A reader who is a doctor writes:

About the health care debate…

1) I think we need to consider the “wealth” of our country and how we divide it before this whole discussion of health care goes on.

I view the whole nation’s wealth as a pie divided into two parts, private wealth and public wealth. The public wealth is schools and libraries and roads and the services provided such as police and ambulance and firemen. The private wealth we have is that which we earn and invest, including our houses, computers, and even our institutions such as the private universities.

We have an enormous amount of examples of private wealth today (computers, entertainment, vacations, cell phones) I don’t remember as a kid. The amount that the I surrender to pay for the public wealth today is less than my father did in the 1970’s.

What is currently being discussed is a redivision of that big division of wealth from private to public…for the cost of maintaining health care plans to cover the uninsured will definitely cut into private wealth. Its just unacceptable to say that this health plan will cost tax-payers, but it will. We are discussing the choice between a nation with a Wii in every other house, or more universal health coverage.

Now, decreasing private wealth has enormous impacts in economics, descreasing consumption, which would descrease jobs, etc. So, lets not take this lightly. However, this also reflects a system based on consumption, not necessarily a system based on proper use of resources. (I reflect on the nation of iPhones and iPods and laptops, etc).

On the record, as a pediatrician in Pennsylvania, I practice with all children receiving health care. Consider it “obamacare for pediatrics.” Its good. I get paid just fine, the hospitals get reimbursed. The problem only comes when these kids get older (18 or more), have chronic health problems requiring future care, hospitalizations, and medications, and cannot get health insurance. Universal pediatric health care is paid through Medicaid, a program that reimburses hospitals and physicians far, far less than the government program Medicare.

2) When the discussion goes on about reducing the cost of health care through competition, choice, etc, as the right wing has promoted, it should be clear that one of the largest expenses in health care is personnel. Salaries. One is clearly discussing cutting salaries or jobs. Nurses salaries are an enormous expense in hospitalized care. With so many nurses and other health care professionals in this country, however, the economic cost of reducing these salaries or the number of jobs may have similar results to the economic cost of raising taxes to cover the expense of this national health care program.

3) Salaries for health care professionals (nurses, doctors, midwives, etc) in countries with nationalized health systems are far far less than in this country. Just to point that out.

4) For those Catholics incensed by the immorality of socialized medicine…its not exactly opposed by the Church, may even be promoted by the heirarchy. One would need to search deep to find many uncritical Vatican adherents of our system.

I actually have no interest in the debate. I will practice medicine. Its what I am called to do and love it. How its paid for is not my interest now.

I am just somewhat lost in the debate…which is somewhat trivializing or hysterically dramatizing the various points of cost, salary, economic impacts, as well as the role that the loss of insurance plays in one’s health. This is not trivial and occurs all the time.

As far as the rule for the debate in the future, should I be declared “king” it would be as I tell my 6 year old, “no whining.”

Just my inconsistent thoughts.

I’m too busy to comment, but I thought it might be an interesting discussion starter.