The Dartmouth atlas project documented the variations in how medical resources are distributed and used in the United States. It uses Medicare data to provide information about national, regional, and local markets. For twenty years these experts have been tracking differences in treatment and cost around the country. One study compared two urban cities: Boston and New Haven. Both of these cities have prominent medical schools but they found spending differences among communities that could not be explained.
I believe that the access to healthcare is one of our natural born rights as humans. We should be able to receive easily accessible care regardless of where we live, our income, or race.
One of the places visited on the program was Grand Junction, Colorado. One thing that really stuck out to me was that there is a non-profit clinic for people with health care. Also, doctors are able to see Medicaid patients and local doctors created health plans to pay off bills. The doctors take care of everyone and all the patients are charged the same fee for a treatment whether rich or poor.
Another place that was visited was Seattle, Washington. In Seattle they have a non-profit health care organization called Group Health Cooperative. GHC is governed by the consumers which is not common in health care systems. They are the pioneers of "patient centered medical home" which is a new way of managing doctor offices. The doctors organize their day around patient’s schedule, entire medical team responsible for health of the patient. They: get together to plan for the cases of the day, all records electronic, which is easier for doctor and patient. They also have "virtual medicine" which is the use of internet and telephone to communicate with patients.
Everett, Washington
They have hired Clinical Pharmacists who are central points of contact for pharmaceutical companies and the team provides info to providers of medication. The team is responsible for reading literature for all new medications. The errors between doctors and the pharmacy are reduced.
Provident Regional Medical Center
A heart surgeon found that some hospitals used blood product during heart surgery a lot while other hospitals rarely used it during surgery. Studies showed that few patients actually needed the procedure, which is expansive. As a result the surgeons only use blood transfusion as a last resort. This concept is now spreading to other surgeon specialists.
Lebanon, New Hampshire
They use a business model: some doctors paid by a hospital and some have private practices. The bills are paid mainly by insurance companies and Medicare. Another good thing is that they get the patient involved in making treatment choices. They doctors ask the patients what they want.
I am unsure if these methods can be implemented in New York City. It is such a densely populated city and also there is such a proportional distribution of salaries among the people working that many people might not be for it. There are also many private practices so it might be difficult to reach them all.
Maurice, if health care is a right who is paying? Are you going to pay? Where will this money come from? Ask yourself those questions when you see how much is withheld from your pay to cover other people's health care. Also are you going to subsidize the treatment of people who have chronic diseases like diabetes and COPD when they are non-compliant and rack up huge bills at the hospital?
ReplyDeleteFor more than 20 years, the Dartmouth Atlas Project has documented glaring variations in how medical resources are distributed and used in the United States. The project uses Medicare data to provide information and analysis about national, regional, and local markets, as well as hospitals and their affiliated physicians. This research has helped policymakers, the media, health care analysts and others improve their understanding of our health care system and forms the foundation for many of the ongoing efforts to improve health and health systems across America.
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Accessed 8 March 12
Health care is a privilege, there is no constitutional right to health care. Is higher education a right or a privilege? Should you pay for everyone to go to college and get an education?
While healthy people "cost" less to society people need to have motivation and ownership to care for themselves. Many chronic disease require behavior change on the part of the individual. No matter how much health care there is it will not matter if patients are non-compliant.
Charging the same for a procedure regardless of health care coverage is not a new concept nor is having a patient centered medical home, this is simply re-invention of previously used healthcare delivery. These innovations are not applied every where because there is no incentive. When the majority of people do not understand the cost of health care and do not directly pay for it themselves there will never be sweeping changes to the system