Be that as it may, this is SUCH a simple problem. In the plus Column we produce almost all the Pharmaceuticals in the world. We create almost all the Medical Technology. We have some of the best doctors, nurses and technicians anywhere and easy access to them (waiting rooms a side). We have one of the best Departments of Health in the world and a large enough populous to share the burden. In addition we already have an army of penny-pinchers in the form of Insurance Companies. All we have to do is structure it to work together. On the negatives we have a large ALL OF THE ABOVE working for themselves. Oh and an unhealthy lifestyle.

How can we fix it?

a. The greatest economic threat to the U.S. is our runaway health care costs, creating a burden on the business sector, the government and individuals. Though health is highly underrated in most cultures, we put healthcare off till it is critical. We do this as individuals and as a country. When hospitalization occurs the burdened of debt can be more catastrophic than the illness. In some cases this leads excessive debt (damaged credit ratings and bankruptcy).

b. This is a simple program. “WE” as the consumer simply mandate the lowest premiums possible at a fixed rate (pegged to Per Capita Income) for “Comprehensive” Base insurance. We would want to spend $1000.00 a year per person paid by ALL 350million people. We would contract with various Insurance Companies and THEY will work to reduce the overall operation of the medical industry. Without question salaried based, but let the insurance companied neonate it. Convert community health care and private will be soon to follow.

c. The Program
i. Create a government department (under the Health Department to replace the Medicare system (I would use the same name) to oversee that the safety and rights of the clients (arbitration and auditing of insurers and doctors).
ii. Define a NOFUALT medical insurance policy. (I.e. unforeseen accidents and heredity, and CDC issues) this would also include vision and dental.
1. We would cover everything you did not bring on yourself allowing the insurance industry to sell rides for (skiing, pregnancy, STDs, smoking, drinking, diet, etc)
a. Employers would be required to buy riders that cover health issues relevant to the duties of the employee (i.e. mining), but could volunteer to cover the Basic Coverage as well. So Employers would only pay for the risks they create.
2. This is not to say you can be denied medical treatment. You would receive the same treatment as if you had coverage, but you will pay (the lowest rate) back the United States Government (at a % of your income till it is paid in full)
3. Give the medical professionals the last say with no caps provided it makes sense.
4. Mandate yearly payments (preferably as part of your income taxes) and also required (as part of your coverage) to do ALL checkups required by the medical guidelines for your age, gender, and medical history. This would include labs and checkups to promote prevention.
5. Contract existing insurance companies to operate “ OUR” policy
6. And allow insurance companies to sell riders for everything not covered. If people have to more to insure them for easting fatty foods and to smoke, they may not do it.
7. This Basic Coverage cannot be denied or taken away.
8. All doctors are IN the Group, but we pay a flat regional rate.
9. Cost
a. Target (under $1,000 year + co-pay $10)

iii. Work to reduce medical costs
1. Offer doctors free medical education (for additional discounted fees)
2. Create a national medical records database (the time wasted in reading, coding, storing and delivering a medical record is criminal)
3. Create National Liability Insurance for doctors (if you reduce their cost of practice then they can give up some pay with a net 0 effect.
4. Set a payment program for medical mistakes (this is unsettling, thought to put a price on pain, limbs and life as long as we take care of the injured for as long as warranted)

iv. Infrastructure
1. Funds should also cover ERs and a structured network of Trauma Centers, and clinics (paying flat rates to service the widest areas effectively).
2. To nationalize (eminent domain) prescription drugs deemed necessary (i.e. AIDS Drugs, vaccines) refund pharmaceutical manufactures for their development cost (buying the rights) and to contract THEM (First right of refusal) to make it at cost +margin and if they can’t meet the need hire as many other manufactures needed to meet the need.
That’s it!

I have, over the past years enjoyed the excellent service from Medicare. But I was living in the UK when the medical service there was taken over by the government, (1948) and most citizens were delighted with the “National Health Service” The tax increases were acceptable and the doctors we talked with were in favor of the system. At that time treatments had few of the requirements now in use. (CAT scans, MRI, many tests and other analyses).
A few years later I came to the USA, but I still have visits and letters from friends and relatives, who keep me up to date with the system. Everyone in the UK receives free medical services although delay in non critical situations is common. A friend diagnosed with cancer was immediately taken into hospital, and treatment started. But one with a painful hip joint had to wait over two months for treatment. The increasing complexity of treatments has pushed up the expenditure, but with no insurance people to support, the cost per person is lower than in the USA. Generally the people from the UK are happy with the system, and I have not heard many of the complaints that our politicians and news organizations promote. The knowledge that a lack of money can never prevent them getting medical treatment, cannot be given a price. People in the UK live longer than those in the USA, and the death rate at birth is lower.
During a few years living in Canada, about 30 years ago, I found a similar service to that in the UK. Here again the people complained of the time they sometimes had to wait for service but none I knew wanted to revert to the USA medical system. Many of the comments I have seen and heard regarding other country’s health services, appear to be politically generated and do not reflect the true feelings of the majority of the citizens in those countries.
Providing affordable medical services for everyone inevitably increases taxes, but most people will go along with the program. The knowledge that medical services are always freely available lifts a burden from many citizens that cannot be measured.

Ralph W Woodgate.

Highmark Blue Cross/Blue Shield represents many people in western Pennsylvania. After a little research, it was not very difficult to discover hundreds of thousands of premium dollars Highmark spends on advertisements, sponsoring golf tournaments, Penguins tickets, Steelers tickets, and other giveaways. But, they graciously have agreed to turn off their large sign on Fifth Avenue place in Pittsburgh for 1 hour per week to save energy. Would it be naive to expect that this cost/energy savings measure would lead to lower premiums. More than likely, the savings will allow for the advertising department to erect another billboard or sponsor another golf tournament. Does demanding that healthcare premiums to be spent on healthcare and not “spin”, classify a person as a socialist (or perhaps a pinko commy)? Coverage for medical tests continue to be denied, and yet Highmark continues to spend money on non-healthcare promotions.

Healthcare providers consider themselves an industry. They are a tertiary industry at best. They manufacture nothing. They are supposed to provide a service. What percentage of the premiums paid to Blue Cross/Blue Shield actually is used to provide that service ? What percentage is used for lobbying, advertising, and giveaways ? Who is really controlling healthcare ?