I read with great interest the column by Sally Pipes in which she panned the concept of single payer healthcare. I share many of her concerns but as a physician who has worked and continues to work in the trenches of health care and has Master’s degree in Healthcare Quality and Patient Safety I am concerned that the public is not getting the full picture of healthcare in the United States.

Firstly, I think we can all agree that universal healthcare is a goal worth achieving. Does anybody think that it is OK for a diabetic to go without insulin because of affordability? Of course not. And no advanced wealthy country in the world thinks so, apart from the US.

Secondly, the government already funds 50-60% of healthcare expenditures in this country. Between Medicare, Medicaid, the VA, CHP, and other programs the government is deeply involved in funding medical care. Therefore, we are only talking of the 45%, more or less, that is either not funded at all, apart from what comes of an individual’s pocket, or paid by private insurance.

Ms. Pipes also laments about the Canadian waiting times to see doctors or for surgical procedures. Over the last month in my current work in urgent care I saw two patients who only needed prescription refills because their primary care physicians were booked out 2-3 months. I am not talking about highly trained and specialized university physicians but local family doctors.

In fact, why does anybody really think urgent care clinics exist at all. Yes we can treat some of the minor injuries and illnesses that used to go to the emergency department. But looking at the patient population that comes into the urgent care where I work, I would say at least half of them could be seen by their family doctor, if they followed the mantra of “patient centered care” that the healthcare community only pays lip service to. https://www.ncbi.nlm.nih.gov/pubmed/19901351

Undoubtedly, there will be people screaming about the concept of “socialized medicine” and the fear it will lead to creeping takeover of all industry by the government. When President Truman tried to start a system of universal healthcare he was attacked and pilloried as a communist. Political cartoons illustrated a surgeon as a marionette with the strings manipulated by the political elite. https://www.historynet.com/howls-of-socialism-killed-truman-health-insurance.htm

But when I ask people what they mean by “socialized medicine” the response is usually some vague confabulation of communism and socialism that answers nothing. After all, the universal healthcare that is provided in Germany is very different than the UK, Canada, France, Taiwan. Even in the US the healthcare provided through the VA, Medicare, and Medicaid differ.

Finally, the US has an extensive VA healthcare system. I agree that those that carried the greatest burden of our freedom deserve the best care possible. Our politicians agree. Woe to the legislator or president that proposes a cut to the VA budget or a reduction of benefits. Yet the VA system that we have is nearly identical the UKs National Health Service (https://www.nhs.uk/), the most socialized and regimented healthcare system in the world. If our veterans deserve the best and we give them universal healthcare coverage with a UK style health system, what does that say for the rest of us?

Irving Huber, MD, MS-Health Care Quality and Safety

Physician Safety Analyst

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