O'CONNOR HEALTHCARE REFORM CONTEST—2003

EXECUTIVE SUMMARY

This proposal is in response to the solicitation for the OIConnor Healthcare Reform Contest (due date July I, 2003). Tables I and 2 list the major healthcare problems and correlate them to proposed reforms. Tables 3, 4, and 5 consider the following reforms, divided into five sectors of activity:

1. LEGISLATION
   1. Congressional enactment of patients' bill of rights
   2. Make cost-reduction a goal in DHHS and NIH grants and contracts
   3. Public disclosure of HMO and hospital operational criteria and procedures
   4. Restrict medical organizations to non-profit status
2. INFORMATION
   1. Standardization of medical record format for computerization
   2. Diagnostic computers, available publicly (e.g. drugstores)
   3. Automation of diagnostic testing
   4. Non-prescription availability of all but toxic and drug-related medication
   5. Increased role of pharmacist/pharmacologist in advising on medication
3. CORRELATION
   1. National database to correlate data and upgrade diagnosis and treatment
   2. K. Inclusion of DNA profile in national database and all clinical trials
   3. L. Eventual hookup of drugstore computers to national database
4. MEDICATION
   1. Reduction in cost of clinical trials by 'at risk' level of use as virtual trials
   2. Use of national database to check effectiveness and side effects
   3. Elimination of marketing of pharmaceuticals to physicians by reps
5. PROGRESS
   1. Use of other professions (engineers, scientists) as consultants
   2. Use of NASA and DOD and IS0 techniques to eliminate errors Only the reforms in the first two sectors (shown in boldface) are discussed in detail, with emphasis on the enactment of legislation to ratify the Patients' Bill of Rights, the establishment of a monitoring and rating system for physicians and medical service organizations, the development of a widely available computer program to work with the patient's own medical record CD disk to provide the near-equivalent of a visit to a physician, and direct patient accessibility to medication and clinical tests. The remaining reforms are described briefly in

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