Dr. Edward Gray: Is single-payer healthcare a panacea?

The Greeks had a word for it: panacea, meaning the universal cure. Today’s panacea in the United States is single payer. It’s the solution for our healthcare system. The talking points are now part of our lexicon: If only we would copy the socialized healthcare of other countries, eliminate insurance companies. After all, the talking points say, a majority of physicians support this ideal, and government run is cheaper.

Let’s break down just a few of these talking points and really look at the evidence. After all, just because people repeat a narrative, doesn’t make it true.

We are told that a majority of doctors support a single-payer government-run healthcare system. The AMA lost a large number of doctor members due to its support of Obamacare. Only 11 percent of physicians in the United States believe that the AMA stands for their health care views. Less than 15 percent of physicians even belong to the AMA anymore. The statement, that the majority of doctors want a single-payer system is simply not born out by the survey data available.

We also hear that we should be more like other countries, suggesting that socialized medicine in European countries and Canada is superior to the United States. As I completed a surgical rotation at the Derbyshire Royal Infirmary in England, I can comment on this with firsthand knowledge of the British system.

In England patients would come in to see us, the Oral and Maxillofacial surgeons at the hospital. They generally waited four months before even meeting us, and if they qualified for surgery, they had another four-month wait. One family I remember very well, pooled their financial resources and sent their father to New York where he was seen and treated within a two-week period. Another satisfied medical tourist.

The National Health program was started in the UK in 1948. Problems continue to plague the system today. In addition to long wait times, overall quality of care has suffered. In 2007 at a hospital in Birmingham, costs were reduced by not laundering sheets between patients, resulting in a MRSA infection outbreak.

We are often reminded that the United States Ranks 37th in healthcare by the World Health Organization. The implication is healthcare is terrible here. That ranking is highly weighted to cost. Certainly healthcare is expensive in the United States, for reasons I touched on in an earlier editorial. The important thing to remember is that among all socioeconomic groups in the United States, patients live longer with chronic diseases, and have higher cancer survival rates, than in any other country with socialized medicine. That is what matters, if you’re going to get sick, you are better off getting sick in the United States.

A common complaint about insurance companies is excessive profits. Do I like insurance companies? No, I certainly do not. However single payer makes the government the only insurance company. In the private sector this is called a monopoly, and it is against the law. Is a monopoly run by the government somehow more efficient or more altruistic than multiple insurance companies who have to compete for your business?

The best example of a government-run monopoly in United States is the VA. I believe we can all agree that the Veterans Administration Health System is in complete disarray. Poor patient care, multiple scandals, long patient wait times, and hundreds of millions of wasted dollars plague this government-run system. Would anyone argue that the Veterans Administration is a shining example of what healthcare could be in our country? Single payer, government run, means the VA for everyone.

Should we have Medicaid for everyone? This argument makes no economic sense. Years ago the numbers of patients on Medicaid and Medicare were low in comparison to the overall physician’s patient load. It cost the physician money to see those patients because the payments were low, (about one-third normal charges), but because patient numbers were low you simply took care of them. It was part of being a doctor. Now with the numbers of Medicare and Medicaid patients increasing, in order to avoid bankruptcy doctors either have to limit the number of Medicare and Medicaid patients they see, or stop seeing them altogether.

Prior to Obamacare a large majority of patients were happy with the insurance that they had, whereas very few feel that way today. This is due to rising premiums, and out of sight deductibles. Single payer is not a panacea, it is the VA for everyone. Someone please tell the Republicans.

Dr. Edward Gray is a previous hospital pharmacist, dentist, and medical doctor who practices Oral and Maxillofacial Surgery in Gardnerville.


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