Health Care Delivery System in 2005

In order not to reinvent the wheel, the discussion here will be based largely on the excellent and detailed scenario laid out by Hiatt (1987, pp. 190-208) in Chapter 12, ôHealth Services Research: Health 2000, an Experiment in Health Care Delivery,ö of his AmericaÆs Health in the Balance: Choice or Chance? Other health-care professionals who have dealt with this issue will be cited here as well, but Dr. Hiatt has provided the most coherent and logical of such proposals so far seen.

HiattÆs proposal was based not on sheer speculation, but on data collected and evaluated by a stellar planning committee centered around the Harvard School of Public Health. What the committee proposed was that a new health-care delivery system could begin as a regional pilot project, and then be gradually extended to other regions. They were able to see, from the experiences of existing health organizations, that the type of structure they were proposing depended on having the correct size of population base.

The type of integrated health-care delivery system they were contemplating had to be based in a region with a population of abou

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be able to direct allocation of resources in a rational manner. One presumes that there would be the usual sorts of professional planning committees and advisory councils, so that the M.D.s would not feel like they were being dictated to, but ultimately they would have to decide how to carry out the Regional Health CorporationÆs decisions, not whether. A politically adept Regional Health Corporation Board and CEO would, of course, generate consensus whenever possible for keeping this hospital going as the emergency general hospital, for transforming this other hospital into an outpatient clinic, for revamping the old state hospital into a nursing home, and so on. In this way, adequate services for all, and much better services for most, would be provided, with inefficient duplications of services being eliminated. The Regional Health Corporation would thus be able to ensure that the right sorts of hospital beds are available for the varying degrees of care needed, and would also be able to fund home care when that was the medically best alternative. That is, people would not have to be in a hospital in order to receive medical treatment and benefits, as has often happened under private insurance plans, and this is an area in
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Approximate Word count = 2602
Approximate Pages = 10 (250 words per page)

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