Why we need a new vision for health care!

This is the first entry in my new effort to make health care work for all of us. For years, I've posted on others' sites under the pseudonym Healthcare for All. I've received positive comments on my posts, but I think it's time to branch out and address topics I feel are important rather than reacting to others.

After a career of over 40 years in health care, first as a nurse and later as a healthcare administrator and now a healthcare consultant, I think I have much to contribute to the discussion of why health care isn't working. From concerns about access to care and the ability to gain insurance coverage  to questionable quality in the care received and poor clinical outcomes, the state of the healthcare industry in the U.S. is not where any of us would like it to be. We listen to career politicians who describe how they are going to "fix" health care, and yet none of them have any direct knowledge of the effort it takes to run a hospital or physician practice while dealing with limited resources, conflicting care guidelines, an aging workforce and thousands of patients unable to pay for the care they need.

Recently, the Institute of Medicine released a scathing report on the state of the healthcare industry entitled Best Care at Lower Cost-The Path to Continuously Learning Health Care in America. Three major areas that need to be addressed were identified by the committee that developed the report: the rising complexity of health care, unsustainable cost increases, and outcomes below systems' capabilities. They reported that $750 billion, or approximately 30 percent of health spending in 2009, was wasted. More than 75,000 deaths across the U.S. could have been prevented with proper care according to one estimate. The committee also stated that engaging patients and their families in decisions regarding their care leads to better outcomes and reduced costs, but such participation remains limited. The entire report can be accessed here:
http://www.iom.edu/Reports/2012/Best-Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America.aspx

"Making Health Care Work" is an overwhelming topic..I hope I haven't taken on too much! But then, we have to start somewhere. We spend a lot of money on the pursuit of health, but countries with national health care services have better outcomes than we do! From maternal fetal statistics to longevity, we are not the leaders in the world.

I would love to address the Accountable Care Act (ACA), or as it has been renamed, "Obamacare", but I think that might be too challenging. Healthcare costs as a percentage of GDP have increased for many years. It has threatened the US economy and placed our businesses at a global disadvantage. The auto industry routinely tacks on thousands of dollars in healthcare costs to their products...just one example of cost shifting healthcare costs to all of us. Hospitals and physicians set rates higher to cover the uninsured patient who can't afford to pay...more cost shifting. While not perfect, the ACA is a start. I don't want to completely politicize this blog, but I will incorporate some points from the ACA going forward as appropriate...for now, I just recommend that we don't "throw the baby out with the bathwater"! Let's agree that allowing parents to keep their children on their insurance longer is a good thing...especially since it took my children longer than 4 years to get through college! I'm sure as we look carefully at the component parts of the ACA, there will be other good things we need to keep. Take the time to carefully consider what we really need to address in health care going forward and remember that using health care as a bargaining chip in a political race is not always in the best interest of all of us!

Pat Stanfill Edens, MS, MBA, PhD, RN, LFACHE