Dispensing health care efficiently, and collecting the money to pay for it cheaply, that's the purpose of the exercise, no one can compete with the government at these two tasks, no insurance company, HMO, or hospital; nobody.

America’s Veteran Administration is the largest, lowest cost; best outcome producing at any cost, health care delivery system in the US, it uses the world’s best medical software, and it has been controlling the problems with access, cost, quality, and malpractice successfully for years.

A national sales tax could pay for the public portion of a dual choice, public or private system.

The private care option would allow individuals or businesses the unlimited choice of doctors, clinics, hospitals, timing, and treatments, Ford Fiesta or Rolls-Royce, but it would require the user to pay privately for their health services, either by self pay, company pay, private insurance, whatever, but government funded programs should only be distributed through the new public system to assure cost control and outcomes.

Private insurance and care providers would no longer be required to subsidize indigent and pre condition patients who would be treated free at public facilities.

(The Best Care Anywhere by Phillip Longman)

www.washingtonmonthly.com/.../0501.longman.html

True health care reform offering individuals and businesses a choice between dual systems either free public care or private pay private care, you choose, would leave no one behind without care, and it would cost less than the $2 trillion dollars we spend annually for our current systems.

A national sales tax would be the most efficient funding source, which in conjunction with the VA's delivery and software records systems means we would not need to reinvent the wheel to establish a scalable public system to rapidly serve the entire country.

The system could be jump-started by acquiring health delivery systems around the country that would choose to sell to, and be integrated into, the new public National Health Care System.

Building new public health care facilities will produce capital assets that will continue to serve Americans for generations, and provide millions of construction jobs today, and millions of new health care jobs forever.

For individuals selecting public care; all prescribed care and medications would be free, no insurance, no co pays, no precondition exceptions, free period.

Businesses large and small choosing the public care option could also free themselves from all financial burdens or any involvement in any way for the health services their employees receive, whether it’s a one truck plumber or General Motors.

A national health care system should take over state and local government health care systems as part of complete health care reform which would assure enhanced cost controls, consistent operating standards, and it would relieve local funding problems while providing total transferability for patients.

An OMB study comparing this to other reforms would be fascinating.