This is the first of a five-part installment about ten principles that can be followed to create a true reform of the American healthcare structure that will be of little relative Cost to the taxpayer.
First, there is no “right” answer to this issue. There are facts, opinions, myths, politics and reality, all in no particular order of magnitude. Unfortunately, thus far, and likely in the future, the reform will be political and thus costly, painful and will not address the core issues involved in fixing the inherent systemic problems.
There have been many things written with regard to this topic and I suppose one chooses to read that which comports with one’s leanings on the subject. In my case, I have tried to access diverse opinion sources from Brookings and Rand to Cato, National Center for Policy Analysis, The Hudson Institute and everything in between. I have taken the best thoughts from individuals with whom I have corresponded and have incorporated those thoughts, as well as, in a larger measure, my own herein. If some of these words are similar to others you have heard or read, it is not because I choose to plagiarize them, it is because they have become part of the lexicon of my thinking.
This thinking and these principles are also offered as a consequence of extensive American, Canadian, and, to a lesser degree, British experiences as a physician, surgeon, instructor, and cardiac transplant patient (in the former of the three healthcare systems). They are meant to provoke thought and discussion, and are not offered as sole solutions, though they may have some individual merit by virtue of their common sense. I offer them ten principles for healthcare reform and they are of comparatively little cost to the taxpayer when compared to the current Act. They are, in summary, as follows:
- Healthcare is not a right, but a responsibility.
- We do not require a single payer, but, rather, a single payment system.
- Changes should be made in small increments, easily understood by the People.
- Rationing is a logical outcome in any system with limited resources and high demand.
- Efficient, effective healthcare must be provided to the truly needy
- Medicine must be practiced in a manner and place that is economically efficient, evidence based, specific to local community needs.
- All members of Congress, their dependents and all federal employees must live under the same healthcare rules that they themselves create for those that pay their salaries and provide their pensions- We the People. No waivers can be given to any company or entity.
- American pharmaceutical companies must decide at what end of the drug development / delivery-to-patient pipeline they wish the American taxpayer to subsidize. They can no longer take from both ends.
- Healthcare reform cannot occur without tort reform.
- We must create a national healthcare database so that best practices may be established
1. Healthcare is not a right but a responsibility.
If one does not accept responsibility for his or her actions, there are no consequences for a particular behavior and when translated into the delivery of medical care, that only means increased expenditure. “Rights” are either things you, as a free citizen, may do either without interference (with the implicit caveat that you do no harm to others during the conducting of the specific activity deemed a right) or may not be done to you without permission (such as search and seizure). What is implicit in a right is a protection but not a gift of goods and services created because of the work, sweat, time and capital investment of others. If healthcare is indeed a right, then these healthcare goods, as it were, must then be seized forcibly, by law or by theft, from others who have provided them in what, in my estimation, is a frank violation of their rights of not to be robbed of their property. This then begs the question of whether the absolute right to healthcare also involves the right to steal from those who produce the goods and services necessary for that care. In a broader sense one must also ask where do one’s rights end? Do they extend to food, or housing or a job?