I have informed readers in the past what is happening to our physicians in a post titled Who Is John Galt? Ayn Rand’s famous novel aptly described what is predictable and actually taking place in the past two decades involving U.S. health care and our society.
Reminder to readers and newly enrolled Substack followers- colored/highlighted text is linked to supporting or referenced information. Those of us who read Ayn Rand’s Atlas Shrugged, will appreciate that our nation’s doctors are disappearing. Just like the business leaders in her fictional work, doctors are checking out. In the novel, we learned that …
In reflection of this anniversary, I recently began a recent review of our American forefathers focusing on John Adams and Thomas Jefferson. This book is Timothy Sandefer’s book titled: Proclaiming Liberty:John Adams, Thomas Jefferson, and the Declaration of Independence.
Then, this past Monday I got an email for Lee Health’s CEO, Dr. Larry Antonucci, announcing the latest of many consolidation mergers that have been accomplished since Lee Health sunsetted their public charter and went to Non-Profit, private corporate status.
Dated April 27, 2026, his letter states: “We are writing to share exciting news. Lee Health and Florida Heart Associates (FHA) have entered into a definitive agreement to establish a long-term partnership” and “This partnership strengthens access to coordinated cardiac services throughout Southwest Florida, particularly as we expand our team, welcoming 16 accomplished cardiologists, 12 highly skilled advanced practice providers, and all of you who expertly care for and serve patients. Combined with Lee Health’s 52 distinguished cardiologists and surgeons, as well as 63 advanced practice providers renowned for clinical excellence, we are poised to further elevate the quality and coordination of care for patients across our community”.
Things look bad from over here
The Florida Heart Merger Rationale: The move is intended to consolidate specialized cardiac care under one administrative umbrella to prepare for the high-acuity needs of the new Lee Health Fort Myers Hospital campus. Regarding the new hospital, the 810 million dollar project is being built to hurricane-resistant standards and is positioned as the primary hub for the cardiac specialists recently integrated through the Florida Heart Associates deal. This hospital’s earliest date for opening is “early” in 2028.
A bit more digging and I learned there are 4 surgical centers in our community not owned or partially owned by Lee Health. There are a total of 15 actual operating rooms between the four and nine procedure rooms. Lee Health has ownership or partial ownership of 82 operating room beds in our community, the majority (61) are within actual hospital walls.
Lee Health has 350-400 primary care physicians in Lee county. They have an estimated additional 200 Advanced Practice Providers (physician extenders). Gemini’s sweep of the internet indicates we have around 450-500 non-Lee employed or private practice physicians. Unless the regulatory capture payment scheme is addressed, I am sure we doctors outside of Lee’s ownership are on the menu.
I have been sounding the alarm since the Patient Protection and Affordable Care Act was passed and clanging the gong since 2015 when the Medicare Access and CHIP Reauthorization Act (MACRA) was passed.
The present situation regarding our medical autonomy and the role of government can be summarized by these fundamental truths:
Of Limited Power: Our Constitution remains the supreme law, establishing a federal government of strictly limited and enumerated powers.
The Consent of the Governed: This government exists solely by the consent of the people, who concede specific, minimal authorities in exchange for the protection of their inherent personal freedoms.
A Modern Misplacement: Healthcare became a federal concern not by constitutional mandate, but at the whim of the “Great Society”— a recent and radical expansion of authority that misplaced the government’s true role.
The Perpetrated Myth: A powerful alliance—the American Hospital Association, the Federation of American Hospitals, and the AAMC, alongside the American Medical Association and dominant insurers—has successfully perpetrated the myth that healthcare is naturally unaffordable, thereby inviting further federal control.
The Capture of the Market: These self-serving interests have resulted in the Regulatory Capture of our healthcare market, creating a system that serves the institution over the individual.
A Maligned Weight: The American citizen and the independent physician are currently being crushed by the artificial costs and bureaucratic weight of this maligned system.
The Systematic Separation: Patients and physicians—the only two direct participants in the healing relationship—have been systematically silenced and separated by intermediaries.
The Cycle of Blame: In this fractured state, both patients and doctors have been conditioned to point toward the other, rather than confronting the centralized system that has trapped them both.
My contention is that no amount of lobbying or attempts to legislate within the status quo will actually solve the situation. The only true action the market participants can take is to learn the modern lesson of Sisyphus. Recognize, Let Go and Pivot.
The Direct Pay and Concierge Model physicians have stopped pointing fingers, stopped begging for alms and have pivoted to the free market of health care. As we get bolder and more fellow doctors are exerting their authority, the hangers-on of the status quo will begin suffocating on their self-made bureaucratic bloat, lose more market share that can’t be replaced by breaking the backs of individuals being flogged with mandated unaffordable insurance premiums.
Individuals can leave the big insurance models with their ever lengthening list of no payment rules, prior authorization care interference and usury pharmacy benefit arrangements and join health sharing as an alternative to the status quo. Fellow freedom fighter Twila Brase of the Citizens’ Council for Health Freedom offers a helpful patient toolbox to provide information for individuals when confronted by health access points of care laden with bureaucratic forms and consent requests.
Disclaimer: This information is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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