The more I listen to the debate the more convinced I become that single payer is the only option which will reduce costs and provide better medical care. We could easily see the option voted down in the Congress but in the long run as the private insurance system has become totally unserviceable and unwieldy we should stake this out as our position instead of, for ostensibly political purposes, ceding to our adversaries 90% of what they want at the end of the process.
It was nice of insurers to join with others in pledging to reduce costs, unfortunately we instantaneously saw how flimsy this pledge was. They will not digitize and especially not harmonize medical records - they consider patients they acquire at cost their property - nor are they able to negotiate effectively for lower prices a situation which could become worse with interlocking ownership.
If, as we well might, we lose the fight for single payer we should not accept a dubious compromise but come back to the public with an explanation of how they are being sold out by the current system. While it probably won't resonate at first given the marketing dollars of the health industry as time goes by and the situation continues to degrade, the public will begin to understand the reasons of a political approach which has been consistent and forthright.
Single payer will necessitate addressing the problems of unemployment in the medical insurance and administrative sectors. While I have seen estimates of savings here of up to 1/3 of total medical costs, in the short term, with the economy in shambles, the problem of unemployment in the insurance and administrative sectors created by single payer will have to be addressed.
A two pronged attack can help to this end. Phase in the single payer system over several years and provide retraining for insurance and administrative personal who want to work in an expanded National Health Service. This service could have as one of its core goals in addition to administration of a single payer system, expanded out reach to communities and preventive care. If even a small dent is made in problems like obesity and diabetes as a result of the outreach program National Health Service will have done much good.
The problem of medical school costs will also need to be addressed. Partnership with the Medical Schools and the public health system would need to be implemented to address this problem.
For those who prefer the current system to one whose focus is the patient rather than the money, I would suggest having your sanity checked but be prepared, it might cost more than you are able to pay as the extent of coverage for mental illness in most insurance schemes is very low.
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