Two Kinds of Doctors

Well, the American Medical Association thinks the new Republican health care plan is terrible so that makes it darn near unanimous. And as Kevin Drum notes, even Donald Trump seems to be distancing himself from it. He's not out there saying it's terrific, it's wonderful, it's just what he promised the folks who voted for him, etc. That alone suggests it ain't going anywhere. It really is, as others have said, a health care bill written by people who don't want a health care plan administered by the government to succeed.

Some years back, I became very close friends with one of my doctors and we talked about this one day. He said — and I'm paraphrasing here — that there are two kinds of doctors in the world: Those who are in it primarily for the money and those who are in it primarily to help people. He said it's very important that when two or more doctors open an office together, they all be from the same mindset. The office can work if they're all mercenary or the office can work if they're all "Marcus Welby" (that was the term he used) but if you have a mix, the business end of things is guaranteed to crash, burn and maybe wind up with the partners suing each other. It can't simultaneously please doctors who want to make as much cash as possible and those who don't think that's anywhere near as important as helping sick people get better and healthy people stay that way.

This doctor was, of course, from the Marcus Welby category. So were his partners. So was any doctor to whom he referred me. At one point, I told him I'd been going to a gastroenterologist that a previous doctor had sent me to and he (the doctor of whom I speak) suggested I switch to another guy he knew. He said, "The one you've been going to is perfectly competent but you'll always be just a file chart and billable hours to him. You won't get that personal caring that you get from a really good, non-mercenary doctor." I did switch and I did see the difference.

There's a bit of an analogy between the two kinds of doctors and the two kinds of politicians now debating health care. It's not exact but certainly, the problem faced by anyone trying to craft an Obamacare replacement is that they're trying to negotiate a compromise between two parties working at cross-purposes. One side doesn't care if 10-20 million people lose their insurance and tens of millions more see whopping price increases. They don't care as long as it doesn't rebound on them politically…which it will. I don't see how you arrive at a workable plan if you need to simultaneously please those who want a good government-monitored health care system and those who don't.