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Congress is on vacation: Now is our chance




Dear Editor, I am a primary care physician and have been practicing since 1989. I am very active in healthcare reform and I have a Web site ( devoted to that reform. This is my second mass mailing to US newspapers in an effort to give a perspective that is not often offered: one from the mid-point of the reform spectrum. 


My last letter went to 480 newspapers and apparently it was published in a large number of cities. I have received letters and e-mails from Alaska to Florida and from Maine to Hawaii. Varied opinions were sent to me and I answered as many as I could. This mailing will go to over 600 newspapers. 


I hope this letter will stir further debate. I want healthcare reform, but I definitely want to slow Congress down for a while. They are moving headlong towards an ill-conceived and highly lobbied compromise. We need a "white paper" approach to healthcare reform, with little special interest coercion. 


Mark E. Green MD 


Blount Memorial Hospital 


Maryville, Tenn. 




I am very hopeful that we may soon reform our dysfunctional healthcare system, though I am currently very relieved that Congress is recessed. For the next few weeks, they can do little harm to that hope. I truly believe that they mean well, though they are highly lobbied by special interest groups who have substantially more knowledge than they, on this topic. I wonder who is lobbying for the average American. Who is looking out for our "special interest"? In the passion to do something, true reform may be bargained into nonexistence by the two extremes of the political spectrum and by the special interest groups. Simply expanding coverage into this system is not reform. Those who want a system that works for everyone, but favors none, have much work to do while Congress is inactive. 


Currently there are no reasonable plans coming from Congress. I have read all of the major proposals, including House Bill HR 3200. It in an 1100 page monstrosity that favors private insurance and simply tries to control them through purchasing cooperatives. Since all private insurance plans include a profit margin for the private investors and since they also allow their boards of directors to lavish huge salaries on any CEO that can maximize their dividends, I have a fundamental problem with any plan that uses tax-payer money to guarantee that profit. That profit is generally at the expense of patients and providers. 


The Wyden-Bennett "Healthy Americans Act" is well intended, but still depends on subsidies from the tax-payer to buy private health insurance for those who cannot afford it. The Senate Finance Committee has not yet agreed on a plan, but it will most likely be more of the same. At the opposite extreme if House Bill HR 676, which is also well intended, but is not fundable and therefore not passable. You cannot give everything to everyone in America for free and at tax-payer expense. In 2007 America spent $2.2 trillion on healthcare delivery while it only collected $2.4 trillion in taxes. How can the tax-payers, who make up less than 56% of the population, be expected to pay for everyone? 


We must have a public plan option, administered by the public, and granting universal coverage to America. We already spend the money to do to. Medicare is the prototype for that plan. It functions well, though it needs to be more complete and needs further funding. Remember that Medicare is an insurance produce for people who generally no longer work and/or are disabled. It is no wonder that its funding is short. However, its infrastructure is excellent and could serve as the launching board for a plan that could be phased in by age groups till all Americans have it as an option. Those less that 65 years old, or those 65 years and older who currently pay for an insurance supplement, would pay their premiums and co-payments directly into Medicare itself. Medicare would finally have a reasonable income with which to function. 


I do not accept the argument that private insurance plans could not compete with a public plan. They could compete in every way except for their profit margin. So the question is, how much money in America willing to give away to allow private individuals to make hundreds of thousands and even millions of dollars profit? Except for competing with each other for more patients and profits, private plans do not add competition to healthcare. Except for designing new ways to make money, they give no innovation to healthcare. In fact, they add nothing to healthcare at all. For a price, they simply allow it to take place. 


On my web site ( I have a prototype bill that is universal in coverage, fundable, sustainable, and that favors no on group over another. It calls for public administration of the plan under the oversight of the Secretary of Health. It can be phased in by age groups to avoid overloading the infrastructure and/or funding. I have no ownership of this proposal, though it does express how I believe we could build a system of healthcare delivery that will work for all Americans. It is not perfect, though I hope it can serve as a platform to true reform. 


Please read it with an over mind and send any comments on ways to improve it or promote to me at [email protected] Please indicate if I can post your comments on my web site. We must act before Congress has the chance to ruin any opportunity that we have for true reform.



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