Health Care: Meet the American Dream is a proposal to redesign the American health care system using the principles of the American Dream: personal accountability, goal setting and community support. The book is divided into two sections. The first gives an overview of the health care system. The second outlines the plan, called the Dream Plan. An overarching theme of both sections relates to how Americans’ financial contributions are used to generate positive health outcomes.
Section one is a data-intensive strategic, financial and operational review of the current health care system. America spent $3.3 trillion in health care in 2016. How it was spent, by whom and on which constituencies is discussed in detail. The financial imperative for change is established through an analysis of health care spending’s impact on the deficit. A historical review of health care policy highlights the industry’s regulatory challenges. The prioritization of external determinants of health – income, education, behavior – over access to health insurance as the key contributor to positive health outcomes is discussed. The section’s final chapters evaluate three proposals to transform the health care system: electronic medical records, value-based care and a single payer system.
The second section outlines the Dream Plan. It is a futuristic model in which every American is enrolled in either an individual savings plan called a Longitudinal Health Care Plan (LHCP) or public health. The LHCP contains three major components: a Conditions Timeline that uses genetic analysis and predictive analytics to project a customer’s health conditions over the course of his or her lifetime; a Financial Commitment which attaches the costs to treat the conditions as well as an investment plan to do so; and a Customer Action Report that provides customers with steps they can take today to improve their longitudinal health and save money tomorrow. Individuals would pay hospitals and doctors directly for care with their own money, eliminating the “middle man.”
Individuals on public health would have access to a basic set of services modeled after the care that Americans with LHCPs have designed for themselves. In this way, the Dream Plan democratizes health care – everyone gets access to plans designed by the people. If care must be rationed due to budgetary constraints, individuals who visit their primary care doctor each year and/or satisfy work/volunteer requirements would have prioritized access to care. Section two also outlines how payments for different aspects of care, from primary care services to chronic drug costs to catastrophic coverage, would be financed in an LHCP investment plan. A detailed business plan compares the dollars that the average American spends on health care today to the annual per capita spending on health care to demonstrate that Americans should be able to make the required contributions to an LHCP to save for their health care needs. Critical success factors for the Dream Plan as well as short-term recommendations for our current health care system conclude the section.
Health Care: Meet the American Dream is approximately 220 pages. Greenleaf Book Group is the publisher. The book was released in October 2018.