Paul Krugman observed that: "... lower and middle-income Americans would be substantially better off under the Obama plan. But where is the money for health care reform?" (NYT Blog, June 18).

Money is the problem with the existing US health care system. It is not the solution. US health care is about twice more expensive than the European health care systems in term of share of GDP.

The outcomes of medical treatment in the US are much less good than in the EU, and the reason is easy to diagnose. US private companies spend a lot of energy barring, harassing or second guessing doctors until the later either give up on a lot of exams and treatment, or are so slowed down in their care, they just cannot provide it. That is how the private sectors create profits in health care: by denial of service.

Thus throwing more money at the problem should not be the first line of treatment for the sick US health care system. One cannot simply send more money to the same profiteers, and hope things will improve.

Instead one should look back from afar at what is going on: private health care "providers" conspire by employing personnel to withdraw medical care from the population, so as to increase their profits. "Your money and your life" is the practical motto of the private US health care exploitation scheme, a new low in civilization. Profiteering with people's life and health should be made ILLEGAL. And yes we can: the RICO Act will provide Congress with plenty of ammunition.

Once making money by interfering with doctors has been made illegal, US style private health care providers will be MUCH LESS PROFITABLE. The private, profit oriented motive will lose traction in basic health care. Once it is weakened as a capitalist juggernaut, the entire for-profit US health care system could be GOBBLED by Medicare and Medicaid. The USA would end up with a single payer plan for basic, life saving health care (and join the rich countries).

As far as rising money for that later phase, the USA should be encouraged to join the rest of civilization, and reduce its energy usage (which is a multiple, per person, of what is achieved in Western Europe). Fortunately, that can only be done by increasing energy taxes, providing the Federal government with a huge income. The plan should be to exchange Special Utility Vehicles and extravagant profits for the few against health care for all. Of course, it would be unwise to mention this obvious strategy before November 5, 2008.

Patrice Ayme

P/S: The organizing principle of European health care systems is to provide health care. Reducing cost is a secondary consideration enslaved to that primary mission. The organizing principle of the non governmental part of the US health care system is profit for private individuals and organizations (like many "conservative" exploitation schemes, this was set up by Nixon, with federal subsidies, so it could be argued it's not a genuinely all-American system, but something rushed by a crook while he was impeached for high crimes and misdemeanors). In that scheme, reducing cost enables profits, and is the primary mission. US health care is not health care, but a profit center for some of the rich.