Article 103. Proposed Implementation Plan for National Health Care System

Proposed Implementation Plan for National Health Care System

The plan is to implement the National Health Care System (NHCS) in stages as it gradually becomes the nations primary health care system.  The plan also separates rural health care from urban health care to accommodate the needs of the nation.

We will combine the VA health care system with a new Catastrophic Health Care system (a government run system) consisting largely of Medicaid and with Medicare in the second stage.  Remember if you have an efficient effective VA program then no private health care company can compete with it because private companies must make healthcare run more efficient than government healthcare. If they can’t do this then there are no profits. If there are no profits in the healthcare system private systems will just drive up the cost of healthcare to get profits. Our Healthcare costs double that of European government health care and they are not efficient.

I call our current Health Care system a fraud based system because it is largely funded by fraud compared with a Government Health Care system monitored by Lean Teams. The best example of this type system is the Cleveland Clinic which has implemented Enterprise Lean Teams.  See Article 101.

Stage 1.  The Startup Stage
As a government run system the current VA health care system may be worse than that of European health care but they both have the same problems: massive bureaucracy, low efficiency, high patient backlogs and uncontrolled costs.   My approach fixes nearly all of the VA’s health care problems.  Europe does not have this approach yet.  If we can fix the VA problems  then this approach will work for a complete US government run healthcare system. Stage one is to implement this new efficient approach using Enterprise Lean with a new government management system through out the VA System.  See Article 104 and 96.

The government will begin to acquire hospitals under financial stress at little to no cost.  I emphasize that the government is not in the business of buying hospital facilities.  The reason is that the operation of government hospitals will be significantly less than that of private hospitals who will not be able to compete with the efficient government hospitals.

Medicaid patients will share VA facilities and the acquired private hospitals.  They will be slowly moved from private hospitals to the Catastrophic Health Care system. VA patients will be served before Medicaid Patients.

Stage 2. Medicaid and Medicare Patients moved to Catastrophic Care Facilities
In addition to the continuing acquisition of private Hospitals new Eye clinics will be acquired or built in urban cites of over one hundred thousand population to perform mass Cataract Surgery.  This a significant cost saving of over ten times the current approach.

As this stage progresses Medicaid patients will be served first followed by Medicare Patients in the Catastrophic facilities.

Stage 3. Accommodation of Patients without Health care Insurance
Regular Health Care Patients without Health Insurance will be allowed to use the Catastrophic Health Care Facilities as they become available.  These Patients will be required to pay for their own health care but at a cost of about 20% less than in the private sector.   This is a key element of the National Health Care System (NHCS).

Stage 4.  The National Health Care System will be Available to all Americans
The expanded Catastrophic Health Care system (called NHCS) will be available to all Americans. Health Insurance Companies will gradually require that patients move to the less expensive NHCS.

Some Private Hospitals may still be available for those who want them.

The NHCS Rural Health Care System
Small Clinics should be built in towns of about 10 thousand and about 25 miles apart.  The Clinics will be of the following design: They will be built adjacent to a fire station with ambulances. They will be 24-7 Emergency Clinics with a few over night beds and a helicopter port.  Some designs may have more beds.  Besides doctors and nurses this system depends on volunteers from within the community.

Besides an Emergency function the clinics can serve as place for state wide traveling Cataract Surgery teams to do Cataract Surgery.   The clinics can also service a traveling Dialysis Van for patients in remote rural areas.