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A Marshall Plan For America

Posted on | July 30, 2020 | 7 Comments

Mike Magee

Yesterday close to 300 registrants signed up for a webinar sponsored by my Jesuit alma mater, LeMoyne College, titled “The Birth of the Medical Industrial Complex in America, and How Covid-19 Has Made the Case For a National Health Care System”. The college’s motto, “Greatness meets Goodness”, speaks highly of their value system, especially during these challenging times.

During the one hour Zoom presentation, questions flowed in over the chat line which you’ll see reflected in future posts. But the first question asked was, “What do you feel is the most important action step that needs to be taken to start enacting wide-spread change?”

My answer was, “Vote in November.”

I followed that quick response with what I would describe as “A Marshall Plan for America.”

During the presentation, I had shared the fact that, as America’s burgeoning Medical Industrial Complex coalesced in 1950 to beat back President Truman’s plans for a national health care system for our citizens, American taxpayer dollars financed the Marshall Plan construction of national health systems for our two vanquished enemies, Germany and Japan.

In a Rand Corporation post-mortem on nation building some decades later, scholars remarked that, “Nation-building efforts cannot be successful unless adequate attention is paid to the health of the population.”

In the re-build of Germany and Japan under the Marshall Plan, we elected to start with a health plan – in part because we recognized that all other social determinants – justice, housing, nutrition, education, clean air and water, transportation, safety and security – would be enhanced in the process.

We understood that this 1948 infusion of what would today amount to $128 billion would engender trust, improve health and productivity, and process fear and worry which might otherwise undermine the establishment of a civil society and stable democracy.

In answering yesterday’s question, I suggested that we as American citizens essentially face a challenge of similar magnitude.

In rejecting Trump, we are battling the dual scourges of a badly mismanaged pandemic response and the fires of historic and systemic racism. But in addition, we are opening the doors to a cultural and political awakening that could be “A Marshall Plan for America.”

The health care underpinnings of such a plan were driven deep into our cultural soil over a decade ago and have survived relentless attempts to unearth and destroy. These include fundamentals: Health is essential and a universal right. Universal health coverage is necessary to assure population health. All health plans must include comprehensive benefits. Patients with pre-existing conditions must be protected. Our most vulnerable populations are a top priority.

Upon these anchors, and now the sacrifices of over 150,000 Americans dead in part because of Trump’s incompetence, we  see revealed the basic “next-step” building blocks of a new deal for America.

Universality: Coverage for all – shared responsibility and risk.

Strategic Planning: Multi-year national health priorities layed out by a truly representative governance body.

Efficiency: Streamline payments, annual negotiated budgets, strict oversight, standardized national billing and payment systems.

Transparency: No DTC advertising. No kickbacks inside PBM’s. No data profiteering. Industry funded academic researchers must register as lobbyists.

Local Control of Delivery: Federal standards with local autonomy. Public insurance is primary. Private insurers are secondary and supplemental.

The unleashing of a Marshall Plan for America could be triggered by the offering of a “public option.” The response of parents of adult children, employees on skimpy employer based plans, newly covid unemployed, underinsured, uninsured and vulnerable will further strengthen our national resolve and advance our evolution towards unification, peace and productivity.

As Trump and Covid have made clear, “a thousand points of light” is no more a substitute for “good government” than it was for our vanquished enemies following World War II. As we did for them then, we must now ask the difficult question “How do we make America, and all Americans healthy?”

And then build out the answer – from the bottom up.

Comments

7 Responses to “A Marshall Plan For America”

  1. ARTHUR L ULENE MD
    July 30th, 2020 @ 11:58 am

    That was a fabulous webinar, Mike. I’m eager to get a link to the recorded version, so I can share it with friends. All the best….. Art

  2. A Marshall Plan For America – Health Article – Health & Wellness Blog
    July 31st, 2020 @ 8:51 am

    […] This is only a snippet of a Health Article written by Mike Magee Read Full Article […]

  3. Mike Magee
    July 31st, 2020 @ 8:59 am

    Many thanks, Art!

  4. Douglas Henley, MD
    July 31st, 2020 @ 10:11 am

    Mike, Great blog post but in addition to the main principles you note here, I would add the need for any US health system to be foundational in family medicine and primary care or it will NOT work in achieving better quality at lower cost. What we need is a Marshall Plan for Primary Care!
    http://www.healthrosetta.org/marshall-plan

  5. Mike Magee
    July 31st, 2020 @ 10:32 am

    Thanks so much for sharing this resource, Doug. As you emphasize, access to and coordination of care by the primary care team are critical as we move toward a true national health care system that provides universal coverage, strategic planning, efficiency, transparency, and multi-generational care. The work of you and others in the leadership of the AAFP provides a valuable resource as we struggle with the question, “How do we make America and all Americans healthy?” Best, Mike

  6. Paul Laba
    August 4th, 2020 @ 11:36 am

    This is angering. Our country in 1950 set up the foundations for health care systems in Germany and Japan that today eclipse our own. How can that be?

    Replacing Trump with a more forward-thinking (any thinking?) president on health care will help, but given the trials and tribulations of Obamacare and the powers of the Medical-Industrial complex, I don’t see much changing in my lifetime. I hope I’m wrong.

    Paul Laba
    Le Moyne Class of ‘71

  7. Mike Magee
    August 4th, 2020 @ 12:36 pm

    Thanks, Paul! As Father Monan would say, “Hope springs eternal.” Best, Mike

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