Pat,
Up to the point where we disagreed, there is the "ultimate" solution. OK,let's say we agree. Then say NO to National Health, take a giant step back, and go with the "we pay" system.
The answer: NOBODY gets/has Insurance. The Insurance brokers are completely OUT of the picture, except perhaps Medicare (but make that optional for a moment). Now...everyone has to pay. Nobody can afford the expensive stuff, but a lot of that (lifesaving procedures excluded), is totally unnecessary. How can this happen? Easy...1. Doctors cannot be greedy,and must tailor their fees to a reasonable "payable" fee. 2. Hospitals ditto. 3. Pharmacy companies will not get "fat" anymore, and generic alternative companies will need to thrive, and be given a fair share of the market. Citizens should have access to mail order and internet based med outlets (with an appropriate prescription), from companies based in US, Canada, and Mexico, overseas also, if they cannot get generics or alternatives here. 4. All the unnecessary procedures, expensive radiology testing (unless clinically necessary) will/must cease. Yep, thousands of MRI facilities might close. 5. Major Tort reform must be in place for it to work. Firstly, plaintiff must pay attorney a retainer to begin work. 2. Awards cap . 3. Lastly...LOSER PAYS all costs. (A guaranteed disincentive for frivolous claims, which are currently crippling cost effective medical care).
This will result in a tailored, but ultimately affordable system. Agreed, no bells and whistles, but feasible. It won't get done of course, because we all want 4 star stuff done, and cannot get it through our heads that this "stuff" is bloody expensive,and often wasteful. Plus, the huge corporate exploitation of healthcare dollars will absolutely make this impossible, barring some form of revolution by the people. The lawyers and Insurance companies would squash this notion like a bug, and quickly. Won't happen. Sooo...we will have come back to our original dilemna. This continued moneypit system, or a "managed" system for all. Now, this could be a two tiered system. Those that want "more stuff" get to pay more, or pay insurance premiums to companies who pay for them, but the self-employed and unemployed (not covered by Medicare) GET care, and hopefully damned good ethical, compassionate and prudent care (anything less CANNOT be tolerated). This would be closer to the British than the Canadian model. The Doctors and other providers get a choice. They can see Health System patients only (and there should be incentives for that, including job guarantees, locations, retirement programs etc.., similar to VA or Indian Health Care), or a combination of Health System and private or insured patients. For the system to work, all licensed physicians will need to see a MANDATORY percentage of Health System patients. This could be a reasonable percentage, and nothing burdensome, so those who want to work harder/longer hours get more funds if that is the road they choose. Those that are happy with more regular hours, a guaranteed reasonable salary (albeit more modest), would choose the National Health option. There are many excellent physicians who will choose that path, and the patient enrolees in such system will have access to excellent care. I have already chosen a similar system myself, and am much happier with my choice. I get to practice Medicine, not business.
Just think Pat, if ALL physicians today just saw maybe 5% of patients absolutely Pro Bono (they do now, and probably more than 5%, but it is because they are unfairly not reimbursed..I am talking about voluntary Pro Bono, from the get-go), we would not have half the crisis we do now.
We can come up with a Nationally "available" Health Care plan for all citizens, if all are willing to play ball, and it might not have to be run by government bureaucrats, who overspend and waste in so many other areas; I do understand your basis for resisting a National plan like Canada's. There may be another way.
Any more thoughts? Anybody else out there reading this...chime in, please.
Gene
