Healthcare? What Healthcare?

My fellow citizens of Nevada County and honorable Doug LaMalfa, our representative in the Congress of United States:

Let me start with the undeniable (not “alternative,” not “fake”) fact. Everyone of us needs and will need healthcare, in one form or another. This makes us all participants in the healthcare system, now and later. This is why we should, indeed we must, be involved. As a consequence, we shall have the healthcare worth its name or the so-called “healthcare.”

Yes, “healthcare.” What healthcare? The term is being applied to at least three distinct entities. They are (1) the individual healthcare of the body and mind, (2) the healthcare insurance, and (3) the healthcare system. The first two are actually subsets (elements) of the third one.

The healthcare system with its numerous components – patients, doctors, hospitals and other providers, insurance companies, pharmaceutical industry, technology suppliers, government tax and funding laws and regulations, and other stakeholders and influencers – presents such a maze of complexity and dependent relationships… that it is no wonder that discussions about it are endless and not simply conclusive with respect to desired outcomes. The outcomes themselves are fuzzy, depending on who is talking. For sure, there will always be tradeoffs among quality, costs, and timing – unavoidable due to the necessary institutional implementation of the system.

Rather than analyzing the infinite variety of possibilities of what to do about this complexity predicament of healthcare “solutions,” I wish to invite you into a dream. The dream is actually reminiscent of the story of Alexander the Great who, rather than untangling complex knots, cut through the apparent entanglement with his sword.

Imagine that you have a magic healthcare card, in a form just like your Visa or other bank card, in your possession. With this card, if you need to, you can walk into any doctor’s office or any medical facility or hospital, and you will be taken care of. You will pay, say $20 out of your pocket, and this is the end of it. No bills, no further months long hassles about charges for the service, nothing. If you need medications, the same story. You will pay some standardized low medications co-pay and this is it. Also, your card will be available to everyone (no “pre-existing conditions” exclusions, lifetime expense caps, and similar “tools” of for profit insurance companies). Indeed, everyone will be required by law to have it. The card will also guarantee standards of quality. Yes, imagine being a small business owner or employer with zero worries about the healthcare costs related to conducting your business. Wow!

A dream? Really? No, this system in which everyone participates (financially, too – nothing is “for free”) by tax deductions (just like for Medicare) throughout one’s lifetime, is called “a single payer.”

Perhaps amazingly, I live that dream. I have insurance in the European Union. By direct experience and comparison, I wish the European system, or its equivalent, was implemented here.

I shall end up with two questions to the defenders of the status quo, of the so-called “best healthcare system in the world” – which it is patently not:
1. Why should we tolerate the insurance companies with their almost exclusive financial profit motivation, obsolete or non-existent modern technology, lack of standards, unbelievable complexity, and discriminatory practices, such as “pre-existing conditions?”
2. Why do the self proclaimed pro-business and conservatism proponents tolerate the utter financial waste and hardship for business people and people in general, of the current system? As an example, United Healthcare CEO “earned” $66 million in 2014, $102 million in 2010 – think about that!

Final note. “Repeal, repeal” song regarding ACA legislation, without an improvement on it, sounds hollow. Again, the IMPROVEMENT. This has nothing to do with “socialism,” “government cannot do anything right,” and similar notions. It has to do with quality of life. I have just heard “more choices, lower cost.” The attention to quality, also in relation to “choices” and “costs” is imperative.

I am glad I live in California. I hope the dream of a single payer system will become a reality in our state. The good news is that the bill SB562 “Healthy California” is in front of our legislators. Right now. You may find more about at

Support it. It will do good to all of us.

By Milan Vodicka, Ph.D

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