Yesterday I wrote a post about the way our health care system is no longer capable of providing basic, primary care and emergency services to everyone who needs it. There are several causes for this, but the primary cause is that the “system” has been skewed away from preventive and emergency care services (in which there is no profit) and toward the creation of treatments and health care products that do make a profit.
Yesterday’s post focused on a New York Times story about Massachusett, which initiated a “universal” health care program that currently is insuring 340,000 people who had no health insurance before. And now there are not enough primary care physicians to go around. One physician has a 13-month waiting list for basic physicals.
A few wingnuts commented on this same New York Times story. Their take? “See? Socialized medicine doesn’t work!”
Question: Why isn’t universal health insurance working in Massachusetts?
Answer: Good intentions also lead to shortages in everything. What the New York Times calls “unintended consequences,†I call predictable.
If we didn’t have all these wimpy good intentions, there wouldn’t be a problem. Clearly, that millions of Americans have been cut off from basic health care services is not a problem.
Another rightie, Soccer Dad, concludes that the primary care physician shortage proves Mitt Romney (credited with the Massachusetts health care program) is incompetent. Romney may be incompetent, but the fact is whenever and however the U.S. finds a way to provide decent health care services to those currently uninsured, whether by public or private means, what’s happening in Massachusetts is going to be a nationwide phenomenon.
Put another way, the only reason the insured don’t have massive waiting lines for health care services (in most parts of the country) is that so many Americans have been kicked out of the line.
In other Right Wing news — Yes, Hugh, there were arm bands and book bags in 1968. I was there. Wearing arm bands in protest of the Vietnam War was pretty common, actually.
And why can’t we have civilized debates about important issues? Read this and be amazed — at the psychological projection.
Idiots.
Update: Another idiot speaks —
Why, it must be some kind of doctor shortage! … Could it be, oh I don’t know, lack of incentive?
No, brainless one, there is plenty of incentive. However, all the incentive tilts in the direction of what parts of medical practice that are very profitale (i.e., new technologies and drugs) and away from those parts that are much less profitable (i.e., preventive care) or tend to lose money (i.e., emergency rooms). Your market-driven health care system at work.
And, as Kevin Heyden says, Massachusetts has better health care resources than most other states. So “what will it be like in the Southern states that are mostly rural, or the vast wide open states that grow bigger, the wester you go?”
For years I’ve been hearing health-care experts saying that the nation’s ability to delivery basic medical services to its citizens has been deteriorating, even as we continue to excel at the development of new technologies and drugs for extremely serious illness.
The lack of basic services, however, is one of the factors that is driving up the cost of health care for everyone. It would be far more cost-effective if people got regular checkups and went to doctors at the first sign of illness. However, the millions of Americans who are uninsured or underinsured tend to wait until symptoms are more severe and the illness more difficult (and expensive) to treat.
Here’s just one example — the United States on the whole has world-class hospital neonatal care for infants born prematurely or unhealthy. However, we fall far behind most other industrialized nations in providing basic prenatal care for all pregnant women. Thus, a higher percentage of American babies are born prematurely or unhealthy and need intensive, and expensive, hospital care to survive.
This is what’s called “stupid.” Naturally, wingnuts are for it.
Someone asked in the comments if we have to choose between “unevenly distributed access to health care, and evenly distributed inaccess to health care?” No, we don’t have to choose that at all. Wingnut mythology aside, most industrialized nations provide access to perfectly good health care with no waiting lines to all its citizens. Some do a better job than others, but it can be done, and at a lower cost per capita than we’re paying now. But the longer we pretend that somehow “market forces” are going to solve our health care crisis the worse the inequality will grow, because “market forces” are causing the inequality.
When we do ever switch to universal health care, it will probably take several years to build the medical infrastructure needed to deliver good basic care.
maha,
To call these people “idiots” is an insult to those of us who are real idiots 🙂
Please take it back! And find another word(s).
How about ‘slavish marionette’s, without an original thought in their cranium’s, spouting talking point’s…’
Nah, too long…
How about imbecile’s?
Take a look at the American Heritage definitions of ‘idiot’ and ‘imbecile.’ According to my ancient edition, an ‘idiot’ ‘is incapable of learning connected speach.’ So, they can’t be idiots. Their speach is connected – to the same talking point’s. Ergo, they must be imbecile’s!
I’m sorry to unsult all of you imbecile’s out there by this comparison.
There’s just no good way to do this without insulting some poor innocent group…
So we have to choose between (paraphrasing Churchill) unevenly distributed access to health care, and evenly distributed inaccess to health care? That’s depressing…
This is framing, more than anything. People who previously were not getting basic care are now waiting.
People who previously were not getting basic care are now waiting.
Yes. But the larger point is, do you see how the problems are interconnected? Do you see how reliance on a so-called “free market” health care system has created a health care system that is less and less reliable about delivering health care, to the point that just expanding insurance coverage to the uninsured doesn’t automatically mean health care services will be available to them?
