Could a state, or the federal government, set up a system of universal primary care as a first step toward comprehensive, publicly funded health care for all?
Universal primary care seems right. Everyone accesses care and public health improves. It would be affordable in broad terms.
However, as an incremental step toward universal single-payer health insurance, it would not work. Single-payer provides for huge administrative savings by eliminating the insurance middleman. It can also reduce drug prices through negotiations. Such savings will be needed to pay for expected increased usage, expansion of the primary care workforce, improving physician reimbursement over inadequate Medicaid and Medicare levels, and handling, at some point, specialty. And, of course, it means that insurance companies will still be around to mess with the process.
Without the savings made possible by a complete single-payer program, federal or state, that ends private insurance, the "incremental" approach will reach a quick dead end.
It appears primary care now is little more than a wellness check, not even a physical, and a panel of blood tests. Every medical need gets referred out to hospitals, specialists, screening test facilities, pharmacies, and urgent cares. The bureacracy has become as dazzling as the federal government's. And there's round-robin referrals in play to avoid having to do any patient-needed paperwork to obtain disability aid, short-term and/or long term.
Dick Gottfried first introduced the NY Health Act in 1992. Dems have held all three branches in NYS for YEARS and they still won't bring it to a vote. Dems are bad on healthcare in a different way, but bad just the same.
I appreciate this thoughtful essay but nothing is going to change while political campaigns continue to be funded by insurance companies, the pharmaceutical industry and corporate healthcare profiteers. Politicians on both sides of the isle accept this money. So it should come as no surprise that the financial interests of these companies is safeguarded in any proposed legislation.
We also can’t talk about universal primary care without addressing the cost and financing of medical education. As a primary care pediatrician (the lowest paid of primary care specialties), my medical education carries the same price tag and interest rates as that of orthopedic surgeons and anesthesiologists. I will die before I pay off my student loans.
I'm sorry. I just now had a chance to glance at your biography and your homepage. Or through here. Your for a terribly invasive risky procedure a diet/exercise complete lifestyle review and change is the prime example of why our healthcare is the worst on the planet. On you for being a morally bankrupt shill.
Did I make a comprehension mistake in thinking you're only proposing primary care under the plan? Am I wrong in thinking that does not include items such as specialist and major procedures? Everything associated with your body and mind? Optical, demtal, mental?
There must be legislative mandates concerning the entire sector. Such as has the complete eradication of private insurance options. The installation of a true free market, an avenue for providers and facilities to list recent diagnosis and outcomes, at what cost. The sector must be all encompassing for the policy to work as intended. Both pertaining to quality of care and capital outlay for it.
I do apologize. This could've easily been included or insinuated as I am a bit distracted yesterday and today. I am posting replying from the seat of a John Deere combine .
There was a hospital CEO I heard give a speech where he was asked about the future of hospitals and he said something like, "In the future, hospitals or health systems won't provide primary care." The point being some of the same made in the comments and article, that someone else (government, Walmart, etc.) would handle primary care and they would just do all the specialty work.
The results aren't anywhere near the quality of #ByDefinition #UniversalHealthcare.
The total and complete elimination of private healthcare insurance. There are only 13,724,624 ways to make a living in this sovereign.
Mandate Cadillac policyholders receive the monthly skipping that normally went to the insurance company from the employer. Having zero influence on the company bottom line.
Structure and in place a true and unfettered free market for providers and facilities. That will allow the consumer to shop around. Look for the best quality of care for the best price. Make all of these statistics concerning healthcare publicly available and easily understood.
Your provider is anywhere, anytime, anyplace.
The quality of care would rise exponentially in the per person cost be drastically reduced. Currently we spent $453 billion on Medicare and Medicaid alone. Serving 140 million people. Policy as I described could be implemented for attach over 300 billion, serving the entire country.
This is the only policy that I firmly believe could be changed by the electorate if the misinformed members actually understood the dynamic of insurance and legislative mandate concerning it. Market capitalism and a level playing field is something that doesn't exist, other than the farmers market on Wednesday evening and Saturday morning at the park. When carefully and placed with aforementioned true free and unfettered access along with strictly enforced thoughtful, consumer protections it works beautifully. Majority of Americans label imperialism as capitalism. Our entire political discourse is riddled with words that are used to not following their definition.
Like any and every other federal government policy, "we the people" could make best policy practice happen. But we have to stand up to the donor class. Bitching about it on the worldwide Tweeter machine, isn't enough.
You can't have government controlled anything in the United States. Look at the VA trying to control costs. They can even tell what a practitioner is doing day to day, it who s/he has seen. You CAN have a single payer, and I can show you how. Go read my blogs.
Universal primary care seems right. Everyone accesses care and public health improves. It would be affordable in broad terms.
