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Health care can be affordable and accessible

By Gordon D. Fiedler Jr.
The Salina (Kan.) Journal, Aug. 26, 2014

Affordable, accessible health care for all is not a dream but can be a reality, according to David Kingsley, who represents Physicians for a National Health Plan.

Kingsley, of Kansas City, Mo., who has a doctorate in public policy, addressed about 40 people who attended the Salina League of Women Voters Fall Issues Forum Monday night at the Salina Public Library.

He had little good to say about American medical care.

Ours, he said, "is the most complicated health care system ever devised on the face of the Earth."

And it's not producing the desired results.

The United States is 51st among nations in life expectancy, yet spends $8,950 per capita on medical care. This is more than twice that of Canada and nearly three times that of Japan. The Japanese average 12 doctor visits per capita per year, whereas in the United States, visits per capita per year are less than four.

Access to medical care should be a human right, he said.

"Everybody should get treatment on an equal basis. They could get all the care they need, not all the care they want," he said.

Kingsley said there is a need for more doctors in the system and fewer administrative staff. Now, there are about 500,000 practicing physicians but more than 2.5 million office support positions.

One of his PowerPoint slides drew chuckles with the quote, "It takes a lot of people to impede access to health care."

Not a fan of ACA

Lest the audience think he's a staunch backer of the federal Affordable Care Act, also known as ObamaCare, Kingsley made it clear that for all the good it has done, it has a serious problem.

"The ACA's biggest flaw is that it preserves the insurance industry," he said.

The plan that the PNHP proposes would be "Medicare for all" and would offer universal coverage, with no economic barriers to care -- meaning no copays, no deductibles -- and would be similar to the system in Canada, where hospitals remain private and for profit. That's different from the system in Great Britain, where the government owns the hospitals and employs the doctors.

The plan, he said, would be fair, fiscally prudent and patriotic.

Plan based on Medicare

It would be based on the Medicare model, which he said is popular among those 65 and older who are on the plan, and he said he would caution any politician who considers tampering with it.

"Most people like Medicare, so why not make it for everybody," he said.

He has little hope of seeing the ACA get better.

"I hear people say we can improve on it. I'm not a big believer in that idea," he said.

The question becomes what should be done.

"Do we want to continue spending $9,000 per capita and still have 37 million people (without access to care) who are going to get sicker and that really will cost us more money?" he said.

Questions to ponder

He said people have to get beyond the notion that privatizing services is better.

"A lot of things government does, it does well," he said.

Kingsley said it's time to have a conversation and left the audience with some questions to ponder.

"Let's begin to think about what we're going to do about these uninsured people, what are we going to do about paying double for drugs, what are we going to do about an ongoing concentration of industry which maybe 30, 40 years ago would have brought an antitrust lawsuit but isn't happening now," he said.

Cost is in advancements

To the relief of those of a certain age in the audience, he dispelled the myth that the elderly are largely responsible for increases in health care costs.

"The biggest cost in health care that's coming down the road is medical advancements," he said. "This is just the beginning. This is where we have to talk to each other. What are our values? What are our ethics? How are we going to deal with a society that can make a new kidney in the laboratory? It won't be cheap."

Already, cancer patients are receiving "designer" chemotherapy, he said.

"What are we going to do? Who's going to get this? How much can we do?" he said.

--Gordon D. Fiedler Jr. can be reached at 822-1407 or by email at gfiedler@salina.com. This article was distributed by McClatchy-Tribune Information Services. It was originally published under the title of "Health care is topic for speaker."

http://salina.com/search/health-care2014-08-26T01-09-48