Thread by @ASlavitt

NEW: My proposal to change the health care system highlighted by COVID. jamanetwork.com/channels/healt…

This proposal calls for three major changes:

-Centering our relationship on care providers, not insurance
-Untethering coverage from employment to existence
-Baking equity for all communities into he design of the system.

How to get there? Put the care team we see every day in the center of the equation. Your payments would go to them and Medicare, Medicaid & ACA would all be the same.

Providers would get a fixed fee they have to spend on your care or your health.

Your job, our lack of a job, or the good graces of your employer, would have nothing to do with your ability to care for yourself & your family. Your new insurance card would be yourself.

Health equity is not equal health care. It’s home & community based care, personal care assistants, rural broadband, reimbursing family caregivers, cultural & language resources. And disparities measured, reported & part of pay.

There are no single three simple changes that fix the health care system. Each change brings new problems. Health care changes need to happen culturally & not on paper and each locality has differences.

But these are changes it is long past time for. COVID must make us better.

How this system works & your coverage is verified.

“We have a short questionnaire. Proof of insurance. Are you a human?”

“Um, present.”

“Check. Do you have pre-existing conditions?”

“Uh, yes, that’s why I’m here.”

“OK. That’s our checklist. I’m your nurse.”