Executive Summary: The American Healthcare System (AHS)

The American Healthcare System (AHS) design is driven by American principles of conduct, by caring, and by the notion that a smart buyer is the best customer and also serves as a viable control mechanism. All Americans will have access to healthcare and medicine. Our objective is to provide a system which supports people who want to be healthy. The system should be affordable, compassionate, efficient, and effective. We eliminate all activities which detract. We eliminate all programs which are in the middle of the patient and the provider decision processes. We arm both the provider and the patient with quality information to permit each to be effective parts of the team.

We redefine healthcare to include all activities which impact health or wellness. We emphasize prevention. We provide two types of facilities: pay as you go, and not-for profit. The not-for-profit facilities will provide care to all who cannot afford to pay. We identify two types of clinical protocols, standard and experimental. We provide a mechanism to evaluate all experimental protocols. All patients are managed through an Electronic Patient Management System (EPMS) which sends preventive/screening notices to patients and provides sanitized data to the Healthcare Information Infrastructure (HIT) knowledgebase. The availability of treatment data for all conditions permits the evidence-based evaluation of outcomes being experienced. This data, along with accreditation and public health data is provided to consumers and providers, The combination of data availability and data review permits a complete revamping of the way we deal with clinical trials, off-label treatments, and other experimental programs.

We emphasize the critical roll of the community in public health and in care delivery. The HI1 will provide tools to integrate community activities to facilitate preventive, prp natal, medical concerns integrated with daily life's experiences, and emergency care.

A set of national publidprivate panels will validate and monitor the AHS processes and all the components of it. The panels will assure that accreditation of key factors is completed, timely, and comprehensive.

In AHS we see six (6) stakeholders. lst is the patient, family, and support activities; 2nd is the provider group, supported by the EPMS: 3rd is the set of National public/private oversight boards who provide for self-regulation and routine update of the AHS; 4 are the advisory groups and accreditation organizations; sth is the category including government organizations which monitor public health topics, supporting research, and management of key components of the AHS such as the HII; eth includes {hose responsible for legislation and regulatory considerations of AHS and the public health domain. Trie stakeholders to the AHS will benefit from the fact that we have emphasised incentives for quality, accountability, effectiveness, and efficiency.

The AHS will: 1) satisfy fully all stakeholders; 2) ensure healthcare availability for all citizens; 3) reduce dramatically the cost of care, including medicine and treatments; 4) improve significantly the quality of care for all; and 5) improve the accountability of care.

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