Wednesday, August 17, 2011

Third in the Series

The following is the third suggestion on health care reform included in the Commonwealth Fund report to the National Governors Association, as reported by former Vermont governor James Douglas in the May 23 issue of Modern Healthcare:

“Primary care and prevention. We need to encourage everyone to have a medical home with a team of caring professionals to coordinate care. We must think of healthcare as a strategy not just to intervene when someone gets sick, but to keep people well. Furthermore, many chronic diseases can be prevented or their effects mitigated through timely diagnosis and early intervention.”

My first comment is that having a “team of caring professionals” and coordinating care are very much two different things. It is possible to have the expense of the first without the benefits of the second, and even likely unless additional measures are adopted. Coordinating care requires levels of discipline and standardization that so far can be attributed to too few “caring professionals.”

My other comment is that while it is true that “many chronic diseases can be prevented or their effects mitigated through timely diagnosis and early intervention,” the process itself is costly. I am a prime example. My diabetes, congestive heart failure, and prostate cancer were diagnosed on a timely basis and subjected to early intervention. I’ve been through expensive therapy, take a handful of expensive pills every day and make frequent visits to my primary care physician and various specialists, all of whom carefully monitor my condition with lab work and other diagnostic procedures. All of that keeps me in relatively good physical condition so that my consumption of these expensive services looks like going on for a long time.

There are ways to reduce the cost of health care, but prevention and timely care are not among them.

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