Mark Small

Yrs later, as a law clerk, I was in Las Vegas for a pre-trial conference on a case. Afterward, still in a 3-piece suit, I was in the sports book at Bally’s. The floor boss came up to me and wanted to know where I was from. 2/16

Turned out only people from Gaming Comm’n - whom the casino people all knew on sight - and folks who run casinos wear suits in Las Vegas. “And we call to tell each other if we’re gonna stop by, as a courtesy.” 3/16

Even casino owners - who don’t worry so much about competition; it takes a complete idiot to lose money running a casino - check out the competition. Why USA doesnt consider what other countries do in regard to health care is absurd. 4/16

USA ranks 37th - as in 36 other countries R ahead of us in quality of our health care. We can learn fr those 36 countries, such as Singapore (#6), Oman (#8), Singapore (#11), Finland, Sweden, Portugal (#12), Colombia (#22), France (#1), and Italy (#2). 5/16

Here are some things that might be good: utilize the buying power of the consumers of health care to drive down prices, especially of pharmaceutical drugs. A large group can negotiate better than an individual. 6/16

Another idea is cliche: an oz of prevention is worth a lb of cure. If screening tests & other preventative measures require no payment, overall costs of health care go down for everyone. People don’t get tested if the test is too costly. 7/16

This could extend 2 kids, who shouldn’t B punished for their parents’ sin of poverty - or even middle class status. Quality health care early in life correlates positively with good health long-term a/k/a long life. 8/16

We also can cut overhead. The markup for administrative costs can be incredible. And why do hospitals and pharmaceutical companies need to advertise. Not many people choose hospitals because of spiffy TV ads - or based on robo-calls. 9/16

While we’re at it, New Zealand is the only other country that even allows drug companies to advertise. And speaking of ads, as Prof Sheila Suess Kennedy noted recently in her blog, drug companies pay > for advertising than for R & D. 10/16

These all are ideas that can save money and make health care more affordable. The magic wand of privatization works in few places. Health care is NOT one of those places. 11/16

If you don’t want gov’t to control your health care decisions, neither should you want oligopolies - that’s what health insurance companies & so-called not-for-profit hospitals are - to make those decisions. 12/16

The real death panels: ppl in fine business attire who direct underwriters to rule out categories of procedures as too damaging to bottom line After all, insurance companies make $ by taking in premiums & paying out as few claims as possible. 13/16

Of course, some ppl say they want left out of any nat’l health care pool - because they’re not now sick. That’s fine, except almost 100% of us will need health care in our lives, increasingly toward the end. 14/16

We should not be so cruel as to say to those folks, as the light dims and organs in the body falter: TFB - we don’t tolerate dead beats. Everyone will use, or benefit, from the system. 15/16