Written by Terry M Bennett MD MPH   

There is a simple Speech that President Obama has never made, and some simple but dismal facts behind that never made speech:

"Ladies and Gentlemen,
I have looked at the math, and America is spending twice as much per capita, on health care as any country in the world.
While doing that, one sixth of us get no health care at all, are uninsured.
There is a simple, if dismal, explanation for that unacceptable outcome, and it is massive theft from the finite funds.
Nobody ever asked us, and we never agreed, but we have allowed HMO CEOs to pay themselves,on average $10.6 Million per year.
If there are 1000 of them, I have just described a stolen Trillion dollars.
We have also stood still as greedy Pharmaceutical companies have overcharged Americans for drugs by 5 to 50 fold, as compared to world prices for the same drugs.
I propose we take all that heisted money back, prosecute some of the most egregious thefts, and include all Americans into healthcare by using the recovered funds.

Any questions"

That would be a good start.
But,
To achieve this outcome,other changes also must occur:

No More Public or Secret Lobbying of our elected officials as we are observing right now.
No Senators or Congressmen transferring into the Drug Industry or Insurance Industry RIGHT AFTER They have voted for outrageous prices, and obstructed real reform.

( ie; Outrageous Drug Pricing No longer controlled by buying Congressional and Senate votes. No more HMOs given sweetheart Medicare Administration contracts.)

The hoped for result?
"World Drug Prices", here in the USA ,or no drug prices at all... and,
"A Public Option" making it impossible for HMOS and Insurance Companies to steal without any pushback, without any genuine price competition, as they presently do.

If we remove Drug Price Fraud, and HMO Fund Removal Fraud, the only things left to fix are Local Hospital Monopoly/price fixing, and Medical Student Debt, averaging $200,000 per kid.

And, almost forthwith,
The 45 Million can be pulled into the Healthcare Tent
This assumes that almost immediately we cancel US Drug Price Fixing, and cancel HMO intervention and HMO diversion of enormous funds from the finite budget, and vote into Law a Public Option;
The Public Option would look a whole lot like Medicare, if it is properly scripted.
Why Medicare? Because Medicare already exists, we understand it, and it need only be extended to all.
We could opt to buy additional insurance exactly as most of our seniors have done with the Medicare they have.
I return to Drug Prices;
"Medicare D" Drug Pricing has been fraudulently "negotiated" in Washington,
by Special Interests, resulting in no price haggling, no "world prices", no matter what the purchasing volume( Huge!)
Nowhere else on Earth has this collection of frauds been allowed.
Fix these several items, HMO fund diversions, world drug prices, an adequate debtfree doctor supply, Hospitals barred from monopoly behavior, no longer buying and paying for the world's most expensive medicines, and it gets simpler....
Failure to understand and answer/counteract these problems will doom any Universal Healthcare Proposal, no matter how neat. Thieves will be thieves.

Somebody ( Obama?) has to shout "Stop Thief" and mean it, then design a "thief proof plan" or Universal Healthcare will never happen, much less succeed:
One last time:
1. We do NOT have "world drug prices". Instead we are paying for the most expensive drugs, by 5 to 50 fold, in the whole world.
(we waste enough money ,about $150 Billion,annually on these overpriced drugs to pay for the 45 million uninsured.
This price fixing has happened via “lobbying” in Washington DC))

2.We have allowed local hospitals to take over the whole of local health care delivery,to own the facilities,own the doctors, and to act like greedy minicorporations instead of separating the provision of health care from the provision of hospital care as it always was, until HMO CEOs, and then Hospital CEOs poisoned the healthcare landscape.
Hospitals have systematically and un-accidentally diverted outpatient visits to the Emergency Room, and thus upped the fee for each such visit from $75 or so, to $750 or so, and have essentially bankrupted Medicaid and Medicare,in so doing, and are working on the rest of us now.

3. We have allowed HMOs (which are now wholly owned by for profit major insurance corporations) to continue to exist and steal monies from a finite budget, paying themselves, particularly their upper management, enormous and undeserved sums
They provide no positive services whatsoever, and never did.
They are the LEAST EFFICIENT players in the game, stealing 33to 40% of the funds that pass though their hands. Outlaw them, now...

4.We allow US Medical Schools to produce far fewer physicians than we actually need in the USA, and then to indebt the young docs so heavily that they must become hospital employees, eliminating all semblance of price competition ( No other industrial country does this, only the US)
No Family docs equals no Prevention. Prevention absolutely does not happen at Hospital ERs.

5. We allowed the Public Service of Healthcare, in which all of us have a stake, to become a private and often secret business, in which a few Billionaires are created at the cost of decent services for the bulk of the rest of us? Why?

Need I go on? Instead of living out my dream, I am living out the end stages of a nightmare...
I am the last Private Practitioner/GP in Strafford County, NH, with 10,000 patients, and no young doctor to hand over to.
I can no longer pay myself a salary, even though I see 25 or more patients per day.
T M Bennett MD MPH Rochester