Of course the dream died because they, all the experts involved, could not put together a common sense plan, which structures a single payer such that:
- Everyone contributes to paying for it, not just those who actually work and pay income taxes;
- The primary goal is clear and equal access to non-conflicted, sound, ongoing, spontaneously functioning doctor patient relationships;
- Prices paid for services and product would be determined by doctors, hospital CEOs and CFOs, and other major health care business CEOs, all of whom clearly understand how much it costs to operate in American reality, while balancing these profit needs with the welfare of the community at large, i.e., provide fair and generous profit while removing greed, make-work and waste from the system.
The central payer concept, IF STRUCTURED PROPERLY, is a good concept. It favors neither liberal nor conservative ideology. It favors the people living in America.
Is current thinking so constrained that we can only conceive of two choices, either the health insurance companies or the government controls our health care? How about neither of these entities any longer controlling us? How about a central payer, which collects our money and distributes it to pay our health care bills, be founded and operate in an uncomplicated way to accomplish this simple straightforward function? That seems to have been too complicated for Vermont and their consultants.
A properly structured central payer would not attempt to change human nature, but rather provide a framework for the best parts of human nature to flourish and dissuade the undesirable parts of same.
Yes, of course, I’ll likely be viewed as a naive know nothing do-gooder. But let me ask, “Where are we after decades and decades of politicians; think tank experts; the American Medical Association; lobbyists for hospitals, health insurance companies, and drug companies; and spin doctor university economists all contributing to our current landscape?” We are confused and disgusted, wandering in a health care wasteland.
I have previously written a post about Vermont’s Green Mountain Care: http://equalhealthcare.org/2011/06/vermonts-future-green-mountain-care/
When all the experts understand what health care really is and define their goals to serve the individuals living in America with the realization that nothing is free and everyone must have a stake in paying for it, they might be able to come up with a truly great system within which doctors can practice and the rest of the health care system can recognize its role in the support of the doctor patient relationship, i.e., the primacy of the medicine of medicine and the secondary role of the business of medicine. However, I really doubt the will and competence to create a properly constructed central payer exists at the state or federal level.
Thus, the remaining solution for both doctors and patients is for all doctors across the nation to establish a first party payer system in their offices before providing any service. That really would result in consumer directed health care, a favorite buzz word of our glorious politicians.
It’s time to rid ourselves of the health insurance industry and all government payers and to take back control of our own health care.
R. Garth Kirkwood, MD