Healthcare Professionals for Healthcare Reform (HPfHR), is group of physicians, nurses, public health experts, healthcare economists, health information technologists, business leaders, hospital administrators, politicians, patients and many others who developed a 3 tiered healthcare system reform plan for the United States called The EMBRACE Healthcare Reform Plan (an acronym for Expanding Medical and Behavioral Resources with Access to Care for Everyone). The group claims [1] that they are politically non-partisan.
Co-founded by physicians Kimberly Yonkers, [2] Charles Landau [3] and Gilead Lancaster [4] in 2007, the group initially wanted to come up with solutions to the current healthcare system from the point of view of the patient and doctor. They felt that the only effective solution required a complete restructuring of the healthcare system from top to bottom and that systems from other countries as well as single payer plans proposed in this country would never be accepted by the American public or the US Congress.
The group identified five important parts of the American healthcare system that needed to be addressed. These included the inefficiencies in medical offices and hospitals, the need to cover the entire population for basic healthcare services and keep the great quality of the current delivery of healthcare, promote and integrate scientifically validated diagnostic and therapeutic modalities and most importantly, to depoliticize healthcare and allow for a more manageable way to finance it. In addition, it was important that the plan was completely portable throughout the country and did not depend on income, age or employment status.
The group started with an evidence-guided tiered system of healthcare delivery based on the question, “why can’t we build a healthcare system that covers everyone for life saving or death preventing services, and allows them to ‘buy up’ to higher levels of coverage if they want it.
The plan continued to develop, as the group grew and attracted people of many disciplines involved in the healthcare system. As the distance between members grew, discussions were mostly conducted by email, blog posts and telephone. Among the many issues that were discussed during this time, many felt that the plan should have a catchy name. Several proposals for names were submitted and the group voted for Dr, Kimberly Yonkers’ contribution: The Expanding Medical and Behavioral Resources with Access to Care for Everyone (EMBRACE) Health Plan.
In beginning of 2008, with most of the elements of the plan now shaping up, the group began to discuss how to make the plan public. It was felt by most of the members that it should attempt to involve the medical community, and so it should be handled as other medical information- through a prominent medical journal. A writing group was assembled that covered expertise in a spectrum of issues including preventative medicine, public health, medical informatics and business administration.
Since most of the principles of the EMBRACE plan were similar at the time to those declared [5] by the president of the American College of Physicians (ACP), the manuscript was submitted to the Annals of Internal Medicine, the ACP’s medical journal. It was rejected because it was not considered a suitable subject for the medical journal. The manuscript was subsequently rejected by 2 other journals for similar reasons. The group now began discussing publishing EMBRACE in non-medical journals, especially ‘health policy’ journals that may be more receptive to the subject matter, but may have very few doctors reading the plan. Just as the group was ready to submit the manuscript to such a journal, the Annals of Internal Medicine contacted the group and asked it to resubmit a substantially shorter version of the manuscript (half the original size).
After going for peer review and some modifications, the final manuscript was accepted in November 2008, put online in early March and published on April 7, 2009. [6] In the accompanying editorial, the editors explained that HPfHR is one of the groups that ‘are actively thinking about the issue’, [7] and invited their readers to join in the healthcare reform debate. The Annals received and subsequently published 4 letters from readers about EMBRACE in the November 3, 2009, issue of the journal, along with a response from members of HPfHR. [8]
The full publication of EMBRACE [9] came too late for the debate on healthcare insurance reform in the 111th Congress that eventually led to the Patient Protection and Affordable Care Act (PPACA); and in the ensuing storm that developed around this new legislation, any discussion about the EMBRACE plan was drowned out.
Health care reform is for the most part governmental policy that affects health care delivery in a given place. Health care reform typically attempts to:
Publicly funded healthcare is a form of health care financing designed to meet the cost of all or most healthcare needs from a publicly managed fund. Usually this is under some form of democratic accountability, the right of access to which are set down in rules applying to the whole population contributing to the fund or receiving benefits from it.
The Health Insurance Portability and Accountability Act of 1996 is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1996. It modernized the flow of healthcare information, stipulates how personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and addressed some limitations on healthcare insurance coverage. It generally prohibits healthcare providers and healthcare businesses, called covered entities, from disclosing protected information to anyone other than a patient and the patient's authorized representatives without their consent. With limited exceptions, it does not restrict patients from receiving information about themselves. It does not prohibit patients from voluntarily sharing their health information however they choose, nor does it require confidentiality where a patient discloses medical information to family members, friends, or other individuals not a part of a covered entity.
In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the patient's medical history followed by an examination based on the reported symptoms. Together, the medical history and the physical examination help to determine a diagnosis and devise the treatment plan. These data then become part of the medical record.
