This morning I read two competing views about whether our system should become “socialized.”
One view was from Op-Ed columnist Richard Cohen in a piece titled “Socialized Medicine? Bring It On” in the Washington Post.
He takes his experiences accompanying a “friend” to the emergency department and tries to generalize them to the medical system as a whole. There were “interminable” waits, there were not enough beds, and his friend had to wait “in agony” sitting in a wheelchair in a hallway for six hours. He then demonizes insurance companies who denied his friend’s claim for a return to the emergency department, saying that private enterprise makes “lots of money” on health insurance. He concludes that our privatized system has failed to the point that “everyone gets miserable treatment” and advocates for government-run health care because he doesn’t think that the government “could possibly do a worse job.”
Unfortunately, Mr. Cohen’s view relies on many false assumptions.
While Mr. Cohen is correct that our current medical system is “privatized” to some degree, our system is far from completely “privatized.” The government still has a significant impact on the care patients receive. Federal EMTALA laws require that every patient be evaluated – regardless of ability to pay. The threat of government fines and sanctions is hardly a “privatized” system. Through Medicare and Medicaid, state and federal governments control payments to physicians for a significant amount of the care that they provide. Hospitals have to meet their budgets or they will go bankrupt. When reimbursement from the governments declines, hospitals either need to cut staffing and services — which means longer waits and delays in care — or go out of business — which means longer waits and delays in care. The number of hospitals emergency departments decreases each year. As our administration struggles with a trillion dollar deficit, does Mr. Cohen or anyone else expect payments to hospitals to increase with socialized medicine?
Money is a great incentive. People spend days searching online for the best deal on a new LCD TV. People drive across town to get a gallon of milk twenty cents cheaper from a grocery store. Most people would not think twice about switching jobs if they were able to earn a few dollars more per hour for doing the same work. When insurance stops paying for one doctor’s care, most patients abandon ship and find a doctor that the insurance company will pay for rather than paying out of pocket. Doctors and hospitals are no different. When people are provided with an incentive, they will work harder. When deincentivized, they will work less. At some point, they will leave the system.
Look at the state of primary care in this country now. Doctors are leaving because the good aspects of helping patients are outweighed by administrative hassles, paperwork, and decreased reimbursement. Does Mr. Cohen think that there will be less administrative hassles and increased payments in a socialized system?
One quote just keeps resonating in my mind: “The government that has the power to give everything to you has the power to take everything away from you.”
The competing view I read was from a forwarded e-mail about an economics professor:
An economics professor at a local college made a statement that he had never failed a single student before but had once failed an entire class.
That class had insisted that Obama’s socialism worked and that no one would be poor and no one would be rich, a great equalizer.
The professor then said, “OK, we will have an experiment in this class on Obama’s plan”. All grades would be averaged and everyone would receive the same grade so no one would fail and no one would receive an A.
After the first test, the grades were averaged and everyone got a B.
The students who studied hard were upset and the students who studied little were happy.
As the second test rolled around, the students who studied little had studied even less and the ones who studied hard decided they wanted a free ride too so they studied little.
The second test average was a D. No one was happy.
When the 3rd test rolled around, the average was an F.
The scores never increased as bickering, blame and name-calling all resulted in hard feelings and no one would study for the benefit of anyone else.
All failed, to their great surprise, and the professor told them that socialism would also ultimately fail because when the reward is great, the effort to succeed is great but when government takes all the reward away, no one will try or want to succeed.
With tens of millions of uninsured patients, I worry about the health of our country’s citizens.
I worry more about the health of our country’s citizens if we implement a purely socialized system.