Basic Health Access Outline
Health Care: Dividing the Nation
Basic Health Access: Bringing a Divided Nation Back Together
Taxonomy, Themes, and Theories Related to Experiential Place and the Principles of Health Access
Common Sense Health Access Solutions for Entire Nation
Descriptive
Introduction
• Normal Distributions in Physician Origins, Medical School Admission, Training, and Policy Regarding Health Resources
• Failure of Health Access – Exclusive Focus in Origins, Admissions, Training, and Policy
• Optimal Health Access – Movement Steadily Away from Most Exclusive in Origins, Admissions, Training, and Policy
Common Sense Health Access Outline
Principles of Health Access Summary Points
· Health access requires a series of coordinated steps over decades of application. Failure to maintain a health access priority is devastating to future health access.
Basic Health Access Concepts To Review
· The United States has not established primary care or basic health access as a priority. To understand what the United States has, new workforce tools are required. These include the most needed health access careers (rural physicians, underserved physicians, and family physicians), basic primary care (family practice, general internal medicine, general pediatrics), the distortions of expanded definitions of primary care, proper coding of physicians according to concentrations of physicians rather than income or population density, the Standard Primary Care Year measuring tool that allows existing primary care forms to be compared by primary care contributions rather than claims of primary care, the basic concept of experiential place, the requirement for complete populations of physicians and non-physicians to be used regarding workforce design, common misuses of Standardized Testing that result in admissions of physicians with lower probability of needed health access, higher MCAT scores do not translate to better physicians or medical schools, higher scores do result in decreases in health access careers, issues of objectivity and broad perspective rather than narrow or biased perspective, birth origin studies, simultaneous considerations of admission, training, career choice, and policy
Taxonomy, Themes, and Theories Related to Experiential Place and the Principles of Health Access
Odds Ratios of Most Needed Health Access Careers
Exclusive Origins Contribute at Lowest Levels to Needed Health Access
Future Physicians: Children of Combinations of Concentration Versus More Normal Children
· Children arise from a wide range of origins. Bivariate considerations are far too limiting. Experiential place involves multiple dimensions related to concentrations such as income, people, physicians, and resources. More normal children have mid-range or lower density in income and other concentrations. Characteristics important to health access, people-focused careers, and physician location are associated with different origin types.
Exclusive Scores From Exclusive Origins Then Exclusive Careers and Locations versus More Normal Versus Health Access Focus
Admission Directed Away from Primary Care
· Admission preferences of the most exclusive children that have the most exclusive colleges and scores results in decreased primary care and health access.
Setting the Record Straight About Health Access Schools and Programs
· Limitations have not allowed proper interpretations regarding many of the current models, programs, and theories regarding health access.
Training Directed Away from Primary Care and Health Access
· Exclusive training results in lower probability of health access
Career Choice Broad Scope Generalist Versus Specialist and Family Medicine Section
· The broad generalist family practice mode of care is the only mode associated with multiple times greater most needed health access careers.
Policy and Past Present Future Primary Care
· The policy set point determines primary care choice and retention in primary care. Health access favorable policy did not exist prior to 1965, the second period with the creation and growth of Medicare and Medicaid built the potential for health access, the third period in the 1980s was neutral. The 1990s reforms were strongly supportive of primary care and health policy. The 1990s policies also resulted in declines in specialist workforce production (hospital based support specialties). The most recent policy period has been destructive for primary care. Primary care has been converted to specialty and hospital careers. Internal medicine, physician assistant, and nurse practitioner graduates have been moving steadily away from primary care during training, at graduation, and each year after graduation following policy design that rewards hospital and specialty careers and concentrates 90% of the health resources related to physicians in 4% of the land area.
Addressing health access summary
State and Site Specific Health Access
· The Americans left behind are far more than a majority. There is absolutely no describing how incomplete the health access design has become. Systemic changes are required, but implementations must be at the state and local levels.
Moving Away From Concentration
· There are multiple reasons of the highest national priority that would guide a departure from concentration. Public health, infectious disease, pandemic preparation, disaster response, economic reasons, and unifying the United States.
· The current system benefits 75% of physicians, over 90% of medical schools and graduate medical education programs, and the small portion of the population most connected to 4% of the land area. Any departure from this concentration improves health access, but any real departure will be vehemently opposed by those doing well in the current dysfunctional system. Health care improvements like improvements in child development, education, and all basic top priority infrastructure, are all about the needs of 65% of Americans as compared to those doing extremely well. The resolution is not about a level playing field. The resolution is about the decisions made by lower and middle income children to invest in a future for themselves and a future that benefits the United States. Right now, too few make this investment and we all suffer the consequences. It is steady slow improvements in opportunity that result in optimal national outcomes.
