MD000613Here’s the big scary idea: Care in countries with universal health coverage is rationed with waiting lists and limited choice.

Yes, this is a real problem in some countries … including the US. I’ve had to wait for appointments simply because I couldn’t afford the out of pocket expenses or the copay. I’ve considered not renewing a prescription for a medicine I needed because of our financial situation at the time. I’ve had to wait because my doctor’s case load was too high. I’ve also had healthcare policies through employers who did not cover optical, dental, physical therapy or chiropractic.

Those are all forms of rationing.

True, patients in Britain and Canada may have to wait weeks or months for non-emergency care or elective surgeries. BUT, rationing is far from universal. In many other “developed” countries, folks get quicker access to care than we do in the States. Germany, France, Denmark, Sweden and Japan all do better than we do on both waits to see specialists and waits for elective surgery. And, as TR Reid found out, in Japan you can literally just walk into a doctor’s office without an appointment. (I’ve found one clinic here in SJ where you can do that and it’s always swamped.)

As to choice—Germans get over 200 private health insurance plans to choose from, which is a broader choice than many Americans have even with the ACA/Obamacare. Plus, if they don’t like their plan, they can change it at any time without increasing their premiums.

Oh, and there’s no such thing as an “out of network” doctor. Right after I had brain surgery (yeah, yeah, I heard that mumbled, “Well that explains a lot!”) my company went to a new insurer. I was informed I’d have to do my follow-up exams with another neurophysician. My GP hit the ceiling and wrote the insurer insisting that I be able to see the doctor who’d done the surgery. I was blessed with a fierce and protective GP. Not everyone has that.

Then there’s pre-authorization: having to make an appointment with, pay for and wait for an office visit with a GP in order to see a specialist. This saves money? Really? It sure doesn’t save time which, for a freelancer IS money. My German friends (hi, German friends!) don’t have to do this. They just go to whatever doctor they think they need to see. My Canadian friends (hi, guys!) only have one choice for coverage, but they, too, can see any doctor they need because all doctors, hospitals and clinics are in-network. Some plans in other countries even pay for spas and health club memberships. (Big sigh. A pool! My kingdom for a pool!)

So, there it is. The fear of rationing and limited choice presupposes that Americans aren’t smart enough to devise a plan that doesn’t have rationing or pre-authorizations. I’m pretty sure we are smart enough. If not, we can always hire one of the Japanese or Euro experts to help.

“I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.’ …whatever you did not do for one of the least of these, you did not do for me.” — Jesus Christ, Matthew 25:40,45

The next myth is about the bloat of bureaucracy necessary to having a universal healthcare system.


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