09/09/2009 05:12 am ET Updated May 25, 2011

Universal Health Care: Possible?

A single-payer health care system in the U.S. seems desirable, but probably not attainable given the power of the insurance industry, for-profit medical corporations & other pressure groups. However, it may be possible to cover the estimated 47-50 million people who are uninsured with a plan that provides basic health care, as has been established in the state of Oregon. This plan would include those now on Medicaid, and could include others who would pay for coverage.

The soaring cost of medical care in the U.S. is a major issue now, and methods suggested to ameliorate this could include electronic medical records, cutting administrative costs, and paying physicians a salary instead of fee-for-service care. There are two areas of research in the field of medical care delivery, not well known to the public, that could improve medical care while cutting costs. These are Quality of Care criteria and Evidence-Based Medicine.

The criteria of Quality of Care are meant to establish guidelines for physicians, both primary care and specialist, for what should be done and not done in his or her practice to stay within guidelines of good medical care. Often, these are based on evidence-based medicine, which holds that any treatment, either medical or surgical, should be established as safe and effective by stringent research. A recent example of this is the treatment of osteoporotic vertebral fractures by injecting a cement into the vertebral body to relieve pain. This treatment was widely hailed and demanded by patients, but a recent report suggests that the treatment was no better than placebo.

As a famous architect once said, in another context, "Less is more."

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