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

Healthcare as Economic Stimulus

Posted: Sun, Jan 18, 2009

By Taylor Dickinson

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Rather than delay healthcare reform until after the economic crisis is over, make it the centerpiece of a direct economic stimulus to every taxpayer. Protect everyone's access to health care by creating a permanent "health tax-credit" to be subtracted from their total tax owed to the government. This credit must be used to choose and purchase health insurance. The federal and State governments can satisfy their political responsibilities by sharing the cost of this credit. The individual gains economic independence and personal control over health care and our government achieves its goal of universal coverage.

Rebuild Health care

This economic crisis presents a unique opportunity to make this transition. Rather than disburse billions of dollars into "work projects", use this money to begin to rebuild health care. The stimulus is two-fold; Individuals now have the resources to buy health care and business is no longer required to fund it. The latter provides an ongoing stimulus which will permanently improve the international competitive position of American business. This in turn will produce tax revenue to government and jobs for people.

Empower People

Empowering people to buy their own health care will obviate the need for an elaborate bureaucracy. Health care is an intensely personal endeavor. One's own life is its centerpiece. A single payor must, by design, be blind to this reality. To succeed, a single payor must usurp the individual prerogatives of the right to the pursuit of happiness, not only of each citizen, but also of their physician. Health care does not exist without physicians. A single payor system only functions by conscripting physicians into the system. This is true in every western nation. The Chaoulli decision by Canada's Supreme Court clearly establishes that this is an infringement upon individual rights. This might be acceptable if there were not an alternative. America has the opportunity to sustain its values and achieve universal care.

Cost: The Wrong Focus

The focus on controlling cost attempts to answer the wrong question. Today's health care is organized around extraneous economic elements. Business and health insurance companies bargain over a price which protects their profit margins. To them health care is a management problem. But controlling business cost and protecting human life are two disparate and incompatible endeavors. Medicare and Medicaid suffer from the same distortion of purpose. Balancing government priorities should not place individual health on the scale. Choices in health care should be made by patients and their physicians. This goal is possible.

Change health care delivery.

Spend government's investment in health care on creating risk bearing physician partnerships charged with the same responsibilities now managed by private insurance companies, Medicare and Medicaid. Require that within these partnership's physicians forgo fee-for-service thereby unifying their clinical focus. Incentives now become directed toward clinical outcomes and reduction in unnecessary cost. They must justify the price (premium) they charge to the patients they serve. Extraneous costs disappear. Insurance company profit and billing costs evaporate. Conservatively, this alone will save 20% off the top. Direct the government effort toward establishing at least one such group in each state. Rather than regard our physicians as the intractable source of our medical economic woes, make them the linch-pin to a rational approach to healthcare delivery. Our society has a responsibility to protect the health of every citizen. Let our physicians establish its price.

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