Nice to see this being discussed. One question for Christine, speaking
as an internist and therefore presumably knowledgable, what about
Medicare? It seems to work in spite of all the propaganda and political
spitefulness expended on it. It has a few percent overhead, as opposed
to more than 30%, so called "administrative overhead," of the private
insurance cabal. It fits into a fee for service environment such as I
also feel is important for private office practice.
A bigger problem to my mind is the stranglehold on the system held by
the drug companies and equipment manufacturers, and the resulting
astronomical cost of inpatient care and diagnostic and threaputic
modalities that we are forced to use by "practice guidelines" promoted
by the insurance companies and authored by academic physicians in the
pay of these same drug and equipment manufacturers. I dispair. As it
is set up, it seems just too corrupt a system to produce any
improvement, no matter what innovations are proposed.
BTW, all that would be nescessary to "cover the cracks" in a fee for
service system would be to allow us to take the cost of care of
indigents (in a system where they are few) off our incomes for tax
purposes, as is allowed in virtually all other businesses who are
allowed to wirite off bad debts against income.
herb
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