Chapter 3. Accessible, Affordable Care --- Financial Paradigm
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From... Fixing United States Health Care --- Citizen Letters
T Michael White MD
Chapter 3. Accessible, Affordable Care --- Financial Paradigm
“Every single one of us deserves access to quality, affordable health care.”
Sara Gideon
July 4 th
Fine Citizens hello.
These financial thoughts directly address the clinical case presented in Chapter 2 above: Accessible, Affordable Care --- Clinical Paradigm. Please give it a turn.
Looking back, imagining the planned United States Health Care System (USHCS) to be up and running as carefully designed, tax-payer funded, single-payer, regional provider infrastructure, a significantly ill (viral myositis) young lad had access to and received immediate affordable, basic/necessary, compassionate --- safe, timely, efficient, effective, equitable/just, patient-centered care (ABC-STEEEP). A significant clinical success story for sure but the clinical implications are only a small part of the message. Benefits extend far beyond the clinical.
Please consider…
A blue-collar kid received care without out-of-pocket expense;
His Mom does pay a modest annual tax as a percentage of her income;
Her employer does pay a modest annual tax as a percentage of corporate income;
The year before the onset of the USHCS, the young family paid $900/month in
healthcare premiums ($9,800/year) and faced co-pays, co-insurance, an $8,000/year
deductible and $16,000/ year out-of-pocket maximum. Each day the family confronted The Great American Health Care Paradox I --- expensively ‘insured’ when well and expensively uninsured if/when accident/illness would intervene;
The care was provided by a 5-Star regional health system based in Albany devoted to universal citizen access to ABC-STEEEP. Facilities include rural centers; regional
hospitals; a university children’s hospital; and a university (quaternary care) medical
center;
Carefully supervised artificial intelligence functions enabled 24/7/365 effective access to ABC-STEEEP;
Care as described eliminated a crowded emergency department visit that in previous years would have had a $200 co-pay. Follow-up visits would have required $35 co-pays;
If meds had been required, they would have been included --- not so in prior years;
The lad’s portable, up-to-date, accurate, legible and always available medical record is a priceless gift to care givers; and
Implicit efficiencies were realized:
Mother’s sanity was preserved;
The need for stormy early morning distant travel was abrogated;
The emergency department was unburdened;
Urgent care and primary care team care was facilitated;
The mother maintained full employment (and a precious full week’s take home
pay);
Her employer is smiling;
Return to school was immediate;
If traveling, the same care would have played out anywhere in the United States
and Territories;
The talented working mother is positioned to consider better employment
should the opportunity arise --- her family’s health care insurance is not
employer dependent; and most importantly…
Enlightened planned infrastructure design eliminates abuse, bureaucracy,
duplication, fraud, greed, inattention and waste and enables universal citizen
access to ABC-STEEEP.
All good. However, the main advantage for this family and for millions of other
American families is they are insured from the fear of facing insurmountable health care
expenses that jeopardize family career, education, finance, food, health, housing and
retirement securities. With their security, the security of hospitals, communities and our nation are enhanced.
Respectfully submitted,
Dr. Mike
Please share your perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you as your insights will significantly enhance my efforts. Importantly, if/when a message rings true, please forward it to those you deem may desire to know. TMWMD
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