By Joseph Q. Jarvis | Published: 4 July 2026
There were four physicians serving in the Continental Congress in 1776, all of whom signed the Declaration of Independence and heard the Liberty Bell ring. They, along with their colleagues, believed that signing that document would probably lead to their deaths by hanging for treason. That was a courageous act; the collective courage of these men, their fellow delegates to the Congress, and many, many other Americans who lived and served as patriots during the years of the Revolutionary War, is what we celebrate today.
Only one of those four physicians actually had a real medical degree—Dr. Benjamin Rush. He received his medical education at the University of Edinburgh. His medical practice was up to date for the time meaning he was using bloodletting, including leeches, for virtually every malady. It is likely that patients who were brought to the attention of medical doctors during the Revolutionary War era were more likely to be harmed than helped by the care they received.
Dr. Rush was a forward thinking man who had the courage of his convictions. He had a history of trying to solve societal problems using the openminded methods of the Enlightenment. His treatment of the mentally ill has warranted a posthumous designation as the Father of American Psychiatry. On Independence Day, I celebrate Dr. Rush and am grateful to him for his lifetime of service to the cause of liberty and social progress.
Progress in medicine, however, was slow in coming. It remained the case that patients were more likely to be harmed than helped by medical doctors until early in the 20th century. For most of that century, patients were marginally better off seeing a physician than not, on average. Unfortunately, just as progress in medicine was actually improving the odds of success in the care of the patient, such that physicians were offering more than marginal improvement in outcomes, American business made access to physician care increasingly difficult.
When I was training as a medical student in the late 1970s and early 1980s, the percentage of American workers receiving solid health benefits from their employers reached its zenith. And then something happened to those benefits to make them less solid. Just as remarkable new diagnostic technologies, such as CT Scans, became available, and remarkable new pharmaceuticals reached the market, such as cimetidine, ‘managed’ care became increasingly common.
‘Managed’ care is a euphemism for methods to distance patients from care in order to optimize profits. The tricks of the trade in health insurance always come out with benign sounding jargon. ‘Health maintenance organizations’ sound like wonderful business plans, but what they actually do is delay, deny, and defeat care and the professionals who treat illness and injury in order to make more money.
For instance, as one of two principal regulators of managed care in Nevada during the late 1980’s, I witnessed a new innovation in managed care by Sierra Health Services, the largest HMO then active in the Silver State. Sierra Health Services began to routinely deny payment for routine care. Why? Because of what is called “the Float”. The funds that Sierra Health Services had received in the form of premiums were ostensibly available to pay for medically necessary care. If a claim was filed by a physician who had provided care to a patient who was a Sierra Health Services beneficiary, but was denied, then those funds could be diverted away from accounts payable into a “Float” fund that could be invested. Claim denial often became permanent because beneficiaries could only overcome the denial if they appealed it, and many did not. That of course improved the bottom line of Sierra Health Services. However, if an appeal was initiated by the patient, and eventually approved, then the float still had use of the funds for the interim time, often as long as weeks to months. While the bottom line for Sierra Health Services always improved with each of its ‘managed’ care innovations, the likelihood of patients seeing a benefit from medical care which was thus ‘managed’ declined.
We are at the point in American history where our nation’s capacity to improve human life through our collective will and policy is immense, but, in the case of health care, we are not improving. We are sliding back to the time when the odds of harm with health care are greater than if the patient stayed away from the health care system to begin with. The business of American medicine is imposing bloodletting upon the American populace. Health insurance is a rent seeking enterprise, extracting wealth from health care without adding value. Health insurers are thus leeches sucking the life out of both patients and doctors.
Denial of care is not liberty.
Surprise bills are not freedom.
There is no point in conducting research funded publicly to find new treatments for cancer and heart disease if deductibles keep patients from seeking life and happiness.
Today, July 4, 2026, 250 years after Dr. Benjamin Rush signed the Declaration of Independence, celebrate his courage. Be glad for this land of opportunity where each of us has a right to vote and participate in our nation‘s political life.
But, remember, if Dr. Benjamin Rush were here with us today, he would be astonished at the remarkable ability of modern medicine to treat patients, and chagrined at what he himself had done to patients in his day. But he would also recognize the medical industrial complex for what it is, a plague on the American people which causes all of us to suffer, bleed and die unnecessarily and bleeds our family and public funds dry for the enrichment of the few.
Let us therefore resolve to end the tyranny of health insurance over American physicians and patients. We at the Utah Cares Political Issue Committee have drafted the Declaration of Independence from the business of insurance in health care, known as the Utah Cares Act (read it at View source at utahcares.health) and invite all Americans to join with us to get this Act on the ballot in Utah. Once we succeed here, we will bring that success to every state in the Union.
Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.