Experts debate options for health care reform
San Diego Daily Transcript
January 25, 2002
John Baldwin, M.D., Dean of Dartmouth Medical School:
"The great majority of American people, around 85 percent, if you ask them, 'Do you have a right to health care?' they say yes. But that's not true, it's written down nowhere that you or I have the right to be cared for if we become sick."
The crisis started eight years ago with the "businessification of medicine," he said. When President Bill Clinton's universal health care initiative failed and the Republication Congress of 1994 was elected, the HMO mechanism took hold.
"What we learned was that health care was not a business. It is an essential service like national defense. The Eisenhower highway system is not a business."
Baldwin disagreed with representatives of the American Medical Association who supported flawed policies such as defined contribution, health marts, medical savings accounts, and increased consumer risk sharing:
"As marketers in medicine would say, 'You buy what you can afford.' What does that mean when you're a kid with leukemia in a Hispanic neighborhood that has no insurance, and then compare that with a child from a wealthy neighborhood? Buy what you can afford."
"The first step is to enact in legislation what most American people believe: They have a right to health care. Based on the massive amount of information, determine what ought to be done for people with evidence-based medicine. Then the economic step, how much would that cost?"
Baldwin admits his system would alter how so-called "medical business" functions. Regardless, the nation's leaders should appropriate money based on a rational system in the context of universal access to health care, he said.
"There are some things that aren't businesses and that's OK. I haven't heard anyone talk about privatizing the Marine Corps."
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