A physician "comes out" for Single Payer

...My comment evolved into something much more -- it forced me to crystallize my thinking in a direction that many other factors in my life have pushed me away from.

You see, I'm a physician, and a very close family member is a physician. I am a delegate to the AMA -- which, as you know, remains steadfastly opposed to a single-payer solution, although it has developed an extensive reform proposal based upon providing insurance to everyone via tax credits -- subsidized health insurance.

But I have come to the conclusion that our insurance based system is simply not reparable.

I've decided it was time to come out.

But in the end, the AMA plan, like President Obama's plan, and Sen. Baucus's plan, is still based on the core of our present system: one that is run by, dominated by, and subservient to the health insurance industry, the hospital industry (especially those tied in to the insurance industry), and big pharma.

It is a system that has created an unfixable disconnect in the traditional concept of a market driven by supply and demand, in that the purchasers of health care are not those who are receiving the care. It is a system in which the basic idea of competition has been turned upside down, driven not be quality, value, service or convenience, but by the most self-serving deals that can be driven by the insurance industry.

Single payer health care might mean the death of private medicine in this country. It would likely mean that the clinic that my family member spent an entire professional career proudly building using loans that the clinic's physician partners took out on their own risk, would go out of business, because unless reimbursement rates were substantially increased above current Medicare rates, medical practices, even successful group practices, that are not owned by huge corporations or integrated systems that can take advantage of tax scams like those described above and preferential pricing only available to hospital owned practices -- will not be able to stay in business.

But you know what? Private, independent medicine is being slaughtered now. It's going extinct. And with its loss, an important part of what in the past made American medicine so vital, so personal and of such high quality will disappear, too.

That may be the price we have to pay. I have concluded that it's time to get private insurance out of the business of running and paying for health care, even if we were able to get every man, woman and child a health insurance policy, especially when insurance is used, as it often is now, as a way for huge corporations to gain a stranglehold on markets, and take all choice away from patients. Even if it means that many of my colleagues, including in my own family, wind up having to sell (probably at a substantial loss) what they've spent their lives building.

You see, while I understand capitalism, I also firmly believe that in an enlightened, wealthy society, we really have to do what does the most good for the most people. And if we believe that health care is a right and not a privilege, polishing the edges of a system that is rotten at the core will never get there.

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