I know that I will catch flack for this. I will hear the normal argument from those in my field who feel that I should know better, and those who have no idea how this business works but feel that they are pretty right on the subject. I will start off by saying I am not an expert, all I have behind me is experience and some graduate school training that has been aimed to help me better understand the current issues in healthcare and the economics behind it. This is something that I feel has nothing to do with Democrat or Republican. That being said, I do feel I have some strong points that prove why a more global healthcare market is the way to go.
1. Capitalism has no place in healthcare.
I know, it's the core of America and success, but in medicine it doesn't have a place. This is a business that should be about the people, not the money. How is it that CEO's of non-profit hospitals make a lot more money than those of for-profit facilities? This doesn't seem to make sense, yet that is how it is. Medicine is the business of people and taking care of them. Sure you know if you get into certain areas of medicine you will have good job security and a good salary, but you have to love this job because it cannot be about the money. I don't know how many times I have worked myself sick and went back for more because it's what I love. I didn't do this for the money, the money is just a perk for the sacrifice we make. Back to capitalism, If you don't have insurance and your 15 year old falls and breaks his arm it will get fixed right? Not necessarily. First you have to find a charity doc to do it, second a hospital that will do it, and third a ton of paperwork that will hopefully get you approved. You may make too much money, or when he is in the ER for the break they will feel as if it doesn't need emergent surgery and say see the doctor outpatient. Well that means they want their money upfront and may have arrangements that you cannot meet. Granted the doctor can work around it and hopefully he will, the fact that we are about money in medicine means it comes before you, unless you are dying. I won't go on anymore, but I hope the point is clear.
2. Those who need and have insurance are the ones who pay.
Maybe it sounds crazy, but it's true. The ones who have insurance pay because the corporations know they will be at least getting a certain amount. So if you are losing money in one area and need to make it up in the other what do you do? You jack up the prices of medicine, like we have seen over the past 15 years, Because here's the deal, most likely if you pay all cash, you get a discount for what the insurance gets if you pay your balance. So there goes the rate for cash payers, they are getting a discount most likely. If you are low income and can't afford it, they will try to qualify you for indigent programs and in turn discount all or most of your care. So now we have those who are insured. You insurance pays a certain amount, and I doubt they are going to discount that so they will pay more, and then you have the part you are responsible for. You may get a discount, maybe, but they can easily say this is what you owe and take you to court over it. The problem is that it has been done and these cases you see such things as someone paying upwards of $50.00 for one Tylenol. The problem is that you are paying for inflate medical costs, where one procedure can cost 60K here in the U.S., in Australia it is 10K... See a problem?
3. We are the last industrialized nation to still not have global health coverage.
Not the best point, but it is true. We aren't living longer than our neighbors of have socialized medicine, so I think it's safe to say that there won't be a quality gap. The idea is that medicine is a right not a privilege. People shouldn't die because they can't afford to go to the doctor, we are so advanced this day in age that it should not happen.
4. Medical costs would greatly decrease.
Those in the medical field have probably heard the term defensive medicine. To make it short, it's where a doctor orders tests that are most likely not needed because he/she is afraid of legal repercussions. Doesn't sound that awful because better safe than sorry right? Wrong, you pay for it, you get exposed to radiation that isn't needed, and may receive treatment that isn't needed because of it. It is a vicious cycle, but they have to protect their-selves and with the business the way it is, that tends to be the only way. A nice doctor may save a lot of people money, but he puts himself at a high risk of legal action. Therefore, the physician is forced to practice medicine in a defensive manner. On the other hand, when you are looking at it from a socialized standpoint, we are doing what is right for the patient and the public, not what is the best defensive practice. If you need admission you can get admission, if you need a scan get it, if you don't the government is behind the doctor who says the test is unnecessary and is not needed. The idea is that they physicians can practice responsible medicine that doesn't go over the top because they have more protection. In turn you have less overly radiated children, less unneeded procedures performed, and a significant decrease in cost of medicine. I could write a hole thing on this, but I just want to get across the basic point.
5. Everyone gets the care they need and the class system is removed from medicine.
Lastly, I feel that the most important thing here would be that everyone gets the healthcare they need. I am not claiming that this is the fix all, but it's a good start and we have many examples to go by to help figure out the system. If we think that our current system doesn't need fixing, we are greatly mistaken. ER's could no longer be a primary care clinic for those on Medicaid or government programs because they would be held to the same standard and the ER's would have more ability to refuse or refer out non-emergent things. This gives the power back to medicine, whom should be responsible for taking care of you. No more insurance companies dictating what you can and cannot do, it's what the physician feels is necessary and pertinent.
I understand there is a lot of work to be done here. This is just my perspective on why it would be a move in the right direction to go through and make this more of a reality. I think there is a lack of understanding about what socialized medicine would mean. I don't think people really understand what it means and how it works. I know that we use Canada as an example, but we have to understand no system is perfect and we would have to create our own. I found myself reading a copy of Emergency Physicians Monthly and was surprised to see that they were endorsing socialized medicine. I think when you pull out the politics and money, socialized medicine is the way to go because we are taking care of people because that's what we love, not because it makes money.
