Healthcare is largely unaffordable, and therefore largely unaccessible, to the majority of the population in the USA. The median income is about $60K and the person per cost of healthcare is about $8.5K per annum. Regardless of who pays -- the government (through taxes), the employers (as a benefit of employment), or the individual, healthcare is largely unaffordable. Government mitigates risk for private insurance companies by removing the elderly (Medicare), the poor (Medicaid), children (CHIP), veterans, coal miners, Native Americans -- in other words, the most expensive groups to insure -- from the healthcare pool, and the delivery of healthcare on an individual basis remains unaffordable and therefore unaccessible to middle income and low income individuals. Insurance companies are in the business of mitigating risk of large healthcare expenses, not in the business of providing healthcare itself.

Pooling healthcare costs into a single plan (such as Medicare for all) mitigates risk and makes healthcare accessible, but does not make it affordable. First and foremost, to make healthcare accessible to all, it must be made affordable for all, And that requires a careful analysis of the opportunities for reducing costs while maintaining standards of care. Such analysis requires people skilled and knowledgeable in the task who are not beholden to a particular set of interests rather than mass or collective action.

Would I give a day if I thought it would improve healthcare. Absolutely. I have have and will continue to do so as the opportunity arises.

Dr. Marcinko:
Coulf you, please provide the details of calculations and assumptions used to reach your conclusion (10,000 participants generating 27 additional productive years? If so, also please include the supporting statistical analysis).

Dr. Marcinko:
Thank you for your quick response. Could you, please provide calculations supporting your conclusions?
Regards,
Karel Petrak

As you define collectivism, I think the concept of a more holistic view that works toward helping all members of society makes sense. But I think the issue in the US is not so much about focus, but changing the internal structure of a fragmented healthcare system. We need to keep our business model, but fine tune them to ensure that all members of society are covered and that the cost of healthcare is on par with the rest of the world.. There is no reason why the US should pay more for medications then more centralized healthcare systems.

In terms of the bizarre question, I would not give up a day of my life. Because if I did, that is one less day that I can provide care to others and try to have a positive impact on their lives as a pharmacist and impact the life of my little boy.