Between Stars and Stripes: Regions for American Healthcare Reform

Analyzes government administration healthcare reform requires. Defines vast scaling of enterprise to cover the entire US. Reviews management constraints to supervise and learn. Always requires hierarchies. Too many layers pass effectiveness thresholds. Proposed reforms: "Medicare for All," may extend UK NHS-like program to US residents; "Public Option" may extend government insurance to US residents who choose it. Debate thus far about costs. Administrative requirements more critical to success (or failure.) Ignored in some plans. Examine how scale is managed in healthcare delivery, in smaller and some large nations. Administration of major medical reforms across US market will take a decade plus to roll-out. Must be carefully managed, to meet healthcare expectations and maintain political support. Success will exploit regionalisation, seeding new programs in areas with equal population sizes and ethnic compositions. Nationalization of some insurers is better than "putting them out of business," could smooth Public Option surge. But perfection is enemy of good: success will follow Moynihan's rule: show benefits to the privileged to serve the underprivileged.