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Just A Thought

November 27, 2013

I never intended this to be a spot for political ideology, and I am certainly not a blovious orator over our politics. I am a business strategist by day, and there has been something nagging at me for some time regarding the most recent and divisive conversation about health care in our country. More specifically, about how the president is approaching a solution to universal health care, or whatever the goal is. I promise this is not a finger-pointed slam against anyone, but rather a small idea that I just think could be successful given some time and attention. Here goes.

The more I learn about the current Affordable Care Act, the more it appears our government is assuming the role of an insurance broker. The idea seems to be that if everyone has insurance, then their health care could be covered. By passing laws that require everyone to get insurance, and insurance companies to provide coverage, the only part left was to facilitate that transaction – hence the exchanges being touted by the White House. This leaves me scratching my head in befuddlement since it does nothing in the medical arena. It’s just insurance, and we all have experienced some of the under service when our doctors are inaccessible; or their decisions are railroaded by policies, and then they are just plain underpaid for their services and can’t stay in business or provide quality service.

There are a number of pieces to this puzzle over there across the room that no one has really discussed at length in public. First I’ll just bring them up, and then, hopefully, tie them together. Our government is currently responsible for 56 military hospitals and 365 military clinics serving 9.7 million beneficiaries; and today, nearly 1,200 health centers operate nearly 9,000 service delivery sites that provide care in every state, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific Basin. Also, our government manages the National Health Services Corps,  In 2012, NHSC clinicians working at NHSC service sites provided primary medical, oral, and mental and behavioral health care to 10.4 million underserved people in these communities, known as Health Professional Shortage Areas. In 2013 NHSC clinicians are providing health care to over 9.3 million people across the country. The program has more than doubled since 2008, when 3,600 clinicians participated.

Okay, so my point is, our government is already managing and operating a large network of medical facilities providing people from all walks of life with healthcare, and especially those who are underserved in healthcare. If the goal is to improve the accessibility and quality of healthcare, it would stand to reason that the most direct route would be to improve and expand on the network for which the government is already exclusively responsible. Not only does this have a direct effect on those constituents and issues being targeted, but it also supports employment and education opportunities by being on the demand end of the see saw.

In reviewing the reports containing this information, I’ve also learned there are substantial gaps in our government’s ability to fulfill the growing demand for their services. The result is that the quality drops and the ratio of providers to patients is dramatically increased. It appears this gap is truly the driver for the mandates for insurance. It appears the White House no longer has confidence it can provide the increasing level of service with the decreasing participation of health professionals. I’m disappointed the response was not to improve the network but to work to make others responsible for the constituents. It would have taken longer, but working on attracting professionals, and expanding and improving the network seems like a good idea. This would also provide market pressure with more services, and options to service, which affects price making health care more affordable across the board…there is still time.

https://www.fas.org/sgp/crs/misc/RL33537.pdf

http://www.hhs.gov/budget/2013-program-inventory/program-inventory-053113.pdf

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