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Herbert Rubin M.D. apparently did not enjoy Jane Sarahson Kahn’s piece last week reporting the results of the recent Annals of Internal Medicine study examining physician attitudes towards national health insurance.  Here is his email to us, edited slightly for length:

"In the free market where I practice, I have no need for wonks, insurance weenies or regulators. It’s me and my patients. I give them what they want, they give me what I want. No intermediaries or academics needed. Thats how every other good or service is sold and bought. No need for those who fancy themselves more clever than the market.Most overeducated experts are risibly obtuse. The diagnosis is the lack of a free market … The cure is the collapse of the current doomed non-system and the irrelevant band-aids proposed, and return of buyers and sellers with no self-interested intermediaries. The more wonks tinker, the better I like it. If single payer comes, I increase my fees, and laugh."  

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8 replies »

  1. A single payer system is the only reasonable approach to the health care financing crisis. Those who believe it is going to lead to long lines for care and poor care, need only speak to virtually any Medicare patient. Having practiced medicine for nearly 40 years, i do not know of any Medicare patient that is not delighted with their care. They have freedom of choice of physician, hospital, testing, and medication. We could have Medicare for all, cradle to grave. We could save in excess of $400B per year and have a superb health care system. We would need to put in place safeguards so that providers (physicians and hospitals) are appropriately reimbursed. The biggest losers in the single payer system will potentially be providers and of course the private insurance companies, not the patients.
    There needs to be a dramatic change in the manner in which we finance health care. Trimming around the edges will not suffice. There are more than 100M people receiving poor or no care.

  2. A single payer system is the only reasonable approach to the health care financing crisis. Those who believe it is going to lead to long lines for care and poor care, need only speak to virtually any Medicare patient. Having practiced medicine for nearly 40 years, i do not know of any Medicare patient that is not delighted with their care. They have freedom of choice of physician, hospital, testing, and medication. We could have Medicare for all, cradle to grave. We could save in excess of $400B per year and have a superb health care system. We would need to put in place safeguards so that providers (physicians and hospitals) are appropriately reimbursed. The biggest losers in the single payer system will potentially be providers and of course the private insurance companies, not the patients.
    There needs to be a dramatic change in the manner in which we finance health care. Trimming around the edges will not suffice. There are more than 100M people receiving poor or no care.

  3. A single payer system is the only reasonable approach to the health care financing crisis. Those who believe it is going to lead to long lines for care and poor care, need only speak to virtually any Medicare patient. Having practiced medicine for nearly 40 years, i do not know of any Medicare patient that is not delighted with their care. They have freedom of choice of physician, hospital, testing, and medication. We could have Medicare for all, cradle to grave. We could save in excess of $400B per year and have a superb health care system. We would need to put in place safeguards so that providers (physicians and hospitals) are appropriately reimbursed. The biggest losers in the single payer system will potentially be providers and of course the private insurance companies, not the patients.
    There needs to be a dramatic change in the manner in which we finance health care. Trimming around the edges will not suffice. There are more than 100M people receiving poor or no care.

  4. A single payer system is the only reasonable approach to the health care financing crisis. Those who believe it is going to lead to long lines for care and poor care, need only speak to virtually any Medicare patient. Having practiced medicine for nearly 40 years, i do not know of any Medicare patient that is not delighted with their care. They have freedom of choice of physician, hospital, testing, and medication. We could have Medicare for all, cradle to grave. We could save in excess of $400B per year and have a superb health care system. We would need to put in place safeguards so that providers (physicians and hospitals) are appropriately reimbursed. The biggest losers in the single payer system will potentially be providers and of course the private insurance companies, not the patients.
    There needs to be a dramatic change in the manner in which we finance health care. Trimming around the edges will not suffice. There are more than 100M people receiving poor or no care.

  5. “Overeducated” is new right-wing code for “elite,” where “elite” in this case means “having some thoughtful knowledge of the subject and tenable opinions instead of a blind obsession with forcing sick, helpless people to earn the privilege of a doctor’s care.”
    Oh darn. I must be elite now. Or is that overeducated?
    Nah. I dropped out of college.

  6. I do not think that Dr. Rubin’s Email merits further discussion. He made it clear that financial interests are his first and foremost priority. If he thinks that the free market will improve/solve all health care problems in the US, he should elaborate. Otherwise, he should look at his possessions and rejoice in privacy.

  7. “Most overeducated experts are risibly obtuse.”
    So is Herbert an undereducated medical expert or an overeducated medical expert, risibly speaking of course? Does he think he needs to learn any more about disease?
    “The cure is the collapse of the current doomed non-system”
    Not sure if that’s a cure but it appears that’s what everybody in the system now wants before any fix. But I doubt any fix will be a total law of the jungle free market. We got here because of too little control.
    “If single payer comes, I increase my fees, and laugh.”
    Only if there are not price controls – the system used in every other single-pay/combined system.
    There’s always those in the “let them eat cake” crowd. Herbert tells us he’s part of the problem not part of the solution. I wonder if he is in favor of the free market solution for medical law suits or if he wants the govm’t to control trial lawyers? Lawyers giving their clients what they want and clients giving lawyers what they want.