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Medicare for all? I don't think so

by Philip F. Jacobus, CEO | March 20, 2019
I feel that I have liberal leanings, even though I am a business man and I believe it is the responsibility of all of us to take care of each other. But I am not in favor of Medicare For All or so-called single-payer.

Many people point to England and Ireland as an example of how single-payers systems work, but I wonder how many of those people are aware of the fact that sometimes you can wait three months for an MRI in England and Ireland. However, if you have the $400, you can pay Alliance Imaging and get an MRI tomorrow.

If single-payer was such a great thing in the U.K., why are there private insurance companies there? The reason is that nobody wants to wait weeks to see the doctor, so people with money buy private insurance. It is my belief, if we, here in the United States adopt a single-payer system then people who can afford it will still opt for private insurance.

Also, the idea of putting the government in charge of our healthcare worries me. They can't fix our roads or bridges. Our airports aren't world class anymore and the bureaucracy is really disheartening. I don't feel as though our politicians care about us at all.

Look at the VA. Veterans have to wait a long time to receive treatment and I don't think it is a secret to anyone that the VA healthcare system doesn't work very well. For anyone who wants to put the government in charge of our healthcare, I would say, prove to me that you can fix the VA and then talk to me about taking over healthcare. For the time being, you have your hands full...

And even though all of us involved in healthcare can take pride in the fact that we have saved people's lives and helped to make people live longer, we all have to agree that healthcare is a for profit business. It has to be.

I suspect it is easier and cheaper to get an MRI in Manhattan than it is in rural Nebraska. Why? Because there is more demand in New York City than rural Nebraska; and because there is more demand, there is more supply. And because there is more supply, there is more competition.

In my opinion, competition is a good thing. An airport that has only one restaurant and therefore no competition, usually offers less quality food with a lower level of service. However, an airport with 30 restaurants, there is a little competition to provide better food and better quality service.

Southwest Airlines prospers because they provide efficient and friendly service at a competitive price. Competition is a good thing.

Do I have the answer for healthcare? No, I don't. But that doesn't mean that Medicare for all is the answer.

If you ask me, we should tweak the Affordable Care Act. And if we are going to offer something for everyone, my idea would be to give everyone a guaranteed annual physical at no cost.

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About Phil Jacobus

Phil Jacobus has been involved in health care since 1977, when he visited China to sell equipment. He has done business in 35 countries and still travels extensively. Phil is active in charity, helps rural clinics and always tries to help DOTmed users when he can.

Phil is a member of AHRA, HFMA, AAMI and the Cryogenic Society of America. He has contributed to a number of magazines and journals and has addressed trade groups.

Phil's proudest achievement is that he has been happily married to his wife Barbara since 1989, who helped him found DOTmed in 1998.


David G. Imber

Japanese Healthcare

March 24, 2019 03:59

I'd urge all concerned to look at the Japanese system, which is universal and non-single-payer. No system is perfect but it does exceptionally well. It's not for no reason (DNA and cultural differences aside) that Japan has the longest-lived population in the world. Their system, which is similar to the Swiss, scores near the top of ever measure of effectiveness, and everyone receives an extraordinarily high standard of treatment, in a timely way, with little or no fee. Medicines cost less than most copays in the U.S.

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