Should the federal government run health care clinics and hospitals for anyone receiving government sponsored healthcare (Medicare, Medicaid, Obamacare)? Young doctors out of med school could be offered employment and reduction in student loans for working in the government run facilities. Will this help reform healthcare in America?

Sheffield, Jamaica Correspondent-I’m not trying to reveal the pessimist that I am, but irrespective of who or what control the healthcare facilities of the day, we will still get sick and die. I need sickness gone permanently!

Now that’s out of the way, for the sake of fostering a peaceful debate and accommodate the many opinions out there, I think governmental benefits, especially sponsored healthcare, should be administered or operated by the Federal Government.

This is actually beneficial for several parties involved. Not only will those who are disabled and senile benefit, but families living on low incomes will be taken care of as a result of this healthcare structure.

To supplement, doctors and especially young physicians with thousands of dollars in medical student loan debts will be able to sleep well at nights, knowing that their debts are being paid off.

Under the new federal repayment program, many physicians have been able to pay off their debts in short or total through the Income-Based Repayment system.

This is made possible in government based facilities and can be considered a public service. Doctors get a chance to carry out their practice while paying off an insurmountable debt.

This will definitely not have a colossal impact on how healthcare is meted out, but in some ways, it could be a form of reformation. As far as I’m concerned, the healthcare system in America needs more than just implementing the federal government to run clinics and hospitals, it actually needs an absolute overhaul.

Gastonia, NC Correspondent-I think the idea of employing young doctors and nurses just out of school to staff government health clinics is a fantastic idea, provided they are supervised by experienced professionals with experience in both treatment and management. Without that element, the clinics run the risk of becoming dangerous places full of missed treatments, poor diagnoses and sub-par patient care. It’s not that the young docs and nurses would be bad at their jobs, it’s just that without experience they simply don’t know everything they need to know.

I’ve long been a strong proponent of mandatory national service for young people, be it military or in public service, and this could easily be worked into that. In exchange for a subsidy of their education (not a full one), the young medicos would agree to work in the government clinics for an agreed-upon term upon graduation. It’s similar to the setup used for decades by the ROTC, and used in the medical field by some training schools. A personal friend received her physical therapy training in The Netherlands for free in exchange for a term of service at one of the clinics owned by the company here in the U.S. Granted, she ended up marooned in Rome, New York, for three years, but it gave her a career.

Vigilance must be exercised in making sure that the standards of care at the government clinics are maintained, lest a debacle like that with the VA hospitals occur. There will be resistance from the private medical industry, although the patients cared for at the government clinics will largely be those who wouldn’t be visiting those private clinics anyway.

Overall, I think this idea could revolutionize health care delivery and improve overall public health nationwide. I’d like to see a requirement for biennial checkups put in place for all those receiving federal health benefits, in hopes of catching problems before they become crises. The benefits of preventive care are proven, and would save millions of dollars in the long run.

Prescott Valley, AZ Correspondent-Since the federal government is inept at running much of anything efficiently, it would probably be in the best interest of those receiving government sponsored healthcare (Medicare, Medicaid, Obamacare) to not subject themselves to care in a federal government health care clinic or hospital, but with the number of programs that are currently run by the federal government, it is difficult to say what alternatives would exist to cover the sheer numbers of existing patients in these and other programs.

The federal government currently runs six major health care programs that include Medicare, Medicaid, Obamacare, SCHP (State Children’s Health Insurance Program), Department of Defense TRICARE, the VHA (Veterans Health Administration), and the Indian Health Service (HIS). The number of health care clinics and hospitals that would be necessary to cover this number of programs would become a huge part of the budget that is set aside for all of these programs. To build, man and staff new facilities would be cost prohibitive, and the doctors, nurses and other personnel working in them would have to do so at low salary levels, or for free.

Medicare, SCHP and HIS are dealing with groups that have high health care needs and low socio-economic status and many of these same groups receive health care across other programs. DOD TRICARE, VHA, and HIS serve the military, military families, veterans and Native Americans are other examples of government programs that are directly affiliated with the government with cross dependency on other programs.

