The Trouble With “Single-Payer Healthcare”
This is interesting testimony to the Pennsylvania House Health Council by Neurosurgeon David McKalip, M.D. that exposes the many myths involved with the Single Payer Healthcare that Obama loves so much.
The Trouble With “Single-Payer Healthcare”
By David McKalip, M.D.
Published 05/12/09
Pennsylvania HOUSE Health Council TESTIMONY
David McKalip, M.D.
Chairman, Council on Medical Economics, Florida Medical Association
President, Florida Neurosurgical Society
Chairperson, Florida Taxpayers Union
“Any society that would give up a little liberty to gain a little security will deserve neither and lose both.” — Benjamin Franklin
“Was the government to prescribe to us our medicine and diet, our bodies would be in such keeping as our souls are now.” —Thomas Jefferson: Notes on the State of Virginia, Query XVII, 1782.
Thank you for bringing me to testify before the Pennsylvania House Health Care Policy Task Force. I am a private practice neurosurgeon from Florida and for over ten years, I have practiced in academics, small group and solo settings taking care of patients from all walks of life. While in my first practice at San Francisco General Hospital, I saw the many shortcomings of a government run hospital. Even with dedicated professional health care staff, the constant budget shortfalls, debt and politically motivated regulatory burdens drained the hospital there. Patients waited weeks to go to rehabilitation units while patients in private systems went in days. Repeat patients never took responsibility for their own health — always assuming that the public system would be there for them. I went to San Francisco a young liberal and left two years later a disillusioned doctor. After about two years in private practice I began to realize that only the private sector could deliver high quality affordable health care in the most fair and equitable way without rationing. That is not to say that the current structure of private health care is perfect — it is encumbered by a complex and odd system of financing that few economists would design: third party financing of first dollar coverage. Nevertheless, the care patients receive through private health insurance is far better than that received by those with government funded health care. Better than private or public third party payment is the results produced when patients spend their own money from a health savings account backed by a catastrophic health plan. (But I will discuss that more later).
I saw Medicaid patients for seven years by choice even though Medicaid in Florida pays only 56% of Medicare rates and each patient entering my practice was the equivalent of me writing them a check. I couldn’t blame other neurosurgeons who were not taking these patients and I saw patients drive hours to see me. Finally I opted to see Medicaid only for hospital emergencies — not in my office.
Another publicly run health system also has neglected some of our most valued citizens: The Veterans Administration. Layers of stifling bureaucracy and limited resources have lead to long waits for advanced medical care. At multiple V.A.’s I saw Veterans wait months for a spine surgeon while living with crippling pain or slowly evolving paralysis, get put on another waiting list for surgery and have their surgery cancelled at the last minute simply because there wasn’t enough staff to keep working after 3 pm or any interest of the employed physician staff to work harder.
I have seen Medicare patients denied advanced spinal surgical techniques or subject to overnight stays when others go home the same day due to arcane rules. I have had to perform two surgeries on Parkinson’s patients for dual brain stimulator pacemakers since Medicare won’t pay for the single pacemaker at the same price! I have seen how Medicare patients wait over an hour to see a Nurse Practitioner for 10 minutes and their doctors for 3 minutes and leave confused only to enter the mill again. I have seen referrals to specialists from Nurse Practitioners that a primary care physician could have avoided. But the number of primary care doctors has dropped as Medicare has artificially controlled the amount of payment for their services. I also routinely see able-bodied patients inappropriately granted disability for health care and disability benefits.
