Monday, August 03, 2009

How to Reform Healthcare Sensibly: Focus on Two Clear Goals

The focus of the current healthcare reform debate is way out of balance:

  • Issues of money and insurance are by far the main focus
  • Issues of quality and knowledge are a minor focus
  • Issues of empathy and compassion are mostly out of focus.

Focusing on all these issues in a balanced way is absolutely essential for creating a sustainable, high value system in which everyone: (a) has access to excellent affordable healthcare, (b) gets the knowledge and guidance needed to make informed decisions and take responsible action, and (c) is incentivized to "do the right thing."

If, however, we continue to focus on financial matters without equal regard to quality, knowledge, empathy, and compassion will result in more of what we already have: A healthcare system (comprised of many disparate sub-systems) that delivers inferior quality care and poor access compared to other countries, while (a) costing much more than any country in the world and (b) knowing almost nothing about the most cost-effective ways to prevent and treat health problems (see this link).

In other words, the American healthcare system has the lowest level of value (cost-effectiveness) in the industrialized world with no end in sight! Our dire situation will only get worse UNLESS we begin to take a balanced approach that focuses on improving care quality and efficiency, providing everyone access to good care and information, and fostering healthy lifestyles.

The ONLY way to accomplish this, it seems to me, is to focus on these two goals:

  • Enabling all clinicians to continually learn how to make (and keep) their patients healthiest and happiest for longest, using the most cost-effective methods of treatment and prevention, and encourage/reward them for doing so.
  • Enabling all consumers/patients to continually learn how to make (and keep) themselves healthiest and happiest for longest, using the most cost-effective methods of self-care and self-maintenance, and encourage/reward them for doing so.

Enabling and rewarding clinicians and consumers/patients to do these things would save huge amounts of money, continually improve care quality, and vastly improve the health and wellbeing of all by:

  • Eliminating waste, over-treatment, and excessive expenses
  • Minimizing errors, omissions (under-treatment), and legal expenses
  • Fostering wise decisions and competent actions based on valid, ever-evolving, evidence-based knowledge
  • Making healthy living more feasible (e.g., making good foods more available and affordable than unhealthy foods).

Isn't it time we start figuring out how best to do this!?!

My next post expands this discussion and relates it to President Obama's healthcare reform objectives.

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