Schuler On Health Care

A little behind in everything right now so no original post tonight.

I do, however, want to point you to a particularly good piece of thinking on health care and what’s transpiring right now. It’s from Dave Schuler. Here’s a small piece:

That those without healthcare insurance have poorer outcomes than those with insurance is manifest. The statistics are widely available and I won’t both to cite them again here. The shame falls on the society as a whole but it falls most squarely on medical professionals themselves. Under theEmergency Medical Treatment and Active Labor Act of 1986 hospitals and ambulance services are legally required to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. Additionally, physicians are ethically required to provide care to the poor. I recognize that this idea is somewhat controversial among physicians. Over the years the ethical obligation has transmogrified from a personal one for individual physicians to accepting Medicaid to being affiliated with institutions that accept Medicaid.

I won’t expand on this at length but that’s inadequate. All ethical obligations are personal rather than institutional and it’s patently absurd to insist that the janitor and the physician, both affiliated with institutions that accept Medicaid, share the same level of ethical obligation.

However, the necessary implication of that obligation is that physicians must charge some patients more than others. That’s a primary cause of the opacity of medical billing.

He covers a lot in a concise post that’s not from the Ezra Klein school of defend at all costs. More to the point, he doesn’t come at it from a partisan point of view at all.

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