Core Principle for the American Healthcare System: That It Meet the Needs of Everyone and the Primacy of the Doctor Patient Relationship

In my last post (, I listed three core principles upon which we can structure American healthcare reform: 1) That the system meet the needs of everyone; 2) That it be free at the point of delivery; and 3) That it be based on clinical need, not on ability to pay.

Does the American healthcare system meet the needs of everyone? The answer, of course, is a resounding NO! Why? Because the powers that be, major healthcare business corporations (health insurance companies, large hospital chains, pharmaceutical companies, and others) and our politicians (federal and state), have not figured out a way to make it happen. Why? Because they don’t want to figure out a way to make it happen. Why? Because that would disrupt their mutually beneficial nexus of intertwined tendrils of greed, aspirations for ongoing re-election, and ridiculous political ideologies of both liberals and conservatives. Until this nexus is torn asunder, the American healthcare system will simply never accomplish the goal of meeting the needs of everyone.

Certainly, there are good ways, which I have outlined in my new book, Socialized Health Care Reform (available soon), to genuinely accomplish this first core principle of meeting the needs of everyone. However, two fundamental questions arise: 1) Define needs; and 2) Is this goal correct for America?

Let’s examine the 2nd question first. Do the people in America want their healthcare system to meet the needs of everyone? I don’t know the answer to this question. I know my answer but I cannot speak for anyone else. And I DO NOT TRUST POLITICIANS TO SPEAK FOR US. I think I can state the answer many people would give to this question, i.e., “Yes, our system should meet the needs of everyone.” But do they really mean this in their heart. Does a rich man/woman, who has absolutely zero financial difficulty in purchasing first class health insurance for the entire family, really feel that the poor man/woman, who has difficulty feeding, clothing, and educating their children and who can’t even entertain the idea of a health insurance policy, deserve to see the same doctors; to wait in the same office waiting room; to have the same private room hospital facilities, the same after hospital care management, etc., as him/her? What is the true answer to that question?

“Define needs,” What does this mean? The healthcare system itself cannot answer this, nor can politicians or healthcare corporations. The only way to approach getting real factual data for this is through an individual, sound, ongoing, non-conflicted doctorpatient relationship for each person living in America. Do you think politicians and healthcare business people give a damn about the doctorpatient relationship for individual people living in the USA? You may respond, “Well, that’s a medical question; business people and politicians don’t have to and shouldn’t concern themselves with this.” That statement is incorrect a thousand times over. Thinking about how our system can make it happen that non-conflicted, sound, ongoing doctorpatient relationships are open to everyone is precisely the major goal with which politicians and healthcare business people should concern themselves. True healthcare reform will not occur until they accept that all of their other agendas must be subordinate to and exist to serve the primacy of the doctorpatient relationship.

R. Garth Kirkwood, MD

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