Public-Private Balance
An active citizenry and productive workforce is dependent on the maintenance of the general health of the whole population. This common interest does not preclude the right of any individual to seek their own healthcare with their own resources. Clarity in understanding the purpose, and the limits, of public healthcare is necessary to draw the right balance.
Public healthcare must seek to meet the most basic needs of all before it strives for higher goals. This means that public healthcare will be focused on preventitive and basic remedial services. It does not imbue on the citizen a right to any healthcare procedure available, only to the same care as can be afforded for all.
Community
General Practice
The most effective healthcare services are delivered in the framework of a General Practice physician (GP) who has a personal relationship with their patients and with an emphasis on preventitive services.
The provision of BASE services generally, and specialized education credits for public service in particular, allows the principle of micro economics to operate in the healthcare market too. The portion of the overall healthcare budget (defined as a portion of the Income Tax revenues) that is allotted, by the Community government, for preventitive services can be assigned to each Community resident. That is then paid to their GP of choice. GPs with small numbers of patients will receive less income. New GPs can enter through apprenticeship or sponsorship until they build their own patient list, during which time they will have the support of the BASE services, just like everyone else.
Urgent Care
Communities need to supplement GP services with Urgent Care centers to provide round-the-clock access to emergency healthcare services.
These Urgent Care centers offer a consistent, reliable source of healthcare for those with urgent needs while relieving GPs of the need to run their own 7×24 access services. They may be staffed by the Community’s GPs or by physicians specializing in urgent care.
Regions & above
The more expensive and specialized the healthcare services get, and the smaller the portion of the population in need of them at any one time, the more likely it is that such needs will be met by services established at layers with larger consitiuencies. This is natural logic and already in play and needs little change.
Perhaps the only factor worthy of note is to reiterate the natural impact that the structure of the Standards of LIFE will have. It is the perogative of Communities to promote their services and so it is the Communities that are effectively the ‘customers’ of BASE services delivered from any higher layer. This will result in facilities such as hospitals run at a Region or State level being dependent on providing the services demanded of them by the Communities they serve, for the funds necessary to run such facilities will come from the Communities. (The funds to cover the costs of providing BASE services are distributed to the Communities, and it is then up to them to decide what they would like to promote and, therefore fund, out of their BASE revenues.)