Tuesday, April 21, 2009

WSJ: When Doctors Opt Out

The April 17, 2009 Wall Street Journal published an OpEd by Dr. Marc Siegel addressing one of the biggest fallacies in the debate over universal health care, namely the conflation of "coverage" with care.

Here's an excerpt:
When Doctors Opt Out
We already know what government-run health care looks like.

Here's something that has gotten lost in the drive to institute universal health insurance: Health insurance doesn't automatically lead to health care. And with more and more doctors dropping out of one insurance plan or another, especially government plans, there is no guarantee that you will be able to see a physician no matter what coverage you have.

...More and more of my fellow doctors are turning away Medicare patients because of the diminished reimbursements and the growing delay in payments. I've had several new Medicare patients come to my office in the last few months with multiple diseases and long lists of medications simply because their longtime provider -- who they liked -- abruptly stopped taking Medicare. One of the top mammographers in New York City works in my office building, but she no longer accepts Medicare and charges patients more than $300 cash for each procedure. I continue to send my elderly women patients downstairs for the test because she is so good, but no one is happy about paying.
Read the whole thing.

Governments can make all sorts of promises of theoretical "coverage", but that is not the same thing as delivering actual medical care. And as we've seen in countries such as Canada and the UK, the people are all "covered" but they must often wait months for medically necessary care. And in some case, the government simply denies their care.

David Hogberg summarizes this issue nicely in his OpEd in the June 9, 2007 Washington Times:
'Health care,' more or less

...Believing health care and health insurance are the same thing easily leads to some mistaken, if not dangerous, notions. It leads to the beliefs that (1) universal health care and universal health insurance are the same; and (2) that if a nation has universal health insurance, where the government pays for every citizen's health care, that nation will have universal health care, where citizens will have ready access to health care whenever they need it. As the experience of other nations shows, however, universal health insurance often leads to very restricted access to health care.
There's one final danger that also needs to be raised. If doctors continue to opt out of government-run health care, then the next logical step will be to force them to treat patients. This is inevitable logic of the mistaken notion that health care is some sort of a "right".

Rights are freedoms of action (such as the right to free speech), not automatic claims on goods or services that must be produced by others. There is no such thing as a "right" to a car -- or a tonsillectomy.

Instead, people do have the right to seek health care from providers on mutually agreeable terms free from government interference. The government should protect that right.

Whenever government attempts to guarantee an alleged "right" to health care, it can only do so by violating the actual rights of taxpayers (who must pay for that service) and the health care providers (who must work on the governments' terms, rather than on their own terms). And that is what is fundamentally wrong about "universal health care".