I really don’t like playing the role of the pessimist. I wish Obamacare would transform healthcare into a system that benefits us all. The problem, however, boils down to the difference between capitalism and socialism.
Now this may seem rather extreme. Why introduce such “hot” terms into the healthcare debate? The reason is quite simple–it is completely relevant. For example–I am a member of a small medical practice…..4 physicians, 20 employees. I have a small business. I have expenses which must be met on a biweekly, monthly basis. Salaries, rent, overhead, malpractice costs etc. etc. I have a strong vested interest in making my practice consumer friendly. After all I am not the only gastroenterology practice in town. If I don’t produce a satisfactory product– patient care— I may go out of business. If a patient calls for an appointment I will see them (or one of my partners will see them ) the same day. If they need a colonoscopy or upper endoscopy on a timley basis, I will make sure they can obtain that procedure in a short time. I feel a compelling ownership of my medical practice– no one will write me a pay check if there are no funds to distribute. Now compare my situation with a V A doc. Regular hours, regular vacations, limited involvement in the business of running a practice.
Why should the VA doc insist on an immediate visit for a patient, or a scope ASAP. It’s not his practice. The VA doc is a salaried employee. It is the difference between capitalism and socialism. This is not a direct criticism of the VA doc. He/she have chosen to work under that system for a variety of reasons. But the incentive to work harder, to see more patients in a timely fashion, to add work to their schedule is just not there. It is human nature. When we lose that awareness, we wind up with a healthcare system like Canada, western Europe, England. Healthcare may be inexpensive for many, but the wait times and attention is much deferred.
A two teered system will emerge here as there–delayed healthcare for the masses, immediate attention for cash paying patients. It is only a matter of time.