I am a physician and I couldn't disagree with the other of the piece "good old days" more, except about the when few people had insurance, office visits were cheap and I could barter my medical care for painting, snow shoveling or just write it off as good will.
Now I volunteer at a free clinic in Syracuse. People come there from the doctors' offices to get drug samples because they cannot afford their prescriptions or to get less expensive blood tests or find out how to get an affordable needed X-ray. Other patients with complex medical problems can't afford to see a diabetes doctor or heart doctor. Some can't get timely and affordable appointments for a physical examination that will allow them to go to work.
Many physicians seek the best paying specialties and fewer choose primary care. In fact, at the annual meeting of the Medical Society of New York, physician-delegates voted against supporting debt relief from New York State for primary care physicians who go into practice in underserved areas of New York after their residencies.
It is interesting that we physicians make money for the most part from the misfortune of their patients - namely, being sick. The reward of helping people stay healthy or regain their health should count for something and allows many of us to accept lower payments from Medicaid and Medicare than we could demand in a non-insurance controlled market. Most of the insurance companies in Nw York show a profit and pay their executives very well.
I cannot guarantee that ObamaCare will actually save on the cost of healthcare, but I believe it will. I cannot guarantee that patients insured through ObamaCare will easily find a primary care doctor or even that there will be a shift towards primary care in medical school and residencies, but morally I wonder why medicine is not moving in that direction in seeking applicants to medical school and residency programs who meet the current health care needs of the population.
There are certain basic requirements that all of us need: food, clothing, shelter, education and health care. We can survive without Cadillacs or Jaguars. If we can't sustain our health, we may be compromised in many ways.
Yes, it's about politics now, in both parties, but I believe President Obama is more concerned that all citizens have access to a reasonable level of health care, regardless of their income. Some government control is necessary if the profession of medicine, the pharmaceutical industry, medical technology companies and insurance companies place profit above their concern for the health of our citizens.
Joel Potash MD