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Monday, July 8, 2013

If you had the chance to do it all again...

... how would you design a national healthcare system?

How would it be paid for?

What would the various roles of the various stakeholders be?  Ignore traditional healthcare titles and borders for the most part (e.g., doctor, nurse, hospital, clinic, payer, pharmacy, et cetera), but include the other members of society (governments, employers, people).

Who would be the professional members engaged in healthcare delivery?  What other roles would they also have?

How would services and supplies and equipment be developed and distributed?

Who would be in charge of its governance?

Think really big, and really long and hard.  Be very creative.  Ignore existing limits and boundaries.

Work through a few scenarios, including routing care, emergency care, catastrophic illness, normal illness, health and wellness, all the rest.  What does it look like.  Change it around until you think you like it.

NOW.  How would we get there?  What are the steps?

OK, you have the next 10, 20, 30 ... 50 years.  Don't tell me your plan.  Just do it.

1 comment:

  1. As an enlisted medic in the sixties, I came to realize the importance of continual education, training, drills and the division of labor in healthcare delivery. My peers and I would perform triage, take vitals and histories, treat the patients we were allowed to, send the rest up the line to increasingly more trained delivery professionals (nurses, doctors.) So the big change I would advise, spend limited funds on point of delivery and far less on IRS agents to collect premiums. The other big change is to consolidate the 55 or so state and territory Medicaids into a single operation under federal laws instead of states. There is no reason to develope expensive billing software 50 times over.