2023 This topic is a touchy subject laced with politics and policies and makes for an uneasy conversation

This topic is a touchy subject laced with politics and policies, and makes for an uneasy conversation at times. But from a health care provider perspective, I personal feel that for the United States to be the United States and unable or unwilling to provide universal health care is a travesty. I know that there is the ACA (Affordable Care Act) and it has some flaws that need to be worked out in order for the majority of the population to be covered.  However, due to the architect of this legislation being who he is, and the country still being so divided, instead of trying to find solutions to remedy the situation, the government in office now wants to dismantle the entire ACA bill out of spite. Putting millions of U.S. citizens in the same situation they were in before ACA, and that is uninsured and unable to get proper medical attention. Just my opinion. This country was built and is sustained on the backs of the working middle class, and for them not to be able to have access to affordable health insurance coverage is just wrong. The U.S. health care system in context of delivery of health care is only to treat symptoms, not to cure. Because there is no money in curing an ailment, but if you can live a long life on the medications available and you can afford it, then that’s what it’s going to be. Because I could never understand how would have medications to prolong someone’s life with an illness, but there is no cure.

The US health care system is struggling with a mismatch between the large, simple (low-information) financial flow and the complex (high-information) treatment of individual patients. Efforts to implement cost controls and industrial efficiency that are appropriate for repetitive tasks but not high-complexity tasks lead to poor quality of care.

Multiscale complex systems analysis suggests that an important step toward relieving this structural problem is a separation of responsibility for 2 distinct types of tasks: medical care of individual patients and prevention/population health. These distinct tasks require qualitatively different organizational structures. The current use of care providers and organizations for both purposes leads to compromises in organizational process that adversely affect the ability of health care organizations to provide either individual or prevention/population services.

Thus, the overall system can be dramatically improved by establishing 2 separate but linked systems with distinct organizational forms: (a) a high-efficiency system performing large-scale repetitive tasks such as screening tests, inoculations, and generic health care, and (b) a high-complexity system treating complex medical problems of individual patients.

A Report from Senator Sheldon Whitehouse for the U.S. Senate Committee on Health, Education, Labor & Pensions outline the underlying silent fact that this report is that the drivers of unnecessary and excess cost in the U.S. health care system result from systemic causes. Public insurance programs, private insurance coverage, military and veterans’ care, even corporate self-insurance, all are seeing dramatic and continuing cost increases. The problem is system-wide, and the solution must be too.

If these issues are not addressed, policymakers will face increasingly unpleasant and difficult threats to the insurance coverage, both private and public, of millions of Americans. Gail Wilensky, who oversaw Medicare and Medicaid under President George H.W. Bush, said, “If we don’t redesign what we are doing, we can’t just cut unit reimbursement and think we are somehow going to get a better system.”3 The ACA offers solutions that do not cut benefits or increase premiums, but instead reform systems of health care delivery to improve health outcomes and cost efficiency. The key challenge facing the United States is how quickly, thoroughly, and efficiently the reform of our health care delivery system can be implemented.

Con quest 1 rochelle