Thursday, March 22, 2007

Problems and Solutions

Early in my career, it occurred to me that there were many problems in this world and many solutions. The challenge was to match them up correctly.

I was reminded of that by an Op-Ed column that appeared in the March 4 issue of The Sunday Journal in Albuquerque, NM, a copy of which was kindly sent to me by long-time friend Bill Busby.

The piece was authored by Jim Hinton, CEO of Presbyterian Health Services, the major health care provider system in the city. The title was Getting Everyone Health Care Will Improve It. He called for “A transformation in health care in which quality and access to care accelerate while costs stabilize and ultimately decrease.” He went on to suggest the strategy for achieving these goals in New Mexico would be for the state to “look to a universal coverage model in which government is the facilitator but not the single payer.”

Hinton made a valiant effort to connect his solution to the problem. He talked about the current need to shift the cost of caring for the uninsured to the insured. He mentioned the different models of universal coverage being considered. He spoke of crisis care and emergency room overcrowding. He mentioned the Internet as a source of health information and the importance of rewarding providers for quality. He referred to preventable medical errors.

But just how achieving universal coverage would improve safety, quality and cost was never quite clear – at least to me.

My own conclusion is that universal coverage is a solution for the problem of the uninsured, but it has little relevance to these other issues and is being used as a smoke screen to distract attention from the failure of the provider community to address problems it could do something about if it would.

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