By SHENG CHANG, M.D., Ph.D.
The new California governor Gavin Newsom says healthcare is a fundamental right for all Californians. It is actually for all human beings of the world.
Many well developed countries like Canada, Japan, France, England and many European countries and Taiwan have universal healthcare for their citizens. California is the 6th largest economic entity in the world, it should also has universal health care for all Californians.
The annual health care expenses per person for every Californian has reached almost $10,000. But still there are 3 million people in California have no health coverage. While the other countries that have universal health care spend only half that amount per person per year. In US, there are almost 30 millions who have no health insurance at all. There must be something wrong in our current health care system.
Universal health care is not Free, as many people have thought. The system emphasizes the care for all Californians. To achieve this purpose, we just need to fine -tune the current health care system.
The basic principal of healthcare for all should contain the followings:
1. All Californians should be able to choose freely the doctors, the pharmacies, the hospitals and all other health care providers as they wish.
2. All insured should pay one way or the other for the system they enjoy.
3. There should be a health department in the State that manages and is responsible for the operation of this healthcare system, and there should not be any intermediaries, or alternate entities in between the Sate and the Californians. So that all resources are spent in the actual delivery of the healthcare to the insured without being intercepted by the middle men or organizations., like in current system.
4. There should be full support from the Federal government for California to implement this universal and single payer health care system, because at least half of the fund are from the US, i.e. Uncle Sam.
For the insured or all Californians, they should pay the premium as they have been paying now. Their employer can pay for part or all of the premiums depending on the employment contract. For those without jobs, then the State can pay for their premium and put into the fund for the system, mostly like the current MediCal mechanism, ( in other states, it is called medicaid.) The amount of premium will depend on the age and also the incomes of the insured. Earn less will pay less. For those seniors and disabled, the Medicare fund is to be used. For illegal aliens, they still need to pay the premium. They can work with special permits in some farms and industries to earn some monies. For traveler and transients, proper calculations of the premium should enable them to pay and get coverage.
All insured should be allowed to see any doctor they wish, buy medications from any pharmacy they like, and admit to any hospital they prefer. Proper transporting mechanism should be established so that all insured can travel to any preferred health care providers. Under this situation, all health care providers will be encouraged to maintain at the best possible status to attract the patients. And the providers of lesser grades will be weeded out naturally to the benefit of all insured.
All health care providers, including doctors, pharmacies, hospitals, laboratories, X-ray facilities, Rehabilitation entities, skilled nursing facilities, durable equipment suppliers etc, should be equipped with electronic medical record system. So that they can communicate with all other providers for the care of the same insureds or patients. By this way, the waste of resources could be reduced to the minimum due to avoidance of repetition, abuse and overuse. The basic requirement of being a part of the entire health care system is to have an Electronic Health Record system set up in the facility of the health care providers. The State can share the cost with the providers. And there will be no more than 2 to 3 vendors to design the system, but the different products should be able to communicate with each other.
All providers should have malpractice coverage with the State as the sole vendor, so that the rate can be properly and reasonably controlled.
All providers should receive continuing medical education to keep up with all current and new medical knowledge and information.
A checking mechanism shall be established in the State so that bad apples can be taken out of the system. The system should not be spoiled by a rotten apple. The State can work with the Medical Board for this purpose.
California and other states have gained many progressive congress seats in Washing DC during this election, it will make this Medicare for all issue easier to implement, at least in California.
Let California be the first state which successfully implements the healthcare for all under the single payer system operated by the State government.