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"It's about Health not Health Care"

Posted Sep 16 2008 6:16am

Former Oregon governor and ER physician, John Kitzhaber, spoke for the medical staff of an area hospital last evening offering his thoughts on the fundamental flaws of our current healthcare system and on how the current debate falls short of redesigning a system for the future.  Highlights from the talking included:

  • People really don’t care about health care, what they want is health
  • The triple aim of healthcare improvement should be to improve the populations health, reduce per capita cost and to improve patient experience
  • It is the public sector’s responsibility to pay for the health care needs of those who cannot afford to do so themselves, but this is not an open ended reponsibility
  • The “floor” or basic level of care to which everyone will have access is, by definition, what we are willing to pay for with public resources
  • The current politicial debate is on how to finance our current health care system.  The issue is not how we pay for health care it is what we are buying.  The problem is the organization and delivery of the system itself
  • The current system was designed for acute episodic treatment and not to manage or prevent chronic illness including mental health/drug dependency
  • Reform must take into account the huge array of economic stakeholders including insurance companies and the pharmaceutical industry– 1 in 11 US jobs is healthcare related and no one wants to lose theirs
  • Physician leadership will be key in laying the groundwork for diagnosing the problem for the public

Overall this country doc could certainly relate to what the other country ER doc from Roseburg, Oregon espoused.  A nickel and diming of the health care system, so to speak, is a short term band aid at best.  Eventually the political will must be present for a fundmental paradigm shift.  It is physicians and others at the grassroots level that will make this happen.

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