I have a boat.  It is a very small sailboat, a Sunfish for you boat literati.  I have abused that boat shamelessly.  I have put holes in the bottom of the boat.  I have patched hole after hole, until now the bottom of the boat has very little of its original cover.  It floats — well, it will when I fix the last hole I put in it — but there is little hope for the poor thing.  It is quite likely that the next hole will end its useful life, and I will need to either give up sailing or get a new boat.

We in the United States are doing exactly this with health care.  We have a health care system that is leaking worse than my little Sunfish.  We are paying outrageously more than other countries for medical services, medical devices and procedures and for pharmaceuticals.  Example:  my brother was paying seven dollars per pill for a medication, and, when he visited his in-laws in Belgium, he was informed that they were buying the same medication for seven cents per pill.  In addition, we are paying for the administration of our health care triple what other countries are paying.

Yet we are pretending to solve the problem of the cost of health care, a problem that Warren Buffett calls the biggest economic problem in the nation, in the very same way that I treat my little boat.  We patch here, paint there, but we never have the nerve to face the fundamental issues, and those are not very hard to identify.  We pay too much for the treatment, and we pay too much for the administration.

To those two problems, there is a solution, and there is only one solution.  We must completely abandon our patchwork of health care, and we must install a system of universal health coverage.  To do this, we must stop the political nonsense and join hands, Republican and Democrat.  The Republicans are right about administration.  It is better done by private industry than by government.  Democrats are right about cost.  It must be controlled by negotiation and fee schedules.

So, one more time, here is the radical solution, the new Sunfish of health care.  First, mandate universal care.  Yes, some non-citizens are going to benefit, just as Americans do when they get treatment in other countries.  Take the premiums out of wages as we do with Social Security.  Provide the poor with basic coverage, as we now do so inefficiently with emergency rooms.  However you do it, cover everyone.

Second, give it to the private insurers to administer.  Divide the country with a grid.  Auction off the sections of the grid to private insurers, and give them a monopoly in the areas they purchase.  Put a Public Service Commission over them to control their profits.

These two radical steps will save enormous amounts, in two ways.  First of all, it will allow us to negotiate as a group with medical providers, most particularly with pharmaceutical companies and providers of medical devices, and it will allow us to control the present outrageous profits of the health systems.

Second, it will allow us to eliminate the overlapping coverage we now are required to purchase.  Since all health care is taken care of, it can be eliminated in other policies — worker’s compensation, auto insurance, products liability coverage, homeowner’s coverage, etc.  For example, medical expense was once forty percent of the cost of worker’s compensation coverage.  It is now seventy percent.  Remove medical expense from worker’s compensation claims and you slash the cost of that coverage for industry.  The same goes for auto coverage, malpractice coverage, products liability coverage, homeowners coverage and others.

We are draining the resources of this nation for no good reason except to assuage the lobbyists for the moneyed interests in health care.  That is not the doctors or the nurses or the host of other real health care providers.  We, we, must stop patching the boat and take these radical steps.  If we do not, this particular boat will sink, and it will take us all with it.




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