108A. Charley Price’s Prologue ꟷ We Must Start Anew
- T Michael White MD FACP
- 1 hour ago
- 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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108A. Charley Price’s Prologue ꟷ We Must Start Anew
“It should be one's sole endeavor to see everything afresh and create it anew.”
Gustav Mahler
The WhiteHouse on the Belleair Bluff
Sunday, November 30, 2025
Dr. Mike,
A letter to the file…
Over the years, your first rule of educating has been to keep it interesting ꟷ as a teacher, you are in the entertainment business. On Tuesday, you will speak to a room of national leaders, each experiencing perfect health care, and speak to
https://www.fixingushealthcare.com/. Good luck with that.
So, you need a hook. Totally modern, they are all into Artificial Intelligence. Querying
the status of our country’s health care AI politely reports:
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Thanks for asking…
The US healthcare system ranks last overall compared to other high-income countries in key areas like access, equity, and health outcomes, despite spending more on healthcare per capita than any other nation. While the US performs well in specific areas like patient-centered care and pandemic response, it consistently underperforms in equity, administrative efficiency, and long-term health outcomes such as life expectancy. Rankings by specific category:
Overall: Last place among peer nations in a comprehensive 2024 report.
Access to care: Ranks last, with high rates of adults not seeking care due to cost.
Health outcomes: Ranks last, with lower life expectancy and higher rates of preventable deaths and maternal mortality.
Equity: Ranks last in health equity, with significant disparities between high and low-
income individuals and racial and ethnic minorities.
Administrative efficiency: Ranks last due to high costs and time spent on paperwork
and insurance disputes.
Care process: Ranks near the top for areas like preventive care and patient engagement.
Have a nice day...
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A pretty good start ꟷ but better to engage a corporate President/CEO as a warm-up band:
We Must Start Anew
By Charley Price
“It should be one's sole endeavor to see everything afresh and create it anew.”
Gustav Mahler
Dr. Mike White and I go back aways ꟷ way back. It has been a good ride.
So, when he asked me as a corporate executive to submit a prologue to his Fixing United States Health Care ꟷ Letters to the File: 1) I was delighted; 2) I knew just what I would say: this important, meaningful work by this award-winning (The National Quality Forum/The Joint Commission Eisenberg Award) author is worthy of your attention; and then 3) I would crunch a few numbers and share my corporate executive view of health care with you.
But, as man plans God does laugh.
With my deadline approaching (I’m a deadline kind of guy), I had a serious bike accidentꟷ my clavicle and ribs had seen better days. And the incident essentially wrote this prologue. When my shoulder violently hit the pavement, I may have been one of four guys in my corporation (all receiving state of the art care):
A senior executive consultant with Medicare. Annual premiums $2400. Hospital
charges $110,000. Recognized charges (after magical insurance/hospital Kabuki Dance) $15,000. Medicare pays $12,000. I only owe (co-pay and co-insurance) and happily pay $500. My co-pays for follow-up care will be minimal.
The company’s P/CEO with employer-sponsored health care. Premiums for wife and self $14,000/year. Employer subsidy about $28,000/year. Similar hospital numbers to above. My share (co-pays; deductibles; co-insurance) is $8,000, which I can comfortably but unhappily pay. It feels like I am insured until accident or illness intervene. Good news ꟷ I have met my annual out of pocket max and most follow-up care will be covered. Bad news, the numbers will reset January 1 st .
The company’s junior executive. Similar numbers to the P/CEO. However, life’s realities (education loans, mortgage/rent, car payments, day care) make $8,000 out-of-pocket almost insurmountable. Suddenly, my family’s education, finance, food, health and housing securities are in jeopardy. I fear what the new year may bring. I realize I am not insured unless I am protected by Medicare and/or personal wealth.
The company’s new line employee who will not qualify for health insurance for six
months. Fearing, uninsured, I may face full charges (no magical hospital/insurance
Kabuki Dance performed), I frankly do not want to even begin to think about it.
My executive conclusions ꟷ as one responsible for the employees entrusted to me, I
have grave concern. Increasing numbers of our citizens are or nominally insured or uninsured. Each day, personal, community and national securities are in jeopardy. Our United States Health Care (non) system (Dr. White’s Hot Mess) has failed us. It cannot be tweaked into functionality. We must start anew.
Starting anew, we can do better. We must do better. (450 words)
Respectfully submitted,
Charley Price
President Cox’s Wholesale Seafood LLC
Tampa, Florida
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Enough (so well) said.
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
107. ‘Medicide’ ꟷ Failure to Make Whitefish Bay (A Fiction)
108A. Charley Price’s Prologue ꟷ We Must Start Anew
(more to follow)
