Health-care reform that benefits the public as a whole is hard to achieve because power resides with those who make their money providing care, insurance, and drugs. They in turn “educate” the politicians to their point of view.

We supposedly have massive reform with the Affordable Care Act, which admittedly will help some people who heretofore have had difficulty getting care they can afford.

But drug prices are still immune to negotiated pricing. Physicians can still graduate in specialties where there is no shortage, because that is where the money is, while patients are desperate for more general practitioners. Hospitals and physician practices continue to consolidate, making reimbursement levels harder to negotiate. Insurance companies thrive on administrative complexity. And patients are restricted as to whom they can see depending on which insurer they have.

Real health reform will come when enough of us who ultimately pay the bills demand a smart system that costs almost nothing to administer (Medicare at 2 percent), allows choice of doctor, that everyone qualifies for (minimal enrollment costs), and which mandates that the people’s power broker — the government — negotiate fair and adequate fees as a “single payer.”

Politicians know how to design a workable single payer system. But we have to take the politicians out of the pockets of the medical industrial complex and capture them firmly in the pockets of those of whom they were elected to represent and serve — you and me.


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