You never feel quite so good or quite so confident in life as when you complete two things: a good dental checkup with a professional cleaning and when you walk out of your doctor’s office and he’s told you you’re good for another 3,000 miles.

Both experiences … which I usually have twice each year … are worth my weight in gold. I am truly blessed.

Several years ago, I reached the age when Medicare became my mandatory medical program. No option. That’s the law. Stop making those expensive insurance payments each month, pay a quite reasonable Part A premium, add a medigap policy for a modest charge and make the shift.

I can’t say that my already excellent health care got any better. But I can tell you it didn’t diminish a single degree in quality as it got more affordable. My primary care doctor continued his fine ministrations. I needed no referral to see the specialist of my choice. Even my prescriptions got cheaper. Pretty hard to find a downside.

I review the above facts periodically. Like every time some misguided citizen decries the eventuality of single-payer care for all our medical needs. It’s coming. You can bet the farm on it. Not this year or next. Maybe not for a generation. But it’s gonna happen.

We are being driven to a national single payer system by many factors. One is economy-of-scale. Another is getting the for-profit element out of care so it can be priced uniformly according to actual cost rather than the financial needs of boards of directors and stockholders.

Tort reform is coming, too. And legitimate drug pricing is on the horizon within a government-operated system redesigned to get a handle on some of the ridiculous 200-300-400% markups on drugs before they get to the consumer.

Maybe the largest single factor is to get the hands of larcenous insurance companies out of the national pocket. When primary payer responsibility rests with a single entity the current medigap program, which works so well for seniors, can be redesigned for everyone. A few companies may go out of business. Happened when Medicare came along. But I’d bet it’s more likely there would be a wave of creative insurance opportunities benefitting those covered. Which would mean everybody!

An often unaddressed factor in our health care cost is the expensive business of research. This country is the world’s leader. Hands down. When talking about cost, that’s the 900 pound gorilla in the room. Public and private research expenditures are in the billions each year and that’s not going to change. But we’ve got to separate care from science and develop a way of paying for each using innovation we have not thus far applied.

Maybe the most significant reason single payer care is coming is that we’ve failed in every other attempt to work within the current and badly disjointed system. There are too many egos to be satisfied; too many high-dollar vested interests and a chicken-like spine in politicians who’ve been involved thus far. None of that will change. Nor will the escalating costs that we cannot sustain. Not unless we create a completely new delivery system with our hands on the controls.

It can’t be successfully conceived or designed with political interests in control. Never happen. The driving force will have to come from outside in much the same way as the President’s debt reduction panel. Only we’ll have to take their work more seriously. The best minds … free of axes to grind … will have to be at the table. They’ll have to “think-outside-the-box,” looking at all systems now being used in all countries. They may have to take a bit from here and a bit from there if some things are found to work well. They may have to go from the ground up. Or some combination.

When I see the goofball emails about government involvement in health care equated to a dying … and poorly run … postal service, I get steamed. The comparison is ludicrous. Electronic technology is dooming snail mail more than any other factor. Technology and private competition.

Medical care is unlike anything else in our lives. When we’re well, we don’t give it much thought unless it’s to complain about cost or availability. But when we need it, we want the best and we want all there is to take care of us or our loved ones. We want it now! And cost, at that moment, is irrelevant.

We’ve treated discussions of it, thus far, as a political issue. It’s not basically a political issue. It IS the most personal national issue we have. It’s got to be dealt with in that perspective.

Single payer health care is coming. Sooner. Later. But coming. We’ve about exhausted all other ways to solve an issue that can, and will, eventually bankrupt us. And, from my own experience, I can’t say the idea is all that distasteful.

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