THINKing Outside the Box

In 1993, the Clinton Administration undertook to create a system whereby all Americans would have affordable health care insurance. A year later, the recommendations of the “Task Force on Health Care Reform” were dead, the supposed victim of too much complexity and too little consumer choice.

Maybe so, but even had the recommendations passed, they still would have completely missed the real issue: That Americans need access to affordable health care rather than affordable health care insurance.

The United States is the only developed country in the world that does not have universal health care, and at every turn you will find opposition from insurers, doctors, lawyers, manufacturers and pharmaceutical companies, because implementing such a system would severely reduce the massive profits they reap. Every time a reform attempt is made that requires them shouldering a greater portion of the financial burden, we hear the cries of “socialized medicine!” and “less choice!” and we naively buy into it. Meanwhile, more than 45 million Americans have no choice at all; and many of the ones that do have done so under very limited parameters.

The only reason these parochial interests have been able to keep this dying horse going is a combination of ignorance and complacency on the part of the electorate, compounded by a pusillanimous Congress that doesn’t want to make the hard decisions and risk losing all those patronage dollars. There is, however, a way that universal health care can become a reality by using a combination of legislative and grassroots solutions, some components of which are as follows:

• Mandating that all taxes paid by health insurance companies, pharmaceutical companies, equipment manufacturers and the like be placed in a public trust, the revenue of which can be used to subsidize more costly medical procedures for those that can’t afford them. Closing all those tax loopholes would be a good thing as well.

• Requiring all practicing physicians to accept 10 percent of their patients on a pro bono basis in exchange for which they will be allowed a tax deduction based on a reasonable rate of reimbursement.

• Counter the trend of medical school students to select fields other than primary care by offering generous incentives up to, and including, full forgiveness of student loans if the student agrees to work in the primary care sector for a specified amount of years.

• Focus on switching the medical mindset to preventative, rather than curative medical care. Requiring medical schools to adjust their curriculums, creating community outreach programs that train students while providing basic medical care, imposing a sliding scale on payments for indigent clients; developing a network of clinics to relive pressure on emergency rooms; offering once yearly physical, dental and vision checkups to all citizens and placing payment on a sliding scale from free to a reasonable rate of reimbursement.

• Streamlining the administrative process between providers and insurers to reduce overhead.

• Broadening the definitions of acceptable treatments.

• Make liability insurance on physicians not for profit with nondisbursed funds reinvested in a trust for those cases deemed to be the result of egregious misconduct on the part of the physician or hospital.

• More aggressively enforce standards of conduct on physicians to insure incompetence is weeded out immediately.

There are certainly more suggestions than those mentioned here that should be considered. The point is that universal health care has been neglected for so long, no one segment of society can sustain the entire cost of reforming our current system to reform it. We can, however, get creative, garner the energies of the public and private sectors, academia and the general public to each sacrifice a bit and achieve what most believe is a right.

By the way, regarding last week’s column “Paranoid or Profiled?” the final tally was:

Profiled: 6

Paranoid: 1 (or more accurately, just pissed off).