Saturday, March 27, 2010


Unencumbered by any research or expertise, I offer a few thoughts on reform of our health care system. The landmark law just enacted does many good things but is mainly health insurance reform that does little to control the high cost of U.S health care.

To address costs, perhaps a place to start would be with education of doctors and other medical personnel. Don't know how but if we can curb the inflation in educational costs there will be less pressure on graduates to command high incomes.

All providers, including government, must negotiate with pharmaceutical companies for lower prices. And re-importation of drugs should be allowed.

Health insurers, hospitals and other large providers should be regulated like utilities. Limiting the percentage of premiums that can be used for expenses other than health care and preventing the duplication of facilities and costly medical equipment are two avenues to pursue.

We should be encouraging, perhaps subsidizing clinics and other institutions that provide efficient, effective care. Typically, these employ physicians on salary and use best practices to ensure highest quality at lowest cost. Some may provide medical services to members who pay an annual fee. We should replicate the model clinics over as much of the country as possible.

Provisions in the new law encourage an increase in primary care and efficient team practice with bonus payments for certain physicians and expansion of community health centers. A step in the right direction.

VA hospitals. Although others may differ, I understand that the VA provides very good care at relatively low cost. This could well be an available option. (To avoid overloading, some limitation may be needed- such as availability only to those living within 100 miles of a VA hospital).

At all times, those who have insurance or other approved coverage can go to whatever private care that is available, paying with own funds.

Give our people a number of choices: private insurance, VA, approved clinic membership, or Medicare for all. In the case of the VA and Medicare, we must be sure that the fees are high enough to ensure sustainability.

With the new law, we have finally recognized that our country deems health care a right for all. We'll have to continue to explore the best ways to bring our country to the top level of countries providing health care for their citizens.


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