Why you don’t want the government in charge of health care (or anything else)

Everyone has heard the arguments against state-run health care. I hope to help you understand something a little different than the usual- a fundamental flaw in the way the government works. I want to share with you an experience we had recently.

Residency programs are largely funded by the local government. Sometimes, citizens get together and start a community residency themselves. Why? Well, the number one reason is this: Statistics show that doctors tend to stay where they do their residency. Any city that has a doctor shortage should be concerned about the ability of a local residency program to recruit top-level candidates. It’s their tax dollars that are primarily responsible for funding it.

My husband and I picked the residency that he is at because of its moonlighting program (that means working extra shifts for extra pay). We have a quarter of a million dollars in student loan debt and four kids. A resident’s salary (about 40k) wasn’t going to be enough for us to meet our responsibilities. Last month, the Graduate Medical Education (GME) Board at my husband’s residency voted to ban moonlighting for all residents. This was a huge blow to the residents who were recruited to this community with broken promises.

The taxpayers should be furious. This will significantly impact the ability of recruiters to bring top level candidates to their community. And, there are other reasons this decision directly affects the people who live here. First, local hospitals fill extra shifts by hiring residents. The inability to do so means longer ER wait times and more stress for the doctors that work there. Second, moonlighting helps residents get experience in a lot of different settings. It affects their education, which makes them better doctors. Third, doctors do much better work when they aren’t overly stressed about paying their loans and providing for their families. Also, working outside their specific hospital helps residents to form connections with other doctors in their community. When it comes time for them to find a job, they will be more likely to stay local. The people of this city are educating these doctors. They deserve to keep them here when their education is finished.

Then why did they do it? Are their any advantages to this plan? The GME board is made up of the residency directors of each specialty. Most of these doctors, for reasons of their own, made the decisions to not allow moonlighting within their own specialty. Should they care what the other specialties are doing? No. Does it affect them? No. But now, their residents can’t come to them and complain, “Hey the ER lets their residents moonlight. Why can’t we?” They can just claim it’s out of their hands. It was a GME decision, not theirs. It’s a purely selfish decision based on personal comfort and a power grab.

This, my friends, is the problem with government. The GME board has made a decision that will affect the well-being of every member of this community for the worse. But they did it for their own personal reasons. The problem with the people who use tax-payer money is that the taxpayers do not hold them responsible. Taxpayers pay their taxes and assume the money is being well-used. There isn’t accountability to shareholders or even the expectation of a decent profit. The government is expected to spend more than it brings in. And when the policies fail, the people vote them tax increases because obviously there isn’t enough money for success. In business, they would give the people who implemented the idiotic policies less money, or just replace them.

Here, we have a situation where policy decisions are made simply for the whims of the policy makers. This was done just so the GME board does not have to accept responsibility for and explain their own choices. How much more likely is it for government policy to be determined by lobbyists and special interest groups? Don't all policy makers look for the opportunity to say "It's not my fault...I'm on your side." In government there is no accountability.

Why, oh why, would anyone want to give these people (who are primarily concerned with self interest) to have power over more of YOUR life?