Much is currently being written about how President Obama should re-shape the American Healthcare system. Most commentators agree that the current arrangement for healthcare in this country is too expensive, highly inefficient and provides unequal levels of care, including minimal care for the 47 million uninsured Americans.
As a physician with a longstanding interest in how health services are organized, and who has lived and worked in the Usa, Australia and Britain, as well as consulted to many other countries, I have strongly held views on the types of directions America should take. And at one level they are remarkably simple, and can be summarized in three suggestions.
Kaiser Medical
1. A public-private partnership religious doctrine has to be central to the whole re-engineering of the health system. America is founded on capitalist principals, where the profit motive is central, and any new advent to healthcare must concentrate this with the need to institute core public services that may be less likely to ever perform a profit. There must be the possible for cross speculation in all directions - and with funding for care in case,granted on the basis of yearly or episodic whole of person care provided, rather than on personel piece rates as at present. Numerous studies have shown that if health systems can be given the incentive to furnish quality care efficiently over defined time periods, and Kaiser Permanente is an exquisite example, that they can do this. The original point of this advent is that it will force more resources into stoppage of illness - to wellness promotion - rather than into the treatment of illness that has already commenced. Of policy in such an environment anyone, no matter what their insurance, should be able to receive accident care in any hospital at any time - public or private. The whole law must be developed with interoperable health data technology systems, including inpatient accessible electronic curative records and the provision of a unique health identifier for everyone. This advent will greatly enhance the delivery of healthcare, and the safety and privacy of health information.
2. The public component of the healthcare law would consist of universal basic health assurance (including catastrophic care insurance) and many accident and isolated health services, as well as much more public health focus on stoppage and health promotion. public programs should also pick up much of pre/post natal and early child care (by far the most important care in the whole health system) to ensure all mothers and babies are properly looked after, and probably care of some extra populations who cannot afford incommunicable health assurance such as the unemployed, some seniors and distinct impoverished or geographically isolated groups.
3. The incommunicable component would be funded with the aid of tax incentives to encourage most people (or companies) to take out incommunicable assurance with aim that at least 80-90% of the people should have incommunicable insurance. It is crucial to reach this level of assurance to be distinct that patients have "skin in the game" and are financially responsible for at least a good proportion of their healthcare costs, and do not see healthcare as something that is in case,granted by the government for free. The incommunicable sector should offer a full range of services from birth to death - with the quality to charge extra for distinct "non-essential" services such as cosmetic surgery and other niche areas - but with regulation to forestall people being excluded on grounds of pre-existing conditions. A voucher law for distinct groups, such as the chronically disabled, funded by government payments would allow all to entrance the incommunicable healthcare law depending on need. The assurance process for this incommunicable component needs a complete overhaul to cut administrative overheads and simplify the payment process - my view of the simplest way of doing this would be to limit the number of incommunicable assurance fellowships and make sure that they are financially viable and large adequate to offer uncostly regulated levels of healthcare services to their members.
These 3 steps to providing great care, and fairer entrance to care, for all Americans are taken from what I reconsider to be the best parts of the American, British and Australian health systems. No country has a exquisite health system, and all are dependent on the core cultural philosophies held by the personel nation. America is the Land of the Free and can afford to choose the best of what other countries have attempted as it debates how to enhance its healthcare system, and finally the force and fortitude of its people.
additional reading How to design a New American condition Care theory - 3 uncomplicated Proposals
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