The following MACRA comments were written by a Kansas City dermatologist, Viseslav Tonkovic-Capin, MD, who grew up under Communism in Czechoslovakia.
I was born and raised in communist Yugoslavia. My dad was a 9 year-old boy when WWII started and was courier for partisans, i.e. resistance against nazis and fascists during the war. After the war it was easy to dupe people into communism, because as an idea it sounded great, but within a several months or years almost everyone realized that it simply will not work.
My dad became lawyer and judge just to end up in the political prison because of his disagreements with the communist interference into his judicial duties. In short order my entire family turned from communists and communist sympathizers into people severely allergic to anything resembling communism.
My dad summarized the difference between communism and the Free World:
In communism they claim that everyone should be the same, while in the Free World they believe that everyone should have the same chance.
We all must understand that we will never be the same- someone will work harder, while others would rather have fun and not work or work just to get by.
It is up to each individual to decide what she/he wants to do with her/his life, society should not preclude anyone to shoot for the stars. Communism was doing just that- first by sidetracking and imprisoning any dissenting people and even more pervasively- you would get paid the same as the lazy guy next to you, which was an ultimate motivation killer resulting in implosion of the entire society.
Communist bureaucrats flourished as they would come up with various meaningless and superfluous rules and regulations just to justify their own existence and their salaries, all at the expense of the entire society which got completely stifled,
ineffective and suffocated to its ultimate inglorious demise.
This is what is happening now in the US healthcare with these MACRA/MIPS and other meaningless and utterly experimental rules.
Has there ever been any successful business, trade or service in the entire human history that had similar rules and regulations?
I resolutely say no! There has been none.
Why then do they think that it would work in the US healthcare system? I know that it will not, as I and my family has already seen it in communism.
We need to go back to basic and common sense rules that where sharpened over the thousands of years of evolution of the human societies- you work -you get paid, you don’t work you don’t get paid.
You see patients you get paid, you don’t see patients you don’t get paid. Only patients (i.e. thousands of years old market forces) should decide who is doing good care for them just as you would decide if your hairdresser did a good job for you or not. Not some faceless bureaucrat in some remote gray, dark office, as they plan to do it now.
I could go on and on, but will stop here as I have to go to work!
Good luck to all of us!