October 26, 2007:
When something is offered for free, the demand skyrockets. Universal health care would provide 'free' -- though all this 'free' stuff would be paid for by increasing your taxes -- medical services, so the demand for those medical services would skyrocket with no limits.
With unlimited demand for those 'free' services, the costs would skyrocket, too, which means your taxes would skyrocket. When people finally decided they'd have enough of the tax increases and the government couldn't raise them anymore without causing open revolt, the only other way to control costs would be to start limiting the availability of medical services. There would be limits placed on the number of operations, prescriptions, and other services that would be available to Americans, which would mean people would have to wait in line until their turn came up.
In order to enforce these limitations, the government would then have to determine who is most deserving of the limited medical services available. At that point, you would start seeing things like smokers being denied treatment because they're less deserving than non-smokers, fat people being denied treatments because they're less deserving than slim people, and so on.
So, the end result is huge tax costs for your 'free' health care, long wait times, denial of treatment based on who is more 'deserving', and government deciding who those 'deserving' people are.
January 17, 2008:
Universal health care -- exactly what all of the Democrat presidential candidates are proposing -- is a disastrous model for something so critical as health care.
First, it's anything but 'free' because your taxes will skyrocket to pay for health care products and services. Second, when health care becomes 'free' to anyone walking in off the street, the demand for everything will skyrocket. The slightest sniffle will result in a run for antibiotics, and so on. When demand exceeds supply, you'll see taxes continue rising to cover the additional products and services being dispensed. When prices/taxes get so high that even Congress is reluctant to continue raising them, the only recourse left is to limit the supply artificially. This will cause longer waiting times for even the most routine procedures and medicines, often stretching out to months; specialized procedures will become exceedingly rare. At this point, you'll also see decisions being made on the most 'worthy' recipients of certain procedures and medicines. Too fat? Smoker? Got diabetes? Sorry, you can't have that procedure. You don't deserve it.
Massachusetts implemented a state-wide law to do essentially the same thing in 2007. How did that work out for them? It's an unfolding disaster. Key excerpts for a New York Times story:
Once they discover that she is Dr. Kate, the supplicants line up to approach at dinner parties and ballet recitals. Surely, they suggest to Dr. Katherine J. Atkinson, a family physician here, she might find a way to move them up her lengthy waiting list for new patients.
Those fortunate enough to make it soon learn they face another long wait: Dr. Atkinson's next opening for a physical is not until early May — of 2009.
Since last year, when the landmark law took effect, about 340,000 of Massachusetts' estimated 600,000 uninsured have gained coverage. Many are now searching for doctors and scheduling appointments for long-deferred care.
Dr. Patricia A. Sereno, state president of the American Academy of Family Physicians, said an influx of the newly insured to her practice in Malden, just north of Boston, had stretched her daily caseload to as many as 22 to 25 patients, from 18 to 20 a year ago. To fit them in, Dr. Sereno limits the number of 45-minute physicals she schedules each day, thereby doubling the wait for an exam to three months.
"It's a recipe for disaster," Dr. Sereno said. "It's great that people have access to health care, but now we've got to find a way to give them access to preventive services. The point of this legislation was not to get people episodic care."
Massachusetts has taken some measures like forgiving medical school debt, but that isn't likely to be enough. The primary need is for general practice doctors, and that's where the shortage is.
Studies show that the number of medical school graduates in the United States entering family medicine training programs, or residencies, has dropped by 50 percent since 1997. A decade long decline gave way this year to a slight increase in numbers, perhaps because demand is driving up salaries.
There have been slight increases in the number of doctors training in internal medicine, which focuses on the nonsurgical treatment of adults. But the share of those residents who then establish a general practice has plummeted, to 24 percent in 2006 from 54 percent in 1998, according to the American College of Physicians.
Not only are there increasing demands from regulation and increased patient loads, but they're being paid far less.
The need to pay off medical school debt, which averages $120,000 at public schools and $160,000 at private schools, is cited as a major reason that graduates gravitate to higher-paying specialties and hospitalist jobs.
Primary care doctors typically fall at the bottom of the medical income scale, with average salaries in the range of $160,000 to $175,000 (compared with $410,000 for orthopedic surgeons and $380,000 for radiologists). In rural Massachusetts, where reimbursement rates are relatively low, some physicians are earning as little as $70,000 after 20 years of practice.
Dr. Atkinson, 45, said she paid herself a salary of $110,000 last year. Her insurance reimbursements often do not cover her costs, she said.
"I calculated that every time I have a Medicaid patient, it's like handing them a $20 bill when they leave," she said. "I never went into medicine to get rich, but I never expected to feel as disrespected as I feel. Where is the incentive for a practice like ours?"
So, what are we to make of this? The point is that this issue is not at all hard to predict. Not only do we have Europe to look to for an example of disastrous universal health care, but we have our own example in Massachusetts. Let's summarize: we predicted long lines, and we got 'em. We predicted lower quality of care (shorter times with the doctors), and we got 'em. We predicted problems with getting everyone on the program, and we got 'em (there are still 260,000 who haven't joined). What do you want to bet are the results on the predictions of higher costs and limited services? I'd say they're pretty good.
And don't forget the prickly question of what to do with the people who aren't on the plan? Are they going to be thrown in jail? Hillary would garnish their wages. What if they still didn't go? No one seems interested in these questions, but they are very important for us as voters to contemplate. You can bet that if something is required, there will be some who still don't play along.
We already have too many disincentives (high malpractice insurance, heavy government regulation, etc.) for people to become doctors, and universal health care will only magnify that problem. And all this is happening BEFORE the baby boomers get any older! You can bet that the next few years will see an exponential explosion of health care needs, and that could swamp the entire system.
This is what the Democrats are selling. Don't buy it!
There's my two cents.
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