The Dartmouth Atlas Project was a national study to assess the health care system in relation to the cost of care across the United States. The study found that some areas were able to provide great quality of care and much lower costs than similar health care programs that cost more but provided the same quality of care. It showed that more spending does not automatically mean higher quality of care.
2. Do you think that access to health care is a right or a privilege? Explain.
I believe in a country as rich as America, health care is now a right. If this were a third world country that was unable to afford basic health care, the lack of an equal system for all would not be as unsettling. However, we are the richest country in the world and could provide health care of great quality to everyone regardless of income. Health care is not a luxury that would be "nice to have". Without proper and affordable health care, people can suffer serious illnesses that can easily be prevented. The right to health care is similar to the right to education and sanitation. It is a right because it affects people's well-being. To take it away as a right and label it a privilege would be to institutionally enforce the inequality established by income.
I believe in a country as rich as America, health care is now a right. If this were a third world country that was unable to afford basic health care, the lack of an equal system for all would not be as unsettling. However, we are the richest country in the world and could provide health care of great quality to everyone regardless of income. Health care is not a luxury that would be "nice to have". Without proper and affordable health care, people can suffer serious illnesses that can easily be prevented. The right to health care is similar to the right to education and sanitation. It is a right because it affects people's well-being. To take it away as a right and label it a privilege would be to institutionally enforce the inequality established by income.
3. Describe and discuss at least one innovation from each of the medical systems visited on the program that you find important/ interesting.
The first medical system visited was the one in Grand Junction, Colorado. I found it rather self-less and interesting that so many doctors agreed to pool the fees for all procedures, coming up with set fees for each procedure for all payers, regardless of insurance. This truly allowed healthcare for everyone as even the doctor in charge of the program states that a person with only Medicare qualifies for the same procedures as he does. The pooling of resources could be railed against by conservatives as "socialist" health care, but in reality, it is the only way to truly support the less fortunate. The program in Grand Junction is a prime example of the equal access that could happen across America. The program's commitment to all pregnant women regardless of insurance is also admirable and shows how this generous model is truly economical by the thousands of dollars saved from fewer premature babies.
The second system was that of GroupHealth which had the concept of a "patient-centered medical home", an innovative idea that allowed doctors longer and more personal time with patients. I found the use of technology in this system very interesting because it seems like the model that we will see first in the future. Though I question whether a doctor would be able to properly give advice solely over email or phone, I do think that emailing and calling can be valuable additions to normal visits. It helps doctors build relationships with their patients and work with them to improve their health in a personal way. This is important because it will encourage patients to follow their doctors' advice more and therefore cut costs on future illnesses.
The third system was in Everett, Washington where doctors and insurance companies shared data to lower costs on medication. This is important because the cost of medication is a huge part of the total cost of care. If costs can be lowered in any way, they should.
The fourth system was that of the Dartmouth-Hitchcock Medical Center where doctors gave their patients a true say in their treatment instead of the traditional model of expecting the patient to blindly follow. I hadn't thought about the personal aspect of health care before, except in religious contexts where a patient could refuse life-saving surgery due to religious objections. But giving patients a say in their treatment is very important to their satisfaction with the health care system. The system's goal is to increase and maintain the well-being of the patient, mentally and physically. If a patient prefers not to get rid of his or her pain for personal reasons, the health care system should accomodate that because to do otherwise would affect the patient's mental well-being unnecessarily. This prospective emphasizes that health care is not only about keeping everyone's body healthy but that there are many mental and social factors to consider.
The first medical system visited was the one in Grand Junction, Colorado. I found it rather self-less and interesting that so many doctors agreed to pool the fees for all procedures, coming up with set fees for each procedure for all payers, regardless of insurance. This truly allowed healthcare for everyone as even the doctor in charge of the program states that a person with only Medicare qualifies for the same procedures as he does. The pooling of resources could be railed against by conservatives as "socialist" health care, but in reality, it is the only way to truly support the less fortunate. The program in Grand Junction is a prime example of the equal access that could happen across America. The program's commitment to all pregnant women regardless of insurance is also admirable and shows how this generous model is truly economical by the thousands of dollars saved from fewer premature babies.
The second system was that of GroupHealth which had the concept of a "patient-centered medical home", an innovative idea that allowed doctors longer and more personal time with patients. I found the use of technology in this system very interesting because it seems like the model that we will see first in the future. Though I question whether a doctor would be able to properly give advice solely over email or phone, I do think that emailing and calling can be valuable additions to normal visits. It helps doctors build relationships with their patients and work with them to improve their health in a personal way. This is important because it will encourage patients to follow their doctors' advice more and therefore cut costs on future illnesses.
The third system was in Everett, Washington where doctors and insurance companies shared data to lower costs on medication. This is important because the cost of medication is a huge part of the total cost of care. If costs can be lowered in any way, they should.
