The American Healthcare "System" in 2005 -- Part 7: A Public-Private Mix Is the Best Way to Fix Our Broken System

Editor's Note:
American Health System Reform has returned to the front burner for 2007-2008. MedGenMed ran a sequence of Webcast Video Editorials in 2005 that tried to tell the whole story -- past, present, and proposed future -- in 7 easy lessons. It was well received then with high readership but the politics was cold. The situation in American healthcare has not changed fundamentally since 2005, except that conditions have worsened and a new presidential campaign is upon us. Ergo, the politics of health "system" problems is now hot. So, we are republishing all 7, in order, on sequential Thursdays. Read, enjoy, or get angry, but let us know what you think. Send us your reactions, proposals, serious health policy articles, letters, brickbats, essays, whatever. Help us boil the pot to inform the profession and the populace.

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I believe that the best, albeit imperfect, solution to the healthcare dilemmas we now face is a public-private mix of funding and caregivers, with a heavy dose of individuality.[1] Let self-care be encouraged and enlightened; the medical Internet can greatly help enable that. Let most Americans be responsible for negotiating and paying for routine ambulatory care, with money that could be from a health savings account, up to an annual out-of-pocket cost that is means-scaled, based on Internal Revenue Service information. Let all Americans be required to own comprehensive catastrophic healthcare insurance (the so-called individual mandate) from whatever source, that kicks in after a high means-based deductible and carries no copayment component or annual or lifetime maximum. Let all serious evidence-based prevention, as determined by a nonpartisan, nongovernment, nonindustry, credible independent organization be labeled as public health, and paid for by government since such is in the national interest.[2] Let freedom reign; let science inform; let knowledge rule; and let the marketplace guide; but let there be a safety net for all, without big holes in it. That's my opinion. I'm Dr. George Lundberg, Editor of MedGenMed .

Readers are encouraged to respond to the author at or to Paul Blumenthal, MD, Deputy Editor of MedGenMed, for the editor's eyes only or for possible publication via email:


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