A friend who works with the unemployed called me up the other day huffing with indignation. The local charity clinic, apparently overwhelmed, had changed its policies so that her unemployed uninsured would no longer be able to seek care there.
“Someone has to do something!”
Um, what exactly would that be? I’d love to help, but I have bills to pay (as do charity clinics) so I can hardly provide medical care without seeking payment. I understand her desperation (and that of the people she so valiantly helps) but who, exactly, is supposed to do what, precisely?
Things are going to get worse before they get better, I fear. The unemployment issue goes way beyond a devastating economic downturn. It’s a reflection of the most basic economic principle of supply and demand. Wages are the “price” of labor — prices go down when supply goes up. In the case of labor, it’s when you have large numbers of people willing to accept lower wages. Can you say “outsourcing?” Watch as the jobs flow overseas while we’re still left with all these people, but not enough jobs to support themselves. In the meantime they all still need healthcare, but can’t pay for it.
Someone has to do something!
Guess what? It just so happens that we really do have a healthcare infrastructure in this country. Between the Veterans Administration (VA) and public healthcare clinics, we have rather a good start at building a truly national healthcare system. Perhaps now is the time to expand it.
Why not throw the doors of the VA open to the unemployed? It’s not be the same as a personal primary care physician who knows you well, but it’s better than nothing. And make no mistake: “Nothing” is what the unemployed — and many other Americans mired in poverty — have in endless supply. While we’re at it, why not expand the network of public health clinics? Hire doctors, pay them a salary and supply the clinics with tax dollars, and let them care for everyone who walks in. No need for insurance. Make it a real safety net, at least for the basics.
While we’re at it, how about opening a couple of public hospitals back up. We used to have them; Most were shuttered when the private sector realized there’s gold in them thar ills. Hell, why not buy up doctors’ offices and turn them into public health clinics. I’m game. Buy my building, give me VistA and teach me how to use it, indemnify me against malpractice just like doctors in the military, hire me a staff (with government benefits — more than I can afford to pay), pay me $150,000 a year (or the regional equivalent), and I’ll see anyone who walks in the door for you. I’ll bet you can find plenty more docs like me who’d be willing to take the same deal.
Why stop there? At some point down the road, it would probably make sense for the government to open up its own medical school. Why not? Stipulate that 60 percent of its graduates have to go into primary care. Hell, go around the country and start up 10 new family practice (FP) residency programs with six slots each. That’ll put 100 new FPs a year into your nice new public healthcare system.
What would this do to private practice? Nothing at all. You can still see any doctor you want — you just have to pay them. Granted we’d end up with a two-tiered system, but so what? It would be far superior to what we have now. For starters, it would be an actual system that we could work with rather than a collection of ragtag rugged individualists prancing around ordering MRIs for every ache and pain just because they own the machine.
Someone has to do something!
*This blog post was originally published at Musings of a Dinosaur*