Health Care Reform: introducing the term US MEDcare

February 20, 2019

 

Universal health care is the standard for all developed nations. It seems therefore absurd to think that the wealthiest country, the USA, cannot afford it. How can everyone else then?

 

1. the discussion is awkward using terms like universal health care and medicare for all (Canada uses the term medicare for their universal health care system). The terms seem somehow frightening, socialist, which in the US is almost the Bacio della Morte for anything. This may be the best term: US MEDcare.

2. the system that would work in the USA is essentially the system used in most developed countries: combining universal government paid health care (US MEDcare) with private insurance.

3. use the Australian Health care system as the model, easiest to just copy it exactly, so we can enact it quicker. To improve on  it, it would be wise to get input from the UK, Irish, French and German health care systems.

4. US MEDcare should be a single payer, government system, and not a private insurance conglomerate system. The great majority of universal health care systems are single payer government.

5. Private insurance therefore is not disbanded, and may be as successful as it currently is. How it essentially works: if you want faster service, more expensive treatments, treatments into older age, obtain supplemental private health care insurance.

6. Decisions need to be made, US MEDcare can't pay for everything, a body of expert has to decide what is in system and not. Much of the health care dollars are spent on the last 6 months of life. This is a major reason that US health care is so much more expensive than all other countries with no demonstrable benefit for it.

7.  The cost of drugs has to drop dramatically. It is funny to hear politicians say buy drugs from Canada.. the same companies are making these drugs for the US and Canada. The reasonable trade-off is to increase the duration of patent-protection in exchange for dropping the charge of drugs. The relatively short patent protection accounts for the reason that companies have to charge so much (to the US market). Other methods to decrease company costs for drug development have to be explored, for example partnering with governmental agencies.

 

Advantages of US MEDcare:

1. control and standardize expenses. This system can dictate to hospitals, their charges to standardize them. Right now the hospital charges are like the Grand Bazaar. 

2. an advantage not discussed, as companies would no longer have to pay health care for employees, the cost of manufacture in the US can drop by atleast 20%, making 'made in the USA" possible again. This would be an employment boon.

3. many individuals who can't pay for health care, get 'free' health care at Emergency Departments. The costs of this is enormous and not documented. This is the second major cause for the enormous costs of US health care. US MEDcare would decrease that dramatically.

 

What else needs to be done to reduce costs:

1. Reform medicolegal system. Much of this will happen because if health care is covered, injured individuals do not have to worry about being rendered bankrupt by an injury, and therefore are not driven to legal action in order to get life-long health coverage. Other points I have previously discussed, an important one: medical experts should be agents of the court.

2. Management of non-residents. Co-pays important for them, and I recommend important for all services, to minimize frivolous health care utilization.

 

Credentials.

It worries me that most individuals speaking about health care actually have no particular knowledge about it, including if they are physicians. It is not an American issue, however I find it remarkable that individuals with no knowledge will speak out with so much pseudo-authority on the subject. In this arena, as in national security, people with knowledge on the subject must determine policies and programs, not uninformed blow-hards. Credentials are important.

 

In my case, I trained in Medicine and Radiology, and practiced for a few years in Canada. Did some medical training in Australia, and health care training in Germany, and have trained and practiced in the USA for 27 years. There may be no better teacher than experience in a health care system. I have written a text-book on Health Care Reform in Radiology and have written greater than 10 major peer-reviewed articles on health care policy, including several major papers evaluating multiple national health care systems - a unique effort in Radiology. So, yes I have the credentials to talk about health care systems. One additional issue is important, Americans do tend to have the arrogant vision that they have to develop programs on their own. My view is similar to the famous quote of Sir Isaac Newton: "If I have seen further it is by standing on the shoulders of Giants"   There is no substitute to instruction from other systems, that are already established and have gone through the learning phase;  and to focus on in-depth understanding by writing major peer-reviewed papers relying on the knowledge of experts in other nations.

 

Finally, tying this back to GDD sufferers: what my program recommendations above also result in> all health care of these sufferers should be covered by US MEDcare- many sufferers have been rendered desperately poor because of the disease, and because insurance does not cover the disease as the entity is 'not recognized enough'. This should never happen in a country as wealthy as the USA.

 

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