The Health Care Revolution: Making the Mess of Today Into The Best Care of Tomorrow

Executive Summary

Our health care system in the United States is unsafe, difficult to access, and often times not compassionate. Various factions in the health care industry and the lack of long range planning have contributed significantly to this unfortunate circumstance.

This paper explains how these factions integrate and have brought the health care system to its' present situation. It then offers a plan of what we as a nation need to accomplish to establish a fair and cost effective health care system that covers all Americans. Finally, it addresses how each faction of health care will operate in the new health care system.

Fundamental actions that serve as the basis of the new health plan include the following: Now through year 5:

1. Dedicate $1 5 billion per year over five years to develop, install, and test a national electronic medical records system on an isolated network not associated with the internet. Basic clinical decision support systems should also be integrated and utilized in the system. The money for this program comes from government initiatives.
2. Begin intense public education about the effects of lifestyle issues on health and begin education on the manner in which our health care system will change in the next 15 years. Emphasize that, eventually, life style risks will play a large role in how services are offered and who pays for them.
3. Allow the opening of medical savings accounts in which people or their employers can deposit up to $1 0,000 per year on a tax deductible basis.
4. Insurance companies begin actuarial analysis on using lifestyle risk factors in determination of premium rates.

Year 5 through year 10:

Commence nationwide use of an electronic medical record with basic clinical decision support systems. Continue development of more advanced clinical decision support systems that are to be embedded within the electronic medical record system.
 

Cover uninsured with a basic care package focusing on preventive health care and care consistent with evidence based medicine guidelines. Money saved from the use of the electronic medical record system (minimum $100 billion per year) will finance this initiative. Gradually transfer Medicaid, Medicare, and armed services to this package by year 10. Continue intense public education about the effects of lifestyle issues on health and begin education on the manner in which our health care system will change in the next 15 years. Continue stressing that eventually, life style risks will play a large role in how services are offered and who pays for them. Offer covered interventions to assist with lifestyle changes that affect health.
 

Patients covered by private insurance are gradually offered the basic health care plan until all individuals in this country are covered. Fee for service insurance is gradually replaced by indemnity policies that can be used for care not covered under the basic health plan. Change medical education to six years combined undergraduate and medical school training. Begin institution of required two year residency training in primary care in the community setting focusing on history taking, patient communication, physical exam, and use of clinical decision support systems. Primary care practice can begin after this residency, or further specialty training can be obtained.

Year 10 through 15:

1. Coverage of the entire population is now through the basic health plan. This will cover all preventive care, evidence based primary care, and all specialty care as guided by clinical decision support systems. Additional care desired or not covered can be obtained through private indemnity plans or through medical savings accounts.
2. Continue with interventions for lifestyle issues that affect health. By year 15, if the patient does not participate in these interventions, care for end stage processes will be limited unless the patient pays for this care through private means.

Back to top