The Problem With Socialized Health Care

One of my co-interns went on a well justified rant today about the problem with socialized medicine.   At the county hospital, all the doc's are salaried.  I'd like to think that most of them still work hard and do what's best for their patients, but there are always exceptions.

In one particular department, where most specialists would be raking in the dough by billing for specialized procedures, the contrast is striking.  At a private hospital, these would be the docs drooling over every possible procedure and making obscene salaries because of it.  But at County, you have to beg and plea to get them to do anything at all.  They are only in house from 10am to 3pm (with a few hours for lunch), and will not EVER come in outside those hours for anything less than a catastrophic emergency.  They don't get paid per procedure, so they aim to do as little work each day as possible.  And will gladly admit it.


But that misses the whole other side of socialized medicine.   It overlooks the patient with no insurance who is getting a life saving Whipple tomorrow for an otherwise incurable pancreatic cancer.  And the undocumented illegal immigrant who has has been wholly cared for in his last days of life with the upmost dignity and respect without question, relieving his family from some of the related anxiety and fear that otherwise accompanied his passing.  And the patient who missed her OR date because she couldn't afford the bus fare to get to the hospital; and we gladly rescheduled her without berating her behind her back for ruining our carefully constructed OR schedule. 

Yes, salaried doctors might get lazy.   Yes, unionized nurses might not work as hard.  But God help me if I ever have to tell a patient that I can't operate because he can't pay.  I'd rather fight tooth and nail against an inefficient and frustrating system, than reject those most of need of my services.