January 1, 2010
Over the months I have been publishing my thoughts here, I have decided to limit my focus to strictly the issues pertinent to maintaining and improving one’s personal health (with just a few exceptions here and there). My hope is you have been exposed to a few things that have been helpful.
That’s about to change. In addition to having done my homework on the areas of nutrition, supplements, exercise and longevity, I have also spent a fair amount of time learning about how health care services are provided in the US. It should be no surprise to you that I have formed very clear perspectives on these matters as well.
After considering starting up a separate blog to cover those issues, I have decided to begin covering those issues in this blog – in addition to providing even more info on how to keep yourself healthy. I hope to persuade you that one of the necessary elements for improving the way health care is provided is to have more of us managing our personal health in a way that aligns better with the bodies we’ve been given.
Given the attention this issue has been receiving as of late I expect it will be broadly engaging (although, it is fair to say I’m on the wonk side of things so prepare to wade in the deep water).
So, by way of introduction, here’s my brief manifesto regarding the health care issues of the day:
- We need to change the narrative on healthcare
- Access to suitable healthcare services should be considered a right in this country – as it now is in every other industrialized country in the world
- There should be a ‘floor’ below which no one would be allowed to go below and a ‘ceiling’ above which individuals would have to pay for their own services
- One’s access to these services should not differ based on one’s financial means (you can pay more for the guiding, but the core medical services should be equitable)
- No person should be rendered financially bankrupt solely due to medical bills
- All persons should be required to financially participate in the system (with suitable subsidies for those who truly cannot afford to pay in)
- It is imperative that we reform the way for which services are paid
- universal coverage without respect to pre-existing conditions
- ending policy rescission practices
- ensure portability (i.e. remove ‘work lock-in’ and ‘spouse lock-in’)
- radically alter the business of health insurance that mandates the MEMBERS are the priority, not profit or equity investors (again, like every other industrialized country, by the way)
- It is equally important that we simultaneously revamp way care is delivered
- radically alter payment incentives to focus on outcomes as opposed to solely paying fees for services
- Explicitly emphasize primary care as a means to enable better primary prevention
- Explicitly pay for care coordination services (“medical home” model or the like) to provide higher-quality, more cost-effective secondary prevention (focusing in on the most costly chronic conditions: diabetes, congestive heart failure, coronary artery disease, hypertension, cancer), with the explicit goal to reduce costly hospitalizations that arise from acute events due to poorly-managed chronic conditions
We must create an equitable and sustainable healthcare system in the US (notice I said ‘create’ – since we do not have a health care system today, doesn’t make sense to talk about changing the existing system).
To get a sense of the perspectives I’ve considered in coming to this point of view, here is a very brief list of books I consider most valuable in becoming knowledgeable on these issues:
|Healthcare, Guaranteed: A Simple, Secure Solution for America|
|Health Care Will Not Reform Itself: A User’s Guide to Refocusing and Reforming American Health Care|
|A Second Opinion: Rescuing America’s Health Care|
|The Innovator’s Prescription: A Disruptive Solution for Health Care|
|The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care|
|Chaos and Organization in Health Care|
|Money-Driven Medicine: The Real Reason Health Care Costs So Much|
|Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer|
In the weeks and months to come, I will provide more background on additional books and other resources that will help you become better informed citizen and more empowered consumer of health care.