Well here we are in the final push to get a new health care reform bill. The latest strategy is to have a “non-vote.” The Dems now propose taking no vote on the Senate bill but simply vote to take a pass. I guess they are reading the polls that show most Americans do not want the new bill.

Now before you paint me as a Tea Bag supporter or hostile to universal health care let me state my position on the matter. I stand squarely in the camp of those who want to get some control on health care costs. Extending health insurance to some 35 million more Americans does nothing to do this. In fact, since the Feds agree to pay the insurance for those who cannot afford it, this bill amounts to a windfall for the insurance companies.

I was all for HMOs years back since they had the potential to control costs. But the AMA ran a successful campaign to kill this movement.

Today Medicaid, the joint Federal-State program to provide health care for the poor, is dispensed mainly via HMOs. My Medicare Advantage Plan, which is used by 11 million Medicare recipients, is essentially an HMO. Thus over 60 million Americans receive medical services through HMOs paid for by the Federal and State governments.

This is important because Medicaid and Medicare do control costs by setting payments they will make for services. In he Medicare Advantage plan Medicare sets a fixed fee it pays to the HMO and the HMO then sets what it will pay accordingly.

My suggestion, provide HMO plans via Medicare and Medicaid for all who want them. For those who prefer more control over their health care, let them buy private health care insurance. I would also ask that private insurers be allowed to compete on a national basis, and not state by state.

I would be happy with a single payer system, i.e. all medical care is paid by the government. I like the one in Spain in which the Social Security administration owns most hospitals and most doctors are on the government payroll. But if you think an HMO is hard to deal with in getting treatment, try dealing with a single payer system.