creating work
P A R K I N S O N ‘ S L A W
5 Pages — 1 —
INTRODUCTION
“Work expands so as to fill the time available for its completion.”
C. Northcote Parkinson (1909 – 1993)
“Business as usual” as the basis improve our nation’s HEALTH and its Healthcare is unlikely to solve the fundamental problems that exist. Even with a goal to promote universal health insurance, the Affordable Care Act (ACA) of 2010 did not achieve a solution to the paradigm paralysis that afflicts our nation’s healthcare. Furthermore, spending more of our nation’s financial assets on direct healthcare is probably aggravated by the already excessive inefficiency of our nation’s healthcare industry. During 2017, the ACA 2010 would have impaired the Survival Commons of each community further by its then proposed reduction of funding for expanded Medicaid.
Presumably, Parkinson’s Law will continue to operate as it has in the past, including healthcare. Mr. Parkinson was an accountant for the British Admiralty during World War II. He noted that the British Admiralty, its navy, had the same number of ships during WWII as compared to WWI. But, the number of personnel required for the administrative support of these ships had increased by 7% every year for over 24 years. Compounded annually, the total personnel increase equaled 500%. Remember, there was no significant change in the basic function and structure of the ships between the two wars: a very large steel ship with a powerful steam engine.
Currently, the word “time” in the quotation above is now commonly replaced by the words “space,” “resources” or “employees” without loss of meaning. With a healthcare perspective, the spending for our nation’s healthcare in 1960 was 5.0% of the national economy. In 2016, it was 18.2% and estimated then to be 19.6% by 2021. Between 1960 and 2016, the increasing portion of our nation’s economy devoted to ‘health spending’ represented an increase of 5.0% compounded annually, adjusted for inflation and economic growth. Truly, this represents a very sad commentary about the growth of our nation’s healthcare industry.
Fully implemented beginning in 2015, the Accountable Care Act (ACA) of 2010 has so far left unchanged both the increasing level of our nation’s health spending and its decreasing level of quality. Furthermore, there are still no efforts to systematically improve the equitable availability of Primary Healthcare within every community.
PARADIGM PARALYSIS
Solving the financial barriers to healthcare is an example of an isolated “fix.” The need to improve the financial attribute of equitable availability is very important and long overdue. But, unless there is a means to spend this investment in association with improving the social capital assets of each community, the actual benefit may not yield a true benefit as opposed to the mere perception of a benefit. Furthermore, the inefficiency of our healthcare industry might well be aggravated. Reducing the cost of Medicare, as projected originally by the Accountable Healthcare Act of 2010, is really not feasible without an improvement in the equitable availability of enhanced Primary Healthcare. Unfortunately, the ACA 2010 had no provisions to uniformly promote equitably available as well as ecologically & culturally accessible Primary Healthcare
The VISION for guiding any new institution for healthcare reform should be “Stable HEALTH for Each Resident Person.” A key attribute for the MISSION of NATIONAL HEALTH would then be to reduce the ‘health spending’ for our nation’s healthcare as a portion of our nation’s economy by 23% over 10-15 years This reduction could have reduced our nation’s ‘health spending’ to 13.0% rather than 18.2% of the gross domestic product during 2016.
During 2016, the $950 Billion excess national expense would have represented the cost of fighting 9 Iraqi/Afghanistan wars simultaneously in 2005. It is very hard to explain why! There are many identifiable issues but no ‘Smoking Gun.’ We can explain away maybe 1/3 of the excess expense. Presumably, Parkinson’s Law represents another 1/3. It is likely that the other 1/3 remains to be solved by an improvement in our nation’s Primary Healthcare, community by community.
NATIONAL HEALTH
A full description of this proposed institution can be found on the NATIONAL HEALTH Proposal Page and its five Sub-Pages. As part of a New Strategy, NATIONAL HEALTH would promote Altruism, Cooperation, Reciprocity, Trust, and Excellence as the benchmark PRINCIPLES for its affairs. Guiding the reform of a $4.55 Trillion industry during 2022, unanticipated barriers will almost certainly exist. These benchmark PRINCIPLES would guide the affairs of NATIONAL HEALTH when an Operational Statement does not exist to guide the specific tasks for reforming these barriers. — 3 —
Ultimately, the NATIONAL HEALTH Proposal would promote the formation of a CommunityHEALTHForum, or Forum, by each community of approximately 400,000 resident persons, based on local population density. Locally initiated and supported, each of the 810 Forums would have the responsibility for promoting equitably available, enhanced Primary Healthcare for each of their resident persons. Forming a collaborative process among their locally existing hospital systems, the Forums would eventually achieve a precisely focused, combined improvement of the nationwide healthcare for the Basic Healthcare Needs of every resident person, community by community.
resolving the PARADIGM SHIFT
The New Strategy may also be viewed as a means for promoting synergy among the dominant traditions of our nation’s healthcare. The current Legal, Medical, Social, Economic, and Innovation Traditions will require an indirect focus on the New Strategy. This New Strategy would also implement the locally originated community reform process to facilitate FOUR NATIONAL PROJECTS for improving the availability and training of Primary Physicians. (See its PAGE and four Sub-Pages for details)
The community needs for Primary Healthcare are best known by each local community. With locally sponsored collective action, the neighborhood requirements for Basic Healthcare Needs will depend on the Four National Projects to support equitably available, enhanced Primary Healthcare. The national and community requirements for this plan for healthcare reform will require an intense and widely supported commitment as expressed by the actions of Congress and each State’s legislature. This level of commitment must acknowledge that true healthcare reform is necessary to promote our nation’s autonomy within the worldwide community. This autonomy will be crucial as our nation participates in the world’s marketplace arenas for its Resources, as well as its Knowledge, and Human Dignity.
Since 1969, the continuing advancements in the character of healthcare for Complex Healthcare Needs have not been matched by a uniform improvement of Primary Healthcare for each resident person. The continuous renewal of Primary Healthcare will be especially required to augment their skills associated with integrating each resident person’s Basic Healthcare Needs with any necessary Complex Healthcare Needs. Acknowledging the traditions requiring reform with a set of PRINCIPLES establishes the foundation for promoting the character as well as functions of NATIONAL HEALTH. Given the formation of this new institution, achieving locally-focused collective action combined with a nationally acknowledged VISION describes the basis for the future reform of our nation’s healthcare industry.
Whether it be NATIONAL HEALTH or another form of healthcare reform, the future of our nation within the worldwide community is at stake. The forces of Parkinson’s Law, as noted above, must be put aside. We must reassess our national angst in the midst of worldwide turmoil and focus on our nation’s healthcare. This focus should especially consider its contribution for promoting a Survival Commons within every community. As a matter of national priorities, “Stable HEALTH For Each Resident Person” should especially apply to our nation’s women during a pregnancy, their children, the disabled, and the homeless. — 5 —