It’s the communist way, comrade
the party elite never had to wait in line or suffer without medication
just wait until someone over 70 tries to get some IRS clerk to approve hip replacement or chemo, especially if their personal records are flagged with any conservative affiliation
1. Wait in line, wait several months, wait for the bureaucrats to decide your fate, crappy, one size fits all, costly and very wasteful, government run, taxpayer paid service care.
2. Out of pocket service care that only the rich can afford. If you really need that surgery, then pay up!
Logically, the author’s projections make sense, and would be the normal economic response. However, we in the US have a hangup with this thing called “fairness.” It wouldn’t surprise me to see legislation forbidding this type of behavior, because it “unfairly” advantages people who have more money.
How could such legislation proceed? I’m not sure—but one way would be to forbid doctors accepting insurance payments from having any sort of side contract for additional service.
Of course, people of means will eventually find a way to pay for better service. There are already the beginnings of medical tourism for elective surgery. My crystal ball says that offshore medical clinic ships will become a reality. Medical care on those ships will be like gambling on a cruise ship, where the slots are turned on and the wheel starts to spin once the boat is 12 miles offshore.
Leni
I will, of course, be on the lower tier, but that doesn’t mean my doctor won’t call me. He loves to talk over the phone. He’s never met my wife, but they can talk for an hour when he calls. I haven’t given him my email or cell phone number.
That thought out of the way, the leftnuts wanted Obamacare because they thought it would mean free healthcare for everyone, no more discrimination between rich and poor, and all that crap. When everyone discovers they are paying more, a lot more, and getting less at twice the hassle, people are going to want something else. The rich will still have quality healthcare, but the poor will be reduced to lab rats being tortured by bureaucrats.
“These doctors promise prompt access to care and usually talk with their patients by telephone and email. They serve as an advocate for their patients, in much the same way as an attorney is an advocate for his client.”
Unfortunately, those doctors will be on the obamacare hit list and not be able to have hospital privileges.(The you will assimilate clause)
“Sorry sir, but our records indicate that you are a conservative and own a firearm, therefore your daughter is not covered under the current healthcare system. So I regret to inform you that she cannot have the needed medical care she requires and will no doubt expire sometime later today.”
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“Amazingly, one in five patients who enters a hospital emergency room leaves without ever seeing a doctor ? presumably because they get tired of waiting.”
Probably illegals, Medicaid, young people buying IPhones/PADs and Macs and not buying health insurance, all seeking free health care. So they weren’t really emergency patients.
We have heard of this Granny back in the Midwest with adult married children with kids on her and her husband’s side of the family. She is the on call granny when one of the grandkids get hurt or sick enough to go to an ER. She wears an ICE hat and jacket into a crowded er waiting room. Usually that clears out about 90+% of the waiting room. If the room is filled with the local white/brown/black trash drug seekers. She will bring her husband, who is a retired sheriff deputy wearing his sheriff’s ball cap and jacket.
Between the two of them, they empty the poseur patients and illegals from the er waiting rooms rapidly.
Concierge medical care may be a good choice for those who can afford it.
Several of our younger relatives and friends , with good jobs and incomes are looking at going to Concierge medical care to avoid hours in a doctor’s waiting room with the unwashed, illegal, gang bangers and others even lower in the Gene pool. Apparently, some conservative talk show hosts have said this is a good idea.
With any choice, use Buyer’s Beware. It might be best to try a few months versus paying for a for year. Two couples who opted for Concierge medical care had the opposite results. One couple found it harder to make appointments with their Concierge doctor than their old doc who had reduced his office time to two days a week. Their Concierge doctor never returned call and didn’t follow through. Fortunately, they had opted for the quarterly payment and left after a few weeks. It wasn’t a non refundable yearly payment.
The other couple love their new their Concierge doctors, staff and NFP for the docs, they still see their Concierge docs, and will renew their annual contracts.
Another possible option for basically healthy young people is to approach the Concierge doctors and offer them $150 cash for the setup visit and a $100/visit afterwards. We know healthy singles and couples who have been successful with this up front deal. They seldom need to see a doctor more than a few times a year.
For a few years I was a volunteer working with indigent people, many with various disabilities. I noticed when many of these people were enrolled in Medicaid they would go to the doctor frequently. They would go to the doctor if they caught a cold. In two different cases I remember clients called ambulances because of perceived “heart palpitations.” In neither case could the EM doctor find any problems after doing a range of tests.
If you advertise “FREE” kittens or puppies the people who show up at your door are mostly those too dysfunctional or poor to take care of a pet.
Welcome to Europe.... Public vs Private.
Not sure. But I am certain in which one members of Congress and the Executive Branch will be.
When that happens, it is time to start shooting the “other tier”.
I’ll predict there will be American clinics that treat only Canadians, and Canadian clinics that treat only Americans. The airlines will be the big beneficiaries of Obamacare.
Other option--access to medical care is destroyed: for everyone, and rich people too.
Two tiers would require a infrastructure of hospitals that are for profit, because there are too many regulations for our not-for-profit and nonprofit hospitals to embrace the "rich tier."
How many do we have already, profitable for-profit hospitals? Not many. I can't even think of any off hand.
And this fictional for-profit hospital which caters to the wealthy cannot have an emergency room. Think about it. ERs must take all comers by law, but the the law creates no ERs. So the for profits cannot be in the ER business or they would cease to make enough profit to run the rest of the hospital.
So, the wealthy do not have their own ER. If Bill Gates wrecks his car in a town that has a for-profit hospital, he still has to go to the hospital that caters to the poor. Then, once stabilized, he can be transferred to his sort of place.
The wealthy like to travel, and it would behoove them to stay away from places that do not have a hospital waiting for them.
Hospitals are very much like the Space Shuttle. This is a useful analogy. They are both highly complicated, expensive repositories of technology and highly trained personnel.
Once you shut down the Space Shuttle, even Bill Gates with all his money will never ride in one.
I do not think this two-tier system is as inevitable as everyone assumes. You just need to know a little about the ecosystems of hospitals.