EMBRACE single system healthcare reform
© Getty Images

With the ObamaCare-repeal efforts by Congressional Republicans under way (even in the absence of a coherent alternative) and the town-hall pushback from voters all over the country, it is easy to lose track of the ultimate goals of a healthcare system: universal coverage and good evidence-based care. Instead, lawmakers are preoccupied with legislation to repeal the Affordable Care Act and modify other federal programs such as Medicare and Medicaid.

We believe that Congress can achieve the fiscal goals they seek, while offering free basic universal healthcare and affordable private insurance. This can be done with a plan that would create a modern, efficient and science based American healthcare system that would please most of their constituents. It is time for Congress to consider a “single system” healthcare-reform plan named EMBRACE (Expanding Medical and Behavioral Resources with Access to Care for Everyone).

ADVERTISEMENT
Developed by a nonpartisan group of healthcare professionals, the plan offers guaranteed basic universal coverage while eliminating healthcare related federal agencies such as HHS and the VA health administration. EMBRACE is designed to incorporate seamlessly 21st century concepts such as science-based guidelines and web-based technology. It relies on three principal innovations that are designed to work together: An evidence-based 3-tiered benefits system; a web based, nation-wide Health Information Platform (HIP); and an independent Nationals Medical Board (NMB) that oversees the nation’s entire unified healthcare system- thereby creating a “Single System." 

THE NATIONAL MEDICAL BOARD 

The NMB, the main component of EMBRACE’s infrastructure, will be an independent non-governmental body like the US Federal Reserve. It would be chaired by a physician appointed by the president and approved by the Senate, and comprised of physicians, nurses, experts in public health and healthcare administration. Under EMBRACE, all healthcare related federal agencies and programs related to healthcare delivery and payment, such as Medicare, Medicaid and the Veterans Health Administration, will either be eliminated or integrated into the NMB. 

THE TIERED BENEFITS SYSTEM 

The Tiered Benefits System is comprised of three levels:  A basic tier (Tier 1) that covers all life-threatening conditions and all life extending or preventive services. A second tier (Tier 2) will cover conditions that affect quality of life, and Tier 3 would cover “luxury” services. 

The benefit tiers are separated in this manner to determine coverage. Because Tier 1 conditions are the most serious in terms of both personal and public health, they are covered by a form of public insurance that is managed by the National Medical Board. This coverage is automatic and universal and does not depend on age, gender, employment status, preexisting conditions, or even military service; it covers the entire population from cradle to grave. Tier 2 is covered by private insurance or paid out of pocket and Tier 3 services would generally not be covered by insurance, which is typical of the current system. 

THE HEALTHCARE INFORMATION PLATFORM

Although the three tiers provide separate coverage, they are all connected by a centralized platform called the Healthcare Information Platform: a secure web-based system available to every licensed healthcare provider.

Funding for all NMB activities will come from an annual congressional appropriation. This funding will cover all the nation’s anticipated healthcare related expenses, including payment for Tier 1 services and NMB commissioned studies.

The benefits of EMBRACE would be profound and far reaching. For consumers, it will provide free basic healthcare services from cradle to grave with automatic enrollment, no out-of-pocket expenses and identical access to every licensed clinician and every hospital. Consumers can upgrade their basic (Tier 1) coverage through private insurance offering easily comparable private plans which would be significantly less expensive than current private plans. It would allow for universal portability of all coverage from job to job and state to state and would have significantly lower out of pocket costs.

For government, EMBRACE would provide a patient/consumer-friendly system with universal coverage, hold in check or even reduce public healthcare expenditures, eliminate healthcare-related federal agencies, stop the impending bankruptcy of the Medicare Trust Fund, free businesses from the need to provide healthcare insurance, enable full participation of for-profit health insurance companies with some “free-market” features without compromising the patient’s health or adversely affecting the publicly funded system. 

For Congress, EMBRACE offers a bipartisan method to accomplish truly universal health coverage while eliminating some of the politically incendiary programs such as Medicare and Medicaid- and the ACA.

Dr. Lancaster is a co-founder of Healthcare Professionals for Healthcare Reform, a former member of the American College of Cardiology’s Board of Governors and author of “EMBRACE: A Revolutionary New Healthcare System for the Twenty-First Century”. Dr. Drozda is Director of Outcomes Research at Mercy Health, is a past chair of the American College of Cardiology’s Clinical Quality Committee, and is an emeritus member of the ACC’s National Cardiovascular Data Registry Management Board.


The views expressed by this author are their own and are not the views of The Hill.