Single-payer healthcare is a type of universal healthcare in which the costs of essential healthcare for all residents are covered by a single public system.
Community health refers to simple health services that are delivered by laymen outside hospitals and clinics. Community health is also the subset of public health that is taught to and practiced by clinicians as part of their normal duties. Community health volunteers and community health workers work with primary care providers to facilitate entry into, exit from and utilization of the formal health system by community members.
The American College of Physicians (ACP) is a Philadelphia-based national organization of internists, who specialize in the diagnosis, treatment, and care of adults. With 161,000 members, ACP is the largest medical-specialty organization and second-largest physician group in the United States, after the American Medical Association. Its flagship journal, the Annals of Internal Medicine, is considered one of the five top medical journals in the United States and Britain.
UnitedHealth Group Incorporated is a for-profit American multinational managed healthcare and insurance company based in Minnetonka, Minnesota. It offers healthcare products and insurance services. UnitedHealth Group is the world's seventh-largest company by revenue and the largest healthcare company by revenue, and the largest insurance company by net premiums. UnitedHealthcare revenues comprise 80% of the Group's overall revenue.
A primary care physician (PCP) is a physician who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis. The term is primarily used in the United States. In the past, the equivalent term was 'general practitioner' in the US; however in the United Kingdom and other countries the term general practitioner is still used. With the advent of nurses as PCPs, the term PCP also has been expanded to denote primary care providers.
Annals of Internal Medicine is an academic medical journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world. Annals publishes content relevant to the field of internal medicine and related sub-specialties. Annals publishes a wide variety of original research, review articles, practice guidelines, and commentary relevant to clinical practice, health care delivery, public health, health care policy, medical education, ethics, and research methodology. In addition, the journal publishes personal narratives that convey the feeling and the art of medicine. Selected articles in the journal are open access; these include patient oriented content and Clinical Guidelines.
Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society". According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.
The medical home, also known as the patient-centered medical home (PCMH), is a team-based health care delivery model led by a health care provider to provide comprehensive and continuous medical care to patients with a goal to obtain maximal health outcomes. It is described in the "Joint Principles" as "an approach to providing comprehensive primary care for children, youth and adults."
The healthcare reform in China refers to the previous and ongoing healthcare system transition in modern China. China's government, specifically the National Health and Family Planning Commission, plays a leading role in these reforms. Reforms focus on establishing public medical insurance systems and enhancing public healthcare providers, the main component in China's healthcare system. In urban and rural areas, three government medical insurance systems—Urban Residents Basic Medical Insurance, Urban Employee Basic Medical Insurance, and the New Rural Co-operative Medical Scheme—cover almost everyone. Various public healthcare facilities, including county or city hospitals, community health centers, and township health centers, were founded to serve diverse needs. Current and future reforms are outlined in Healthy China 2030.
Unwarranted variation in health care service delivery refers to medical practice pattern variation that cannot be explained by illness, medical need, or the dictates of evidence-based medicine. It is one of the causes of low value care often ignored by health systems.
Healthcare reform in the United States has a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, which amended the PPACA and became law on March 30, 2010.
Healthcare in Georgia is provided by a universal health care system under which the state funds medical treatment in a mainly privatized system of medical facilities. In 2013, the enactment of a universal health care program triggered universal coverage of government-sponsored medical care of the population and improving access to health care services. Responsibility for purchasing publicly financed health services lies with the Social Service Agency (SSA).
The healthcare reform debate in the United States has been a political issue focusing upon increasing medical coverage, decreasing costs, insurance reform, and the philosophy of its provision, funding, and government involvement.
The Expanding Medical and Behavioral Resources with Access to Care for Everyone (EMBRACE) plan is a healthcare system reform proposal introduced by a group called Healthcare Professionals for Healthcare Reform (HPfHR). The plan incorporates elements of private health insurance, single-payer and fee-for-service models in one comprehensive system. It has been referred to as a "Single System" healthcare system. First published in the Annals of Internal Medicine in April 2009, the plan got some early discussion in the healthcare community, but appeared to have come out too late to have had any impact in the development of the Patient Protection and Affordable Care Act (PPACA), the 111th Congress’ landmark health insurance reform legislation. A book outlining the EMBRACE plan in more detail was authored in 2016 by Dr. Gilead Lancaster, a cofounder of HPfHR.
Barbara Starfield was an American pediatrician. She was an advocate for primary health care worldwide. Her academic and professional life was almost fully dedicated to the Johns Hopkins University.
Halyard, formerly Kimberly-Clark Health Care, now part of Owens & Minor, sells sterilization wrap, facial protection, gloves, protective apparel, surgical drapes and gowns in more than 100 countries.