It is the year 2018, and patients don’t always receive good care and doctors questions their career choice. How have we arrived at this tragic state of affairs? The answer is that our for-profit health care system is the principal cause — not only of poor patient care but physician burnout. Only a single-payer system, which is anchored in the idea that good health care is an inalienable right and not a privilege, will allow both doctors and patients to extricate themselves from this suffering.
Under the current system, millions of Americans are forced to go to doctors that they don’t want to go to. Vast numbers of Americans are also regularly compelled to stop going to doctors that they have known for years and don’t wish to leave.
Due to a complicated health condition, I have seen dozens of different doctors over the past two years. Should my insurance suddenly change, this painstakingly constructed system of specialists could come crashing to the ground. Being forced to leave a doctor that you have known for years is a shame — not only because no one will know your medical problems quite like they do, but because once a good doctor-patient relationship is lost, it is gone forever.
This revolving door is harmful for physicians because if a doctor has a practice with patients incessantly coming and going, it will invariably foment alienation — a driving force behind physician burnout.
The argument that a single-payer system would be impossible to implement in practice is contradicted by the fact that Canada — along with the overwhelming majority of countries in Europe and Russia — have nationalized health care systems that are in many respects superior to our own. How can we call ourselves a civilized nation when millions of Americans with serious illnesses are more fearful of bankruptcy and losing their insurance than they are of death from widespread disease?
There is no logical reason why a New Yorker should be denied the right to see any doctor that they wish to see at Lenox Hill, Mount Sinai, Weill Cornell, Columbia, NYU or Sloan Kettering. Isn’t it preposterous that millions of Americans live either within walking distance or a reasonable subway ride from these hospitals, and yet their health insurance prevents them from seeing the majority of physicians that actually work at these institutions?
The question of who will foot the bill should be asked, not in regards to who will pay for single payer, but in regards to how we can continue to maintain a system of nine-hundred military bases all across the globe. According to that great bastion of Marxist heresy The Washington Post, “The U.S. wars in Afghanistan and Iraq will cost taxpayers $4 trillion to $6 trillion.” And this was written on March 28, 2013. How many hundreds of billions of taxpayer dollars have we spent on sustaining this bloated empire over the past four years? Instead of using this money to establish an excellent health care system that we can be proud of, we are using this money to wage war. Think about that the next time someone says we can’t afford a single-payer health care system.
The exploitation of doctors has a disastrous impact, not only on their morale but on the quality of care they can provide. It’s analogous to giving a high school English teacher hundreds of students per semester and putting them in the impossible position of being unable to make detailed corrections to these essays.
Constantly attempting to come up with different business models is not the answer, since the underlying problem of a two-tier system where rich and poor get radically different standards of care will remain unchanged, while those with limited income will continue to be bombarded by unacceptably high premiums and deductibles.
Lamentably, the most pressing problem in this debate is the fact that millions of Americans continue to look at health care as just another business. The astronomical cost of college tuition has resulted in over a trillion dollars in student loan debt, while the quality of education has been steadily declining for decades. As with education, we can choose to either have a good health care system, or we can continue to allow a corrupt few to make staggering amounts of money while generating the most abject suffering and misery for untold millions of their countrymen.
Tying health insurance to one’s job is profoundly unethical, as the overwhelming majority of Americans with full-time jobs can be fired at the drop of a hat if they take a significant amount of time off from work due to illness. Moreover, primary care physicians who elect not to take insurance at all will not be able to provide patients with critical in-network referrals.
How can the adage “do no harm” be implemented in practice when vitally important health care decisions are routinely made by hospital administrators, pharmaceutical CEOs and insurance executives whose only reason for getting involved in health care in the first place was to maximize the greatest possible profit? Remove the profit motive and compassion, dignity and humanity will be restored.
Why must we continue to allow parasites and con artists dictate to doctors how they can treat patients, while dictating to patients which doctors they can and cannot see? Good doctors who are forced by insurance companies to provide patients with inferior care will be prone to feelings of guilt, shame, remorse and depression. Indeed, this is a barbarous, unconscionable state of affairs, and it cannot hold water in any rational or civilized conversation.
The time has come for Americans to put an end to this foolishness and to disenthrall themselves from these corrupt elements that straitjacket and humiliate both doctors and patients alike.
David Penner is a writer.
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