Health policy

December 14, 2012 By e-Patient Dave 15 Comments

Best Care at Lower Cost: As the crunch hits, will the best survive?

Update 12/16: comments below this post have added more detail and documentation.

On one level this is a happy post. On another level, it’s a storm warning.

The happy part:

Of all the amazing, inspiring, humbling things that have happened in this three year adventure, one of the best is being invited to participate in discussions with professional societies I respect. For instance, twice this year I’ve written for the SGIM Forum, published by the Society of General Internal Medicine. Real medical leaders are actively listening for the patient’s perspective on many aspects of the challenges facing health and care, especially in America.

For the current issue (December 2012 – click image at left) I was invited to write a post-election perspective for their Health Policy Corner on the outlook as reform rolls out. The angle I chose was to ask, as the new rules unfold and the business of medicine changes, will the best providers be protected?

It was a riff on the Institute of Medicine’s new report, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. The most-quoted item in that report is that we have $750 billion of excess spending in American healthcare.

And that’s a problem. A big one.

The storm warning:

$750 billion is an incomprehensible number; it’s impossible to imagine how much financial pain there will be as we work to fix it. So I put it this way: if Intel, Microsoft, Apple, GM, IBM, Ford, Chrysler and Dell all went out of business, it still wouldn’t add up to that much.

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December 3, 2012 By e-Patient Dave 10 Comments

From now on for me, it’s health and care

Health & Care signature

This post became a chapter in my 2013 book Let Patients Help: A Patient Engagement Handbook.

Every year in this season I reflect and renew, emerging in January with new views. This year the first conclusion arrived early: I’m changing a key part of my language. From now on for me it’s not “healthcare,” it’s “health and care.”

Why? Because I’m increasingly seeing that it’s incomplete to look at transforming medicine by just talking about the care part – the part that kicks in when something goes wrong. All of us – patients and providers and insurance and government and industry and everyone – need to be thinking about health, every time we approach a problem with the health care system.

I know I’m not the first to say this, but as a marketing slogans guy (“Let Patients Help,” “gimme my damn data” etc), I’m keenly aware of the power of handy language. Everything I explained above can be said over and over, but it doesn’t fit easily into everyday discourse. “Health and care” is an easy plug-in replacement for the usual “health care.” And that boosts the odds people will use the new wording.

And language defines our thinking.

The implications for patient engagement are clear: it’s not sufficient to get engaged (to get it in gear, to get activated) only when sickness hits. My view from now on is, if you wanna be an e-patient, it starts with holding up your end of the bargain before you get sick.

So for 2013, let’s broaden our scope: the focus of our work should be “health and care.”
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One more thing: I like the word “care” – it’s patient-centered. In my life getting doctored and nursed, I’ve had the experience of being cared for, and I’ve had the experience of just being treated, without care. When I’m in trouble, what I want – what we should all shop and ask for – is great treatment delivered in a caring way.