DOCTORS’ LOUNGE
DOCTORS’ LOUNGE
( continued from page 31) the losses to their hospitals and providers. True cost savings come from prevention and early treatment of illness, not cheap, partial-coverage policies.
A third critical measurement set observes another old aphorism,“ Follow the money.” Doing so reveals that the ultimate payer for all health care costs and losses is always“ we the people.” All private insurers, Federal programs or state programs are but intermediate agents who collect our money and pass it through pathways of variable efficiency.“ We the people” fund all erosions along the way, such as bureaucratic inefficiencies or monopolistic overpricings of drug companies, device makers or corporate insurer oligopolies. At the outcome of care, we also fund all losses, as noted above for the uninsured and underinsured. As ultimate payers, we have the right and obligation to intervene when our money is skimmed, wasted or used without the compassion or outcomes we wish. Subsidizing coverage for the poor is both compassionate and a prudent protection of our invested health dollars. Moreover, we have every right to require willful freeloaders who have sufficient means to purchase insurance to do so, rather than allowing them to impose a mandate upon us to pay for their care. The principle to“ follow the money” shows that facilitating and requiring all to have health insurance both brings them better health and insures ourselves against losses of paying for their illnesses in advanced stages.
At this time, we have an opportunity to rigorously hold ACA replacement proposals to the standard of high-quality coverage for all, and to end completely the leaving of citizens uninsured or underinsured. This is the only way to end unnecessary, tragic human losses and stop the enormous fiscal costs shifted back upon ourselves. Consensus among politicians to determine which intermediate agents manage our health investments will surely be rancorous, as many of them do not understand the aforementioned principles, and many of them are self-entrapped in ideological bunkers. Physicians should vigorously pursue opportunities to educate and give better insights to our elected representatives, both directly and through our professional associations. Full coverage of all Americans is the only economically sensible, fiscally conservative, just and compassionate health policy, if costs, consequences and citizenship responsibilities are carefully measured.
Dr. Tobin is a professor at the University of Louisville School of Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery. He practices with UofL Physicians-Plastic and Reconstructive Surgery.
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