The suggestion by a ‘think tank’ that more well-off patients should be charged £20 when they see their NHS GP has been greeted with howls of disapproval here in the UK. I’m informed however that people in America are totally bemused by this news item. For them £20 to see a doctor must seem like winning lotto! Allow me to explain:
Citizens’ rights in the USA are enshrined in the Bill of Rights of 1689.The bill is essentially the first 10 amendments to the Constitution and comprises:
Freedom of religion
Freedom of speech
Freedom of the press
Freedom of assembly
The right to bear arms
The protection against unreasonable searches and seizures
The right to refuse to witness against ones self * (aka ‘taking the 5th’)
The right to a speedy trial
The right to trial by jury
The protection against cruel and unusual punishment
Now you have to admit this is good stuff; I’m not that keen on cruel and unusual punishment myself. But note one important ‘right’ that is not there – the right to medical treatment. You have the right to bear arms and if you aren’t rich you have the right to bear illness and suffering too. Of course if you’ve got money you can buy yourself a lot including a new face and other parts of the body, drug cocktails for your kid with ADHD, organs from people in other countries and so on.
A lot of people run out of money when they get ill in the USA. More than 60% of bankruptcies filed in the last 2 years in the USA were caused by high medical bills. No wonder Americans are always muttering something about ‘health insurance’ in voices laden with fear and anxiety.
So why is medicine so expensive in the USA? After all it’s just a service industry where you buy a service from a medically trained person called a ‘doctor’ – isn’t it? Afraid not. My art, the art of medicine, has become a commodity to be bought and sold by creatures made of very different stuff from simple patients and doctors. Other animals need to make a very good living out of health care: The insurance salesman, the ambulance chasing lawyer, the vexatiously litigious patient and the executives of Big Pharma all have fancy cars, houses and at least one family each to feed. Doctors need to pay huge insurance premiums in case they are sued – which they inevitably are. So the price of seeing a doctor goes up and up and up… Drug companies spend fortunes on developing drugs so they must make a decent profit for their shareholders! And there’s a lot of shareholders who need to make money out of sick Americans. Yes, the shareholders are mainly Americans too. Oh forget about it – it’s too complicated to explain but I’m thinking of selling out myself. Any drug company want to offer me a 7 figure salaried job? No, no, not pounds! Dollars will be fine. USA! USA!
Hey Doc, that is funny stuff and almost close to the truth.
Capitalism has one job:”Use free markets to seek maximum return on capital.”
In this regard, our medical complex of insurers, drug companies, plastic surgeons and other subspecialists, lawyers and plaintiffs, lobbyists and their bought politicians, have all achieved success. THAT is why the status quo is being defended to the hilt, no matter how many people get sick or die in the process. Sick and dying people are drags on ROE…return on equity. A claim denied is money in the bank.
Doctors also prefer the status quo. Can you imagine what a cardiologist would do if you had a preventive that reduces cardiovascular disease by 90%? Yes, they would get divorced and the wife/husband would seek the safety of a cash-receiving face/boob/tummy/bum/lip lifter!
Can you imagine what a hospital CEO would do if traffic was cut by 50%? Yes, they will become bankers (if smart), a legal position for mega robbery. Who would then run the hospitals…..altruists? Would you want more bankers?
Speaking of selling out, I’m now awaiting news about whether I have been hired by a large health insurer as a Chief Medical Officer. I will be handsomely rewarded and will also get more for each claim denied. It’s legal and a conscience is merely the notion that somebody may be looking. Americans have little time for this nonsense.
One more thing you will hear from the land of the free and well insured: “Socialism is behind the new healthcare bullshit reform argument.” Allow me to correct this: Socialism is when the govt. OWNS the means of production. In the case of USA!USA!, the means of production owns the govt. They finance the political campaigns and thus deserve to rape the place like true professional capitalists. Individual taxpayers serve only to bail out banks….and donate at least 6 months of the year for this noble cause. Noble victims, as you Provocative Therapists call them, eh?
As GW Bush said:”The Constitution is just a goddamn piece of paper.” Since when was this place about fair rights for all? Democracy is mob rule.
Truth is the hardest thing to face. Karl Marx, an economist, is hopefully twisting in his grave. Government cannot control the economy……free markets must do so. Patients are innocent bystanders. Medicine is business. Patient centricity is an illusion, even over there in Britain where everybody is gentle and well mannered.
Sorry that you will now have to pay 20 quid, but you should also consider tipping a doctor who adds a physical examination to your enjoyable visit.
Love,
Ruth
Yes, I’m beginning to understand medicine USA!USA! style better now. Prevention is NOT better than cure in USA!USA! Preventative medicine is clearly very bad for the economy especially the medical economy. Perhaps smoking should be encouraged more. Smokers make more money for doctors while they are alive and they die well before they become a burden on the state. Perhaps we will see a return of the Marlboro Man.