Dr. Thomas J. Gates’s “In my opinion article, the primary care solution” sets forth many ways to improve health care delivery and reduce expenses.  First he points out “With overall costs having doubled in the last 10 years, and projected to double again in the next 10, the current chaos is simply unsustainable.” His main argument is “There is a large body of scientific evidence that has conclusively shown that when it comes to health care, more is not better.  Comparisons between high-cost and low-cost regions within the U. S., or internationally between high- and low-cost countries, show that spending more money not only does not improve outcomes, it actually seems to make them worse.”

He goes on to state “Public option, health care cooperatives, single payer, marketplace competition:  The current contentious debate has narrowed into an argument about insurance.  But what we really need is not health insurance reform, but health care reform.”  He concludes “We can and must have universal coverage and reduced costs. The way to accomplish this is to make a robust primary care system central to health care reform.”

WATCHDOG: The good doctor is excellent in diagnosing the ailment but falls short in prescribing the cure!

Only a single payer system, which in one form or another exists in advanced nations throughout the world, will deliver “universal coverage and reduced costs.”

Failure to learn from other nations is an example of the ruinous conceit of Lancaster exceptionalism and “American exceptionalism”, a carry over from the days of old when we were far wealthier than other nations due to our abundance of natural resources, limitless frontier, and buffering from national defense obligations by distance.

And if we are going to single payer, it should include scholarships for medical education. This will level the playing field, attract a huge number of talented individuals, and justify a system that generously remunerates health care providers, but without burdening them with huge debt and causing maximizing earnings to be a high priority.