The reality of social healthcare/government funded healthcare

There are many people who believe that the current healthcare system is not equitable and fair for all Americans.  I do not disagree.  Healthcare is a bloated trillion dollar industry that makes money for hospitals, pharma, and health insurance companies while the patients suffer from it.  It is expensive, it is biased, and it is not patient centered.   Health insurance that is tied to your job is too expensive to take with you when you leave that job, benefits are not equal at all jobs, and some jobs (like mine) where you are a small business owner and  independent contractor, you are responsible for your own insurance coverage.  Many believe that “medicare for all” is the answer.

Here are some realities to socialized government insurance that people should understand before jumping on that bandwagon.

First off, government funded insurance does not = you will receive prompt treatment.  When the government is paying for something, they will ensure they make money at the end of the day.  There are fewer hospitals, fewer providers, and appointments are difficult to get due to more need than providers to see patients.  The wait time for a specialist can run 8-12 months.  Imagine being in kidney failure and you cannot see a nephrologist for 8 months?  You could die before you ever see the person who is specialized in your disease.

Second: elective procedures.  Yeah, those go bye bye unless you want to pay out of pocket.  When the government is funding your healthcare, they won’t pay out for something unless it is medical necessity.  Example: gall bladder removal.  You may have a colicky gallbladder that causes you some issues every so often.  You may have a few days of feeling crappy, pain and nausea, and then it calms back down.  It reappears every 3-6 months.  Currently, your provider will say “yeah, that is making you feel ill so if you want to, let’s go ahead and get rid of it”.  It isn’t an emergency, it is done for patient comfort and early intervention.  Elective intervention.  Government sponsored healthcare?  You will not be getting that gallbladder yanked out until you are sick and miserable.  When that colicky gallbladder gets to the point of causing you pain and illness every single day, THEN they will pay to remove it.  We wait until someone is at the end stage of a disease process to intervene rather than early on when it’s just bothersome and annoying.

Third:  healthcare is anything but equitable.  Government healthcare dollars are finite.  They have a budget.  If you think your current insurance provider denying care is a bad problem, you haven’t seen anything yet.  Government healthcare dollars go to places where they get the most good for the most people.  A sad example: a 39 year old with breast cancer is going to get treatment such as chemo/surgery/radiation.  But your 80 year old nana?  She is not going to get aggressive treatment.  Because the life span of that 80 year old is far lower than the 39 year old, and they will prioritize care to the younger patient.  Because the dollars spent will equal more good for a longer period of time on the 39 year old than the 80 year old.

Another example of the equitable care situation.  Under current models of care in the USA, we will pursue treatment as aggressively as the patient wants to.  (It does make the hospital more money to do so). Using cancer as the example again.  A patient comes in and we find that their newly diagnosed breast cancer has spread to lymph nodes and there is also a spot on the colon.  This is considered stage 4 metastasis cancer.  With treatment options, surgery, chemo, etc, there are many patients who can go on to live for 5-10 years or more with a terminal cancer diagnosis.  I know of more than one woman who has battled metastasis breast cancer for 10-15 years before it takes their life.  They have ongoing oral chemo and radiation and scans, we spot treat areas that pop up, etc.  That kind of care is expensive and we know it is not going to be curative.  We are merely trying to get as much time as possible for that patient.  Under government healthcare, this will not happen.  If someone has a terminal stage 4 cancer diagnosis they will not get aggressive treatment.  The dollars will be used to treat more people with a stage 2 cancer that CAN be curative, versus the stage 4 that we know will end in death sooner than later.  Treatment options of today will not be the same.  Again, finite dollars, do the most with the dollars we allocate, and we don’t spend those dollars on “right to try” when it is going to be a multi million dollar treatment to prolong the inevitable.  Sounds cold and callous, doesn’t it?  There will be an age driven and diagnosis driven hierarchy for who gets the dollars for treatment.  The disabled, the elderly, and the chronically ill will suffer the most.

Lastly, did covid teach us anything?  HOW many people became angry and mad with how hospitals treated families of covid patients?  Refusing to let family be at the bedside.  Their loved ones dying alone.  Refusing entry in their building unless you were vaccinated.  Or masked up.  If the government pays for and runs your healthcare, there will be NO OTHER OPTION.  Comply or die.  The best example I can give is the VA and Medicare.  Both government funded healthcare.  Do you know what their vaccine mandates looked like for their patients and providers?  Draconian mandates is the best way to describe them.  Patients were threatened with loss of VA benefits if they did not get vaccinated.  Medicare patients were herded up in the hallways and told if they didn’t get the vaccine they were going to die.  Nursing home patients had zero autonomy while the nurses vaccinated all of them.  Medicare mandated it.  The VA mandated it.  Government healthcare.  What do you think vaccine mandates would have looked like if our entire healthcare system was government funded?  Every single one of us would have been mandated to vaccinate or else we would not be allowed to access healthcare period.

There are a host of other issues with socialized/government sponsored healthcare, but these are the ones that hit the compassionate trigger button for me.  I never want to be the provider that has to tell someone no because our finite funded dollars will not agree to treat them.  Nor do I want to be the one forced into getting a vaccine I do not want.  Nor do I want to be told that I cannot get a treatment I may need because the government dollars refuse to pay for it.