Here are the principles I believe we should use to shape our healthcare system:
1. Empower patients. Patients should be the masters of their fates. To help them, we must coordinate the messages they are getting about their health. Instead of a mix of messages from the American Heart/Cancer/Diabetes/etc Association, the Academy of Nutrition and Dietetics, the Centers for Disease Control and Prevention, the Department of Agriculture, and so on, let us create a single portal with clear, evidence-based information.
Diabetes, heart disease, sarcopenia, and cardiac disease are causing so many of the problems we see in our patients. We can empower patients to lead healthy lives, taking advantage of technology such as biosensors that connect to smartphones and activity monitors that measure how much you walk, helping them focus on performance and prevention.
2. Expand access. Right now we are talking about whether people with preexisting conditions should be able to buy health insurance, and how long kids should be able to stay on their parents’ health insurance plans. Let’s keep it simple: Everyone should be able to buy health insurance. Period.
3. Centralization. The market for healthcare coverage should not stop at state borders. In Maryland, the Shock Trauma Center at the University of Maryland, a single integrated trauma hospital, cares for people in Maryland, New Jersey, parts of Pennsylvania, and beyond, and they do it much better than anyone else. Everywhere else, gunshot victims may be treated in one place, car accident victims in another, and so on. The University of Maryland is the model for ultimate specialization in regional Centers of Excellence.
Similarly, if you could sell insurance over state borders, instead of insuring 1 million people in each state you could insure 100 million people across states. That would increase the risk pool, attract more insurers, and bring down the cost.
By Bert R. Mandelbaum, MD, DHL (Hon) | Medscape
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