Working Together to Create an Affordable Health System

As we approach the presidential election next week, health reform is front and center as a key issue for the US. Entitlement programs, liability concerns by professionals, broad insurance coverage plans, and patient requests for expensive care have put the country on an unsustainable course that threatens us financially.

Many of the ideas for health reform, including encouraging more comprehensive primary care through patient centered medical homes, bundling payments to providers, and reclaiming money paid to hospitals for unsatisfactory outcomes are nibbling at the edges of what needs to be done.

But I can envision a radically different system from the one we currently have, one that centers on effective partnerships between professionals and patients in which the focus is on the issues that are truly necessary and really make a difference.

Here listed is a few of these:

• A commitment to nutritional balance and appropriate calorie consumption
• Regular exercise
• Avoidance of smoking
• Moderation of alcohol consumption
• Regular preventive visits to the doctor, using published guidelines for testing
• Commitment to careful control of blood glucose for diabetics
• Patient commitment to blood pressure measurement and adjustments necessary to achieve control.

Finding a physician who will lower the barriers to care, communicate easily and effectively with you to help you answer your questions, and provide guidance as needed is another crucial step in the effective, efficient health care system of the future.  

There is currently a growing shortage of primary care physicians, especially those who are open, innovative, and willing to maintain these types of patient relationships.  An essential part of the effective health reform of the future will require addressing the need to train these additional primary care physicians.  

Far too much effort, attention, and money is currently being spent on unproven or ineffective strategies and far too little is directed towards the outcomes in the bulleted list noted above.  Hopefully, this discrepancy will begin to be increasingly noticed and will start to be addressed.  

The answers to our un-affordable health care lies not in personalized medicine and ever more expensive procedures but in focusing on the basics of health and building a system around keeping Americans adherent to those principles.

Your comments or dissenting opinions are always welcome.