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Wednesday, July 28, 2004

Getting here from there

It is well known that the public spending on health care per capita is higher in the USA than in any other country, in spite of the fact that tens of millions of Americans don't have health insurance.    It is particularly galling that the French manage to provide high quality health care to all while spending less.  However, a less ambitious goal came to my mind: Italy (where I live).  Italy spends very little money while providing extremely inconvenient and unpleasant health care to all.  This doesn't cost the state much partly because upper middle class Italians get private health care to avoid lines etc. 

I want to top Phill Gramm, who said Clinton care meant replacing the best health care system in the world with a system modelled on the post office.  I propose supplementing the most expensive health care system in the world with one modelled on the Italian public health care system.

The idea is how about public walk in clinics to provide ambulatory care for a nominal fee with no restrictions on eligibility whatsoever.   There are already public clinics in medically underserved areas, but this proposal is to have them roughly everywhere.    The aim would be to give people who use the emergency room as the family doctor someplace closer to home, less huge, less unpleasant and less expensive.  

This proposal is partly inspired by Ed Meese, who responded to the observation that more people were going to food pantries and soup kitchens in 1982 than had been in 1979, by noting that there was no means test for soup kitchens, taht is,  as paraphrased by indignant commentators, that anyone who wanted to could wait in line to get an baloney sandwich.   Exactly.  Middle class people are not going to burden the public free clinics.  

What's the problem ?

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