101. Introduction to Part II ꟷ The Solution
- T Michael White MD FACP
- Nov 13
- 4 min read
Fixing United States Health Care - Letters to the File
Part I. The Hot Mess
Part II. The Solution
by
T Michael White MD FACP
The Realization of Universal Access to ABC-STEEEP
(Affordable, Basic, Compassionate - Safe, Timely, Efficient, Effective, Equitable/Just, Patient-Centered Care)
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101. Introduction to Part II ꟷ The Solution
“Every great and deep difficulty bears in itself its own solution.
It forces us to change our thinking in order to find it.”
Niels Bohr
The WhiteHouse on the Belleair Bluff
Wednesday, November 5, 2025
Dr. Mike,
A letter to the file…
In undertaking Part I of Fixing United States Health Care ꟷ Letters to the File (The Hot Mess), your goal was to research and then articulate 1) that which is good about our fine country’s health care; and 2) where there is concern for our health care and room for
improvement. The Part I process, which provided feedback from many, has led you to
conclusions that enable this Part II ꟷ The Solution. Your Part I, The Hot Mess, observations:
The fine citizens of the United States require and deserve universal access to ABC-
STEEEP (affordable, basic compassionate, safe, timely, efficient, effective,
equitable/just, patient-centered care). Currently this requirement is not being
addressed.
Without planning or oversight (i.e., without leadership), America’s health care is a non-system that has evolved into an inefficient, inequitable, chaotic, hot mess.
America’s health care is a disturbing, unjust paradox. Some, like yourself Dr. Mike, are
positioned to receive superb, comprehensive complex care. Others, in increasing
numbers, lack access to even basic care.
Care is becoming more expensive for all. Excess expense is increasing the numbers
without access to ABC-STEEEP. Even the privileged likes of you, Dr. Mike, have begun to avoid or delay necessary care because of expense.
In general, beyond those protected by Medicare and personal wealth, health care
insurance has become a criminal sham. Premiums themselves are quite dear. When
significant illness or accident intervene, co-pays, co-insurance and deductibles become immediately insurmountable. This painful paradox now exists ꟷ insured when healthy but uninsured when significantly ill.
Lack of access to affordable health care impacts more than health. When significant
accident or illness intervene and care is unavoidable, the expense of care (the bill) is
increasingly eroding our fine Americans’ career, education, finance, food, health,
housing and transportation securities.
Our chaotic health care non-system does not just victimize patients. Our young
professionals in training; our dedicated physicians, nurses and therapists (our ‘Better
Angels’); our dedicated health care institutions; our fine communities; and our proud
nation’s economy and security are in jeopardy because of organizational inattention and the resultant disarray of health care.
The leaderless health care non-system that has evolved is 1) fiscally inefficient; 2)
robbed by profit taking and greed; and 3) victimized by duplication, fraud and abuse. Precious resources that should enable a solution are routinely being extravagantly wasted.
There is a new, pernicious, evil beast on the prowl. Instead of addressing our chaotic
health care non-system, politicians without public health medicine prerequisites are
choosing to actively undermine our nation’s public health medicine infrastructure. This will only increase pain, suffering and need for care and make our dire situation worse.
Dr. Mike, when you first soldiered forward to advance ABC-STEEEP, you felt very much alone. Now, you realize that you are no longer alone. Most sentients, though remaining silent until approached, are well aware. Their reasons for silence? 1) Some perceive their care is just fine and not in immediate jeopardy ꟷ the I got mine syndrome; 2) some, aware that the health care sky is falling, are deeply alarmed but are paralyzed by a sense of futility ꟷ the nothing can be done syndrome; and 3) some, brutally disillusioned by the realization that our fine country would treat its fine citizens this way,, are overcome with sadness ꟷ the broken-hearted syndrome.
And then there is you…
Dr. Mike, 1) you recognize and articulate the health care problem; and 2) you, like Niels Bohr, are confident that every problem has a solution. Your diagnosis ꟷ the United States health care (non) system is a hot mess. Your prescription (RX) ꟷ great simplifying
leadership (as described by Colin Powell, “Great leaders are almost always great simplifiers, who can cut through argument, debate and doubt, to offer a solution everybody can understand.” Your solution ꟷ like airports, bridges, the electric grid, highways, ports, and waterways ꟷ universal access to ABC-STEEEP must be infrastructure funded by The United States Treasury.
Individual, family, institutional, community and national security require infrastructure that enables universal access to ABC- STEEEP ꟷ to affordable, basic compassionate, safe, timely, efficient, effective, equitable/just, patient-centered care.
Respectfully submitted with fondest personal regards,
Dr. Mike
You may leave an anonymous comment without username and email ꟷ please do. Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you as this draft and subsequent chapters will be significantly enhanced.
Dr. Mike
Letters to the File ꟷ Part II
101. Introduction to Part II ꟷ The Solution
(more to follow)
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