Bernie Sanders’s dream is another country’s reality
I am a general practitioner physician. I am a U.S. and Canadian citizen practicing in Sydney, Australia, working under a government-run system similar to “Medicare for All.” I see four to five patients per hour, and my days are long and exhausting. I get paid by the government, and this means I am making only half of what a general practitioner in the U.S. makes on average.
Most GPs like me have electronic records, and the hospitals and the specialists do as well. But there is no system to connect them all together. We have to write each other letters, or call to communicate; it’s very time-consuming. The Australian government is struggling to implement a centralized system but it hasn’t happened yet.
But the major problem with our health-care system isn’t for doctors like me. It’s for patients. My own personal tragedy in another Medicare-like system in Canada, where my family lives, illustrates the problem.
My father received a phone call advising it was time for my mother’s echocardiogram. My father was shocked by this call and replied, “My wife cannot attend, as she passed away eight months ago.” My mother died tragically of a ruptured thoracic aortic aneurysm. Earlier that year, her GP noticed a change in her heart murmur, and he referred her to the cardiologist. The cardiologist then reviewed her and ordered a “non-urgent” echocardiogram to investigate further.
Sadly, my mother did not get called for her non-urgent echocardiogram until 15 months after it was ordered. Had she had this test earlier, she most likely would not have died. This kind of delay, in my opinion, is the biggest downfall of a socialized medical system.
You may ask if I am a supporter of a publicly run, socialized medical system. The answer is that, despite losing my mother, I find I am still a supporter of parts of the system — but definitely not all.
The positives are invaluable: the promise of accessible medical and surgical care for everyone, no matter your age, gender, ethnicity or socio-economic status. This system works well when you are very sick — if you are having a heart attack or stroke and require urgent care and treatment; if you have appendicitis and need urgent surgery; if you are injured in a motor vehicle accident and need a trauma team. The care in these instances is top-notch, and there are no waiting times.
It is the semi-urgent and non-urgent medicine that gets put on the back-burner. Here lies the huge downside: The people who need knee replacements for osteoarthritis must grapple with waiting times of 12-18 months for surgery; patients who need reviews of their chronic rash, or swollen joints or fatigue, have to wait several months to see specialists as an outpatient in the hospital. In the meantime, there are general practitioners or primary care providers they can see to try and help with their conditions.
General practitioners like me are extremely important in a public-care model. We are the front line for management of prevention and chronic disease. We can manage many urgent presentations, and we help decrease patient waiting times in the emergency departments of hospitals. I perform minor procedures, screening tests and treat most acute ailments. Yet I am undervalued and underpaid.
Of course, the taxes are higher to fund a public Medicare-like health system — it is not free. It is not sustainable financially for many countries and, as more people live longer and are kept alive by the latest technologies, the financial burden on countries like mine with socialized medicine will grow.
I truly believe that people deserve access to medical care. But how they can best get it is the question. The U.S. has a free-market health-care system that is already working to a large extent. Does it need improvement? Yes. But it certainly treats its doctors — and its non-acute patients — better than we do down in Australia.
No system is perfect. Had my mother been living in the United States, however, she might well not have died of that aneurysm.
Jill Gamberg, M.D., is a General Practitioner, Board Certified Lifestyle Medicine Physician and Medical Director of Healthshare.com.au in Sydney, Australia.
Marc Siegel, M.D., a professor of medicine, medical director at Doctor Radio at NYU Langone Health and a Fox News Medical Correspondent, assisted in writing this. Follow him on Twitter @drmarcsiegel.