Executive Summary of the Diagnosis and Prescription

While the technological performance of the U. S. health care system borders on the miraculous, the systemic performance in terms of cost, effectiveness, access, and consistency of quality is far more human and flawed. There is an accurate diagnosis and, beyond treating symptoms, a radical or rooted, effective prescription or remedy - the Informed Market Organized System [IMOS].

Real power is to frame the debate. Leadership is the key; people tend to be over-managed and mentally constricted but underled with an unrealized mental capacity. Healthcare reform, really a systemic transformation? starts with the mind. The increasingly problematic U.S. approach is an unconscious conspiracy - it is a fbnction of an organizational and relational ignorance, sustained by the culture, and akin to a dysfknctional family: poor problem recognition and solving, control, manipulation rather than actualization, shallow or adversarial communications, distrust and denial.

The healthy, objective mind is the metaphysical product of the physical organ that is the brain which is a highly sophisticated neural network or organization meant to construct reality accurately and holistically. The mind must be irdormed and enlightened with fact, information and principles to be able to visualize and actualize viable reform as effective? networked7 healthy relationships. A superficial and impotent pop psychology or feelings-rooted optimism or idealism cannot provide the insight nor the passion as well as the teeth for viable, non-cosmetic reform. Nothing is so dysfbnctional or disorganized that someone doesn't benefit.

The unconscious mind is one that is deficiently informed or ignorant and prone to illusion, linear thinking [often manifest in jumping to false conclusions and deficient remedies], self deception and self-medication in habituation and codependence, It is not that minds are often dark, it is that they are drawn to conclusions7 principles and remedies that are shallow, deficient, distorted or incomplete. More precisely, the American health care culture and system are less enlightened and are polarized, akin to Polaroid sunglasses which filter sunlight. Healthcare delivery organization in the world is polarized between nationalized and often standardized, one-plan, one-payer systems found in most Western democracies at one extreme and the U.S. approach which has hundreds of thousands of plans and hundreds of payers at the other extreme.

The solution lies in the objective or radical center - the performance apex of an inverted T with the base representing the polarized extremes. [A diagram is part of the report.] Radicaly like a radish, means rooted in the ground or in reality, not ideology or, worse, polarized violence. Roots are unseen but essential for healthy development and nurture the entire plant. Like roots, reform needs to be nourished bottom-up or from the heart, not imposed legalistically top-down from the disconnected head. IMOS has multiple standardized plans, modified community rating, frees insurance from the employer and empowers the consumer with responsibility and real choices.

Reformation requires true heart including courage, not mere sentimentalism, in a struggle of human and organizational or community development through leadership, resisting polarization and the subsequent politicization. Yet the reform dynamics and design need not be unduly complex if the diagnosis is accurate and the remedy cost-effective.

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