There is no other viable option. Human nature will not allow any other system to work. We have proved that already.

My first job related to health care was processing major medical claims for my employer. I reviewed receipts, checked for eligibility of the services presented and assisted employees with questions and putting their claims together? This was before there was separate prescription drug coverage.

Later I designed various plans for employees to select among – fee-for-service options with different deductibles and out of pocket costs, HMOs and PPOs – all with different premiums.

I helped start several HMO and PPOs serving on the boards of directors of four plans.

For many years I negotiated with several unions about employee health insurance premiums and out of pocket plan provisions.

We tried every trendy strategy to manage costs – plan choice, promoting second opinions, giving employees time off to have pre- admission testing when that was a thing, using wellness programs with cash incentives and more.

Nothing worked to control costs, adverse selection occurred between plans as employees enrolled in the plan providing the highest benefits for their situation.

There are two things I learned over the years, two indisputable facts:

• Patients will never act like consumers. Healthcare is not like any other purchase
• Nobody thinks they should pay out-of-pocket for their healthcare

That leads me to an obvious conclusion. After about eighty-three years of experience with health insurance in this Country in its various forms, the only way we will assure universal coverage, stop adverse selection, have a more equitably distribute costs, fairly reimburse providers and give us a chance at better coordination of healthcare is to adopt some form of

Medicare for All

funded by payroll taxes on workers and employers, income-based premiums, and out- -of- pocket costs (deductibles and co-pays on some services).

No, I’m not talking about the Bernie Sanders type model where everything and anything is included, but a more modest start. Thereafter expanded as Americans are willing to pay.

Any such new law must require that the program be fully funded through taxes and premiums covering all spending at all times.

Every citizen or legal resident must participate, but would be free in addition to purchase private insurance on their own at their expense.

No, it is not socialized medicine, it is universal insurance‼️