Healthcare Solutions^1-5

1. Provide essential healthcare for everyone living in the United States, with each individual having a medical home—a personal professional healthcare provider.1
2. Establish what constitutes essential healthcare; essential describes needs and not demands.8,9
3. Involve 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 decision-making.
7. Remove 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 healthcare costs:
   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 needed.13
 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 underused services.
k. 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 currently taught.