Day in and day out, doctors and patients endure our broken health-care system. They are working and surviving in a less than therapeutic environment riddled with problems, which make it almost impossible to provide care in a timely and effective manner. Who better to comment on an agenda-driven movie on the issue than the people closest to it?
Most have heard about or experienced the long wait times in emergency departments and physicians' waiting rooms. Many have tried to get in to see a specialist, only to be told it will be weeks or months before they can be seen. There have been countless studies on nurse, physician, pharmacist and medical technician workforce shortages, with Arizona often cited among the most severe, due to our population boom.
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The Arizona Republic and others have written about the medical liability insurance crisis plaguing doctors and hospitals. Society wants to be paid for some less than perfect outcomes, and this in turn feeds a billion-dollar habit called "defensive medicine."
Then there's the payment system for doctors and hospitals, run by third parties who regularly stand between doctors and their patients. They budge their way into medical decision-making, denying certain medicines and procedures in the spirit of saving money, all the while their investment portfolios grow into the billions and the fees they expect patients and employers to pay increase yearly. From Wall Street's vantage, the handful of mediglomerates remaining are a limited form of free-market competition. But from the bedside vantage, free markets have all but disappeared for small-business medicine.
Our broken system's pathology is in its bureaucracy, not its anecdotes. If anyone bothers to ask, doctors and patients on the frontlines will tell you to break apart the behemoths - the large for-profit health plans and federal programs - and work toward basic catastrophic coverage.
Yes, we need to ensure major medical expenses are covered for all. But, bring back the free markets that breed quality and efficiency at the bedside. Get rid of the free-care mentality, which leads to inefficiencies and waste. Push for personal responsibility for our own health. Support preventative-care and healthy-habit initiatives.
Remove third-party interference completely, and the associated friction costs. Allow medical decision-making and spending to be the decision of the patient, based upon their doctor's qualified recommendation. Or several doctors' qualified recommendations. Let the people decide for themselves the level of care they want to pay for and the services they want covered. This would lead to more informed patients, who would take the responsibility to consider their health care decisions, because not only is it their health, but their money.
Numerous studies show that a strong physician and patient relationship leads to better outcomes and satisfaction, yet third parties - health plans, the federal government and others - continue to come between doctors and their patients, with non-medical personnel making medical decisions via the telephone, based upon what is cheapest, not what makes the most sense medically.
The doctor and the patient have all but been taken out of the medical decision equation, and America has never been more dissatisfied with its health care. The doctor/patient relationship is on hospice care - the end is not only inevitable, it is near.
The Canadian system Moore so admires has the same problems we are now facing, only more severe. Do you really think creating another massive bureaucracy to administer health care is the answer? We already have that and it's called Medicare and Medicaid. And, because of those systems' limitations, invasion into medical decision-making, and flat or falling reimbursements, doctors are abandoning those systems.
Creating another bureaucracy will not provide more access to care, it will further crush it. And quality will suffer. It's no secret that competition leads to better quality. Every industry in America has competition and there are levels available to every citizen to access the products. Health care should be no different. Already today, patients without health care insurance are being served by physicians offering creative coverage plans. When allowed to exist, competition leads to creativity and better relationships. Our country was built on this ethic.
Zuhdi Jasser is the immediate past president of the Arizona Medical Association. He is an internist practicing in Phoenix.
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