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Letter to the editor

November 14, 2008

Don't fear socialized medicine; it's here already



To the editor:

In the wake of the recent Democratic Party sweep in the national election, there are those who fear creation of a federal government controlled medical system (Socialized Medicine). But be assured. It is already here.

The template is here in the form of existing structures: Hospital-controlled inpatient and outpatient services, hospital controlled medical practices, separation of medical practitioners into fulltime hospital physicians (hospitalists) and office-based physicians (primary care doctors).

Effective price control mechanisms also are present. All Medicare and Medicaid charges are controlled, with private insurers basing all their claim payments on the feds' standards.

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What about the supply of available medical doctors in the face of these constraints? Will medical schools be able to attract qualified students in the face of rising tuition costs and horrendous individual post-graduation debts (about $100,000 each at present?)

No problem! Cheap is (still) cheap. Substitute NPs (Nurse Practitioners) and PAs (Physician Assistants) for MDs and doctors.

Pretend to assure quality of care by requiring supervision by physicians. A ratio of one doc for 10 NPs or PAs sounds financially reasonable.

What about medical liability insurance? Ah, there is the rub! There's a plurality of lawmakers, state and federal, and lawyers. Nuff said.

Perhaps physicians will become a new priesthood, adding an oath of poverty to the Hippocratic oath on entering practice.

Charles Spenser, M.D. (Retired)
Hagerstown

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