Monday, November 5, 2012

The Election: Retaining, Advancing,  or Transforming American Culture and Its Health System
A President needs political understanding to run the government, but they may be elected without it.
Harry S Truman (1884-1972), Memoirs, II, Years of Hope and Trial (1955)
November 5, 2012 -   Tomorrow Americans will decide what kind of country it wants to be – a nation like others in the industrialized world or the exceptional nation it is. 
It will decide whether to :
·          Retain its uniquely capitalistic culture or to become just one among other countries with more government-centered health systems. 

·          Expand the size of government or reduce its scope.    

·         Unleash the entrepreneurial forces and freedoms of its culture or to rein them in with government regulations.  

·         Keep the best features of its health system or to overhaul them in interest of widening access.  
 . Decide if the high costs of its current health system are worth the overall  excellence they provide and the world admires.

·          Encourage its bright young people to enter medicine as physicians, or discourage them with limited incomes and unlimited regulations to choose other fields of endeavour.

·         Have an adequate supply of physicians to meet demands of a growing population or replace and buttress them with non-physician health professionals.

·         Change the character of the current health system by decreasing the number and rewards of being a specialist and expanding number and rewards of being a primary care physician.

·         Pay  for the expansion and regulation of the Accountable Care Act through  government “savings” largely directed at electronic monitoring and regulating the accountability of physicians, restricting their clinical actions, relying instead on bureaucratic  protocols and algorithms,  cutting hospital and physician incomes,  and cutting Medicare to fund Obamacare.

·         Keep in place a center-left President in  a center-right nation that self-identifies as 20% liberal, 40% conservative, and 20% independent.

·         Opt for a comprehensive government health reform overhaul or incremental government-reform in a nation that needs health reform.

·         Choose tax-raising “free” entitlements requiring massive government spending or pay-as-you-go health savings accounts or low-cost cash practices and retail clinics  and urgicarecenters requiring less government spending.
These are not easy decisions, and both sides have their pros and cons.   A final solution will be a compromise between the two.
I will discuss these options In a book I am writing now  New Voice of Health Reform: The 3-Rs: Rhyme, Rhetoric, and Reality.  Book Three: The American Culture and Its Health Care System.

Tweet:  Tomorrow’s Presidential election is largely about retaining or advancing American culture and its health care system.

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