You tell ’em, Dr. Paul! (In your own sensible way)

Dr. Paul DeMarco of Marion, at the Gallivants Ferry Stump Meeting in 2006.

Dr. Paul DeMarco of Marion, at the Gallivants Ferry Stump Meeting in 2006.

Our own Dr. Paul DeMarco is as always dispensing wisdom, or at least good common sense, in his op-ed piece today.

As you know, Paul used to be a regular on my (old) blog, but he got sick and tired of all the pointless, childish yelling, and some of the comments bothered him too, so he quit contributing. But we remain friends and stay more or less in touch. And he’s one of those doctors who knows what’s good for what ails America: a single-payer health care system.

Here’s an excerpt from his piece this morning (I’d reproduce the whole thing, but that might step over the line copyright-wise, and then Cindi would have to call me and yell at me, and I’d yell back at her, and she’d go to her office and sulk until she thought of some more choice things to call me, then she’d come back and yell at me some more, and it would be just like old times, but I know she’s busy, and I don’t want to put her to all that trouble):

Ironically, the cure is right at our fingertips: Simply expand Medicare to all Americans. Canadians, who cover all their citizens with a system similar to our Medicare, point to it as a source of national pride. In the ’60s, they recognized that justice was the first principle to be addressed in health care; once they decided that no citizen should go without reasonable access to medical care, they were well-positioned to face the difficult but not insurmountable questions about what should be covered and how to pay for it. While it is clear that the Canadian system has its problems, there is little doubt that taken as a whole it is better for the average citizen. The Canadians achieve similar overall health outcomes as the United States while spending just over half what we spend.

Are there Canadian health horror stories? Certainly, but America has no lack of those herself. More to the point, anecdotes shouldn’t be the basis for health policy. The United States would have to address legitimate concerns such as waiting times and access to specialists if we adopted Medicare for all. But universal coverage will immediately improve the lot of the many hard-working small-business people with chronic diseases who are floundering without health insurance. My barber is a perfect example. He’s one of Main Street’s most solid citizens. His shop lights are already on when I drive by in the early morning, but he must rely on charity care because as an owner-operator, he can’t afford a health policy. His plight does not exist in Canada.

Americans are rightly skeptical of government and wary of our recent deficit spending. But the notion that publicly funded health care is a new and radical idea for us is nonsense. Medicare, Medicaid and the Veterans Administration are all federally funded single-payer systems that have been in place for decades.

U.S. Medicare alone covers 45 million people — 12 million more than the entire population of Canada. Some seniors are so comfortable with Medicare they seem to have forgotten it is publicly funded; at town meetings, they have argued against the public option as unacceptable government intrusion while at the same time singing the praises of Medicare. And although the empty claim that government-funded health care would be bloated, intrusive and inefficient has been repeated incessantly, the truth is that U.S. Medicare achieves satisfaction rates similar to private insurers while operating with roughly a third of their overhead….

Notice how deferential Paul is to mindless anti-gummint sentiment, with that “Americans are rightly skeptical of government.” Paul’s a very civil guy, which is why the blog makes him uncomfortable. He gives the knee-jerk anti-gummint types more than their due, despite his politely reminded us that so many of them don’t know what they’re on about (such as the cranky old people at town meetings who somehow don’t understand that the Medicare they love so much is a gummint program, which to me ought to be grounds for having one’s right to vote revoked).

And before you Ayn Randians get all cranked up about the failings of gummint, let me say that you’re right: Gummint has it’s flaws, just the same as private companies or the Church or non-profit agencies or anything that’s run by mere humans. But as Paul also explains, Medicare produces results at least as satisfactory as the private sector, at about a third the overhead.

As I said, Paul always makes good sense…

13 thoughts on “You tell ’em, Dr. Paul! (In your own sensible way)

  1. Lee Muller

    Dr. DeMarco is all sentiment and no sense.

    Medicare is a complete failure. It is bankrupt, again.

    Medicare is 215 times larger than it was originally projected to be in 2009. Its latest benefit add-on for prescription drugs, is already 300% larger than it was “budgeted” to be just four years ago.

    14% of Medicare was lost to fraud last year, according to the GAO audit. Another 27% was lost to waste, administrative blunders, and reasons no one can explain.

  2. Lee Muller

    The overhead costs of private medicine are mostly due to mandates placed on physicians, hospitals and insurance companies by federal and state governments.

