No one system escapes criticism. It appears that there is good, bad, and ugly to be found in any system you choose. For sure there would be winners and losers. THE PRIME DIRECTIVE:
- One Operations Manual
- One Policy Manual
- One Reimbursement Manual
USE THE HEIRARCHY OF EVIDENCE
1A-Strong recommendation. High quality evidence. Strong recommendation can apply to most patients in most circumstances without reservation
1B – Strong recommendation. Moderate quality evidence. Strong recommendation, likely to apply to most patients.
1C – Strong recommendation. Low quality evidence. Relatively strong recommendation; might change when higher quality evidence becomes available
2A – Weak recommendation. High quality evidence. Weak recommendation, best action may differ depending on circumstances or patients or societal values
2B – Weak recommendation. Moderate quality evidence. Weak recommendation, alternative approaches likely to be better for some patients under some circumstances
2C – Weak recommendation. Low quality evidence. Very weak recommendation; other alternatives may be equally reasonable
USE WHAT BENEFITS THE HEALTH CARE CONSUMER & HEALTHCARE PROVIDER
-emphasis on the SDOH
-special coverage for designated groups
-Accountable Care Organizations
WE NEED A PLAN WHICH WILL HAVE APPEAL REGARDLESS OF THE SEAT ON THE POLITICAL FENCE.
- One which will reduce the deficit
- One which would correct the variability of the current (MULTI-PAYER) For Profit HealthCare Insurance Model
- One that would meet the requirements of RETURN ON INVESTMENT
- Address the SDOH
- Reduce COST
- Improve QUALITY
- Increase ACCESS
AND-it needs to align with what the people want. Consideration should be given to the needs of providers as well.
Can you say FOLLOW THE YELLOW BRICK ROAD?
 “Grading Guide.” UpToDate, 2018, www.uptodate.com/home/grading-guide.
 Epstein, Reid J. and Ken Thomas, “Democratic Candidates, Pressured by Party Base, Split on How Liberal to Be,” WSJ 20 Mar 2019, www.wsj.com/articles/democratic-candidates-pressured-by-party-base-split-on-how-liberal-to-be-11553093765
 Armour, Stephanie and Kristina Peterson, “GOP Puts Off Unveiling New Health Plan Until After 2020 Election,” WSJ, 2 Apr 2019, www.wsj.com/articles/trump-sees-no-vote-on-gop-health-plan-until-after-2020-election-11554212678
 Kim, Seung Min and Josh Dawsey, “For Trump’s ‘Party of Healthcare,’ there is no health-care plan,” Washington Post, 30 Mar 2019, www.washingtonpost.com/politics/for-trumps-party-of-health-care-there-is-no-health-care-plan/2019/03/30/b4005bd0-5264-11e9-8d28-f5149e5a2fda_story.html?utm_term=.dca7fa256dd2
 Ward, Emily, “White House working on secret healthcare plan with three conservative think tanks,” Washington Examiner, 31 Mar 2019, /www.washingtonexaminer.com/news/white-house-working-on-secret-healthcare-plan-with-three-conservative-think-tanks