As I watch Republicans scramble in a vain attempt to repair a terminally ill healthcare plan, indeed, severely defective from its inception, I must ask the authors the true 64,000-dollar question: "Where the heck is Tom Coburn?" No offense to Dr. Tom Price, but Coburn is the real dean of any legitimate attempt by conservatives to initiate private sector-based national healthcare. Make no mistake. I am in no way a proponent of the private insurance-sector-owning "global" national healthcare policies. I do not think that they are financially capable of doing so without massive handouts by the federal government and I believe that the math will prove this every time. I have written many times that if Medicare is "deloused," "fumigated," cleansed of fraud and lobbyist infestation, it can be extended in some form to all.
Dr. Coburn, however, makes a reasonable case for private insurance companies based on a similar concept of "pest control." He believes that if we had transparent prices for durable goods, oxygen, laboratory tests, drugs, hospital and outpatient treatments as well as more up-to-date government oversight, some of the classical conservative measures might actually work. He has a point, of course. Health-savings accounts, interstate competition, vouchers, tax credits, limited Medicaid expansion, and other "conservative" financial contributions by the federal government could at least be fairly evaluated if the "proximate" or true costs of medical care could be controlled. That is, the real cost of an antibiotic, a cast, a procedure, hospitalization, a motorized scooter, oxygen or a shoe insert has to be known before the bean counters can calculate "real costs." How much does it really cost an insurance company to manage and own healthcare policies before they pay out CEOs and shareholders? As Coburn, like his former colleague Bernie Sanders, rare honest birds for Senators, fully realize, no program will work as long as it is hampered by the widespread fraud and deceit perpetrated by members of the Senate, the House, and government agencies in their dealings with various corrupt lobbies.
President Trump would be wise, even now, to do what should have been done already, to assemble a bipartisan healthcare committee, chaired by his Secretary of Health and Human Services, Dr. Price. On that committee he should warm seats for Coburn, Tom Daschle, former Bush HHS Secretary Michael Leavitt, and various other conservative and liberal students of national healthcare as opposed to political hacks with ties to the very lobbies that currently benefit so generously from our present "system." If nothing else, they could show credible evidence that no matter the political ideology of our country's healthcare initiative, it must begin at the initial source of the problem, which is the unfettered cost of the physical care of patients.
Allen Finkelstein, D.O., M.Ed. 3/24/17