In the current healthcare reform debate, GOP lawmakers have made clear that they view healthcare like any other commodity governed by the laws of supply and demand. But there’s a big difference between shopping for a new refrigerator and looking for a doctor while you’re sick.
The Republican View of Healthcare
Ted Rall
Ted Rall is a syndicated political cartoonist for Andrews McMeel Syndication, WhoWhatWhy.org and Counterpoint. He is a frequent contributor to The Wall Street Journal, a graphic novelist and author of many books of art and prose, and an occasional war correspondent. He is, recently, the author of the graphic novel "The Stringer."
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Theoretically, it should work – hospitals and big pharma should lower their prices and increase quality in order to attract customers.
Somehow, it doesn’t work that way. Has anyone seen the Invisible Hand around lately?
This is a more succinct cartoon reminiscent of a recent one by Ruben Bolling.
With regard to 4) I think many if not most of MDs would much prefer a public system. As long as their credentials are their USP – i.e. similarly qualified doctors from e.g. Cuba may not practice in the U.S. without a full re-education – they’re still going to get good salaries. It’s the insurance companies middlemen who are dead weight.
Personally I think the point of doctors and lawyers being overpaid workers compared to factory and office workers, while correct, is a double-edged sword. Since when is the left in favor of a race to the bottom for all wage earners?
A humane and sensible reform might start at taking away most of the risk (very long education and debt before pay-off) and especially at reducing the crazy hours and abuse both these professions have to take especially at the entry-level as interns, etc. And further muddy and relax the divide between nurses and doctors, etc.
As (among other things) an MD – and speaking only for myself – I have to agree with you, Andreas ; what one as a physician doesn’t want in an employer (which the insurance companies in effect are, even under the guise of the so-called «free market») looking over one’s shoulder and saying, «that isn’t covered by Patient X’s policy» and «there’s a cheaper – albeit less effective – alternative to the course of therapy you’ve suggested for Patient Y», which, I understand, is the way things work in the US nowadays, and one of the reasons that country is noted for poorer outcomes in healthcare among OECD members, despite devoting more than half again as the average of its GDP to that sector. (The other main reason, I understand, is poor preventive care, not least in maternal healthcare, which is also a consequence of the for-profit system)….
Your comments about internships are also correct – I recall being on duty for 72 hours straight on weekends – although from what I understand, that is no longer allowed here in Sweden, as a matter of patient safety. As this Wikipedia article indicates, the current situation is in the United States seems even now to be similar to that I experienced several decades ago ; perhaps you or someone else has more recent experience and can confirm or deny ?…
Henri
@ Henri,
really interesting to hear from your experience.
For-profit medicine and prevention are an interesting combination, there was a recent plea on the subject from Samantha Cerra, a pediatrician:
I had the privilege of meeting a young woman and her mother in our clinic. The mother had a heart condition that is often passed genetically from parent to child. As she and I spoke about definitive testing that would tell us if her daughter carries the gene that might cause her to develop the same condition, she started to get nervous.
She was afraid that this test, which could help us treat and protect her daughter, was a medical Catch-22. Without it, we wouldn’t know how to care for her daughter. With it, her daughter might be labeled as a person with a pre-existing condition, which could make her unable to afford the care she needs.
I can’t add very much, my direct experience with the U.S. system for residents is second hand at best, though those stories corroborate the harrowing details you provided in the wiki article.
I also know some who are interning in law firms in the U.S. It’s a weird situation, since likewise their (expensive) education itself is itself worth little except as an entry card to a possible internship position which in turn has them self-exploit themselves in horrible working conditions with the carrot of making partner dangled in front of them.
The psychological trials and tribulations that young adults “voluntarily” undergo in pursuit of joining the supposed elite (and the addictive potential of the journey itself) has been dramatized in the excellent Brazilian scifi mini-series 3%.
On the other side of this “process” is the invested-ness of people who are told that they made the cut (for the time being). What I do have direct experience of is research, I’ve seen junior scientists transformed from an empathic understanding of their own precarious existence to a full neo-liberal make-over in less than a year on getting their first major grant (that will of course only give them security for 3 years or so).
If people overcome these selection hurdles, they’ll certainly get high salaries (compounded by the lack of time to actually spend any of it), high salaries by the standards of commoners, that is, not the 0.1 percent.
The choice before this supposed professional elite (or what’s left of it) – whether to side with the 0.1% or with the rest of us – will likely define the struggle of our generation.
«The choice before this supposed professional elite (or what’s left of it) – whether to side with the 0.1% or with the rest of us – will likely define the struggle of our generation.» I suspect that, in the usual course of affairs, this elite will split ; some will take the high road and some the low, but I haven’t a clue as to who will first get to Scotland. But as the song goes, meetings with one’s true love on the bonny, bonny banks of Loch Lomond don’t seem to be in the cards….
Henri
For complex procedures how many hospitals will give a price quote and if they do how useful is it?
I listened to stories on the radio from a doctor that writes articles for major media, as a doctor even she couldn’t get a decent price quote from a hospital.
I went to find an internet source, it turns out even the part of right that thinks that shopping for serious health care is not the same as shopping for goods. Too bad their solution might of worked fifty years ago when doctors couldn’t do much for serious conditions and the middle class was strong but it won’t work now.
From the right wing Cato think tank ……https://www.cato.org/blog/why-hospital-price-quotes-are-so-often-useless
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This] hospital typically charges between $2,360.45 and $22,290.74 for this procedure or service. This is an estimate only…
Our goal is to provide you with the most informed and accurate estimate of the cost of your treatment. If circumstances result in a final bill that exceeds this estimate by more than 20%, we will work together with you to resolve the balance.
For surgical services, the price quote does not include any physicians’ charges. The surgeon and/or anesthesiologist will bill you separately for his or her time.
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Too bad the conservative fix is just to put money in the consumers hands and ease the regulations on opening new hospitals….money in consumers hands is usually code for tax cuts and easing regulations…..lowering safety standards.
Result
The Wealthy, medical palaces with best staff, luxury beds, live music, chiefs
Full service hospitals for the rich
Cut rate hospitals for the average person…some services won’t be there because average people won’t be able to afford it…if you want advanced treatment sell you house and make an appointment at full service facility.
For the poor, strip mall clinics with new staff with cut rate certificates (many conservatives love 2 year for profit collages) the better clinics will tele consult with full MDs the rest well….
For the very poor the government might provide inoculations to reduce the chance of plagues and pray that a charity can help.
«For the very poor the government might provide inoculations to reduce the chance of plagues and pray that a charity can help.» From what I am given to understand, members of the US government are very skilled at praying….
Henri
Yep it’s part that thin veneer to win over the right church vote…words are cheep.
I detect a certain irony – inadvertent or otherwise – in this situation….
Henri