The USS Quad Damage

Health care is in a bad way. The entire system needs to be overhauled so it doesn’t end up costing us an increasing fortune over time¹, and the only way to do that is by... erm... giving it tons of money. Indeed, in order to get nurses, doctors, and other related professionals to tackle this issue, we need a bunch more of them, and / or we need them to have the kind of free time it takes to ponder these issues. As fewer people get sick, the need for doctors and nurses will ease, and the number of doctors and nurses will naturally go down.

Here’s the plan:

Increase the number of tiers of nurses. Have junior and mid-level nurses as they are now, but also have senior nurses, and give them extra responsibilities. A senior nurse should possibly only get a simple consult from a doctor, but should otherwise be able to handle outpatients and simple inpatients. Doctors should effectively not have to worry about the patients under the care of a senior nurse. Mid-level nurses should be able to handle patients “generally” — that is, the nurse-doctor relationship is at a similar level to what it is now. The junior nurses do simpler tasks and are trained by the mid-level nurses.

Then add a new tier of nursing — social nurses. These nurses should be given pro-active control of the population — say about 2000 (demographically balanced) people each. These nurses would then go and coach healthy people on their habits, and work with them on diet and other things. Senior nurses, as they gain experience and training would migrate to social nurses. These nurses would also have access to the data for their population. Everyone would have a social nurse, and they would be entirely paid for by the government. They could also (with some administrative help) organise various doctors' appointments, dental appointments, etc.

Doctors would also be split into a few tiers. GPs would now exist in clinics, generally advising social nurses (who have years of hospital experience). Some smaller clinics or “private practises” with a single social nurse could exist with remote access to a network of surgeons or GPs in hospitals. There would also be a new tier of doctor — social doctors. Their purpose is to monitor deeper health effects in society and push for societal change. Partially social scientists, they would try and change culture so that the worst aspects of our lives do not cause health effects later in life. Partially, they would serve as a sort of center for disease control, but more for diseases which do not exist yet, but eventually will.

Combined with a decent communications infrastructure, having multi-tiered doctors and nurses, and increasing their responsibilities appropriately, will cost a lot of money, but it should hopefully sharply reduce disease and illness, allowing us a more sustainable health care system.

¹ Citation needed, but it was projected to cost over 50% of our taxes one day.