I have this car that has numerous problems; it doesn’t run smoothly and makes numerous noises. When I took it to the mechanic, he looked at the carburetor (my car is an old model) and said it needed to be replaced. Among other problems there were leaking gaskets, the radiator has a leak that required, like the oil, to be filled nearly daily. The transmission sticks and the brakes grind. The windows don’t roll down or up, the dash lights don’t all come on and the windshield wipers are stuck.
The mechanic, looking over the car, at the wear on the vehicle could tell I also drove it hard. And, I did. I pushed the RPMs into the yellow, if not the red frequently as I like to accelerate quickly, drive fast, and brake hard. With respect to routine maintenance, I didn’t bother with it; keeping its gas tank full was good enough.
To get it fixed, the transmission will have to be wholly replaced, the pistons and rods have been damaged from low oil and they have to be replaced, the radiator, carburetor, numerous gaskets, hoses, and fittings all have to be replaced. As I didn’t replace the brake pads routinely the whole brake assembly had to be replaced. Many parts will be needed, and it will take a long time to take the car apart, remove the bad parts, install the new parts and finally put the whole car together again.
My mechanic, being well-trained and experienced said he could fix my car; he could get it working practically as good as new… as long as I’m willing to pay for the repairs. Can you believe that? There was this other guy who came in to have his car looked over; my mechanic only charged him the regular fee for maintenance. Granted, this other guy’s car was in good shape as he took care of it and only had the oil changed along with the air filter, but why should he not have to pay more? He could afford to pay more. My mechanic is being unreasonable and taking advantage of my needing to get my car fixed.
A confession: this isn’t about a mechanic looking over a car, but a doctor looking over the health anyone’s body.
Now, some will decry that there is no equivocating how one treats their car with the health of their body. And, they are mostly right, but this isn’t about that comparison; this is about the mechanic/doctor and how they are expected to act. Regardless of whether someone pushed their body hard, didn’t take care of it and it is having problems, or just had ‘bad luck’ from anything that wasn’t initiated by them, it doesn’t take away from the fact that the doctor, like the mechanic, has to invest his resources (time, experience, money and goods) into fixing the body of the patient, instead of a car.
For example, to replace the aforementioned transmission, amongst the other parts will require the manufacture of those parts, the assembly of the parts (each required an investment of research and development, and education to first formulate), the packing, shipping and installation of those parts. If the parts are to a newer car that has much more technological advancements, there will also be the advanced training on how to install those parts – then there is the installation itself, along with all the time that will take. It doesn’t matter if the breakdown came about how I drove it, or if it was a defect in the original manufacture; the mechanic has the same work to perform regardless of how mechanical faults came to be. With a body, for example in replacing a hip there is the manufacture of the part (and its first research and development), the collecting and transport of the rare materials to create the pieces, the manufacture of the machines that made those pieces and so on, along with all the other aspects that the mechanic must undertake to deal with automobiles… only with the much more expensive work that is medicine. For the doctor to treat the patient, it doesn’t matter how the maladies came to be, only that it is and there are requirements for treatment.
With the fact that the doctor has to go through extensive training, and for specialists even more training in their respective fields, along with the huge expense that exists in the medical field with respect to the equipment used, the upkeep and the very buildings all is housed within or based from, the costs are a necessary part of the service. To make the cost the same regardless of the patient’s in coming to use the service need (routine check-up or chemotherapy) is the surest way to make it so no one will be able to use the service for it will not be sustainable and shut-down. Every step in the process of treatment requires funding, and the funding is a necessary part for each step for without funding there is no way that the pieces could be shipped, created, researched, doctor to receive his training, et al.
To make everyone pay the same regardless of services needed is to deny the economic reality that there is a cost to everything, included medical services. A want to insure everyone not only doesn’t help everyone but will in the long-run end with hurting even more people for the medical system will regress to the lowest remaining services, and those will be in short-supply – those services will still be reserved for those with the proper connections. No one can remove the cost of production; the way to make it more affordable is to let the market come in and let the other, necessary forces come in – how prices change from changing supply-and-demand. If the market is removed, then the available services will be reduced greatly. The masses will be out again with less of a chance on receiving treatment.