DOCTORS ’ LOUNGE
DOCTORS ’ LOUNGE
( continued from page 31 ) the losses to their hospitals and providers . True cost savings come from prevention and early treatment of illness , not cheap , partial-coverage policies .
A third critical measurement set observes another old aphorism , “ Follow the money .” Doing so reveals that the ultimate payer for all health care costs and losses is always “ we the people .” All private insurers , Federal programs or state programs are but intermediate agents who collect our money and pass it through pathways of variable efficiency . “ We the people ” fund all erosions along the way , such as bureaucratic inefficiencies or monopolistic overpricings of drug companies , device makers or corporate insurer oligopolies . At the outcome of care , we also fund all losses , as noted above for the uninsured and underinsured . As ultimate payers , we have the right and obligation to intervene when our money is skimmed , wasted or used without the compassion or outcomes we wish . Subsidizing coverage for the poor is both compassionate and a prudent protection of our invested health dollars . Moreover , we have every right to require willful freeloaders who have sufficient means to purchase insurance to do so , rather than allowing them to impose a mandate upon us to pay for their care . The principle to “ follow the money ” shows that facilitating and requiring all to have health insurance both brings them better health and insures ourselves against losses of paying for their illnesses in advanced stages .
At this time , we have an opportunity to rigorously hold ACA replacement proposals to the standard of high-quality coverage for all , and to end completely the leaving of citizens uninsured or underinsured . This is the only way to end unnecessary , tragic human losses and stop the enormous fiscal costs shifted back upon ourselves . Consensus among politicians to determine which intermediate agents manage our health investments will surely be rancorous , as many of them do not understand the aforementioned principles , and many of them are self-entrapped in ideological bunkers . Physicians should vigorously pursue opportunities to educate and give better insights to our elected representatives , both directly and through our professional associations . Full coverage of all Americans is the only economically sensible , fiscally conservative , just and compassionate health policy , if costs , consequences and citizenship responsibilities are carefully measured .
Dr . Tobin is a professor at the University of Louisville School of Medicine , Department of Surgery , Division of Plastic and Reconstructive Surgery . He practices with UofL Physicians-Plastic and Reconstructive Surgery .
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