Dr. Brady recently wrote an editorial for an orthopaedic journal regarding the healthcare debate in the US.

Below is his editorial.


Healthcare Disaster?  I DON’T BUY IT
By Paul C. Brady, M.D.

 
Last month Bennie Lindeque’s editorial asserted that the American healthcare system is a ‘disaster’.  I DON’T BUY IT.  And here are some other things I don’t buy.

1.       Foreign healthcare systems are better than ours:  Dr. Lindeque outlined the healthcare systems of 4 other countries.  He mentioned both pros and cons of these healthcare systems but his editorial was clearly biased in favor of these systems over our own.  While a detailed discussion of international healthcare is beyond the scope of this editorial, I will assert that EVERY national healthcare system functions by employing one common strategy…RATIONING!  Whether it is rationing in terms of services provided or timeliness of providing those services… it WILL require rationing – period.  If government healthcare systems are so great than why did the incoming president of the Canadian Medical Association recently state… "We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize”.  That doesn’t sound like a system we want to emulate.  Foreign healthcare systems are superior to ours?  I DON’T BUY IT.

2.
       A government healthcare system is necessary in the USA as one additional option:  Some argue insurance companies need the competition and that a government system will only be one of our many choices.  First of all, someone please remind me of a government run system…any government system…which works efficiently.  Can’t think of one can you?  Secondly - to actually think the government will not eventually become the only choice in a single payor system is foolishness – I don’t buy it.  How could any other insurance company compete with an organization which uses tax dollars to undercut its competitors?

3.
       The United States healthcare system ranks 37th in the world according to the WHO:  First of all, this ranking was performed in the year 2000.  So why are we talking about it almost a decade later?  And isn’t the WHO a subsidiary of the United Nations?  Oh that’s an extremely objective and unbiased organization (please feel the sarcasm).  If the US is 37th in the world then please tell me the 36 other countries you’d like to go to when you need your hip replacement, or when you need heart surgery, or when you develop prostate cancer.   37th in the world… I DON’T BUY IT.

4.
       There are 47 million uninsured Americans.  This one is easy…I DON’T BUY IT and anyone who does is either dishonest or delusional.  That severely inflated number includes illegal aliens, young people who CHOOSE to forego healthcare, and people eligible for other programs who have not applied for those programs.  The true number is likely closer to 15 million.  And let’s remember that EVERY one of those 47 million people DO have health care.  They can walk into any emergency department in the country and immediately receive the same state of the art medical services that Donald Trump would receive.

5.
       Healthcare is a right:  It may not be a ‘politically correct’ opinion but I just don’t see healthcare as one of my inalienable rights.  I don’t buy it.  If healthcare is a right then for me to not provide elective care (such as an elective shoulder surgery) to an uninsured patient would be unethical.  I don’t buy that.  I would agree that withholding emergency care is unethical but I do not believe I am ethically bound to provide my services as an arthroscopic shoulder specialist to every uninsured patient in the country. 

6.
       Tort reform:  ANY healthcare overhaul that doesn’t address tort reform is worthless…PERIOD.  The pundits suggest that medical malpractice is actually a small piece of the healthcare expenditure pie – I don’t buy it.  Between the direct costs and more importantly the defensive medical costs, tort reform is one step that could immediately and dramatically impact our healthcare system in a positive manner if it were enacted.  Just look at the Texas example.  The fact that tort reform is not on the healthcare agenda is proof positive that this entire healthcare debate is just a political game.

7.
       “If you like your doctor…you can keep your doctor.  If you like your healthcare plan…you can keep that plan”…Quote from President Obama:  Mr. President…I DON’T BUY IT.  This is false for two important reasons.  First of all if my employer discovers that a government plan is much cheaper than their private insurance plan – it’s just a matter of time before they switch to the government plan.  Thus I lose the healthcare plan that Obama promised me I could keep.  Secondly when my doctor realizes that the government plan physician reimbursement hardly covers his overhead and elects to opt out of the government plan…then all of a sudden I also lose the doctor that Mr. Obama promised me I could keep.  Clearly this statement is blatantly FALSE.

8.
       Healthcare costs being 16% of the US economy is a bad thing:   The vast majority of the dollars spent on healthcare actually stay in the USA.  This can’t be said of the auto industry and the recent government cash for clunker program that sent over 50% of our tax dollars to Japanese auto makers.  Healthcare employs millions of people in the US.  Multiple healthcare industries have successfully been developed and yes… even insurance companies have made a great deal of money.  But that’s our country!  If a company provides a valuable service then they usually succeed and expand.  Why are we so quick to villainize them for this success?  Saying that our healthcare system is bad simply because of its share of the GDP (16%) - I don’t buy it.
I know our healthcare system is not perfect.  There are many things we could change.  However let’s also remember that the United States is intimately unique in the world.  No other country has the cultural diversity that we enjoy.  While this is wonderful and makes our country unique, it also adds to the challenges that we face with our healthcare system.  The bottom line is that it is impossible to think that a single system – particularly one run by our federal government - will accommodate all of the diversity in our country.  Instead of an overhaul, why don’t we work toward making strategic changes in our system?  Is our healthcare system a disaster?  I don’t buy it.  But if Obama gets his way and we become a single payor government healthcare system…I guess I’ll be forced to buy it – and so will you.
 
Author:
Dr. Brady is a shoulder specialist at Tennessee Orthopaedic Clinics in Knoxville, TN
Dr. Brady has no relevant financial relationships to disclose.
 
For more information about other things I don’t buy - visit
www.paulbradymd.com