|Guarantee Universal Health Care
I am generally in favor of a free market
economy, so much so that I’d like to eliminate collective bargaining. However, I
don’t believe a free market system is appropriate for health care. I prefer a
government-run system financed entirely by taxes.
One reason is that in a market system,
the supplier’s main goal is to make money. Faced in any situation where there is
a choice between doing the best thing for the patient and maximizing profit, the
provider will choose the latter. We can live with that in other areas of the
economy because the customer can shop around. If he doesn’t like the deal he is
getting, he can go elsewhere, or he can delay the purchase, or he can find an
alternative solution such as renting instead of buying. That is not the case
with health care. Often, the “customer” is sick or injured and in no condition
to go shopping. Even if there is someone to search on the patient’s behalf for
the best medical care, they may not have time to do so. Often, medical care
delayed is medical care denied.
One way to implement the system would be
to extend Medicare to all citizens, financing the entire system with an income
tax surcharge. Robert Samuelson, an economist who writes a column for Newsweek,
suggests a dedicated health system tax that makes it clear to citizens what the
system is costing them. Samuelson considers the rising cost of health care a
more serious issue than the fact that a lot of people are without health
To reduce costs, we should begin moving
as rapidly as possible toward direct provision of services by non-union Health System employees at Health System
facilities, replacing the current system in which private providers bill
Medicare. Our veteran's hospitals are a current example of government facilities
staffed by government employees. We could start by taking over failing
hospitals in the inner cities, making sure that the neediest of our
citizens have access to health care. We should also quickly take over
the functions that are most susceptible to fraud. It is estimated that
up to 10 percent of Medicare's current budget is lost to fraud.
Another early step should be the design
of an ideal community health care delivery system or "unit", a
collection of facilities capable of providing all the health services
required by a community defined by some combination of population size
and geographic area. Once this health care unit is designed, a model
should be put together in a real community to see if it works. The
successful health system unit would then be duplicated throughout the
Benefits to the Patient:
- Medical records would be
kept on a national database, instantly available for treating a patient
regardless of his location. The database would also make it possible to
contact the physician and/or patient when a new treatment of a condition
- The most current
information on diseases and standard treatment would be instantly available
to anyone in the system. Notification of critical new information could be
instantly distributed to all concerned personnel.
- When the goal of a system
is not generating revenue, but providing the best care at the lowest cost,
other efficiencies are possible:
- Fewer office visits
would be needed because a medical help line would be available for
people to call for advice. Some problems may not require treatment at
all. Others may be treated simply by ordering a prescription, or
suggesting other self-administered treatment. When hands-on treatment is
necessary, the Help line would direct the patient to the nearest
qualified facility, or the qualified facility where the patient is
likely to be seen soonest.
- A greater emphasis
would be placed on preventive medicine.
- One agency in the System
will have the mission of finding and testing new treatments and procedures.
Once the best treatment has been determined, it will be published on a
national network to which everyone has access. Once a condition is
diagnosed, the physician will be able to look it up and find the best
Benefits to Business:
- Business costs would be
reduced because they would have none of the expenses related to providing
health insurance for employees and retirees.
- Workforce mobility would
increase when employees no longer hold on to a job just because of its
health insurance program. Workforce mobility increases productivity because
employees move to the job for which they are best suited.
- Because employers will no
longer be concerned about employee health care costs, they will be less fearful of
hiring people with health problems. For the same reason, confidentiality of
medical records will be less of an issue.
- Universal access to health
care should reduce the number of workdays missed due to illness.
- Evening hours for health
care will reduce the need for employees to take off work for doctor
Benefits to the Economy in General:
- A single health care
system will be less expensive just because one system is less costly to
administer than multiple systems. The health insurance industry would
- Physicians would no longer
have to purchase malpractice insurance. The system would discipline bad
doctors and provide for compensation of patients harmed by the system.
- A National Health Care
System would be paid for out of the General Fund, which will be supplied
primarily from the income tax. Shifting to this National Health Care System
will require a big increase in taxes, of course, but due to the efficiencies
of the new system, the total cost will go down. Our taxes will go
up, but we will be better off because we are no longer paying for health
insurance and we are paying less for goods and services due to the fact that
businesses are no longer paying for health insurance for their employees.
- To the
extent possible, physicians and other medical and administrative staff will
be government employees. No unions will be allowed. Staff will be paid the
lowest wage/salary required to attract qualified people.