This week we watched a PBS video
called U.S. Health Care: The Good News. The video discussed the current state
of health care in the United States but mainly discussed examples of health
care systems in certain communities that provide a good model for how health
care should work nationally. The first focus of the video was on the Dartmouth
Atlas Project. This project studied Medicare billing records and mapped the
healthcare expenses throughout the country. The basic findings were that places
with more doctors and medical equipment had more doctors visits and medical
examinations, however they found that this did not correlate to healthier
people. The increased availability in medical treatment caused more practices
to be done that were not always necessary or required.
Basic health care should be a right
to everyone. However, we need to put an effective health care system in place
that will treat people in the most cost efficient ways while still giving them
the best possible healthcare, which is no easy task. America certainly has the
resources to accomplish this it is just a matter of coming to an agreement on
the best possible system.
The program brought up the case of the healthcare system in
Grand Junction, Colorado, which has been under the national spotlight as having
one of the best systems in place. It has even been visited by President Obama,
who commended the doctors there on their innovative health care set up. The
doctors here charge all patients, regardless of their type of insurance, the
same price for the same procedures, which allows them to provide the same care
to all patients, even those with Medicaid. As was brought up in the video, this
does not seem like any radical thinking, but it is far beyond most health care
set-ups throughout the country. This system also requires that all member
doctors see any patient belonging to that particular plan. The system in place
in Everett, Washington has also integrated some very efficient tactics into
health care. At the Everett Clinic doctors are required to answer questions
about the patient they are seeing to verify whether or not the test they are
looking to run are necessary. This helps reduce medical expenditures by
preventing doctors from running unnecessary tests. The program also focused on
the Dartmouth-Hitchcock Medical Center, which has taken the treatment of
patients to a new level, by incorporating them more in the treatment process.
As opposed to diagnosing a patient and simply giving them some options they
integrate the patients into the process and educate them on whatever treatments
or medications they may be involved with.
The practices seen in this video
can certainly be implemented in the area of the country where I am from,
however there is not a pressing necessity for change. Where I am from, there
are many doctors available and the vast majority of people have adequate health
insurance. The most important changes would be in incorporating more cost efficient
practices, specifically by reducing unnecessary procedures.
I like how you mentioned the cost efficiency of a healthcare system. In Canada we have a healthcare system like the one you are suggesting, however, ours is definitely not cost efficient and has various problems (like wait times). If America put a healthcare system into effect, perhaps our healthcare systems could learn from each other. Also, there seem to be a lot of unnecessary procedures wherever you are – in Canada and in multiple areas in America. I wonder if the Everett Clinic’s system would work everywhere to rectify that problem.
ReplyDeleteKat
Hi Jameson - you did a really great job on this blog! Your recap of the PBS special and the Dartmouth Atlas are really well-done - what do you think of supply-driven demand that you brought up - did it surprise you?
ReplyDeleteI agree with you that access to health care is a right, and that it is sadly lacking in our country. You did a very nice job explaining the innovations found around the country that were presented in the special. Just a few clarifications - for the Grand Junction healthcare structure, the reason that all patients will get equal treatment due to the fact that all reimbursements are equal is that doctors won't then preferentially treat those from whom they will get higher payments. It also does not require that doctors see any patient belonging to a particular plan, but that they see patients belonging to any plan. Also, as used in the Hitchcock Center at Dartmouth, do you really think that shared decision-making is the most radical of the interventions outlined (since you said that this was taking it to an even higher level)? I think that this is the most widely utilized, or believed-to-be-helpful, though perhaps not practiced, intervention outlined. What do you think about the co-op system in place in Seattle?
I was interested in your last paragraph. Be careful with your wording - I don't think that many of the innovations were necessarily just about increasing insurance coverage - they were about reducing costs even in areas where most are insured, which you acknowledge in the next line when you say that your town could benefit by incorporating more cost-efficient practices. You've contradicted yourself here a bit. Also, why do you think that cutting out unnecessary procedures is the best of the practices discussed to cut costs in your hometown?
You did a very good job with this blog - I look forward to hearing more next week!