Everyone knows that doctors take an oath to “first do no harm.” Since Hippocrates declared this fundamental principle of healthcare in 400 B.C., doctors have routinely taken this oath when they complete medical school. While nurses and other non-physician healthcare workers don’t take this specific oath, it is deeply ingrained in the culture of medicine that the patients come first.
Fast forward today to Kaiser Permanente, the nation’s largest managed care integrated health system, where some 75,000 Kaiser workers walked off the job and stranded sick patients this week. It seems their new mantra is “first pay me more.”
Kaiser is the nation’s largest single-payer healthcare system whereby the same entity pays for and provides medical care. Progressives have been pushing hard to convert the whole nation into this single-payer model. Kaiser Permanente is often hailed by the left as a model of single-payer healthcare. Imagine the whole country having doctors walk off the job, stranding their sick patients and postponing urgently needed procedures. That’s what’s happening in Great Britain where the British National Health Service is also on strike.
The Wall Street Journal editorial board tells us Kaiser serves nearly 13 million patients nationwide, mostly on the West Coast. Patients with Kaiser insurance are treated by doctors and nurses employed by Kaiser. Its managed-care system has been hailed as less expensive than standard private insurance. Kaiser controls spending in part by restricting patient access to outside providers and typically requiring primary-care physicians to authorize specialty care. The flip side is that sick patients may have to wait longer for treatment.
This is socialized medicine by just another name. In every socialized medicine system in the world, expenses are controlled by restricting access to care and in some cases refusing to authorize needed treatment if it is considered too expensive.
Kaiser’s single-payer model has other adverse effects. Unions say it skimps on staff, resulting in lower-quality care. It’s not unusual for unions to complain about staffing levels since they want employers to hire more workers to boost their membership. But Kaiser’s model is intentionally lean. Patients “are telling you how long it took to get the appointment, and then you have to tell them how long it will be to get results,” an ultrasound technician who has worked at Kaiser for 27 years told CBS News. “There’s a breakdown in the quality of care.”
Kaiser’s strike is the largest by healthcare workers in U.S. history, and patients will suffer the most harm. “Non-urgent” operations and chemotherapy treatments this week were rescheduled, in some cases reportedly for months later. But because patients are locked into the system, the stakes are lower for both the union and company. Kaiser has offered to increase wages by between 12.5% and 16% over four years, but the unions are demanding a 24.5% raise. Medicare payment cuts and the end of the national pandemic emergency will likely crimp its revenue. Other hospitals and physicians can bill private insurance more to offset government payment reductions, but Kaiser can’t.
This is a real-life demonstration of the consequences when you allow healthcare workers to unionize and you put the same people in charge of determining what treatment is authorized who also pay the bills. The conflicting incentives of providing quality healthcare and saving money means the patients will be the ones to suffer.
Single-payer healthcare is socialized medicine, whether run by a private corporation like Kaiser Permanente or the federal government. Both situations lead to lower quality healthcare, rationing, and reduced access to care. But the real villains in this current situation are those healthcare workers who have forgotten their commitment to the care of their patients in order to serve their own selfish desires. Shame on them!
