Universal health care for America? Yes, now, here’s why and how.
Along with the growing demand for free, basic health care for all Americans, and the absurdity that we are the only well-developed nation in the world without universal health care, we can add the urgency of health risks related to climate change including new disease patterns and surfacing of old viruses and bacteria from melting tundra. For me, universal health care is now a national security mandate.
Here’s my roadmap to improve and implement H.R. 676, "Expanded and Improved Medicare for All," with immediate, short-term, mid-term, and long-term actions:
Immediate
Clarify the purpose of 676 to focus on health outcomes and not just the payment system; I propose: “To expand comprehensive health care delivery and improved health care outcomes through government-funded insurance, and for other purposes.”
Short-Term
- Given that between 2010 and 2016 every single one of 210 new drugs approved for market came from the taxpayer-funded National Institutes of Health (NIH) and the National Science foundation (NSF), I will support every legislative effort to reduce costs of pharmaceuticals including legislation or actions that will:
- Allow Medicare to negotiate drug costs
- Use Bayh-Dole Act to allow agencies that funded original medical research to “march-in” and change licensing of patents to expand use of and dramatically reduce costs of infection control or life-saving drugs in national emergencies
- Cap out-of- pocket prescription drug costs
- Allow easier imports of generic drugs
- Repeal legislation and change regulations to limit patent protections and enable quicker marketing of generic alternatives
- Call for open collaborations and “NASA for Medicine” to focus on developing critical, affordable, taxpayer-owned life-saving medicines
- S. Department of Health and Human Services (HHS): Publish National Health Care Assessment that summarizes existing state assessments (available since they are mostly required by law) with no new contracts and using in-house research and analyst resources
- HHS: Publish interactive map to identify well-served and under-served congressional districts in America; no new contracts, in-house resources only
- Identify better incentives for the 17 states that still refuse to expand Medicaid (for example, Texas has 2.5 million uninsured people and loses out on at least $65 Billion while pushing care onto the backs of county health systems)
Mid-Term
- Finances and Funding: NO new taxes on payroll or self-employment income; fund initial expansion of public health services with state and federal health care funds, monies recovered from health care fraud, monies from eliminating cap on social security tax, institute modest tax increase on unearned income including stock and bond transactions for top 5% of earners, hold congressional hearings on instituting small transaction tax on the movement of money by banks and other financial institutions, reduce costs to be paid to insurers as a result of conversion to non-profit status, eliminate two year’s salary for displaced workers in areas with expanding employment; and limit payments to Board members
- Do cost-benefit analysis to identify existing confidential, electronic medical records systems that can be adapted for universal health care (such as those from Defense, Veterans Affairs and Medicare) instead of creating entirely new system
- Recognize that only 18% of Americans trust government to do the right thing so develop and implement an information campaign that emphasizes Freedom of Choice
- Develop an electronic medical record system in accordance with federal guidelines including full testing at all stages of development
- Recognize and address hacking risks and lack of sufficient information technology staffing in government
- Demonstrate that government can make a difference by funding pilot projects based on best practices and whole-of-government coordination to solve a specific problem such as childhood obesity or national suicide rates
- HHS: Publish plan to dramatically expand numbers of health care professionals in underserved areas including rural America, within VA health care and Indian Health Services
- Identify true administrative cost savings and employment transition costs given health care providers still need clerical and billing personnel
Long-Term
- Fully test new systems before going operational
- Clarify realistic implementation plans and schedules
- Develop measurement system that focuses on health outcomes
- Recognize that improving health outcomes is a whole-of-government effort and put in place mechanisms of cross-government coordination that will enable measurable health outcomes
We know what the American people want; we know what to do. I fully believe we can make universal health care a reality here at home if we act wisely and work together.
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