Physicians for Universal Health Care?

Despite our love for a fee-for-service health-care system, health care in the US costs individuals and the government more than in any other industrialized nation — while providing less.
Despite our love for a fee-for-service health-care system, health care in the US costs individuals and the government more than in any other industrialized nation — while providing less.

Moreover, it seems that Americans want a universal program. According to a May 2016 Gallop poll, 58% of Americans surveyed were in favor of a federally-funded health-care program that provides insurance to all Americans.1

So why is there still such opposition? I suspect corporate interest plays a large role, as do physicians. Historically, physicians have strongly resisted universal health care. A classic example is Ronald Reagan's 1961 album, in which he speaks out against socialized medicine. It was sponsored by the American Medical Association.

Health care is a necessity in any society. Like the other services our society agrees are necessary, there is no reason to think universal health care would be any different from government-funded police, fire and EMS services — all of which operate more reliably and at lower cost to citizens than their privately operated counterparts.2

Which brings us to a fundamental question that we must ask ourselves as physicians: “What are the goals of a health-care system?” Is it to generate profit by taking advantage of an illness or injury, or is it to provide appropriate care to those who need it so that they can recover and return to being productive members of society? (Note that I am not asking what your goals are as a member of the health-care system.)

Health care is different from other free-market industries in that we do not sell services that people merely desire. We provide services that people need to survive and to function. Denying people care based on whether they can pay for it would be like the fire department refusing to extinguish a burning house, or a police officer refusing to step in during a robbery. Yet, that is exactly what we're doing every day when we deny people health care based on their income or lack of health insurance. By forcing patients to wait until things get bad before they seek care, we've managed to increase the cost of health care for taxpayers, who must now flip the bill for that uninsured patient — a fact that most Americans happen to inconveniently ignore when voting on health policy. 

Ironically, despite our love for a free market and a fee-for-service health-care system, health care in the US costs individuals and the government more than in any other industrialized nation — while providing less. As physicians, we have a duty to our patients and to our society, not because they pay us for it, but because we chose to serve them as physicians. We are bound by an oath not to do our patients harm. Yet, we do them harm each day that we selfishly advise them against a political shift in health policy that would benefit them the most.

References

  1. Newport F. “Majority in U.S. Support Idea of Fed-Funded Healthcare System.” GALLUP. Updated May 16, 2016. Available at: http://www.gallup.com/poll/191504/majority-support-idea-fed-funded-healthcare-system.aspx. Accessed December 20, 2016.
  2. Ivory D, Protess B and Bennet K. When You Dial 911 and Wall Street Answers. New York Times.  Updated June 25, 2016. Available at:http://www.nytimes.com/2016/06/26/business/dealbook/when-you-dial-911-and-wall-street-answers.html?_r=0. Accessed December 20, 2016.

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