Socialized Medicine

It's not that socialized medicine doesn't provide adequate care, but right now the privatized American system provides better than adequate care for those with health insurance. However, many Americans don't have adequate insurance or adequate care. The easy answer is to go to a single payer medical care system like those in Canada and Europe that provides equal access to medical care for everyone. Generally, this works.

BUT . . . that really is not good enough. The United States doesn't enjoy its economic position because it was constantly striving for economic equality. Thus, it makes no sense to lower the quality of care of those Americans with excellent care so that those without care can get some. The United States should strive to provide excellent care for all -- not meet in the middle.

Personally, I don't want adequate health care; I want superior health care. Those who can afford it shouldn't be made to lower the quality of care they receive. It is not the American Way. We need to find a way to provide health care for all without compromising the quality of health care many Americans currently receive.

Many would argue that this does not need to be the case. Let me share an anecdote. British Ambassador to the United States Sir Christopher Meyer wasn't feeling well. Turns out he needed surgery. He was preparing to go to the Mayo Clinic in Minnesota for treatment. However, Her Majesty's government told him to wait until his US posting was up (which was happening shortly), and they wanted him to wait to get the surgery in the UK -- it would be much cheaper. He got the surgery in the UK, just in the nick of time. Had he waited another day or two, he could have died.

So, someone in the elite who should have access to the best health care has a bureaucracy decide where he should get his health care, because health care is rationed equally. Hmmmmmm.

But "Wait!" you say. Why should the elite get better care???!!! Well, my socialist friends, because that is the way the system works. There is nothing wrong with people with more resources getting more. It is called capitalism. Now, I am not getting carried away and advocating a strict capitalist model with no social contract. Ayn Rand's world of "Atlas Shrugged" is not a good model either.

So what can we do? We tweak the system we have. We take what works and use it. Private insurance works. We have more access to the best medical technology than any other place in the world. Believe it or not, Medicare works. It is super efficient with administrative costs at less than 2%. HMO's don't work so well. It's like socialized medicine. Each patient is allocated a certain amount of resources and there are incentives for not exceeding the allocation. That type of system is a race to the bottom. Not where I want to get care.

So, we like private insurance and Medicare and don't like socialized medicine and HMOs. Let's work with that.

Because our model includes a social contract we have to have some government involvement, but at the same time we want to make sure we are using the vaunted American market forces to keep innovation up. So, the first thing we do is require companies with 15 or more employees to provide health insurance to their employees. It's not a burden, it's a benefit. You will have better employees if you give them better insurance. We are using a 15 employee minimum as that is that standard for imposing federal regulations on businesses. By the way, did I mention that we will eliminate Medicaid, which is the state run health care system for the poor? Don't worry, they will get health care--better health care.

Now, we have all those people who don't work for companies with more than 15 employees. Well, there is still private health insurance for them to buy either from a private insurer or through the Federal government through a plan we will call Medicare for Small Businesses.

Thus, we take Medicare and expand it. But we are eliminating Medicaid, so we eliminate 50 separate bureaucracies and expand a very efficient system. Thus, we have a huge savings there. We also eliminate a set of taxes that fund Medicaid. Medicare taxes won't increase because we will be taking premiums from those who don't get private insurance from their employer. Small employers can opt-in to the Medicare system or provide private insurance.

The federal government is paying for the bulk of Medicaid anyway. So why duplicate the effort 50 times over, and have 50 different standards to get into the system and 50 different systems for reimbursement. It will also lower the cost of drugs as drug companies won't have to seek formulary approval in each state.

So, those who can afford it, can still get the best insurance and best medical care available. Those working for employers with 15 or more employees have private health insurance. Those working for smaller employers can have either private insurance or a Medicare for Small Business Plan. Those who are unemployed are on Medicare at a reduced premium or with no premium depending on need. There is no rationing of health care and there is no increase in bureaucracy.

There is not necessarily equal access to health care, but their is access. Under this plan, no one will be without access to health care and there will be no reason for anyone not to seek medical care when they need it. Because there is insurance for all, people can go to doctors instead of emergency rooms at public hospitals for health care. This saves money as ER care is much more costly than a doctor visit--a more efficient system because people can now choose to go. They are not forced to seek a de facto socialist system by burdening public hospitals. Thus, health care is redistributed by market forces. Ahh, the American Way.

Americans need to remember what brought prosperity to America in the first place. Competition is key and the private sector is the backbone of our economic strength, but there is a responsibility to those on the periphery of the system. They can't be left behind, but we don't have to accept mediocrity across the board to honor our social contract.

Socialized medicine is un-American and stupid.