An autonomous model of health care: Are third parties really needed?  

作　　者：Elmar H. Frangenberg 

机构地区：[1]CP Rochester, Rochester, USA

出　　处：《Health》2013年第10期1590-1600,共11页健康（英文）

摘　　要：This proposal offers a novel approach to the organization and financing of health care and is explored for its impact on the current United States system as the most prominent outlier regarding excessive cost in relation to value. The unique nature of health as a private and common good as well as a foundation for equal opportunity has eluded satisfactory management through either market forces or government intervention. The remedy is an independent, citizen-carried cooperative administrative structure, whose members own and apply their aggregate assets for their own benefit according to democratic principles. Citizens are assessed at a collectively approved rate of equitable tax deductions proportionate to their means for a designated health care fund. The resulting single payer guarantees standardization of services and reimbursements with an expanding emphasis on outcome towards optimum population health. Transparency ensures parity and flexibility for diversity and a goal of personalized medicine. All persons are enrolled on the basis of their civil status as beneficiaries. A close partnership between integrated providers and patients is practiced towards an affordable balance between investment in and value of services. Thus financing is a closed loop and therefore the most effective cost control mechanism at the individual and collective levels. Other than a regulatory and oversight function of government, the traditional third parties, namely employers, insurers and public subsidizing entities, are no longer required for catering to individual health care needs. Useful functions of existing institutions are transitioned into direct collective consumer control. Far reaching positive social, economic and political consequences are explored. The principles of this new approach have general societal appeal.This proposal offers a novel approach to the organization and financing of health care and is explored for its impact on the current United States system as the most prominent outlier regarding excessive cost in relation to value. The unique nature of health as a private and common good as well as a foundation for equal opportunity has eluded satisfactory management through either market forces or government intervention. The remedy is an independent, citizen-carried cooperative administrative structure, whose members own and apply their aggregate assets for their own benefit according to democratic principles. Citizens are assessed at a collectively approved rate of equitable tax deductions proportionate to their means for a designated health care fund. The resulting single payer guarantees standardization of services and reimbursements with an expanding emphasis on outcome towards optimum population health. Transparency ensures parity and flexibility for diversity and a goal of personalized medicine. All persons are enrolled on the basis of their civil status as beneficiaries. A close partnership between integrated providers and patients is practiced towards an affordable balance between investment in and value of services. Thus financing is a closed loop and therefore the most effective cost control mechanism at the individual and collective levels. Other than a regulatory and oversight function of government, the traditional third parties, namely employers, insurers and public subsidizing entities, are no longer required for catering to individual health care needs. Useful functions of existing institutions are transitioned into direct collective consumer control. Far reaching positive social, economic and political consequences are explored. The principles of this new approach have general societal appeal.

关 键 词：Consumer OWNED PLANS Fixed Global BUDGET Integrated PROVIDER Organization Internal Cost Control Universal Societal APPLICABILITY 

分 类 号：R73[医药卫生—肿瘤]