From a social standpoint, our society has spoken and has indeed determined that health care is a right. Along with sewage, clean water and vaccines, universal health care in the form of Medicare is one of greatest achievements in the history of public health. On a personal level, however, nobody is an indentured servant… you can practice medicine and opt out of Medicare and thereby avoid “government” payment.

Neurology would be a tough specialty to practice eschewing Medicare, but not impossible. It’s too bad that you haven’t even started your career and you already feel “coerced” and “angry.” You call doctors “beggars” because their political action committee pleads their case to Congress. You seem somewhat young to be so cynical.

Relax. After all the sausage is made in Washington, primary care physicians will make 3X the median salary in the US and proceduralists will make about 5X. You will still be able to choose which patients you want to care for and you can still charge whatever you want for your services– that will never change.

People who paid into medicare were robbed. This is the unfortunate truth. This does not give them the moral right to steal from someone else.

I don’t believe that health care is a right because I don’t believe that I have a moral obligation to “serve” others. I will probably be coerced into doing so, and this angers me. I also believe that income taxation amounts to theft. I get stolen from every year. Just like I eat food from street vendors even though I know I’m going to get sick once in awhile, I’m not going to pursue a specialty in which I am uninterested in order to avoid being victimized in any way.

You make a very important point: Medicare’s creation was a huge boon to physician salaries. And now some physicians are sitting on the steps of capitol hill, hat in hand, begging to keep the money coming. That is shameful.

The worse frustrations in medicine are NOT from Medicare. The real frustrations, and the greatest drain on the health care system, come from the uninsured who get sick and require care… and those numbers are increasing.

The wisdom I have acquired with the 20 years I have served since entering medical school has taught me that the greatest rewards in medicine are not financial, although we are able to make a good living in this culture.

Furthermore, health care is a right in western civilization. When someone gets sick, they go to the emergency room and get treated. Acute care hospitals are compelled to care for them and physicians, even those in private practice, must serve in order to maintain their hospital privileges. So, if you truly believe that health care is not a right, then stay away from any field that requires participating in a medical staff in an acute care hospital.

There is no question that physician salaries are decreasing and frustrations are increasing as Medicare funding is being strained. Politicians do not have the answers and doctors’ groups don’t either, but that is the system. Even so, it’s better than it was 50 years ago when many people had no resources to pay anything for their health care, and doctors routinely accepted barter for their services. The biggest boon to physician salaries was the Medicare system and now the system needs an overhaul.

I feel your pain. Practicing medicine is a continuous struggle and it never ends. But the rewards are worth it.