I tried but failed to post the following to the comments section of the Change.Gov Briefing Book item dealing with the proposal that we made (updated 1/20/2009 3:50pm pst):
I thought a summary of this proposal might quiet some concerns and allow others to see just how interesting this proposal is.
The outline of the US healthcare crisis has been reported well. At $2.3 trillion per year and 16% of GDP our healthcare costs are unsustainable. Double the typical expenditures for developed countries, still we lack proper care for all. For example, we are 37th in infant mortality. We have notoriously deteriorating services and bureaucratic styles of operation. Insurance companies, accountants, statisticians, and lawmakers are telling doctors what to do.
Primary care physicians – our first line of defense and our only hope of moving to preventative medicine – are overworked (2000-3000 patients each will not work) and underpaid. 50 million people are without health insurance. Even those with insurance are often unprotected. The leading cause of bankruptcy is now health problems.
Nearly everyone thinks they know what problem is, but the truth is that the public story is oversimplified and very few people, including the doctors, know what is wrong. In fact, many of the “improvements” of the last decades have made the situation worse in many respects.
We must address the problem on several fronts, all at once. The common solutions are incomplete and insufficient. Universal health care and/or insurance reform is only one of the changes needed. Others say “take the business out of medicine.” You cannot take “business” out of medicine – the investments required to do good modern medicine are too large.
Some parts of the problem remain hidden or only partly visible. Two examples are the costs of renovating our aging population of hospitals and moving services out into communities, and the degree of danger posed by hospital-acquired infections – now a leading cause of death in the U.S., and only the tip of the iceberg has appeared in the press.
Insured or not, patients are going to continue getting insufficient care and to suffer from the lack of doctors, aging inflexible facilities that we cannot possibly afford to repair or replace, and the tortured processes of care that doctors are compelled to navigate through – to a significant degree because of the facilities and the processes of building them.
No one has thought that facilities would fundamentally alter the crisis in U.S. healthcare. We are going to turn that common sense on its head.
Two and a half years ago a distinguished team of doctors, researchers, architects, builders, and technologists in Seattle went to work on the question of how to make high quality healthcare available in the underdeveloped world, and they came up with the innovation that is presented here. (One member of the study group has been awarded a Nobel prize.) The centerpiece of the invention: build facilities out of steel and plastic, like an automobile, on assembly lines, to manufacturing standards, and then assemble them where they are needed. The important results of this innovation are drastic reductions in the time it takes to put a facility in place and decreased cost of the facilities, greatly increased flexibility to be repurposed and reconfigured, enormously improved patient care at much lower costs, and a systemic approach to reducing the dangers of hospital-acquired infections.
Only as the innovative ideas became clear did we realize that these same facilities fit exactly with the need in the U.S. for safe, inexpensive, fast neighborhood and distributed healthcare facilities, and that their availability could trigger vast and important improvements in the healthcare industry. The availability of these facilities will give doctors more room to do their work in many ways.
Our plan was always to use factories like automobile plants to do the manufacturing. It was only with the current economic collapse that we saw how the possibility of employing otherwise fallow assets in automobile plants and employees could help the economy in a big way if we move fast. We included that in the proposal found here. It is unlikely that the U.S. automobile industry can recover by simply selling more automobiles, and especially in this downturn. The industry needs additional products to manufacture, and the equipment and practices they now have are perfect for the kind of healthcare facilities we have designed.
One commentator spoke of no evidence. We have lots of evidence, but little room here in which to present it. For example, CareCyte’s CEO has built many of the most complicated buildings in the Northwest, including the first laboratory to work with live HIV, hospitals, and semiconductor fabrication plants. This is a proposal from a seasoned team.
Summarizing, this is a proposal directly addresses important healthcare problems facing our county – problems of access, costs, and quality – and does it in a way that simultaneously will provide jobs and economic support to the automobile and other industries.
Chauncey Bell
Chief Operating Officer, CareCyte, LLC.
