Health care reform requires better access and quality: dialysis as an example

Having spent two years in Oxford as a Marshall Scholar in the mid-1970s, I came back to medical school believing in a national health service—i.e., Medicare for all. But I learned firsthand that a monopoly can provide access without ensuring quality. When quality isn’t the priority, there’s no hope for lowering costs or alleviating suffering.

Medicare is already the single payer for dialysis and has failed patients miserably. As a result, …

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