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Fixin' Healthcare

Sunday, January 14, 2007

Transformation Of Healthcare - Mirror, Mirror On The Wall

The chorus calling for change in the healthcare system is so loud that it seems like one voice. On closer inspection, however, there is revealed to be many issues and many advocates divided among the issues. Among the advocates there is sympathy for all the issues but no common agreement for establishing priorities.

Policy makers have approached healthcare reform in a piecemeal fashion. Financial adjustments intended to save money have been unpopular and generally unsuccessful. Actions that influence certain aspects of health care delivery, such as the Medicare drug benefit, are popular but it remains to be seen if there is a corresponding improvement in health status.

Compassion and politics are directing many of the proposed healthcare reforms. Universal, single payor health insurance should solve some of the acute financial problems suffered by some individuals. Initially, most providers would experience increased income. Most people would be happy, at least for a while. But, it is the same medical care system and evidence is accumulating that overall health status is declining in America regardless of health insurance.

An agenda of eleven principles outlining reform of healthcare in America has been presented by national associations representing physicians. Number ten is as follows: "Sufficient funds must be available for public health and other essential services to include, but not be limited to preventive services, trauma care and mental health services".

A recent article in the Wall Street Journal described an effort by Virginia Mason Medical Center in Seattle to lower cost and achieve comparable or improved outcomes. They succeded but created a financial strain for the hospital. Another report in the January 16th issue of the WSJ described the negative responses experienced by a Chinese physician who practices prevention and lowers cost but creates financial problems for the hospital.

There is no evidence whatsoever that healthcare providers in America oppose, circumvent or undercut prevention. It is far more likely they believe prevention will make no difference in their practices. Many do not believe that prevention will be effective beyond a minor role. Thus, the rank at ten of eleven.

"Transformation of healthcare" is a phrase to convey broadening of perspective in regard to change in healthcare. Its purpose is to emphasize the goal of optimum health status and optimum mental, emotional and physical performance. Process in healthcare cannot be ignored but process is not a goal, and process is subject to change.

The concept of healthcare transformation is based upon an understanding of health consisting of two related but unequal divisions. The larger division and the one of primary importance is wellness, prevention and rehabilitation. Wellness and prevention applies to every adult and child in America without exception. Medical care is the other division and it applies to each person in America who suffers with illness, disease and injury. After successful medical care people will continue through rehabilitation to their optimum health status.

Subsequent posts on this blog will explore the many considerations that might be involved in the transformation of healthcare. The Lifestyle Chronicles will be incorporated into this concept. Undoubtedly, medical care reform will proceed at its own pace but America needs a new approach to health and this will help reform medical care.

Let's build it and make them want to come.

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