Despite passage of the ACA five years ago, every day the equivalent of a US jumbo jet full of Black passengers fall from the sky killing all aboard, representing the numbers of preventable deaths of US medically underserved Black residents because of medical errors, systemic treatment disparity, racism and lack of cultural competence, lack of timely provider access and the refusal of the health system to provide affordability for health care services. Health care experts accept that the US health care system is broken, and some claim it is too big to fail. Especially so today when the pace and size of the growing health care institutional infrastructure has become regionally and even national in scope and in ownership and management. Of increasing concern is the fact patient in-hospital deaths now have become the third highest annual cause of US deaths, and the failure to support sustainable, affordable post-discharge timely monitored care transitions that avoids costly unnecessary hospital readmissions and emergency room visits, is strong evidence for implementing home and community based health care delivery that is innovative and technology driven. This book starts at the beginning of the US health care system and describes what went wrong, and why despite the knowledge of overt intentional discriminatory action; the US Apartheid-like health care delivery system continued to dominate and institutionalized racial care delivery harming millions of underserved US residents even when use of innovative technology existed for relief. Even when new laws were enacted to "fix" the identified failures and weaknesses of the US health care delivery infrastructure and business models; the willingness of providers to re-frame entrenched profit driven business models to achieve the goals imposed by the ACA proved to be difficult. As a result, today’s established institutional providers are annually paying billions in ACA imposed fines for excessive levels of patient readmissions and delays for costly ER visits that could be mitigated through adopting proven affordable technology innovations and community partnerships. For reforms to take hold in delivering affordable health care to millions of intentionally underserved US residents there has to be both trust building and patient-centered care activities undertaken to overcome past intentional misconduct and distrust of the health care system and its providers. This presentation offers solutions and a path forward to point out how the underserved can and must become an active participant in their health care, as well as proffers comment on and comparisons to existing and new entrant care delivery models. The time is now for putting tools in the hands of the underserved to receive the historical promises of equality, access and competent cultural services care delivery. Finally, a business case is made showing how much of the US annual health care spend is currently available to support the underserved sector of the US population, and demonstrating how much in savings can be realized through use of telemedicine technology and innovative applications supporting PCPs and hospitals. Telemedicine technology can transform US health care delivery and save lives.
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William T. Johnson, J.D., LL.M has been a hand's on Chairman of a 100 bed skilled nursing facility founded over a century ago to serve the needs of Black citizens left outside of the health care system. Home Echo Club evolved into a highly acclaimed and innovation focused "home" that was awarded its status listing in the Best of the Best US Nursing Homes, and received citations from state and federal governments in recognition for receiving deficiency-free state compliance and regulatory surveys and a FIVE STAR customer satisfaction performance. Mr. Johnson's law firm focused on civil rights, health care law and policy, elder care law, and as a business lawyer Mr. Johnson represented clients in medical care and allied health, assisted living, and ambulatory centers [including a health provider organization before the United States Supreme Court challenging a provision of the Social Security Act]. A prolific writer and lecturer, Mr. Johnson is published in telecommunications magazines, banking and legal industry articles, newspapers and law journals, including publication in the Harvard Business Review, a Crain’s Business cover story and a Black Enterprise cover feature. Mr. Johnson served terms as Trustee of Capital University, Talladega College, Central Michigan University, the Ohio Foundation for Independent Colleges, and as a Trustee for International Association of Homes and Services for the Aging. Michelle D. Johnson, a graduate of Hampshire College and the University of Pennsylvania, Wharton School of Business, Stonier Graduate School of Banking, and Georgetown University Graduate School, combines experience as a banking executive directing the Community Reinvestment for a commercial lender with building statewide coalitions of community based organizations focused upon improvements for outreach in education, health care access, economic development and affordable housing. Michelle Johnson integrates her relationships in the non-profit industry with exceptional leadership skills, demonstrating organizational attention to detail with use of IT technology applications that support tools for addressing and creating relevant programs for underserved distressed neighborhood residents. Michelle's work for 5 years in the underserved areas of Miami and Dade county was intensely focused on creating the foundation supporting a Florida technology integrated accountable care community infrastructure.
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