Born on the government dime

Nobody likes the present U.S. healthcare system.

The disagreement comes in what to replace it with.

I asked some friends with long careers in healthcare delivery what they thought would make sense. Mark Knudsen focused on insurance contracts. Bruce Van Zee, M.D. suggested Medicare for All. Today's guest post is by Joe Yetter, M.D.

As a patient/customer, I am very happy with Medicare. My wife and I have monthly premiums totaling some $1,500 based on the sliding scale, so it isn't free, but it is fair if one accepts the notion of progressive taxation. It is simple from the patient perspective, and providers know how to work with it. Is it "socialism?" I suppose, but so is fire insurance, and I am accustomed to that and see its value. Medicare does the insurance function of spreading out to a pool the costs of healthcare. Medicare seems to work.

In 2022 Joe Yetter was a Democratic candidate for Congress in Oregon's 2nd Congressional District, but lost to Cliff Bentz. He lived and worked within an even more socialized system: the one for the U.S. military and its veterans.

Guest Post by Joe Yetter, M.D.

I was born on the government dime, and I expect to die on the government dime. Everyone should have this same good fortune! With a long, healthy life in between, of course.

I'm "entitled." My dad joined the Army on December 8, 1941, and served for over 20 years, including several years in combat in Europe. I joined the Army in September 1968 and served (with a break in active duty) until February of 2004. My dad's service and my service earned medical coverage for him and his family, and for me and mine as well.

Joe Yetter, being sworn into the army by his father

My own experience with government-run health care started before I was born; my mom received her prenatal care at Madigan Hospital in 1946. Dad was, at the time, part of the Army of Occupation in Japan; I didn't meet him until I was six months old (and peed in his face, I am told).

What I believe: Health care is a human right. Government of the people ought to provide medical care for all the people. And society will be better off for that.

What I know, from my experience and education: Good care is good for everybody.

I trained in, practiced medicine in, and have been a patient in military facilities, VA facilities, and civilian facilities, in several states, and on three continents. My experience—as a doctor, and as a patient—is that universal coverage, and especially government-run health care, is far superior to what's available in the broader civilian world.

When I practiced medicine in the Army, I never had to consider whether my patients or their insurance would pay me. If a mom brought her child in with an ear infection, I'd prescribe medication and know that she could pick it up at the pharmacy a few steps away, all free of charge, and that the return visit would be free of charge as well. The system would alert me if she didn't pick it up. In my long career in military medicine, I never once got that alert.

When I practiced medicine in civilian life, I routinely fought insurance companies, delivered news to patients that medical services had not been covered, and saw patients be worse off for lack of coverage. I witnessed dying patients and their families bankrupted and fighting insurance companies while they ought to have been grieving together in their parting days. Never, ever in the Army. Human beings deserve better.

I earned considerably more in civilian practice than in the Army. I was a lot happier in the military, and that experience was nearly universal among physicians I knew over many decades. I had several colleagues commit suicide in about ten years of civilian life, and none during my decades in the military. (That's my own anecdotal experience. Suicide rates among physicians are higher than in the general public, and veteran suicide rates are higher than civilian rates. I could find no data comparing suicide rates between military and civilian physicians.) Nurses, techs, and other personnel seemed to me to be a lot happier in the Army, too, and the atmosphere seemed a lot less hierarchical—a real paradox, I think.

Retired

What I'm saying is: Coverage for everybody is good for everybody—patients and medical personnel alike. And better for taxpayers, too: right now, we spend over 17 percent of our GDP on a flawed, family-bankrupting "health care" system, while most other developed nations, many with lower per-capita GDPs, spend between 9 and 12 percent. These nations have better health care and longer lives than we do. We are paying nearly twice as much for worse results. What we are doing is neither smart, nor compassionate.

We are better than this. We are smarter than this.

Aren't we?

What I want: An Improved Medicare for All that covers all medical care, including mental, dental, vision, podiatric, and everything in between, that is medically indicated and provably efficacious. No copays, no deductibles, no prior authorization, no complex paperwork for patients or their doctors. I'd exclude glamorizing cosmetic surgery, unproven "alternative" medicine, bogus fad nutritional stuff, and anything for which we don't have good evidence.

 

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