Scott Young
Kaiser Permanente Executive

Scott Young

Scott Young, M.D., is the associate executive director for clinical care and innovation for the Permanente Federation in California.

Coverage Is Just a Starting Point

I volunteer as a family physician at a community health center in East Oakland, Calif., and see first hand the human tragedy that befalls those without health insurance. Our nation's first and foremost moral imperative is to achieve universal health coverage. This can be done in the manner many have suggested: apply appropriate market reforms and require insurers to accept everyone. An individual requirement to participate in the system will be needed, with supplemental subsidies for those who can't afford coverage. But reform cannot stop with coverage. Congress must make both coverage and how care is delivered top priorities.

A new health-care system is not sustainable unless we take on its major flaws. High costs are at the top of that list. Payments to physicians and hospitals provide rewards for the quantity of care delivered, not for better care or for care that is well coordinated between primary care doctors, specialists and hospitals. A major flaw is that the system is not set up to support physicians and hospitals to give the right care in the right place at the right time.

Our nation needs to reform how health care is both financed and delivered. One without the other only perpetuates a system that leaves the patient no better and our country poorer.

By Scott Young  |  June 9, 2009; 7:13 AM ET  | Category:  Health Care Reform Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati  
Previous: Equal Health Coverage For All Americans | Next: The Lessons of an Uninsured Physician

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do not side with big business and the insurance companies and pers drug companies.....side with the AMERICAN PEOPLE AND BARACK OBAMA .........THAT IS THE REASON HE WAS ELECTED...WHEN IT COMES TO HEALTHCARE IN OUR COUNTRY. AMERICA WILL MAKE THE PLAN WORK...WE WILL NOT LET IT FALTER...HAVE FAITH IN AMERICANS AGAIN.

Posted by: STANTONCAROL | June 14, 2009 8:46 AM
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But the problems of delivery are hard and the problems of finance are easy. Why not solve the easy ones, the ones that do not cost any more money, first to get heath care to All of our people, and then we will have time to work on the hard ones?

Myth - "It will be very expensive to get good health to everyone."

Fact - Actually there's a way we can have better universal health care at no more than we are now paying (see 5. below). Here are the facts (cf. www.pnhp.org):

1. We waste $100 - $200 Billion a year on the high overhead of insurance companies.
2. We waste 200 - $400 Billion a year on doctors filling out forms for insurance companies.
3. I don't know the compliance cost of patients fighting with insurance companies, but it must also be in the 100's of Billions.
4. We pay the highest drug cost in the world to drug companies that spend twice as much on profit and three times as much on "marketing" as they spend on research. This is about another $100 Billion each year.
5. Because of the above, we could give Super Medicare (few limitations, no co-pays, no deductibles and complete drug, dental & mental coverage) to everyone at no more cost per person than we are now paying.

Other countries with single payer systems get better health care as measured by all the basic public health statistics and they do it at less than half the cost per person. If we build on our rotten system, we will get a health care system with rotten foundations.

Len Charlap
Princeton, NJ

Posted by: lensch | June 9, 2009 9:51 PM
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