108C. Dr. Dana Kellis’ Epilogue ꟷ A Single Payer (not a single provider) System
- T Michael White MD FACP
- 1 minute ago
- 5 min read
Fixing United States Health Care - Letters to the File
Part I. The Hot Mess
Part II. The Solution
by
T Michael White MD FACP
The Realization of Universal Access to ABC-STEEEP
(Affordable, Basic, Compassionate - Safe, Timely, Efficient, Effective, Equitable/Just, Patient-Centered Care)
******
108C. Dr. Dana Kellis’ Epilogue ꟷ A Single Payer (not a single provider) System
Dana S Kellis MD PhD MBA
“What we are missing, utterly and completely, in this government is accountability.”
Paul Hawken
The WhiteHouse on the Belleair Bluff
Sunday, November 30, 2025
Dr. Mike,
A letter to the file…
At this point, with P/CEO Charley Price’s help, you have made it this far and now have to figure out how to get out of Dodge.
You perceive well-founded skepticism in the room: 1) how can my care be so good and our (non) system be so bad? and 2) how can such a gravitas-lite, humble messenger be believed?
Your instincts have you suggest they look right and left and confront that at some level they know of:
A well-employed, employer-sponsored insured child/grandchild with $12K in out-of-
pocket expenses in 2025 ꟷ with deductibles that will reset January 1st ;
A cherished physician (age 69) who cannot retire until his spouse (age 62) qualifies for Medicare ꟷ he works for employer-sponsored health insurance;
Wonderful empty nesters whose brood has returned home because health expenses
have eroded their education, finance, food, health, housing securities ꟷ and left them without a sense of self-worth;
A child/grandchild stuck in a job he/she hates for fear of losing (quite lousy) health
insurance;
A housekeeper (single Mom) who now lives in her car because health care expenses
now preclude housing security;
A proud geriatric couple (aka The Belleair Hostages) fearing a move from FL (the devil they know) to VA because of health care fiscal uncertainties in VA.
That strategy my bring the conversation to closure ꟷ but it is always best to go to an
encore and bring out certifiable gravitas to close the show.
******
A Single Payer (not a single provider) System
By Dana S Kellis MD PhD MBA
“What we are missing, utterly and completely, in this government is accountability.”
Paul Hawken
I begin by applauding Dr. White’s erudite summation of the health care crisis facing our nation, as well as his personal dedication to using any means possible to address and eradicate the calamitous risks facing Americans as they attempt to access excellent doctors and hospitals to secure care for themselves and their families but are unable to do so because of both inadequate insurance coverage and insufficient personal wealth. I observe this first-hand on a daily basis as my well-insured, middle-class daughter attempts to secure care for her 4-year-old son with diabetes. Between insurance premiums, deductibles and co-pays and uncovered specialists, medications and equipment, she is left unable to afford other basic necessities like housing. Fortunately, my wife and I have sufficient resources to make things work, but there remain many “what-ifs” ꟷ like the ever-present risk of a serious diabetic complication, or the possibility that my wife and I will no longer be able to help, or what would happen if she lost her employment and her employer-sponsored health insurance.
I am fortunate to have advanced degrees in medicine (MD), public affairs (PhD), and
business (MBA), as well as decades of experience treating patients, working as a healthcare executive, and teaching at the graduate level in business, public affairs and medicine. With this background, I offer the following observations, predictions, and suggestions.
Our nation faces a perfect health care storm of:
A surging incidence of chronic and acute illnesses (diabetes and related conditions, measles and other viral illnesses, obesity, mental illnesses, gun
violence, and so forth);
Exploding costs for care (driven by unmitigated increases in charges by physicians and other professionals, hospitals, insurances, pharmaceuticals, technologies, and regulatory costs); and
Plummeting confidence in healthcare providers and treatments as Americans
interact with a system seemingly more attuned to profit and expansion than to
access and affordability. Overlaying all of this is a surfeit of absent, feckless, or
destructive political leadership.
Every system is built to produce the results it is producing. We have a moral obligation to ensure that people receive the care they need. Nevertheless, even if 100% of Americans were miraculously provided with Medicare-like coverage in our current system, we would still have a burgeoning crisis (see #1) that threatens to undermine our nation. As Dr. White concludes, we need a new system. We need to somehow find the political, moral, and professional fortitude to bypass the endless and pointless discussions about how to pay for health care and instead tackle the real “elephant in the room” ꟷ our unfixable and irredeemable health care system.
There are (mostly) no villains in all of this. To the contrary, there are many well-
meaning, intelligent, and moral people working as doctors, nurses, hospital
administrators, and so forth. The problem is they work in a deeply flawed system that makes “doing the right thing” almost impossible.
Our new system of healthcare must meet the following objectives, driven by ABC-
STEEEP (affordable, basic, compassionate ꟷ safe, timely, efficient, effective,
equitable/just. patient-centered care) principles:
Empowered competent leadership accountable to patients and communities and who are divorced from motives for profit, accretion of assets, or political gains;
Accountability and transparency for expenditures and costs of care, and
elimination of fraud, waste and duplication;
Accountability and transparency for quality;
Accountability for coordination of care;
Accountability for the health and safety of communities served, including
planning and striving for prevention of disease.
I believe the only structure able to meet these requirements is a single payer system
(not a single-provider) with authority and responsibility to meet the health care needs of each American. Such a system would save many billions of dollars and make the United States the healthiest nation on Earth. (615 words)
Respectfully submitted,
Dana S Kellis MD PhD MBA
Academician, Administrator and Clinician
Patriarch and Church Elder
Farmington, Utah
******
Enough (so well) said.
Respectfully submitted with fondest personal regards,
Dr. Mike
You may leave an anonymous comment without username and email ꟷ please do. Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you as this draft and subsequent chapters will be significantly enhanced.
Dr. Mike
Letters to the File ꟷ Part II
101. Introduction to Part II ꟷ The Solution
102. The United States Health Care System ꟷ Enabling Legislation
103. The United States Health Care System ꟷ View From Space
104. My (Unique and Very Personal) United States Health Care ꟷ Getting Started
105. My Semi-annual Primary Care Team Visit
106. The United States Health Care System ꟷ My Contract
107. ‘Medicide’ ꟷ Failure to Make Whitefish Bay (A Fiction)
108A. Charley Price’s Prologue ꟷ We Must Start Anew
108B. The Enabling Cataclysm ꟷ A Fiction?
108C. Dr. Dana Kellis’ Epilogue ꟷ A Single Payer (not a single provider) System
(more to follow)
