Comments on: A Good Idea from Hillary…

By: Dr. Val

Dr. Val — Tue, 09 Oct 2007 01:48:07 +0000

I agree with you, Charlie. If we only applied the simple principles that we already know - healthcare would be so much less expensive. However… just as those of us who are overweight know what we should be doing… there is a disconnect between knowledge and its application. So I would also like to add that we need to figure out creative ways to affect change in diet and lifestyle habits that underpin many of America’s chronic health conditions. We have to incentivize increased physical activity and healthy eating… and for those who need meds, we must help them become compliant. Those “simple” changes would also save tons…

By: Derek Koziol

Derek Koziol — Wed, 03 Oct 2007 15:36:23 +0000

Debate/communication is a wonderful thing, but there needs to be focused effort when it comes to current policy vs. coming up with another “new” idea to add to a growing list of proposed solutions. Talk is not always cheap, but I am tired of hearing opinions with no apparent follow up. It would be nice to audit current policy and see how we can better utilize what we already have:
- All individuals must have access to basic health services. Public and private programs should incentivize broad and consistent physician participation.
- Basic level of coverage should be clearly defined, periodically updated and adapted for gender and age. Coverage must emphasize preventive and supportive, as well as curative, services.
- Healthcare delivery system should provide safe, quality care that is EVIDENCE-BASED and resulting in appropriate outcomes for the patient. Services should be coordinated to assure continuity.
- Healthcare delivery system should be patient-centered and responsive to individual patient needs, preferences, culture and values. The delivery system should be transparent, and should encourage accountability by making appropriate information available to assist consumers’ decision making. The system should be equitable, and simple to understand and navigate.
- Healthcare should be affordable and there should be every attempt to avoid waste.
- Sufficient financing should be available to the healthcare delivery systems to meet long-term responsibilities for providing safe, evidenced-based and quality care.
- CONSUMERS INVOLVEMENT is key in creating a viable healthcare system (policy is influenced by consumer involvement). Consumers must fulfill an obligation to maintain a healthy lifestyle; take advantage of preventive care; and seek more advanced care when it can make a difference. Consumers should be offered incentives for being wise in their involvement and willingness to be pro-active in their care.

By: Peter S

Peter S — Tue, 02 Oct 2007 09:13:05 +0000

Charlie, With all due respect, you are scarcely the only person in health care who\\\’s been talking about spending more money on the application of what we know…and learning more about what works. Maybe that\\\’s true among your rarified peer group in this state, but while you and others have been talking, this train is far down the tracks in several other countries, including England. In the US, even when we do know, it\\\’s hard to actually make the changes because of our ridiculous and fragmented financing system. Much easier to do in a country that has a health care system. Even if we spend more on applying what works, what are the levers for change in this system?

By: Mt57

Mt57 — Sun, 30 Sep 2007 17:46:55 +0000

I agree with you, Charlie to the extent that the higher priority in healthcare and therefore the better focus of spending is not “access” (i.e., paying others’ medical expenses), but improving quality significantly. Whether in private sector or public sector, Americans will support politically and pay for something that works well. For example, imagine if the aftermath of the war in Iraq had gone as dreamed by the White House - how many people would complain about the war today?

With due respect, however, an institute doesn’t guarantee best practices get put in place. The more difficult tasks are to find that mechanism and create a consensus behind it.

By: Charlie Baker

Charlie Baker — Fri, 28 Sep 2007 22:51:08 +0000

Cary - Talk is not completely cheap. In many cases, it’s talk that turns a notion into an idea - and from there it becomes a proposal - and perhaps a policy. I’ve been talking about spending more money on the study of health care delivery for years - by myself. It’s only been in the past couple of years that a growing number of voices - policymakers, academics, politicians and others - have started to say - “Hey wait a minute! We need to spend more time and energy on applying what we know, instead of simply chasing the next new thing.”

So while it’s just all talk at this point, it’s starting to feel to me like a growing chorus of influential people are seeing this one the same way. And that’s a good thing.

By: Cary

Cary — Fri, 28 Sep 2007 15:11:28 +0000

I agree. But talk is cheap, and all this is, is talk. There are many holes in Hillary’s Universal Health plan. For instance, she assumes there are 47 million uninsured Americans every year. However, of those 47 million that are supposed to be uninsured, 10.2 million of them are non-citizens. Of the remaining 36.8 million uninsured, more than half were estimated to not be out of coverage for a full year in between jobs. When asked about Hillary’s plan not including any answer for these non-citizens or temporarily uninsured, Senior policy adviser Laurie Rubiner said, “We have not dealt with every single detail with this plan.”

By: Zagreus Ammon

Zagreus Ammon — Thu, 27 Sep 2007 18:02:06 +0000

There is already an independent institute of best practices. It’s called AHRQ. It should take the lion’s share of NIH funding, but takes a teeny proportion.

Well, I guess you’re right (and Hillary as well), it’s really only just an agency.

By: Bill

Bill — Wed, 26 Sep 2007 12:56:19 +0000

Quite simply — YES!!! We need to get better
at applying the tools we have, rather than
developing more and more new tools that
cannot efficiently, and effectively, utilize.

But you already said that — beautifully.