    I have been analyzing and improving clinical practice systems and insurance systems longer than Dr. DeMarco has been practicing. He needs to leave his small town and find out how things work in the rest of America.

  3. doug_ross

    Does Dr. DeMarco have a comment on the cardiologists and oncologists who are balking at the Democrats plan to cut payments for their services by 10%?

    Medicare already underpays for services to the point where many doctors will not accept Medicare patients who do not have additional insurance. How will that be resolved in Dr. DeMarco’s plan? Will doctors be forced to accept all patients and be reimbursed not based on their skills but by a government proscribed rate? I can envision the medical profession turning into the public education system – where salaries are based not on performance but on degrees held and years of services. And we know how well that system works to attract and retain the best and brightest…

    The end result of a single payer system will be the creation of a two-class healthcare system even more unbalanced than the current one. Or even worse, you will find doctors will simply stop practicing altogether rather than be subject to the salary caps set by the government.

    Why is it that health care is the one area where people actually think the government should decide how much a good or service should cost? It doesn’t work.

    Let’s also not forget the massive fraud and waste in all of the government run healthcare systems (Medicare, Medicaid, VA) that Dr. DeMarco mentions. How is that going to be any better in a single payer system? The amount of fraud in Medicare alone dwarfs the salaries of all the insurance company CEO’s combined.

  4. doug_ross


    You recently mentioned how Mark Sanford doesn’t have any advisors who will tell him when he is wrong. I was wondering who you have approached to give you the other side of the single payer issue so that you can develop an informed opinion? If you want, I can put you in touch with a local ortho surgeon who could explain to you how the system works for him now and why he will never accept Medicare patients. Are you willing to do that?

  5. Brad Warthen

    Hmmm. What makes you think I am not amply exposed to opinions to the contrary, Doug? I mean, look around you.

    As for credentialed adversarial comment, I recently had a conversation with an emergency room doc who wants nothing to do with “socialized medicine.” Nice guy, and not at all shy about sharing his opinions. But I was unpersuaded.

  6. doug_ross

    So if he didn’t persuade you to change your view and you didn’t persuade him, what do you think the outcome will be if single payer was implemented? You think he’ll say, “Oh well, I’ll just take whatever the government will give me”?

    What percentage of surgeons would have to oppose the single payer option before you would accept that it will never happen? Can you find a practicing cardiologist or oncologist who thinks Medicare works?

  7. kbfenner

    Hear hear, Dr. Paul, and I don’t blame you for ditching the blog trolls.

    I suggest that using docs around here skews the sample a bit to the right, away from Medicare, since this has to be one of the reddest states.

  8. doug_ross

    So we should ignore the opinion of doctors who practice in South Carolina because they might not agree with Dr. DeMarco? How about trying to refute their opinion with facts versus just ignoring them?


    Troll: Someone who doesn’t agree with me

  9. doug_ross

    I’ve made my opinion known many times on Brad’s blog – fix the problems with insurance companies by preventing them from denying coverage and allowing for portability when changing jobs. That can be done with legislation that doesn’t require 1000 pages of nonsense. Insurance companies get away with all sorts of bad behavior with the help of politicians who take their money.

    Then allow any American to buy into the same healthcare plans that government employees have at the same cost. That will increase competition and lower prices.

    Remove all barriers that prevent insurance companies from competing across state lines. Again, increase competition and lower prices.

    For the people who can’t afford insurance, I have no problem with implementing a 1% surtax on high incomes to pay for premiums as long as people are still responsible for copays. But, as I’ve said before, if you have a cell phone, cable tv, buy cigarettes or alcohol — then I don’t want to hear about your inability to pay for insurance. If healthcare is a priority, prove it with the way you spend your money.

    And no coverage in any way shape or form using tax dollars for illegal immigrants. Free healthcare should not be an incentive for people to cross borders illegally.

    Incremental reform is what we need. Let the Senators vote on these issues one by one versus throwing the kitchen sink into a massive bill.

    Wouldn’t it be great to get an up-or-down vote from each Senator on a bill that reads:

    “No insurance company can deny coverage to any person who is willing to pay for it. “

  10. Lee Muller

    The problems with medical care in America all stem from government meddling. The solutions and improvements all reside in removing government from the practice of medicine as much as possible.

    Individuals and families should be moving to having their own insurance policies, just as they do for life, automobiles, their houses, boats, motorcycles, and other things. Obtaining insurance through an employer is a silly relic of World War II, invented to circumvent government wage controls.


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