From the perspective of fifty years of medical practice, almost everything the medical bureaucracy did to reduce cost and improve care made it worse.
As with any problem, education might best be the starting point. Medical schools must lead the Renaissance of education, six years with a PhD degree and a much more vital role in continuing education and research. There is a need for much more science education in AI, the genome, and quantum physiology.
Older physicians should rotate back to their medical schools on fellowships. Research should come in balance with high volume clinical care at graduated low cost. Research must occur in medical schools, not corporations, drug companies, or secret laboratories. Subsidizing medical schools heavily will save wasted dollars elsewhere. The medical school clinics will ensure equal access to all and the highest standard of care.
Get corporations out of medicine. A hospital CEO has no business receiving a multimillion-dollar salary. Hospitals do not need a CEO but an administrator and a highly organized nursing staff. The same applies to corporation sponsored insurance. Corporations might provide insurance but should not restrict the choice of providers, nor should insurance companies. Doing so for quality reasons had the opposite effect. Family doctors quit in droves or went into other specialties. Robert Kennedy Junior's book may be controversial, but he validly criticizes corporate capture.
Subsidize primary care physicians with RN salary coverage and a small reimbursement for clinic overhead as a visit charge. This subsidy must support after-hour telephone coverage and cover-physician availability. No more, "If this is an emergency, hang up and call 911."
End mandatory guidelines. Guidelines are helpful but are inflexible, do not evolve well, do not cover everything, and, most significantly, do not cover multiple problems. Multiple problems are more often the case and frequently contradictory to the guidelines. Reduce the cost of CME and board examinations. Subsidize both. Give back responsibility for credentialing to the county medical society or state society akin to the lawyer's bar. It would be further helpful for county societies to have cooperative help from legal colleagues.
Perinatal care needs a limitation to liability, especially for the physician attending a delivery. Liability issues plague the dismal neonatal mortality rates. Some protection is necessary to allow family doctors and obstructions to risk obstetric work and give common access to prenatal care.
The distribution of healthcare remains a problem. Medical schools might provide extensions to rural areas. Six years of medical school would yield more clinical and laboratory research and the providers necessary for rural healthcare coverage, quality and access.
There are more things in this World Horatio, than are dreamed of in your philosophies Shakespeare Definitions from Oxford Languages · Learn more: adjective relating to existence. "The climate crisis is an existential threat to the world." PHILOSOPHY concerned with existence, especially human existence as viewed in the theories of existentialism. "The existential dilemma is this: because we are free, we are also inherently responsible." LOGIC (of a proposition) affirming or implying the existence of a thing. the existential proposition that truth and reality are constructed fictions" Even physicists struggle with truth. Reality in the laws of physics repeatedly give way to new findings. The James Webb Telescope finds galaxies beyond the time and space of the established Universe. Anthropologists find evidence of civilizations earlier than documented history. What is truth? The use of the word existential as a syndrome for virtual truth begs the question o...
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