woman considering an abortion, regardless of the woman’s preference or choice. (The law passed does not require a transvaginal ultrasound.)

What’s going on here?

Part of the problem is that few politicians are actually doctors, so very few of them understand what the hell they’re talking about. The only doctor in the Virginia Senate spoke up, and nobody seemed to care:

Senator Ralph Northam, a Democrat and the only physician in the Senate, called it “a tremendous assault on women’s health care and a tremendous insult to physicians.”

That’s never stopped politicians though. They seem to revel in both their religious beliefs (contrary to the separation of church and state doctrine that is the foundation of our country), and their ignorance of professional areas like the physician-patient relationship.

It gets worse…

In Alabama, the Virginia furor fanned new controversy over a proposal in the Legislature, prompting a swift reaction from voters and the author of the bill, which is called the “Right to Know and See Act.”

Even if it is amended to offer a choice of probes, the bill would contain some of the country’s strongest pre-abortion mandates.

It would require the ultrasound screen to face the woman while the doctor narrates the images, although the law states that it should not be “construed to prevent a pregnant woman from averting her eyes,” the bill reads. Doctors who do not follow the prescribed routines could face felony charges and could be sued by the potential father and grandparents.

Wow. Just wow. This is about the most ludicrous thing I’ve ever heard in my lifetime. Is it now the government’s job to prescribe medical procedures… not just what is done, but exactly how it should be done?

A woman who is already seeking an abortion in any state already has the “right to know and see” their fetus. This was never a choice taken away from women. But now the government — led by Republicans who constantly claim they want less government intervention in our lives — is taking that choice away, state by state. Idaho appears to be the next state likely to pass a similar measure.

I wonder what’s next. Telling us how a rectal examination for prostate cancer should be mandated for every male age 22 through 72 with a specific time period (“a minimum of 5 minutes during which time the physician will ensure they thoroughly determine through digital insertion the texture of the anus to preclude any potential cancerous lesions”) and method (“the patient will view the examination through an appropriately aimed camera, which will also be broadcast on an Internet service so others may benefit from the pre-knowledge of the individual’s care”).

Of course not. Because none of these politicians would ever think to pass bills that regulate male-specific health care in any way, shape, manner or form. You will never see a bill passed that suggests the government shouldn’t be paying for Viagra pills (they do), or how exactly vasectomies should be performed.

For some reason, when it comes to women and women’s health care, politicians seem to feel they have free rein. Why?

I suspect it comes down to a combination of ignorance — lack of actual experience in the world of medicine — and religious belief that overrides a politician’s common sense. Then throw in some male bias for good measure. If these legislatures were composed of a majority of women and/or doctors, I strongly suspect these laws would not be passed. If Republicans actually believed in their rhetoric of less government regulation, they wouldn’t be passing these laws.

But because they’re composed mainly of old white men with a Christian background — people who will never be in a position to consider an abortion — they seek to impose their own personal religious-based morality on the rest of their constituents. This suggests that their beliefs are more important than the personal doctor-patient relationship between a woman and her physician.

Americans seem increasingly content to let their government regulate more and more of their lives, ignorant of how this may someday directly affect them (even if the exact current regulations do not). It’s a sad chapter in American health care, and hopefully a wake-up call for millions of women voters in the next election.

For additional reading:

• Virginia Ultrasound Bill Passes as Other States Take Notice

• Virginia Gov. Bob McDonnell signs Virginia ultrasound bill
• Democrats ride Romney’s Planned Parenthood remark, ‘We’re going to get rid of that’

What is the risk that, as soon as the health care system reform becomes an intense focus of policy (as it is now), more and more attention will get devoted, not to controlling health care spending, but to continuing to spend while finding reasons why what was just spent does not form part of what could/should be reformed? Based on the developments of last 2 weeks, including the huge fight over the real cost of the proposed reform and the continuing discussion over Atul Gawande’s masterful article, “The Cost Conundrum” , my guess is that we are heading straight into Goodhart’s kingdom. Seriously, when was the last time you saw a winner of the Nobel Memorial Prize in Economics make a comment in a blog post about health care?

Discussions about the reform of the system are clearly no longer directed to improve care, outcomes and  patient experience. On the contrary conversations have become almost exclusively about lowered costs. It is as though most of the people involved in thinking about the reform really don’t want to remember that medicine (the topic central to health care reform) is all about you and me, the current and future patients, not about saving an array of professionals whose income has become totally dependent on the accumulated and constantly growing dysfunctions of the system.

Health care reform should start with simply accepting that all human beings have the right to be treated as human beings, in sickness just as much as in health. As long as our bodies remain the best income proxies for millions of Americans whose business depends on extracting as much value from sickness as possible we will have a nasty case of Goodhart’s law and real reform will remain impossible.

Pay attention to how the politicos and the media are churning news, almost non-stop, about how much the reform will cost. Will it be $1 trillion, $1.6 trillion or $3.7 trillion? Ask the average person and they’ll almost certainly look at you with eyes filled with fear and guilt, because everybody knows something must be done but frankly, the more we hear about it the more we experience that it’s just too overwhelming.  We have been spoon fed sophisticated lies for too long. Because we have been used as the proxy source of income for all the participants of Opaque, Inc we have never been told:

• what is the real cost of care for each one of us and,
• how we have been brainwashed to believe that so called unlimited medical choices always result in better outcome.

Attacked by soundbites that include one of the huge numbers, we become paralyzed and unable to start questioning any of the statements made by each of the defenders of the established order, as well all the statements made by politicians who are almost always motivated by undeclared biases.

But when the dust settles, we will be left with one simple question. Are we getting better care than before? My theory is that you cannot reform the health care system as long as you fixate on the system. It is too broken and too dysfunctional for multiple reasons as noted by countless experts. But almost none of these experts live and breathe what the people in this blog are experiencing daily.

Health care is not about money, it is about care. It is not about RBRVS, it is about helping the patients having to make complex decisions about pros and cons of various treatment options. It is not about private insurance vs public plan, it should be about health and wellness. It is not about unnecessary procedures, it is about ending the paternalistic model of medicine. Truly empower the patients and they’ll be able to see through many of the dysfunctions and will force changes faster than any mandated reform.