Send a Tweet
Most Popular Choices
Poll Analyses
Share on Facebook 13 Share on Twitter 1 Printer Friendly Page More Sharing
Exclusive to OpEdNews:
OpEdNews Op Eds    H3'ed 8/4/19

An elegant solution to the American healthcare crisis that should satisfy all parties

By       (Page 1 of 1 pages) (View How Many People Read This)   3 comments
Author 513919
Follow Me on Twitter     Message David Moskowitz
Become a Fan

Having spent two years in Oxford as a Marshall Scholar in the mid-1970s, I came back to medical school believing in a national health service; i.e. Medicare for All. But over the next 30 years I learned at first hand that a monopoly can provide access but not quality. When quality isn't job #1, as GM ironically claims, there's no hope for lowering costs or suffering.

The public-sector solution must be fully accountable. Medicare hasn't been and never will be.

My suggestion for the public sector is the Public Health Service: use it for the 50 million un- and under-insured while leaving private-sector insurance and Medicare alone.

The PHS used to care for thousands of Americans. Its last TB hospitals closed in the 1950s. But in 1921, it loaned 57 of its hospitals to the VA after World War I to care for the veterans lying by the roadside. It's time to repay that loan, with appropriate taxpayer-supplied interest, now that the country needs the infrastructure. The thousands of veterans I spoke to in St Louis in the 1990s all supported this idea.

There is nothing more American than the PHS. It was established by Congress in 1789, and can take care of anybody Congress directs it to, including the 50 million un- and underinsured Americans. VA physicians see only a fifth of the patients that private-sector doctors do, 200 instead of 1,000 or even 2,000 in the private sector. Having them work harder, five half-day clinics a week instead of just one, would let them see everybody at little extra expense.

Besides, the VA/PHS has a long-standing tradition of clinical research and teaching. Without it, there would be no academic medicine in the US.

The Secretary of HHS could order the PHS to improve outcomes and lower costs for common diseases, something nobody in healthcare currently does. Medicare doesn't even pretend to. The NIH abandoned clinical research in the 1960s, focusing on "mechanism" ever since. There is no money, for example, to repurpose generic drugs for new disease indications, which is the safest, quickest, and cheapest way to improve outcomes.

I discovered this when I solved dialysis 25 years ago. The VA fired me for it, and Medicare, already Single Payer for dialysis, had no interest in cutting 7% of its budget. Ditto for healthcare globally; dialysis is the main pillar of the lucrative status quo, and how the entire subspecialty of nephrology gets paid:

https://www.bmj.com/content/363/bmj.k4303/rr

 

Rate It | View Ratings

David Moskowitz Social Media Pages: Facebook page url on login Profile not filled in       Twitter page url on login Profile not filled in       Linkedin page url on login Profile not filled in       Instagram page url on login Profile not filled in

David W. Moskowitz, MD- Founder, Chairman, Chief Executive Officer of GenoMed.com Dr. Moskowitz majored in Chemistry (summa cum laude) at Harvard College, Biochemistry (first class honours) at Merton College, Oxford, and received an MD (cum (more...)
 

Go To Commenting
The views expressed herein are the sole responsibility of the author and do not necessarily reflect those of this website or its editors.
Follow Me on Twitter     Writers Guidelines
Contact AuthorContact Author Contact EditorContact Editor Author PageView Authors' Articles
Support OpEdNews

OpEdNews depends upon can't survive without your help.

If you value this article and the work of OpEdNews, please either Donate or Purchase a premium membership.

STAY IN THE KNOW
If you've enjoyed this, sign up for our daily or weekly newsletter to get lots of great progressive content.
Daily Weekly     OpEdNews Newsletter
Name
Email
   (Opens new browser window)
 

Most Popular Articles by this Author:     (View All Most Popular Articles by this Author)

Quercetin or Quarantine? Or, When Do You Confront a Bully?

An elegant solution to the American healthcare crisis that should satisfy all parties

To View Comments or Join the Conversation: