America and A La Carte Care

America's vast resources cannot provide unlimited health care under its current system. But America can afford and provide efficient, scientifically sound, compassionate and high quality health care which meets the needs of most of its citizens. Efficient, science-based, health care requires (at least): (i) elected officials who refuse to bend to political and financial pressures from the electorate, industry, entrepreneurs, insurers, the press, and other self-interested parties; (ii) an independent, adequately budgeted and funded federal agency which is shielded from political pressures, and given authority to approve or disapprove (on the basis of conflict of interest-free scientific consensus) public health measures, medical treatments and procedures for payment by payers; (iii) a conflict of interest-free medical profession which genuinely advocates for its patients, provides highly competent care which not only cures, but more importantly prevents disease, and abandons infighting with respect to "turf," financial reward, markers of competence and competition; (iv) a health care industry (including pharmaceutical manufacturers) which, instead of focusing on high management salaries and returns on investment, profits/surplus, prestige and control focuses on excellence and appropriateness of care and products/services and is then provided with sufficient financial support to preserve its capital base and generate reasonable profits; and (v) a public which accepts science as the basis for medical decision-making and payment and demands health care consistent with scientific medicine.

I am not optomistic that we will soon see such a system. There are too many interests lined-up at the health-care trough who now buy their way to the front of the line.