The other point is, it doesn’t have to be this way. There are solutions to these problems. However, there are no cheap and quick solutions, and the Right will fight implementation of the solutions tooth and nail.
Speaking of framing, can we stop calling the Massachusetts plan “universal health care”? The correct term is “mandatory health insurance.”
As usual, you have a good point, maha, but after reading that Hewitt post, I despair. I don’t know which is worse, that Hewitt’s listeners are so eager to label Hillary a liar that they imagine that bookbags and armbands didn’t exist in 1968, or that Hewitt claims that at the age of 12 he wasn’t aware of such things, and couldn’t possibly have an opinion. I was 8, and I remember such things clearly. Was he living in a cave? (Perhaps so, given his attitudes.)
We can’t even have consensus about the historical reality of bookbags and armbands? On college campuses in the 60s? Are they kidding? No wonder they can’t wrap their heads around the idea that the shortage of primary care doctors has been there all along, it’s just now distributed differently and therefore more obvious to them.
c u n d, imbecile is too polite a word for them.
Folks, we are going to have to come to grips with reality here. When we elect a president who implements health care for all, there is going to be a shortage of doctors. I disagree with Barbare on ‘several years to build the medical infrastructure’. It should read a couple of decades. The impact of universal health care on the medical system will be a wingnuts dream – UNLESS we can think and operate outside the box.
Let me be clear that I am not suggesting we shortchange anyone who needs care. My favorite person is my 4 year-old daughter, and the preferred pediatrician is not an MD, but an ARPN, if I have the initials right. She’s a highly trained nurse with incredible empathic talents. She also knows what she does not know, so we will get bumped ‘up’ to an MD or specialist when needed.
While this ‘nurse’ caregiver is gifted, I do not think she’s even close to unique. I’m told that the floor nurse in a hospital will save patients from malpractice more often than we want to know. To put it simply, she saves the patient from the doctors screwups.
There are a lot of highly trained non-MDs who can handle a huge portion of the primary care work. They only need to be licensed and certified to do it, and trained to recognize when a situation requires the MD. IMO, doctors have held way too much ‘busy work’ that a competent RN could do.
The fact is, that no matter what solution(s) we choose, there will be adjustment’s and certain ramification’s.
We know that the idiot-Right will freak out, and point out any shortcoming’s.
Health Care is one case where we must, ‘stay the course….’
We have to stop worrying about the Right Wing freaking out.
a) It’s what they do.
b) It’s all they do.
c) It’s starting to lose its luster.
After their Second Great Experiment (Prohibition being the first, and we all know how that one turned out) we once again have an opportunity to defuse their whining and just let them scream.
I would give a lot for one talking head, for one show, to counter their talking points with, “But you were wrong about that, and that, and that. Why should we listen to you now?”
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I work with and know a lot of folks in the existing ‘market driven’ health care system, doctors, nurses, physical and respiratory therapists, and so forth.
Seems to me that the day when the sanity of universal single payer health care replaces the market system [profiteering entities replaced], then we will witness a resurgence of good quality care, even in spite of there being shortages in numbers of trained caregivers in the early transition times. I say this because those folks I know are burnt out with the pressures of paperwork, with making care ‘align’ with the demands of insurance company strategies, and with being very overworked by the ‘market’ push to get fewer employees to do more work, and without additional pay.
We need to put the honorable professionalism back into this system so that those who have a calling to serve the health needs of the sick and injured and frail will not simply be used by profiteers who could care less about the nobility of service to others.
The maldistribution of medical specialists is a long standing problem, and has only been getting worse. Medical education, like most higher education, is getting more and more expensive, as the state shoulders less and less of the cost of running public colleges and universities. College tuition, in real dollars, has skyrocketed in the last twenty years; so have medical school fees. Very few doctors graduate debt-free; many have massive debts.
Once out, they realize that, in order to pay off their loans, they have to become a specialist or sub-specialist. Primary care jobs don’t pay very much (relatively) and, if you’re going to be thirty when you finally finish, and saddled with a few hundred thousand dollars worth of debt, you have to consider these things.
Back in my day, before the Reagan revoultion had run its course and wiped out every last vestige of progressivism in our government, there was a program that would allow new doctors to write off their medical schoool debt in exchange for working in primary care in underserved locations for a number of years. The program was a good one, and it worked. So of course it is no more.
Now many schools steer students to private lenders instead of government loans (kickbacks….), and there is no loan forgiveness. Are we surprised that medical students choose the beter paying specialties? Many would love to be in primary care, but just can’t realistically do it.
I hope I live long enough to see the how the typical infirmities that come with advancing age, meet up in the current crop of wingnuts as they age, so they can see how their stupid ideas have ruined everything in this country, especially healthcare at a time when they will need it most.
Anyone who thinks our system is great is either: young and healthy, or old and rich. I saw a great saying the other day, that should be made into a bumpersticker: There are two types of Republicans – millionaires and suckers.
Moonbat – I want one of those bumper stickers.