· The United States is a world leader at the most important period in human history. At this most critical time it must facilitate a movement from centuries of concentration to a 21st Century moving slowly toward better balance. People frankly do not have education and social development to live together in such concentrations with such poor planning and implementation. Centuries of concentrations of sciences and math have not been balanced by accountability, social responsibility, and communication ability. Without resolutions of concentrations of nuclear materials, concentrations of explosive devices, concentrations of weaponry, concentrations of disease causing materials, concentrations of ultimate wealth, and concentrations of exclusive profits, those left behind will continue to work for better opportunity for their children. The world will be fortunate to survive the decades and centuries of conflict that have just begun.
Primary Care Deficits: Balancing Production of Primary Care Across Birth, Medical School, Residency, and Practice (formerly birth deficit PC)
· Will the United States tolerate a system where some states invest in children who become the teachers, nurses, public servants, and most needed health access professionals while other powerful economic states invest little and reap the rewards. States, counties, and zip codes with top concentrations benefit from the human infrastructure of parents, neighborhoods, school districts, states, provinces, prefectures, nations, and populations who do invest in children.
Human Infrastructure and Access, Cost, Quality
· The leadership of nations involves those with top education and training, advantages of birth, and top social organization skills. Generally these are children that are most urban and highest income, children of the most educated and professional parents, and children of the most socially organized parents or parents in leadership positions. In many instances such parents and their children believe that they are justified in their leadership. Often such parents and their children are less and less aware regarding how they came to power, the responsibilities involved, or the difficult challenge of maintaining the awareness/wisdom that is required to run a nation wisely. Because so little effort has been involved in rising to positions of leadership, those who make nation’s work are often disregarding. Those that make nation’s work efficiently and effectively are the frontline human infrastructure. Those who believe in No New Taxes or steadily declining taxes are completely out of touch with the incredibly complex infrastructure that has been built in nations such as the United States or what maintains the infrastructure or what it takes to rebuild, revise, and progress infrastructure.
· Lower and middle income children are those that arise from the populations left behind by designs of nurturing (parents poorly skilled, distracted, focused on self or survival), child development (minimal or abusive levels of day care support versus active), early education (full year schools focused on the teacher child relationship with maximal learning), education funding (funding at similar levels for all children rather than property tax based discrimination against those in lower property value areas that require more resources to achieve the same outcomes, and by designs of higher education and opportunity. However sufficient lower and middle income children must do well 1) to prevent incredible losses in social support, legal, prison, poor health, and other costs 2) to become the teachers, nurses, public servants, and basic health access professionals that become the human infrastructure.
· Lower and middle income children are the ones that fulfill the Preamble of the United States Constitution but do not have the protections of the preamble. Lower and middle income children are the children that have needs that most must be addressed to form a more perfect Union, they are the ones that risk their lives inside and outside of the United States to establish justice, they sacrifice income and prestige and power to insure domestic tranquility, their actions in their jobs and families and daily lives are essential to promote the general welfare, without their dominant role as human infrastructure there would be no Blessings of Liberty, and sadly it is their Posterity, their children and grandchildren, that are being left out of all of the above priority characteristics often attributed to those living in the United States. Once enough lower and middle income people decide that the United States design no longer works for them and their children, there will be no United States Constitution or a United States.
We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.
Health Access Leadership Training
· There are many in the United States that believe that health access “just happens” and even those that believe in some health planning have a limited perspective just how much planning is required. Even the various primary care training programs espouse leadership development but use the funding for lower priority areas rather than training leaders for future health access. In addition, the United States is terminating the professionals from positions that would lead states and populations to better health access. There are methods of gathering health access leaders together to train each other. This is also the folly of a perspective that rewards top concentrations of information and expertise. There are none with sufficient decades of exposure and study in all of the dimensions required to develop health access. Health access leaders only have each other, limited lifetimes, and an overwhelming task with greatly limited resources – but the most important tasks to perform.
Current Issues
· Health access issues are always current but the decisions made typically lead to more problems and issues that are not resolved. When basic health access is addressed, much of the controversy in health care will also be addressed.
· Physician expansion, too many or too few, balance in workforce by specialty and location, physician productivity, the role of non-physicians, and the basic cost, access, and quality permutations are always current issues.
· One of the greatest tragedies is workforce researchers that think that they have permanent jobs. Those that truly have passion for their research have the strongest desire to resolve health access difficulties. It is the primary task of all physician researchers to put themselves out of a job by resolving their particular research problem.
· The United States can resolve health access difficulties, but it fails in awareness, in training, in empathy for those left behind, and in many other areas that prevent health access recovery.
Health Access Book Powerpoint Graphics
Real Health Access Recovery - Producing and Retaining Basic Health Access Nurses and Physicians
· Producing and Retaining Basic Health Access Nurses and Physicians Logic dictates only one career choice to recover health access in America. There is only one choice that is efficient and effective enough to work under current policy that destroys primary care. Only one choice can deliver the numbers needed and even that choice will need to be protected from policy and from those who profit from the destruction of primary care. There is only one logical choice when proceeding from the most important aspects of who actually stays in primary care, who delivers the most primary care, who distributes to the locations and populations in most need of health access, and who remains most resistant to the policies, practices, and brokers who destroy health access in America.
Foundations of Basic Health Access