We need an actual health system, not disease profit centers

Health and health care are too important to each of us, our country, and our businesses. We are paying way too much for a dysfunctional system. There is a uniquely American solution to this- making health care an adapted Public Utility. The state based regional systems would no longer be "competitve" with each other. They could negotiate equipment and supply costs, they could help each other when disasters strike. Yes, they could also negotiate drug prices, something Congress can't do thanks to Part D Medicare.

The advantages to this system design are overwhelming. No more insurance, no more copays, no more deductibles, no more medical bankruptcies. We reduce health care costs by 42% nationally. Every community will have access to health services, including as many social and economic determinants of health that a system could address. Having a footprint in every community allows us to entrain other assets in, internet, trade schools, college access, state agriculture and other business assets. The goal is to have actual healthy communities, rural, suburban, and urban.

Many have asked for a better understanding of this model, so here is the outline:

Goals

·?????? Equitable, targeted, data driven evidence based access appropriate to every communities needs

·?????? Quality evidence based care

·?????? Equitable, targeted, and evidence based distribution of resources

·?????? Interdisciplinary practitioner led administration so that the system is congruent with their values and maximizes their skill sets

·?????? Equitable and positive outcomes

·?????? Cost efficiency

·?????? Social accountability and a mandate for direct public reporting

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Organizational Design

·?????? State based regional systems

·?????? All healthcare services

·?????? University Medical Center based Regional Councils (Interdisciplinary) Chaired by Nursing

·?????? Direct affiliations with Public Health, EMS, University

·?????? National Central Advisory Council (Interdisciplinary) housed in HHS- apolitical and elected from State regions for 5 year terms

Community focused distribution of resources based on need and data.

Operational Control

·?????? Central Advisory Group provides recommendations to the state regional systems and disseminates best practices

·?????? State regional Councils directly supervise other large hospitals

·?????? State regional Councils also supervise healthcare to rural areas

·?????? Interdisciplinary advisory group consults on long term care, nursing homes

·?????? State regional councils coordinate distribution of resources in conjunction with Public Health

·?????? Large hospital councils supervise all other hospitals in their region

·?????? Large Hospital councils also supervise all other medical providers in their region and within their specific areas

·?????? All hospitals are led by Nursing as the Chair of their councils (interdisciplinary)

·?????? State Regional Council chairs are elected by the facility nursing councils for 5 year terms

·?????? Large hospital nursing leaders are elected by all the nurses in their region for 3 year terms

·?????? All councils have a direct tie in to Public health, academia, and EMS

·?????? All specialty medical groups will have their own open meetings to foster communication

·?????? Facility leadership will also meet with LPN’s and CNA’s regularly to discuss issues.

State Based Regional System Advantages

·?????? Maintains focus on community level care while providers focus on family/individual health services

·?????? Allocates resources based on community needs

·?????? Regions can join together for increased purchasing power

·?????? Regions can cooperate with other regions in emergencies

·?????? Regions can share resources

·?????? Regions maintain holistic focus on service by serving urban, suburban, and rural areas- NO community left behind.

·?????? Respects State-Federal boundaries

·?????? Regions have fiduciary responsibility for their own budgets

·?????? Regions have flexibility for innovation in the delivery of services, and since they are non-competitive, can share best practices

·?????? Regional approach allows financing based on service provided, not procedures

·?????? Regional approach allows for direct, real time cooperation and communication with Public Health and Academia

·?????? All regional system facilities and services become open to both research and practitioner education

·?????? Regional system assumes all malpractice liability for all providers, but also institutes, maintains, and empowers peer review process

·?????? Regional system provides a known and trusted voice for healthcare issues in the communities they serve

·?????? Regional system uses public health data, Nursing community Assessments, and evidence based best practices to determine allocation of resources and distribution of personnel.?

·?????? Regional system can offer tuition reimbursement for providers in areas of need