No health care system in the world is perfect, so you need to care for your health yourself, and doctors should only help in emergencies. Ever since I was a little girl, my mother taught me to take good care of my health. I live alone now, but to keep myself safe, I often buy disinfectants here and for a good reason. There are a lot of germs in every home that we don't see, but they are bad for your health; therefore, it is important to get rid of them.

I've been in emergency medicine since 1997, starting in the Army. Currently working as a contractor in the "C-Suite" while still seeing patients. Having seen both Universal Health Care while in the Army and non-universal care working in for profit and not-for profit institutions, along with working for EmCare (EmScare) the predecessor for EnVision, there is a fundamental question in the US that we have not asked and the reason for the dysfunctional system: Is healthcare a public good that the government can give (and potentially take away or limit) or is it a business?

Our dysfunctional system is because we are trying to meet both sides of that equation.

From the Army and Universal Healthcare - there needs to be responsibility. Frequently I would "care" for patients who waited hours for acetaminophen because it was "free."

I was in business school during the ACA. From a business and quality of medicine standpoint, if a system is created that suddenly gives care to everyone, where are the people that are going to provide the care? It takes 11 years after high school to create a general internal medicine physician, family practice, pediatrician, or emergency medicine doctor, 5-7 years for a physician assistant, and 7+ for an Advanced Registered Nurse Practitioner. Yes, people go into these professions for altruistic reasons, but at the end of the day they want want to make a reasonable wage (doing well by doing good). The cost of medical education has exploded-One of my former Army medics is about to finish medical school, tuition was over $40,000- a year and he is about to go into internship and residency making around that much-so he has to have an income after training to be able to pay off that debt and interest. Further, if there is no basis to make a good income, then physicians, PAs, and ARNPs, being smart people, may be less likely to go into healthcare. Since the banks just received a few trillion dollars of our money, let me become a banker instead? Additionally, most of health care costs does not go to the medical staff. [forbes.com]

For Universal Healthcare advocates, what is the amount of your money you are willing to pay for universal health care? Are you ok with rationing care? In countries like the UK and Canada there are higher levels of deaths from curable cancers due to lack of access (https://www.worldlifeexpectancy.com/cause-of-death/prostate-cancer/by-country/male) and are you OK with a system where the elites go outside the system to get care when they want it (https://www.kevinmd.com/blog/2010/02/canadian-premier-danny-williams-united-states-heart-surgery.html)?

As a business person at heart, healthcare does not need to cost as much as it does. Look at the Direct Primary Care movement [dpcare.org] where one contracts directly with a primary care physician. Insurance is one of the big choking features of our current health care model. In 2016 the heads of ~20 Blue Cross/Blue Shield companies made over $100 million between them. That was money collected from premiums that was not used to pay for the delivery health care or medical professional salaries. IMO health insurance should be like care insurance, for the catastrophic things like cancer, heart attack, or surgery like appendectomy. Your car insurance does not pay for new tires, oil changes, or windshield washer fluid. Why do we expect health insurance to do so much more?

Great post! I met an ER Dr in Vegas when I was a driver. He told me he worked for a contractor company. But they were severing ties with Dignity Health Care. A major player in the Healthcare Industry. I am pretty good at getting people to open up and this guy tells me that Dignity contracted his company and put the Docs to work in their Urgent Care Centers, that's why they were stopping the contract. When I asked what the big deal was he says: "Any building with 4 beds and an ER MD on site is now an ER. So they can bill you $1k instead of a $50 co-pay or whatever your insurance covers. And, since many crappy plans don't include non emergency ER visits, if any at all, its all cash and carry. So you get the bill and if you don't pay it they send you to their collections department, ruin your credit etc."

That's our Healthcare system for anyone who has the slightest notion it does not need a complete overhaul.

I will say though, that it was refreshing not every company is a party to nonsense like that. It gives me hope.

It can happen under universal healthcare to a certain extent. The NHS in the UK has had trouble with GPs. Consequently, people who had trouble booking appointments ended up using ER. These have of course lessened to very large degree during the pandemic.

I see your viewpoint fully but the media does not follow up on things like this and do the reporting that you did just now for all of us. Instead, media takes the words of the hospital CEO as truth and if you call them on it they claim they needed a view from "the other side" to be fair - but there was no other side. It makes me want to ask home dumb media is today. This is all similar to people who cannot afford their own healthcare but they remain against healthcare for all. Americans remain against their own best interests in a bath of bad politics.

Reminds me of an episode that was exposed just after my partner died. While in Seattle we had gone to one of the top hospitals in the area, Swedish. After her diagnosis her son said to go there at a branch (Cherry Hill) as it was touted as being one of the top neurological centers in the region so we did. Her son, a Pulmonologist, knew how to pull strings and did but, unfortunately, nothing could be done. Later there was a series of expose's about that very branch of Swedish. It seems a talented neurosurgeon had been able to turn the hospital into a big money earner. He would participate in several surgeries at the same time. In reality he would have other doctors perform the surgery and he would sign off on them. It was one scam after another and some got worse and some even died. Because of the multi- expose he was forced to resign as well as the hospital director. A new director came aboard and pledged, in several full page paper ads, how they were committed to reform. Again and again, healthcare often is only about money.

I know a guy that has a cure, but people keep telling him it's not doable..what's he call it..oh yeaaahh.. Medicare for All..that'd work..

Where's the article?

back in the day, i used to take my son to the local ER because he'd need a reason from the hospital that he could not attend school that day. I knew that he would survive after the visit because usually it was a spurious claim of some sort of illness, yet I was not certain at the time. obviously universal healthcare on demand is the ultimate solution, when the new day comes.