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Tuesday, April 01, 2008

Survey indicates majority of physicians favor universal coverage-but what kind?

A recent survey claims that more than 50% of physicians (over 80% of psychiatrists for some reason) indicated they favor universal medical coverage. The research is in the April Issue of the Annals of Internal Medicine-subscription required

I believe-with no survey to support the claim-that many would say they would opt for
universal coverage because they believe or hope that almost anything would be better than the morass of increasingly impossible to deal with nonsense with the the third party payers.

However, a key point ignored in the survey is what is meant by universal coverage.
Such programs can vary on a number on dimensions but the most important in may opinion is will the patients be allowed to seek care outside of the system or seek more care than the basic coverage of the system provides. If not, we would have a system much like that in Canada or if such freedom would not be crushed then perhaps a system more like Great Britain or France.

How many physicians would favor a universal coverage system of the Canadian type?

DrRich discusses this important issue here.

He makes the important distinction between equality of access and equality of outcomes-choosing between autonomy and equality of outcomes.

...universal healthcare does not necessarily preclude individuals from supplementing publicly-funded services with their own resources. To achieve equal access to all healthcare services (and not just the services that are publicly-funded), we would have to actively restrict individuals from exercising their rights of individual autonomy.

[With the Canadian type system] we would be denying individuals the right to spend their own money on their own health....

...it is beyond disturbing that we seem ready to abandon our foundational principle, especially since it will be for no good reason. We would be empowering our government to abridge our personal liberties, all in a vain attempt to achieve something that our founders recognized could never be achieved and should not be sought - an equality of outcomes .

Yes,way beyond disturbing.

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