Author’s Notes: This one is pretty straightforward. I shouldn’t have to do too much to it. There are a few places I just have to re-word it because the expression now drives me nuts.
There are currently many problems with American health care, and many are concerned about the future of health care in America. Our presenter proposed that the future of health care reform is in the present and our actions today will have an effect on health care for at least the next 20 years. I would not disagree with her on this point. I would also not disagree with her that quality, price, and access are the most important aspects of health care that those involved in the reformation of the system would need to reconsider. The issue on which I do disagree with our present is that a form of socialized medicine is the best way to reform the system.
Quality is a huge concern; the majority of Americans want the best care by the best physicians if it is within the individual’s means to do so. When the best care is out of reach of the individual, the individual still chooses the best health care provider that fits the budget. Not all physicians are the best or most competent. I am not convinced that socialization of medicine would allow for the continuity of care Americans have come to expect from providers. Should the nation switch to a form of socialized medicine, many physicians may discontinue practice due to burn out from not being able to handle the workload. Quality decreases from sheer numbers that have access to the system. The increased workload would affect medical schools; they would have to decrease not only the time spent learning the trade but also what is taught in regard to the trade just to provide enough doctor’s to meet the needs of the public. Quality would again be decreased because the prospective doctors’ experience and knowledge would be less. If the government were to monitor the curricula in medical schools and set up standards which every prospective doctor were to maintain (Hello, young grasshopper! They already do–it’s called licensing.), I might feet more comfortable; however, familiar with the tendency of government either to fail to monitor industry or to ignore obvious violations of law and ethics until public outcry demands justice, I do not see the implementation of a standard curriculum or enforcement of the curriculum anytime soon. (There are none so blind as those who will not see. I don’t like outcomes based education and common core; therefore, even with their implementation, I can’t see how it could extend beyond the current classroom.)
Cost is yet another problem. Allowing everyone access to the system means that there will be people who cannot afford to pay for the care they receive. The money has to come from somewhere. It is neither right nor just that those who cannot earn their living or cannot make ends meet are denied access to care; however, it is neither right nor just that those who can and do earn a living, who make ends meet, and who can afford to pay for care are forced to pay for the inability of others to pay for the care. (Except this is what happens through higher fees, premiums, deductibles, and co-pays…) The money has to come from somewhere. Doctors will not be willing to take voluntary pay cuts. Why should they? They spend twice as much time receiving their educations as the average American and deserve a comparable wage. Pharmaceutical companies cannot afford to decrease costs. (I could beg to differ, but I won’t for now.) Many of the chemicals used to created prescription medicines are very costly, production is not easy, and the purity and quality of the drug must be very high so that people are healed and not harmed. All of these factors result in high costs. Were income to be cut, the pharmaceutical companies could not afford to continue production. (Or to do research to find new drugs, as the session leader noted.) The costs for socialized medicine will have to come from the taxpayers of America who already feel very overwhelmed with the amount paid to the government. (Again, there is nothing new under the sun.) I do not see that the support for socialized medicine will be high when increased taxation becomes the means to support the system. (That’s why they play the name game. It’s not a health tax; it’s a penalty when you choose not to participate. It’s not socialized medicine; it’s a new law to ensure everyone has equal opportunity and access.)
Access is yet the third issue. While I agree that all should have access to high quality care, I understand the weariness that could descend upon the medical profession were every ingrown toe nail and hair treated. (Translated: let’s all be wise consumers and do as much for ourselves as we can.) I also understand the need for increased access in rural areas; were it not for our local family doctor, the nearest doctor would have been 30 or 40 miles from our home. With increased participation, in order to avoid over-burdening the system, someone would have to determine who does and does not receive care. The problem with a human gatekeeper is the human gatekeeper is not God. (Shades of the Veterans Administration scandal, anyone?) There is no way of knowing without tests if the nausea a patient feels is morning sickness, a migraine, the stomach flu, or a symptom of a more serious cardiac ailment. My mother had rheumatic fever as a child, and it damaged her heart valve. Before her second surgery, despite all her symptoms, the diagnostic test failed to show the severity of her issues. Under socialized medicine, she would not have had her surgery because the tests showed nothing (and she would have missed grandkids and my second and best wedding). Because the system was not socialized, the doctor opted to do the surgery on past history and strength of symptoms alone. During the surgery, it was discovered my mother’s heart was in severe failure and she would not have survived another week.
I realize that the problems I have raised are those which others have raised before. The solutions are vague and fleeting. I do not have a lot of optimism that there will be a solution that satisfies everyone. I fear that the middle class will again be saddled with everyone else’s problems because the poor just cannot afford to take it anymore and the rich have enough money and power to weasel out of anything that becomes mandatory. The real question is whether health care is an inalienable right that ranks with life, liberty, and the pursuit of happiness or privilege afforded only to those who can afford to pay out of their pocket or who work for a company that offers insurance.
Well, well, well… here we are 20+ years later under Obamacare. Only a year in, so it’s hard to judge its efficacy. I will say I am not better off since the implementation of this law. The doctors I see at the various practices seem more tired, and their office workers are guaranteed work through more paper work. The middle class is still squeezed by onerous taxes and laws. Increase law just does not improve a situation.