There is an elephant in the room… and nobody seems to want to address it. The high cost of healthcare in general and the impact that it has on the US budget are a major drag on our economy. There is a way out. Here’s a proposal to consider. Please look it over and post your comments. It’s not perfect, but it’s a start.
WHY is a new path to US healthcare needed?
1.1) To reduce the national debt
The current cost of the system of healthcare in the US is a major reason for the current budget deficit. Nuff said.
1.2) To create competition
The key to reducing cost in our economic system is choice. Without choice there is no competition. When the price of steak gets too high then folks can switch to hamberger. Not so much with healthcare. When health (and sometimes life) is on the line we tend not to settle for hamberger.
1.3) To eliminate non value added cost
So much of healthcare cost is unrelated to actual healthcare. It’s tied up in paper, administration, regulation, insurance, advertising, the latest medical gadgets, showplace facilities,and excessively complicated and unrelated education.
HOW to shrink the elephant?
2.1) See the big picture
How do we actually shrink the elephant? Well, first, we need to see the whole beast. The old joke about the blind men describing the elephant based on what each feels really explains much of why prior solutions have not been particularly effective. Fixing any problem requires first finding the root cause; doing that requires seeing the elephant as a whole.
2.2) Don’t keep trying what has already failed.
We’ve tried trimming the elephant down bit by bit… like setting fixed payments for specific medical conditions… without much luck.
We’ve tried to tie him down with mandatory insurance (Obama Care)… he may be on his knees, but he still weighs the same.
We’ve tried leading him by the trunk with promotions of healthier lifestyles… but he stays as big and obese as ever.
2.3) Go for the big, harry, audacious solution.
Unfortunately, the big money is in the system itself. There are just too many hands in the pot. Only a radical change from the current convoluted tangle of intertwined interest groups can fix it… it’s time to cut the Gordian Knot.
2.4) Get out of the box
Stop treating the notion of “universal healthcare” as socialism. Our Declaration of Independence lists “life” as the FIRST of three unalienable rights. Our Constitution reiterates this right in its Preamble where it defines “promote the general Welfare” as one of the primary purposes of the document.
Ensuring every citizen access to adequate healthcare for maintaining good health clearly fits the definition of “welfare” just as well as ensuring our economic system of capitalism enables our economic freedoms. If nothing else, controlling healthcare cost is absolutely necessary to reduce the national debt. Time to drop the semantics.
WHAT system can get this done?
3.1) Characteristics…
No frills
No choices
No paper
No cost
3.2) Concept
Adopt a military style… enlist personnel for a term equal to twice the time required to train them.
Make medical training similar to that for military medics by eliminating extraneous topics (those included for the RN, BS, BA, MD, dentist, pharmacist, or similar status).
Once their enlistment obligation is fulfilled require all States to accredit them to perform any federally funded service.
Set pay and benefits comparable to military personnel of similar responsibility and training (MD as Captain for example). Advancement thru the ranks would be based on mastering progressively higher levels of competency.
Create training paths for all medical services currently paid from any federal funds.
Enlist all qualified applicants including high school students right after graduation. Use quotas for level and type of training to ensure staffing is adequate but not excessive.
Rotate training with an equil period of hands on practical experience. Break the training into segments that will allow personnel to opt into another related area if they aren’t able to master a more advanced one.
Base promotions on the current Corps needs as well as performane at required levels.
Utilize any available federal property (VA hospitals, unused militaty bases and facilities, etc.). Where such are not avaiable, lease inexpensive space in strip malls.
Use basic furnishings, proven equipment, computerized systems (including existing diagnostic programs proven to equil or exceed that of physicians), and a medical history system tied to SSI numbers.
Use the level of practioner that suits the need. If an RN will do, don’t require an MD.
Replace ALL healthcare benefits (including insurance premiums) now provided or paid by the federal government to legislators, civil service employees, military personnel, and any other persons now covered by current federally funded programs (Medicare, etc.).
Implement services progressively as personnel and facilities become available.
Like any complex endeavor, develop and follow a comprehensive planning approach like that used by privately run projects.
WHO has to do this?
4.1) Any real solution will require BOTH parties. This is nothing less than a war… and it’s time healthcare is treated as such.
4.2) DOGE must address the massive unproductive and irrelevant activities buried in the web of beaurcracies. The elephant must GO but also must those responsible for it’s care and feeding.
4.3) As cartoonist Walt Kelly’s character Pogo famously said “We have met the enemy and he is us.” No matter what solution is identified it can only happen if all parties and members of the three branches of the federal government work together. In the swamp, that will only happen if “we the people” create a tidal wave that threatens to wash it away at the next election.
WHEN
5.1) No time like the present… If our new president truly wants to unite this country, and I think he does, he should begin with a program that has something for both parties as well as “we the people”.
5.2) Properly configured, a MediCorps style service can begin immediately to meet healthcare needs by accepting currently accredited health professionals. Medical students should also be accepted based on applicable education already completed so they can step into the service at that level.
5.3) Begin now to absorb all medical services paid by federal taxes. Start with services for the highest need groups (veterans, homeless, medicaid, etc.)
IN CONCLUSION…
Healthcare has two perspectives… one is economic and the other is social… yet both are two sides of the same coin. If our political parties can recognize AND ACT on this fact maybe they can get behind this or a similar concept… only then can we effectively shrink this elephant in our personal and national budgets.
PS… obviously this proposal is only a starting point for discussion. Please give your comments so it, like our original constition, can be a policy both FOR and BY the PEOPLE.
Doug Brister