by Keith Risman

Created on: October 22, 2007

You may as well ask if giving $1000 to every family is politically feasible. Who would not vote for such a wonderful benefit as universal health care. The real question has more to do with economics. Let's phrase the question so that the answer really means something.

Is it possible to provide Universal Health Care, have it paid for by the government (That really means we pay for it.) while not significantly reducing the quality of care that patients receive?

The answer is yes, but not on the path and system we have currently taken. As long as doctors, drug manufacturers, hospitals, medical equipment manufacturers and medical service providers receive fixed insurance based payments from Medicare, or Blue Cross or any other insurance provider, there is no mechanism where by any of these providers will be willing to lower their fees. Their goal is to maximize the amount of fixed fees they receive for service. This results in ever increasing costs to the system.

The solution is to force competition for patients, based on quality, cost of service, standard of care met, etc. If your hospital has a greater cure rate than another then it can charge the higher rate. Doctor's should be limited to charging by the hour, not the procedure. Why does an hour knee surgery cost $3,500 from the doctor? Is he or she really worth $3500 per hour? Nevertheless, because insurance pays this, we let it happen.

If doctors had to compete for a limited set of funds to perform standard tasks and were awarded at least part of the funds based on outcomes, then much of the cost could be gotten under control and patient outcomes improved as well.

Further, for all those that ride the system now, such as illegal aliens, need to pay into the system they are using. If they work illegally, then their employers need to be aware and by law have a health deduction. The employers know, the workers know. It is not a big mystery. While we are waiting to decide what we are going to do, let's fix that part of the system. It needs to be a cost of working illegally.

For medical providers it is more about gaming the system, not providing the best care at the most affordable rate. If we create a single pool from insurance, employer pay,employee pay and as much as possible from those not currently in the system and put real competition and common sense into the system, then we could have universal care with quality patient outcomes.

The system we have now is leading to the situation where almost no one will be able to afford medical care, even with group insurance. We can choose to fix it before it breaks, or after it is broken.

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