In the documentary US Healthcare: the Good News, we learn that there is such a thing as unneeded care and it raises the costs of healthcare much more than it needs to be. The documentary follows several communities that have managed to give its people high quality healthcare for low costs.
The Darthmouth Atlas of Healthcare is a record of variations in US healthcare. It uses Medicare data to follow the differences between healthcare and costs in various communities in the US. Put simply, it is, as the name tells us, an atlas of healthcare. This atlas started as the Dartmouth project when Dr. Jack Wennberg was sent to study the places in Vermont that weren't getting enough medical care but instead found variations between treatment and costs in Vermont's communities. This was evidence that in healthcare, the bigger the number of doctors in an area, the bigger the number of doctor visits. So all around the country, treatments are being given to patients who don't need them and the healthcare system is paying for these unnecessary treatments.
I believe healthcare is a privilege rather than a right. A right is something that we as individuals just get without the permission/concern of others. A privilege is a special right granted by someone or a group of people. Access to healthcare is not a right because it involves more than our individual selves. Some parts of health can be taken care of individually but most parts require the help/advice of a physician. If we say healthcare is a right, then in getting a physician's help, we are including other human beings in our right. We are saying that this doctor and that doctor has a right and an obligation to help us when in fact, they only have a moral duty to help us. I believe something is only a right when it doesn't interfere in other people's rights. At the same time, access to healthcare is a privilege because when we are able to see a doctor that is willing to treat us, it becomes a special right that a doctor and an insurance company grants. Many people in America do not receive help from their insurance companies and in turn, their doctor. They are not given this privilege. In various places in Africa, some people are allowed the privilege of seeing a doctor and others are without that help. If access to healthcare were a right, then everyone would get it without help from anyone but since that is impossible, it becomes a privilege that has to be granted with the help of someone else.
Many communities in the US are creating a good balance between healthcare and costs using various methods. The doctors in Grand Junction, Colorado decided that every patient they get should pay the same fee for the same treatment. Even though this makes sense, it was found that all over the US, different patients pay different fees for the same treatment. Grand Junction is one of the few communities that does not do this and the results have been favorable to them. The hospital, GroupHealth, in Seattle, Washington is also doing its best for high quality health with low costs. GroupHealth uses the Patient Centered Medical Home where doctors organize their day around the schedule of their patients and since doctors are paid salaries, they don't have to worry about their income being affected. It's easier for doctors and patients to access medical records since all medical records are electronic. GroupHealth also uses virtual medicine to help treat patients and that increases patient doctor time and they try to treat patients before they become sick. Another place that balances healthcare and costs is The Everette Clinic in Everette, Washington. Some of their methods includes taking out unneeded treatments and unneeded pharmaceuticals. This way, they save money without risking their patient's health. The Providence Regional Medical Center also cuts costs and provides quality healthcare through blood transfusions. They found that many patients who do not need blood transfusions get them so they worked to lower the number of transfusions given to patients. One last place that follows the low cost, quality health mission is the Dartmouth-Hitchcock Medical Center. Here, the doctors involve the patients in treatments choices. In doing this, they decrease the number of unneeded treatments and make their patients much happier.
I am from Baltimore city and I think that the way medical care is delivered in the places in the documentary can be duplicated in my area. Baltimore has some of the highest rates of violence and crime in the US which equals more doctor/emergency room visits.In Baltimore city especially, many of the residents cannot afford to pay very much for healthcare so getting better quality health for low cost would be really beneficial to the people who need it and to Baltimore as a whole. One reason I believe this has not occurred already is because of lack of information or disbelief in available information. Many of the physicians in Baltimore City, would need to come together believing that in lowering costs in various areas of healthcare , there would be more benefits than losses to them.
I like how you outline the goals of the Dartmouth Atlas Project. I also agree with you that the healthcare problem is pending and needs urgent attention, especially in cities like Baltimore. Being from New York City, I find that both regions have similar problems, as (like in any big city) there is a large divide between classes. That being said, it is especially difficult for poor city residents to get the health care they need. In addition to having the doctors believe in lowering the costs, I think outside services need to interfere in order to fix the problem. For example, insurance companies should increase coverage. I think a combination of many factors can help start to solve the problem, although a solution is very far in the future.
ReplyDeleteI enjoyed reading your blog, especially your views on whether health is a human right or a privilege. While i think your idea on this is interesting, you may want to consider reading the United Nations International Covenant on Economic, Social and Cultural Rights. It recognizes the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
ReplyDeleteThe steps to be taken to achieve the full realization of this right shall include those necessary for:
1. The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child;
2. The improvement of all aspects of environmental and industrial hygiene;
3. The prevention, treatment and control epidemic, endemic, occupational and other diseases;
4. The creation of conditions which would assure to all medical service and medical attention in the event of sickness.
In examining whether these innovations can be duplicated for example in Baltimore, think too of other factors beyond not knowing about what is happening elsewhere. What may be some of the benefits to Physicians and hospitals in charging the cost of care by type of procedure and insurance?