At the beginning of the American Revolution, that patriot and author Thomas Paine wrote a pamphlet laying out in no-nonsense form the basic reasons why Americans had to leave British rule and become a country of their own.  He entitled it Common Sense.  It was just that, a plain and simple and sensible explanation.  It had an enormous impact on the revolutionary spirit, precisely because it was so plain and clear.

Today the American Congress is faced with an issue of huge magnitude — health care.  The president is meaningless to the task before the Congress.  It is our elected representatives who have to figure this out.  Sad to say, so far that struggle has been muddied by considering political issues and the interests of the wealthy.  What those representatives, Democrat and Republican alike, have to do, if they are to come to a just and reasonable program, is to put all that aside and look at the matter from a common-sense point of view.

From that common-sense point of view, the main issues are really quite simple.  First, every American deserves basic health care at an affordable price.  Second, the system as it exists is providing that basic care, but it is doing so at ridiculously high prices.  Every American who has a serious health problem but no insurance can get care at any emergency room, and that makes the care outlandishly expensive.  Second, we have allowed some in the medical system to charge outrageous prices for their services.  This is particularly true of the drug providers, the providers of medical products, and the executives running medical systems.  Thirdly, the cost of administering health care in America is higher than any other country with health care, and it is astoundingly wasteful.

The problem fairly dictates its own answer.  First, provide insurance for everyone.  Second, demand that the medical industry slash its costs.  Third, eliminate the useless parts of the administration of health care.  That is all easy to say, but one might assume, as Trump apparently discovered recently, that it is complicated.  Well, it is, but drastic steps are needed, and private interests have to be put aside to accomplish those steps.

Number One.  Mandate basic health coverage for all Americans.  Do it through private insurance or do it through government, but do it.  For those of you who think that limits your freedom, think it out a bit — the present system is killing your pocket book, and that isn’t helping your freedom much.  Yes, we will have to subsidize the poor, and yes, we will suffer some limits on our own care.  No matter how you cut that, though, it beats the hell out of what we are doing to this nation and to its people today.

Number Two.  Negotiate the price of drugs, medical products and the cost of medical systems.  Negotiate as a group.  No drug should cost ten times in America what it costs elsewhere.  No MRI machine should carry a price that is not negotiated.  No administrator should be paid twenty million dollars a year.  Period.

Number Three.  Eliminate subrogation.  I am quite sure that there are many, many ways to slash the cost of administration of medical services, but the big one is to eliminate the overlapping coverage for which we are all paying today.  Remove medical expense as an item of coverage from every other kind of insurance — liability, auto, homeowners, products liability, medical negligence — any of the several kinds of insurance that now charge for coverage of the exact same bills as our health care.

If we do all this, many people are going to scream bloody murder.  The drug companies, the medical product manufacturers, the executives at Humana and Aurora and elsewhere, the trial lawyers (of whom I happen to be one).  But they will all holler for the same reason — they will be losing the money that has made our present system so crazily, and unjustifiably, expensive.  Medical care will not work in America until we cut — no, slash — its present costs.  If we do this, it will be a piece of cake to provide basic health care to every American.

We will, of course, have to do something for the wealthy.  They will need to have their boobs bolstered and their wrinkles removed.  Allow those who need Cadillac coverage to go pay for it themselves.  This is, after all, America.  You should be able to do what you want.  You just don’t have the right to hurt the rest of us by doing so.  That, it seems to me, is the very minimum meaning of the ideal that begot America.  All human beings have inalienable rights.  Basic health care is essential to the first right, the right to life.  We can all have that.  We just need to use some common sense.















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