Universal Health Care

As a physician with 35 years experience in many health care arenas, I strongly support universal healthcare.  In 1974, I took the Hippocratic Oath to do my best to save lives. I believe having health care insurance is a necessary but insufficient tool to help Americans live longer and more productive lives.  That said, I believe like Civil Rights that Health Care Rights need to be part of the social fabric like Medicare and Medicaid that weaves Americans with one another as caring human beings.

First of all, I do not believe one should govern by popularity. Our Founding Fathers created a republic based upon representative democracy to prevent the public from being swayed on issues that they may not always be fully informed on and on issues for which they may not always have all the relevant facts on hand.  So, we leave it to the President to propose and for the Congress to dispose of ideas that either become the law of the land or not.  Related to this point, I am reminded of the quote by Rosalind Carter. “Great leaders take us not necessarily where we want to go but where we ought to go.”

 Secondly, I don’t know of anyone who is opposed to the abolition of the existing right of insurance companies to deny any American citizen coverage based on pre-existing conditions.  That said, in order to change that onerous rule, we need coverage for ALL.  Why?  Think of it this way.  What if we all chose not to have car insurance?  What if we then had a car accident?  Would we expect to be able to buy car insurance after the accident?  No!  So, if we want to be rid of pre-ex conditions, then everyone must be covered now.  And, I believe there is no other way to get everyone to purchase health insurance unless it’s mandated since young people, as just one example, may not want insurance because they believe they will not get sick.  However, as a physician, I’ve seen far too many young people die unexpectantly without coverage either because they believed they were invincible or because they couldn’t afford the insurance premiums.

Thirdly, many folks assume universal health care means socialized medicine.  From my perspective, it does not.  What I favor is the retention of our current private and public insurance programs and delivery systems.  We then need to  include all citizens into this larger risk pool.  That’s not socialism.  Socialism is when the Government PAYS for all care and OWNS the entire delivery system of physicians, nurses, and hospitals.  We don’t need that, I would not support a socialized medicine approach and the current health care bills that have been passed in Congress do NOT call for a complete socialized Government take-over of our healthcare system.

Fourthly, by including everyone in existing private and public programs, we should could use the existing health care delivery systems to educate everyone on wellness, possibly to avoid sickness, so we can begin the process of increasing the prevalence of wellness, reducing the incidence of chronic diseases and as a result achieve better clinical outcomes for those with these expensive conditions.  Thus, universal coverage will begin a long process of helping all American at least partially change their mindset from a costly sickness driven healthcare model to a value oriented and less costly wellness model.  Also, by including healthy people in the risk pool, that alone will drive down insurance premiums.  The cost of insurance is usually based on the prior experience of the health plan’s members’ sickness and costs of the group without the new folks added that would be healthier and less costly, at least when they purchased insurance to join the larger universal coverage pool thereby spreading the risk.

Lastly, while premiums are unaffordable for far too many Americans, we need to do two things.  Drive down the costs of healthcare (this will be a future blog on my ideas to do this) which should lower health insurance premiums and in the meantime, temporarily assist those who cannot presently afford the soaring health care premiums to purchase insurance.  Therefore, just like every other country in the industrialized world, America can have universal coverage while retaining our existing PRIVATE and PUBLIC institutions.  And, as both major political parties are strongly wedded to Medicare and Medicaid, allowing folks to voluntarily opt into an existing  Medicare program if the premiums are lower than alternative private plans seems like a reasonable and competition driven approach to reduce unconscionably high health care premiums.

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