Ninesixteen, thank you for your voice of clarity in this interesting debate. I too am surprised to see so many future physicians opposed to socialized medicine (which is essentially what we are talking about here). It is not really necessary to debate whether or not socialization would improve medicine, as we need only look at any other developed nation in the world, almost all of whom employ some form of socialization in their medical systems, to compare. These countries enjoy medical care for ALL their citizens, not just a privileged group, pay far less for it than we do, and have longer life spans, lower infant mortality rates, etc. I guess it's a matter of priorities- these systems are not perfect, as no humanly designed system ever will be, but at least nobody living within them dies for lack of a readily available antibiotic or routine operation, or has their home repossesed because they couldn't pay their hospital bill. What's more important- that every person has access to at least basic and necessary medical care, or that the relatively rich can get an MRI every time they snap their fingers? While it is true that you may wait longer for certain health care procedures in a socialized system, at least you would have the guarantee of getting those services if you need them, whether you have a job and money or not.
The strong concept of individualism drilled into us in this country from infancy on teaches that if you work hard, you will succeed- so by implication, those who are not successful must be lazy. But this is such an obvious fallacy, as the hardest-working people in this country are often the least successful monetarily. Still, we view poverty and the poor as "their" problem, and this attitude is clearly reflected in the lack of concern for the well-being of those 40 million people in this country who cannot afford health insurance, and the ridiculous suggestion that a fee-for-service arrangement will solve this country's health care woes. As for the issue of choice, how much choice do any of us have now? Do you decide which doctor to see, what tests to order, which medicines to take? No- your insurance or HMO decides for you (assuming you are lucky enough to have health insurance), based not on what is necessarily best for you but on what is most cost-effective for them. It is disgusting that the same profit driven logic that is used in car insurance is applied to human life, and that companies are making money- huge, vomit-inducing amounts of money- off of our illness. At least in a government run system, you would have some marginal say in how the system was run through your vote. How much say do you have in how your medical insurance works now?
I work at a non-profit clinic now, which receives government funds for low-income patients to receive reproductive health care services. Almost none of our patients have insurance, and without this funding- which the Bush administration will almost certainly not renew when it comes up for review in two years- they would go without these services. The $200 the government pays for these women to receive annual pelvic exams and birth control for a year saves thousands in costs that would otherwise result from unwanted pregnancies, which would in many cases add both the mother and child not only to medicare but also welfare and other social programs and cost the state tens of times more than the cost of simply providing them with effective birth control in the first place. The $15 pap smear and the $10 chlamydia test they receive screen for problems that, if caught early, are relatively easy and inexpensive to treat, but if left undetected and untreated could lead to cervical cancer and pelvic inflammatory disease and cost thousands to treat, as well as cause life-threatening health complications for these patients. If they could not get these services for free through my clinic, then they would not get them- for many of them, the choice is between paying rent and buying groceries or paying for health care, which is not really much of a choice at all. If everyone had health insurance, no one would need to make such a choice. I dread the day when I will have to work within the private system and watch people make decisions like that all day long. It is such a wonderful thing as a health care provider to be in an environment where neither I nor my patients have to have money be the primary deciding factor in whether or not they get the health care that they need.
I agree that socialized medicine poses a problem in terms of doctor's salaries- as long as medical education remains prohibitively expensive, no one will be able to afford to go tens of thousands of dollars into debt only to make $40,000 a year. The solution? Socialize higher education as well- I believe the two must go hand in hand in order for such a system to work. Of course, I highly doubt any of this will happen in my lifetime, but what a wonderful thing it would be if we looked at society as a team effort where nobody is winning if the team is losing, rather than the each man for himself attitude we currently seem to espouse. It's not as if this is all some wild idea- many countries have succesfully socialized both their educational and medical systems. But I doubt with America's overall inability to see the big picture and our almost complete brainwashing by the corporations who profit from our ignorance, we will implement any similar programs here in the near future. The financial interests are too deeply entrenched to make such a thing feasible.
And before I get some patriotic idiot telling me if I don't like it here, why don't I move- believe me, I would if I could, but highly socialized nations, such as many of the Scandanavian countries, have very restrictive immigration policies (a major but necessary drawback to such a system), and wouldn't want me until I have a useful skill, by which time I will be so deeply in debt here that I will have to work at least for several years in the private sector just to pay off my debt. Oh well, maybe I'll retire in Denmark.
