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MM wrote
"“The Trump chart doesn’t say what the White House seems to think
it says,” Kliff concludes. “It isn’t telling us that
single-payer healthcare has long wait times. If anything, it says that
it is possible to build a single-payer system with short wait times—and
our Medicare program has already done it.””
https://www.nakedcapitalism.com/2018/10/buried-hilariously-stupid-white-house-attack-socialism-accidentally-strong-argument-medicare.html
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Thoughts on single payer which, no less than Medicare, is at best a way
station to what everyone deserves as birthright: adequate preventive and
curative health assistance, at commensurate costs which do not obscenely
enrich a few. In other words, it's an arrangement which if implemented
still masks serious shortcomings. Present single payer schemes from what
I see would not at all disturb the over all regime of the
pharmaceutical/medical complex in this country. We might come to the
point where we are universally protecting each others' health, as best
we think we can, through an insurance scheme into which everyone pays
who is able, similar to any practical solution to a common problem like
auto and accident or unemployment insurance. But at what hidden taxed
costs, increased social rot and ill-health, profit-taking and related
gross inefficiencies?
What do about systematic inflated charges, over billing, the many
overpaid (possibly many overburdened) doctors in a system of guild
restrictions on entry (now mitigated to the limited extent that
substantial returns on investment allow by a less-trained phalanx of
physicians' assistants and nurse practitioners)?
What about over-reliance on allopathic, chemical-based medicine to the
virtual exclusion of serious peer-reviewed research on and evaluation of
naturopathic, herb-based and other possibly more effective types of
medicine, and the need for much greater emphasis on nutrition,
preventive care, and on the ways in which the toxics in our food and
environment combine to undermine health - - not to mention the
undermining effects of social inequality?
What do about the bloated and rapidly increasing profits of clinics,
hospitals, pharmaceutical companies, government-funded or subsidized
institutional and university research labs, all the others who benefit
from the profit-making subsidized, proprietary and other rights built
into medical, biological, and other health-related research and
marketing? All of which are hidden beneath any current health scheme.
This may be one reason that the medical-industrial complex might
ultimately accede inasmuch as profit-taking will still be there, on
stilts, protected with all necessary caution in back-filling increments
which protect their flanks, as they have to an extent elsewhere. How has
that worked for the Scandinavian countries, or UK, France, Canada?
Another factor that is important where I live: care supply. What of the
fact that, in small rural communities such as mine, hundreds and
thousands of people cannot find a doctor to care for them? Doctors
typically seek out remunerative regions in which to plant their
practice, those large urban complexes with attractive returns on their
investment in education, more comfortable amenities and better prospects
for their children. Among patchwork remedies might be that medical
schools require as a condition of scholarships or lightening the debt
load for an education in medicine, or the federal government requires as
a condition of license to practice, that on some equitable basis doctors
do a far more extended period of service than mandated so far, or
mandate total career commitment, to under-served communities. That
includes most especially under-served, more populous communities in
urban areas. Without some better equalizing arrangement we in poorer,
less well-educated, isolated communities have neither the local means
nor infrastructure to bring in competent medical staff and facilities in
sufficient quantity and quality to maintain our health. (And by the way,
is it possible that any adequate solution to our social and polluting
environmental problems will mean extensive dispersal to underpopulated
areas, exacerbating this problem as well?) The result of course is that
rural health and that of poor urban regions lags far behind.
Looking for solutions brings up Cuba. Although I have little information
from what I see they are gradually being forced into the capitalist,
profit-oriented medical system, particularly as it applies to r&d and
pharma trade and and resource access, vulnerability to profit-seeking
capital entering to drive down costs and capture market, participation
on competitive terms in the global, dog-eat-dog, cost-cutting
pharmaceutical industry. Doesn't the same apply to any national plan,
short of universal socialism, to redistribute health care costs,
including single payer and attrition in other countries' health systems?
Other nostalgia: remember the barefoot doctors of Maoist China?
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