Health Care Answers

One of the hottest topics of the decade is health care. Will we ever get it all sorted out? Probably not, but it doesn't keep people everywhere from trying to work out the problems. I recently read an article that I found most interesting about a community that was doing something innovative to bring down the cost of health care.

Studies show that 80% of health care services are used by 20% of the people. The people that use the bulk of the services are generally poor. There are many reasons for this, the most important being that poor people often do not have insurance and over use the emergency rooms. A small town in the NorthEast decided to try a different approach.

What they did was use nurse practicioners and social workers to do follow up on people released from the hospital. Often what would happen is that a poor, uninsured person would need medical attention, but as soon as they went home they would go back to their old ways, often not even taking their medication. Then they would end up right back in the hospital, worse off and requiring more expensive treatment than before.

So much of health care does not involve a medical doctor or a registered nurse to administer treatment. Social workers and medical technicians can do a lot to keep patients on track. Take diabetes for example. This is a disease that requires education and adherance to the program for the patient. There must be follow through for diabetics that come for treatment or they will get sicker and will rack up huge medical bills. A trained medical technican could keep a patient on track.

The study in the small town that tried to use auxillary resources to follow up with hospitalized patients found as much as a 40% decrease in rehospitalization, and the cost of medical care dropped dramatically.

As I've said before, "All change is local," and individual communities are going to have to work out solutions that work for them, then extrapolate that to a larger population.

No one asked me, but I've always felt that prevention should be the focus of doctors. Teach your patients what they need to keep their good health, and when they start to falter, try to fix it. Don't wait until a 16 year old boy weighs 280 pounds and has Type 2 diabetes to try to change his diet and exercise. The writing was on the wall for such a boy for years. Now he will probably be a medical drain on society for the rest of his life.

I remember years ago when I went to West Africa and needed several preventive immunizations. Blue Cross would NOT pay for the immunizations. They must figure that it was cheaper for them to take a chance that I wouldn't get sick than to pay for the vaccinations. It's the same today with the Shingles shot. They won't pay for it. They are betting that you won't get it. This just seems wrong to me.

Health reform is not a lost cause. It takes innovation and real guts to make change. Change may upset the pharmaceutical industry. They're hoping we need the meds they're offering. If we were all healthier, pharmaceutical companies would suffer. There are so many political and economic implications associated with change that it's hard to imagine anythng substantive will happen any time soon. All we can do is keep informed, keep healthy, keep educated and hope we've got good genes.