NATIONAL HEALTH usa

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 i n i t i a l    S T R A T E G I C    P L A N 

10 Pages                                                                                —   1   —

A.  ‘VISION ‘ 

STABLE  HEALTH   FOR  EACH  RESIDENT  PERSON

B. MISSION

To  stabilize  the  HEALTH  of  every  resident  person

with  a  continuously  renewed  understanding  of  our  nation’s

Resources,  Knowledge,  and  Human Dignity.

C.  PRINCIPLES

            1. Altruism 

Our nation’s heritage began with traditions formed largely with our rural communities.  These traditions reflected a reliance on individual responsibility, social cohesion, and their Family and extended Family for each resident person’s HEALTH.  There was also a tradition of helping each others’ neighbors when life events have created special needs.  These health benefits absent their associated community’s social capital, its social cohesion, are now provided by a very large, healthcare industry.  For our modern-day healthcare industry, the challenge for NATIONAL HEALTH would be to sponsor the reform of our nation’s healthcare to achieve equitably available, ecologically accessible, justly efficient, and reliably effective health care for each resident person.  Given the contemporary decline of each community’s social capital, NATIONAL HEALTH would promote each community’s collaboration with its adjacent communities for the benefit of each other’s Survival Commons (viz, augmented safety-net).   

Success would be assured by each community’s level of commitment to their resident persons with special HEALTH needs.  These needs would be defined as the developmental, social, or economic factors that adversely influence a resident person’s capability to achieve Stable HEALTH, especially during infancy, a continuing disability, homelessness, or a pregnancy.  For each resident person encountering any of these HEALTH Conditions, continuously individualized Primary Healthcare offered responsively to each of these resident persons would represent the ultimate expression of Altruism by our nation’s healthcare industry.

            2. Trust

No effort to promote change can succeed without a commitment to establish its trustworthiness as its agent of change.   NATIONAL HEALTH must focus the execution of its own internal affairs to support this standard.  The day-to-day character of NATIONAL HEALTH must achieve a widely acknowledged level of responsively-transparent leadership sustained over a long period of time.  To the extent that each Community HEALTH Forum becomes trustworthy, the structural foundation for the MISSION of NATIONAL HEALTH will be firmly in place to rebuild our nation’s social cohesion for its population HEALTH.

David Mechanic offered a carefully considered analysis of our nation’s healthcare in his book published in 2008: THE TRUTH ABOUT HEALTHCARE. (24)  Its Chapter 9 offers a view of the requirements for any strategy to improve trust in our nation’s healthcare.  Also, Robert Hurley wrote his own analysis of the attributes for becoming trustworthy published in 2012: THE DECISION TO TRUST: How Leaders Create High Trust Organizations. 

Finally, the level of trust within a community’s social interactions underlies its level of Social Capital for how each resident person resolves the social dilemmas they encounter daily within their Family, neighborhood, and community.  Along with cooperation and reciprocity, the measurable attributes of social capital have been identified as a basis for improved, self-reported HEALTH.  A multi-year study of the connection between longevity and poverty published in 2016 verified this relationship except for a few isolated communities.  These isolated communities did not have the adverse effect of poverty on longevity.  These communities exhibited an attribute that would represent a higher level of social capital such as the level of bonding, bridging, and linkage caring relationships within their community’s resident persons’ networks. 3.Cooperation To the extent that mutually-supportive relationships evolve through its PRINCIPLES, NATIONAL HEALTH would have the best opportunity to achieve improved efficiency and effectiveness by our nation’s healthcare.  In the future, our nation’s healthcare industry will experience an increasingly more rapid redefinition of its MISSION at all levels of our legal, medical, social, economic, and innovation traditions.  The renewal of these transitions will likely depend on how well the various competing vested interests are positively engaged in the underlying institutional reform process. Cooperation will be an essential attribute of the synergy necessary to successfully sponsor the immediate and continuing reform of our nation’s healthcare industry.  The future challenges for our nation’s healthcare industry are profound.  They include 1) our nation’s increasing Federal debt, 2) the number of citizens over the age of 64 years that will double between 2000 and 2030, 3) the currently unrecognized level of epigenetic and genetic diversity underlying each resident person’s HEALTH, 4) the adverse effects of climate change, and 5) the adverse effects of the world-wide internet on the social capital required for each community’s collective action projects intended to improve the Stable HEALTH of their resident persons.4. Reciprocity The political process ideally grows out of the reconciliation of alternate views of a problem or goal.  This reconciliation is more likely to balance the legitimate vested interests associated with these alternate views when it reflects honest attempts at reciprocity.  The ability to apply Trust, Cooperation, and Reciprocity to a social dilemma is commonly acknowledged as representing the social capital contribution for its resolution.  For example, there were two somewhat distantly separated communities on the eastern coast of Japan that suffered extensive damage from the “worst ever” tsunami in 2004.  Several studies evaluated the separate level of social capital for each community that accurately predicted each community’s resilience for their recovery.  The community with a higher level of social capital recovered substantially more quickly. It is likely that the social determinants for each person’s HEALTH have historically evolved from substantially different processes, community by community.  The nationally sanctioned strategies for healthcare reform occurring in 2018 show no signs of any progress for resolving the cost and quality problems associated with our nation’s healthcare.  Most importantly, healthcare reform will need to resolve the character and distribution of Primary Healthcare that is offered within each resident person’s community.  Secondly, there are no current means to locally individualize our nation’s disaster preparedness at the community level.  For an influenza pandemic, it will preferentially affect young children and the elderly.  In each community’s hospital Emergency Department, how will these Emergency Departments work together with reciprocity to allocate the scarce resources for artificial respirators within their community?  And, third, what are the alternatives available within each community to invest in the social capital attributes necessary for each woman during a pregnancy?  The ability to search for alternatives that are uniquely appropriate for each community should be directed locally based on an established community commitment, such as a Community HEALTH Forum.The need for pervasive Reciprocity among the legitimate vested-interests will be profound.  For a national commitment, nearly 800 communities would be identified.  The population for each would average @400,000 based on geographic area and population density.  It may be viewed as a generational commitment with a 10-15 year startup phase.  The focus on local Reciprocity will be vital as the effort to solve the cost and quality problems with our nation’s healthcare industry take on a new reform strategy.  Reducing its health spending by 30% as its portion of the national economy and reducing our maternal mortality incidence by 70% will, at a minimum, require an invigorated expression of Reciprocity as well as Cooperation and Trust within the municipal life of each person’s community.  

