The Health Care recommendations in this Blog are freely given to be used by the Federal government and the States with only the acknowledgement of its origins.
The Federal Government shall Repeal and Replace the Affordable Health Care Act with the following new National Health Care System (NHCS). The Federal Government shall immediately cease payments to Health Insurance companies. Block Grants may be given to States instead.
Key Characteristics of the National Health Care System (NHCS)
- The NHCS covers all Medicaid Patients and eventually all Americans
- No one will be required to purchase Health Care Insurance but those who can afford it will be required to pay for their own health care or acquire insurance.
- Catastrophic Health Care will be funded by savings from elimination of waste in the current Healthcare system and in the Federal governments operations.
- Catastrophic Health Care will not be funded by individuals purchasing Insurance.
- Insurance Companies will return to their practices before the Affordable Care Act.
The Role of the Federal Government, the VA and the States
The Federal Government will implement the NHCS by supporting each state’s acquisition and conversion of hospitals to the NHCS requirements. Ref: Articles 109,110.
The Veterans Affaires Hospitals will be reformed to make them more efficient. Veterans will also be able to use the new NHCS state hospitals.
Each State will acquire, reform and manage hospital acquisitions for the NHCS. This will begin in its larger cities where the largest number of Medicaid recipients live. Ref: Articles 107,109,110.
Proposed Implementation Plan for the National Health Care System
The plan is to implement NHCS (by changing from a private based system to a government based system) 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 allow the VA Health Care system to use the NHCS consisting largely of Medicaid and Medicare in the first stage.
Savings
The savings resulting from switching from a Private to a Government System is estimated at 60% of current costs. Medicaid savings is expected to average $1billion for each state. Due to the increased efficiency of the NHCS staffing and
hospital facilities can be reduced by 20% or more in larger cities. General Hospitals in rural areas will be less affected because of low patient volume.
If you have an efficient effective Government Run Health Care system 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 private system they will drive up the cost of healthcare to get profits. I call our current Health Care system a “fraud based system” because it is largely funded by fraud. Our Fraud Based Healthcare system costs double that of European Government health care systems and even they are not efficient. The present fraud based system cannot be fixed and it is best scrapped as the most costly mistake ever made in health care.
Stage 1. The Startup Stage Beginning January 2018
Each State Government will begin immediately to acquire General 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. At least one General Hospital will be acquired by the state in each major city in stage 1.
The Hospitals will be reorganized in the following manor:
General hospitals do nearly all Procedures with low patient volume and at high cost. The New hospital design I am proposing is exactly the opposite: wholly independent routine procedures with high patient volume at the lowest cost. Procedures which do not meet the following criteria will remain in the General hospital system with Urgent Care. Ref: Article 110.
Criteria for the selection of Procedures:
Repeatable processes with the same time for all patients (relatively routine)
Sufficient Patient Backlog for Continuous operation
Daily Plan efficiently designed by each Lean Team
Balanced Operations (no one waits on others to do their jobs).
Veterans will share NHCS hospitals with Medicaid and Medicare patients
Lawrence Rosier Principal Consultant is making the following proposal to States:
In the interest of quickly bringing my recommended reforms to as many States as possible allowing them to benefit in massive savings in regular State Government activities, and in Medicaid and Medicare health care. Saving To each State 60% of current Medicaid hospital costs or an average of $1billion per State.
Each participating State will work through Lawrence Rosier Consulting (to prevent duplicated work) with other states in the development of shared efficiently designed Daily Plans by Lean Teams. This will allow up to 50 Daily Plans to be developed and implemented in the time it would take for only a few Procedures by an on-site Consultant. After review of each State’s developed Daily Plans for a Procedure by Lawrence Rosier Consultants it is made available for implementation to the subscribing States allowing for immediate savings to become available. This is a continuous process until all hospital Procedures meeting the criteria have been completed. Note that the new hospital operations do not require management scheduling and budgeting personnel. Ref: Article 109.
Stage 2. Medicaid and Medicare Patients continued move to NHCS
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 90% the current approach. Ref: Article 110.
As this stage progresses Medicaid patients will be served first followed by Medicare Patients to make sure of a continuous backlog of patients.
Stage 3. Accommodation of Patients without Health care Insurance
Regular Health Care Patients without Health Insurance will be allowed to use the NHCS 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 NHCS.
Stage 4. The NHCS will be Available to all Americans
The expanded NHCS will be available to all Americans. Health Insurance Companies will gradually require that patients move to the less expensive NHCS Health care system.
Private Hospitals will 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 rural traveling Cataract Surgery teams to do Cataract Surgery. The clinics can also service traveling Dialysis Vans for patients in remote rural areas.
Concurrent Reform of the VA Health Care System
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 including its management problems. This is the same approach that works for a complete US government run healthcare system. Start by implementing this new efficient approach using Enterprise Lean through out the VA Health Care System. See Article 104 and 96.
No comments:
Post a Comment