Do you realize that the United States already has nationalized health care for the elderly? We have had it for forty years. It's called Medicare.I thought that was important enough to warrant a separate post.
Medicare is indeed a type of socialized medicine, and as such we should consider how well it has worked in discussing nationalized health insurance. Here are some important facts to consider.
1) To save money, the government periodically cuts Medicare payments by fiat. A procedure Medicare paid a few thousand for in the 80s may only get a few hundred today. Sometimes this is due to to changes in technology, but sometimes it's just a cut.
2) When Medicare payments are cut, other patients feel the squeeze. It takes a certain amount of money to run a medical practice or a hospital. If Medicare patients (who make up a large percentage of patients in many specialities) pay less, other patients may have to pay more to make up the difference. If that sounds unfair, remember ...
3) When Medicare payments are cut, doctors and hospitals feel the squeeze. Many will stop accepting new and even current Medicare patients. In the latest round of Medicare cuts, it appears radiation oncology (my field) is going to take a particular hit with some practices seeing 30% cuts.
At this point, we're not talking about a doctor not being able to pay for his new boat. We're talking about not being able to pay the light bill. A survey (pdf) of members of the American Society of Radiation Oncology (ASTRO) suggests that up to 40% of practices may have to close down, and more will "consolidate" offices -- meaning they'll close locations.
All of this means ...
4) When Medicare payments are cut, Medicare patients feel the squeeze (pdf). "Managing" medical costs by simply cutting reimbursement means that Medicare patients have a harder time finding a doctor and may have to travel farther to get the treatment they need.
In radiation oncology, where patients are often treated Monday-Friday for six or seven weeks, increasing travel can cause a great hardship, especially when you consider that Medicare patients are already living on a rather limited income.
And after all of that ...
5) Medicare will be broke in about 10 years. If Medicare is the model for how the government will provide health care to everyone at an affordable price, it has failed. The only reason it has survived as long as it has is because it exists along side a robust free-market system.
So what about Medicaid? It's worse. It pays less than Medicare, so their patients have a harder time finding doctors. The VA? Don't get me started.
So what will happen when everyone is in a system like Medicare? Look at Great Britain and Canada, and see the lottery to get a family doctor, the do-it-yourself dentistry, the lack of ICU beds, and the wait to get a heart bypass, and ask if "free" health care is worth the cost.