Thread by @ajlayon

@voxdotcom Ms. Chandra - your son is why, since before I became a physician, I’ve believed in and supported a single payer health system.

And still do.

The ACÁ was just a good first step; we need to do more. Trump’s “health plan” is more of his abuse.

Pleased your son is better.

@voxdotcom Medicare for All only resolves one piece of our healthcare disaster: Access. Yes, it’s an important piece but it’s not enough.

If everyone in our country has access to healthcare, and if we continue to (mis) manage the healthcare system, we’re in for a disaster
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@voxdotcom Remember, we spend about $3.5 trillion now with significant numbers of us - about 23 million - uninsured. Our spending is the highest in the industrialised world.

If all we change is access we go broke. We need to do more.
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@voxdotcom Our focus would be/should be firstly on prevention - the hard stuff!! - including exercise, diet, and time to deal with both.

When treatment is needed it must be high quality, safe and evidence based. If no evidence exists academic medical centers do research
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@voxdotcom We will eliminate the 30% to 50% in the health system that is waste (see Elizabeth McGlynn’s article in the New England J Med 2003, there are others too). In a $3.5 trillion health system that’s a lot of cash that can be used to cover the costs of the uncovered.
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@voxdotcom We negociate drug prices and by cutting out much of the for-profit insurance companies and their expensive products, we eliminate their overhead of up to 30% (S. Woolandler, New Engl J Med 2001). There will still be SOME insurance since Medicare covers 80% of most cost
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@voxdotcom But the cost to us of the insurance for the 20% will be low and could be eliminated completely by legislative change.

We’d have to have a national discussion on salaries for hospital administrators and physicians. Is ANY administrator worth $5 million/year?
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@voxdotcom Would be a challenging discussion. But needed

We’d have to have national discussions about birth control, death and dying and so forth. We can no longer simply deny discussion of these and other issues.

We must become a health system that’s responsive to our people.
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@voxdotcom We would need to root out all the ways that we see our fellow humans as “other”: sexism, racism, homophobia and so forth.

If we do all this.......
We have a chance.

@voxdotcom The above was 8/

None of the above is theoretical, this is entirely doable if we desire. What we lack - at present - is serious and responsive (to us, not billionaires and corporations) leadership.

Yes, I’m calling BS on the Rs in power.

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