That would be former Governor of Montana Brian Schweitzer.

Way back in early 2009 as the healthcare debates were heating up, I undertook a study of the history, successes, and failures in the US health care “system.”  The more I researched and did back of the enveloped calculations, the more convinced I became that even single-payer (which wasn’t even an option) wouldn’t be robust enough to deliver Universal Health Care at a national cost anywhere near what other countries spend on national health care.  

The OECD reported the comparative costs of health care among western countries, most with some system of UHC.  What’s particularly striking is that in 2009 (not too different from the 2008 report that I consulted) the US spent more public dollars, on a per capita basis, on health care than all but two of the comparative countries.  More public dollars (along with a lot more private dollars) and we weren’t even close to providing UHC.  

As bad as those comparative numbers are, they would be much worse if the US senior population percentage were similar to that in most of the comparative countries.  The US senior population in 2009 was just under 13%; whereas, it was 15% in the UK and 17-18% in several European countries and 20% in Japan.  I wrote a series of diaries on why we can’t get from “here” to “there” (UHC) with health insurance reform.  

I ended the first diary with:

Stay tuned (only because this diary is already too long).  In the interim think about Detroit, Swine Flu & Single-Payer.  Two buzz words: public and free.

From the fifth diary

How can we not see that US public health facilities, Community Health Clinics and free clinics are the only viable key to expanding access and affordability  to the tens of millions of Americans that have been left behind by The Best (and most expensive) Health Care in the World?

Montana has put something similar to the test:

A year ago, Montana opened the nation’s first clinic for free primary healthcare services to its state government employees. …

He and others faulted then-Gov. Brian Schweitzer for moving ahead with the clinic last year without approval of the state legislature, although it was not needed.

How’s it working for those state employees and retirees with health insurance?

Visitation is more than 75 percent higher than initial estimates.

“For goodness sakes, of course the employees and the retirees like it, it’s free,” says Republican State Sen. Dave Lewis.

And because it’s free to patients, hundreds of people have come in who had not seen a doctor for at least two years.

Hill says the facility is catching a lot, including 600 people who have diabetes, 1,300 people with high cholesterol, 1,600 people with high blood pressure and 2,600 patients diagnosed as obese. Treating these conditions early could avoid heart attacks, amputations, or other expensive hospital visits down the line, saving the state more money.

Pretty darn well.

How’s it working fiscally?

Even so, division manager Russ Hill says it’s actually costing the state $1,500,000 less for healthcare than before the clinic opened.

Pretty darn well.

Free is critically important.  As I surmised, it is attractive to certain people and population demographics with health insurance.  Free of the billing tasks, doctors and nurses can deliver more patient care in the same number of hours.  That alone eases the shortage of primary and preventative healthcare providers.  The bonus comes with early treatment of conditions that will be much more expensive to treat later.  

Well done, Mr. Schweitzer!  A mighty fine first step outside the health insurance closed maze.

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