The Efficiency of Local U.S. Health Care Systems

A huge question facing politics in our nation is why the United States’ health expenditures are the highest in the world, but the system has been deemed one of the worst. US Health Care: The Good News focuses on successful health systems around the United States that endeavor to achieve both fiscal and physical health. It is based on the findings of the Dartmouth Atlas Project, which tracks differences in health care and spending among American communities, and recognizes certain successful local models that other communities could learn from to achieve the best care systems possible.

The United States was founded under the primary goal of allowing its citizens “life, liberty, and the pursuit of happiness.” While the right to health care is not exactly an amendment in the constitution, but it is a right that should be recognized as part of its citizens leading a healthy and productive life. With an estimated 30% of the current system’s expenditures deemed unnecessary, achieving universal health care is difficult. A restructuring based upon successful programs needs to be accomplished before this right can be realized. At the moment, being provided necessary health care is considered a privilege based on insurance coverage. This does not need to be the case.

The first program highlighted was that of Grand Junction, Colorado, where the doctors have achieved high quality care at low medical cost. The town has in place an independent practice association, where the group of practices blends together earnings and distributes it so that, whether Medicaid or private insurance is being used, the returns balance out. This has allowed a feasible expansion of access. The key innovation here appears to be strong physician leadership. Two systems in Washington State were featured – Seattle and Everett. Seattle’s cooperative group of 300 doctors has proven highly effective. An interesting innovation is that emailing their patients is part of the doctors’ jobs. While other types of businesses have resorted to technology long ago, the medical field is just jumping on. Electronic medical records reduce costs and expand patient-doctor communication as an effective use of time and resources. Meanwhile, an intriguing aspect of Everett’s system is the idea of a nurse care manager – an employee whose role is to work with patients as a counselor so that they may find the most cost- and health-effective treatment for their particular condition. Finally, the Medical Center in Lebanon, New Hampshire emphasizes the importance of a patient’s awareness of their treatment possibilities. This has appeared to be extremely effective in eliminated unnecessary procedures based on a patient’s own informed consent. Improving doctor-patient communication is vital to solving the fiscal issues of the U.S. health system.

These innovative systems are certainly doable. The problem in my community, as in others, is it takes a shift from traditional, profit-driven systems to make way for new ways of thinking. It will be difficult to change the way that the system is run, but it is certainly possible. The first step, for example, would be to have electronic medical records. Putting a certain amount of returns back into the practice to improve efficiency is worth the investment. Health has become a business, and in order for a business to be successful it needs to be competitive and innovative and make changes where needed.