106. The United States Health Care System ꟷ My Contract
- T Michael White MD FACP
- 5 days ago
- 6 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)
******
1106. The United States Health Care System ꟷ My Contract
“We are all in a social contract.
Whether we like it or not, we live in each other’s good graces”.
John Popper
The WhiteHouse on the Belleair Bluff
Saturday, November 22, 2025
Dr. Mike,
A letter to the file…
You are now a full-fledged, card-carrying, member of the United States Health Care
System (USHCS). To join, you signed a contract. Now that you have had significant experience with care, go back and consider that which you have agreed to…
******
My (Unique and Very Personal) United States Health System Care Contract
Greetings:
Your signature below signifies that you understand and agree to the following
regarding your United States Health Care System (USHCS) Care contract. To assist your
understanding, please chat with ChatbotUSHCSFAQs.com for clarifying answers to your
questions.
In a perceived true medical emergency, always immediately call 911.
The United States Health Care System (USHCS) is a United States government process that creates the infrastructure that provides qualifying residents of these fine United States universal access to affordable, basic, compassionate, safe, timely, efficient, effective, equitable/just, patient-centered care (ABC-STEEEP).
Your United States Health Care is administrated by an ascendant regional health care system (Boca Ciega Bay Health Care System) that meets the following stringent United States Health Care System (USHCS) criteria:
Not for profit;
Fiscally sound;
Sponsor of an ascendant, nationally recognized 5-Star rated Medicare Advantage Plan:
That provides public health, primary care (including behavioral, obstetric
and pediatric care), urgent care, emergency care; specialty and sub-
specialty care; home care; hospice care and prescription plan. That proffers external regulatory-body evidence (for example, The Joint Commission) of consistent provision of compassionate, safe, timely, efficient, effective, equitable/just, patient-centered care (ABC-STEEEP);
That proffers external regulatory-body evidence (for example, Leapfrog
Hospital Safety Grade) of superb clinical, quality and safety, and patient
and provider satisfaction scores;
That participates in a USPHS process to identify, address, adjudicate and
compensate patients who have been avoidably harmed; and
Passes a stringent USHCS forensic auditing process that identifies ethical
fiscal practices and prevention of duplication of services, fraud and abuse.
The Boca Ciega Bay Health Care System meets or exceeds all requirements and, in fact, serves as the paradigm for USHCS regional health care systems.
The United States Health Care System (USHCS) replaces all other government health care programs (for example, Medicare, Medicaid, CHIPs, Veterans Administration, etc.).
The United States Health Care System (USHCS) addresses affordable, basic,
compassionate, safe, timely, efficient, effective, equitable/just, patient-centered care
(ABC-STEEEP). It does not address domiciliary considerations (i.e., room and board).
The United States Health Care System (USHCS) is supported by personal and corporate income taxes and is funded by the United States Treasury. The USHCS is required by legislation to function deficit free.
The United States Health Care System (USHCS) is designed to protect qualifying
individuals from incurring devasting health care bills that erode 1) personal (and family) education, food, health, housing and transportation securities; community security; and national security.
By signing below, you will voluntarily enroll in the United States Health Care System
(USHCS). It is ready (cradle to grave) to serve you. Importantly, enrolled, you are not
required to use it.
If you desire to purchase additional supplemental health care insurance (or
otherwise fund your personal health care) you are free to do so. For clarification: 1) the United States Health Care System (USHCS) will not be responsible for any charges incurred; and 2) your tax dollars will continue to support of the United States Health Care System (USHCS).
As you enroll in the USHCS you have been made aware and agree.
Enrollment is a privilege; and
The privilege is accompanied by a responsibility for you to actively participate
in preserving your health and facilitating your care. By signing below, you are
agreeing to consider your health care as your job #1 ꟷ a job that requires you to
be dedicated to being informed about and involved in your health care.
How does the United States Health Care System (USHCS) work? Basically:
From day one you have access to affordable, basic, compassionate, safe,
timely, efficient, effective, equitable/just, patient-centered care (ABC-STEEEP).
Your coverage is portable throughout the United States and Territories.
Recognizing no man/woman can be an island, depending on your personal
circumstance (age, computer literacy, education, hearing, vision, etc.) you may,
from time to time, need support from significant others (family, friends,
etc.) to take full advantage of your United States Health Care System (USHCS).
