With all the talk of the Obamacare replacement and the failings of our medical system in America I decided to address this constant call from the far left that the Government should just impose Medicare for all and do away with all private insurance companies the way Canada did for so many years.
First of all, yes, I agree there are issues, large issues, with American medical care, but I do not believe Medicare or any form of mass Government control over health care is going to work well in America for several reasons.
The first and most obvious is the cost, we already have massive cost issues operating Medicare for the small portion we cover now as well as hundreds of Billions of dollars in Medicare fraud. We can't accurately cover costs efficiently now with just 55 million Americans on the program, taking that total to 220 million people means that all the problems we have now will increase along with it, and most likely the problems will increase at greater rates because chasing down possible fraud and abuse is harder and harder the larger the system gets.
The second and less advertised huge problem with Medicare is the fact less and less doctors are willing to accept Medicare patients due to the low payouts and the extreme degree of costly documentation needed to process claims:
"And so I made a difficult decision. I have decided to opt-out of Medicare, acknowledging that I can no longer play a game that is rigged against me; one that I can never win because of constantly changing rules, and one where the stakes include fines and even potential jail time. "
In connection with my over 30+ years of commercial and residential construction I have had the great opportunity to be involved with all levels of the medical world from negative pressure isolation rooms to General Practice offices and I have taken the time to sit down with actual doctors to discuss medical related issues and patient care and insurance countless numbers of times. The number 1 issue they all agree is a problem with Medicare is payouts that do not cover actual costs of care, and the second issue is paperwork and long waiting times to actually get paid for the services rendered. I also have the benefit of my sister who managed a private office for her husband in general care as well.
If a Medicare patient goes to a GP doctor for a cold or basic complaint, the doctor will lose money on that visit, it will cost them more in processing and time spent documenting that basic care visit than they will get back from the Government, period. This is why so many doctors try to add some testing and counseling and such to the visit to try and make up for the money they just lost. So why does any doctor accept Medicare patients? Because they actually care about society and their patients and want to help them, but they also need to pay their Bills so it becomes a constant battle to do both.
Now this is of course a bigger issue for private doctors than large medical corporations. Those larger groups can more easily absorb the costs of paperwork and processing because they push through a much larger number of patients with the same office workers processing so it is a little easier to maintain. That combined with the latest trend to use nurse practitioners instead of actual doctors helps these larger companies to keep costs lower.
So then you may say that we just replace all private doctors with these large corporations right? Well that sounds easier than it really is, smaller towns would not have enough patients to keep the facility constantly operating so they could not justify the cost in building a very expensive facility and staff it. Besides, while these large companies may be making it work today, their profit margins are not that good and there are better ways to make money than this so there may not be enough motivation to chase those limited dollars.
Okay, so private industry does not want to serve those patients, we just have the Government do it and set up a nation wide medical system similar to the VA, right? Well aside from all the bad publicity the VA is getting for not handling Veterans very well for their medical needs, you are now talking a massive amount of new entitlement spending that will rival our defense budget, where does the money come from? And even if we do this, who do you staff it with? The VA is recruiting doctors from other Countries because the pay is too low to entice Americans doctors to work for them, there is no expectation this would change for a Medicare only hospital system. In fact it would most likely be much worse because even the corporation run hospitals get regular patients too so they have the higher payouts from private insurance to add to their Medicare funds, if you had a hospital that could only operate on Medicare funding levels the cost controls would be draconian.
Lastly, many of the states who saw Medicare expansion under Obama saw this effect first hand, just having a medicare card or a Obamacare card did not equal medical care, you have to first find doctors who were willing to accept these policies and today, there are not enough doctors to go around with the few low paying policies we have today, what happens when most Americans have only these low paying policies?
There are a lot more issues to consider, but look around at the various Countries who do provide socialized healthcare. Many are severally cutting back, Canada had to allow private insurance and is currently operating a two tier healthcare system because of the massive waiting times for medical care under the Government system. They have an annual meeting called the "taming of the queue" trying to address these long waiting lines but have not made any real changes to those waiting times in the last 10 years.
I wanted to add at the end one of the problems with America that is unique is the way we are mostly spread out all over the place in America and the few places that seem to be doing a better job with socialized healthcare all have more dense populations making it easier to serve them.
Thank you for taking the time to read my story, all reasonable replies will be answered.