a brief outline of coverage

• Health services are client-centered
• Basics of system building
• Specification of the top system parameter: delivered health
• The core system components needed to deliver health
• The second system parameter: cost
• The third parameter: financial risk management
• The Public Health component
• Individualized health services: the role of a primary physician
• The shelf of service providers
• An association of primary physicians
• Cost and cost-effectiveness
• The funding pathway
• The system support component
• Overall system design
• A specification and audit component
• An action plan for system development

The so called “health care” we employ today
in the U.S. is the most costly among the health systems offered by
developed countries. It is also one of the least successful in delivery
of health. We are well aware of this; we read and hear complaints about
our health care just about every day.

This focus on cost is unfortunate. When we direct our
attention to cost, we direct it away from the primary target outcome
of health delivery; that is individual health.

Our focus on cost is a consequence of our tendency
to think of our present health care as belonging in the same category
as business systems. It does not!

In system technology, the top defining feature of a
system is specification of what outcome is to be deliver with identification
of the user of that outcome.

For example, the target outcome of a business system
is profit for its owners. In contrast, the target outcome of a health
delivery system is superior present and future health of each individual
the system is obligated to serve. In the case of health delivery for
an individual, cost is in second place: it is a consequence
of efforts to deliver the targeted health outcome for that individual.

A health delivery system belongs in a significantly
different catgory than a business system.

A health delivery system is a client-centered system. It
belongs in this category along with schooling and elder care, for other
examples.

To design and operate a client-centered system,
one needs to have a set of special skills — as does an engineer in the
automotive industry. The skills that are needed in health delivery
include, but go beyond, the skills of a physician.