essential healthcare for everyone living in the United States, with each
individual having a medical home—a personal professional healthcare
what constitutes essential healthcare; essential describes needs and not
everyone in financially supporting universal healthcare
4. Provide financial incentives for reducing human
behaviors that drive up healthcare costs.
5. Provide financial incentives for health
providers to deliver essential high-quality and cost-effective care.
6. Educate users of healthcare systems with
information on cost and effectiveness and involve users in
the burden of health insurance costs for essential care from employers,
who at their discretion can provide supplemental insurance coverage.
8. Follow evidence-based protocols and procedures
for which all healthcare providers would be rewarded.
9. Standardize provisions of healthcare in order to
eliminate six fold differences in spending per capita between
geographical regions and hospitals with the knowledge given to users
that spending more for services does not result in improved outcomes.
10. Provide no funds to increase the already
oversupply of specialists. Provide for the number of family
practitioners needed to provide essential services for everyone.
11. Specific measures to contain
a. Change from private insurance with overhead costs of 30 percent to a
publicly funded program with overhead
costs of 5 percent.
b. Support evidence-based clinical guidelines and protocols that would
be followed for the delivery of high quality healthcare.10
c. Reduce costs and use of expensive
and nonessential or unproven technology.11
d. Pay only (or provide incentives for
use of) for services essential for quality healthcare and
established as effective on evidence-based research.12
e. Use more trained individuals to
perform services that physicians now perform.
f. Pay for only generic drugs unless
research studies prove a clear benefit for a non-generic drug.
g. Reduce the capacity of
infrastructure for healthcare provision to meet the needs and reduce the
number of specialists. Provide incentives for medical care providers to
practice in family or general medicine. “Multinational comparisons
demonstrate that countries with the best health system performance (as
indicated by longevity, infant mortality, etc) and patient satisfaction
have the highest percentage of physicians who are family physicians.”
The United States also has too many physicians and more specialists than
h. Centralize information centers and
sources. In addition to be information bases for verifying diagnostic
and treatment protocols acceptable for payment, such centers can be used
for specialist consultations and evaluation of test results such as
imaging studies that can be electronically sent for evaluation.
i. Based on evidence-based
protocols, establish healthcare budgets for medical problems. To spend
within a budget, healthcare providers and patients would have to make
choices regarding use of diagnostic and management procedures, intensive
care, hospitalization stays, and palliative care that are not
evidence-supported as effective or necessary and would exceed a budget
before essential services can be ordered.14,15 Data show that budgets
using such protocols can reduce costs more than 30 percent.
j. Reduce the level of errors that are unacceptable
for all other industry.16 The U.S. healthcare system is plagued by
widespread preventable errors, unnecessary procedures, and misused and
Educate patients on the cost and management of health problems.17
Healthcare quality is dependent on education that can begin early. This
must be taught yearly through the 12th grade. As a basis of practical
and applicable science, healthcare science must be comprehensive and
essential, with greater importance than the science information