                                    during the first four years with the preparation of a comprehensive strategy

                                    for a  NATIONAL HEALTH  self-assessment of its ability to demonstrate

                                    the  new strategy  based on its  PRINCIPLES  of Altruism, Collaboration,

                                    Excellence, Transparency, and Trust;

                        ii. Finalize Three National Projects for the 

                                    PRIMARY HEALTHCARE  BENEFITS  PLAN,  

                                    PRIMARY PHYSICIAN  EDUCATION  PLAN, and

                                    HEALTH SECURITY certification;

                        iii. Promote 81 functioning  District Coalitions, each with a full complement

                                    of Community HEALTH Forums within two years; and

                        iv. Reduce the proportion of the national economy devoted to healthcare spending

                                    from X% (average of health spending as percent of GDP during 2 years 

                                    before the initial Meeting of the Board of Trustees) to X-2% of the GDP

                                    during the 4th calendar year after the initial Meeting of the

                                    Board of Trustees;

COMMENT  In 2018, our nation’s healthcare spending represented 17.8% of the gross domestic product (GDP) or $3.73 Trillion.  The GDP in 2018 was $20.94 Trillion.  Assuming GDP growth at 3% annually for three years, the GDP in 2022 would be $23.57 trillion. A reduction from 17.8% to 16.8% would represent health spending of $3.96 Trillion for our nation’s healthcare during the fourth year, based on 2018 data: an increase of $23 Billion (instead of the anticipated increase of $47 Billion).  The ultimate GOAL is a reduction by 5% (from 17.8% to 13.0%).  The actual spending change may be less depending on overall economic growth, especially as it encounters a smaller allocation to healthcare spending.  This would be a major stimulus since the reduction of health spending would lower the cost of Medicare/Medicaid to the Federal treasury, 45% of health spending in 2018.

                        v. Initiate a Plan for a 2-year evaluation beginning 5 years after the date

                                    of the initial Meeting of the Board of Trustees to reassess

                                    the Congressional Charter and its future options for promoting

                                    the adaptability of our nation’s healthcare;

                        vi. Reduce the state by state variability as compared to the best 9 states average

                                    of the Maternal Mortality Ratio by 50%;

                        vii. Promote the certification of as many HEALTH  SECURITY  clinics as necessary 

                                    to offer enhanced Primary Healthcare to 10 million citizens within each Region; and 

COMMENT  This would involve approximately 2,500 Primary Health Care clinics within each Region, about 30 per CommunityHEALTH Forum.

                        viii. Initiate Federal legislation as necessary to support the implementation of each 

                                    A) Community HEALTH Forum including

                                                1) clarification of any potential restraint of trade issues  and

                                                 2) arrangements for improving the financial support

                                                             of certified Primary Healthcare clinics

                                                             serving chronically under-served locations  AND

                                     B)  the national reporting of financial efficiency for resource allocation

                                                 by each HEALTH SECURITY certified Primary Healthcare clinic.