Thoughts on Health Care Reform

I was recently asked by our friend, Gary DuBois, to join a conversation of Americans, ex-patriots and citizens of other countries about the state of the health care system in the United States and prospects for meaningful reform. Gary asked me to participate based on my work in the health care arena over the course of several careers.

Although I write on many subjects as a result of research, health care is one subject I write about based on extensive personal professional experience. I have been involved with the world’s and U.S. health care system at literally all levels, from the general practitioner’s office to large scale vertically integrated healthcare systems (birth to death and everything in between), diagnostic imaging, pharmaceutical, device manufacturers, insurance companies, public policy, etc.

The current and coming debate on health care reform will be filled with super-heated rhetoric and emotionally compelling marketing messages designed to sway political and public opinion. If it follows the historical pattern of public policy debate in the U.S., there will be very little discussion of facts.  I believe the debate will produce a better outcome for the citizens of America if the citizens are educated on some facts concerning health care and those citizens subsequently demand their elected representatives operate within a framework of factual information.

Click here for the rest of the document:


12 thoughts on “Thoughts on Health Care Reform

  1. jerry obrien

    Great article Doug. I work for a major healthcare company (UHG – Prescription Solutions) and couldn’t agree more. What industrialized nation that resembles the US the most has a healthcare system we should mirror?

  2. Ron Baker

    Very thought provoking piece. I can’t imagine any health-care plan that would be perfect; however, as you and others correctly state, what we have now is broken or essentially nonexistant. I think that what we are going to have to have is a health-care system that provides care for those who have little or no income but does not put an undue burden on those who do have an income. In short, those of us who can afford health care are going to have to assist those who cannot. I also think that we have to avoid the phrase “socialized medicine,” whatever system is ultimately put into place.

  3. Liisa Hiatt

    Well, when I suggested you take a look at our website, I had no idea you would find it quite so interesting. Thanks for helping us get the word out! I am going to share your blog with our team.

  4. Neil Raden

    I’m just chuckling to myself that such a careful writer as you, Doug, could overlook the misspelling of expatriates to “ex-patriots.” Unless that’s what you meant. LOL


  5. Doug


    Hey, ex-pats = ex-patriots, right? 8^)

    Thanks for the heads up.

    I’m not sure if that one is as embarrassing as typing ‘compromise’ when my brain was thinking and seeing ‘comprise’. I finally caught that one a couple of hours after posting.

    No excuses other than being in a hurry and my copy editor being sick today. I’m not going to bug her to proof this thing. She’s armed with a variety of blunt objects next to her tissue box.


  6. Neil Raden


    The only thing I’d disagree with is that lawyers and insurers are the only ones getting rich. Everyone in the pool is. The phara/biotech industry, medical equipment, doctors (compared to other countries, our doctors are entitled), even the charities like the American Cancer Society or government like the NIH. The money they spend is staggering and the results they get are criminal.

    There is only one solution and that is to blow it up and start over with a universal system like Canada, UK or France.


  7. Pingback: Autopsis » Blog Archive » Health Care Reform FAQ

  8. Patty


    Great discussion. I particularly agree with your comments on tort reform; this is something that could be implemented now without the emotionally charged debate on health care solutions and yet start to create big impacts right away. One other comment, though, which is not so encouraging. In many of those countries with existing universal coverage — such as Canada, the UK, Sweden, universal coverage is typically utilitized by those with minor day-to-day type issues, a cold, sore throat, etc., and those who can’t afford to go outside the system. Those with the means to do so, opt to utilize private medical care when there is anything serious or significant to be treated, sometimes even travelling to the U.S. for such treatments. “Universal” still does not mean “the same for all,” no matter how it is described. It becomes a system for those who have no other choice and, while there is some level of care, there is a reason why those who can afford better, opt to do so. Sorry, no solutions here, just another wrinkle to add to the complicated problem.

  9. Tim Harmon

    The U.S. healthcare system is something I’ve fiven a lot of thought to over the last 7 years. Even vetted a business plan for a tech startup to address that vertical back in 2002.

    In essence, I agree with your thesis (I think) — i.e., that the U.S. healthcare system is an embararrasment, and needs to be reengineered. That being said, though, a couple of points:

    1. Someone pointed out Canada’s healthcare system. I’ve lived in both Canada and the UK, and although I personally admire their healthcare systems, there are many residents of those countries who don’t. For example, a Canadian’s non-critical healthcare is taken care of well, but debilitating health conditions not so well. I have a friend with extreme case of acute arthritis, and an MRI could not be scheduled for him until 4 months out. He wound up driving to Buffalo and paying for an MRI out-of-pocket.
    2. You can’t necessarily correlate a relative country healthcare index to life expectancy rates. While the U.S. life expectancy is indeed significantly lower than many other developed countries, the U.S. also has much higher murder, suicide, and accidental death rates.
    3. Malpractice lawsuits have to be a major contributor to our high healthcare costs, if not problemo numero uno. Cap ’em!
    4. And this is perhaps the toughest issue — what should govenment do, vs. what should private enterprise do? — i.e., what is a “human right” (or humane right)? Is decent healthcare a right that should be afforded to all? How about a decent education? A safe neighborhood? Or the right to retire in dignity if you’ve worked hard all your life, but your bank and your insurance company squandered almost all your 401K/IRA retirement funds on speculative mortgage-backed financial instruments?

    I actually am one of those that believes that a decent standard of healthcare is a human (humane) right. But where does it stop? Should a person have the right to be treated in an emergency room if they’re critical (yes)? Should they have the right to surgery for a broken leg (yes)? Should they have a right to an antibiotic if they’re infected? Should they have the right to healthy, non-toxic, non-processed foods (can you get fresh, organic produce in inner-city ghettos)? It’s always been a pet peeve of mine when private enterprises (beholden to shareholders and profit), and not governments, control a resource that we all need in order to survive — in this case food, and in many cases (and more in the future), water. And in many of these cases, the companies that do control these resources are not even “public” private enterprises — they’re “private” private enterprises (i.e., not publicly traded), so they’re not even beholden to the public.
    5. Insurance companies are another — should they be publicly traded entities, sacrificing all to the god of profit every quarter/year? When they’re insured everyone who can afford their rates, what can they do to continue to increase profits? A: Cut costs, i.e., deny benefits. Free-market capitalism is not always all it’s cracked up to be.

  10. Joe Barker

    Great essay Doug! I think you are right on the money of what has and is happening with our health care. We are do a complete overall. As the most developed country on the planet, we can surely provide affordable health care for our citizens. Thank you for you contribution and hoping that it will spur more debate and action.

  11. VV Burns

    Heh Neil –

    If “everyone in the pool is” (getting so rich) I suggest heavily loading your stock portfolio in these companies to hedge your future healthcare and retirement fund.

  12. Pingback: Autopsis » Blog Archive » Health Care Reform, the Napkin Version