Checking for a pulse...

(...of the healthcare delivery/system in this country. The information below was sent to me by Country Squire. (BTW guys he's related to me via marriage and he is dear to me) At any rate would love to get your opinions - mine are left below (with some edits/corrections but the gist is the same). The reason why I entitled this post 'Checking for a pulse' is because I feel most of the citizens of this country simply don't have one when it comes to the important/vital issues facing this country - we seem to be just phoning it in - I have a suggestion: Wake up!))

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"The President's State of the Union speech last week sparked a healthy debate over what to prescribe our ailing health-care system. Mandates or markets, single-payer or private sector, generic drugs or brand names? The list of differences is endless. What everyone can agree upon is that health care must be fixed. For both government and the private sector, our current system is unsustainable, and Health and Human Services Secretary Mike Leavitt is trying to change this.

Many entrenched health-care interests often claim that transformational solutions will not work because "health care is different." Health care is, indeed, different, and that is not a good thing. Innovation is slow, quality indicators are down, costs are perpetually on the rise, and tens of millions of individuals are locked out of the insurance market.

Rather than attempting to "fix" health care by himself with one magic bullet, Secretary Leavitt is putting the system on the right course to fix itself. Echoing the renowned Harvard business strategist Michael Porter, Leavitt is moving health care toward a value-based system.

Value-based health care means that providers, health plans and other health-care professionals are rewarded--and procedures and products are encouraged and utilized--based upon the true value they bring to the consumer. This means critiquing every aspect of the delivery of care, divining its true value by knowing its cost and quality. This formula works in every other market, and it must be the foundation of health care.

We can bring about real change by centering the system on what Secretary Leavitt calls the "four cornerstones"--information technology, performance measures, transparency and payment reform. The largest purchasers of health care, from state and federal government to the private sector, can change health care by ingraining
these four priorities into their purchasing and procurement--and then demanding accountability.

First, we must get information technology into the hands of health-care providers. Compared to every other sector of society, most physicians and other providers step back in time when they enter their offices, giving up computers and the Internet for pen and paper. We simply cannot deliver better quality, eliminate waste and improve efficiency without equipping doctors with the point-of-care patient information and decision support tools. And the technology must be interconnected, or interoperable, so that every IT system, no matter where it is, can deliver the right information on the right person at the right time.

Second, we must accelerate our efforts to create common measures to evaluate performance and cost. Today it is nearly impossible to determine, in any reliable way, who delivers the best quality care and at what cost. Government and industry are working to standardize common measures to enable us to gather and measure performance and cost in a common way, so we can compare apples to apples.

Third, we must widely distribute this information to consumers. Currently, the health-care system keeps consumers in the dark about the cost and quality of the care they receive. Try finding out which doctor has the best results for treating patients with asthma or diabetes. Try finding out how much a knee replacement will cost. Sites like FloridaCompareCare.gov and MyFloridaRX.com, which contain a wealth of quality and cost data, have proven to be incredibly valuable to consumers.

Additionally, with the right privacy and security protections, the federal government should release the data it has to let the public see which doctors are delivering the best care. Wouldn't you like to know who has the best track record for delivering high-quality care? You have the right to know this information, and t he federal government should release it.

Fourth, we must change the way we pay for care. In our current system, hospitals and providers that deliver better care are reimbursed, for the most part, at the exact same rate as those who provide poorer care. That is like paying the same price for a new Cadillac as you would for a used Yugo. This egregious approach must change so that better performers are rewarded.

Secretary Leavitt is trying to ingrain these "four cornerstones" into the federal government's purchasing of health care, most notably through President Bush's Executive Order #13410. This order instructs key federal departments, including HHS and the Veterans Department, to say to its contracted hospitals, physicians and other providers: We will not do business with you if you do not agree to these principles.

With a $600 billion budget at HHS that's set to explode in the coming years, Secretary Leavitt knows that sitting idly by is not an option. It is not an option for other big purchasers of health care either, be they from the private sector or state government. That is why GE, IBM, Ford, GM, DaimlerChrysler, Humana, and others have pledged to instill these cornerstones into their health-care purchasing. Governor Tim Kaine recently signed his own Executive Order to do the same in Virginia.

