The Doctor Weighs In

Ok. so we took a break.  It turned out to be a year.  But, we're baaack. 

By way of reintroduction, TDWI writers like to write about health related topics, although sometimes we stray into other areas.  Not sure we will be posting daily, but we will be posting.

What is on our minds?  Health care reform.  Are we for it, yes?  Why?  Because our "health care system" is not working for many people.  Not all, mind you, but let's face it, lot's of folks are not getting the basics.

Did anyone watch the PBS special on health care last night?  If so, I have to ask the question, even if you love your doctor and love your plan (i.e., the system is working for YOU), do you want an American health care system that forces folks to get divorced in order to be poor enough to qualify for Medicaid?  How about having to sell your house and give away the few valuables that you have so that you are poor enough to get assistance when you have to "relocate" into a nursing home?  If we really have the "best healthcare system in the world" doesn't it have to work for most folks, not just the lucky ones who have employer-sponsored care or are wealthy enough that they can buy what they want?

We (TDWI) are agnostic about the health reform proposals making their way through Congress.  But we do feel strongly that certain elements of reform are essential:

1.  Get everyone in the insurance pool -  mandate coverage.  Failure to do that means that the insured continue to subsidize the uninsured

2.  Support Comparative Effectiveness Research:  we ought to be making health care coverage decisions based, whenever possible, on what has been demonstrated to work, bring value, improve outcomes

3.  We cannot pay for everything that everybody wants to be paid for by insurance:  I work for a health plan.  There are people in our plan who think we ought to pay to put in a swimming pool in their backyard because their doctor told them they need exercise.  There have to be some rules of engagement.  This is what managed care is all about.  Too bad the media maligned managed care in the 80's, we might not be in as bad a shape as we are now if we had supported good managed care.

4.  We need to recognize that health doesn't equal health care.  Good food policy, smoking cessation programs/legislation, exercise programs at work/school, safe car designs, etc. impact health every bit as much as world class ERs and world class cancer care.  We need to be holistic in our approach to health and embrace a national culture of health.  It may make some people gag when I say this, but my fru-fru county of record (Marin, California) leads the way when it comes a healthy culture.  Folks exercise, work out, and are amongst the best weighted, most fit folks in the country.  (No smoking here).

Well that's it for the inaugural return to TDWI.  As always, we welcome you comments (good, bad or ugly).

G'night