 Mission and Core Values
The mission of health planning is the development of comprehensive,
community-oriented health systems designed to assure universal access to
necessary care of the highest quality and most reasonable cost possible. Health
systems must embody a public decision-making process which is sensitive to
community values and the concerns of consumers, providers, payers, and the
needs of underserved populations. That public process must provide broadly
representative mechanisms for identifying community needs, assessing capacity
to meet those needs, allocating resources, and resolving conflicts. These goals
are the best way of assuring accountability and equity in the design and
direction of the future healthcare system.
The core values of our mission are access, quality, community participation,
and collaborative planning: We endeavor to improve these values within health
systems as a matter of good public policy. Health planning requires good public
process in which all health is public health.
The challenge that health planning addresses has always been that of making
the healthcare system more accountable to average residents in their
communities. The longstanding commitment of providers to a community mission
which built public trust is being eroded by corporate business practices which
generate profits, often without any community benefits. The reliance on market
competition for " healthcare reform" is a political and economic
experiment which is resulting in dislocations throughout society. The challenge
to public policy is to facilitate the development of a responsible marketplace,
one in which the sought-after benefits of competition are realized.
" Of all forms of inequity, injustice in health care is the most
shocking and the most inhumane." - Martin Luther King, Jr.
To achieve benefit from this process for all residents, it is necessary for
legislators to take a more active role in shaping the transformation of the
market. Government is obligated to exercise sound stewardship of the public's
resources, much of which it controls as the primary payer of services.
Healthcare is a social good like safety and education which, in a democratic
society, requires intelligent government oversight in order to balance
competing needs and priorities.
Health planning must embody
a resource allocation model which reflects the specific, measurable healthcare
needs of the populations served. It must overcome the reluctance of some
providers to address the needs of high-risk populations. It must encourage
integrated delivery systems to develop long-range plans addressing all needs,
and hold them publicly accountable for meeting them.
 Universal Access
By universal access, we mean access for allUnited States
residents regardless of age, health status, employment status, or income. With
either a private or a public system, access can be provided by either insurance
or entitlement. Access must be affirmed by ensuring that no barriers, such as
the availability of competent personnel, language, and cultural congruence,
exist. All served must have their dignity respected.
Our emphasis on primary care and prevention implies a major
role in providing health education to enable people to become promoters of
their own wellness. All health care services should be accessible as needed,
with mental health services being available
as comprehensively as physical health services. Planning
should be employed to minimize both over-utilization and under-utilization, and
to monitor the adequacy of access through the actual use of services.
Consumers must have the right to choose their own health
care providers and to participate in decisions about their care out of respect
for them and their ability to exercise informed judgment in their own interest.
Looking at the total system, it should be obvious that there
are major social justice issues to be overcome. Equitable financing in a
private system requires spreading of risk through community rated premiums that
acknowledge our interdependence and reduce our differences. The resources taken
out of the community to fund health care should be returned as benefits to the
community.
The premiums, deductibles, and co-payments, if any, should
be scaled by everyone’s ability to pay, both to avoid barriers and as a matter
of social justice. Our current system of financing primarily through
employment-based premiums is extremely regressive in offering the greatest tax
benefits, i.e., subsidies, to those with the highest incomes. Where our current
system uses experience rating, it imposes monumental barriers to access for the
least fortunate.
In making public health a fundamental national priority, we
are acknowledging its practice of prevention on a community scale and its
effectiveness. Twenty-five of the thirty years added to our life expectancy
over the past century were added through improvements in public health.
There should be no surprise that, since we stand for
empowering communities through planning, we seek the collection of relevant
data to support that planning through public reporting processes in which
consumers, as well as providers participate in evaluating outcomes. In the
interests of accountability, consumers should be represented on all boards
overseeing health care.
Accountability
for Quality
Quality must be measured so that consumers and purchasers are able to make
informed decisions, and physicians and their patients share responsibility for
their judgments about treatment options. Public access to outcomes data
reflecting the performance of health systems and health professionals should be
considered a civil right which, if denied, abridges a person's autonomy and may
place a person at physical risk. Governments should operationalize a consumer
entitlement to information as a means to informed consent, and a provider
imperative to improve through collaborative peer review.
The accreditation and certification standards of professional organizations
and the licensure standards of government should incorporate the best currently
achievable levels of quality. Health care delivery organizations and health
care professionals bear responsibility for monitoring and improving the quality
of the care they provide, and for meeting recognized accreditation or
certification standards. They must collect information regarding patient
outcomes, patient satisfaction, and the resolution of complaints, and make such
information readily available and understandable.
Quality must be a key factor
in evaluating the impact of new technologies, new processes for health care
delivery, and new public policies. The ultimate validation of quality is to be
found in its contribution to the improvement in health status of the American
population. High quality health care is therefore primary, preventive care in
which the provider assumes responsibility and accountability for the coordination,
integration, and continuing management of the patient's total health care and
related services.
Community Participation
in Health Planning
Individuals need to take responsibility for their health decisions and be
prepared to share responsibility for management and improvement of their health
with the providers who serve them. Providers need to relate to individuals as
members of communities, and see communities as the contexts in which health
awareness and health status may be improved for all members.
Sharing responsibility for such improvement is a joint endeavor in which
communities need to be given a voice, and given the education and the
information necessary to use it in their best interest. Communities should be
enlisted as active participants and given a meaningful role in:
- How health plans serving their communities are
governed
- How quality of care is measured
- Making the health care system more responsive to
consumer needs
- Planning and development services to meet their needs,
and evaluating results
- Providing oversight for provider initiatives
- Validating the missions of health care systems
- Improving the health status of all of their members
and, Determining how societal resources are distributed.
Empowering
Healthier Communities through Collaborative Planning
All health systems need to have missions which receive their validation
through the support of the community which is their focus and which has a
meaningful voice in their governance. To be meaningful, that voice must include
a role in how systems allocate their resources and in how the quality of their
health care is measured. The ultimate goal of health systems should be to
empower their communities to become healthier, a goal which they can foster by:
- working with regional health planning and public health
agencies
- assisting their communities in health planning and
health policy development
- undertaking community health needs assessments of
community health improvement projects
- collecting data and providing information to their
communities
- providing health education to their communities to
enable spokespersons to exercise informed judgment on health policy
issues
- helping to mobilize community health initiatives
- building capacity to address community priorities
- assuring access to high quality health services and
- publishing comparative performance data on the access,
outcomes, and consumer satisfaction achieved by their systems.
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