Health Care Reform: A Modest (Hippocratic) Proposal

by PAULA D. GORDON, PH.D. December 29, 2009
Authors of the health care reform bills before Congress seem to be unaware of the nation’s current shortage of health care professionals. They also seem to be unaware of how the current shortage might become even greater if proposed reforms became law. Forty-nine percent of recently polled physicians indicated that they would leave medicine or retire.
The bills’ authors not only fail to consider such personnel shortages, they seem oblivious to the impacts that their reforms would likely have on an already fragile economy, on businesses, unemployment, and individual and family solvency. They overlook impacts on the availability, delivery, and quality of care, particularly senior care. They fail to acknowledge the inevitable rationing of health care and the consequences of micromanaging health care providers.
Why not consider instead a far less risky set of reforms? This could include the following:
  • Minimize fraud and abuse in existing programs (requiring no new legislation).
  • Encourage States and the legal profession to enact law suit reform.
  • Create incentives and programs to increase the number of health care professionals.
  • Promote the spread of low cost community-based clinics to provide primary health care to uninsured citizens. (Models already exist.)
  • Promote the spread of low cost community-based clinics that can provide primary health care to those presently not covered by insurance. (Models clinics already exist.)
  • Encourage state-based incentives for insurance companies to make available catastrophic coverage for low income as well as high risk applicants and individuals with pre-existing conditions. (Examples exist.)
  • Identify and promote successful private sector approaches such those developed by Safeway and Whole Foods.
The bills’ authors advocate a different approach, one that involves extensive government intrusion, intrusion that many argue has no Constitutional justification. They seem deaf to the concerns of health care professionals and the public, especially seniors. Perhaps, even more problematic is the fact that even lawmakers admit that they find the current bills incomprehensible. What a quagmire for all concerned if an indecipherable bill ends up being enacted into law, especially when that law is destined to impact one-sixth of the nation’s economy!
Congress has a choice: Pass the proposed legislation and risk repeal by those voted into office in 2010 or begin anew with some realistic, low cost, clearly stated initiatives that can be agreed to by a bipartisan majority, initiatives that have a chance of improving the system, initiatives that will not place the economy in further jeopardy and that will not threaten to decimate both the insurance industry and the practice of medicine. A majority of Americans are currently satisfied with their health care. Why not undertake simple improvements and, in keeping with the Hippocratic Oath, “abstain from whatever is deleterious”? Contributing Editor Dr. Paula D. Gordon is a consultant, researcher, analyst, writer, speaker, and educator. She has also served in a variety of capacities in the Federal government, including staff officer, policy analyst, and special projects director. She has an extensive background in several domestic policy arenas including drug abuse prevention and homeland security. Her websites at and include her articles, reports, publications, and presentations on drug abuse prevention and homeland security respectively. Her doctoral dissertation, Public Administration in the Public Interest (posted at focuses on complex societal problem solving and governmental change. She is based in Washington, D.C. E-mail:

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