February 20, 2019
January 31, 2019 by Dr. Varner in Policy
The progressive media has made a huge stink over Senator Rand Paul’s upcoming trip to Canada for hernia repair surgery, implying that he’s a hypocrite –that he’s trying to prevent a socialized healthcare system from happening in the United States while traveling abroad to benefit from one.
That’s simply not true. Like me, Senator Paul knows the highest quality care can never be delivered under a socialized system –and that the care delivered in US hospitals under Medicare and third-party payer reimbursement is practically indistinguishable from care delivered under foreign socialized health schemes.
As a hospitalist, I know exactly how terrible US hospitals are: patients don’t get to pick their doctors, seldom get to pick their surgeons, and are treated like welfare beneficiaries rather than valued customers. On top of all that, patients have to pay anywhere from $600 to $1,400 a month for their insurance under the individual mandate and are still on the hook for $8,000 deductibles before insurance forks over a single penny.
That’s why when I need medical care, I go to Mexico. And I live in Washington State. I’ve had surgery in Mexico, I’ve had diagnostic procedures there, and I even travel there to visit my dentist. I go that far because I object to the double whammy of outrageously high prices and poor services that plague health care in the US. I want a system where I exchange cash for medical care and thereby have the status as customer instead of ‘welfare beneficiary.’
Senator Paul is paying cash for hernia care at the only hospital in the world dedicated to hernias. If you want to get the best possible outcome from a surgery, my advice as a doctor is to pick a surgeon who has done the procedure you’ll undergo many times before. The more surgeries they’ve done, the better they become at performing them and at managing any complications you might have. Senator Paul is seeking out the best care in the world and paying with his own cash. This isn’t hypocritical –it’s smart!
Why can’t more Americans have this kind of access to care? If media reports are correct, Senator Paul is paying about $8,000 (local market prices) for his care in Canada. But the per capita expenditures on health care in the US are more than $10,000 per person, per year. In most US hospitals, hernia surgery costs between $10,000 and $20,000.
Health care in the United States is so expensive because we funnel almost all of our healthcare spending through third parties. This creates a situation where the marginal cost of extra services to the patient is low, while the total cost skyrockets. It’s the equivalent of sending Chris Christie to a lobster buffet: the price will be high on the way in, but you know he’ll overconsume.
The Affordable Care Act only made things worse, since the goal was simply to get more people ‘covered.’ Well, millions more people have health insurance today than 10 years ago, but their plans are financial liabilities that cover next to nothing. Now they can’t afford their insurance or their actual care.
Being aware of the indigent and also a physician, Sen. Paul does pro bono surgeries for the poor in his home state of Kentucky and abroad. With the costs of health care in the US, that’s not cheap.
So let’s review the facts. He’s paying cash at the market rate at a private hospital, he performs free surgery for poor patients, and the left-wing media is desperately trying to brand him a hypocrite. Meanwhile, Bernie Sanders is a millionaire who owns three houses despite his railing against capitalism.
Left-wingers like Bernie Sanders and Alexandria Ocasio-Cortez are obsessed with stopping guys like me and Senator Paul from getting good medical care. Their version of socialized medicine would make everyone suffer equally in the substandard welfare-based hospital system.
Socialism in health care is already present in the United States, and it doesn’t work. Currently, America’s top five private third-party payers (Aetna, Anthem, Cigna, Humana, and United Healthcare) get almost 60 percent of their proceeds from Medicare and Medicaid –taxpayer money. And 57 percent of hospital revenues come from Medicare and Medicaid. That’s socialism, and the hideous healthcare system in the United States is the natural consequence.
The few positive breaks people get are due to voluntary charity by people like Dr. Rand Paul offering free care; or through cash-only clinics that offer primary care services à la carte for less than $100. These few breaks happen in spite of government intervention, not because of it! On the other hand, Sanders and Ocasio-Cortez’s radical form of egalitarianism would turn every successful person into a beggar.
Free market reforms can make excellent health care readily affordable to everyone. The focus of our discussion on healthcare reform must be on lifting the regulatory burden and allowing markets to function normally. I want everyone in the US to have health care as good as the care that Senator Paul and I get outside of the country. This is possible, but only under a system of free and unburdened markets applied to health care.
As long as the deranged voices of Ocasio-Cortez and Sanders drown out the reasonable voices of people like Senator Paul, I intend to keep visiting my doctors in Mexico. My vote may not count at the ballot box, but I’ll keep voting with my feet and my dollars.