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    Ahh…motherhood statements. Tis the season for it.

    Forget about funding (or your statement 3)…you are never going to get any agreements on the re-distribution of global wealth and power. There will always be those that are less well off than others. That is the reality. Plus it dilutes your argument from one of providing for healthcare and throws in socialism (which turns people off)

    What we should be doing is developing a cheap, highly replicable and adaptable model of healthcare that can be rolled out in the remote and developing world.

    So it should be like a franchise…and should be based on the four pillars below.

    1. Immunisation – To get rid of diseases
    2. Nutrition – Food is such a big part of preventative health
    3. Medication – Access to cheap medicines extremely important
    4. Communication – The ability for remote paramedics, doctors to get access to knowledge/resources of the big cities.
    5. Education – Of local health care professions.

    You get those things right, you are well on your way to making universal health care a reality.

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    Tim Senior

    Ahh…more motherhood statements!
    Scott, your four pillars are great. If they were to be implemented, you’d run into 2 problems.
    1. How will this be funded? A user pays model would mean the people who need it wouldn’t have access to it (whether direct payments or insurance). Which leaves you with some form of government/third party paying, collecting money through taxes or something similar. Which brings you straight back to Fran Baum’s third recommendation.
    2. Ultimately, set up the clinics using this model, and pretty soon, you’ll have health professionals saying “where are people going to get their food from,” “we need clean water supplies,” “we need infrastructure for sanitation,” “we need a regular electricity supply to maintain the cold chain,” “we need better economic conditions so people can get meaningful jobs.” As Fran Baum says, the clinics set up with this model will fight a consistently losing battle if the conditions people are living in are not changed.
    Deciding that advocating on social determinants of health is too big or too hard is deciding to make our health systems less effective. It doesn’t mean we shouldn’t build clinics as suggested by Scott, but we do need to advocate for improved social and environmental conditions at the same time.


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