We believe that only the actions of informed, engaged citizens can move us beyond partisanship and find the way to better health and health care for all and that positive and lasting social change only comes when engaged citizens work together in common cause. This article describes ten general categories that you can participate in. Choose your level of engagement based on your availability and resources. Make your voice heard by taking responsibility for your life and the health of your loved ones, improve the health of your community, and have a say in strengthening the political discourse and financial future of the nation
Assume personal responsibility for your health and healthcare needs
Take personal responsibility for your health and wellness. From life style choices and following recommended prevention practices we can make healthy choices in our lives. Whether you are healthy or suffer from a chronic condition, or care for an elderly frail parent, there are lots of things that you can do to improve your health and contribute to the health of our healthcare system. There are countless resources you can use to manage and improve your health and have your say in the ongoing national healthcare debate. Find out what are the prevention and wellness recommendations. If you need ongoing health care, become a partner with your healthcare team. Learn how to get the best care. Develop your health care plan that reflects your health care needs and values as well as the resources that are available.
Assume personal responsibility for cost of healthcare
Take personal responsibility as a consumer. Assess your health/medical care finances. If you have employer provider or individual market health care insurance assess ways to get the best value. If you are getting treatment, learn to find the best value and resources. The cost savings involved would be tremendous as well. If more Americans would take the time to educate themselves regarding healthcare decisions, they would then be responsible for their own outcomes and the malpractice problems would work themselves out then too. "Informed consent" has been a joke to a large degree because it has only been half-heartedly implemented.
Assess the health and medical care in the community
Healthcare is personal and local. From environmental factors to availability of healthcare providers and other resources, the community serves as an important structure for achieving health care services. Assess the health care need and quality of your community and country. As a member of the community, make sure that the health care resources and community environment are the best they can be. Help define community health care needs. Help monitor outcomes and demand accountability from health can institutions and government. Engage with health care organizations in developing a consensus regarding community needs and benefit reporting.
Participate in meaningful dialogue
Missing from the political process that led to the President’s signing of the Patient Protection and Affordable Care Act was a civil dialogue informed by reliable information. How do we achieve universal, accessible, effective, safe, sustainable, and affordable healthcare for all Americans? What is the vision of health and the health care system to achieve it? What are the barriers, including citizens and health care provider’s behavior as well as institutional and governmental structures, how to best overcome them. What are the resources necessary to achieve excellent health care for all? How do we promote innovation that improves the quality of life of all Americans? How do we address the emotionally charged politically driven cultural divides that are so prevalent in health care? The answer must include accountability of stakeholders, transparency of performance outcomes, sustainability and innovation must be central to the dialogue.
Participate in formulating a vision of excellent outcomes
The next phase of healthcare reform must be driven by the objective of achieving improved healthcare outcomes for all Americans. The framework for the healthcare system must address the interconnected issues of insurance coverage, access to necessary health care services, cost to the individual, business and society, the quality of healthcare services and innovation. The vision must be patient focused. Citiznes4health has developed a process for such a vision. It is based on the following 8 categories of health care encounters:
Healthy adults and children
Maternal and infant health
Chronic conditions, normal function
Stable but serious disability
Short period of decline before dying
Limited reserve and exacerbations
Frailty, with or without dementia
Building on the priorities for services in each category we establish and clearly define goals and measurable outcomes. We identify best practice to ensure that each person’s health needs can be met effectively and efficiently. The following interconnected principles offer the foundations for health care system that is patient centric and achievable. Using these principles as guidelines we can develop the framework for the objectives of the future American health care system.
Healthcare is complex and ever changing. Numerous organizations are involved in creating the knowledge needed for the patient and physician to make clinical care decisions. Given the cognitive limitations, physicians require constant information and data. Performance outcomes are an essential ingredient for excellent patient care. There are numerous national, institutional, international based treatment guidelines that are available and can contribute to improved decision making and outcomes. The health reform bill and prior to that the stimulus has provided funding and process for improving knowledge base. Holding providers accountable for the outcomes is important for the health care system. You cannot manage what you cannot measure.
Accountability of stakeholders
Democratic societies require accountability of the various governmental and other public bodies that serve their citizens. Providing the multiple services that are required to meet health care needs requires a wide range of stakeholders. From health care providers including clinicians, non for profit and for profit institutions and businesses, governmental institutions, foundations, charitable organizations and regulators and policy writing politicians. What should health care institutions be accountable for? How should accountability be enforced? Citizens, consumers and patients working with regulators can hold institutions accountable. Various tools are available to hold health care related institutions accountable.
Transparency and performance reporting
The effectiveness of health care depends on the close cooperation of all parties involved, yet to some extent, certain levels of distrust pervade the healthcare system. Constructive steps are needed to build higher levels of trust into the fabric of the system. There is a need for increased process transparency and establishing a shared sense of value in health care. Increased transparency is a prerequisite for trust. Need to transform health care into a system whose processes, decisions, policies, and practices are developed in a manner that is more open to scrutiny and have appropriate levels of accountability.
Assessing the mission of healthcare organizations
Many of the institutions providing health care forgot their mission. While it is assumed that they exist to provide health care services to their community, too often the mission is lost. Is the mission consistent with the needs of the community? Is their governance structure and strategy consistent with the mission? Are the incentives aligned to reflect the mission? Challenge hospital/ cmhc administrators and board of trustees. Establish goals that are reasonable and are consistent with their mission.
Hold accountable for negative impact on the community
Hospitals have critical roles in the delivery of healthcare in communities across the nation. As nonprofit institutions, health care systems, insurers and community health care centers have important fiduciary obligations to provide benefits to their communities commensurate with their tax exempt status. Community benefit standard. Section 9007 of the Patient Protection and Affordable Care Act , creating a new 504(r) of the Internal Revenue Code, lists “Additional Requirements for Charitable Hospitals,” to increase the accountability and “charitability” of tax exempt hospitals. How will these requirements be met? Engage with health care organizations in developing a consensus regarding community benefit reporting.
Health insurance companies received scrutiny during the health care reform debate and are still the focus of political attention for good reason. Health insurance companies are essential at present as the cost of health care services is unpredictable. Various formats for health insurance from government run, to free market. Holding the insurance companies accountable and their processes, behavior transparent..
Health care exchanges (information re value of the insurance)
Demand Health Information Technology
With the American Recovery and Reinvestment Act authorizing $36 billion in outlays for health information technology—an unprecedented investment in the nation's health information infrastructure—this year's focus on health IT is especially timely. We will assess the impact of this historic $36 billion federal investment in health IT and the need for meaningful measures of quality improvement.
Potentially preventable hospitalizations—inpatient stays that might be avoided with the delivery of high quality outpatient treatment and disease management—serve as useful indicators of possible unmet community health needs. By measuring the frequency of such hospitalizations among patient subpopulations, policymakers and providers can identify those communities most in need of improvements in outpatient care as well as the conditions for which care is most needed. Rates of potentially preventable hospitalizations are higher for vulnerable populations with limited access to care.
Help fight fraud and abuse
Participate in efforts to improve health care and cut costs such as help fight fraud and abuse.
Reframing The Healthcare Conversation
July 12, 2019
Treatment Plan for the United States Health Care System