My post over at The Future Well that argues for creating two healthcare systems in America:
My solution is to create two systems– one for the light users of healthcare and one for the heavy users. Light users, the 85-90% of people who spend only 20% of healthcare dollars, need very different services than the 10% of the population who spend 80% of the $2.5 trillion dollars spent on healthcare every year in America.
The light users need healthcare in an efficient, pleasant experience much like visiting the Apple Genius Bar when your computer breaks. The light users need retail-like services for acute care (broken arm, sutures, etc.) and a simplified chronic disease profile (heavy emphasis on anxiety, depression, asthma, etc).
The heavy users need experts in behavioral and lifestyle modification and managers that coordinate a team of experts and specialists organizing complicated cases where people have many diseases and many needs (for example, people with diabetes who also have depression, congestive heart failure, and blindness). They need acute care from physicians when management breaks down.
Currently, all Americans are thrown into the same system. However, about 90% of us are light users. Both light users and heavy users go to the same place and have access to the same services. All services try to meet the needs of everyone. But it’s not working for anyone. We need to restructure and redesign the “System” into two communicating, efficient networks that have different resources, processes, and experiences.