Universal Health Care again

I posted a while ago about Universal Health Care. A friend and I were chatting last night about it and that motivated me to discuss it again.

A couple things he said got to me. For one, he said something like “40 million people in this country don’t have access to health care.” This is rubbish! (I used to have British friends … but then they got to know me better.)

The much-touted 40 million uninsured do have access to health care. They have to pay for it. My insurance doesn’t cover the cost of lunch at McDonald’s, but I still have access to it. I can walk into McDonald’s, slap down a couple bucks, and eat a meal with a lot of calories. Similarly, anyone who is prepared to pay cash can get an appointment with a doctor and pay for the care.

Oh, but they can’t afford it!! Yes they can. People who can’t afford it qualify for Medicaid. And we should all pay attention to Medicaid, because many doctors won’t accept Medicaid patients and some say the ones that do accept it aren’t all that great. We should notice this because Medicaid is the clear model for what universal health care will be.

Getting back to last night’s chat, I asked my friend how doctors would be paid in a universal health care system. Who makes that decision? And what guarantee do we have that the doctors won’t decide to go into another line of work when we stiff them on reimbursement?

Another friend of mine is a doctor, and he’s always talking about finding another way to make a living. He works long hours and makes good money, but he sees reimbursement rates being reduced every year, and thus his income looks like it will go down. So why should he bust his hump for that?

In last night’s chat, my liberal friend cast this doctor income issue in the context that doctors make too much money and that a system that reduces their pay wouldn’t be a bad thing. Really? Tell them that. From what I read, many doctors make somewhere between $100K and $200K. Not too shabby, but these are very talented people who work very hard. Many of them can find other ways of making money and might choose to do so if government screws up the health care system to bring doctor pay to a “fair” level of $100K or less.

I’m waiting to see a politician come out and say that doctors make too much money. You better hope you don’t get sick after you say that in a campaign. “Senator Smith … nice to see you. We’ve got some great medicine for you.”

4 comments to Universal Health Care again

  • When I did the ‘Health Care’ forum with the current Congresswoman from the 20th district, they asked a question about whether health care was a ‘right’ or a commodity. The implication was that if it were a commodity this was just horrible and of course it is a ‘right’. At the time I hedged and said it was neither, but in retrospect the answer was; “Everybody likes to get paid for their work, doctors are no different.”

    Here’s the link to the first hour of that debate.

    Obviously this was a setup for the former Congressman and the values of free market. Yours truly took the hit. Thanks again Warren. Have a good New Year.

    Eric Sundwall

  • The model for “universal” health care in the US is Medicare, not medicaid. Medicare is actually the best insurance plan; the one that pays the most and has the least amount of “hassle factor.” Medicaid, at least in NY, is very good for recipients, but they pay so little to the doctor that reimbursements don’t even equal the cost of the encounter for the doctor. Hence, many doctors do not participate. With regard to your comment that people who can’t afford health care qualify for medicaid shows that you actually lack some understanding of medicaid and the system in general. To qualify for medicaid in NY, you have to be in abject poverty (< ~14K per year) or have all of your assets taken from you, after you get sick, first, and be a US citizen or legal resident, and be able to navigate the myriad and byzantine application forms, and then you may qualify. If you are middle class, get sick, lose your job,and lose your health insurance, you are pretty screwed. And that puts most New Yorkers at risk. And no, the ER is really not a good option, if that's what you were thinking. If you don't have insurance, get sick and require hospitalization, you are at severe risk for financial ruin. If you own a home or have any assets, the hospital will place a lien on those assets, so that they can collect. That is how it is. I believe that a true single payor system would be the best, but it is not going to happen anytime soon.
    Anyway, good post. I like your blog. Did you win your election?

  • Anonymous

    I am new to whole universal healthcare issue as I just entered the workforce. However, if the government can’t even run Walter Reed correctly, with a few thousand soldiers, what makes anyone feel good about handing over healthcare for an entire nation? I pay $150 a month on top of what my employer pays for my health insurance. My insurance isn’t great it as a $500 deductable per person and 80/20 from there out, but I know it is better than anything the government can offer, especially under the notion of “free” to everyone.

  • Anonymous

    Why you all talking about what on the surface and don't look deep in the problem? Government doesn't care about your health, but they still care about your votes. They pushing for UHC to get a full control over you, not to help you to see a doctor. When you decide to be for or against it you need to decide if you want to give a government a full control over your life in exchange for an insurance policy and do you really trust government today and in future to keep this insurance working when you would need it. Democrats/liberals are talking about Medicare like a big achievement. But look at it. They made multiple generation of Americans not to save for health care and don't plan retirement health care spending assuming they would have medicare and would not need to save. Generations of Americans could save money on their own when they where working but instead they paid it in taxes and government was suppose to manage this money for them. And what's now? Every 5 minutes they are threatening pt and doctors that medicare is running out of money, we need to cut this and that. And what elderly people suppose to do? Go back to work at 80 yo and start saving or beg government to pay for them after they paid government all their life?
    Nobody will be able to stop it for now, but they still will not have enough time to finish everything before next election.
    So please everybody please think hard before you vote next time. Once they get control it's no way back.