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

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

Planning

Greetings Folks:

As we are in the time of Man where we have unprecedented communications capabilities, it is my hope that this communication will be disseminated as widely as possible and that we can begin discussion on the following.

As we are in time of man where we are facing unprecedented peril, we must foster unprecedented fundamental change from the brutal amoral and immoral and violent Capitalist domination to a cooperative communitarian one based on love, quality of life, and sharing.

We must reassess the world situation starting with local concerns. We need a worldwide economic democracy, a "system" truely of the people, for the people, and by the people. Peace, equity (equality and ownership), and sustainability need to be among the basic pillars of our plan.

We must plan.
We must cooperate.
We must inculcate the need to diligently pursue and encourage the love of each other, and persistently act upon that understanding.
We must understand that nature, including human work, is the basis of all wealth, and recognize the impending finitude of our natural resources as it relates to the prospects for future generations.
We must accept that all people should be considered to be created equal at birth and work to make that a reality, but that risk in labor, best intentions, and hard work need to be rewarded.
We must understand, accept, and act upon the maxim that the children of the world are the highest priority.
We must return or instill humanity and equity to work and workplaces.
We must create an Equity Union to replace the usurious banking system and the currently inequitable equity holding systems of the Capitalist status quo.
We must rebuild our communities, production, distribution, and transportation systems, so that all communities are walkable (i.e. people can get the products and services they need within walking distance to their homes).
We must work towards a goal of allowing all people to work at or as near to home as possible.
We must create community centers in all neighborhoods to facilitate community participation in the betterment of their neighborhoods and the world, to facilitate the efficient distribution of necessities to the neighborhoods, and to provide the resources that will allow work to be done at or close to home (e.g. teleconferencing, internet and other computer access, intra and inter community communications, etc.)
We must foster and facilitate inter-community, inter-regional, and world wide cooperation.
We must reduce the use of the automobile by 80% in the next 20 to 40 years.
We must reform our health care system to provide universal access by implementing a single payer plan, regional HMO Risk programs, and slowly but greatly reducing the budget to those local and regional health entities to rid the system of its current rampant abuse and fraud.

In essence we must rearrange:

reassess
reimagine
reorganize
relocalize
reallocate
rebuild
reform
reduce
reuse
recycle.

We must plan according to the principles and values mentioned above and we must educate consistently with our mission, plans, and goals.

I'm a Work kin for peace and cooperation,


With much love,

Mike Morin