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    So What Does Work?

    September 28th, 2007

    by Jeff McKune

    My Dad and I were recently discussing healthcare issues, and he told me that he argued healthcare topics when he was on his high school debate team. In fact, in 1947 he was given the debate topic "Should the Federal government provide a system of complete medical care available to all people at public expense?" Sixty years later, the question of government's involvement in healthcare is still a hot topic, and it is one of the leading topics of the 2008 presidential race.

    A little over a week ago, John Stossel hosted a 20/20 program titled "Sick in America: Whose Body Is It, Anyway?" One of the things I liked most about the program was the way that Stossel covered some challenging issues such as the linking healthcare insurance to employment, over utilization, and the profit motive. He also had a nice segment comparing the system in the United States with those in other countries, specifically Canada. I found the whole program to be refreshingly frank.

    The last part of the program focused on private solutions to healthcare problems versus government solutions, and the importance of competition and individual choice. Stossel gave a couple of examples where competition among healthcare providers has led to improved quality and lower prices, even during a time when most of the industry is experiencing higher prices. Those two examples were LASIK eye surgery and cosmetic surgery, both of which are usually not covered by insurance. LASIK prices have dropped 30%, and the quality has improved. Providers have to compete because patients are shopping around knowing they will pay for the procedure out of their own pocket.

    When discussing healthcare challenges, we often focus on what does not work. But what does work? The things that work for healthcare are the things that have worked for our country in many other industries: Freedom of choice, competition, innovation, and the availability of information for potential buyers. If we know these things work, as hospital leaders, how can we best connect to these basic tenants?

    Comments, Pingbacks:

    Comment from: hospitaltony [Member]
    thanks Jeff for the reminder. I remember Quint Studer recently put on a conference entitled "What's RIGHT with Healthcare" which was a refreshing change from the typical doomsday focus.

    Is it possible that a few impassioned few can make a difference? begin to turn the tide? empower people to think differently and more innovatively about healthcare?

    I totally agree with Lavinia's comment in a previous post - why is healthcare reform only about insurance status?
    Permalink 09/28/07 @ 20:38
    Comment from: Lavinia Weissman [Visitor] · http://www.workecology.com
    Tony and Jeff, I would really like to dialogue with both of you about this and not on line. Jeff, I am glad you started this conversation.


    What would happen if we had the conversation what is health and how best to fund it?


    I have been working on my new website and as a result connecting with a lot of people I trust to learn from, including Tony. The questions and the stories coming my way are very unusual.

    I have also been given the honor to meet with a group of people in the UK, who convene meetings routinely with Sir William Stewart, head of the Health Protection Agency in the UK. We are meeting in December to chat about some specifics in a sphere of discussion about health hazards and exposures that is really opening my eyes to see the question: What is health and how do we sustain health - individual, family, community, nation?

    BTW, I hope you HOSPITAL folks who blog here will consider submitting a periodic contribution to my new site which will be formed around the a blog. The Magazine title is The Culture of Cooperation - Defining WorkEcology (work that sustains us)

    Talk about it amongst your group. I have a hard head about publishing and editing and will be stubornly managing the blog in a publishing cycle with contributions that are more like magazine articles.'


    Tony if you want, maybe you can expand on your thinking and research about what is happening among employers re: health insurance. Did you catch the WalMart changes?

    We will publish our new site by January 2008. It is in production now.

    Best,
    Lavinia
    Permalink 09/28/07 @ 22:59
    Comment from: Patricia Donovan [Visitor] · http://blog.hin.com/
    Jeff,

    I did not see the program but your post resonates. Having just spent a week in London getting my daughter settled in university there (bucking the U.S. education system but that's a comment for a different blog), I spent a fair amount of time viewing the evening news. I was struck by the fact that although our healthcare systems are vastly different, we still face the same issues --- placement of physicians in high street stores (our retail clinics), overcrowded EDs and PCPs missing the signs of mental health issues in patients. I don't think we have the hospital wait lists here that they do there --- 660,000 Brits on the waiting list this year, down from over a million in 2006. Definitely food for thought. Hope to catch the Stossel report in a rebroadcast.

    Cheers,
    Patricia Donovan
    Permalink 10/01/07 @ 10:55
    Comment from: A Key [Visitor] · http://www.cathetel.com
    Having had cataract operations on both eyes with no cost and many others tests, especially cholesterol, and heavy metal tests, as a resident of Ontario, I have found the healthcare system unbeatable. Much better management is required, however, to protect the system from cheaters (non-residents) and from the definition of available services. When I saw the episode of Seinfeld in which the character George Costanza was faced with the option of a $4000 tonsil operation in the hospital, or going to a questionable but cheap alternative medicine practitioner, I was most amused, and pleased, that I live in Ontario and not in New York.
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    I feel that its responsibility of government to provide free medical services to the public
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