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The ongoing “discussion” regarding the development of a new health care program has only distracted the majority of health care giver away from meeting specific needs of a community and more towards how even the most basic needs of a population can best be met.

Even though the last health care system or program (and still current for the time being) was “problematic”, to say the least, some of the valuable directions that program took us were geared towards better managing “managed care” practices and guiding health care providers in directions other than along some superficial, impractical route toward making patients healthier.

The problem with the last (and still current for now) system is that even though it managed to increase the coverage of previously unmanaged  populations, it also increased the cost for other receiving their care, and even disenrolled a significant number by making them ineligible for continued service.

The most important victims of this failed health care administration process, initiated by PPACA and driven further in the wrong direction by the plans being shared right now, are those who have been inadequately covered much of their life, and those with medical issues that are not at the center of the whatever actions these new programs will be taking.

 

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Long term care related needs, or in particular chronic disease care related needs, are once again the main argument being addressed.  During the 1970s, this is why many people could not be managed well or completely.  The existence of a prior diagnosis enabled health care insurers to charge more to these people for coverage, and to even refuse payments for illnesses and health events related to diseases they did not already manage.

The logic for this argument was never fully put into writing, but in a contemporary sense, these companies can now argue that they refuse to cover chronic diseases diagnosed prior to coverage, because the patient was not enrolled in their care once the disease developed.  The implication here is that, had the patient been enrolled in their system, then that patient would be in great or better health, theoretically, and the needs of the patient presently wouldn’t exist, due to their “incredibly great preventive care program”.

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Now of course, such programs did not exist at all back in the 70s, nor do they really exist today.  There are care management programs and services out there in the health care systems, there are programs focused on specific diseases that serve to manage their patients better.  But these programs work at some “minimalist” level, for the most part.  We in health care still leave it up to the patient to take responsibility for his or her health, which still is the best way to manage these problems that cause lifelong disabilities and progressive disease problems.

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Still, the main health related issues suffering the worst from the current indecisiveness of congress and the other untrained politicians making decisions, in areas that require IQs another 25 to 50 percentile above their own, pertain to the forgotten less commonly monitored, severely under researched disease and health problems that exist in the current population.

The most likely patients to suffer the worst consequences of what is now taking place in Congress and the US healthcare system are the members of the youngest generations.  the types of problems they suffer with regard to health happen, because the physical and mental health of their parents are once again put at risk.

These under researched medical problems, which have not been adequately analyzed at the spatial level nationally except by myself, are the focus of these 3D Population healthgrid maps published on this posting.

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The ability of our standard healthcare insurance programs to produce these insightful maps, like the many regional Blue Cross-Blue Shields out there, the various Aetnas and Cignas, has been around for nearly twenty years now.  I first demonstrated the ability for a program to produce this type of mapping 8 years ago on this site, and not that the math related abilities to produce these results at the software-hardware systems level, have existed for about 12 years, perhaps 15 years. The fact that no companies produce these products in large amounts suggests that either–they are not wise when it comes to the best use of their technology, or they are hampered by major companies designed to produce these kinds or tools (Cerner and Soarian) and their lack of skills at this level as well, or finances are simply preventing them from developing this fairly simple method of HIT production.

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The requirements for these 3D models are basic, There are no GIS programming or programs or tools and extensions required to develop a 3D modeling of you population’s health.  This tool may be used to identify the highest risk areas.  It may be used to define exactly where the most important interventions need to be directed.

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The current squabbles between pro-PPACA and pro-Trump enthusiasts are wasting time trying to get a system up and running, again, at some mid-to-late 1970s discriminatory health care level.  This form of ‘selective managed care’ is better off referred to as “Survival Care.”  It increases the pressure on the patients to make choices about what to include in their coverage, and what not to pay into, in spite of the risk that a new disease could later impact your life.  For the child, since the child makes no choices about what he or she needs the healthcare coverage for, the child is a passive victim to this new form of healthcare mismanagement.

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The lack of adequate physical care coverage and the lack of adequate salary or income to meet your special needs as a patient, increases the likelihood that other socially-induced problems will erupt in greater numbers, in spatially denser patterns.

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As the children of this new form of mismanagment age, they will in turn cost the system more.  Whether or not this impacts the mortality of certain diseases needs to be seen.  It will however increase the underlying comorbidity factors that can exist in a given population.  These victims of infancy and being young children will age, and the related mental or behavioral health prevalences for whatever their lifestyle progresses towards will resurface as new problems, new diseases.

 

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This is the consequence of the problems that US health care is now facing, due to each and every president who has failed to manage the most guilty — the insurance companies that refuse to take the steps they need to take, no matter what president defines those steps for change.

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If the plans don’t change, “Trump Care” is going to flunk out, in much the same way as PPACA failed.    Just like their precedents failed – – – the “Advantage” programs, “Managed Care” ideals, the pre-managed care HMOs, all of which failed because they ultimately were rebelled against and/or modified by past and present health insurance companies.