With the billions already being invested to keep these programs afloat, there would have to be additional monies raised through increased taxes or philanthropic efforts across the entire country to establish government run health care clinics and hospitals. It seems that the more money that is put into government run programs the ensuing results are almost always decreased health care and higher costs and prices.

If young doctors were offered employment and reduction in student loans for working in separate government run clinics and hospitals, they would have to work for next to nothing in order to make up the costs for providing health care to the millions of people enrolled in government run programs. They might be working for the experience and possibly for release from student loan debt, but the quality of health care they provide will likely be limited, manipulated and subject to government dictates. They may gain on-the-job training, but little else.

Healthcare can be reformed in America when a number of major steps are taken to get the government out of the health care business. That can only happen with the repeal of laws that have contributed to the current health care debacles over the years. Bureaucrats and other outside interests must not be allowed to interfere in the doctor/ patient relationship. Also, tax laws affecting medical expenses must be changed to allow citizens credit for most, if not all, their medical expenses. Medical insurance sales should be allowed to happen across state lines and long-term policies should be available to younger individuals that provide for fixed prices for long periods of time. Tort reform must be part of reestablishing health care in America and lowering costs as well.

The private sector could offer competition through privately run clinics and hospitals, and some have and have become more of an alternative than any kind of government run facility. Depending on a patient’s economic situation, he or she should be part of a graduated insurance or medical payment plan within a private clinic or hospital. No matter the financial situation of the patient, no one should receive medical care and particularly extended medical care for free, and non-citizens should not be allowed to use a clinic or hospital without payment of some kind. Unless a doctor agrees to perform care for free, taxpayers and others should not be forced to pick up the tab for those using and abusing the health care system.

There are solutions to health care reform in America, but those making policy must be willing to relinquish their stranglehold on what real medical care entails. No quality medical care can be realized through government force, taxation, regulations, bowing down to special interests and other bureaucratic stumbling blocks, which have turned the dispensing of medicine into the tangled mess that it has become. Quality healthcare will not be assured until there is greater consistency in procedures and processes that operate outside of the federal government.

Owatonna, MN Correspondent-There is no question that our country’s health care/health insurance delivery system is in crisis. With the recent defeat of the Republican party’s attempt to repeal and replace the Affordable Care Act (ACA), it doesn’t appear that traditional political solutions will work. Radical, outside-the-box solutions must be considered and tried.

The idea of federally-run clinics and hospitals makes some sense but perhaps doesn’t go far enough. The dominant talent of our government seems to be running the most powerful military force the world has ever seen. Why not take those skills and translate them into a military-styled approach to health care? Set up government-run clinics and staff them with doctors, nurses, aides, etc., but also have these people enlist for four-year terms with the option to re-enlist and spend an entire career working for the government.

The biggest upside to this is to remove the profit motive for providing health care. All staff will be on salary, and there won’t be pressure to oversell treatment and services. Government hospitals and clinics will be tax-funded, so the pressure will exist to keep costs low. These hospitals and clinics can move into existing facilities or can be built where the need for care seems greatest. Staff will be assigned to where they are most needed, like poor and rural areas, just like troops are regularly rotated to different bases in the country or the world depending on what is needed for the military.

Staff can enlist for four years and receive credits to offset their student loans until those are paid off. If they choose to re-enlist and their loans have been covered, bonuses could be provided for years of service, or advancement can be offered similar to soldiers being promoted to higher ranks, with corresponding raises in pay and responsibility.

This model would be akin to the Veterans Administration Hospitals that we have, except the scope will be expanded to more people and more locations. One of the big advantages might be the government being able to negotiate better prices for drugs, machines, and technology because of economies of scale. This may help keep costs low and more transparent than they are now with private facilities hiding their actual cost of providing services from consumers so they can manipulate pricing on a case-by-case basis and maximize profits.

Despite the possibilities, we must remember that government has a natural tendency toward inefficiency and lack of accountability. Some sort of private model must be enacted within a new federal system for containing costs, maximizing efficiency, and still providing quality care. If those goals can’t be achieved, our health system will never get out of this crisis.

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