Isn't it amazing that by implementing a universal health care system, as introduced in this article, we can save more in one year than what we spent on the Iraq and Afghanistan wars since 9/11, i.e. a trillion dollars? We can save this much each and every year and keep our entire population healthy. Will we do it?
Dr. Clayton Christensen has written on "disruptive innovation" extensively. He defines disruptive innovation as a business model that brings to market a much more affordable product or service that is much simpler to use. The non-profit, independent single-payer insurance agency that is proposed in my book, Universal Health Care System for the United States of America: A Disruptive Innovation, is exactly that. It is affordable and it is simple. Its cost per person will be less than half of the cost per person in the present system. This will cut our country's health care expenditure, now at $2 trillion, by more than $1 trillion/year. It is not "socialized medicine" and it is simple to manage. It is structured by legislation as a regulated, non-profit, single-payer insurance agency. It is to be administered privately by a director elected by policy holders. Thus it avoids the inefficiencies of government bureaucracy. It covers 100% of individuals' health care, including prescription drugs and devices, with no copay. Preventive care is included in all policies. There is no billing or form to fill out by doctors and other providers. There is also no expensive claim processing, by Medicare, Medicaid or insurance companies. This alone will save approximately $364 billion/year, and doctors will be able to spend their valuable time taking care of patients instead of filling out forms. There is complete choice of doctor for patients.
Since my book Universal Health Care System for the United States of America came out April 1st, 2009, the naysayers have thought about it as an April Fool's Day joke, a fantasy that will never be realized. Some may say there are "too many forces against it," namely pharmaceutical and health insurance companies. I beg to disagree simply because all other businesses small or large and all the people will be for it. Anxiety and uncertainty about our health care will be once and for all gone. Even pharmaceutical companies will cut billions in costs because they'll have no need to advertise, lobby, or provide gifts. This will increase those companies' net profit, to the benefit of their shareholders, or decrease the cost of medication!
Remember, we live in the age of "Yes, we can." Who ever thought a black man would be our president when Obama started running for office? The conventional wisdom was: "Too many forces are against him."
The reason this proposal may actually pass is because in addition to its universality and the simplicity of its administration, it addresses the core problem with the present system, i.e. profiting from peoples' illness. The negative impact of the profit motive on health care has been extensively written about in books such as The Truth About the Drug Companies: How They Deceive Us and What to Do About It, by Marcia Angell, Private Medicine and Public Health: Profits, Politics, and Prejudices in the American Health Care Enterprise, by Lawrence Weiss, and On the Take: How Medicine's Complicity With Big Business Can Endanger Your Health, by Jerome Kassirer. (Their accounts are corroborated by my 40 years of firsthand, personal experience as a physician within "the system." The stories are instructive and heart-wrenching.)
Other developed countries by and large have taken profit out of the equation. In our proposed private delivery system, we will be doing the same. There will be no conflict of interest in preventing illness or giving good care. There is no profit motive to do unnecessary procedures, fraudulent and double billing, and/or skimping on giving care (as in the case of pre-paid plans, i.e. HMOs).
I must introduce a caveat here. This plan is comprehensive and, yes, disruptive in a good way. It represents a systemic change, as was recommended in 2004 by the National Coalition on Health Care, the nation's largest organization committed to health care reform (consisting of over 150 million Americans). To provide such a universal health care system at less than half the present cost, and all that with good quality control and choice of doctors and multiple policy options is obviously wonderful. But none of this is possible by pussy-footing to introduce various changes at the edge of the existing hodgepodge of the for-profit health insurance industry. People must understand that the "profit" in health care is the core problem and it must go. Developed countries (such as the U.K., Italy, France, Iceland, Denmark, Canada, etc.) all have universal care through socialized, government-run programs. Their quality of care is far superior (ours was rated 37th among industrialized countries by the World Health Organization in 2000, and we are worse off now) and their cost per person is less than half of ours. The proposed, non-profit, privately run single-payer agency would be many times more efficient because it is not socialized medicine and it avoids the inefficiency of large bureaucratic government management.
It is time to call it as it is. Profit in health care is the problem. It must go. The private, non-profit, single agency financed by people and managed privately is the answer. To those who say it is a fantasy and it will never pass, I would say: stay tuned. We live in the age of the "audacity of hope," the age of Obama, the age of "Yes, we can."
In the coming articles I will address a) quality control of patient care, b) incentives for good care, c) malpractice insurance, d) integrity of medical research and education, and many other topics. For a free download of the book, Universal Health Care System, see uhc.helpeachother.com.