03/18/2010 05:12 am ET Updated May 25, 2011

An Open Letter to Senator Max Baucus : Save Your Health Care Bill With Simple Reform

Dear Senator Baucus,

Here's a follow up from the USC Medical School Professor with forty years of academic, military and private practice experience who offered the simple, common sense five bullet point plan to reform health care, with no new taxes or addition to the national debt.

I've reviewed the current form of the your Senate Finance Committee bill, which is basically a good compromise, but has significant watered-down defects as it's about to go to vote:

1st - Senator Baucus, please don't forget to cover all Americans, not just 94% as per your current plan, with no new taxes or addition to the national debt. We can access excellent care for even the hard core indigent and illegal alien population via the reemphasis and mandate of the 159 American medical schools to provide care first to the population in their own shadows, before handling private patients. Here, I've even written the amendment for you:

Proposal for Chairman's Mark to America's Health Future Act Amendment to Title III, Subtitle A (Transforming the Health Delivery System)

Short Title: Reemphasize the mission of the 159 medical schools which receive federal funds

Description of Amendment: Mandate America's 159 medical schools to primarily provide comprehensive health care to the hard core indigent and illegal alien populations within their shadows (service area), to optimize medical school education opportunity, and effect dramatic savings due to the low overhead of provision of medical care by medical schools. Secondarily to provide care to privately insured patients, follow the USC/LA County Hospital's successful model.

Offset: 10 years savings to health care system with this mandate using existing federal, state, local grants, as opposed to new taxpayer contributions: $300 billion savings, or more.

2nd - Senator Baucus, don't forget to really eliminate the 50 state patchwork of insurance regulations and open the whole U.S. market to all competing insurance companies (as the Congress has with 305 choices). Do this tomorrow and the country could immediately save hundreds of billions of dollars per year from meaningful competition.

3rd - Senator Baucus, don't forget the universal call for meaningful tort reform of the medical system. We don't need experiments. It's worked great in California for 34 years! You're a rancher, why do you have to protect trial lawyers from coming to the table to help all Americans now?

4th - The American taxpayers will be clobbered by the hidden Value Added Taxes (VAT) you're adding to insurance products (tax on medical devices, tax on certain policies, tax on pharmaceuticals). Allow the contemplated savings on competitive insurance to be passed directly to the citizens, not to the government by way of new hidden VAT taxes.

5th - The mandate to all working Americans to participate in health insurance has been watered down to give no teeth to this important policy. All must participate with real IRS fines and penalties, or the numbers won't help to bring down health costs for all. Senator Baucus, restore the fines to higher than the cost of insurance premiums, or the young won't participate.

Senator Baucus, please try to get your plan back to where it could really work, not just give political cover.


Paul Toffel, M.D.