However, as an incremental step toward universal single-payer health insurance, it would not work. Single-payer provides for huge administrative savings by eliminating the insurance middleman. It can also reduce drug prices through negotiations. Such savings will be needed to pay for expected increased usage, expansion of the primary care workforce, improving physician reimbursement over inadequate Medicaid and Medicare levels, and handling, at some point, specialty. And, of course, it means that insurance companies will still be around to mess with the process.
Without the savings made possible by a complete single-payer program, federal or state, that ends private insurance, the "incremental" approach will reach a quick dead end.
It appears primary care now is little more than a wellness check, not even a physical, and a panel of blood tests. Every medical need gets referred out to hospitals, specialists, screening test facilities, pharmacies, and urgent cares. The bureacracy has become as dazzling as the federal government's. And there's round-robin referrals in play to avoid having to do any patient-needed paperwork to obtain disability aid, short-term and/or long term.
Dick Gottfried first introduced the NY Health Act in 1992. Dems have held all three branches in NYS for YEARS and they still won't bring it to a vote. Dems are bad on healthcare in a different way, but bad just the same.
Indeed
Can primary care for children (PEDS) exist without vaccines?
I appreciate this thoughtful essay but nothing is going to change while political campaigns continue to be funded by insurance companies, the pharmaceutical industry and corporate healthcare profiteers. Politicians on both sides of the isle accept this money. So it should come as no surprise that the financial interests of these companies is safeguarded in any proposed legislation.
We also can’t talk about universal primary care without addressing the cost and financing of medical education. As a primary care pediatrician (the lowest paid of primary care specialties), my medical education carries the same price tag and interest rates as that of orthopedic surgeons and anesthesiologists. I will die before I pay off my student loans.
Oregon has proven half measures don't work. Just another excuse for the industry and it's Beneficiaries to deny real world politic
What do you mean by "half measures"? What are you referring to?
I'm sorry. I just now had a chance to glance at your biography and your homepage. Or through here. Your for a terribly invasive risky procedure a diet/exercise complete lifestyle review and change is the prime example of why our healthcare is the worst on the planet. On you for being a morally bankrupt shill.
Did I make a comprehension mistake in thinking you're only proposing primary care under the plan? Am I wrong in thinking that does not include items such as specialist and major procedures? Everything associated with your body and mind? Optical, demtal, mental?
There must be legislative mandates concerning the entire sector. Such as has the complete eradication of private insurance options. The installation of a true free market, an avenue for providers and facilities to list recent diagnosis and outcomes, at what cost. The sector must be all encompassing for the policy to work as intended. Both pertaining to quality of care and capital outlay for it.
I do apologize. This could've easily been included or insinuated as I am a bit distracted yesterday and today. I am posting replying from the seat of a John Deere combine .
There was a hospital CEO I heard give a speech where he was asked about the future of hospitals and he said something like, "In the future, hospitals or health systems won't provide primary care." The point being some of the same made in the comments and article, that someone else (government, Walmart, etc.) would handle primary care and they would just do all the specialty work.
I’m going with expanded and improved Medicare For All. Stop the beyond billions in corporate welfare.
From the patient perspective this would be a gamechanger! How can we help advocate for this?
There does come a point where we do have to start triaging and saving as many as we can.
The results aren't anywhere near the quality of #ByDefinition #UniversalHealthcare.
The total and complete elimination of private healthcare insurance. There are only 13,724,624 ways to make a living in this sovereign.
Mandate Cadillac policyholders receive the monthly skipping that normally went to the insurance company from the employer. Having zero influence on the company bottom line.
Structure and in place a true and unfettered free market for providers and facilities. That will allow the consumer to shop around. Look for the best quality of care for the best price. Make all of these statistics concerning healthcare publicly available and easily understood.
Your provider is anywhere, anytime, anyplace.
The quality of care would rise exponentially in the per person cost be drastically reduced. Currently we spent $453 billion on Medicare and Medicaid alone. Serving 140 million people. Policy as I described could be implemented for attach over 300 billion, serving the entire country.
This is the only policy that I firmly believe could be changed by the electorate if the misinformed members actually understood the dynamic of insurance and legislative mandate concerning it. Market capitalism and a level playing field is something that doesn't exist, other than the farmers market on Wednesday evening and Saturday morning at the park. When carefully and placed with aforementioned true free and unfettered access along with strictly enforced thoughtful, consumer protections it works beautifully. Majority of Americans label imperialism as capitalism. Our entire political discourse is riddled with words that are used to not following their definition.
Like any and every other federal government policy, "we the people" could make best policy practice happen. But we have to stand up to the donor class. Bitching about it on the worldwide Tweeter machine, isn't enough.
I am on the edge of my seat as to what solutions if any will arise out of the rubble of the current FAILED "healthcare" industry.
You can't have government controlled anything in the United States. Look at the VA trying to control costs. They can even tell what a practitioner is doing day to day, it who s/he has seen. You CAN have a single payer, and I can show you how. Go read my blogs.