The fourth system was that of the Dartmouth-Hitchcock Medical Center where doctors gave their patients a true say in their treatment instead of the traditional model of expecting the patient to blindly follow. I hadn't thought about the personal aspect of health care before, except in religious contexts where a patient could refuse life-saving surgery due to religious objections. But giving patients a say in their treatment is very important to their satisfaction with the health care system. The system's goal is to increase and maintain the well-being of the patient, mentally and physically. If a patient prefers not to get rid of his or her pain for personal reasons, the health care system should accomodate that because to do otherwise would affect the patient's mental well-being unnecessarily. This prospective emphasizes that health care is not only about keeping everyone's body healthy but that there are many mental and social factors to consider.
4. Do you think the way medical care is delivered in the places visited in the program can be duplicated in the area you are from ? Why do you think it hasn't occurred already?
I'm from Fullerton in the suburbs of Southern California and I think it's certainly possible to duplicate the health care systems visited in the program there. The video lists and focuses on three changes that need to happen: doctors and insurance companies need to work together to lower costs, they must be willing to adapt new technology so doctors can spend more time with patients, and doctors must be willing to give their patients a real voice in their treatment. Though some doctors and insurance may be willing to lower costs out of self-less concern for their communities, others may not. Lowering costs may make the cost of care cheaper, but doctors may loose money and therefore may not be willing to do so. Regarding new technology, many hospitals and clinics have changed to electronic records but some, for selfish reasons, may try to take on more patients instead of using the extra time to focus on the patients they already have. The third change is trickier to implement. Even if the doctor is willing to be selfless, he or she may not want to leave medical decisions like whether or not to have surgery up to the patient, out of concern that he or she does not have the medical understanding to make a right decision. So really, for many of the changes needed for health care to be improved like the systems featured in the program, doctors and other figures of the medical field need to set aside their selfishness out of concern for their communities. Whether these medical leaders in Fullerton will choose to act, truly depends on their sense of duty to their communities. I think these changes will be easier to implement in smaller towns like Grand Junction, Colorado and my hometown of Fullerton, California, where the doctors in the town probably all know each other and have a greater sense of community. I don't think it hasn't occurred already in my hometown because the median income is rather high and most people can afford the current system of health care, so there has been no rally for change. In areas different from Fullerton, where there is an immediate need for change, they may not have occurred because doctors are not willing to give up some of their pay for the community.
I'm from Fullerton in the suburbs of Southern California and I think it's certainly possible to duplicate the health care systems visited in the program there. The video lists and focuses on three changes that need to happen: doctors and insurance companies need to work together to lower costs, they must be willing to adapt new technology so doctors can spend more time with patients, and doctors must be willing to give their patients a real voice in their treatment. Though some doctors and insurance may be willing to lower costs out of self-less concern for their communities, others may not. Lowering costs may make the cost of care cheaper, but doctors may loose money and therefore may not be willing to do so. Regarding new technology, many hospitals and clinics have changed to electronic records but some, for selfish reasons, may try to take on more patients instead of using the extra time to focus on the patients they already have. The third change is trickier to implement. Even if the doctor is willing to be selfless, he or she may not want to leave medical decisions like whether or not to have surgery up to the patient, out of concern that he or she does not have the medical understanding to make a right decision. So really, for many of the changes needed for health care to be improved like the systems featured in the program, doctors and other figures of the medical field need to set aside their selfishness out of concern for their communities. Whether these medical leaders in Fullerton will choose to act, truly depends on their sense of duty to their communities. I think these changes will be easier to implement in smaller towns like Grand Junction, Colorado and my hometown of Fullerton, California, where the doctors in the town probably all know each other and have a greater sense of community. I don't think it hasn't occurred already in my hometown because the median income is rather high and most people can afford the current system of health care, so there has been no rally for change. In areas different from Fullerton, where there is an immediate need for change, they may not have occurred because doctors are not willing to give up some of their pay for the community.
Sally,
ReplyDeleteVery good blog this week. You summarized the Dartmouth Atlas well and went into a lot of detail regarding each of the innovative health systems discussed in the video. You also state that you think health care is a right. I enthusiastically agree with you on that one! It's interesting that you state Fullerton is rather affluent, so doesn't have as much motivation to change their system. This is a good point, but sadly, I'm not sure there's much motivation to change in the communities with wide disparities in income. I think your point about selflessness and community action is the key to making a good system, whether from a rich or poor area.
Erin
Sally,
ReplyDeleteYour blog was very well written! You summarized the video well and it was insightful. I thought your second paragraph was interesting on how you think Health Care is a right in our country because our nation is well off and should be able to afford Health Care for everyone. Your third paragraph was very well written and had a lot of intricate details. I think you opinion and ideas to get the innovative Health Care in other parts of the country was a good idea and I agree that doctors need to be selfless in order for the system to truly work.
Great job!
Laura