By Evan Tuchinsky
Paradise (Calif.) Post, Oct. 19, 2010
Last week I took an assignment from another newspaper to cover the Mad As Hell Doctors’ appearance in Chico. The advocates for a single-payer system were completing a tour of California, and the capacity crowd at Harlan Adams Theater was the biggest they drew. They found a very receptive audience.
The panel – four physicians from the Pacific Northwest, joined by a local doctor and two local nurses – raised some thought-provoking points about healthcare reform. If you’re unhappy about the Patient Protection and Affordable Care Act, you’re in good company, and you have something in common with these crusading physicians who find reasons for displeasure on both sides of the debate.
They’re mad about disinformation like “death panels” and “socialized medicine,” which clouds the discussion. They’re also mad that the single-payer option wasn’t even considered by the White House and Congress, leaving us with a compromise bill with fundamental flaws.
They see single-payer insurance as critical.
“Single payer” tends to get lumped in with “nationalized medicine” even though there is a key distinction: Insurance would come from the public sector, but care would come from the private sector. Despite the oft-heard crises of “keep your government out of my healthcare,” MAHD speakers argue that the majority of healthcare money flows from the government right now. Three of the five groups covered by insurance are seniors (Medicare), children from low-income families (Medicaid/Medi-Cal) and military veterans (VA).
The imbalance in economics comes when private, for-profit insurers can cherry-pick plum customers. If all insured Americans – young and old, healthy and sick – were part of the same “risk pool,” instead of segregated, premiums from the former would cover expenses of the latter.
The so-called “government option” would have been a disaster, one Mad As Hell Doctor explained, because “the private insurers would game the system and throw all the sick people to the public option, and when the public option failed, the private insurers would say, ‘See, the government can’t do healthcare!'”
The idea of a government-run insurance monopoly raises understandable fears, even among those who see benefits in a single system – benefits such as less paperwork, fewer sets of rules and, correspondingly, a greater share of each healthcare dollar going to actual healthcare.
Before getting alarmed, though, it’s important to look at the status quo and assess fears accordingly. Take the notions of lines and rationing, for instance. There already are lines. Emergency rooms are backed up. It’s hard to get a doctor’s appointment if you don’t already see a primary-care physician. And, as one MAHD speaker asked, how long have you waited on the phone line when calling an insurer?
As for rationing, insurers do this now when they deny treatment or require lengthy authorization processes for procedures, medicines and equipment they cover. The Mad As Hell Doctors gave me a lot to think about, and I know I’m not alone.