It's very interesting looking at the posts on this topic. They range from libertarian (pay your own way) to pure socialism. I'm sorry to report that all forms of socialism fail over time. We are witnessing it right now in our own country. Our money system and the health care and corporate systems are socialistic. They all are in bed with govt and get special privilege from govt. This is unsustainable due to human nature (we look out for ourselves first). The current situation is being blamed on free markets or capitalism. This is like in the 1930's when they blamed the gold for all our problems. Well, gold hasn't been used as currency for a long time and here we are in the beginning of a new depression. We could never blame govt interference, so it must be the free market. I'd like to know which market is free--meaning unregulated.
It is also interesting to see where we came from. I know quite a few very old doctors who informed me that no on that they know of ever went without the health care they needed before insurance or government was involved. It seems that the federal govt invented a problem---elderly and poor having no insurance---and then fixed it. Just look at health care costs before and after insurance programs started. You can look at dental as well. My Dad told me how he fought his own union when they wanted to add dental coverage. His argument was that it would drive up prices. Soon after dental coverage became common, he noted that his copay was about the same as the whole office visit once cost. Any time you remove the burden of payment from the consumer in ANY industry, they will no longer care about cost and make poor decisions.
It's amazing how much time I spend discussing the cost/benefit of testing with self pay patients and how patients with insurance don't ever ask or seem to care. Comprehensive insurance will always increase costs no matter who pays. A single payor (socialism) will lead to further increases in cost. The doctors (us) and hospitals will pay big bucks for lobbyists and stay on top of the food chain in a government program. The only solution to this is unthinkable right now. Just cutting the system off and making people pay for care themselves would indeed be devastating to both the patients and health system for several years. Bu tin time the costs would go back to what the market can actually sustain. The price of drugs would also come down or the companies will go out of business.
We all see the incredible waste in our system on a daily basis. I don't believe the doctors are willing to endure the pain that would be required to really return the system to reality.
Lets look at the cost savings. We would have a reduction in overhead needed to sustain a practice. We would need to set prices that patients could afford to pay. We would need to prescribe only the drugs that are really needed. Let's face it, that latest statin drug really isn't as great as we make it out to be when you look at number needed to treat to get a true benefit. People would think very hard about what treatments they want and what testing they think is needed based upon our giving them the hard facts. Yes, some catastrophic coverage would be need to be in place. We also would need to drop malpractice coverage and get our personal finances out of the reach of lawyers. If there is no easy to reach cash, a lawyer will not take a malpractice case. People would re-establish the knowledge that mistakes happen and are no ones fault---it part of nature.
I know that his will get all the socialists upset, but people do very well without government interference. It would be great to see one state reject all federal aid and also stop paying for the aid. That same state could get rid of all the onerous regulations as well and make people individually responsible for their own business. Hold people accountable personally for abuses (even corporate), and not allow ANY special privilege (including STATE licensure of professionals). (We could still set up professional credentialling). I suspect that that State would quickly become so prosperous that all the others would be crying foul.
Sorry to ramble, but seeing people post solutions that were the cause of the current failure makes me crazy. If only we had more regulation and GOOD people running things, everything would be grand. Well good people work hard, they don't generally run for public office. Public office and power attracts exactly the wrong type of people. Just look at the constant abuses and scandals from all sides of the aisle in Washington.
