Models, Proposals and Polls

Models, Proposals and Polls are all needed to create a usable healthcare constitution.  They are sequential stages in the overall process.

Healthcare system models are descriptions of what the "ideal" U.S. healthcare system should look like in terms of its overall structure and function.  Models should describe where the money to finance the healthcare system comes from, how its allocation is decided and by whom, and the political, medical and structureal arrangements that make the system function.  Everyone should be able to agree that the "ideal" design would result in a healthcare system that is efficient, economical, just, sustainable and provides the appropriate level and quality of healthcare services desired by the population within the limits of the resources available.  (Of course, what's "ideal" depends to a large extent upon the views, experiences, and evidence taken into account by the creators of the model.  One person's perfect system might be another person's nightmare.  That's why it's important to have all of the compenents of the healthcare system in the model, and then to subject each model to discussion and polling.)

Healthcare constitution proposals are attempts to create a set of general rules that will codify the ideal healthcare system.  The role of a constitution is to spell out the rights, responsibilities and limitaions of each party involved in the healthcare system, and specify how those parties should interact with one another.  By doing so it can prevent abuses of power and sudden, disruptive changes in healthcare policy.  Constitutions should have a binding influence on all of the parties involved and, once agreed upon, should not be easily changed.  Also, a good constitution should not be too detailed nor too vague.  An excessively detailed constitution can stifle innovation and beneficial evolution in healthcare.  One that's too vague can leave patients and providers inadequately protected from the actions of governments and powerful corporations.

Public opinion polling is the primary way in which we can gauge how Americans feel about the important provisions of any given model or proposal.  Ideally we would have every American vote on every major provision within a healthcare model or proposal, but this is clearly impossible. (It might be possible to ask Americans to vote adopt a completed healthcare constitution and then compile the results, but even this isn't going to be easy to do.)  However, we clearly need to ask people how they'd like to make the tough choices inherent in any sustainable healthcare system.  For example, we know that healthcare resources are finite, while people's wants are infinite.  Therefore it's not useful to ask whether healthcare goods and services will be rationed.  Instead we need to get some idea of how the American people believe that they should be rationed.  Addressing tough questions like these while we're still in the constitution planning and adoption process is the purpose of polling.

Given these stages, there are many ways for all of us to participate in the process of creating and implementing the "ideal" healthcare system that is likely to work best for America:

• If you  know of a better healthcare system model than any proposed thus far, apply to become an author and propose one.
• If you like a healthcare model that's already present, but see flaws or can suggest ways in which it might be improved, then express your comments and observations in the Discourse section of the website.
• Likewise, if the current healthcare constitution proposals are lacking, you can propose a new one or provide recommendations for improving one that already exists.
• What hard choices should we be asking the public to make in the form of polls?  Propose some well-thought-out poll topics and the questions we should be asking in order to reach valid conclusions on that topic.
• Have a special insight or piece of information that you should share with us?  Let us know.  If it's timely and space is available, it might end up as the subject of a guest blog.
• Like what you're seeing in terms of process, but wish that would happen faster, more efficiently and more effectively?  Then sponsor this project by donating time, money or both!  We need both funding and volunteers to keep this effort going.

Our mutual goal is to create - through evidence, intelligent discourse and consensus - the best healthcare system we possibly can for the United States.  The hardest work will come when we try to implement the resulting constitution in the face of "politics as usual", special interest lobbying and entrenched political and financial interests.  At that point we'll need everyone's help; both to implement the constitution (either through the passage of laws or as an influential moral compass for our political and economic leaders), and defend its use and integrity over time.