Posted Jan. 24, 2015
Ashland Daily Tidings, Opinion
This year marks the 50th anniversary of the Voting Rights Act of 1965 and of the enactment of Medicare. Not long ago, a U.S. Supreme Court dominated by Republican appointees gutted the Voting Rights Act, and a Democratic president who never could have been elected without it took Medicare for Everyone off the table when he proposed his much ballyhooed health reform.
The American Medical Association tried to defeat Medicare. It cleverly labeled all such proposals “socialized medicine.” Medicare isn’t socialized medicine. The VA health care system is socialized medicine. Its hospitals are publicly owned, and VA staff are salaried employees paid with tax dollars. Medicare is only an insurance program.
So Medicare didn’t threaten the livelihood of physicians. Instead, it added huge numbers of paying clients to their patient base. The AMA had identified the wrong threat. The real threat emerged in the 1980s. It was the private insurance industry, not public insurance, that drastically interfered with the practice of medicine.
Private insurance plans forced most physicians to join groups like health maintenance organizations, hospital systems, and other large groupings — some of them corporations interested in profits, not health care. Often physicians couldn’t treat their patients without approval for payment from the patients’ insurance carriers, whose on-staff medical personnel could second-guess the attending physician. In more subtle but ever-present ways, the imposition of a corporate model has distorted the practice of medicine and diminished the satisfaction of practitioners.