You pay for what you get....

"Every Cause has its Effect; every Effect has its Cause; everything happens according to Law; Chance is but a name for Law not recognized; there are many planes of causation, but nothing escapes the law."
~The Kybalion


The frequently invoked colloquialism “you get what you pay for” often appears to be untrue.  You might think that, according to this idea, if you pay top-dollar for an item or a service, you will be guaranteed to receive a top-notch item or service in return. You may be able to remember specific examples when this hasn't been the case in your life.  You might be tempted then to dismiss this expression, and condemn it to a life of imprisonment  in some dark corner of your mind, with all of the other misleading statements you've collected in your years.

The esoteric root of the phrase, however, conveys an immutable universal law.  Sooner or later, one way or another, we always pay for what we get.  There is no effect (getting) without a cause (paying).  In Hermetic terms, this is called the Law of Causation.  In the health care industry, this law has been confounded for many decades by the ever-expanding presence of third party payers.  Now, the insurance company steps in the middle, and receives payment from a business in exchange for taking on risk for its employees.  When an employee seeks care, the insurance company is expected to pay for the care.  The doctor provides the care, and then asks for payment not from the person to whom the service was given, but from the insurance company, an impersonal entity with an address on the other side of the country.  It begins to become very unclear where the causes and effects are in this scenario, and consequently, nobody feels accountable for what happens.

During my 16 years as a dentist, I have seen the value of a doctor’s care, skill, and judgment fade into the background.  I think people still want good doctors, but the trend seems to be that we no longer think we should have to pay them.  Those insurance megacorporations with the big buildings downtown will take care of that kind of stuff for us...won't they?

I've come to see that the only way I can directly correlate value with service is to engage in voluntary direct exchange with another party, quid pro quo.  I still believe the doctor-patient relationship to be sacred, and the involvement of outside “third party payers” in the decision-making and treatment-planning process contaminates the primary goal of treatment, which is always for the patient to heal.  The best doctors are knowledgeable guides who harm no one, while they lead their patients to ever-higher levels of health and well-being.  Insurance companies are like charlatans, bandits, and gypsies along the path, whose only interest in the traveler is to cleverly lead him off the path, onto the collectivist paddy-wagon, and ultimately separate him from his money.  

Be wary, America.  The guides are disappearing.