The Democrats are in full swing this election season with promises of healthcare for everyone. They make it seem as if a magical fairy will sprinkle greater access and shorter waiting times upon the entire country, all the while keeping our taxes at the same level. What they don’t bother to mention is that the true cost of health care—$2 trillion—rivals the federal budget. In essence, to pay for everything we would have to nearly double the tax rate just to keep things the way they are now. What politicians also fail to mention are the further economic consequences of going to a single-payer system. Consider all of the men and women currently employed by the multitude of insurance companies. The moment we enter a single-payer system all of those people are going to be unemployed. Such a massive wave of people losing their jobs will lead to an immediate decline in government revenues and an increased burden on the welfare system.
While Hillary Clinton is trying to convince us to use evidence-based medicine as a way of deciding which medications and procedures get reimbursed, I wonder what standard would be used to uncover which parts of medicine are truly evidence-based. Using such a system would mean that all sections of complementary and alternative medicine could not be paid for. Many common surgical procedures such as the Whipple would also have to disappear. And even some of our medications—we aren’t sure of the mechanism of action for some of them—would cease to exist. Further, given the ever changing nature of medicine, how quickly will the government respond to new evidence? Just this week an article came out in PLoS Medicine stating that antidepressants are ineffective in patients with mild or moderate depression. If we were to use Mrs. Clinton’s principles of evidence-based medicine, would physicians have to rate a person’s depression in order to get a prescription to Prozac covered?
Also, now that healthcare is now “free,” will there be any limit to the amount of services that a person can use? Can a person with a headache demand an MRI just to rule out the one in a million chance that there is an intracranial bleed? Will over-the-counter medications now be covered? How many ultrasounds will a pregnant woman be allowed to have? I foresee physicians’ offices getting overloaded with very minor complaints: everything from an ingrown toenail to sunburns. And why stop at primary care? So long as we’re getting everything for free, let’s not even bother with setting an appointment. Let’s just go straight to the emergency department for any complaint that we want to get seen that day. My own hospital has loads of uninsured patients showing up to use the department as fast access primary care. I can’t imagine the time delay that will occur once millions more start to take advantage of this system.
Probably the greatest bite in the ass is that the American Medical Association—the group that is supposed to be protecting doctors’ interests—is the very organization that is stabbing us in the back with regard to health insurance. The AMA has recently begun airing commercials called Voice for the Uninsured in an attempt to shame us for having medical coverage. When I was a first-year medical student, many of my classmates joined the AMA by signing on for the $40 annual fee. I didn’t sign on back then and I have no plans of joining now. Yet somehow, I continue to receive postcards from the AMA on an almost weekly basis urging me to sign up for their program.