A health care strategy for Bernie Sanders

Sen. Bernie Sanders, shown at a rally in Portland, Ore., has a plan for a single-payer health care system that the author supports, and wants to improve. believes can be PORTLAND, OR - MARCH 25: Senator Bernie Sanders speaks at a rally March 25, 2016 in Portland, Oregon. Sanders spoke to a crowd of more than eleven thousand about a wide range of issues, including getting big money out of politics, his plan to make public colleges and universities tuition-free, combating climate change and ensuring universal health care. (Photo by Natalie Behring/Getty Images) The upcoming California primary offers an opportunity for Sen. Bernie Sanders to add substance to his call for a single-payer health-care system with little risk of losing voters because broad support exists here for a universal health care. Indeed, our California Legislature approved such a plan and I am the nurse who wrote it. I applaud Sanders for injecting meaningful health reform into the campaign and offer six policies to better define his plan and provide a foundation for negotiating the Democratic Party platform at the convention. less Sen. Bernie Sanders, shown at a rally in Portland, Ore., has a plan for a single-payer health care system that the author supports, and wants to improve. believes can be PORTLAND, OR - MARCH 25: Senator Bernie ... more Photo: Natalie Behring, Getty Images Photo: Natalie Behring, Getty Images Image 1 of / 3 Caption Close A health care strategy for Bernie Sanders 1 / 3 Back to Gallery

The upcoming California primary offers an opportunity for Sen. Bernie Sanders to add substance to his call for a single-payer health care system with little risk of losing voters because broad support exists here for universal health care. Indeed, our California Legislature approved such a plan and I am the nurse who wrote it. I applaud Sanders for injecting meaningful health reform into the campaign and offer six policies to better define his plan and provide a foundation for negotiating the Democratic Party platform at the convention.

(1) Give all Americans access to the discounts on drugs and medical equipment negotiated by the U.S. General Services Administration for federal government agencies, but for which government (such as Medicare) and private health care programs are not eligible. Do not duplicate the GSA negotiating process because that would add administrative costs large enough to nullify the value of the discounts.

(2) Authorize community-based collaborative capital health care planning, including some antitrust exemptions, to eliminate redundant investment, one of the largest, but least discussed, drivers of health system price inflation.

(3) Establish a National Quality Registry to which medical errors that killed, injured or had potential to, must be reported. Authorize it to investigate mistakes and implement corrective action. Whether annual preventable deaths are 98,000 as some contend, or 400,000 as others assert, our dilemma as a nation is that no one has authority to fix what must be called a care quality crisis. The federal government counts mistakes. Private hospitals and doctors discuss them behind closed doors and in court. This resolves problems for a small number of patients, but it does not protect the public. The annual, preventable loss of life and limb inflates health spending mercilessly.

(4) Establish a national task force to develop tools that ease communication among disparate electronic health systems. Doctors cannot have a full understanding of what’s happening to a patient when the patient’s medical records are scattered among multiple providers and institutions and can take weeks or longer to obtain. Lack of information is extraordinarily dangerous to patients and is a root cause of preventable mistakes.

(5) Authorize physicians to cancel co-payments when a patient demonstrates they are a financial burden. Money made from co-payments is buried under the weight of spending on illness made worse by postponed or neglected care.

(6) Put Medicare on every Affordable Care Act Health Exchange and allow all Americans to buy into it. It will compel private insurers to offer policies of comparable quality and price or risk losing customers, and will put downward pressure on premium prices for years to come. Over time, it will lower administrative costs as private plans consolidate products and public programs merge or disappear.

These policies could bring us closer to a cost-effective universal health system without unwelcome disruption that some fear a single-payer system might cause, and do so in a way that aligns with our American ethos.

Judy Spelman, R.N., was the chief architect of the 2005 California Healthcare Insurance Reliability Act, which was passed by the Legislature and vetoed by Gov. Arnold Schwarzenegger. She lives in Point Reyes Station.