Access to medical care: right or privilege?

America is the only industrialized nation where you can go bankrupt because of medical care. The ACA helped mitigate that risk for tens of millions, but the Trump Administration is promising to abolish the ACA. 

For those with some form of health insurance (private insurance, the ACA, Medicare), there’s still the challenge of (a) finding a physician and (b) keeping their attention for more than the few minutes they could afford to spend on each patient.

Now, for the privileged, there’s “concierge medicine.” A few thousand dollars on top of your regular insurance gets you more time with your doctor and easier scheduling. Of course, if you can’t afford that extra payment, you get the physician cattle call with the rest of the hoi polloi. And increasingly, you’ll be seen by a nurse or physician’s assistant.*

Doctors are embracing concierge medicine because it allows them to practice the sort of medicine they trained for, without the pressure to cut every encounter short. And they make more money, too. Money is important for a primary care doc in America. Primary care is one of the more poorly compensated branches of medicine,** which explains the meager number of med school grads who go into the field. On top of that, many or most med school graduates are looking at hundreds of thousands of dollars in tuition loans to pay off. 

There’s something very wrong with a country in which healthcare access is stratified by wealth. But the alternative would be Marxism/socialism/communism, right?

*I’ve been seen by nurses and physician’s assistants and gotten very good care
**poorly compensated relative to medical practices that do procedures: gastroenterology, surgery, radiology, etc.

https://www.bostonglobe.com/2024/11/15/business/concierge-medicine-doctors-primary-care-yearly-membership-fee/