Draft Chapter #1: An Introduction to Fixing United States Health Care
- T Michael White MD FACP
- Dec 8, 2024
- 6 min read
By T Michael White MD FACP
This tome, Fixing United States Health Care, represents a collection of imperative thoughts regarding the design and implementation of a United States Health Care System.
Its genesis — all understand that our fine United States does not have a health care system. Most understand that, as a matter of decency, our fine country must, to secure national and personal potential and security, design and implement a United States Health Crae System.
In late 2024, a webpage/blog — fixingushealthcare.com. was created by Dr. Hightower, Dr. Kellis and me to serve as a brainstorming platform. The process continues. Many have viewed. Some have commented. All input has been enlightening and beneficial. This book synthesizes those thoughts into an action plan for the design and implementation of a United States Health Care System. This book is being published in draft form on the website. Comments will improve our final effort.
This undertaking is a group effort. In general, a written chapter is followed by point/counterpoint commentary. Drs Hightower and Kellis and I will be primary contributors. Guest authors will, from time to time, join the fray.
In 2000, Dr. Hightower and I published Affordable Basic Health Care for All --- An American Health Care System. The effort was necessary but has proven woefully insufficient. That said, the text is recommended.
As we embarked on the webpage, Dr. Dana, Dr. Stephen and I each wrote introductions. They reflect and share our academic, administrative, clinical, patient and scientific perspectives and our authors’ intent. They follow…
An Introduction to fixingushealthcare.com — Dr. Hightower
“In order to have good health you need a patient and you need a concerned health care provider.” Benjamin Carson
Wednesday, October 23, 2024
Dear Mr. President, Honorable Members of Congress, Distinguished Staff and Fine Citizens,
I want to thank you and your predecessors for the opportunity you provided me in 1978 to attend medical school through the Public Health Services Grant. I worked in an underserved area for four years after completing medical school and residency in Internal Medicine. This opportunity to practice in one small, rural town in America was an amazing eye opener to the struggles and efforts needed to maintain good health in the thousands of rural communities throughout our nation.
Most of the patients I encountered over the four years in the remote New Mexico community of Truth or Consequences (T or C ) were geriatric patients and the concepts of prevention were not as prominent then as they are now. My community had a small 20 bed hospital. The nearest major hospital was 80 miles south. We relied a lot on communication with the University of New Mexico Medical School and their trauma unit for our emergencies and on back-up helicopter transportation for critical accidents or illness.
Small communities like T or C are often close knit and thus more likely to spread disease quickly. Acute injuries also are challenging as the resources for stabilization may not be available and transportation, even by helicopter, can take too long. Infectious disease within the schools is always a concern, as essentially all students are within the same building. Obtaining appropriate immunizations for the students and our adults was always a burden for the small hospital. Prophylaxis testing (for example, colonoscopy) for preventative health, which has significantly expanded, is also challenging from equipment and expertise perspectives.
Efforts to address these issues for the betterment of health care in our rural areas are essential. It is estimated that 60 million people, many in their geriatric years, live in designated rural areas. My experience is they are not looking for a hand-out. They are looking for a hand-up to help provide them with the opportunity to stay in their community and to stay healthy. I strongly concur with their goals and I will be providing you information, through letters like this, about how and what may provide our best opportunities to fulfill those goals as we move forward.
Sincerely,
Stephen F Hightower MD FACP
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An Introduction to fixingushealthcare.com — Dr. Kellis
Dana S. Kellis MD PhD MBA FACP
“Outsiders often have an insight that an insider doesn't quite have.” Diane Abbott
Wednesday, October 23, 2024
Dear Mr. President, Honorable Members of Congress, Distinguished Staff and Fine Citizens,
I address you with respect and appreciation for your dedicated efforts to improve the lives of the American people. Thank you for using your time, talents and resources to find solutions to some of our country’s vexing challenges. I wish to, along with my colleagues Stephen F Hightower MD FACP and T Michael White MD FACP and other contributors, share ideas and perspectives as you face hugely consequential policy questions regarding the future of health care in the United States.
Our country faces a perfect storm in health care. Americans’ health is deteriorating due to a profusion of health care crises: the ongoing Covid epidemic along with increasing incidence of other infectious threats; the exponential increase in diabetes and other chronic illnesses; the rapidly increasing mean age of our population with an associated explosion in age-related illnesses and disabilities; and narcotic-related deaths and addictions — to name just a few. At the same time, Americans have seen a deterioration in their ability to pay for the health care they desperately need. Employer-based insurance has become unaffordable for the bottom and even the middle tiers of workers due to escalating deductibles and premiums coupled with decreasing coverages. Government-subsidized insurance is often little better, with limited coverages and huge deductibles. The third component of this perfect storm is the inability of many health care facilities to stay ahead of the increasing financial and workforce demands necessary to address their communities’ burgeoning needs.
As physicians who have spent considerable time in their careers not only practicing medicine, but also helping to administer hospitals, training programs, clinics and other parts of the health care universe, we believe we can provide valuable perspectives and insights into potential solutions to address these seeming intractable challenges. We have no ‘dog in the hunt’ in these efforts, other than to help both the country we love as well as the profession to which we’ve dedicated our lives to be successful while maximizing the health and physical/emotional welfare of countrymen and women whom we and you serve.
Sincerely,
Dana S Kellis MD PhD MBA FACP
******
An Introduction to fixingushealthcare.com — Dr. White
T Michael White MD FACP
“True beauty is born through our actions and aspirations and in the kindness we offer to others.” Alek Wek
Wednesday, October 23, 2024
Dear Mr. President, Honorable Members of Congress, Distinguished Staff and Fine Citizens,
Hello.
Thank you for being positioned to have the expertise, the courage and the power to potentially do so well for so many. With this privilege comes responsibility. Please endeavor to step up daily and realize your exceptional potentials.
This is the first of what is intended to be many blog submissions for your consideration. Each will be designed to encourage and assist you to advance the health care of the citizens of these fine United States. I anticipate that your staffs and you will respectfully pay them heed. Thank you. Each will be shared on our website: www.fixingushealthcare.com
Who am I? After all is said and done, I am a blue-collar kid from Schenectady who has devoted his professional and personal energies to enhance the health of those entrusted to me. Serving in various academic, administrative, clinical and scientific capacities, I have, imperfectly of course, done my best. But I could have done so much better if these fine United States had a health system that provides compassionate, safe, timely efficient, effective, equitable (just), patient-centered care (C-STEEEP) — my goal from my first day in medical school. Realizing such a system is now my mission.
What may you anticipate — i.e., what are my aspirations? By design:
Letters to you from yours truly;
Letters to you from my learned co-collaborators Stephen F Hightower MD FACP and Dans S Kellis MD PhD MBA FACP;
Letters to you from interested, welcomed contributors (including yourselves);
Celebration of successes;
Lament for failures;
Proffered solutions;
An iterative learning/teaching/learning cycle;
Responses from you; and unfailingly
A practiced decent, kind, respectful, professional tone.
Thank you for considering. Please anticipate that there will be (much) more to come. My readers and I look forward to your shared perspectives (your realities). Benefiting greatly. we will be most pleased to hear from you.
Sincerely,
T Michael White MD FACP
******
As we move forward with the publication of this book, Fixing United States Health Care, it is our intent to remain faithful to our code. We observe that we are off to a good start. Asa we journey forward, please caravan along with us.
TMWMD
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