Wednesday, December 24, 2008

Universal Health Care and Health Care Reform

The following essay was written in response to an inquiry asking for help to form a single payer health care finance system in the State of Colorado:

I think it is a mistake to do single payer on the state level. All you will be doing is rearranging the redundancy of claims (if any - I would propose that there not be), information systems (including medical records), actuarial, underwriting, accounting, and medical management (the last which I strongly believe should be done by experienced Primary Care Physicians who are of course of the highest quality in general medical expertise and very cognizant of the cost and over-treatment problems and issues). Besides, states are arbitrary boundaries and metropolitan areas and bioregions would be more effective and efficient planning regions.

Single payer(s) would eliminate profits, marketing costs, and if structured correctly could bring fairness, effectiveness, and efficiency to the health care delivery realm.

The ideal would a world single payer system, with unity in policy, management, payment methods, and health (care) equity, but health care services (at least in the longer run) should be viewed as a last resort relative to environmental/public health matters.

Of course administration on the world-wide or national level (in the case of the USA) would be unwieldy, so regional planning/administrative units would need to be set up. But policy should be global, and if not feasible, national, so that a coordinated, effective, equitable system could be planned and implemented. States could be regional planning/administrative units, I suppose, but maybe EPA regions or some variation thereof would be a better place to start. Certainly that would be an issue of discussion whether the plan be national or global.

Remember, there is going to be a lot of friction involved with such a radical change and there will be continued resistance from the status quo because of that. The fate of workers involved in the payment and delivery systems needs to be of paramount concern and the holdings of Capital and the interests of the medical/pharmaceutical industrial/distribution complex can not be ignored. Another reason that we need an Equity Union.

Please feel free to distribute this communication as widely as possible.

Workin' for peace and cooperation,

Mike Morin

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