Pros & Cons of Socialized Medicine
Daily Observer
S.Q.
Lapius said “no” for the last time, and punctuated
the finality of his mood, by slamming down the phone.
I
was busy stirring the fire and getting the new log positioned, and really
hadn’t followed the conversation that Lapius had just
terminated so vigorously. I might have
asked him what that was all about, but it turned out to be unnecessary.
Lapius sidled over to watch me work, and said, “You will
never guess what that was all about.”
“Tell
me who you were talking to and I’ll take a shot at it.”
“Ok. I was talking to Crabgrass.”
“He
wanted you to sign another petition to have the Congress repeal the Medicare,”
I said, searching for the wildest improbability.
Lapius stared wide-eyed, “How did you know that?” he
asked. “Did you know Crabgrass was going
to call me?”
“No. But I know Crabgrass. He ran the hammer and sickle up on his
flagpole the day Medicare was passed.”
“Yes,”
agreed Lapius.
“It figures. One of the most
advanced minds of the middle ages.”
“But
you do agree that government interference does have a stifling effect on the
medical profession, don’t you, Simon?”
“Of
course I do. But that doesn’t mean they
should scrap programs that help pay for medical care. It is the way that they do it that should be
changed. After all, we physicians gladly
accepted government subsidizing to research, hospitals, training of doctors,
and medical schools. We can’t complain
about those programs. They have given
tremendous impetus to the entire medical profession. The medical profession, in effect, has
accepted areas of socialization.”
“Are
you in favor of socialized medicine?”
“I
am in favor of the government picking up the bill for health care, and against
any program that disrupts the doctor-patient relationship.”
“Terrific. You favor two irreconcilable positions. In the first place, the bill for health is
open-ended. There is no limit to how
much a government can spend for the health of its people.”
“True. But what else are governments for, or at
least our government, anyway, but to insure its citizen’s life, liberty and the
pursuit of happiness. Certainly it
follows that to assure these qualities, our government
must invest in health, education, and housing, and create the healthiest
environment possible for its citizens.
After all, that is what a family does, that is what a community tries to
do. The federal government is simply a
higher plane of social organization that should be helpful in these matters.”
“Then
why shouldn’t you favor socialized medicine?”
“Because
I don’t think it will be necessarily helpful.”
“Why not? You are
being inconsistent.”
“Because
it may destroy the medical profession in the process, and without the medical
profession, the noble aims cannot be fulfilled.
The first generation of socialization seems to work fairly well because
the doctors who have been in private practice are swept into it and apply the principles
of service they had applied in their private practice. But eventually a different type of person
goes into medicine, one who is willing to sacrifice some individuality, to make
medicine a routine
“How
can the doctor-patient relationship be preserved if government is going to
institutionalize medicine?”
Lapius shook his head.
“I don’t really know. Perhaps the
best compromise would be an extension of the Medicaid system.
Set
a realistic fee for services, and have the doctor submit the bill for services
on a monthly basis as he does today.
This will allow patients free choice of doctors, and permit the
physician to govern the medical problems of patients, choose appropriate
specialists and so forth.”
“It
could be expensive.”
“Everything
is expensive. But they could save money by
eliminating the very expensive watchdog bureaucracy that monitors fees and
services and utilization.”
“Be realistic, Simon. No government is going to spend money without
finding out where it goes and how it is being spent.”
“They
did with Lockheed and the Penn Central.
To make the system work the government will have to trust the doctors
more than it does and to trust the hospitals.
Sure there will be some cheating.
But the loss to cheating will not be as expensive as the cost of
supervising every iota of medical care.
If you think your patient needs something you will be able to order it,
without the concern that some clerk miles away may deem it unnecessary and
interfere with the care of your patient by canceling the order. The systems must be built on faith and trust,
and this is where the government has erred.
They have set up a policing system which, frankly, in my opinion, runs
counter to the spirit of the constitution, and the precepts on which the nation
was founded. After all, volunteerism is
as American as apple pie. Communities
can be depended on to develop volunteer police and fire departments. Volunteer rescue squads sprout all over the
place and do a terrific job. The spirit
of volunteerism must be built into any government system to make it work, and
this is being excluded.”
“You
favor volunteerism, I take it.”
“Of
course,” said Lapius.
“So
why do I always have to build the fire?”
“You
volunteered, my boy. You
volunteered.” Lapius
said, warming his hands over the curling yellow flames.