Aircraft carriers?
Wednesday, January 14 2009
Louise at Colorado Health Insurance Insider won a spot in my heart by being among the first people to link to this blog, so it pains me to see her taking Dr. Rich at face value.
Sure, if you let Dr. Rich own the discussion of universal healthcare, it sounds awful. Dr. Rich doesn’t like universal care, is pissed off because it might be imminent, and doesn’t have any reason to treat the matter with any sincerity. Instead, he frames the debate with this question:
Under our system of universal healthcare, will Americans be permitted to spend their own money on their own health?
Which he then answers thusly:
For many who are proponents of universal healthcare, the answer to this question is clearly “No.”
There are times in blogging when a link (at least one) is mandatory. This is one of those times, but Dr. Rich doesn’t point to a single proposal for national healthcare reform that suggests what he is decrying. Not a one. Instead there’s a lot of hand-waving about “Prohibition” and “the collective”.
The rest of the post is wasted on fantasy – like offshore hospitals on former aircraft carriers. You would think someone would already have thought of this, given the hundreds of millions of people presently living in universal care systems. Dr. Rich claims that in a system of universal care, “human nature” will drive people to look outside that system to satisfy their needs: are these foreigners not humans? Where’s their aircraft carrier? Or maybe – just maybe – these systems actually do a pretty good job of satisfying their citizens’ needs.
Granted some people will not people satisfied: and what difference does it make? If most people are satisfied with the universal care system – as most people are in most of the industrialized world – who cares that some folks will want to sneak off to Indian reservations or foreign countries or even aircraft carriers?
Dr. Rich claims to be worried about freedom, but he’s really only interested in his freedom to take money from sick people. For those sick people, few ways to organize healthcare could be more illiberal – more suffocating – than what we presently have. A universal care system would free millions of people to live better, happier, more productive lives. And for the few disgruntled cranks left over: let them have their aircraft carriers.
Clearly, a two-tier system is not in the best interest of universal healthcare proponents. Most physicians would choose to take high-paying patients, whether they are privately insured or self-paying, rather than going through a government system wrought with excessive bureaucracy which pays out less to decrease systemic costs. Why deal with the problems of working for the government, which include more headaches for lesser pay? This will lead to fewer physicians becoming a part of the government’s system and less access to medical care for individuals within the government system.
The government must absolutely prohibit self-pay to prevent this situation. Without it, the two-tier system will result.
Peter – you’re assuming there will be enough people with the means and dissatisfaction necessary to support a second-tier, and that most doctors will find universal healthcare unacceptable. These are far from proven assumptions; if this is something that happens in real life, you – or Dr. Rich – ought to be able to demonstrate it from the dozen or so industrialized countries with functioning universal healthcare. So far all I’m seeing is a lot of inference, and not a lot of evidence.
Many physicians (30%) already are extremely dissatisfied with Medicare and Medicaid and refuse to take on new patients in that category. That percentage will grow as Medicare goes further into bankruptcy and makes deeper payment cuts. This is the reality of medicine today as a result of government involvement. Extrapolate to see what happens when the government’s role expands. If 90% of physicians refuse to be slaves of the government, where will the patients go?
Where the physicians go, the patients will follow.
P.S. NHS in Britain prohibits patients from purchasing certain medications outside of the government.