by Christopher Cornue

Allow me to be bold and perhaps even controversial for a few moments (er, paragraphs), please. During a recent collaborative visit with some healthcare organizations in England this month (of which I'll be writing future postings in the next several weeks), I was hit by a revelation during one of my presentations. I was talking about some of the innovative strategies for total access in some of our states ... specifically, Massachusetts, Illinois, California and Oregon and thought about the unique opportunity that each state has in the US. Also, each state focuses on specific metrics (as part of a state-run group, Joint Commission or other national body). As most folks know, each of these states (and others) have developed different versions of plans to ensure there is access to healthcare for kids, women, or everyone, depending upon the respective state. It was then that I realized the United States is a huge laboratory for health care reform ... with 50 separate labs working on solutions to health care. This is exciting!

So, what if we take this to the next level (here comes the controversial bit, and I admit I don't know all the dynamics regarding the plausibility of what I'm suggesting - so don't kill me!). What if the Federal Government were to identify a block of funding for each state... and each state would be overall responsible for the delivery of healthcare in that state with: 1) everyone having access to healthcare; 2) quality metrics are established and trended; 3) patient's satisfaction with their care is tracked, trended, addressed; and 4) poor performers (hospitals, clinics, physicians, etc.) are improved. Each state can do something different, depending upon their unique challenges, population, resources, etc. -- but they would have the ability to create programs providing healthcare to their respective groups.

I know there are other options too (i.e., federal funding could be provided to each state to develop a program that could then be potentially rolled out nationally, etc.), and that's the exciting part - that there are 50 test tubes for what could end up being a solution to our healthcare issues nationally. So, is this "out there," are there efforts like this already in place, etc.? OK, I'm finished - thanks for allowing the moment of boldness!