Saturday, February 23, 2013

Improving the Healthcare System

We all know that a huge chunk of the national spending goes to healthcare. Treatments and visits to physicians have varying cost from region to region, but does that equate to different levels of service and healthcare? The Dartmouth Atlas Project compared medical billing records all of the country and found that there is a huge variation in how much clinics charge patients yet the quality of healthcare they received were more or less the same. The initial speculation is that many physicians give unnecessary treatments to patients; they overkill the patients’ conditions to ensure that they are treated (or, for some, so that they can reel in more money).
I think health is a right, and not a privilege. The most basic general thing that humans have is their health. If they don’t have health, nothing else matters, so if we were to give anything to someone it would be health. Anyone is entitled to and has the right to have better health just because that’s the most essential gift that anyone can receive. How can we deny people of lower income from living their lives in good health? The need for health is more basic than the need for food, sleep or entertainment, because without health or life, food, sleep and entertainment are irrelevant. Of course people of high socio economic levels would have more options available to them in terms of treatments, but everyone is entitled to basic healthcare.
In light of the Dartmouth Atlas project, the documentary US Healthcare: The Good News showcases healthcare systems around the country that has lower than average cost but higher than average services. In Grand Junction, CO, the physicians in the county made a pact in which they promise to charge all patients the same amount of money for the same type of treatment. They do not discriminate between a  patient with private insurance and one with Medicaid. Moreover, a portion of the money received from patients are withheld and distributed among physicians monthly. This system equalizes the cost to visit a clinic, making it affordable for those of lower socio economic levels and ensuring that the poor can get similar, if not the same, quality of healthcare as do the rich.
In Seattle, WA, Group Health is a cooperation of physicians. The physicians are paid a fixed alary and schedule their work day around the patients’ appointments (not the other way around as it is normally). Moreover, they keep electronic records for easy access for both patients and the staff. Patients are given more time to talk with the physicians about their aliments and can contact them by phone or email; this allows the physician to really understand and keep track of the patients’ medical history. The best thing about the fixed salary part of this system is that physicians have no reason to prescribe expensive or unnecessary treatments for patients to make more money, since they are paid the same amount of money either way. This also allows them to take their time with each patient without rushing to maximize the number of patients they see to get more commission.  This system makes the lives of both the staff and the patients much easier.
In Everett, WA, the Everett Clinic is a huge clinic with over 300 physicians working together in it. They strive to eliminate superfluous treatments and costs. They do this by creating strict checklists to approve or deny expensive (and often unnecessary) treatments like CAT or MRI scans. They also use generic drugs and drugs that are the most efficient. They claim that they more money for the community this way by ensuring that the people stays healthy for work.
I think any of these systems could be implements nationally. The main problem is human greed and the lack of strong initiative and leadership. I don’t think convincing all the physicians in a region to voluntarily reduce their income would be easy; moreover, these systems seem to only work if most, if not all, the physicians are receptive to this system. These systems are all or nothing. Either everyone’s doing it in the community or none. I think if we want to see systems like these implemented nationally, it has to be done at a federal level and voted on in the Senate (perhaps making it constitutional iilegal to knowingly prescribe unnecessary treatments). I am sure that this is all possible just as we can evidently see in the cases shown in the documentary, but scaling this up to a national or even state-wide level would deem a challenge.


  1. Thanks for your post. It's interesting, I watched this documentary with my wife about 2 years ago and we were both heartened to know that major experiences are happening within health care.

    The physicians in this documentary have made choices to advance patient health rather than to follow a pure profit motive. This is not necessarily bad business, it is playing the long game. You would imagine that these practices would appeal to patients and that overtime and that more patients would be attracted to these patient centered practices.

    Thanks again for your comments.