This article was first published in 2003 in the journal Orthopedics. It was written in response to a fellow Orthopedist's call for government single party payer. Little did I know at the time how serious an attempt would be made within the next 7 years to "transform" medicine in America.
Lee D. Hieb, MD
Universal Healthcare Myths
Several superficially compelling reasons for universal healthcare are usually put forward. First, as the business of medicine becomes more complex, some physicians believe universal healthcare would be less of a hassle. Recently, a neurosurgeon commented, “I would be happy if the government would pay me $250,000 a year and took care of all running of the office so that I could see patients.” The second argument preys on physician ethics. It is often stated (and Dr Weiner discussed it in his article), that physicians under a capitalistic system fail to care for needy and sick patients. Presumably, universal healthcare, with the government looking after everyone, would somehow do charity better, and would “leave no patient behind.” The third myth is that the economy of scale would somehow cause medicine to cost less if run by a single-party payer. It is argued that the cost of the various insurance companies and government paperwork would be lessened if one unified form and one unified payer existed.
Universal Care Around the World
In the Soviet Union, medical care was free to all, but only the Polit Bureau (eg, high-ranking officials, their family, and friends) received any good care. When Boris Yeltsin required cardiac surgery, he went to a special hospital only for government officials, and was treated by American-trained surgeons. He even flew Dr Debakey from America to Russia to make judgements about his case. Why? Because he knew that he could not trust the physicians, nor the system he had helped create. As Ayn Rand wrote in Atlas Shrugged, “It is not safe to trust one’s life to a man whose life you have throttled.” According to Ann Ebeling (her husband, Dr Richard Ebeling, is President of the Foundation for Economic Education), who was raised in the Soviet Union, quality medical care was simply not available through state run medicine. To get help, patients would bribe doctors to come to their apartments and bring whatever equipment could be mobilized illegally from the hospital to perform lifesaving procedures. Black market private practice was the only effective medicine during the 70 years of economic decline and tyranny of Soviet Socialism.