Dr. Steven Knope transcript, Part 2: ‘Health insurance is not synonymous with health care’

In my interview on Tuesday with Dr. Steven Knope, a concierge medicine pioneer, I asked what he thought about the movement in Washington to impose health care reforms.

His answer:

If you’re talking politics, let’s get it on the table: We’re talking about socialization of the entire country, whether that’s the auto industry, the banks, massive stimulus spending and omnibus bills and TARP. These guys are not playing by the rules, they’re certainly not following the Constitution of the United States. If they decide to put some of these fee-for-noncovered-services concierge practices in their sights, they could make life difficult for certain concierge doctors. It’s just going to depend on how tough these doctors are, how willing they are to fight as to whether or not the administration can get everybody in lockstep with this socialized medicine model. I’ll tell you that it will not happen in my practice. I have several constitutional lawyers in my practice who have already agreed to take this to the Supreme Court if necessary. I will personally never return to a hamster wheel practice again. I will leave the country before I do that. Trust me: I take care of people from Canada who fly to see me. I’ve taken care of people in the English system. My patients have had disasters while traveling in New Zealand. There is nothing — nothing — good about big government managing medicine. It just doesn’t work.

Health insurance is not synonymous  with health care. There’s nothing synonymous about it. If you look at this experiment in Massachusetts, which was very interesting, everybody in the state of Massachusetts has now been mandated to carry health insurance [MM: Although members of health care need sharing ministries have been exempted]. What they’ve rapidly found now is that there aren’t enough primary care doctors to actually see the patients. Now there’s a year and a half wait to see an internist. The ERs are still overflowing now with people who have insurance but don’t have a doctor.  (President Barack) Obama and (U.S. Rep. Nancy) Pelosi and all of these folks who think that you simply insure people and now everyone gets health care are sorely mistaken. This is no more well-conceived and thought out than was the stimulus bill that nobody read. At some point, intelligent people have to stand up on both sides of the aisle and say, ‘Look, I know what you want and I know the kind of utopian values you profess to have, but if the numbers don’t work, then why don’t you explain to me why you think this program is going to work? If Medicare and Medicaid are already scheduled for bankruptcy and we’re already insuring 30 million people on that program, then how are you going to insure and take care of 300 million?’ The numbers don’t work. It’s analogous, when I listen to this politically correct speak, it’s really analogous to dealing with one of your teenage children. ‘Daddy I want it now.’ You say, ‘Look, we live in a real world with a budget. You can’t get a BMW at age 16. It’s not going to happen.’ ‘But I deserve it. My friends have one.’ ‘I understand, but that’s not the reality. The numbers don’t work.’

I’m not hearing even liberal publications like the New York Times or the Washington Post or the Huffington Post for that matter come out and say, ‘Look, these are the numbers of the Obama health care plan and this is why it will work and this is what conservatives don’t understand about it.’ I don’t hear any substantive discussion like that where people are saying, ‘This is why it will work. Let me convince you. You don’t understand.’ It’s this moralistic, utopian, ‘It’s a right, it has to be there, write the check and we’ll figure out later how we get the money into the account.’ It’s just absolutely without any rational thought at all. Not that I’m passionate about this. (Laughs.)

You look at this, you see Boehner standing there, John Boehner, standing there on the floor of Congress, and he drops this 1,100-page stimulus package that he got 11 hours earlier and said, ‘Nobody in this entire Congress has read this bill and we have just spent over a trillion dollars with interest.’ Bam! The thing hits the floor. And if that were not enough then here we are 120 days into this saying, ‘Now we need to do the same thing in health care. We just need to rush this through.’ It’s absolutely irrational.


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