Zoltan,
"autonomy under socialized systems is restricted far more severely than under our current system."
I used to think so, but I'm not so sure anymore. I practiced in the Air Force for about 5 years, and there were almost no restraints on the doctor's judgement in admitting the patient, ordering tests, drugs, or keeping the patient in the hospital until he was ready to go home, in the doctor's judgement. In Germany, you stay in the hospital 5 days after a hernia repair! Now we send 80 year-old men home the same day, even with nobody to care for them. A neighbor brings him back because his bladder is distended and he can't urinate. He waits a couple of hours in the Emergency Room, etc., etc. This is progress?
Furthermore, the physician under any socialized system has some avenue of response if he is disciplined or criticized. Now the HMO can drop you from their "panel" without cause. Yes, you get dropped if you keep too many people in the hospital to long.
I'm about as politically conservative as you can get, and I have to bite my lip to say that any governmental program could be better than (genuflect) PRIVATE ENTERPRISE, but I'm just about ready to do just that. Patients are now just "covered lives", groups whose medical fate is bargained for by their employers and middle men who then go out and contract for "providers" to care for them. Picture (figuratively) a hospital containing these "covered lives". The HMO man looks over the crowd of doctors outside the walls, looking for work, and says, "Which ones of you will work the cheapest? OK, I'll take you, you, and you.
Sad.
Jack |
