Single Payer and Private Side By Side


In 2007 the national bill for Health Care (insurance and medical claims) totaled 2.24 trillion dollars. The population has almost doubled in the past 50 years; its median age has advanced due to incredible progress in overcoming disease. Thwarting death is a very expensive proposition. Currently Congress and Administration are trying to wrestle Health Costs down to more reasonable levels, or at least reduce projected annual increases which would double Medical cost by 2017. Before cutting costs they should consider the following Rx. for a better Health System.


Our Health Care System at present consists of Public Single Payer Systems (Medicaid, Medicare, Indian Health, Primary Care and Veterans) side by side with Private Insurance HMO systems. The recommendation here is to flesh out the Single Payer Primary Care Centers and leave High Tech and Specialty Medicine in the private HMO sector. Public and Private Side by Side.


The lynchpin of the Medical System is effective Primary Care. Currently a Single Payer Primary Care System originally designed for underserved areas and the medically indigent and virtually unknown, is flourishing. 8,000 of these Primary Care Centers are at work throughout the country their patient rolls increasing proportionately to the surge in unemployment. The salaried medical staff includes a Pediatrician, a Primary Care Specialist, an Internist, Gynecologist and Dentist.


The Primary Care Centers funded by grants from HHS via HRSA are managed by Community Boards. They see patients from every financial level charging what people can afford. They accept cash, insurance, or no fee at all. In other words they are entrepreneurial and government would not be on the hook for their entire cost. 


By multiplying their numbers manifold and expanding the scope of the practice of Primary Care Medicine we could have efficient unified Primary Care and every citizen insured or not would be assured of Primary Care Medicine.


Properly trained doctors are Guardians, the Good Shepherds who guide their patients through the maze of Specialty and High Tech Medicine, keep track of their progress via conferencing with the specialists and continue with after caret  Primary Care Centers and/or their satellites can be open 24/7. This system would protect Emergency Rooms from overcrowding. The Centers would be electronically connected so that traveling patients could feel medically “at home”.


An additional 8,000 Centers would employ 200,000 medical and clerical persons and help to anchor Strip Malls now losing leases. They can be created gradually over time by application from communities that need them. They can be formed by Primary Care physicians in private practice who decide to become salaried employees and enjoy protection from the Federal Claims Tort Act.


Primary Care in America today too often is languid, passive and boring to its practitioners because of HMO panel restraints and fear of litigation. Patients complain that all their doctors do is order tests and refer.  Examinations are incomplete, those parts of the physical examination that are invasive may be ignored or defaulted to specialists, which means they are never done unless the patient happens to visit the appropriate specialist, and for some quirky reason urinalysis too often is omitted.


These deficiencies will be remedied by Primary Care Centers. Understanding this concept should precede cutting the Costs of the flawed Health Care System.


High Tech Medicine and Surgery are top flight—unsurpassed anywhere, leave them alone. Vote for Single Payer Primary Care Medicine side by side with Privately Insured High Tech Medicine.