Bob Franza’s take on the healthcare mess

Ok. It has been a long time since I posted here. Sorry to be away.

We have been busy attempting to start this new company, and it has been far more difficult than we had expected. The mess produced by the national discussion about “healthcare reform” – read healthcare insurance reform – has paralyzed developmental and innovation initiatives across the country, and we are entangled in it. Anything that is not following a traditional path or that has not been already demonstrated to the satisfaction of the general observer is stopped cold.

The following is the text of a note posted yesterday on the White House Contact Page by Dr. Robert Franza, CEO of Sustainable CyberLearning of Seattle, formerly of the Seattle Science Foundation and the man who convened the study group that invented the CareCyte innovations.

Dear Mr President,

In your radio address today you state – “This was the moment we built a health care system worthy of the nation and the people we love.”

Mr President, you have equated establishing “health care worthy of the nation and the people we love” with reforming health insurance.  Unfortunately, providing insurance is only a portion of the challenge.  You have yet to address the inadequate health care infrastructure and delivery system – a problem vastly larger than inadequate medical record management and access to affordable insurance.

Fortunately you have citizens who know how to solve both issues and what is remarkable is that you can eliminate all the policy speak, beltway spin salad that has characterized much of your White House messaging the past several months by doing two things:

1. Unequivocally and persistently until it is passed – Support Rep. Weiner’s amendment to replace Division A of HR 3200 with the text of HR 676, the “U.S. National Health Care Act,” sponsored by Rep. John Conyers. This would effectively transform HR 3200 into single-payer legislation – exactly what Americans need and exactly what you need to get out in front of the growing chorus of those questioning your commitment to sign a law that delivers to all Americans that which Medicare, for 44 years, has efficiently delivered to some Americans.  Thanks to the cogency of Rep. Conyers original bill, the resulting legislation will actually be something that most Americans could read and understand;

2. Give me a call – seriously.  During the past three years my colleagues and I in Seattle have devised a realistic, readily implemented, modern health care infrastructure.  We have been trying to inform you for the past two months of how that health care infrastructure can be accomplished, the jobs it will create, and the exportable US products it will generate, and the enormous waste it will eliminate while providing ALL Americans access to safe health CARE.  By the way, Sir, legislation is not needed to advance our plan – you have adequate funds available via your 2009 ARRA to launch.

Mr. President you can jump in front of all the distractions and simply demand passage of the Weiner (Conyers) amended HR 3200, and use it as the blueprint during reconciliation with whatever comes out of the Senate to provide Americans access to a competitive and proven health insurance plan.

Mr. President you can call us and we will explain to you how you can then do for our health care infrastructure what FDR did for provisioning access to electricity (TVA, BPA) and logistics (Liberty Ships) and truly transform not only the quality of health CARE in America, but create a new and sustainable manufacturing sector, jobs, and high quality exportable US products.

Yes. We. Will.

Thank you,

Bob

In his point #2, Bob is referencing a proposal for a new national mid-level healthcare infrastructure for the country that will accomplish the apparently irreconcilable objectives of lowering costs, making healthcare more accessible, and increasing quality, all at the same time. We have proposed the actions to the White House through Washington State Congressional Representatives. If you are interested in seeing our proposal, drop me a note at “info@carecyte.com” with your email address and I will send you a copy.

Best,

Chauncey

Summary of the Proposal We made to the Obama Healthcare Team

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 37^th 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.