Several years ago, I wrote a feature on a Virginia doctor who decided to leave the system. He was one of the better-known and respected physicians in the area, and his leaving this group of providers was a shock for many. He was tired of dealing with insurance companies and their piles of paperwork.
He started "Doc at Your Door" and now brings his services directly to patients. He does not accept Medicare or Medicaid or other insurances. It’s a pay-as you go plan; you pay for the time he spends with you.
I mention this as a segue into this book review because the Virginia doctor is an example of a physician who has chosen an alternative way of providing medical care to his patients and billing for his services.
Author Rich Yurkowitz, in his book “Medicare for All, Really?: Why a Single Payer Health Care Plan Would Be Disastrous for America,” considers himself an influencer. While not a physician striking out on his own to change the system, Yurkowitz provides readers with a wealth of information that, at the end of the day, argues against a single payer plan.
Stacking Up the StatisticsYurkowitz is a health care actuary by trade. He has spent decades analyzing data. It’s not enough for him to say that we’ve gone astray or missed the mark when it comes to handling America’s health care system. He is taking a broad look through a panoramic lens to offer readers a unique perspective on the future of health care: where it is today and where it’s headed.
“Medicare for All” has become a hot-button topic, and there would appear to be two major camps. For the first, it sounds wonderful and could be the saving-grace answer for fixing a broken system; for the second, it would be the downfall of the country’s health care system. Of course, it’s become a politically charged and divisive issue.
It's also a very confusing, complex, and difficult puzzle to put together—let alone have a meaningful conversation about—as there are so many moving parts.
This is where Yurkowitz puts all the playing cards on the table, assembling a vast array of information, much in graphs and charts. He not only arms readers with copious amounts of data but also offers help for how to look at this data and decipher what it actually all means.
A Rewarding ChallengeYurkowitz promotes what he sees as good about the current system, particularly in terms of medical innovations, new creative cures, the quality of physicians and hospitals, and the ability of the system to grapple with complex problems.
He acknowledges that the COVID-19 pandemic brought pressure to bear on the health care system, but he warns that overreacting to this emergency by proposing major overhauls is a knee-jerk reaction. The results could have a negative effect in the long run.
This is not a leisurely read. It’s not a book with which you would curl up by the fireside or take to the beach. If you are not a numbers person, the diagrams and charts may be overwhelming.
What is laudable and worth noting is the author’s sincere desire to give readers a boost in understanding a complex issue. He offers a lot of statistics regarding how the U.S. health care system compares with other countries, what percentage of GDP (Gross Domestic Product) we pay for health care, how household disposable income should be factored into the equation, and so on.
His narrative style is conversational. From time to time throughout the book, he interjects what he refers to as left-right dialogue, paraphrasing or mimicking a theoretical debate that a democratic socialist might have with someone more conservative. It’s an effective and entertaining literary structure and gives readers a break from the wealth of statistical data: data not meant to bore but to elucidate, yet can still be heavy.
Yurkowitz supports a free market system with more competition rather than less among health care providers. Innovative market solutions are, for him, a better solution than a government fix.
Clearly, he is anti-M4A (Medicare for All). For him, it’s bad policy. He offers a solution and has sent a copy of his book to Congress.
He doesn’t see his book as a money maker or one that will make a bestseller list. As a health care analyst, he is offering his decades of experience and hopes to influence the national debate on health care, particularly when it comes to legislation and what solutions would be more cost effective.
It’s a technical read, one that, according to the author, he has always wanted to write, and that he hopes the reader will find useful in sifting through the plethora of data on health care. Most importantly, he wishes to give the context needed for the situation to be better understood.