Executive Summary
PUSH - Partners in United States Healthcare

PUSH GOALS FOR HEALTH CARE DELIVERY IN THE UNITED STATES:

1. Minimize politicization of health care decision making.
2. Provide universal coverage.
3. Obtain the highest possible quality of care at the lowest possible cost.
4. Drive all Patient Care Organizations (PCOs) to compete on the basis of quality of care.
5. Facilitate competition among PCOs. All members may change to a different PC0 if they judge it to be better.
6. Design and promulgate a standard "outcome report" to be required from each PC0 every year to facilitate quality comparisons.

PUSH STRATEGIES FOR THE ACCOMPLISHMENT OF THESE GOALS:

1. Create a Federal Health Policy Board, patterned after the Federal Reserve Board, whose members will have long and staggered terms, and create regional, state and local boards and advisory committees that will also have long, staggered terms.
2. Require the Federal Health Policy Board to:
   1. Select the comprehensive benefits to be provided.
   2. Calculate, separately, the national health costs per capita of those under sixty-five, those over sixty-five, and the cost of the limited benefits for which undocumented aliens would be eligible.
   3. Index the cost of living in each health care market area to the national cost of living, in order to determine the health care capitation rates to be used in each health care market area.
   4. Recommend to Congress the amount of the appropriation required to finance the program.
   5. Select benefits to be eliminated if the appropriation is inadequate to finance the entire program.
   6. Specify the mode for identification of patients - by an altered Social Security Card or by a separate Health Insurance Card.
   7. Request the National Governors Association to counsel with the Federal Health Policy Board to review the following proposals for State Health Policy Boards, with necessary infrastructure to:
      1. Receive and distribute the federal capitated fimds.
      2. Maintain a current register of each resident's choice of health care organization membership.
      3. Obtain and transmit necessary information between the Federal Health Policy Board, the State Health Policy Board, the Market Area Policy Boards, and the various franchised health care organizations. The assistance of the National Governors Association will help assure the best infrastructure and facilitate its accomplishment.

PUSH STRATEGIES WILL:

1. Avoid federal micromanagement of medical diagnosis and treatment;
2. Provide Congressional control of health care appropriations, and enable Senators and Representatives to demonstrate to their constituents their prioritization of health care and other costs;
3. Compel each competing health care organization to use (or change to) whichever medical, surgical or other diagnostic and therapeutic alternative may be most efficacious, thus increasing patient satisfaction and decreasing the health care organization's operating costs.

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