On the subject of doctors supporting socialized medicine, a reader writes:
“In my experience, a lot of doctors are in the front line of ‘everyone deserves health care as a right.’ Is it because the caring and ‘altruistic’ go into that line of business? A lot of them dislike ‘big pharma’ as well. This is just what I’ve picked up talking with some physicians.”
What’s wrong with “big pharma”? Why is something bad just because it’s big? I want important things like medication to be manufactured and brought to market by big, competent, profit-making companies. Of course, I have nothing inherently against small companies, either. But mass production always requires big companies. Big is not always bad, and it’s often good.
Probably the biggest mistake that doctors make is assuming that politics doesn’t matter. Given the senseless behavior and inherent foolishness of most politicians, one can understand their attitude. Doctors have much more important things on their minds than the posturing, power plays and pettiness of politicians.
At the same time, the politicians who most Americans don’t respect have been handed a whole lot of power to control medicine. No other profession has been turned over to politicians in this way.
Probably most people would say the most important two professions are medicine and law. I don’t see anything like the equivalent of Obamacare, Medicare and everything else being imposed on lawyers and their clients. What would happen if politicians passed a law establishing a ‘National Legal Board,’ authorized to set reimbursement rates for lawyers and create government programs to make sure everyone has a lawyer, on demand, provided by the government? If medical care is a right, legal services should be a right too, shouldn’t they?
You’ve never seen this happen and you’ll never see it happen. This is because the vast majority of politicians are lawyers. The last thing they’re interested in doing to themselves or their colleagues is subjecting their salaries to government directives. And the last thing they want to do is disrupt the marketplace for their business by having the government become the primary or exclusive provider of their services. It’s not going to happen.
Yet with doctors and medicine, it’s a whole different story. And doctors have allowed it to happen. They are sanctioning, directly or passively, their own destruction.
I try to give doctors and other health professionals the benefit of the doubt. They’re uninformed and preoccupied with more important things. I like the fact that they’re preoccupied doing things that are so admirable, and could be of potential relevance to me someday, should I need a doctor for an illness. But keeping your head in the sand is not admirable. At a minimum, they should be directing their professional organizations to stop assisting in the gobbling up of their profession by government rules, regulations and bureaucracy. They should demand a free and open market for medical services, or even start establishing one themselves.
Before long, I believe a free market for medicine will happen—because it will have to do so. Currently, even many doctors fail to understand that the problem with our ‘health care system’ as we know it is not private, for-profit insurance companies. The problem is that it’s a third-party reimbursement system, largely fostered by government laws and policies, which takes both the patient and doctor out of the fee negotiation process. No other profession is like this. Neither customer nor provider of service—neither patient nor doctor—feels any sense of responsibility for setting, earning or paying a fee. It’s all left to a third party. Up to now, that has been a mixture of government and private sector. Obamacare shifts the trend heavily, if not exclusively, to government.
Remember that Obamacare passed for a reason. It passed because a majority believed that health care as we know it is dysfunctional. A majority didn’t necessarily believe that Obamacare was the answer, and a majority still don’t. But that doesn’t matter to its supporters, who seek to impose it—fascist dictator style—on to the population, and thanks to the Supreme Court will now be able to do so.
The point is, this cannot end well. The very assumptions which made Obamacare passable in the first place are the very assumptions which will lead to its demise. Obamacare passed because people said, ‘We have to do something different. We can’t have third parties making medical decisions for us, we can’t keep having all this red tape and bureaucracy.’ But Obamacare is going to either freeze in place the red tape, unaccountability and bureaucracy, or expand it still further. If these things are so bad—and nearly everyone agrees they are—then Obamacare will not rid us of them, but merely expand them.
In that case, how can Obamacare sustain its popularity over the long run—when it’s not even popular now, at the starting gate?
The only answer is a free market. We will get to one, eventually. The only way we won’t is if the country collapses into dictatorship, and the government forbids it. This is actually possible, although it will not happen unless the entire economy collapses. If the entire private economy collapses due to hyperinflation or some other economic disaster brought about by government recklessness, then the idea of a private market will be beside the point. If the government at some point reverses its present course, and significantly reduces taxes and regulations allowing the private economy to grow again, then the push for a private market in medicine will increase. This is because as the rest of the economy makes progress, health care will stick out like a sore thumb for all its mediocrity and stagnation.
In the meantime, look for a two-tiered system. You’ll be going either to a ‘Medicaid doctor’ or a private doctor. I can’t predict what the precise terms will be, but it will be something like that. So long as the private economy stays afloat, and you can manage to stay afloat in it, you’d be well-advised to put money aside to afford the better and private doctors, at least for the more important and life-threatening matters.
This two-tiered system will suit many doctors just fine, in all honesty. It’s not altruism so much as that. There are doctors who are better, and who will profit in what remains of the private system, for those who can afford it. And then there are doctors who don’t really care, who’ll do the bare minimum to avoid getting sued, and they’ll be part of the public system.
I doubt that many good doctors are really socialists at heart. They have to know the truth, although around their liberal Democrat friends they might be afraid to say it. You cannot possibly survive medical school, with all it requires to focus on hard reality, and be foolish enough to believe in socialism on principle. But some doctors and nurses are undoubtedly guilt-ridden and feel that they owe their talents to those who need them, whether they pay for them or not. “You’re capable of doing something for me — and you owe me!” Imagine if any other business worked this way. The customer would be sent on his or her way.
I don’t know about you, but I would rather not go to a doctor who feels that his or her services are not worth paying for; but based on the widespread indifference to what’s happening in health care, I guess that’s just me.
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