National medical care is not hard

This is why national health care plans always win out over our ridiculous greed-driven plan.

Just imagine you go in for a checkup and the doc gives you bad news. You have a cancer. Fortunately, it’s treatable. She schedules you for a CT scan and a number of other tests. You are scheduled to see an oncologist, who will be in charge of your case. You go in. The oncologist reviews your CT and your lab tests, and establishes a series of treatments that include the very latest developments. She consults with a nearby teaching hospital, which gives you a series of injections and medications that make your own body attack your cancer. After a number of treatments you are returned to health. Your oncologist monitors your health for years after your treatment. For this extensive and expensive medical care you pay nothing out of pocket.

Who gets paid, and how much? Everyone is paid a salary. Nobody gets money for scheduling extra tests. Nobody gets more for scheduling extra appointments. Or for prescribing a particular drug. Nobody’s salary is ridiculously huge; nobody’s is too low. The technologists and administrative personnel are also salaried. There are far fewer administrators because there are no insurance companies to pay. All pay follows a government pay scale, with adjustments according to locale, with extra pay in occupations and in places where there is extra need. All personnel earn more with longer service and more advanced expertise.

The government pays off the educational debt of newly minted physicians. They do not need insurance, because the government treats all conditions, including bad outcomes, and accommodates patients who were injured by their treatment. Each doc’s practice is monitored by government agencies, and extra training is required in the case of deficiencies. The government requires continued training to keep them up to date.

Every person in the country receives unlimited medical care paid through taxes. Health care workers are salaried, and all products, including medicines, are not allowed to be exorbitant as at present.

Is national health care free, as we so often hear? Of course not. It’s paid for through our taxes. But paying for it through taxes means it costs 50% of the market-driven cost we pay now.

Here are some of the reasons we pay so much now. Docs graduate with enormous education debt, which requires them to earn a high salary from the first. They also pay huge malpractice insurance premiums. The technologists in their service are paid moderately. The many administrative personnel who are required to manage the massive paperwork required by the insurance companies are paid the least the system can get away with.

But insurance companies are the biggest reason our health care costs so much. Insurance companies try to minimize all services in order to maximize profit for their shareholder owners. They pay full time people to disallow medical care. They may disallow expensive tests. They may refuse to pay for the treatments the doctor requests. They may refuse to renew any patient’s insurance, or even pay for treatment if the patient’s condition is presumed to exist prior to signing on to their insurance plan, or even if they decide it’s too expensive. Their upper executives are paid tens or even hundreds of millions of dollars every year. Stockholders expect a significant return on their investment.

The result is that our healthcare costs literally double what other countries pay. Double! Moreover, the quality and success rate of our medical care is inferior to many others, not to mention that many Americans have no insurance at all, and their health suffers for it. Lack of insurance often results in medical bankruptcy, or death from untreated conditions.

And yet conservative Republicans will not even consider proven superior systems. Why? Mostly because that would remove the possibility for the top administrative officers to become billionaires, and it is Republican dogma that says making the rich still more rich will somehow benefit the country. In spite of years of claims to the contrary, Republicans simply do not have a viable plan for health care. That is because they insist on a for-profit capitalist plan, and not a single dollar of the billions spent on for-profit insurance goes toward medical care of any kind.

The real purpose of our present plan is to maximize profit and executive pay.

How to Kill Obamacare for Good

Obamacare is a disaster. It’s a demented, twisted, far too complex and distorted excuse for a healthcare plan that should be replaced forthwith. The reason it is so bad is that our basic health care system is so bad. In fact, what we have is an inadequate non-system managed for the benefit of moneyed interests.

The question is, What should replace the Affordable Care Act? Should it be the non-system we had before, that fails to protect millions, costs twice what the best systems cost, yet provides inadequate care, causing thousands of deaths yearly from lack of treatment?

What should replace the Affordable Care Act?

Or should it be the only reasonable alternative, the system that every other advanced nation on the planet has, except ours.

The reasoning behind medical insurance is simple. Rather than trust to luck that we will remain healthy all our lives, or that we’ll be able to readily pay for all our medical needs, we prepare for the possibility that we might one day have medical bills we can’t afford to pay by pooling money with a large number of others. That way, if medical disaster strikes one person, it is paid from this pool, and does not take all of a family’s money, which destroys opportunity for generations. This is not only bad for the family, but bad for the whole country. We all know this.

