The Healthcare Letter to Americans is a gift to us all, thank you. No doubt the issues of healthcare reform are deep and wide and to think we, or our elected officials will solve such a complex problem in one fell swoop is ridiculous. As you pointed out, reform is an ongoing process, you don’t wake up one day and boom, everything is all of a sudden okay. Progress not perfection. Let’s frame this in the process context.

I see two primary components: Process and Education.

Right now we have a healthcare process. The problem may not be the process; rather that the process is being overloaded. When you overload a process it busts at the seams. Take a look at the obvious effects/results of the overloaded healthcare process: higher costs and survival mode. What I mean by survival mode is you go in to the mode of spending all your energy putting out fires, is it not reasonable to draw the conclusion that our healthcare system is really good at putting out fires, just look at the use of antibiotics and medicine in general, look at the overuse of our emergency rooms. There can be no doubt we have overloaded the system/process.

Education: this is it. It all starts here. If you believe that legislation is the answer to fixing the healthcare crisis then I would ask, why can’t we legislate that all persons young and old, new mothers and fathers, families, schools, doctors, healthcare professionals, businesses be required to attend classes on how better to care for your body. Let’s start with what we are eating!!!!

Is legislation a potentially key component? It can be, but it’s not where the true problem solving is going to take place. In truth I bet it’s already taking place, that there thousands of people and teams making tremendous improvements in our system already. Let’s start with those groups first, get them in the same room each quarter for the next 5 years, that’s 20 meetings of the minds. Heck, maybe it should be 100 meetings in the next five years.

From my perspective, it all starts at home, education. We are missing the boat here. Why not make a commitment today to change the future (true healthcare reform) through our children. Let’s start educating our children today on healthcare, personal hygiene, what to eat, how your body works, how doctors are helpful, what are their areas of expertise, what questions do we need to ask when we visit our doctors, etc. Once the person is empowered, to truly understand how their body works in the environment it lives in, then the healthcare meeting with a doctor or nurse becomes an ongoing education experience. It’s like going to class, you learn, you communicate, you listen, you practice, it’s the ultimate team approach.

As you pointed out in your letter, “…at the end of the day, personal accountability and responsibility could make the US the model of healthcare for the world and an economic engine for our country, not a resource to be rationed”. Clearly the reform process will have multiple tracks, a legislative one, an education one, a technological advancement track and so on. What has me concerned is that it seems we have only one major organized force, congress, managing the process. My guess is there are hundreds, if not thousands, of major forces affecting positive change in healthcare. Let’s hear from them as well. I think your letter opens a door to this kind of dialogue.

One last thought, I realized after I went to bed last night that Sarah Bartosz’s note is an indication of how many of us feel, not that we don’t want improvements, we just want to be included in the discussion and the solution. This is what your letter does for us, it allows us to be involved. Don’t close the doors on us Washington! Thanks Oaks!!!

Thank you for sharing. I couldn’t agree more. What is the rush? Your son is a perfect example of how long term we need to be thinking. Unfortunately not all those in Washington have the fortitude to look long term, their time frame is much shorter… the next election. Not that they don’t care, but lasting hope, the hope you have, we have for your son and our families can not be legislated.

Hagen

Hope is a fundamental right of every American and we can’t have politicians trying to make quick health care decisions impacting the hope and prosperity of each and every one of our lives . . . especially the lives of our children, our most important natural resource.

Congressman Jim Himes,

We want to assure you that we support health care reform legislation to make health care more affordable and insure proper quality of care for all Americans. My wife would not be alive today if she had not received had a double lung transplant in 2004 due to a rare genetic condition.

As a result of this experience, we are critically aware of the high costs of health care and insurance coverage issues. The Greenwich Post reported that I expressed my concerns regarding the public option at the Greenwich health care forum at Town Hall in their article on 9/3/09. They also published our letters to the editor: “Town hall meeting needed in health care debate” on 8/20/09 and “Public option puts seniors at disadvantage” on 9/10/09.

Our over-arching concern with health care reform is that good medicine costs money. While universal access to affordable insurance coverage is a worthy goal, we believe the United States needs to solve the cost problem by redefining health care competition in the delivery of services. This involves focusing on value, as measured by health outcomes per dollar expended, driving increases in productivity, just like we have done in other industries.

It’s just not electronic medical records and better coordinated care for chronic diseases. We need to increase the number of primary care doctors. We need to expand the number of neighborhood clinics and the role of the nurse practitioner. We need to have the doctors and hospitals publish their prices and health outcomes so that patients can seek out the most efficient healthcare providers. The Cleveland Clinic and Intermountain Healthcare are examples of the potential to increase quality and at the same time to decrease costs. We need consumer-driven healthcare insurance policies that offer real “choice”. We need to expand the use of genomics to personalize treatments. We need tort reform to curtail the practice of defensive medicine and applaud President Obama’s willingness to consider demonstration projects.

Access to specialized care and therapies for individuals with rare diseases must also be addressed. In that regard, we support comparative effectiveness research that identifies treatments and services that are effective in clinically treating rare diseases. It is important to provide physicians with such clinical information to assist in the prescribing of proper therapy. Do NOT let comparative effectiveness become the means for prescribing through the creation of formularies and other restrictions on therapeutic use.

Thank you for publishing this letter. I plan to circulate it as broadly as I can and hope that others will do the same.