Your primary computer/phone contact will be (you may choose to assign your
expert a personalized nickname) Osler (a male voice), Nightengale (a female
voice) or Robot (an electronic voice) ꟷ your caring, expert, personable USHCS
Artificial Intelligence (AI) Center 24/7/365 starting point. This resource will
efficiently assist you to 1) longitudinally organize and manage your care; and 2)
begin to address your acute care needs (remember in a perceived medical
emergency always immediately call 911).
Your vital signs (temperature, respiration rate, heart rate, pulse oxygen and
weight will be readily monitored electronically. This will provide powerful
immediate clinical information in real-time and (diminish the need for many
routine office visits).
Local pharmacy-based public health resources will address routine health
maintenance issues such as vaccinations/immunizations and cancer (breast,
colon and prostate) detection.
Local pharmacy-based public health resources will provide privacy, phones
and computers for you to schedule at your convenience should you need
access to these resources.
You will choose or be assigned an age, gender and chronic condition appropriate physician-directed Primary Care Team (your gatekeeper) whose office will skillfully (with your USHCS AI Center support):
Maintain your up-to-date, accurate personal medical record;
Manage your longitudinal care;
Address your acute care concerns;
Triage your care (as appropriate) to virtual, Primary Care Team office,
urgent care, emergency medicine; hospital; specialist consultation; home
care; and/or hospice care;
(With USHCS AI Center pharmacy support) manage your medications;
Continuously educate you regarding (specific to you) health care issues.
Many interventions that traditionally require physical office visits will be
addressed efficiently and effectively through convenient, efficient, real-time
virtual interactions.
As mentioned, each patient will be assigned to an appropriate Primary Care
Team. Patients with complex chronic conditions (for example, cardiology,
endocrinology, oncology, nephrology, neurology, rheumatology) that dominate
their care needs will be assigned to a Primary Care Team that has advanced
expertise in addressing the longitudinal care of their specific chronic condition.
Importantly, habitual noncompliance with care on your part will be investigated and measures to ensure compliance will be designed and implemented. In the event of habitual noncompliance, you may be assigned to a Primary Care Team with expertise in such matters. If, despite best efforts, inveterate, habitual noncompliance persists, in rare circumstances, persistent abuse of privilege may be considered as grounds for dismissal from the United States Health Care System (USHCS).
Beyond taxes, will you have out of pocket expenses?
To ensure judicious/thoughtful use of services on your part, certain
services (for example, urgent care) will require a modest co-pay;
For clarification, there will be no deductibles or co-insurance;
You may choose to purchase, for a modest fee, supplemental USHCS
basic dental, hearing and vision insurance;
As mentioned, your USHCS coverage is portable throughout the United
States and Territories. mmYou may choose to purchase, for a modest fee,
supplemental USHCS travel insurance to cover emergency care when you venture beyond prescribed borders.
You will encounter out-of-pocket expenses if you:
Independently engage treatments beyond the scope of the United
States Health Care System;
Independently engage in care not authorized by your Primary
Care Team; and/or…
Insist on care which, after careful expert ethical review, is deemed
unnecessary and/or futile.
As previously mentioned, you may purchase supplemental insurance for
or otherwise fund exceptional care beyond the scope of the United States
Health Care System (USHCS).
This brings us to your signature. The United States Health Care System (USHCS) looks forward to serving you….
Ideally, once you have agreed and submitted this signed contract, please, at your convenience, begin to chat with your preferred expert Chatbot (Osler,
Nightingale or Robot) who will be pleased to hear from you and will efficiently
move your care forward.
However, your first encounter may be the result of an acute care (accident
or illness) need.. No worries ꟷ all will efficiently fall into place.
Signature:_________________________________
Date:______________
******
Dr. Mike, based on your review of this contract and your experience to date, this is all
making sense. Admit it sir ꟷ although by design it is not all things to all people, even you find yourself a bit impressed.
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
102. The United States Health Care System ꟷ Enabling Legislation
103. The United States Health Care System ꟷ View From Space
104. My (Unique and Very Personal) United States Health Care ꟷ Getting Started
105. My Semi-annual Primary Care Team Visit
106. The United States Health Care System ꟷ My Contract
(more to follow)
Comments