Saturday, August 15, 2009
National Healthcare II
Having worked in and around emergency medicine at different layers my entire adult life, there are a few things I've learned about providing medical care that influence my opposition to nationalized healthcare.
1) We already have universal coverage. If you call 911 and tell the operator you scraped your knee and you want a paramedic to take you to an ER, it will happen.
This is very inefficient and you'll have to wait a long time, but no one is turned away.
2) People don't really want universal healthcare, they want equal healthcare.
This won't happen no matter what. The President won't be going to the same doctor you will. There will be a two tiered system--a fee for service immediate treatment option for the privileged few, then the DMV style care for the rest of us.
3) Everyone has a line in the sand for when they are sick enough to seek treatment.
For the welfare class, this line is often towards the ridiculous. 911 for sore throats. For the upper middle class it's the other extreme---waiting for their own physician to be at work to get a broken bone set. This line is chosen based on a few factors---discomfort/fear level, financial considerations, inconvenience.
Those are the influences, here's my conclusions. The big problems are a lack of supply of healthcare provision, and too many layers of bureaucracy between providers and patients. Government involvement will make both of these worse. There is absolutely no example of government running things more efficiently than the private sector. As for supply, once government sets income rates for providers, fewer will be attracted to the profession.
The biggest factor of all---an increase in demand. If you want to increase demand for something, make it free. Waxman's models don't account for this increase, and even Obama admits he doesn't know how he'll pay for it. "We'll only tax those earning more than $250,000 a year" Well, a whole bunch of those are people in the healthcare business that you'll pull the rug out from under....