A Modest Proposal to Begin Health Care Reform

No, I will no advocate eating the children of the poor, as the original A Modest Proposal did. But I think we have the seeds of a good health care system in the US right now, and yet I hear of no one proposing to grow and use it. I speak of course of the Public Health Service. I believe that we should expand this service a thousand-fold, and have it work in cooperation with all other public health services and clinics around the country, whether state or county-based. Ultimately, we need a health clinic in every village or neighborhood.

We're running into a shortage of nurses and doctors, so why not offer worthy students a free ride through school in teaching hospitals, paid back by a few years of service in the PHS? NPR did a series about health care in Europe, and while I didn't hear all of it, some of the countries had a system reminiscent of this.

Also, we could easily fold volunteer service into this, because good nutrition and regular exercise are the foundation of good health. So we need community-based centers for health, where doctors and nurses can be based, as well as space for classes and activities.

See, the problem as I see it, is that so far the debate has not been about health CARE, but about medical insurance. While decent insurance is a good idea, what the insurance companies have been doing is rationing care, and scooping profits out of the system. Instead, we need to focus on HEALTH and CARE. Not money, not drugs, although those are a necessary part of the equation. But the focus should be on health care for all, using best practices at every level.

It's about time the debate was about the best way to achieve that goal.


There are risks and costs to a program of action. But they are far less than the long-range risks and costs of comfortable inaction. - John F. Kennedy

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