Problem

The problem with healthcare lies with administration.

With the introduction of increasingly clinically constrictive legislation by misinformed politicians and the mismanagement of hospitals by grossly non-clinical administrators, doctors no longer lead their practice, business protocols and algorithms lead their profession for them.

Crippled by the astronomical costs of insurance paid by the practitioner (liability), and by the patient (payment), doctors in the USA today make no more than other doctors, yet the healthcare system is expensively hostile to patients. Insurance

It’s time to look at how France has socialized healthcare and effectively regulated the insurance industry to create a healthcare system that is truly universally accessible, not a luxurious commodity.

Solution: Tech

Consumer web apps backed by AI, in conjunction with smart IoT health accessories, can provide the POS infrastructure upon which to create a healthcare system where people are the focus of healthcare, not insurance companies.

Heart rate, blood pressure, blood profile, skin graft, etc. all gathered using the most advanced nurse assistant, a smartphone. An app that pushes the limit on the sensors of these devices in order to capture accurate and real-time data on patients in order to cut down costs on diagnosis and cutting out the middlemen between patient and doctor.

Syncing your device to a health application that reliably tracks your health will significantly lower the costs of healthcare administration and diagnoses.

Imagine walking into a clinic and checking yourself in via iPad and then waiting for a doctor to pull up your web app data on his/her cloud service so that you can get a clear, AI-assisted, diagnosis and plan of action from your physician within 20 minutes of arriving. And imagine the experience costing you 10% of your current co-pay without insurance.

Solution: Policy

The only way to introduce lasting change in the healthcare is with a supporting foundation of policy. Without regulation, we cannot hope to introduce the above Tech Solution to healthcare.

Insurance has become a dirty word in America. It has been perverted by the countless claims echoed without answer and the heinously hollow coverage policies in the current private insurance markets. Profits in the industry do not need to be regulated, the ways in which those profits are earned do.

Current Insurance business model:

A) premiums paid by insured => keep steady flow of revenue for the legally bound (ACA) insured to find and remain covered by an insurance provider

B) high deductibles paid by insured => keep costs low by shifting the burden of service into the pocket of the insured to discourage spending on medical expenses

C) dense policy packets with poor to non-existent coverage baked within legal lasagna => invest into a rockstar legal team that can prudently disarm claims all the while mitigating media coverage that would otherwise eat into the revenue stream generated by the premiums paid by the insured.

Proposed Insurance business model:

A) alternative investments or subsidies/tax breaks make profits => revenue stream to support operations

B) innovation by practitioners (doctors, nurses, technicians, etc.) in the form of IP => revenue for the insurance company

C) create “clinic cafés” with natural/bio homeopathic medicinal products => revenue stream from patients

D) automated administration with tech for reimbursed billing to patients => patient pays for service and is partially reimbursed later

The grounds for a claim should be regulated to favor patients, not insurance companies. Regardless of financial capacity, a patient is treated on-site based on web app data. The costs of service are absorbed by the subsidized insurance company.