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Common sense health care for all would save money, lives

By Bill Roy
The Topeka Capital-Journal, Nov. 10, 2013

Americans don’t have to suffocate themselves with wasteful health care spending that does not do the job. The system I describe below would save Americans nearly $1 trillion annually. Budgets from households to governments could be balanced. And, oh, it is so simple and sure!

Health care would be administered by states and other independent jurisdictions within principles set forth by the federal government, and required for federal matching funds. States could qualify for funds on their schedule.

The first principle is universality.

Every American should be able to access health care without payment at the point of delivery within the state or jurisdiction in which he or she lives. The state and federal government will pay the bills from taxes imposed and collected. Each state may decide upon which taxes to levy, and deductibles and co-payments within reason.

The second principle is comprehensiveness.

The system must provide those services that are medically proven effective. Within this broad requirement each state will decide what it pays for. Many of the nostrums you presently see advertised on television, you would have to buy on your own.

The third principle is availability and accessibility.

We cannot provide everything for everyone everywhere. But we can remember there are people west of US-81 highway, and to the extent possible provide timely services for them or arrange to get them to where services can be provided.

The fourth principle is one’s right to care must be portable.

It should go where you go. That does not mean you can fly to Switzerland and order up a panoply of services which your state automatically pays for. But it does mean if you are in Switzerland and become ill, your state will take responsibility to pay bills within limits provided by state legislation.

The fifth and key principle is the health care system must be publicly administered.

In 2010, we spent $8,233 per person for health care, at least $3,000 more than any other developed nation. They had universal care, which reduces doctors’ business offices from 10 rooms to one.

Currently, health insurance companies take 10 to 30 cents out of each dollar for sales, administration and dividends. Medicare is administered for less than 5 cents on the dollar. Obamacare will attempt to recover overpayments to insurance companies — lots of luck. It also throws money at Medicaid (a federal-state program for the medically indigent). But states may in turn assign the poor (340,000 KanCare patients) to for-profit insurance companies, which benefit from administering or providing their care.

For dessert, this system will let you choose your doctor and hospital — as does Medicare today. The above proposals have many components of Medicare for all. But, most of all they are the principles of Canada’s Medicare, a program that has worked (they live two years longer, and have lower new-born and infant mortality than we do) for about 50 years for two-thirds our cost.

A caveat: Every nation in the world is struggling with health care costs because medicine can do more each day to help people. Some scientific advances save money but many, such as the joint replacements that weren’t done 40 years ago, cost more.

There would be new taxes but overall costs would go down dramatically. First and foremost, we’d avoid thousands of deaths each year that result from no or delayed medical care. And by opening the door to those who struggle to get care, we would take our place among the civilized nations.

Bonus: For anyone who believes health care is too expensive, The Wall Street Journal reported in 2006 that United Healthgroup was about to pay retiring CEO William W. McGuire $1.767 billion. Our health care system produces one thousand seven hundred and sixty-seven million dollars for one person, and bankruptcy for thousands.

Bill Roy is a retired physician and former member of Congress. He has a law degree and lives in Topeka.

http://cjonline.com/opinion/2013-11-10/bill-roy-common-sense-health-care...