We attended a health care reform forum this week

We attended a health care reform forum this week. One of our local chiropractors has been hosting a series of what he calls transformational dialogues, and this was one of them. Nice idea. Rather than a battle between supporters and opponents of health care reform, the focus was on encouraging a thoughtful discussion about the important questions that need to be asked. Dr. Craig posed questions for the panel which included doctors, nurses, anthropologists and a health care policy advisor.

A few of the issues raised included: health care as a right vs. a privilege, how to reduce health care costs, how much profit should be involved in health care, and what drives the intense feelings on both sides of the issue.

Here are a few points that were made in addressing these issues:

• Canada spends half of what we do. We are ranked #37 and Canada is #3.


• A study in the New England Journal of Medicine of 6000 physicians representing every specialty reported 63% in favor of a strong public option, an additional 10% in favor of single payer. 


• In the 60s, the American Medical Association (AMA) fought hard against Medicare. The AMA represents only 25% of physicians. 


• Pharmaceutical companies spend only 13% of their money on research. They rely a great deal on government funded research.


• Only two countries in the world allow advertising of medications on television - the U.S. and New Zealand.

The Chaos of Health Care Reform

Well folks, it has been quite a ride since we last visited our blog and the issue of health care reform. The process of "discussion" of options and plans has been chaotic and downright nasty. We are interested here in looking at the big picture. In the course of traveling that route, we have come across some very thoughtful articles that address various pieces of the puzzle. One of those pieces is the cost of health care and how to control it.

One article that we especially like is called 'The Cost Conundrum' by Atul Gawande. It appeared in the New Yorker in June 2009.

Here's the link. http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

The author looks at the costs of health care in the U.S. He searches for the places that spend the most money on health care as well as those that spend the least. McAllen, Texas turns out to be one of the most expensive towns in the U.S. for health care. He also looks at models like the Mayo Clinic, which operate in various parts of the country, and Grand Junction, Colorado, a community which provides high-quality health care at substantially lower cost.

What accounts for the differences? After a great deal of digging, interviewing and comparing, he points to one particular issue and dividing principle. Rather than trying to maximize profits for the practitioners, the leading doctors and the hospital systems in the lower-cost places have found ways to reduce or eliminate incentives to spend more for the sake of maximizing profits. They also take collective responsibility for improving over-all patient care.

There you have it - one piece of the big puzzle. It is not easy to change an underlying philosophy and approach to patient care, but it has clearly happened successfully in some places and could be replicated and save lots of money without compromising quality of care.