The Real Opportunities To Improve Health Care- A 10 Step Program

The ongoing health care reform debate in Washington requires that all Americans including those in Congress to seize the opportunity to show true leadership on health care reform by dong their part to making health care work.

To really make a difference, Congress and Americans need to stop pretending that they can waive a magic wand and “fix” health care.  There are no easy fixes.  There are just a series of tough realities and steps that all Americans have to embrace to improve health care in the United States.   If you agree with the health care truths discussed in this Article, let all members of Congress know your feelings and join the Coalition For Responsible Health Care Reform group on linkedin to discuss and plan specific steps that you can take to improve health care for your family and others in your community.

10 Health Care Truths

The following are 10 key realities: 

  1. Being old or being sick (or having a loved one who is) stinks. Not everyone was born with a BMW for a body and even some BMW’s are lemons.  Wellness can delay this reality for some people but not everyone.  I don’t live an unhealthy life.  I don’t smoke, don’t do drugs, exercise, etc., yet I’ve had cancer twice.  A good friend who lives a totally healthy life is awaiting a heart transplant at 47.   Even for a car, there isn’t always a clear “evidence based” answer to the questions what’s wrong, how to fix it, when the expense is worth it and how do I find the money and other resources? Sometimes you just have to just keep pouring in more oil and let it leak. The government can’t change this anymore than anyone else. 
  2. Money only can do so much to fix item 1 and there isn’t enough money to fix what can be fixed for everyone (assuming there is a fix).   We can put more money into the system if Americans support taking money from somewhere else to provide more money for health care.  Individual families currently make these choices by deciding whether to buy and how much coverage they can afford without giving up other things that their family views as more necessary than health care coverage.  Congressional proposals would take this choice away from American families by dictating both how much and the price of coverage a family must buy as well as how much that American family also must pay to buy health coverage for other Americans. 
  3. The aging population means that the gap between 1 and 2 will continue to grow unless we adopt a rationing plan that decides to let people die by denying care. Many old and sick people are extraordinary functional, valuable and important to someone.   If the government chooses to replace private insurers in running the health care system, grieving families of ill and individuals will be mad at the government when their family members die or suffer because they can’t access or afford health care that the doctors say would help.
  4. Just because the most health care dollars are spent in the last months of life doesn’t mean that these dollars are necessarily wasted. Likewise, pouring dollars into “prevention” doesn’t mean that a large number of people won’t still get older or sick.  People that live healthy lives get sick, have accidents, and get old.  The body wears out.  The ability and practice of the US health care system in saving hands of minimum wage workers, providing diagnosis that extends the range of treatment options and gives people with terminal illness 6 months to 5 years of life, providing treatments that minimize disability and maximize functionality are all good things. The U.S. willingness to invest in our aging and disabled is part of the reason our disabled and aging people tend to be more productive than in other countries less willing to invest in these treatments.  The question should be what quality of life and value was realized for the dollars spent.   
  5. The most overlooked opportunities for quality and cost improvements rest with the people in health care. Studies show that physicians and the RNs working with them agree in less than 70 percent of the times about the care ordered and how to administer it. Communication elsewhere among health care providers further erodes cost effectiveness and quality. Government regulation and the tension that results from regulation and practices that break up health care teams makes this worse contributes to this problem.   Congress’ over regulation of health care and efforts to manipulate health care by manipulation of the Medicare rules already has done tremendous damage by forcing providers to run rabbit trails to try to deliver care.  More Federal involvement will just make this worse. 
  6. Americans want to be good health care consumers.  They just need training and tools to do it better.  We need a national health care consumer education campaign that teaches Americans to better participate in our health care system.  Patients and their families will better manage their own health care when they have better health care information and health care skills training.  Skills training can reduce waste and suffering that happens when patients don’t comply with health care advice and make misinformed decisions.  When families and patients get good information that indicates that the $20,000 spent for a procedure will only cause a lot of suffering and expense to extend a life already suffering for another 48 hours, they usually chose quality of life over length of life.  Families that learn that the less expensive drug works as well as the more expensive one usually will opt for the less expensive one to realize the smaller co-pay. Patients and their families need to be taught to be good and responsible health care patients and to help others in their families and the community to do the same.  The government, health care providers, insurers and community organizations can help by providing education and resources to share this education.  make this easier. Let’s give American’s a health care loaf and turn them loose.  
  7. Americans dont want someone else to manage their health care;  they want more power to manage it themselves.  Current proposals that would give government more control over health care is the last things Americans want.  Instead of taking more control away from individual Americans, Congress should work to empower patients by creating real jobs, funding public, charity, and private indigent care health clinics, hospitals and other venues that service the poor, reducing taxes and other actions that will free uo dollars for businesses and individuals to invest more in wellness and health care coverage.
  8. Change creates additional costs and disruptions that will drive up costs and reduce quality.  The constant changing of the system and the resulting confusion that patients, payers and providers experience accounts for much of the lost quality, high cost and dissatisfaction in the system. 
  9. You can’t change patient conduct by fiat.  Overcoming obesity and other lifestyle diseases is tough even when micromanaged.  Lack of money isn’t the only reason people don’t have health insurance coverage or obtain care with the rationality of a mad scientist accountant. 
  10. Government is the last entity that should have the right to determine – directly or through a politically appointed board – the value of a life and the quality of life members of my family and yours are allowed to access. Government action is always political – even when made by private politically appointed boards. Letting the government “manage” care instead of insurers just lets a bigger, more insulated fox in the hen house. This fox is bigger, more powerful, less accessible, harder to talk to, impossible to be heard by and doesn’t give a darn individually about you, me, or your family.  Anyone who has relied on home health benefits from Medicare or benefits from the VA knows you can’t trust Congress to deliver on its promises.  Whatever the government allocates for health care funding today, informed American voters know that they can’t count on government providing the funds to keep its promises.  These American’s and the millions who know they know this reality:   When the government says “trust me,” run!

What Congress Should Do  To Improve Health Care

Let’s stop pretending there is an easy fix and get onto the business of working item by item on what we can do with these and the hundreds of other little things that together actually will make a massive difference in the real life of patients and their families AND produce meaningful improvements in heath care cost, quality and access.

  • Tell every member of Congress to say “no” to proposals to spend $1 trillion dollars to give the federal government the ability to “manage” health care
  • Tell Congress you want to manage and coordinate your own health care, not delegate that to government to handle
  • Tell Congress to adopt legislation that would make it easier for churches and other community and business associations to pool together and offer coverage along side the existing employer-provided systems
  • Tell Congress to support and fund public and private efforts to develop and communicate tools and education to empower patients to better manage their own health, wellness and their family’s health care needs
  • Tell Congress not to tax employer provided health care coverage and to provide tax-credits to businesses and individuals to make maintaining private health care coverage more affordable
  • Get involved in your family and community in building your own, your family’s and your community’s health care plan.  Build and use your health care consumer and management skills to manage your family’s health and health care.