Wednesday, November 09, 2005

Reinventing healthcare - the very "big" picture

Reinventing healthcare - dream big ! " In this system, every individual has a lifetime health care account. Into this account and through it, money flows electronically from a variety of sources: insurance companies, government, employers, personal earnings and charitable institutions. Funds are fully invested, yet they are accessible for health care at times or for purposes determined by the account holder.

The funds are accessed by an electronic transaction device acceptable at any qualified provider of health care service or products. Each transaction is instantly authorized prior to performance of services, and payment is made electronically when the service is rendered--at a cost of less than two pennies per transaction. The system provides insurers and funders an immense variety of data, allowing them to custom-design authorization procedures to balance costs, losses and the level of service they wish to provide in competition with other providers.

The same system simultaneously carries an immense amount of individual, institutional and community health data. Each provider of health care services has electronic equipment custom-designed for its practice compatible with the overall information structure. Thus, 95 percent of the system is incrementally owned and operated by tens of thousands of health care providers and vendors in free and open competition with one another, yet it functions as a unified whole through common standards, along with a few, central, cooperatively owned elements, such as a central switch everyone has access to. The few paper documents required are now produced automatically and instantly at any point in the system.

The system has complete data on the costs, performance and capabilities of every health care provider, and this is readily available to every consumer. Each consumer has complete freedom to select the provider of his or her health care. An ever increasing amount of health information and care is provided through inexpensive, interactive voice-data-video equipment in the home and at countless community locations open to the public.

The medical history of each individual is encoded in machine-readable format in a health care transaction device, encrypted so that it is not available without consent. However, emergency vehicles and facilities are equipped to override the encryption in the event an individual is incapacitated. With consent, the card can be electronically read to produce all necessary medical history or to create patient records in any format desired by the health-care provider.

Government retains the authority to tax and redistribute income or otherwise set public policy to ensure a minimum level of care to each person, but it is not involved as a direct provider, owner or controller of the system.

Individuals control their own health and health care, as well as the money for it. They initiate all transactions. It is a customer-driven system. Perhaps the most interesting feature is that if individuals can maintain excellent health, a portion of the funds in their accounts eventually reverts to them as capital--so they have great incentive to avoid health risks and obtain the best, moderately priced service."

This is a truly "disruptive innovation". Can we make it happen ? Why not ?

1 comment:

  1. Anonymous3:17 AM

    Great blog I hope we can work to build a better health care system. Health insurance is a major aspect to many.

    ReplyDelete

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