Last week, however, I spoke of the small group meeting that I attended on Health Reform. Last winter, I discussed the two "health reform" meetings that I attended when Tom Daschle was still going to run Health and Human Services. Today, I have to invite you all to weigh in on the "public option" debate.
The health plan that is coming out is going to look a lot like the Massachusetts plan, with employer mandates and cafeteria plans and a lot of administrative fooforall, and, as a denizen of that part of New England, I can tell you getting insurance for everyone does not cut costs unless you include a public option (Medicare for All) in the mix. It is not clear to me that a voluntary public option reins in cost enough, but I know that it is essential.
I also know that once we start to reign in costs, some doctors and hospitals are not going to be able to bring in as much revenue as they once did. That will be a problem, particularly for the surgeons and others who currently bring in the most revenue. But it has to happen or we will not be able to get the system under control. Last, I know that, if you still want people to go to medical school and not make $200K annually on graduation, we need to figure out some other way to pay for it. Students currently graduate owing an arm and two legs; no wonder they opt or higher paying jobs.
The AMA apparently believes that the private sector can do this. (Although a colleague that the AMA has not finalized it POV on this) I don't believe that the private sector can do this- infact the historic record suggests the the private sector only does this sort of thing when threatened by a government plan. What ever plan finally passes, it must have a strong public option to serve as a benchmark for what we expect from the private sector ( I have a soft spot for single-payer, but I am willing to be flexible) If you are a doctor or medical student, please tell the President how you feel about this at the Doctors for America website. Then tell your Congressman.
Thanks for tolerating the digression. Back to mental health tomorrow.