If every major employer, be it a corporation or state government, would embrace these four cornerstones, we could indeed build a value-based system that delivers more choices of greater quality at lower cost to every single American. But to get there, we need continued leadership and immediate action from everyone in health care--now."

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I appreciated your sending this very much. Very thought provoking.

The system is broke. Pure and simple - I see it from almost every angle due to the nature of the job I have, my Yoga practice, and me being a 'patient' myself - something that a lot of health care providers seem to forget until they themselves are faced with a life-threatening illness for themselves or their family members(s)....

A value-based system WOULD indeed help a lot.

Here's what else would help. We have to fix the medicare system. We have to - it's a mess - it' creates a huge mess for doctors and health care AND the consumer.

We do need to somehow provide a national healthcare delivery set up for those who can not afford medical care - not shit like elective surgeries but basic health care. Socially and morally it's the right thing to do.

We HAVE to stop allowing the 'good old boys school' of thinking to keep running the roost at health care institutions - I see this on a very personal level.

The reason why I think this is a huge aspect of what needs to be done is very simple. Prevention. As the saying goes an ounce of prevention is worth a pound of cure. How many of us know this but do nothing to prevent illness. I find it unfathomable and inconceivable that today's modern health care system is not insisting on more focus to these ends. It's insane. If we can prevent devastating diseases like cancer, like heart disease, like diabetes (which then leads to heart disease and blindness, etc) then why aren't we - my humble opinion (for what it's worth) becomes that there's no money to be made if we keep people healthy either for the pharm-rx companies or for the doctors who are being paid by the pharm-rx companies to use their drugs.

When I began teaching Yoga at the institution I work for - I was on the cutting edge of a breakthrough here - I still am. It was an arduous climb. I was beaten down every chance they got because there was no empirical data/evidence that Yoga works - even tho (sic) Yoga is 5,000 (just what we know that's been codified) fucking yrs old. If it had not made it into JAMA or did not have a double-blind-randomised study then it was crap - even though the British Journals of medicine are filled with data about the healing properties (lowers risk of diabetes, CURES asthma, helps depression, cardio-vascular health, I mean you name it - it's a very long list).

I fought hard. I gave them my own data. I talked with them. At one point I said 'look there is absolutely no overhead to offer these programs to your patients, they are doing it anyway, you can BILL FOR THIS!'. Still I struggled. At one point I said to a doctor don't you call it practicing medicine? he agreed - I said - well I practice Yoga too - but the difference is that what I am practicing is 5,000 yrs old - and it wasn't just about Yoga - it was about Acupuncture, herbal remedies, integrative medicine in general....

Needles to say there was a git (a woman who was a total idiot in my estimation) running the 'program' - she ended up losing the respect of her peers and finally they canned the Yoga program (and the others too)..the excuse they used then (at least to explain to my why *I* was not going to be able to teach Yoga), was that I was not a nurse (yeah OK I have the basics of a Bachelor's degree in Yoga by now - besides while you can be a nurse and a yoga teacher you don't have to be a nurse TO BE a Yoga teacher - but whatever - it's called politics - oh and not to get off on a tangent but we need to get politics out of medicine too....)

Enter the new director for the Center for Integrative Medicine - she's a woman who was trained at CWRU and began a program teaching new med students about alternative/complimentary/integrative therapies - she's incredible and she knows her stuff - she met with me and it was like a breath of fresh air - she told me it would take time but she'd get me 'on board' that she considered me a colleague and to just be patient and positive.

Now, I have almost too many opportunities because of her refusal to back down and give in - we are steadily growing ALL the programs and I see this as a huge step in the right direction towards making people healthier in general - cause that's the key. STAY HEALTHY. And you go to your doctor - well we have all these specialists, for this ailment and that ailment - people don't want to be treated like pieces parts - they want to be treated holistically....

So that's my rant...my 2 cents worth (for what it's worth) - I believe adding value to medicine is a step in the right direction - but I think a lot of other things have to come with that including stopping the stranglehold the pharmaceuticals have in this country and getting our asses out of our easy chairs, exercising more, eating right and spending more time restoring our health and our balance in all aspects of our lives..