“The Way I See It” is an attempt by the columnist to enlighten readers on a subject as he views it, and does not necessarily reflect the views of this publication.
National Health Care Proposal
The Liberal/ Progressive demand for some “Universal Health Care” is not going to stop. ObamaCare is an intentional failure, designed as a ‘transitional program’ to total government controlled health care, to both fail and add ridiculous programs like ‘Gender Reassignment’. The Lib/Prog goal is Government Control of all Medical Care, with Government designated “Gate-Keepers” deciding who gets what, and when.
We must come up with an alternate system that will cover basic health care for those that can’t or won’t buy their own and it must be truly affordable. First, it can not be forced on the free-market system we have. Since it will by necessity be government controlled, it must be separate or it will destroy the existing medical care system.
I suggest that we have a para-military National Health Service Corp. The first and immediate requirement is basic medical care and triage for the indigent. There should be clinics available in every county, open to all. Those that can pay are charged a reasonable fee; for the truly indigent it is free. These clinics don’t need traditionally trained MDs. Those that require serious care are forwarded to Regional Medical Centers for serious treatment.
The secret to making this work effectively is cost and training. First, there is no Medical Malpractice Insurance to be paid because patients voluntarily submit to treatment for free or greatly reduced cost. The second is the health care workers are employed in a para-military organization where they enlist for periods of time to get schools and promotions. A Basic Enlistment is for two years service. Basic schools would include Orderlies, Nurses Aides, Medical Secretaries, and support services like Ambulance and Patient Transport Drivers, Security, and Maintenance. Everyone goes through a Basic Training similar to other military branches before their Basic School. It would include a first week of Orientation and Testing to determine ability to qualify for Specialty Schools and also to weed out those who can not or will not adjust to a disciplined environment. Then a 6-8 week para-military training course of working together in a barracks environment, basic hygiene, discipline and responsibility, as well as classes in basic medical subjects, using computers, rules and regulations, and other subjects to insure the enlistee has a good chance of completing their requested school. A basic issue of uniforms will be provided. The last week should be more relaxed, lectures on further opportunities and Specialty Schools, and further testing to see how much the enlistee has improved. Those that qualify on test scores are offered Specialty Schools such as Phlebotomist, Lab Tech, Pharmacist, X-ray Tech, Medic, and Physical Therapist. These should require some extension of enlistment. If they ‘flunk out’ they must complete their enlistment in a job which they are qualified. Also this system could include it’s own Maintenance and Construction Services similar to the SeaBees to construct and maintain facilities, and a Transportation and Supply Service. All of these would provide entry level training and employment in a controlled para-military environment to get young people with low opportunities to learn useful skills, to make a contribution to society, and to secure financial independence.
This can work because the military can train competent Combat Medics in a 19 week school. This is possible through discipline, rigorous testing, and full days in a disciplined environment. After completing schools and more on-the-job experience, a qualified person may sign up for more advanced schools and Civilian Qualification Courses like LPN, RN, and Physician Assistant. A school – work – school – work system allows advancement while gaining experience and competence. New graduates would work in a Regional Center or hospital until they gain experience and confidence in their new position. Pay would be based on job, performance, and time in service like the military. Clinics can be staffed with Medics under the supervision of a RN level person, plus appropriate administrative and support staff. A small clinic with little ‘business’ might only have a Medic or two and minimum support staff as long as there was a bigger facility nearby. Their function is to take care of the small problems and pass the bigger ones up the line.
Space does not allow a full explanation of the ‘upper end’ of the system, but I hope our readers can see that good competent people can be hired, trained, and retained by pay, retirement, housing, commissary, and recreational privileges like the other military services. Another benefit to society is it would provide trained people to the “civilian” medical system by the ones that want out after completing their enlistment, as well as providing opportunities to those that could not otherwise afford the schools in “Civilian” life. The “Upper End” of complex medical problems would have to be done by experienced MDs and medical specialists until this system can recruit or train their own. MDs and Specialists would apply for “Hospital privileges” at Regional Centers and be paid for the work they do there. A doctor could work there and not have to hire and supervise a complete office support staff. Come to work, see patients, get paid, no hassles.
The two main expenses of “health care” with the Medicaid system before ObamaCare were Medical Malpractice Insurance for the participating doctors, and Fraud. The third was waste, mostly in the form of paperwork and bureaucracy. ObamaCare does nothing to control these, and even adds more fraud and corruption in the failed web sites, failed government subsidized “insurance”, the subsidies, by it’s shear complexity increases the waste of bureaucracy. This system does away with all that. What money is spent goes directly to actual health care. Beggars can’t be choosers, so those that who choose this National Health Care Service should get good medical care, but not luxury elective care. Those that want to buy insurance should be able to buy the level of insurance they want and not be forced to buy “insurance” for abortions, sex-change operations, and other “elective” medical treatments. ObamaCare is a huge boondoggle to provide ‘luxury’ care to indigent and irresponsible people and make the working people pay for it, and a huge oversight bureaucracy. This para-military system would be inexpensive and efficient, with little opportunity for fraud, no malpractice insurance requirements, and little waste. Getting low cost heathcare to the poor and allowing people to choose an insurance package that actually fits their needs cound greatly reduce insurance premiums.
This is simply a proposal for a workable solution. I invite comments on the web site, www.thedolphintalk.com. I’m sure others have good ideas and suggestions. We must do something that works for the poor and doesn’t compromise the free-market medical system.