In some ways those are mutually exclusive concepts. People often point out that there is little Healthcare in the United States mostly only sickness care. We take sick people and put them in Hospitals where their expenses make a stay in a luxury hotel pale by comparison.
Doctors in this country, especially specialists and researchers living off of federal grant money generally are expensive and cost hospitals so much for their facilities that it reduces the amount that remains for patient care.
Primary care facilities might be the answer to providing universal coverage even if it is somewhat less comprehensive.
Forty Years ago Free Clinics and Primary Care began trying to do Healthcare on a shoestring budget. They came up with some strange bedfellows to help them. They used New Markets Tax Credits, Private Non Profits tax breaks, earmarks, lobbiests and all the standard Washington and Big Business tools to sell their idea of community health centers.
They used nurses rather than doctors to keep costs down. They preached preventative alternative medicine, diet and exercise counseling and removing all the barriers from basic diagnostics and regular checkups to keep healthy people from getting sick and having to go to hospitals.
They took out the administrative and facility costs, decided that teaching and research could go under education rather than healthcare.
They avoided the kinds of procedures that lead doctors to overcharge patients to protect themselves from medical practice trial lawyer insurance costs.
They disengaged pharmeceuticals and lab costs from expensive hospital super costs and placed more diagnostics under the outpatient community health center sphere of influence.
They made electronic medical records sharing between facilities more universal and their costs dropped dramatically.
Thats the universal coverage part of Single Payer Healthcare. Its revenue enhancement procedures are not likely to be embraced by those serving up comprehensive healthcare so Hospital care is probably going to remaine comprehensive and expensive.
We can let taxpayers off the hook for that and keep it out of universal healthcare with provisions that include only life threatening procedures.
We could cover emergency room care, trauma centers, heart attacks, cancer treatment and give people tax breaks for self help wellness like insurance companies give motorists with good driving records while letting the cosmetic surgery, liposuction, hairtransplants, sex changes and other purely physical appearance procedures be covered by insurance.
We can still have the less than comprehensive universal coverage for community health centers and allow them to use more relatively inexpensive nurses and fewer expensive doctors to keep the costs from exploding. The more people who are covered the better breaks they get on the purchase of towels, gloves, wipes, basic pharmeceuticals.
Their Primary care coverage includes most common ailments, internal medicine, women's health, family medicine, pediatrics, dental, optometry, mental health social work, well babies, drug rehab, AIDS, diabetes, podietry, pharmaceuticals, nutrition programs, alternative medicine, exercise programs, things of that nature.
That care is provided at clinics that are usually in the neighborhood and accessible by public transportation. They are staffed by people who speak the languages of the community. They reduce barriers to the poor, the elderly, the unfortunate, migrant workers, people that are handicapped, financially challenged, overburdened, underserved.
It should be rapid, universal and free including things like dental work, eyeglasses, hearing aids, and all non intrusive procedures that don't involve surgery although it could easily be enhanced to include trauma centers where a patient is stabilized in an emergency, any patient, any emergency.
Administrative costs for services over and above Primary Care could be covered at the State and local level. Private insurance wouldn't be illegal so the haves and have mores could continue to have more in patient services if they wanted to pay for it.
Facility costs over and above Primary care for things like research labs might be handled by teaching universities. We could pay for the teaching and research under education rather than healthcare.
We could protect medical practice from trial lawyer insurance costs. The government might act as the insurance company for people who do have malpractice problems and apply luicense restrictions rather than money damages to physicians who malpractice taking the burden of that away from healthcare.
So far doctors benefit by less paperwork, less worries about being sued for something they can't control, and diagnostics and lab results become more accessible.
When we disengage pharmeceuticals and lab costs from hospital costs universal costs drop dramatically.
When we place more diagnostics under the outpatient community health center sphere of influence patients become better informed and better able to oversee their own wellness.
When we make electronic medical records sharing between facilities easier, including more home monitoring so you can hook your blood pressure and glucose results up to your computer at home and both you and your doctor know immediately if a change in your prescription medication may be warented, thats a plus.
If we accept the idea that there should be a single payer, the government, meaning the taxpayer, meaning for all practical purposes people making over $250,000 a year, then we can take the insurance companies and the paperwork out of the loop and save about one third of the costs we are presently paying.
Most doctors would be for this even if it costs them money because they could spend their day treating patients instead of filling out forms.