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Activities directors, caregivers, and healthcare professionals,
At The Dallas Morning News' invitation, 11 health care experts from the Dallas-Fort Worth area and Texas recently shared their views via e-mail on how to make health care more affordable and accessible.
Here are the issues:
1. Single-payer vs. market-based system
2. Making insurance affordable
3. Rewarding performance
4. Chances for reform this year
5. Fixing Medicare
6. Helping small businesses
7. Long-term care
8. Recruiting doctors to general practice
9. Requiring business to provide coverage
10. Addressing the nurses shortage
11. Encouraging preventive care
Options for reforming health care coverage range from a single-payer system like those in Great Britain or Canada to a mostly non-group market where people would shop for their own private coverage, helped by federal tax credits. Which is preferable? Or is there a better middle ground
DR. RON ANDERSON: I've long been an advocate of the concept of a single-payer system. It's more cost-effective, and its administrative overhead is low. However, I don't think this country is ready for anything that would take away competition. If competition for patient loyalty is possible and if there is still an adequate emphasis on quality, safety and access, I would support it. America uniquely likes competition; we like choices. If the choice of doctor and hospital is made possible, that would be attractive. I think the U.S. will end up being somewhere in the middle of the road. We need to differentiate between socialized insurance and socialized medicine. The former doesn't have to travel with the latter. But to do that we have to change our delivery models to be much more cost-effective than we currently are. But I do think there is a middle ground.
ROSSIA AVERY: As a registered nurse, I have watched insurance companies distort and undermine the delivery of health care in this nation. Patients skip needed medical treatment or appointments or cut pills in half because they can't afford the high cost, even if they are insured. Our physicians are forced to follow protocols that are based as much on insurance profits as on medical standards. And our patients are forced to deal with bill collectors and insurance claims adjustors just as they should be focused on getting better. The insurance companies waste 30 percent of their care dollars on "overhead," although they have never cured a patient and, frankly, deserve no role in the delivery of medicine. The good news is we know how to fix our health care system. Nearly every other industrialized democracy provides quality, universal health coverage from a national nonprofit fund.Think of it as if we expanded and improved Medicare to cover everyone. Under this single-payer system, health coverage and access to care are based on patient need, not your ability to pay. Everyone would be covered for all needed care. You'd be guaranteed your choice of doctor and hospital, and there are meaningful controls on costs. Best of all, medical decisions are in the hands of patients, their families and their doctors and nurses, not private insurance companies. We deserve no less.There are two single-payer bills in Congress, HR 676 and S 703, and Texas is one of many states with statewide bills before the Legislature.
U.S. REP. MICHAEL BURGESS: The guide for reform should read more expert views on health care issues
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