Chapter 3. Accessible, Affordable Care --- Financial Paradigm
- Mar 30
- 3 min read
Updated: Apr 20
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 health care thoughts directly address the clinical case presented in
Chapter 2 above: Accessible, Affordable Care --- Clinical Paradigm. As background, 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 living in a rural community 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…
His Mom pays a modest annual tax as a percentage of her income;
Her employer pays a modest annual tax as a percentage of corporate income;
A blue-collar kid received efficient, effective care without out-of-pocket expense;
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 --- expensively ‘insured’ when well and expensively uninsured if illness or injury should 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 efficient and
effective access to ABC-STEEEP;
Care as described eliminated a snowy > one-hour drive to an unprepared crowded emergency department that in previous years would have had a $200 co-pay.
Follow-up visits would have required $35 co-pays;
Deductibles would have to be addressed;
In this USHCS scenario, if meds had been required, they would have been included --- not so in prior years; and
The lad’s totally portable, up-to-date, accurate, legible and always available medical
record is a priceless gift to his ‘Better Angel’ care givers.
Far beyond this singular clinical and financial triumph, important implicit efficiencies can be enumerated: :
This mother’s energy and sanity were preserved;
The need for stormy early morning distant travel was abrogated;
The emergency department was unburdened;
Urgent care and primary care team care were facilitated;
Despite living in the North Country, their health care felt less rural;
This mother maintained full employment (and a precious full week’s take home pay);
Her employer avoided major staffing inconvenience --- no small consideration;
This boy’s return to school was immediate;
If traveling, the same (totally portable) care would have played out anywhere in the
United States and Territories;
This talented working mother is positioned to consider better employment (i.e.,
advancing her career) should the opportunity arise as her family’s (totally portable)
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 like theirs) is it is insured from the fear of facing insurmountable health care expenses that jeopardize career, education, finance, food, health, housing and retirement securities; and with this security, the downstream securities of our employers, our hospitals, our 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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