Principles of Real Solutions

Cover everyone.

  • Health care is a public good. Like fire or police protection, universal coverage benefits each one of us and society as a whole. Unlike consumer choices, we don't know when we — or a loved one—may need expensive treatment.
  • Universal coverage reduces the risks of contagious diseases, disability, bankruptcy, and the use of expensive emergency services for problems that are better addressed through normal patient care.
  • Health insurance companies profit from “cherry picking” the healthy, and excluding people and treatments that may be expensive. We need a system that is designed not to exclude, but to optimize treatment for all; not to maximize profits, but to minimize suffering.

De-link coverage from jobs.

  • Rising health care premiums are making U.S. companies and workers uncompetitive, and polarizing labor negotiations.
  • Employer-based insurance hurts entrepreneurs and independent workers, the self-employed, the unemployed, part-time workers, freelancers, artists, and the working poor.
  • Employers are ready to off-load the expense and administrative burden of choosing and paying for employees' health insurance.
  • Unlike previous generations, we switch jobs frequently. Switching jobs shouldn't mean changing or losing health coverage. Control costs by cutting bureaucracy.
  • Enormous savings are available simply by freeing doctors from the burdensome paperwork required by insurance companies. Negotiated fee structures and a single payer —or a few regulated payers— would save enough to cover the uninsured, studies show. (See Options .)
  • In most of the industrialized world, private health insurance exists only to provide premium services. Keeping profit-driven health care insurance at the center of our system costs Americans billions extra each year.

Invest in prevention.

  • Coverage should include common sense screening and immunizations, and the complementary health care practices that have proven benefits.
  • We should support healthy habits through treatment of substance abuse, smoking, and domestic violence. Open spaces, bike trails, and community gardens improve health, too, and we should reduce the toxins that contaminate our food, water, air, and soils.

Reduce poverty and inequality.

  • Poverty, powerlessness, and inequality damage the health of the entire society, and each one of us, rich and poor (see Better Health Through Fairer Wealth). A huge health dividend would result simply by reducing excessive CEO salaries and profits, and raising up those at the bottom of the income scale. We could start with the health care sector.
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