CMStrogenic Abuses By Health Care Design
New language is needed to facilitate change. Health Care Designers must LET MY PEOPLE GO.
Freedom from Health Care Tyranny is needed across academics, research, policy, plan, and design.
It took 40 years for protections vs physician abusers and it took 50 years for Human Subject Research Protections. It may well take 50 years to understand CMStrogenic - or the harms done by health policies. The CMStrogenic harms are most easily seen to those least valued
Most Americans remain most behind because of health, education, economic and other policies. Health care and education designs send their providers and schools lower levels of funding.
In general most Americans suffer even more as they age, get sick, have a family member who gets sick, change jobs, or acquire medical debt - they suffer by US design. Each passing year the situations worsen for most Americans.
How Can CMS Be At Fault?
Historically CMS was created to support populations with concentrations of elderly and poor, and they did for a short time. Previous legislation such as Hill Burton also helped such communities. CMS was a supporter, but then reversed policies.
This started with posting about rural hospitals lining up for support funding. Yes, this was considered a major legislative victory - not hardly viewed from the lens of historical changes.
Look at the rural hospital history
Struggling to get started, rural hospitals lined up for Hill Burton funding. There were often many attempts to set up such hospitals in the 1940s, but the organization and financing were often too much.
After 3 tries, the first Hill Burton hospital made it to operation in Nowata OK in 1947. This hospital was a major source of health care, support for workforce, and economics for the community. But in 1983 the CMS implementation of cost cutting via DRGs brought on a reversal from support to mistreatment.
How is in possible that CMS can go from helpful to harmful in such a short time?
It took decades of Hill Burton and the first decade of Medicare and Medicaid to build up, and only a short time to tear that apart.
As it turns out, except for Hill Burton and the first decade of Medicare and Medicaid, the nation has never valued health care for most Americans most behind - across rural, across minorities, across 2621 counties most behind in workforce. The health insurance design reinforces the abuses shaping half enough basic health access where the elderly, poor, disabled, and worst employers are concentrated.
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For 100 years the US has avoided the path of all other developed nations with regard to health plans for all of its people. Patchworks have been developed and even those patchworks cause more harm to most Americans most behind
Only during this first decade of Medicare and Medicaid did the nation support the funding with billions more added specifically to counties most behind in finances, insurance plans, social determinants, employer quality, and inherently in health outcomes.
CMStrogenic changes for over 40 years have killed hospitals and practices where they can contribute the most to Americans most behind.
Research Abuses - There is often poor quality in quality research. This is because of the consistent failure to separate lesser outcomes from populations inherently behind in outcomes and so many other areas pertinent to outcomes and outcomes measures.
Since the 1980s attacks on rural and smaller hospitals were facilitated by flawed research that still fails to control for population differences - the ones that predominate in ways that clinical interventions are powerless to change for hospitals or practices.
Rural, small, low volume all have been castigated as poor quality and in need of closure - in error. At times flawed research has slurred generalists and those who serve minorities - only possible when the research perspective is subspecialty and out of touch with basic health access.
Our understanding of social determinants, situations, environments, and supports as key determinants of outcomes - exposes these policies, ratings, and research - as causing harm, worsening disparities, and moving America away from health equity.
In 2010 the situation has not improved and in many ways was worse in terms of workforce, access, and local economics arising from health care - a top 4 economic source for these counties.
NOTICE that when you harm economics, you harm jobs and social determinants and outcomes for the community - and yet CMS says they are there to help, to improve outcomes, to improve access - not hardly.
CMStrogenic Changes Consistently Impact the populations most behind that are growing fastest in population numbers, demand, and complexity
The impact has not just fallen on the 40 million rural Americans most behind (75% of rural). The consequences plague the 90 million urban people (32% of urban) in 2621 counties most behind. Rural and urban were joined together as just as behind by CMS design. Note that rural populations are stagnant (turquoise), while the 90 million urbans (Red line, read red states and counties also) are the fastest growing US population as more millions are forced to move from counties higher in workforce concentrations with spiraling costs of living and housing to go to counties less costly with half enough basic health access workforce.
Basic Health Access
1 年Stop the decline by health care design that has been destroying all sources of basic health access, particularly for most Americans with half enough primary care and mental health and women's health and basic surgical workforce.