The American Mentality

People talk about a single payer system for our country all the time.   Bernie now wants Medicare for all.  The extreme left wants socialized medicine.  Others bring up Canada and England.  I am NOT going to argue their pros and cons today.  There are tons of both.  Actually, my issue is with our own culture.  You see, Americans want what they want, when they want it, and they want it for free.  It is just in our nature.

Want proof? Here is an interesting poll:

  • A majority of Americans want the U.S. government to require nutrition labels on food packaging, including people who do not read them, according to a Reuters/Ipsos opinion poll released
  • Eighty-four percent of adults agreed that “the government should require nutrition information labels on all packaged food sold in grocery stores” and 64 percent wanted similar requirements for restaurants, according to the poll

  • Most people wanted those labels even though relatively few said they read them. Only 13 percent said they “always” read the nutrition facts when deciding to buy a product

I want ____  done for me even though I won’t use ______.   Huh?  THERE IS A COST FOR THIS!!!

This is just one example and you may feel it is a stretch but I don’t think so. I love my country.  I love the people in my country.  But, oh my god, are we spoiled and greedy.  Personally, I want labels on foods and I do read them but MOST people don’t. They want to eat what they want, when they want, and want no repercussions from it.  Our behaviors are what is killing us and driving up the cost of healthcare.  But I digress.

Could you see a single payer system here with this attitude?  Could you see someone waiting 6 months for a catheterization or a CT scan (the norm in Canada and England)?  I can’t.  I see lawsuits.  I see the ACLU involved.  Would we allow these lawsuits?  Would we allow public opinion to change the rationing guidelines?  We have already done that with Pap smears and mammograms.  They were both supposed to be delayed and less often but the court of public opinion opened up more options.  The cost for this “change” is mind-boggling.

I get that what we in healthcare have doesn’t work.  I believe the Medical Axis of Evil (insurers, big Pharma) needs to be stopped or contained. I just think a free market country can only solve things with a TRUE free market system…. and maybe reality TV.

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “The American Mentality

  1. T Newberry
    October 11, 2017 at 9:22 am

    Sooo your point is that a single payer system would not work in the US because Americans are jerks? I’m not saying you’re wrong, but wow is that cynical.

    • Doug Farrago
      October 11, 2017 at 10:40 am

      Not jerks. Just a little too spoiled.

  2. L. J. Sloss, M.D.
    October 7, 2017 at 6:27 pm

    My impression is that single-payer systems such as the typical European model and Canada are generally quite well received by the populace but fall well short of our standards of availability and timeliness, generating de facto rationing. I do not think this is because of fundamental organizational or philosophical flaws in their variants of “Medicare for everybody” but simply that they are underfunded, markedly compared to the expenditure level in the United States and substantially compared to the optimum in their own systems.

    Personally, I view single-payer as the worst of all possible solutions except for everything else. It could immediately provide a platform for streamlining system management and greatly reducing administrative overhead. There are many hundreds of insurance entities if you count state-by-state, each with a board room and bloated and grossly overpaid administrative hierarchy, each with huge expenditures for real estate and operating expenses, and each as a generator of enormous waste, delay and population-wide stress and distress. My personal experience in dealing with several of these entities is one of constant wasted effort and frustration; if you choose to resort to litigation, you are up against an entity with a huge multiple of your economic clout, with little chance of prevailing without being sucked dry in the process.

    Some version of single-payer with direct responsibility to the political process and the electorate could be constructed by cherry picking the best practices of the single-payer systems already in place and then seeing to it that our own system is properly funded. We could see to it that everyone is covered, with no exceptions. We could have a system that could control drug prices at a level that does not suppress innovation but also does not encourage, support and reward greed. We could throw in a provision that would allow physicians and practice organizations to provide above-average services and be paid for the difference by private funds such as is the case for DPC practices and other retainer-model business entities, thereby encouraging and rewarding genuine quality rather than checking boxes in some make-believe, totally game-able surrogate.

    Developing and implementing such a system would make a lot of worthless drones very unhappy, but it is the fate of drones to be stung and ejected from the hive when they have no useful purpose. I think the worker bees will do much better, be much happier, and produce much more honey that is really worth eating.

  3. October 7, 2017 at 9:32 am

    Yes, the implementation of single payer would be a regulator’s dream. Could you imagine the different commissions set up to decide who skips the line and who doesn’t, what group ‘needs’ screening and what group can go without, and the constant demand for ‘reform.’ Mark Steyn wrote about this a few years ago. He noted that in the UK now both conservatives and liberals are in full throated support of the NHS and fight amongst each other about how to improve it best. Each election cycle it is about who is going best improve the wait for MRI, or some other easily obtainable goal. They do this despite it being axiomatic that the system will always have shortages and misallocation of resources. The politicians know this, but everyday Americans by and large, have no clue….just the way the politicos like it.

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