Real Health Care Reform

.
We’ve heard a great deal lately about health care reform, but that isn’t what they’re really talking about. They’re talking about health care insurance reform. In other words, how do we get everyone covered by some form of health insurance so that they will have access to the health care system we already have?

Well, I’m not particularly in favor of that. I’d rather see us reform the health care system so that we can afford to give proper health care to everyone for far less money. Whether the health care insurance industry is involved, indeed, whether it even survives that reform, I don’t care. I want a system where a sick child can be taken to see a health care professional to make sure that the cold the child is suffering from isn’t pneumonia and doesn’t turn into pneumonia. And the same for the adult with bronchitis.

Lowering the cost of health insurance won’t get us to that point, because all health insurance involves co-pays and deductibles, which very poor people can’t afford. It does us no good to limit individual payments for a doctor’s visit to $25 each if the sick person can’t even afford a co-pay of $5.

Personally, I think the only reasonable route is to institute a system of free health clinics, run not by doctors but by nurse practitioners, in neighbor­hoods that need service, and supported directly by tax dollars. This is the backbone of the system in England, and it works pretty well for them.

The clinics act as a triage filter, treating the sniffles, even setting broken bones, but sending the pneumonias to a “real” doctor and the shattered ulnas to the emergency rooms. That frees the doctors from being overwhelmed by patients whom they don’t need to see and allows local hospitals to maintain emergency rooms for the good of people who face real medical emergencies.

I’ve grossly oversimplified this, of course, and I know that this basic idea would be far more difficult to implement than just renting storefronts and hiring nurse-practitioners, but I can’t think of any other system that really reforms the medical system we have today, which rations care to those who can afford to pay for it while encouraging doctors to prescribe unnecessary laboratory tests and computer imagings because the doctor gets a kickback – or even owns the lab or the machinery outright.

But the people in Washington are not talking about any such reform to the medical system. They’re just talking about reforming the way we pay for a system that is broken. In my opinion, that will be a waste of taxpayer dollars.
.