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Dr. Taylor Dickinson's articles and essays discussing his ideas on tax-preserved Universal healthcare...

Common Purpose »

Posted: Sun, Jul 27, 2008

By Taylor Dickinson

Evidence of healthcare's disintegration is all around us. Over utilized services, disenchanted physicians and rationed care by governments and insurers leave little doubt that the current approach to the delivery of medical care is a chaotic failure. Why? Every aspect of western medicine is divided into unrelated economic segments.

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What Is Healthcare »

Posted: Fri, Jun 20, 2008

By Taylor Dickinson

Our common understanding is that universal healthcare will provide us all with access to competent medical care. We expect that should we become ill; diagnostic tests, surgery, and life saving medications will be readily available. This we expect without equivocation.

But healthcare has taken on a different meaning.

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The Three Canards »

Posted: Tue, Jun 17, 2008

By Taylor Dickinson

Whenever reporters present documentories on universal healthcare services in Europe or elsewhere they ask three standard questions whose answer in America is an embarrassment. But are the expected answers so reasonable?

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Comments on: Sick Around the World »

Posted: Tue, May 6, 2008

By Taylor Dickinson

Of all the pressing domestic issues in this election year, a successful resolution of the problems in healthcare will have the most enduring effect. Any effort to clarify the issues involved therefore deserves thoughtful consideration. “Sick Around the World,” presented by Frontline, does attempt an even handed comparison of universal care in five countries. Its premise is that among these programs we may find useful suggestions to apply to US medicine. In his summary the narrator, T. R. Reid, identifies three common practices used by these nations to organize their healthcare. First, insurance company profits are limited or eliminated. Second, everybody is mandated to buy healthcare. Government must then provide subsidies to the poor. Lastly, providers (hospitals and physicians) must accept fixed prices.

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The Responsible Physician: Part III »

Posted: Wed, Apr 2, 2008

By Taylor Dickinson

What does the responsible physician bring to the table? Each physician has an innate belief that his patient’s welfare must come before his own. This healthcare system would have collapsed long ago if this were not the case. The flaw lies in the misalignment of self-interest. To correct it there must be an economic focus through which the diverse interests in healthcare can be resolved.

How do risk-bearing physician owned medical groups provide this focus?

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The Responsible Physician: Part II »

Posted: Sun, Mar 30, 2008

By Taylor Dickinson

Why should it seem to be a paradox for physicians to manage healthcare? Many blame physicians for the system’s failure. Deterioration in cost of care, ease of access, and availability of services all seem to point toward the profession. Yet it is the constancy of the physician’s dedication that sustains healthcare. Despite steady erosion of income and increased bureaucratic intrusion the profession soldiers on. The myriad factors which sustain the current US system are nicely described in the New England Journal of Medicine by Lawrence D. Brown. But he missed one critical factor. All of the compensating factors he mentions depend upon the input and even generosity of physicians. The system continues to function because the profession consistently places the welfare of its patients above its own. There is an essential iniquity in a society that exploits the humane spirit of its medical profession to sustain its failed healthcare.

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The Responsible Physician: Part I »

Posted: Wed, Mar 26, 2008

By Taylor Dickinson

As our healthcare system crumbles the mantra of cost containment still emanates from the ruins. Few aspects of healthcare escape this indictment. Physicians, hospitals, pharmaceutical companies and even insurance companies are all cited for their contribution to spiraling cost. But we seem unable to recognize that it is the organization of healthcare itself that creates the problem. As long as the belief is held that fiscal responsibility for care of patients can be divorced from the delivery of that care this chaos will continue. The frenzy to contain cost focuses upon care givers. If only they can be constrained healthcare will be affordable.

This is clearly not an effective strategy.

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Great Britain: Equality Without Care »

Posted: Wed, Mar 5, 2008

By Taylor Dickinson

A recent article in the New York Times, Those Who Pay for Private Care Are Testing Britain’s Public Health System by Sarah Lyall, Feb. 21, 2008, demonstrates how a socialized medical system disintegrates over time. This 60 year old National Health Service (N.H.S.) does not pay for many cancer drugs which are considered to be state of the art in the USA.

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Canada Health Act: Proposed Reorganization, Part I  »

Posted: Fri, Feb 29, 2008

By Taylor Dickinson

Preamble

The recent Supreme Court of Canada decision1 places a difficult challenge before the Canadian Healthcare system. The Court upheld the contention that when government imposes delays in access to treatment in order to sustain the Public Health System it violates the individual’s right to life, liberty and the security of the person. Although rationing of resources was the primary concern, this decision threatens to provoke a series of challenges which will seriously weaken the political and economic viability of the single payor system. The Canadian Government’s response to this challenge will critically affect its ability to preserve the goals and principles incorporated in the Canada Health Act.

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Canada Health Act: Proposed Reorganization, Part II »

Posted: Fri, Feb 29, 2008

By Taylor Dickinson

Implementation of Plan

A. Shift to tax preserved funding of health care

1) The current level of health care funding in Canada benchmarks the country’s fiscal commitment to health care. There should be an active review of the adequacy of this funding before the level of tax-preserved funds available to each household is established. The objective should be to establish a level of funding sufficient to provide a comprehensive health care system without the need to ration services.

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