Fixing a broken health care system.

[Solon]

Proposal of the Physicians' Working Group for Single-Payer National Health Insurance

"Health care is an essential safeguard of human life and dignity, and there is an obligation for society to ensure that every person be able to realize this right."

Cardinal Joseph Bernardin

Introduction

U.S. health care is rich in resources. Hospitals and sophisticated equipment abound; even many rural areas boast well-equipped facilities. Most physicians and nurses are superbly trained; dedication to patients the norm. Our research output is prodigious. And we fund health care far more generously than any other nation.

Yet despite medical abundance, care is too often meager because of the irrationality of the present health care system. Over 39 million Americans have no health insurance whatsoever, including 33% of Hispanics, 21% of African-Americans and Asians, and 11% of non-Hispanic Whites. Many more - perhaps most of us - are underinsured. The world's richest health care system is unable to assure such basics as prenatal care and immunizations, and we trail most of the developed world on such indicators as infant mortality and life expectancy. Even the well-insured may find care compromised when HMOs deny them expensive medications and therapies. For patients, fear of financial ruin often amplifies the misfortune of illness.

For physicians, the gratifications of healing give way to anger and alienation in a system that treats sick people as commodities and doctors as investors' tools. In private practice we waste countless hours on billing and bureaucracy. For the uninsured, we avoid procedures, consultations, and costly medications. In HMOs we walk a tightrope between thrift and penuriousness, under the surveillance of bureaucrats who prod us to abdicate allegiance to patients, and to avoid the sickest, who may be unprofitable. In academia, we watch as the scholarly traditions of openness and collaboration give way to secrecy and assertions of private ownership of vital ideas; the search for knowledge displaced by a search for intellectual property.

http://www.physiciansproposal.org/embargoed/angell.html

OK, at the excellent suggestion of wyldwolf, I decided to post a couple of articles about a UHC proposal by doctors themselves, so here they are.

This is the original article he saw:

http://www.pnhp.org/publications/liberal_benefits_conservative_spending.php

[sui generis]

1. unfortunately the doctors I know are by and large against

it because it will cut into their incomes.

If any such plan is to work, it HAS to take into account the cost of medical school, and openly manage expected earnings for practicing physicians so that they aren't disincentivized to participate.

Physician compensation aside, controlling costs in a way to make universal healthcare feasible means pricing regulation on pharmaceuticals and on lab work. It burns me up to hear the first items to be cut in indigent healthcare are adequate lab work and "costly" medications.

First a plan to control your costs so you can see what optimal program costs would be and target how you lay out the additional witholding (ala Social Security withholding) in a way that doesn't just pay for another dividend and posh Manhattan skyscraper for Bristol Myers Squibb. Then figure out how you deal with geriatric care, long term chronic, and acute / transplant / trauma care, because those facts are where most of the outlay will go. The rest of your actuarial groups actually get healthier over time with regular preventitive healthcare and offset other risk costs so that you don't need risk group allocations.

And you basically push current insurers into supplemental insurance - cosmetic, room upgrades, post-trauma, home care, etc. and make their main business administration of the government programs.

At no point would any American EVER be turned away from required medical care for not being able to pay for it, and at no point would any America EVER have to go without their blood pressure, kidney, coumadin, whatever, due to finances or not signing the right plan on the right line on the right day.

[Solon]

2. The thing that really burns me up is the fact that many drugs were...

at least partially paid for through all our tax dollars. Universities recieve grants from the government to research disease, conditions, and drugs all the time, and then that research is sold to a private company, patented, and then sold back to us at a mint. This is outragious, and double dipping.

Also, other factors that save on cost in a NHI or UHC system is this, less beareucratic costs, which seems counterintuitive, but the evidence is there, 97 cents of every dollar that goes into Medicare goes towards medical care, in private systems, you are lucky if its 80 cents of every dollar, and many times much less. Think about all the stuff that would be cut out of a private system, claims wouldn't be needed, there would be few exceptions, which you already mentioned. Also, about 70% of the workforce for insurance companies aren't in claims, but rather are stockbrokers, beancounters, etc. People that wouldn't be NEEDED in a public system.

Not to mention that under a public system, with no worries about shelling out 100 bucks per visit to the doctor means that preventative care could be the norm, reducing, greatly, the costs of health care by being able to catch serious diseases and conditions early, when it is easier and cheaper to treat them. As far as Doctor's pay, it would be reduced, depending on their specialty or if they are a general practitioner, also, the government could help pay back the loans for school over time, with either grants or tax breaks, to doctors who want to treat patients and not just get rich or something.

Just some ideas.