Friday, January 21, 2011

Healthcare Reform- Healing America

I was asked to join a book club by Drs. Gary Cohen and Rob Brookland…they are good guys and I enjoy spending time with them. I think they invited me because they are reading a powerful book on healthcare reform that they thought I would have a strong opinion on. I have to say this is a phenomenal book. It’s written by a long time Washington Post correspondent named T.R. Reid and is called “The Healing of America, The Global Quest for Better, Cheaper and Fairer.” I wish I knew about it six months ago. I would have said to anyone wishing to talk about healthcare reform, “You have an opinion on reform? Go read this book and then we’ll talk.”
What’s interesting about the author is that he has no vested interest in healthcare reform. But, as a reporter who has lived overseas, he decided to set out on a global quest to see if there is something the United States could learn from other countries. He traveled around the world to witness firsthand how other developed countries are able to provide affordable healthcare to their people. 
Right from the beginning he says, there is no perfect healthcare system. Many developed countries have wrestled with the same problems we have and have done quite well for their citizens. What T.R. Reid is saying is this – let’s learn from the success of others.
The book enlightened me about how the many different healthcare systems around the world were born, and how they work. It amazes me that there are no other developed countries where people pay out of pocket for healthcare like we do. Even those Americans with good health insurance pay way more out of pocket than in any other developed country across the world. That’s just incredible.
In 1996, when former President Bill Clinton first started getting this country to think about healthcare reform, both Taiwan and Switzerland were confronting the very same issues. Yet, both of these countries managed to redesign their systems and now rich and poor alike are covered. Look at Otto Von Bismarck, the leader who virtually created the modern state of Germany in the late 1800s. He understood that it was not right for some people to have everything and others to have nothing.  Today, Germany is voted by the World Health Organization to have the second best healthcare system in the world. France was ranked number one. These countries have much higher patient satisfaction and they have clinical outcomes as good as or better than ours. In these countries, people don’t have to worry when they get sick because everyone is covered. People are happy with their healthcare, which is not the case for many in the U.S.
There is a lot of “political noise” about reform in our country. We owe it to ourselves and our children and grandchildren to change the system for the better. The Affordable Care Act moves us a long way in the right direction. The law is not perfect and even after it is fully implemented there will still be some Americans who have no coverage, but it is a start. Let us make sure that it is not selfishness that derails change. I am concerned about people who think, “The system works for me, I have coverage, why should I want anything to change, and I don’t want to pay for others.” If we let this sentiment prevail, we will bankrupt the country and accomplish nothing.
The United States spends TWICE what other countries spend on healthcare, yet we have 40-50 million Americans without insurance. In other developed countries everyone has coverage regardless of socio-economic status.  If we reform the system, we can easily cover all Americans, and even save money in the long run. But it requires people to get educated, work together and change for the better. T.R. Reid’s book shows us how important it is to change the status quo.
A number of people have asked me, where is GBMC going with regards to healthcare reform? If the healthcare reform bill changes with the political landscape, how much of the hospital’s strategic focus will change? The answer is simple – everything we are doing now, all of the changes we are implementing make good business sense and are the right things to do for our patients and our community.
We are putting in place the building blocks that are important for a strong healthcare system:
·         Electronic medical records
·         Extended practice hours, and
·         An overall focus on wellness and coordinated care
We are doing this now so that we can deliver on the vision of better health, better care, lower costs, and more joy. All of these factors are positive even in the fee for service world we live in right now.
A prime example of this new way of approaching patient care can be seen at GBMA’s Hunt Valley practice where Dr. Mark Lamos and the dedicated physicians, nurses and staff are piloting the CareFirst Medical Home project. The pilot program will demonstrate how reform can work to provide the coordinated care necessary for long-term wellness for our patients. Stay tuned for more information on this practice and the pilot program in my next blog.
If you have the time, I urge everyone to read T.R. Reid’s book. It’s certainly eye opening and thought provoking. I’d love to hear your thoughts on this book and on reforming America’s healthcare system – what do you think is the right thing to do for our future?

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