Launch the wait-time guarantee
Year 1 (registry), Year 2 (enforceable guarantee) · UHA Office of Patient Advocacy; regional officesDiscuss this step
capacitylikelihood: highimpact: severe
Wait times rise and the employer-insured revolt
Demand rises immediately while training new clinicians takes years. The previously commercially insured, the largest and most politically active group, notice longer waits and turn against the program before capacity catches up.
Early warning signs
- Registry shows specialty waits above guarantee in 3+ regions
- Rising voucher payments
- Physician opt-out above 5% in any specialty
Mitigation
- Age-phased enrollment
- Wait-time guarantee vouchers
- Capacity capital in Years 0–5
- Scope-of-practice expansion
- Rates above Medicare
Implementation risks
| Risk | Mitigation |
|---|---|
| Guarantees are routinely missed and become meaningless (as with the NHS's 18-week target). | Automatic payment, not discretionary; the cost falls on the regional budget. |