I was inspired yesterday by a diary on Daily Kos written by nyceve, an articulate and powerful advocate for single payer health care, to crystallize my thinking about health system reform in a direction that many other factors in my life have pushed me away from.
You see, I'm a physician, and a very close family member is a physician. I am a delegate to the AMA -- which, as you know, remains steadfastly opposed to a single-payer solution, although it has developed an extensive reform proposal based upon providing insurance to everyone via tax credits -- subsidized health insurance.
But I have come to the conclusion that our insurance based system is simply not reparable.
I've decided it was time to come out.
First, a few words about the AMA
(I must note up front that I do not represent the AMA, and what I am saying here in no way speaks for the AMA. I am simply one of hundreds of delegates representing physicians in constituent societies of the AMA. All my comments here are my own.)
To its great credit, the American Medical Association has made a huge effort to inform the public about the need to fix the huge and growing problem of people with no ability to get the health care that they need. The AMA has spent years developing policy and putting together a comprehensive health system reform proposal. There is much that is of great merit in the AMA's proposal. It is truly progressive in how it is financed, using an income-based sliding scale system of tax credits, all the way to fully paying for people who cannot afford to pay any premiums. It does away with the regressive employer tax exclusion -- yes, regressive, because it primarily benefits the people who least need the benefit.
But in the end, the AMA plan, like President Obama's plan, and Sen. Baucus's plan, is still based on the core of our present system: one that is run by, dominated by, and subservient to the health insurance industry, the hospital industry (especially those tied in to the insurance industry), and big pharma.
It is a system that has created an unfixable disconnect in the traditional concept of a market driven by supply and demand, in that the purchasers of health care are not those who are receiving the care. It is a system in which the basic idea of competition has been turned upside down, driven not by quality, value, service or convenience, but by the most self-serving deals that can be driven by the insurance industry.