Thursday, January 18, 2007

A Libertarian in a Collectivist World: What do you see in the Future of Medicine?

The purpose of this thread is not to start a debate. In this case, I'm looking for people who think a little bit more like me. I'm trying to determine exactly what people think about the future of healthcare delivery in this country. What do you think things will be like in 10, 20, 50 years?

It's sometimes difficult for me, when I think about my position. Here I am, a medical student, severly in debt, and staring at a future that is uncertain for sure. With a country that has allowed the pendulum to swing back in favor of a Universal Healthcare Model, I often feel that I am moments away from being completely at the mercy of parasites in Washington masquerading as crusaders of public good. With the steps first taken in Massachussetts, followed by those which are currently being proposed in California, the country is definitely heading in the direction of Universal Healthcare. Furthermore, with the abysmal approval ratings of the current president, it almost seems that healthcare monsters who manifest themselves in the forms of Hillary Clinton and John Edwards, might actually find themselves electable. We are really being set up for the perfect storm.

So what comes next? Sometimes it seems that we will be forever forced into mediocrity. Our government will sell rationing as a social good, all while ignoring the very laws of scarcity that make the rationing necessary in the creation of policy.

Of course, failure of the US healthcare system could cause a chain reaction that brings down much of the advancement in Healthcare delivery. If the government does successfully bring the whole system under its thumb, it will be the death of the last genuine vestiges of healthcare capitalism in the Western World. Will we see innovation grind to a halt? Will we fall into a dark age reminiscent of Atlas Shrugged, where the intellectual doctor is replaced by a rule following automiton?

Maybe we'll witness a power shift toward the developing world. Some desperate third world country might just develope the will to let its healthcare system operate unhampered. Perhaps they'll see a surge in medical tourism, as the American universal healthcare racket fails to convince the most productive members of society that it has much to offer them.

Maybe we'll just evolve into a two tier system, trucking along the way that we always seem to, with a cash system that buys quality healthcare for its members and a universal system that survives by robbing money and ideas from the cash system. Degradation in quality for the masses will be slow, reflecting a shift that damages quality in the name of access. People will continue to scream at the politicians that the two tiers are unfair, but our great leaders will have to keep the upper tier alive in order to use its services and suck its blood.

Who knows? What do you think?


Anonymous Anonymous said...

I really like your blog, and I too am a Libertarian. I am very curious about what the future will look like for future physicians. With obscene tuition at schools like yours, and high interest rates brought about by the Bush administration, it is hard to see how this isn't a trainwreck waiting to happen. It seems like medicine is definitely leaving its golden age, and is in a very dangerous state.
As a premed who will be starting next year, I also wonder what things will be like in 10, 20, 50 years. I don't think it will be pretty, but unfortunately I can't see myself doing anything else.

7:14 PM  
Blogger MiamiMed said...


9:41 PM  
Anonymous Anonymous said...

It's not nearly as well written as Rand's own books, but it's a good one with regard to medical policy. . .

Perhaps read "Noble Vision" by Gen LaGreca?

It's a pretty frightening glimpse of what horrors a highly bureaucratic centrally-run medical system might produce.

11:45 AM  
Blogger MiamiMed said...

I've actually got that book, but I haven't gotten around to reading it yet.

7:16 PM  
Anonymous topher said...

Libertarian, Atheist, Blogger, Med Student. I think the two-tier system is coming and I'm going to help it. I used to think that I would leave medicine to pursue a JD or MBA, and then go off to fight the war against the misinformation that has people believing that Universal Health Care, Universal Health Insurance, or Single Payer will be good for them. Now, I think I'll move to Florida, setup up a cash-only practice, and provide excellent care to the retiring masses. The alternative (being underneath someone's thumb) would kill me slowly.

Excellent writing by the way.

12:59 AM  
Anonymous Anonymous said...

you are not alone.

10:35 PM  

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