There's No Such Thing as "Free" Health Care

"There's no such thing asa free anything,"my physician-dad says. "Someonehas to pay, and when it comesto health care, the number can getreal big." I wonder if we'll everlearn that lesson?

JAMA

Calling the current US healthcare system "irrational," the Physiciansfor a National Health Program(PNHP; www.pnhp.org) hascalled for a national health care systemthat would cover all Americans.Under the proposal, outlined in theAugust 13 issue of , medicalcoverage for US citizens would bepaid for by the government.

The Chicago-based group favorsa health care system similar to thesystems in place in Canada and GreatBritain. "Access to comprehensivehealth care is a human right," PNHPmaintains, and it's the government's"responsibility to ensure this right."PNHP, whose 7800 membershiprepresents less than 5% of practicingUS doctors, adds that $200 billion inadministrative cost savings could berealized via the single-payer plan.

UNWORKABLE PLAN

I'll admit to my readers that I'vemade up my mind on governmentrunanything—including health care.It just doesn't work. And I know I'mnot alone on this one. In talking withpracticing doctors, it's been myexperience that most are all toofamiliar with the odious and ineffectivework habits of government—think Medicare bureaucracy, malpracticereform, and taxes.

And while I respect any thoughtfuldoctor group that seeks to put theinterests of patients first and believethat they are genuine in their concernsfor our health care system, Iwill never concede to them a greaterlevel of sensitivity on this importantissue. I am a patient after all.

In the end, I suppose it's just amatter of differing philosophies. Mydad claims that 75% of all satisfyingphysician-patient relationships comefrom patients' positive feelings fordoctors. "If it's good, you can reallymake a difference as a healer," he said.I just can't see government involvement—and if they're paying, they'regoing to be involved—making thedoctor-patient connection any better."A single-payer system would demoralizedoctors and patients," says Dr.Donald Palmisano, the AMA's president,who's a doctor and a lawyer.

RIGHTS AND DUTIES

Finally, if we're going to agree thathealth care is a right, then logic andfairness would dictate that along withevery right comes a responsibility.And when it comes to personal responsibilityfor health care, most

Americans fail that test. Whether it'sproper diet, exercise, annual checkups,or taking needed medications—I'm sad to say—most Americansdon't take care of themselves. Thatwon't change just because the governmentdecides to foot the health bill.