Foundation system

Equity in our healthcare system

Millions of dollars are spent seeking “fairness” in our healthcare system while insisting that we have no “fairness” because our entire medical enterprise is systemically racist. To achieve this, some even suggest prioritizing care delivery by skin color.

This approach is problematic. It creates racial division. It also conflicts with the overarching goal of medicine, which is to provide the right care in the right setting at the right time when a patient presents with illness or injury, with an emphasis on preventing illness or injury to the extent possible.

At a time when we already have so much division and resentment, here’s an idea: why not just agree to focus on delivering the highest level of medical care to every patient, regardless of racial, ethnic or other characteristics? ?

The terms equity, equality and parity each mean different things to different people. Yet all three share a common goal: fairness. Instead of promoting divisive and discriminatory demands, wouldn’t we be better off mobilizing and betting on equity? In health, simple fairness and color blindness are both desirable and realistic.

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Rather than exploiting racial division, a patient-centered approach is ambitious and seeks to achieve true equity by creating unity of purpose. The advantages are numerous and the disadvantages almost non-existent.

The relationships most critical to achieving health system equity are the patient-physician relationship, the collegial relationship between physicians and other members of a health care team, and the patient-health system relationship. Health care.

A patient-centered approach avoids divisive ideology. It is a positive and ambitious approach that seeks to achieve true equity by enhancing, not diminishing.

The three pillars of a patient-centered approach to providing access to high-quality care at a sustainable cost are 1) expanded personal choice, 2) personal selection of health care arrangements, and policy ownership. health insurance, and 3) equity in the provision of any government subsidies for health coverage and the federal tax treatment of health insurance.

Rather than assuming that patients are incapable of making informed health care decisions on their own, the patient-centered approach assumes that they can. There are several possible methods for financing and providing high-quality care. Why not put them in competition with each other and let the patient choose the method that suits him best?

Giving individuals the ability and responsibility to choose and own their healthcare arrangements and insurance – with the periodic ability to change if they are not satisfied with their selections – ensures personal control and portability. And, by definition, health plans and others in the health care sector would be directly accountable to the patient.

When purchasing health insurance, virtually all Americans receive some financial assistance, whether it is tax-exempt workplace coverage, some level of government subsidy, or a charity. This assistance should be the same regardless of racial, ethnic or other characteristics. It’s fairness.

A variety of non-health factors, including housing and transportation, but especially education, can contribute to disparities in access to health care. These factors are very real and specific remedies must be applied through sound social and economic policies.

For example, getting students from all backgrounds out of failing schools through school choice should be a top priority for state and local policymakers interested in promoting equity.

A high-quality K-12 education aimed at giving graduates the knowledge to find and keep a job or pursue higher education will allow students to thrive rather than be relegated to a life of poverty and expectations and achievements reduced social and economic.

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In the practice of medicine, to achieve a sustainable health system, health professionals must focus on identifying health disparities and supporting research on how to eliminate them.

Medical education is rightly focused on excellence. Nobody wants their doctor to have received the MD or DO degree as a “participation prize”. Your physician should continue to be encouraged to obtain the best education and continuing medical education possible for the type of practice chosen. Meritocracy in medicine is not a myth.

Likewise, the provision of care must be of the highest quality possible for the medical condition at issue. The doctor is ethically responsible for ensuring that this happens. It is not a zero-sum game with winners and losers.

Education and health are closely linked. The promotion of personal choice and defined contribution financing offers the same benefits in education reform as in health system reform. When responsibility rests with the student and the recipient, cost goes down, quality goes up, disparities are reduced, and health care is improved.

Equity: everyone benefits.