U.S. Health Care: The Good News

            In the PBS Video, entitled U.S. Health Care: The Good News, the possibilities of improving the Health Care system are presented through looking at the communities who have high coverage but low spending systems.

At Dartmouth College, Medicare billing records were studied by economists and published in “The Dartmouth Atlas of Health Care,” which has become the go to text for healthcare variation. They found that there is huge variation in treatment and spending on Health Care in communities across the country. They also found that the more doctors in a community, the more doctor visits, and the more scanners, the more scanning images. This often results in excess care, and is not necessary, but is still being paid for. In a system where supply drives demand, we aren’t getting the value we need from healthcare.

Healthcare is something that is needed throughout the life of an individual, and even before they are born. Thus, I feel that Health Care should be a right for all Americans. I do not believe that low-income families should suffer by not receiving health insurance simply because they can’t afford it. Not giving them health care would ultimately result in more hospital visits, which costs the system more than if they were given treatment. Thus, not only should health care be a right because the government needs to provide a way to keep every American healthy, but this is ultimately going to save money for the health care system overall.

In communities across the country, innovations in Health Care have been adopted that have shown improvement in patient care and lower spending. In Grand Junction, Colorado particularly, I found their innovations to their healthcare system to be extremely important. In pooling the fees for all procedures, and in coming up with set fees for each procedure for all payers, any person with any type of Medicare can receive the treatment they need and physicians get paid the same amount for any type of patient. This allowed Grand Junction to have a very efficient, low cost, and widely distributed healthcare system. Additionally, they made a commitment to providing care for all pregnant women, which ends up saving them money overall because less problems for the infants result later on. In Seattle, a large practice of 900 doctors, called GroupHealth, the “patient centered medical home” has been put in place. The whole medical team is responsible for every patient and revolves around the patient schedule, which are both better for the patient and the doctor. Additionally, all records are electronic, improving care and saving money. At GroupHealth, part of the physician’s job is to answer e-mails, which leaves time to take care of every issue the patient has. In Everett, Washington, the Everett Clinic is a model for high quality care at reasonable cost. An innovation they’ve put in place is the elimination of unneeded and costly tests. If an ailment does not meet certain criteria, the patient will not get that test, which saves money. In Providence, the poor are better taken care of by using resources as efficiently as possible. They use transfusions as a last resort, and since the cost of blood is so high, the system saves money by not providing unnecessary blood transfusions. In the Dartmouth Hitchcock Medical Center, they get the patient involved in making treatment choices, called “shared decision making.” 

I think that an aspect of Grand Junction’s healthcare system that can be applied in my home city, Detroit, could be the charity clinics. This is an aspect of their healthcare system that wouldn’t take money away from the physicians, which might be a harder thing to make happen, but would help the public and help save the city money. In charity clinics, private insurers and donations of hospitals help to pay for the uninsured, which ultimately saves the system money because healthy people cost less. Additionally, records could be entirely transitioned to an electronic system in order to save money and to create a more efficient system. Lastly, a criteria for various procedures could be created so that less unnecessary scans and procedures are done. These may not have been put into place because physicians and the hospital would have to put patient care and the importance of patient cost above the money they make, and could potentially make less money themselves with a more efficient system, which is difficult to get a consensus on.