Our government is missing the mark; prevention and education are essential to drive down costs of health care. As is common knowledge: "many costly and disabling conditions - cardiovascular diseases, cancer, diabetes and chronic respiratory diseases - are linked with common preventable risk factors (World Health Organization)." Tired of asking myself, friends and loved ones the rhetorical question: Why isn't prevention a key point of the current health care reform debate? I looked for some possible solutions to the problem.
Apparently the time is right and the market is ready for real innovation and personal empowerment in medicine. This is a window of opportunity for social entrepreneurs and educators to help Americans take our lives and bodies out of the hands of big businesses and make money in the process.
There are two sides of health care: Preventative Care (which is based on lifestyle choices, education, and preventative medicine), and Disease Management and Acute Care (including testing, diagnosing, symptom relief, and addressing pressing patient concerns). The primary focus of both American Health Care institutions and health insurance providers is disease management and acute care. This forces us to view our bodies through the lens of fear; focused on the notion 'what if I get sick.'
The WHO suggests:
- Support a paradigm shift toward integrated, preventative care
- Promote financing systems and policies that support prevention in health care
- Equip patients with information, motivation and skills in prevention and self-care
- Make prevention an element of health care interactions
Possible Solutions & Opportunities
1) Care Centers and Clinics
Urgent care centers and clinics are filling the role of primary care physicians for many Americans. This is a growing industry. According to the Urgent Care Association of America the number of urgent care centers is increasing by about 100 per year in the US. This is vital because "according to one study published last year in The Journal of the American Medical Association, as few as 2 percent of medical students are choosing to pursue general internal medicine" (New York Times 'Primary Care's Image Problem').
2) Billing and Payment
"Thirty one percent of every health care dollar is consumed by private insurance bureaucracy and paperwork," according to Physicians for a National Health Plan. "Streamlining payment through a single nonprofit payer would save more than $400 billion per year." A recent study published by Criterion Ventures entitled, The Cash Market, highlights that in the current system people are not accessing needed care because of confusing pricing systems and cost barriers. This often leads to more costly interventions down the road. Creating effective and clear billing and payment systems would drive down costs from multiple angles.
Senator Russ Feingold, (D-Wisc.) was quoted by the New York Times, saying, "We need to have some competition for the insurance industry to keep rates down and save taxpayer dollars." Additionally, we need competition in medicine. With so many health issues including: diabetes, obesity, heart disease, and depression attributed to lifestyle and an abundance of trained nutritionists, exercise physiologists and physical therapists poised to serve, the time is right for a shift in the way we look at preventative care and its place in the mainstream. With doctor's visits limited to around 10 minutes-per-patient by insurance companies, opportunities to educate are missed. This necessitates educational projects and clinics to teach and facilitate practices like managing stress, healthy eating, and exercise.
This could have been settled in 1774, when Dr. Benjamin Rush, the only physician to sign the Declaration of Independence, reportedly argued unsuccessfully: "Unless we put Medical Freedom into the Constitution, the time will come when medicine will organize into an undercover dictatorship..." Less than 100 years later, the Popular Health Movement, gathered momentum in the 1830s. Popular Health clinics sprung up as a way to care for the lower class. Similar to "alternative heath practices" of today, these clinics focused on nutrition and herbal treatments. They were so efficient that members of the growing middle and upper classes began to use them. By 1850, the newly established American Medical Association launched a campaign that labeled the Popular Health Practitioners "quacks" and put them out of business.
And here we are, in 2009, with a broken, singularly focused, elitist system. Possibilities are plentiful in the reformation of health care. Needs continue to grow and our government is proving unwilling to truly tackle health care in America. It is up to us to explore this issue and change health care for the better.
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