Should it be the system of every
other advanced nation on the planet?

What we haven’t done is extend that rational idea to its obvious conclusion, the way all other advanced nations have. The largest possible betting pool, the pool that is the most economical and fair, is the entire population. And the most economical agency to manage it is the government. Naysayers should note that the federal government manages numerous national agencies efficiently and competently.

This is what every other advanced country does, and that is why we’re falling further and further behind, at enormous cost, in spite of the Affordable Care Act.

Our non-system is completely beholden to and controlled by private moneyed interests. It has almost nothing to do with providing the best health care for every citizen. That could be changed. Here’s how.

Our system has almost nothing to do
with providing the best health care
for every citizen.

To begin with, the health care insurance industry performs zero health care services, and in fact devotes a large part of its effort to preventing health care service. Why waste all that money to save someone’s life when it could be turned into profit? The entire industry is useless. Yet these companies control nearly every aspect of our health care, and waste one dollar of every four we spend on “health care”. With national health care, these mega-buck companies would be sharply cut back to become agencies that account for how health care is distributed and funded. They would no longer control our very lives.

Second, all doctor training should be funded by the federal government. This would solve several important problems. Doctors would no longer begin professional life in debt for hundreds of thousands of dollars, needing immediate high income. This would allow them to be paid a decently comfortable salary, as in the best European systems, but earning very high pay would not be necessary, and could not be accomplished at our expense. Being salaried, there would no longer be a monetary incentive to order excessive tests and services, also a considerable savings. Each new doc would owe some service, such as a couple of years working in underserved areas, solving another important national need. Being salaried is what happens at the Mayo Clinic, the Kaiser system, and others. It works very well. The care is good, costs are controlled, and the docs are well paid.

Doctor training should be funded
by the federal government.

Big Pharma is an extortion racket, charging exorbitant amounts for newer drugs on which they enjoy a monopoly, wangling to preserve their expired monopoly, and maneuvering to prevent us all from getting the best price on all drugs. The cost of medications should be managed by federal agencies because it’s a public good. Drug profiteering must end if the cost of health care is to be brought to the same cost level as the best European systems—that is, half what it is at present. Federal funding for meds research should be increased, and private pharma companies prevented from profiting from it.

All advertising for drugs should be ended at once. The ubiquity of drug advertisements in several media provides a perverse incentive based entirely on profit, not efficacy.

Development and sale of drugs would continue to be a valuable and profitable industry, but it would not make senior executives enormously rich at the expense of the rest of us. Nor would it continue to pervert doctor incentive by paying the doctor for prescribing a drug. Power over Congress must also be lessened.

Big Pharma is an extortion racket.

In the US a large number of people live in fear that someone who doesn’t “deserve” it might benefit from medical care. According to this thinking, such a person should pay for her own care, and being unemployed because of downsizing is no excuse. Yet such people also believe uninsured workers do not deserve a living wage for full time common work, even though the entire annual wage of such full time workers is less than the cost of health insurance alone. The same deniers fail to acknowledge that a large percentage of people living on welfare are aged, infirm, permanently injured, or children. Either they must accept that it is OK to inflict cruelty on these people, or they must accept that workers need to earn a living wage, deserve to have health care, and those who can’t work must be protected. It is a question of morals, and the deniers come up short. It is clear that every other national system somehow manages to protect every person, including the unemployed.

Would a national system be possible here? I think that’s the wrong question.

We’re not #1. We’re actually #37.

I think the question is rather How can we get from here to there? There is no question in my mind that we must get there, and Obamacare is a tiny step in the right direction. Clumsy and twisted as it is, it protects millions who had no insurance at all. Even with Obamacare, though, we still have a non-system based on grand profit for a few very rich people, a non-system that does not serve everyone, a non-system that costs literally double what the world’s best plans cost, a non-system that provides inadequate care.

Apologists for our non-system are cheerleaders who claim our system has its faults, but our health care is the best, #1. But we’re not #1. We’re actually #37, and we’ll never come close to #1 without radical changes.