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

Displaying articles filed under: Feasability of Reform

Healthcare Reform's Achilles Heel »

Posted: Fri, Oct 16, 2009

By Taylor Dickinson

All current proposals for healthcare reform perpetuate a fundamental flaw. There is no sustainable fiscal link between the delivery of care and its funding. As originally conceived, when an insurance company elected to pool the health risk of patients, it simultaneously assumed fiscal responsible for the cost of delivering that care to its clients. In turn this contract relieved both patient and physician from this same fiscal responsibility. By pooling their risk patients could now reasonably expect access to whatever care they would need without monetary prejudice. These are the assumptions and agreements which formed the basis upon which all parties accepted the bargain. As a result both patient and physician could pursue quality care freed from consideration of its potential financial burden. But this bargain dissociated all parties from the economic realities of the medical marketplace. This arrangement fractured healthcare.

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Healthcare as Economic Stimulus »

Posted: Sun, Jan 18, 2009

By Taylor Dickinson

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.

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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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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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No Payor System