by Terry M Bennett MD MPH
The USA is the last industrialized country in the world without Universal Health Care.
There are some very basic considerations if Universal Health Care is going to get past special interests and actually be enacted.
Without meeting these criteria, the so called “Health Plan” of what ever candidate, of whatever Party cannot succeed.
1. Simplicity..no mysteries as to who is and who is not included
2. Affordability. it costs less than all the present plans, HMOs and etc presently cost.
3. Allinclusive.All US citizens with a social security number and all green card holders with a social security number or equivalent are automatically included.
Provisions will be included for all legally present in the country, and even on an ad hoc basis for those illegals who require emergent care, prior to return to their country of origin
4. Savings over current healthcare budget, via inclusion of all the presently insured into a single plan with a single set of qualifications and benefits, and simple extension of these benefits to all US Citizens
5. Use an existing, 100% portable, working bureaucracy if possible.
Medicare comes to mind, with a Medicare card issued to one and all.
6. No new untried bureaucracies may be included.The wheel has already been invented.
7. Plan should Allow cancellation of existing redundant and inefficient Bureaucracies, if at all possible. i.e the plan should allow cancellation/ discontinuation of present expensive and inefficient, objectionable bureaucracies which are costly and badly run such as VA, Medicaid, State low income plans etc etc.
8. Pharmaceutical costs are addressed and directly reduced to world equivalent prices, so as to end the debate over why medicines should cost many times more in the USA than anywhere else. No more “Prior Authorizations” or “Generic Only” drugs will be forced upon patients to “preserve profitability”.
9.Choice of physician and hospital must be preserved, no forcing of patients into “networks” , as is the present situation.
10.Part of the plan shall be to plan for the future. The plan should produce an adequate supply of physicians, for the future, so as to have the primary care and specialist doctors we need into the predictable future. This will require restructuring of the US Medical education system so that we produce debt free physicians, as is the norm all over the world, but for the USA. A plan of repayment of education costs via service in underserved areas would be readily expanded from present small numbers.
Tuition at medical schools should come under deep scrutiny.
11.Last and most important, the plan should be nonprofit, and fully financially transparent, readily scrutinized. All of the funds budgeted to healthcare should be spent on healthcare, no siphoning of the budgeted funds into large salaries or overheads allowed, as is the present case with HMOs and other “For Profit” plans.
So, Fast, Cheap, and Fully in Control are the Sine Qua Non of Universal Health Care….