To the Editor: As a resident of the New York City–metropolitan area, I occasionally find myself in situations in which I inadvertently meet power brokers.
At a friend's retirement party last year, I happened to have a conversation with an author and filmmaker who was working with some Democratic Party politicians on “getting their word out.” At that particular time, the word to get out was that the newly elected governor of New York State, Eliot Spitzer, wanted to make major cuts in state funding to hospitals.
As I listened to the comments of my new acquaintance, I realized that he had a rather superficial grasp of the complex intricacies of public healthcare. At one point, he turned to me and asked, “So what would you do to fix our broken healthcare system?” I replied that this was a rather deep question, which required more reflection on my part than could be accommodated at a cocktail party.
The following ideas are based on a letter that I sent him a week after our conversation. That letter contained my personal reflections on how government might address the current healthcare morass. Although I wrote these ideas with New York State in mind, they could also be applicable to the United States as a whole.
Before instituting revisions to our healthcare system, it is important that the government have a firm foundation of appropriate underlying assumptions about public healthcare. These assumptions should include the following four points:
With these underlying assumptions in mind, I offer the following 13 guidelines for improving our healthcare system:
I hope that these thoughts are of use to my acquaintance from the cocktail party, as well as to the readers of JAOA—The Journal of the American Osteopathic Association, and the leaders of our nation's political establishment as they ponder our healthcare conundrum.
I invite readers' reactions.