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Government Medical Care for All?

Not much happens these days without some form of extreme reaction by the public. People are demanding changes in healthcare as much as the chaos in politics. I am not surprised since the practice of medicine is embroiled in the politics of healthcare. From the pharmaceutical companies and pharmacies raising drug prices beyond a working man’s wage to big medical insurance companies charging more and more for premiums and delivering less and less to increase their profit margins, we Americans are in a fight for our lives.
 
One confusing part of the healthcare equation is that a practitioner has a sacred bond with their patient, but a third-party payer is responsible for the reimbursement for patient care. Many of these third-party payers most times cares more about penny-pinching than delivering high-quality medical care to their annuitants. The physician has an incredible number of mandates put upon them – many of them create moral and ethical conflicts for the physician - only to find that the practitioner is as vulnerable to the demands of the third-party administrator as they are to the patient. Big Medicine – corporately owned practices - typically embrace Big Insurance because they derive financial rewards from them. Long gone are the days when patients could pay (barter with) physicians by delivering them farm raised eggs every week or repairing their roof when it gets damaged by a massive storm. The small-town community physician is fading into the sunset.
 
It appears that the medical insurance industry is starting to implode; the private medical insurance industry has milked the American public for all the money it can. Medical care costs are rising exponentially; no insurance company can survive with outrageous profit margins if they are genuinely delivering high-quality care to their members. Politicians are speaking up, demanding that some form of Medicare be responsible for everyone’s healthcare. Years ago, I thought physicians would shun such a solution with every fiber of their being. Recently I have heard physicians open to a single-payer system offered by the government. No physician I know wants CIGNA to be a third-party administrator for their health insurance much less Medicare. But CIGNA has a long track record of administering Medicare in almost every state.
 
The ramifications of a single payer system are beyond the scope of this blog. However, there are a few aspects of healthcare that citizens should examine before they get on the only-payer-government bandwagon. The first is the number of physicians that will be available to treat patients under the government plan. Second, will there be alternate healthcare practitioners who could still provide care for cash? Third, who will oversee the system? Forth, how will the current divisive and discordant group in Congress work together to find the best solutions for the highest number of patients? Fifth, should citizens do away with State Licensing Boards and establish a Federal Licensing Administration to reduce the local politics related to a federally mandated program? Sixth, how many other questions will be asked and answered before our citizens are invited to jump off the private insurance healthcare cliff without a parachute?
 
Canada and other socialized healthcare systems cut costs by reducing the number of physicians that are available for delivering healthcare. Our US medical schools do not educate enough physicians for our citizen pool as it is. The USA is a net importer of physicians worldwide. Will the federal government encourage the growth of medical schools to supply more American physicians to our public? I do not think so.
 
I do not have answers to these questions; at least I am thinking about them. I am a Democrat. The idea that Bernie Sanders or Alexandria Ocasio-Cortez represents my thoughts on healthcare reform is absurd. I find that these politicians and others like them are not serving anyone, even though they repeatedly say they are speaking for their constituencies. Their dissatisfactions with the current healthcare programs are well founded; both patient and physician are discouraged. Both politicians are not socialists; they are capitalists. They believe in money and aspire to acquire as much of it as they possibly can. Both are using Politics to generate personal financial gain, not private industry.
 
Bernie Sanders did not work until he was elected into public office in his forties. Alexandria Ocasio-Cortez served as an educational director for the 2017 Northeast Collegiate World Series for the National Hispanic Institute. Both candidates believe the government should employ those who do not have jobs for whatever reason but only as a last option. They envision a bigger government. Both think a college education should be free to the public. Both ideas are socialistic, but neither Sanders and Ocasio-Cortez are dyed and true socialists. They are capitalists using their government connections to make a living, pandering to those members of their respective voter blocks who believe they are disenfranchised for one reason or another. These two aren’t socialists. These two are angry people, appearing to hold a grudge against the wealthy and influential in our country.
 
As a Republic, we must vote for representatives to our Congress who represent us. A democrat is someone who believes that the majority rules. As we categorize most of the Congress, these two individuals are in the minority, much the same way Hubert Humphrey was when I was a young man. We need voices to represent all sides. We also see them for who they are: capitalists camouflaged by socialistic ideas. I know several wealthy preachers, ministers, and rabbis who are capitalists, espousing equality of rights, opportunity, and treatment for all. Their churches and synagogues do not pay taxes. They get their power from helping those who need help. I see Sanders and Ocasio-Cortez the same way.  
 
Expediency in government typically ends up with a greater disturbance than the one the changes were intended to fix. I see our schizophrenic public loudly demanding change that might be expeditious, but very short of the intended goal of doing the greatest good for the highest number of people. And we all know that changes for the highest good of all may be detrimental to our needs on an individual basis. All of us want healthcare reform, but most of us desire compassionate physicians who speak fluent American-English, who have the freedom to spend as much time with their patients as they need to take a thorough history of our illnesses, who have the knowledge base to order and interpret clinical testing results accurately, and who have a firm grasp of their patient in their entirety, so they can prescribe the most appropriate treatment for them, steering clear of potential drug interactions and untoward side effects.
 
Healthcare reform should include all Americans and put the Physician-Patient relationship first in all ways, returning the responsibility of health to the patient, allowing them to make choices based on their world-views. Unfortunately, there is much more money to made in the healthcare industry by telling you what’s best for you than doing what’s best for you.
 
Yep, we need healthcare reform. But first, we need education reform which might lead to excellent healthcare reform. Then again, maybe not. Follow the money, always follow the money.
 
Doc

 

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