Monday, July 5, 2010

Regarding Health Care Reform – July 5, 2010

Regarding Health Care Reform – July 5, 2010

Thanks for "chiming" in, Diane.

Health care should not be viewed as outside the realm of environmental/public health.

Health care reform should not be viewed as outside the realm of comprehensive ecological economic reform.

But, addressing the particular issue, allow me to offer the following for your consideration, communications, and eduaction.

Having worked for about 15 years in the "Managed Care" and Cost Containment Branches of Health Insurers and other Finance Providers, I have had many valuable lessons on how not to do it.

I agree with PNHP and others about the inefficiencies and redundancies of the past and remaining current health finance firms. A single payer is a good suggestion, but the ways and means by which money is garnered into the system (also the allocation policy and methods, which I will address in a moment) is problematic.

Current understanding presupposes a system of taxation, which is quite unpopular with many and even odious to some if not many if not most. For a payment system this is the major issue. There are also infrastructure problems related to existing finance systems. In other words, people have money allocated to physical capital, and there is a large amount of human resources who have dedicated much of their precious time to building the status quo. Everyone gets up and does something similar or very similar to what they did the day before. Radical change is problematic but not insurmountable.

My transition idea or plan, if you will, is a double payer system with Medicare and Medicaid on the "Public Side" and a Union of "Private" Financiers on the "Quasi-Public" Side. Reform would be expected on both sides, and maybe eventually evolving to a single payer?

Where I differ greatly from PNHP and other advocates of Single Payer, is there total abdication of their responsibility related to the huge role that the irresponsible system of health care providers and the medical industrial complex has caused in the dissolution and breakdown of an affordable workable system of health care. The answer here is again Union. Unions of Institutional and Professional providers.

Working with the above defined workers and phasing down and eventually out Capitalists, we would work to establish HMO in every region/locality and budget resources based on a medical policy set by Physicians and others who are well acquainted and versed in the abuses of the Provider Communities and are excellent, knowledgeable, experienced at their trade. Shannon Brownlee and Nortin Hadler are two eminent such Physicians who come to mind and have written excellent books. Physicians with such qualities should be the Primary Decision Makers, especially on the professional side, but also with respect to the use and allocation of Institutional Resources.

But to reiterate, working toward such an ideal needs to be done within the purview of environmental/public health policies, programs which are part of a comprehensive ecological economic reform plan.

In Peace, Friendship, Community, Cooperation, and Solidarity

No comments:

Post a Comment