Every year, at the beginning of the Fall Semester at Humboldt State University, students who live in the dormitories have to take a three hour or so class related to "social justice." The purpose of this class is to ensure that students respect people of different racial backgrounds, sexual orientations, and, presumably, different religions. The irony in this is that Humboldt State actually has an official religion, which all students are expected to follow and whose tenants all professors routinely reinforce. That religion is "healthcarism."
Healthcarism preaches that some day, a great leader will arise from the United States. This leader will raise taxes on the wealthy, cut defense spending dramatically, and create a national healthcare system which will provide free healthcare to all, and then our economy will take off roaring, crime in our major cities will drop, and we'll all be happy.
Healthcarism preaches that some day, a great leader will arise from the United States. This leader will raise taxes on the wealthy, cut defense spending dramatically, and create a national healthcare system which will provide free healthcare to all, and then our economy will take off roaring, crime in our major cities will drop, and we'll all be happy.
Have you noticed I am something of an infidel? To me, the idea of a Federally run healthcare system is the most frightening thing possible. For one, our federal government is INCOMPETENT. Has anyone noticed the sequestration talks? We have a huge spending problem and yet Congress can't get its act together to cut wasteful government spending. Everything the government does is hampered by political wrangling. Wanna buy a few dozen fighter jets to keep the country safe? we'll fight about which district they get built in. Wanna close a military base that's no longer useful? expect business and political leaders to parade in front of the Senate Armed Service Committee about how important that base is to the national defense. As I look at the Republicans' approach to the sequester, I am again frustrated. The GOP is, I think, correct about shrinking the size of government. But the Tea Party is so damned set against raising taxes in any way that they won't agree to ANY tax hikes to get the cuts in government spending that they want. How stupid is that? A national healthcare "system" will not be run for the benefit of the citizen, but for the benefit of the politicians who will make sure the drugs purchased by such a system come from their district.
Then there is the question of medical ethics. Do you want Congress deciding which medical procedures will and won't be available under the new medical system? How hard is it to imagine that the status of abortion, stem cell therapy, or access for undocumented immigrants will change every time there is a shift in the power balance in Washington. I do not want healthcare in this country to be run by an unwieldy bunch of bureaucrats overseen by a crooked bunch of self righteous politicians.
As I look at the mess that is our Federal Government, I see one thing that they do really, really well. The United States trains really good military officers,the best in the world. In fact, we train officers so well that other countries send their officers to the US for training. There are several ways to become a military officer in the United States Armed Forces, but one of the best ways is through our nation's five military service academies, which train Army officers at West Point, NY; Air Force officers at Colorado Springs, CO; Navy and Marine Corps officers in Annapolis, MD; Coast Guard officers in New London, CT; and officers for the Merchant Marine in Kings Point, NY.
These academies offer students a pretty good deal - a four year college education for free, plus a $895/month in a stipend. But the United States gets a good deal as well, in return for this quality education, most graduates owe five years of active duty military service, except for the graduates of Kings Point, who can fulfill their service obligation in the civilian Merchant Marine (but remain members of the Naval Reserve.)
The academies are really good schools too, in 2009 Forbes Magazine ranked West Point the number one college in America, and US News and World Report puts Annapolis at #14 on its list of liberal arts colleges. The other academies are not far behind.
Why are the service academies successful? I don't know, but here's a guess: take the best and brightest young men and women in the United States, and put them in a environment in which they are pushed to do their best every day. Give them a high quality education, for free, and but also inculcate a sense of duty and honor. Sounds like a good idea. Now, how do we apply it to healthcare?
I present the Healthcare Academy of the United States, a civilian medical school run by the US Government. What I imagine is something which at the same time would be very similar and very different than the Military Academies:
Unlike the Military Academies, HAUS would start out as purely a graduate level medical school, applicants would be required to have a undergraduate degree at the time of admission - although I could see an undergraduate nursing program being part of the school eventually. Also, unlike the the Military Academies, students would not be required to join the military after graduation.
However, like the Military Academies, students at the HAUS would be held to high and strict standards. There would be an inspections of uniforms (scrubs and lab coats, not fatigues,) an honor code, and yes, physical fitness standards (no fat doctors.) And, like the Academies, these newly minted Doctors will have a service requirement in which they will be required to provide a minimum of five years of low cost medical care in an under served area (perhaps in conjunction with the US Public Health Service Uniformed Corps.) An inner city, a rural Appalachian community, or an Indian Reservation. After their "tour of duty" they could enter the private sector medical field and make as much money as they pleased.
These academies offer students a pretty good deal - a four year college education for free, plus a $895/month in a stipend. But the United States gets a good deal as well, in return for this quality education, most graduates owe five years of active duty military service, except for the graduates of Kings Point, who can fulfill their service obligation in the civilian Merchant Marine (but remain members of the Naval Reserve.)
The academies are really good schools too, in 2009 Forbes Magazine ranked West Point the number one college in America, and US News and World Report puts Annapolis at #14 on its list of liberal arts colleges. The other academies are not far behind.
Why are the service academies successful? I don't know, but here's a guess: take the best and brightest young men and women in the United States, and put them in a environment in which they are pushed to do their best every day. Give them a high quality education, for free, and but also inculcate a sense of duty and honor. Sounds like a good idea. Now, how do we apply it to healthcare?
I present the Healthcare Academy of the United States, a civilian medical school run by the US Government. What I imagine is something which at the same time would be very similar and very different than the Military Academies:
Unlike the Military Academies, HAUS would start out as purely a graduate level medical school, applicants would be required to have a undergraduate degree at the time of admission - although I could see an undergraduate nursing program being part of the school eventually. Also, unlike the the Military Academies, students would not be required to join the military after graduation.
However, like the Military Academies, students at the HAUS would be held to high and strict standards. There would be an inspections of uniforms (scrubs and lab coats, not fatigues,) an honor code, and yes, physical fitness standards (no fat doctors.) And, like the Academies, these newly minted Doctors will have a service requirement in which they will be required to provide a minimum of five years of low cost medical care in an under served area (perhaps in conjunction with the US Public Health Service Uniformed Corps.) An inner city, a rural Appalachian community, or an Indian Reservation. After their "tour of duty" they could enter the private sector medical field and make as much money as they pleased.
Becoming a doctor is hard work, and requires a lot of sacrifice. Four years of college followed by four years of medical school ain't cheap. By providing students with free medical school, we would be eliminating a large share of the "startup" costs. And by requiring a five year service requirement, we would ask these doctors to pay back those costs in the form of the low cost, high quality medical care. Medical care delivered with honor.
John, your solution doesn't address your problem. You start out by saying that nothing frightens you more than a government run health care program and then you proceed to offer a plan where the government would run not just healthcare but healthcare training. I don't see the connection between the issues inherent in a federal healthcare system and the way doctors are trained.
ReplyDeleteNo, government would not run healthcare under my system. Once a doctor completed her five years of "service," she would be a private doctor, could work for any private hospital, clinic, HMO, whatever. My expectation is that most Americans would continue to receive their care through private means. The difference would be by lowering the back end costs for the doctors, i.e. medical school, we lower front costs for the patient.
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