Health Care Reform # 4

The President has a lot on his plate right now. I’d rather he take health care reform off the table and deal with it right in two years.

I’ve been reading about health care systems around the world and I’ve been reading about proposals being made to change health care in the USA. In my opinion, NONE of the proposals being advanced by those in power are worth fighting for. Here’s what I believe we need:

  • Single payer or even a public option is not necessarily required. But for health care to work without it, insurance companies must become public utilities, simple administrators of a plan set by law. That appears to be the format in other countries which do not have single-payer plans.
  • Primary care must be the emphasis. Most health care is simple and people can take care of it themselves. Most of what remains can be handled by a family practitioner. Expensive specialist treatment should be the exception not the rule. Reimbursement rates should match usefulness. That means more time communicating with patients and fewer expensive tests and high-tech images.
  • Evidence based standards for health care should be established and practice guidelines recommended. There is no reason why 10% of pregnant women get cesarean sections in one town, but 45% get them in another. This would also set standards for testing. That eliminates unnecessary testing and testing performed merely to prevent lawsuits. Similarly if a doctor follows established guidelines, they should be protected from lawsuits.
  • I’m willing to make medical school free so that doctors don’t have to start out with huge debits. Of course, I think that should be true for all higher education, but I’ll start with those who serve our health.
  • Mental health, dental health, optical care, substance abuse treatment, and prescriptions should all be included in the plan.
  • Fraud should be investigated aggressively and punished harshly. Stealing from the public damages the public trust out of proportion to the dollars stolen.

I don’t want to sound like a revolutionary who wants things to get worse instead of a little bit better. But all the “serious” proposals being advanced support entrenched “traditional” interests which sap the current system and do not allow for real progress. I guess I am a revolutionary. I want CHANGE. Can we have it? YES WE CAN!