DIH Healthcare Integration Model

Abstract
A Practical Guide: Get 500 Years of Clinical Research in 20, Avoid the Apocalypse, and Make Humanity Filthy Rich by Giving Papers
Keywords

war-on-disease, 1-percent-treaty, medical-research, public-health, peace-dividend, decentralized-trials, dfda, dih, victory-bonds, health-economics, cost-benefit-analysis, clinical-trials, drug-development, regulatory-reform, military-spending, peace-economics, decentralized-governance, wishocracy, blockchain-governance, impact-investing

5. Why This Works Better Than Direct Payments

Avoids Perverse Incentives

  • No “professional patients” gaming the system
  • No coercion of desperate people
  • Maintains doctor-patient relationship
  • Preserves medical ethics

Reduces Friction

  • Works within existing workflows
  • Uses familiar insurance model
  • No new systems to learn
  • Doctors remain gatekeepers

Ensures Quality

  • Medical oversight maintained
  • Safety monitoring preserved
  • Professional standards upheld
  • Data quality assured

Real-World Example

Sarah has Type 2 Diabetes

Old System

  • Metformin not working well
  • No other options covered
  • Pays $500/month for branded drug
  • Still has poor control

With a decentralized institutes of health integration

  1. Doctor checks the portal for the trial network during visit
  2. Sees 5 relevant trials for new diabetes drugs
  3. Recommends Trial #3 based on Sarah’s profile
  4. Sarah enrolls with one click
  5. The trial coverage plan covers all costs
  6. Sarah pays $30 copay
  7. Gets experimental drug that might work better
  8. Reports blood sugar via app
  9. Data helps next patient

Implementation Requirements

Technical Infrastructure

  • EMR integration APIs
  • Pharmacy network connections
  • Claims processing system
  • Patient portal/app
  • Data collection platform

Regulatory Framework

  • Modified clinical trial regulations
  • Insurance coordination rules
  • Privacy/HIPAA compliance
  • Prescription handling protocols
  • Safety monitoring standards

Who Gets What

  • Doctors: CME credits for trial participation
  • Pharmacies: Dispensing fees for trial meds
  • Hospitals: Infrastructure payments
  • Insurers: Reduced long-term costs from better treatments

The Pre-1962 Model (The Model You’re Reinstating)

Before the 1962 Kefauver-Harris Amendment:

You bring this model back, but with

  • Modern safety monitoring
  • Real-time data collection
  • Systematic outcome tracking
  • Global knowledge sharing
  • Insurance coverage for trials

Cost Structure (Realistic Numbers)

Per Patient Per Trial

  • Medication costs: $200-2000/month (covered by the trial coverage pool)
  • Monitoring costs: $100-500/month (covered by the trial coverage pool)
  • Travel/time: $50-200/month (covered by the trial coverage pool)
  • Patient copay: $20-50/month
  • Data collection: $10/month (automated)

Total trial fund cost per patient: $360-2,710/month Traditional trial cost per patient: $6,800-13,600/month

Efficiency gain: 75-80% cost reduction

Why Doctors Will Love This

  1. More treatment options for desperate patients
  2. Professional satisfaction from contributing to pragmatic clinical trials
  3. CME credits for participation
  4. No liability (covered by trial insurance)
  5. Simple integration (one click in EMR)
  6. Better outcomes from expanded options

Why Patients Will Use This

  1. Affordable access to experimental treatments ($20-50 copay)
  2. Doctor recommended (trusted source)
  3. Insurance-like coverage (familiar model)
  4. No financial risk (the trial fund covers everything)
  5. Helping others while helping themselves

The Transition Plan

Phase 1: Pilot Programs (Year 1)

  • 10 health systems
  • 5 disease areas
  • 10,000 patients
  • Prove the model works

Phase 2: Regional Rollout (Year 2)

  • 100 health systems
  • 20 disease areas
  • 100,000 patients
  • Refine operations
Phase 3: National Scale (Year 3+)
  • All willing providers
  • All diseases
  • Millions of patients
  • Full integration

Integration Strategy

Your decentralized institutes of health (DIH) network isn’t trying to replace the healthcare system. It’s adding an “experimental treatment insurance layer” that:

  • Works within existing infrastructure
  • Respects current relationships
  • Maintains safety standards
  • Reduces costs dramatically
  • Accelerates medical progress

It’s not revolution. It’s evolution. And it starts with a simple insurance card that says: “This covers your clinical trial participation.”