Health care--where do we go from here?

To begin this highly controversial topic, I want to say that simply being a physician does not give me special insight into how our health care system should be overhauled.  I think most people in the country, however, would agree that we have work to do.  I have my own opinion, as you may have suspected, and I don't think I agree with anyone completely.  I'm not even sure if my ideas are the solution, but here goes--

Most of my life I have been convinced that the US has the best health care system in the world, the best doctors in the world, and the best treatments available in the world.  I was convinced that this led to the best outcomes in the world.

And then I researched the data.

It turns out that the US does not have the best health care outcomes.  We aren't second.  We aren't third.  We aren't even in 10th place.

In rankings of 13 countries, the US ranks last in mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60.  Ranking poorly in other areas such as access to care and equity, the US simply comes in dead last.  (Dan Munro, Forbes, June 2014)

So, we just need to spend more on healthcare, right?

If you think that, you would be wrong.  At $9,451 per capita, The US spends almost $3,000 more per capita on health care than the next country (Switzerland at $6,935) and more than double the United Kingdom ($4,003).  (Sawyer, Cox--Kaiser  Family Foundation, May 2017)

Notice anything that the health systems with better outcomes have that we don't?  They all--every one of them--have a single payer, government-run health care system that covers everyone with a basic health benefit.  Keep in mind, it is for less money.  What does that mean for you?  It means that, though you may pay more in taxes to fund a single-payer, government-run healthcare system, you would spend much less than you are currently paying for your health insurance.  As with some of the countries, such as Great Britain, you would still get the option to purchase additional coverage that gives even better access, but it would not be a necessity in most instances.

Mind--blown.  And with a mind not focused blindly on one political party, my mind is changed.

What would it take to do that here?  We as Americans would have to completely rethink everything that we have come to accept about our health care system:  Pharmaceutical company nonsense, malpractice awards far beyond reason, immediate access to whatever test we want, going to the doctor with a "shopping list" that we expect to be filled as if we were just placing an order.  That would not work in a new system, but we would be better off in the long run because of it.

All of that being said, this kind of change will not happen in my career, or even in my lifetime.  The political wheels just turn too slowly for that.

So, what do we do in the mean time?  Keep Obamacare? Repeal? Replace?

Here is my opinion:

Keep the parts of Obamacare that work--no pre-existing condition clause, insurance for dependents up to age 26, etc.  There is a longer list of things that are better than before, but that is a start.

Get rid of the parts that are unfair.  End the "fine" for not purchasing healthcare, and instead give tax incentives for doing so--the result is similar, but just sounds better.

Very importantly, open purchasing options beyond state boundaries to encourage more competition and reduce premium prices that have risen tremendously because of monopolies on access.

Most importantly, stop trying to slam dunk a political win.  Republicans and Democrats alike are most interested in scoring, rather than helping the American electorate.

So, those are some of my opinions on health care.  I have a lot more, but we will save that for another time.

For now, peace--

Anthony