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Originally Posted by kork13
1) It seems that quality of care would diminish in a system where doctors have to see many patients.
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By many, do you mean quantity of patients? If so, that already happens. I routinely see 5 patients/hour. On a really busy day, it will be more. In my old practice, I would see 6-7 most days. Insurance reimbursement is such that if we see much less than that, we don't make enough money to keep our doors open.
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2) If medical care was paid for already regardless what what care you receive, what is to stop worrisome parents or ... "social dregs"... from coming into the hospital about the most minor things? This would drive up operating costs significantly.
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You've just perfectly described the Medicaid system in the US.
Spend a few hours in a typical urban emergency room and you'll see just that phenomenon. Patients come in at all hours of the day and night for total nonsense and very little that approaches being an emergency. Various studies have shown that up to 90% of emergency room visits are for non-emergent problems.
Many times, a patient will call my office to schedule an appointment. When they are given an appointment for later that same day, they fail to show up. We find out later that they went to the ER because they didn't feel like waiting 3 or 4 hours to see me. Instead, of course, they went to the ER where they probably waited just as long.
This doesn't just happen at the hospitals. Loads of patients come to see me for "the most minor things" as well. Here's a typical conversation:
Me: What brings you in today?
Patient: I have a terrible cold that I just can't get rid of.
Me: How long have you been sick?
Patient: I woke up with it this morning.
Me: What have you tried taking for it?
Patient: Nothing.
When patients think of medical care as "free" it gets abused.