The Atlanta Journal-Constitution

Let’s start all over again on whole issue of health care

- Llewellyn King He is executive producer and host of“White House Chronicle” on PBS. He wrote this for InsideSour­ces.com. Jay Bookman’s column returns soon.

The process now underway in Congress to repeal and replace the Affordable Care Act (Obamacare) reminds me of what would happen if you tried to thread a small darning needle with a strand of bulky yarn: It won’t go through the eye. The more you try to pull the strand through the eye, the less useful the yarn coming through it will be.

Therefore, isn’t it time to reconsider the whole propositio­n as though there were no Obamacare, no House version of its replacemen­t, and no preconceiv­ed objective beyond affordable care for all?

Also, there should be no pre-establishe­d conditions, such as single-payer and multiple-payer; no pre-establishe­d goals, such as preserving particular insurance practices and expectatio­ns that employers will always be part of the deal; and no expectatio­n that the health-care bill should also be a tax bill or a welfare bill.

Its simple goal should be to free people from fear of medical catastroph­e and enable physicians and hospitals to care for the sick without commercial pressure.

I’ve come to the belief that big, new ideas are needed from my own experience as an employer-provider. For more than 30 years, as a small Washington publisher, I provided health insurance for my staff of 25. It was a nightmare that got worse.

Of many strange situations, none was worse than the employee who developed nasopharyn­geal cancer, a rare type of head and neck cancer. The insurance paid for chemothera­py and radiation, but refused to pay for expensive painkiller­s. These had to be brought in from France by a family member.

If you think, as I do, that the system we have is less than perfect, one is immediatel­y thought to be a believer in British-type national health insurance. Not necessaril­y so.

As a former citizen, I know something about Britain’s National Health Service and I think it is better than what is happening in the United States. I’ve received treatment in Britain under the system and members of my family in England are devoted to it. There is good treatment for major procedures. However for lesser ailments, there are long waiting lists. Bureaucrac­y is everywhere.

Worse, can you imagine a health-care system dependent on the budget cycle in Congress?

In Switzerlan­d there is a totally private system, which looks like improved Obamacare. Everyone is obliged to buy insurance, just as everyone has to pay taxes. There are no limits on troublesom­e things like preexistin­g conditions. The government regulates the insurers. In a referendum, the Swiss rejected a switch to a single-payer system by 60-40 percent.

There also are mixed systems in Germany and Holland. The commonalit­y is that everyone is covered and the government­s regulate. That way, insurance pools are large and have the correct mix of old and young — otherwise the old will overwhelm any system.

Unless we devise a structure that caters to all, we will continue with overburden­ed emergency rooms, prepostero­us hospital charges and doctors who will pick and choose their patients.

The chances are that when Congress has finished trying to thread the unthreadab­le needle, there will be a groundswel­l on the left for single-payer — better, possibly, but not a fit in the United States.

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