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Here's a concept for radically transforming the United States medical system/industry over the next quarter-century. Note that I am not advocating this...I've just been wondering what it could look like if the US really knocked down the current model and rebuilt it.

We start by implementing a true single-payer health insurance system. Tax rates are going up. For-profit medical care is going away. Medical procedure management begins to cut back on electives such as unnecessary cosmetic procedures. No more Hollywood Doctors. Doctors currently in private practice can continue to practice as before, but they're bound by the limits of the managed single-payer system. Decisions about coverage are handled by a board of practitioners chartered by Congress but set up like the Supreme Court (no terms, no limits, not beholden to political or special interests; however, there are many more on the board and after the initial assignment, the board self-selects its members).

At the same time, we establish a United States Medical Corps as a national organization mapped on the concepts of a military command structure. We set up multiple USMEDCORP "service academies" in major national regions, a la the Naval Academy but focusing only on medical specialties. A central planning office is established under the Surgeon General to decide who and how many are assigned to various specialties, based on aptitude tests and need (e.g. you may think you want to be a brain surgeon but your aptitude tests don't support the skills and we need orthopedists anyway). All students are first taught basic trauma/triage medicine, then basic general practice medicine, then specialized medicine.

In exchange for "enlistment" and full no-cost medical training, people who enlist commit to a 20-year period of service to be performed where the CPO determines the need is greatest. There are signing bonuses and benefits conferred to those who re-up at the end of their service period.

Supplies and technology are contracted, bought, delivered, and operated based on a procurement system modeled after DOD practices that work. Acquisition management reports up to the coverage board for oversight purposes. Major high-tech systems are both assigned to regional medical centers and also to mobile medical labs that can be transported by road, rail, or air as needed to meet emergent requirements. Ambulance and transport services for patients are also incorporated into the Medical Corps, making airlift more available because cargo air and helicopter coverage can be sourced from other Pentagon assets.

At the end of 10-15 years, after a few classes have run through the training system and are assigned out into the nation, we have the solid start to a unified, nationally managed, technologically advanced taxpayer-funded healthcare system. And the national mindset towards public service helps promote this new branch by putting it on a level of importance similar to the Army, Navy, Marines, Coast Guard, and Merchant Marines. After 25-30 years, no private practices will remain. All medical care and services will be administered through USMEDCORP.

[I didn't say it was perfect. I'm not saying if I find it scary or not. You can agree, disagree, poke holes, add ideas, whatever. Flames and/or calls to elect me will be ignored.][Deep Share.]
Jeb Hoge's profile photoBryce Womeldurf's profile photoLinda Dean's profile photo
One big thing that I see wrong is the involvement of Congress. What would stop them from pushing an agenda with the board? Not to mention that more often than not, they trend to select people not by skill level, but by political slant. Or am I misunderstanding the word ”chartered?”

Also, not bashing this, just saying.
Yeah, you probably are misunderstanding that concept. It's like where I work (which I won't name, for my own sake). We were chartered by the VA legislature 40 years ago to provide housing support, but we're not exactly a government entity. We're mostly autonomous...the government doesn't tell us how to do our business and we're not affected by changes in administrations.

So the idea would be that the board of this new outfit would select its own personnel and Congress wouldn't have any say in who was chosen and why. And the board would be big enough that it couldn't be dominated or thwarted by a few extremists.

But you're right, there's an article of faith that they'd all be capable stewards of medical science.
I see what you mean now. That does make sense.
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