Each community medical foundation would offer a system for all patients in their surrounding area. These will be coordinated in big communities based on where the patient would go in an emergency. Foundations will be organized within their state by county or zip code boundaries.
The catastrophic insurance program uses a community-based and community controlled risk pool. This is a central part of the program. All the money is kept in the community and not used by commercial insurance companies for money market gambling.
Each community system will be managed by a board of directors that is chosen from that community. They are chosen to represent the hospitals, medical professionals and the community at large. The members will include primary physicians, patients, the hospital administration and hospital physicians. Other ancillary specialties and the banks can be included. Several capable prominent citizens are included so the board will be more responsive to local issues.
The Local Board of directors will have complete control of the risk pool. They will have increased interest and knowledge of the community. They will have more care and concern for their fellow community members than clerks in another part of the country.
Local medical foundations can coordinate with local participating banks and credit unions to provide other coordinated financial services. The risk pool funds are kept in the local banks or credit union. The physicians, specialists and the hospital itself will all have accounts within the foundation.
It is expected that the reserve fund will grow as the system saves money because of the extremely high efficiency of the system and because patients will always go to their primary care MD first for “free” (prepaid monthly) rather than go to the ER. All the MDs in the system will provide a 24 hour/day contact line that will handle emergent problems.